In our efforts to develop a premium science-based product, we continually scour the academic research world to inform our use of virtual reality in the therapy space. Dr. Sinan Turnacioglu, Floreo’s medical advisor, has written a helpful summary of one of the more notable papers we recently reviewed.

Researchers continue to study the role that new technologies can play in the treatment of children with autism spectrum disorder (ASD). European scientists in the MICHELANGELO study group published results of one such intervention in Child and Adolescent Psychiatry & Mental Health in March 2017. This study evaluated the impact of using a serious gaming platform to augment treatment as usual for children with autism spectrum disorder. The Gaming Open Library for Intervention in Autism at Home (GOLIAH) system includes 11 games targeting joint attention and imitation that were developed from the Early Start Denver Model, an effective early intensive behavioral intervention. Subjects were divided into two groups for a 6-month matched controlled exploratory study: 1) treatment as usual, which was defined as all interventions given to a child during the course of a week; and 2) treatment as usual plus 5 sessions per week of GOLIAH – 4 of these were 30-minute sessions at home, and one was a 1 hour session at a hospital.

Two specialized clinics were involved, one in Paris, France and one in Calambrone, Italy. Fourteen subjects were enrolled in the GOLIAH plus treatment as usual arm, and ten subjects were assigned to the control treatment as usual arm. Subjects ranged in age from 5 to 8 years.

The study team drew several interesting conclusions. Parental stress did not increase as a result of the additional effort required to implement GOLIAH on top of treatment as usual. Subjects in both groups showed improvements in several measures of social communication, adaptive skills, and behavior. However, while subjects involved in GOLIAH improved in their performance of both the joint attention and imitation games, there was no significant difference in the outcome measures between subjects in the treatment as usual arm and the treatment as usual plus GOLIAH arm of the study. Researchers plan to move forward with a large randomized controlled trial of GOLIAH with a younger population of participants.

It should be noted that the gaming platform used in this study is not virtual-reality based, nor is it a mobile application, so it is important to continue lines of research inquiry into the effectiveness of mobile virtual reality applications in improving social communication skills in children with ASD. Also, the authors do make a comment that “treatment as usual” is free for families in the French and Italian health care systems. In the United States, costs of early intensive behavioral interventions can be prohibitively expensive for families, and even costs aside there are challenges with access to properly trained in-home applied behavior analysis (ABA) therapists. There is a tremendous benefit to developing an accessible and affordable program that can be used at home to support social communication skill development in children with ASD.

Jouen, A.-L., Narzisi, A., Xavier, J., Tilmont, E., Bodeau, N., Bono, V., … Donnelly, M. (2017). GOLIAH (Gaming Open Library for Intervention in Autism at Home): a 6-month single blind matched controlled exploratory study. Child and Adolescent Psychiatry and Mental Health, 11, 17. https://capmh.biomedcentral.com/articles/10.1186/s13034-017-0154-7

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