Reducing specific phobia/fear in young people with autism spectrum disorders (ASDs) through a virtual reality environment intervention

Morag Maskey, Jessica Lowry, Jacqui Rodgers, Helen McConachie, Jeremy R Parr, Morag Maskey, Jessica Lowry, Jacqui Rodgers, Helen McConachie, Jeremy R Parr

Abstract

Anxiety is common in children with autism spectrum disorders (ASD), with specific fears and phobias one of the most frequent subtypes. Specific fears and phobias can have a serious impact on young people with ASD and their families. In this study we developed and evaluated a unique treatment combining cognitive behaviour therapy (CBT) with graduated exposure in a virtual reality environment (VRE). Nine verbally fluent boys with an ASD diagnosis and no reported learning disability, aged 7 to 13 years old, were recruited. Each had anxiety around a specific situation (e.g. crowded buses) or stimulus (e.g. pigeons). An individualised scene was recreated in our 'wrap-around' VRE. In the VRE participants were coached by a psychologist in cognitive and behavioural techniques (e.g. relaxation and breathing exercises) while the exposure to the phobia/fear stimulus was gradually increased as the child felt ready. Each child received four 20-30 minute sessions. After participating in the study, eight of the nine children were able to tackle their phobia situation. Four of the participants completely overcame their phobia. Treatment effects were maintained at 12 months. These results provide evidence that CBT with VRE can be a highly effective treatment for specific phobia/fear for some young people with ASD.

Trial registration: Controlled-Trials.com ISRCTN58483069.

Conflict of interest statement

Competing Interests: A priority patent 1307896.9 entitled “Apparatus for use in the performance of cognitive behaviour therapy and method of performance” was filed on 01/05/2013 describing the use of cognitive behaviour therapy using a surround vision system. The University of Newcastle and Third Eye are co-assignees of this patent. Dr Morag Maskey can confirm on behalf of all authors that this does not alter the authors’ adherence to all PLOS ONE policies on sharing data and materials as detailed in the online guide for authors.

Figures

Figure 1. CONSORT flow diagram.
Figure 1. CONSORT flow diagram.
Figure 2. Confidence rating scale for shopping…
Figure 2. Confidence rating scale for shopping scene (child’s version).
Figure 3. Young person in the Blue…
Figure 3. Young person in the Blue Room.
Figure 4. Parents observing child in Blue…
Figure 4. Parents observing child in Blue Room via video link.
Figure 5. Change in confidence levels as…
Figure 5. Change in confidence levels as rated by participants.
Figure 6. Change in confidence levels as…
Figure 6. Change in confidence levels as rated by parents.

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Source: PubMed

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