=Paper=
{{Paper
|id=Vol-2731/paper14
|storemode=property
|title=The augmented reality portal and hints usage for assisting individuals with autism spectrum disorder, anxiety and cognitive disorders
|pdfUrl=https://ceur-ws.org/Vol-2731/paper14.pdf
|volume=Vol-2731
|authors=Yulia Yu. Dyulicheva,Yekaterina A. Kosova,Aleksandr D. Uchitel
|dblpUrl=https://dblp.org/rec/conf/aredu/DyulichevaKU20
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==The augmented reality portal and hints usage for assisting individuals with autism spectrum disorder, anxiety and cognitive disorders==
https://ceur-ws.org/Vol-2731/paper14.pdf
251
The augmented reality portal and hints usage for
assisting individuals with autism spectrum disorder,
anxiety and cognitive disorders
Yulia Yu. Dyulicheva1[0000-0003-1314-5367], Yekaterina A. Kosova1[0000-0002-3263-9373] and
Aleksandr D. Uchitel2[0000-0002-9969-0149]
1 V. I. Vernadsky Crimean Federal University, 4 Vernadsky Ave., Simferopol, 295007, Crimea
{dyulicheva, kosovakateryna}@gmail.com
2 State University of Economics and Technology,
5 Stepana Tilhy Str., Kryvyi Rih, 50006, Ukraine
o.d.uchitel@i.ua
Abstract. The augmented reality applications are effectively applied in education
and therapy for people with special needs. We propose to apply the augmented
reality portal as a special tool for the teachers to interact with people at the
moment when a panic attack or anxiety happens in education process. It is
expected that applying the augmented reality portal in education will help
students with ASD, ADHD and anxiety disorder to feel safe at discomfort
moment and teachers can interact with them. Our application with the augmented
reality portal has three modes: for teachers, parents, and users. It gives the ability
to organize personalized content for students with special needs. We developed
the augmented reality application aimed at people with cognitive disorders to
enrich them with communication skills through associations understanding.
Applying the augmented reality application and the portal discovers new
perspectives for learning children with special needs. The AR portal creates
illusion of transition to another environment. It is very important property for
children with ADHD because they need in breaks at the learning process to
change activity (for example, such children can interact with different 3D models
in the augmented reality modes) or environment. The developed AR portal has
been tested by a volunteer with ASD (male, 21 years old), who confirmed that
the AR portal helps him to reduce anxiety, to feel calm down and relaxed, to
switch attention from a problem situation.
Keywords: augmented reality, autism spectrum disorder, anxiety disorder,
augmented reality portal, innovations in education.
1 Introduction
On 27 March 2020 the Centers for Disease Control and Prevention had published a
report alleging that the number of people with autism spectrum disorder (ASD)
diagnosis were increased and there were identified the ASD for 1 out of 54 eight-year
old children from USA [4]. Besides, throughout the world the number of people with
___________________
Copyright © 2020 for this paper by its authors. Use permitted under Creative Commons License
Attribution 4.0 International (CC BY 4.0).
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anxiety disorders and panic attack is increased. For example, 25.1% of the children
from USA between the ages 13 and 18 have anxiety disorders and 2.7% of the adult
population from USA has panic disorders with twice as many women as men [3]. The
development of methodologies and innovative technologies usage for assisting people
with ASD and anxiety disorders are the pressing challenges.
1.1 The problem statement
The augmented reality technology (AR technology) is one of the innovative
technologies in education and therapy and proved itself to work well in the different
applied fields [17; 18; 26; 29; 34; 39; 47; 48]. In particular, it is being used successfully
to support the education of persons with disabilities, including individuals with ASD
and anxiety disorders [16; 31]. The AR technology usage fosters the social, physical
and everyday skills to empower the persons with special needs to realize the educational
purposes [5]. The AR application efficiency is achieved through the mixed environment
use, where the real objects interact with virtual objects [8; 24].
The aim of the article is to develop a methodology based on the augmented reality
portal usage for assisting individuals with ASD and anxiety disorders. This article
offers the augmented reality portals usage as teachers support tool that allows students
“to hide” at the moment of a panic attack, obsessive-compulsive disorder (OCD) and
other negative reactions caused by anxiety disorders. AR application has been further
developed to acquire the skills of the associative thought process for individuals with
cognitive disorders.
1.2 Analysis of recent research and publications
The results of systematic review Quintero et al. [32] have shown that augmented reality
usage leads to the development of social interaction (communication) skills (24% from
analyzed publications, covering the period 2008-2018), to increasing of the interest,
attention, motivation and academic performance for people with special needs (22%).
Most of the studies devoted to AR technology are based on marker technology and
geolocation detection. The Vuforia library (8%) and Aurasma (HP Reveal) (10%) are
often used for AR application development. When the review [32] was published, the
markerless technology was not studied. Approximately one-fifth of research (18%) was
devoted to augmented reality usage for teaching individuals with ASD.
According to the International Statistical Classification of Diseases and Related
Health Problems 10th Revision, ICD-10, ASD diagnosis involves the impairment in
social interaction and communication models as well as a limited, stereotyped,
repetitive scenario of the interests and actions [14].
The directions of the augmented reality usage for teaching individuals with ASD are
extremely diverse. So, the methodology for learning content development for the
people with ASD based on augmented reality is considered in the article Vullamparthi
et al. [44]. The Android application allows capturing and images recognition of
surrounding objects and set their connection with AR content (photo and video). The
results of research Chen et al. [8] showed that augmented reality usage for individuals
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with ASD to improve emotions recognition and to foster adequate feedback on
emotional expressions of faces. Tentori et al. [40] conducted complex research devoted
to smart environment usage based on augmented reality for therapy of the children with
ASD. The results of experiment indicated that there exists a positive impact of new
environment on motor skills development. To reduce the burden on teachers the AR
environment MOBIS for enhanced visual support was developed by Escobedo et al.
[9]. Experiments have found that environment MOBIS usage provided multi-tasking
and helped teachers to work with individuals with ASD. The web-application AR Layar
to facilitate the independent navigation in the unknown place is described in research
McMahon et al. [23]. Lee et al. [19] showed experimentally that augmented reality
technology jointly with a mental map was effective to learn children with ASD that had
problems with social skills, especially, to answer on greetings from other people.
People with ASD prefer stability and familiar sequence in their activity and
environment. The changing of routine habits provokes anxiety and can lead to inability
to function [30]. Besides, ASD results in sensory hypersensitivity that also leads to
increased anxiety and stress [2; 12; 13; 36]. It is recommended the sensory-neutral
environments to use in teaching process for children with ASD [38]. Besides, the
cognitive abilities are improved in the natural habitat compared to the extreme sensory
stimuli of the urban environment [6]. It is necessary to provide quiet and peaceful places
for students with ASD who are anxious due to increased sensory sensitivity on stage of
training organization in the open educational space of an educational institution [38].
The people who have anxiety disorders not related to ASD also may need a calm
environment. In case of phobic anxiety disorders (code F40 ICD-10), the main
symptom is the fear of being in a certain situation, which, in fact, is not dangerous at a
moment. Other anxiety disorders (code F41 ICD-10) are characterized by
manifestations of anxiety that are not limited to and are not directly related to a specific
situation. Anxiety disorders can provoke panic attacks, depressive episodes, obsessive
symptoms and other negative reactions that limit a person’s life [15].
The augmented reality applications can be useful in neutral, calm environments
creation for people with ASD and anxiety disorders, and without the use of special
expensive equipment.
1.3 The purpose of the article
On the basis of analysis of papers devoted by augmented reality application for people
with special needs we propose to use the augmented reality portal as tool for teachers
and parents to interact with students at the moment when panic attack or anxiety
happens. We also propose to use the augmented reality application for children with
cognitive disorders to enrich their associations knowledge about the real objects based
on the hints in augmented reality mode.
2 Theoretical background
The augmented reality technology based on “aliving” and embedding content in real
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environment helps people with ASD and anxiety disorders to feel ongoing concern and
support. AR/VR/MR-applications help to improve the communicative, emotional and
cognitive skills based on appearance of unexpected augmented reality content in real
environment for test subject. Let’s consider the brief review of AR/VR-applications
aimed at learning of individuals with ASD and anxiety disorders to acquire the social
and cognitive skills and to mitigate anxiety.
AR application to acquire the skill for orientation in a new environment. Using a
mobile application HP Reveal, the teachers and parents can create audio and video
content that will be displayed above the markers. The pictures as markers with the
image of a favorite hero are placed in new environment. The individuals with ASD
receive hints in the augmented reality mode that help to navigate in a new environment
[10].
AR applications to acquire the social skills. The books with the games and elements
in augmented reality mode contribute to the development of cognitive and social skills.
The book involves the children to interact with AR character through the different
scenarios of social behavior to learn the emotions recognition that they feel [7]. The
AR RPG system aimed at participating in various role game to involve children with
ASD in atmosphere of “miniature theatre” with the goal to create the game with virtual
environments that reconstruct the child familiar environments to develop the behavioral
skills in the classroom and in society based on scenarios. An improvement in the skills
of behavior and understanding of gestures and expressions was observed for three
children after AR RPG usage [20].
AR applications to acquire the cognitive skills. The AR technology is actively used
for the formation and development of cognitive skills in various fields of knowledge.
Thus, an experiment to check the effectiveness of using augmented reality for teaching
the English alphabet showed the advantages of using the teaching based on augmented
reality content over the traditional full-time methodology. The AR applications “AR
Flashcards Animals-Alphabet” and “AR Alphabet Flashcards” available at AppStore
were used for the research [37]. When pointing the smartphone’s camera to the first
letter the child can see the name of the pet or predator and three-dimensional picture of
the studied letter, accompanied by the sound of the animal’s cry and a small animation.
The AR video game “Gremlings in my Mirror” was developed based on NyARToolkit
and Unity3D to acquire logical skills for children with special needs [43]. By moving
a pre-printed marker, the child must have time in the game situation to order the
characters by size or to sort by color. As a result of comparing the game experience of
two groups of children – with and without special needs – the same success indicators
are obtained.
AR applications to acquire the skills for emotions and facial expression recognition.
The Brain Power System is based on emotions recognition algorithms and special
equipment usage such as Google Glass. A person with autism puts on glasses and
begins to communicate with a teacher or mother in a playful way. There are two options
for emoticons depicting the right and wrong emotions associated with the face in the
augmented reality mode. The task for the child is to learn how to choose a smiley with
the right emotion. Google Glasses have built-in special sensors that record the level of
stress and anxiety. This kind of application in a playful way allows children with autism
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to improve communication skills and understanding of emotions, establish eye contact
in the communication process and increase self-confidence. The System efficacy
results, described in [22], showed that for two boys during the experiment the decrease
of autistic symptoms after using the Brain Power System was observed.
AR applications to reduce the anxiety. AR/VR/MR technologies are effectively used
to combat various phobias, for example, arachnophobia [28], claustrophobia, etc.
Claustrophobia belongs to the group of the anxiety disorders, manifested by
unreasonable fear in enclosed spaces. One of the effective methods for the treatment of
claustrophobia is the use of virtual reality technology.
It is used to immerse a patient with claustrophobia in a problematic situation at the
time of the therapy under the supervision of a psychotherapist. For example, the
“Claustrophobia Game” allows to move from an environment with worrying increase
to a relaxation room in the virtual reality mode. According to experiments and estimates
based on the Spielberger questionnaire, the level of apparent anxiety in 14 patients
before and after using the game application was decreased [33].
3 Research methodology
To clarify the status of the problem and objectives of the study the scientific papers
about the usage AR/VR/MR technologies for learning of the people with special needs
such as individuals with ASD and anxiety disorders were analyzed, covering the period
2011-2019.
In the practical part of the research, the mobile applications were developed: the AR
portal to reduce anxiety and the AR application to develop cognitive skills. To create
the AR portals for people with ASD we used React Native framework with Viro AR
and to create AR hints application for people with cognitive disorders we used ARKit
and SpriteKit frameworks.
4 Results
In this section the results of the practical part of the study based on the development of
mobile AR applications for people with ASD, hyperactivity and anxiety and the modern
approaches to the design of immersive environments, in particular, AR portals are
discussed.
4.1 About development of the augmented reality portals
Let’s consider the possibility of the augmented reality portals usage to combat
claustrophobia and anxiety disorders. AR portals create the illusion of a transition from
one reality to another in order to decrease the anxiety and to feel safe. The studies
demonstrate the effectiveness of anxiety therapy based on immerse to the virtual reality,
but the use of such therapy is impossible without the special equipment. The results of
our study can be used in problem situations associated with anxiety in the presence of
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any gadget. Besides, there are no significant differences between virtual and augmented
reality technologies to treat the induced anxiety. As shown in [46], the participants with
induced anxiety feel almost the same discomfort, frequent heart rate and level of anxiety
when immersed in an artificial environment using these two technologies during the
experiment. So, we offer to use a methodology based on the augmented reality portal
to help the teacher in case the students start to feel anxiety in the learning process.
The approaches to the augmented reality portals development are considered.
1. The AR portal development based on ARKit and SceneKit frameworks. The stages
of AR portal development include the detection and rendering of horizontal planes;
the handle of session interruption and visual 3D objects placement on View based
on SceneKit; the creation of three vertical planes for walls of portal and creation
node for floor placement with the help of the objects from basic classes SCNNode и
SCNBox; the determination of their position and angles of rotation, texture and
transparency; the detection of doorway. For realistic portal creation it is needed to
create light sources using objects from basic class SCNLight [35]. Another approach
to AR portal developing is to use the Unity3D game engine in conjunction with the
ARKit, ARCore, and ARFoundation frameworks.
2. The AR portal development based on Figment AR application and using Snapchat
Lens Studio. The iOS Figment AR application is a convenient user application with
the ability to create several augmented reality portals in a room and place your
favorite 3D heroes in real environment. To create a portal, just select the type of
portal door (hatch, door, arch) in the menu, determine the contents of the portal based
on the 360 video and 360 photo templates and click on the smartphone screen to
place it in the desired part of the room (Figure 1a). Snapchat Lens Studio allows you
to create augmented reality applications based on predefined templates, for example,
portal template.
3. The AR portal development based on React Native and Viro AR. The Viro AR
platform is designed for the rapid development of augmented reality applications
based on ARKit and ARCore and contains convenient components for developing
an augmented reality portal: the component for working with 3D
objects, the and components for creating a portal
and setting up scenes followed by adding to ARScene [27].
4.2 AR portal and AR hints for people with special needs
A mobile application for iOS has been developed. Three modes are available in
application: a mode for a teacher, a mode for a parent, and a mode for a user. In teacher
mode it is possible to create training content for AR portal based on 3600 video and
3600 image to acquire students with various ecosystems. The teacher in this mode can
tag the content in the portals that caused to student discomfort. In parent mode, you can
create 3600 video and 3600 image to fill the portals with content, which creates a
student’s safe and home environment. In this mode, the user can select content for
augmented reality portals based on templates approved by teacher and parents. This
application allows you to customize personalized content for individuals with special
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needs. The menu of our application and portal loading with the home environment
approved by parent are shown in the figure 1b, 1c. In addition to visualization, all three
modes of the portal are provided with audio recordings such as relaxing music. As
known the music therapy helps to reduce depression, stress, anxiety and nervousness
[21; 42; 45].
Fig. 1. The augmented reality portals and app for people with special needs.
The augmented reality portal can be used by therapists and teachers as a sensory room
to reduce the student’s anxiety level. It has been shown that the safe space of sensory
rooms helps children with ASD and emotional problems learn how to independently
regulate their behavior, which helps to improve concentration on tasks in learning
process [41].
Let’s enumerate the target audience for the augmented reality portal usage:
1. people with ASD, faced with an unexpected situation for them, are pinched and try
to find support in their environment. In such case, the augmented reality portal can
serve as a transition to a protected space for them and can help to reduce the level of
strain and anxiety with ability to continue interaction with student through the portal;
2. people with anxiety disorders can move to the augmented reality portal at the
moment of panic attack or anxiety increasing through illusion of environment
change;
3. people with ADHD feel significant difficulties in the learning process. Teachers
need to create a special learning environment to exclude distractions; to control
impulsive behavior; to redirect excessive physical activity to other activities; to
provide an opportunity for movement (training individuals with ADHD requires
breaks with the possibility of outdoor games and a change of scenarios); to promote
positive social interaction in the learning process [1] and to develop interactive
learning content. The augmented reality portal can help people with ADHD to
change environment in the classroom.
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Additionally, to the augmented reality portal we develop mobile application to help
children with cognitive disorders. Persons with ASD perceive and process information
in different manner than other people. Temple Grandin (2009) distinguishes three types
of people’s thinking: visual thinkers; verbal/logical thinkers; and musical/mathematical
thinkers [11].
For visual thinkers, the process of the associations detection for the presented object
is similar to photos recognition in a search engine. Moreover, the emerging associations
are often not obvious to others, as they are associated with pictures from the past that
are understandable only to people with ASD. As shown in [25], people with ASD have
difficulties to form new categories. For the formation of skills to categorize data, it is
important to enrich the visual associations knowledge [11]. The hypothesis of the
research is an attempt to expand the category knowledge for children with ASD through
photorealistic and sound associations in the augmented reality mode. Such augmented
reality application will help children with ASD to interact with teachers, parents and
peers, i.e. their communication skills.
The proposed mobile application allows children with ASD to see associations for
selected object in augmented reality mode. The application was developed based on
ARKit framework. As static learning content is ill-defined for children with ASD, we
develop interactive augmented reality application that aimed at interest and motivation
increasing in learning process. The augmented reality application with associations
demonstrated as augmented reality hints is shown on figure 2. When child with ASD
hover a smartphone screen on cat image, he can see popup hints with association, for
example, mouse image and milk image. The augmented reality hints are considered as
miracle by children with ASD and can be applied to decrease cognitive disorders.
Fig. 2. The mobile application to demonstrate the associations cards in the augmented reality
mode.
5 Conclusions and prospects for further research
At the final stage of the project, the two experiments will be conducted:
1. to study the response of individuals with ASD and increased anxiety to the use of
the new augmented reality portal;
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2. to test the AR application that presents associations in augmented reality mode for
categorization development and communication skills increasing for children with
ASD.
As an experimental group, it is planned to attract children and adolescents with ASD
that receive a special education at the center of correctional pedagogy and the students
of secondary schools from Simferopol. The results of the experiments will be processed
by methods of mathematical statistics, analyzed and published.
At the moment, the portal has been tested by a volunteer with ASD (male, 21 years
old), who confirmed that the AR portal helps him to reduce anxiety, to feel calm down
and relaxed, to switch attention from a problem situation. The effectiveness of the portal
usage for people with ASD has been proved by the observer with pedagogical education
and degree, certified in the use of information and communication technologies in the
training of individuals with disabilities.
The beta-testing phase for AR application based on demonstration of association in
augmented reality mode was completed. According to evaluations of the application
prototype by specialists in the field of correctional pedagogy, the developed product
can be used as a didactic game for children with cognitive disorders. Such application
is recommended by educators that teach children with cognitive disorders and
psychologists at the center of correctional pedagogy from Simferopol. So, the
developed AR application is ready to approbation on target audience.
An analysis of the literature showed that the usage of AR / VR / MR technologies in
education and quality life improvement for individuals with ASD is very perspective
direction especially for people with special needs. It is no found the studies devoted by
the augmented reality portal usage to reduce anxiety. We propose the augmented reality
portal usage as tool to help teachers to interact with people with anxiety disorder, ASD
and ADHD.
The proposed applications will be shared for free, without payment for use. They
can be used by parents and teachers as the tool for effective interactive and teaching of
people with special needs. It is expected that further introduction of AR portal and AR
application in learning process for individuals with disabilities will allow to improve
the quality of life and academic performance, to reduce anxiety in new learning
environment and to improve cognitive skills.
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