=Paper=
{{Paper
|id=Vol-2731/paper15
|storemode=property
|title=Features of implementation of modern AR technologies in the process of psychological and pedagogical support of children with autism spectrum disorders
|pdfUrl=https://ceur-ws.org/Vol-2731/paper15.pdf
|volume=Vol-2731
|authors=Viacheslav V. Osadchyi,Hanna B. Varina,Kateryna P. Osadcha,Olesia O. Prokofieva,Olha V. Kovalova,Arnold E. Kiv
|dblpUrl=https://dblp.org/rec/conf/aredu/OsadchyiVOPKK20
}}
==Features of implementation of modern AR technologies in the process of psychological and pedagogical support of children with autism spectrum disorders==
https://ceur-ws.org/Vol-2731/paper15.pdf
263
Features of implementation of modern AR technologies in
the process of psychological and pedagogical support of
children with autism spectrum disorders
Viacheslav V. Osadchyi1[0000-0001-5659-4774], Hanna B. Varina1[0000-0002-0087-4264],
Kateryna P. Osadcha1[0000-0003-0653-6423], Olesia O. Prokofieva1[0000-0002-6542-239X],
Olha V. Kovalova1[0000-0001-5061-6506] and Arnold E. Kiv2[0000-0002-0991-2343]
1 Bogdan Khmelnitsky Melitopol State Pedagogical University,
20 Hetmanska Str., Melitopol, 72300, Ukraine
osadchyi@mdpu.org.ua
2 Ben-Gurion University of the Negev, P.O.B. 653, Beer Sheva, 8410501, Israel
kiv.arnold20@gmail.com
Abstract. The article deals with the actual issue of the specificity and algorithm
of the introduction of innovative AR technologies in the process of psychological
and pedagogical support of children with autism spectrum disorders (ASD). An
innovative element of theoretical and methodological analysis of the problem and
empirical research is the detection of vectors of a constructive combination of
traditional psycho-correctional and psycho-diagnostic approaches with modern
AR technologies. The analysis of publications on the role and possibilities of
using AR technologies in the process of support children with ASD (autism
spectrum disorder) and inclusive environment was generally conducted by
surfing on the Internet platforms containing the theoretical bases for data
publications of scientific journals and patents. The article also analyzes the
priorities and potential outcomes of using AR technologies in psycho-correction
and educational work with autistic children. According to the results of the
analysis of scientific researches, Unified clinical protocol of primary, secondary
(specialized), tertiary (highly specialized) medical care and medical
rehabilitation “Autism spectrum disorders (disorders of general development)”,
approaches for correction, development and education of children with ASD, AR
technologies were selected for further implementation in a comprehensive
program of psychological and pedagogical support for children with ASD. The
purpose of the empirical study is the search, analysis and implementation of
multifunctional AR technologies in the psycho-correctional construct of
psychological and pedagogical support of children with ASD. According to the
results of the pilot study, the priorities and effectiveness of using AR technologies
in the development of communicative, cognitive, emotional-volitional,
mnemonic abilities of children and actualization of adaptive potential and
adaptive, socially accepted behaviors are made. The possibilities and
perspectives of using AR technologies as an element of inclusive environment,
with regard to nosology and phenomenology, need further investigation.
Keywords: inclusion, autism spectrum disorders, AR technologies.
___________________
Copyright © 2020 for this paper by its authors. Use permitted under Creative Commons License
Attribution 4.0 International (CC BY 4.0).
264
1 Introduction
1.1 The problem statement
The processes of reforming special education in Ukraine require interdisciplinary
research and finding new optimal ways to develop and shape the personality of children
with autism spectrum disorders. The organization of complete and timely care for
children with general development disorders (F84 according to the International
Classification of Diseases of ICD-10). The main purpose of helping children with
autism is their habilitation. Habilitation is the creation of new opportunities, building
social potential, i.e. the child’s ability to be realized in this society [30; 34]. All social,
psychological, informational and educational work should be aimed at enhancing the
personal, cognitive and social status of such a child. The prevalence of autistic
development disorders is, according to various data, from 6-17 to 57 per 10,000
children. According to foreign studies, with the timely organization of complex
psychological and pedagogical support, 60% of autistic children get the opportunity to
study under the program of general school, 30% – under the auxiliary program, almost
all of them reach the level of socialization necessary for life in society. In cases where
appropriate support is not provided, only 2-3% of autistic children can study in the
education system, the rest do not reach the required level of intelligence and
socialization. The analysis of psycho-corrective, therapeutic and developmental
directions of organization of psychological and pedagogical support of a child with
ASD (autism spectrum disorders) indicates the focus on the individual psychological
features of the respective child, not focusing on the introduction of rehabilitation cases.
Most programs also include elements of the child’s direct communication lines with a
specialist that may be a problem for children with ASD. The relevance of the study of
the given problem is due to the search for integrative components of the organization
of psychological and pedagogical support, focused on a complex combination of
leading psychological and pedagogical approaches and innovative AR technologies in
the process of habilitation and further integration of the child with ASD.
The aim of the study is to analyze the features and best practices of augmented reality
technologies for the psychological and pedagogical support of children with autism
spectrum disorders.
1.2 Literature review
Since the 1990s, special efforts have been made to study the specificity of the mental
dysontogenesis of autistic children, to search for the natural causes and the logic of
autistic development, which revealed the “pervasive” (cross-cutting or spectral) nature
of this disorder [19]. More and more researchers are thinking that autism is affecting
all levels of mental organization. It should be noted that at present there are no generally
accepted theoretical and methodological grounds for studying the features of disorders
of different structures and functions of the psyche in the case of autism, and also - the
relationship between them [20; 21; 22]. Autism is a general (pervasive) developmental
disorder that affects verbal and non-verbal communication and social interaction, and
265
complicates the formation of adaptation processes; Autism spectrum disorders
generally occur at the age of three. Other characteristics that are often associated with
autism: limited repetitive stereotyped movements, intolerance to environmental
changes or everyday life, unusual reactions to sensory stimuli [26]. The researchers
consider Autistic spectrum disorders as a violation of mental development,
characterized by an intense lack of social interaction, the ability to communicate and
cognition of the environment, loss of interest in reality. Generalization of symptomatic
manifestations of autism spectrum disorders according to DSM-5 (Diagnostic and
Statistical Manual of Mental Disorders, fifth edition) is presented in fig. 1 [24].
ASD
Violation of Stereotype /
Intellectual
social restricted Aggressiveness
disorder
communication behavior
Obsessive- Movement Attention Deficit
Language
compulsive disorders, sleep Hyperactivity
disorder
disorder disturbance Disorder (ADHD)
Social phobias
Fig. 1. Main DSM-5 autism symptoms and related problems.
Emphasizing on the phenomenological aspects and symptomatic manifestations of the
autism spectrum disorder, recent studies have focused on the use of information,
computer resources and modern AR technologies to improve the organization of
psychological and pedagogical support and the development of adaptive capacity of
children. Wedyan et al. [42] quite thoroughly discuss the use of augmented reality (AR)
in the diagnosis and treatment of autistic children with a particular focus on the
effectiveness of AR in assisting autistic children with communication, social, mood and
attention deficit disorders. The authors identified the main design features that enable
AR systems to achieve high levels of efficiency of autism therapy. The authors also
classify different systems of AR technologies for corrective process support with
children with ASD based on different criteria. Particularly valuable is the analysis of
an empirical study of the implementation of a method for the diagnosis of autism in
children, focused on the measurement of upper limbs movements [15]. The new method
described by the authors used AR to create a virtual object to encourage children to
move their hands. The system records all movements of children using the Microsoft
Kinect sensor [23]. Thus, the key two components of the system are the AR game and
the motion recorder.
In their turn, Marto et al. [32] conducted a systematic review of the use of augmented
reality in patients with autism, considering not only the social and psychological
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construct but also the medical aspect. In the era of information and improving the
existence of vulnerable sections of the population, including children with ASD, Tang
et al. [39] research on the use of a mobile application based on the main object
recognition module implemented within the deep learning platform – TensorFlow,
which promotes improved learning and communication skills in children with ASD.
Chung et al. [10] offer to adjust the deficit of social interaction and the development of
soft-skills using augmented reality (AR) technology for visual conceptualization of
social stories. Interactive social stories are played with several tangible markers and
AR technologies that mark the corresponding virtual images. Researchers also suggest
the use of three-dimensional (3-D) animation to simulate emotional expressions on the
face, which aims to develop the emotional spectrum and social skills of autistic
adolescents. Lorenzo et al. [31] own research aimed at determining the effectiveness of
augmented reality curriculum based on visual support for children with autism
spectrum disorder to improve their social skills. Su Maw et al. [35] conducted a
systematic review and meta-analysis of the effectiveness of cognitive, developmental,
and behavioral interventions in the context of corrective effects on preschool children
with ASD. Bai et al. [3] focusing on the deficit of symbolic thinking in children with
ASD (autism spectrum disorder), suggested an interactive system that explores the
potential of Augmented Reality (AR) technology to visually conceptualize image
representation in an outdoor gaming environment. The results of an empirical study
involving children with ASD aged 4 to 7 showed a significant improvement in
interactive play [3]. Cai et al. [6] offered to integrate the classic Dolphin Therapy model
with innovative AR technologies by developing an innovative Virtual Dolphinarium
design for potential rehabilitation support for children with ASD. Instead of imitating
dolphin swimming, a virtual dolphin interaction program will allow autistic children to
train by the pool for dolphins and learn (non-verbal) communication with virtual
dolphin gestures. Boccanfuso et al. [5] and Billard et al. [4] focus on the effective use
of robotics in the process of psychological and pedagogical support for children with
ASD.
Researchers empirically argue that the use of robots in the interactive game to
promote the development of movement coordination in children with autism spectrum
disorders and encourage the manifestation of verbal and non-verbal communication
[13; 22]. According to the analysis of the existing scientific and practical tendencies
and developments concerning the introduction of modern AR technologies into the
complex system of psychological and pedagogical support of children with autism
spectrum disorders [18], the question of finding vectors of the combination of
traditional psychological and pedagogical approaches as well as modern approaches
remains a far-reaching aim.
2 Results and discussion
Interdisciplinary research was carried out within the framework of the implementation
of research work, which is performed at the expense of the General Fund of the state
budget: “Development of methodology for psychological and pedagogical support of
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families raising children with special needs” – the state registration number:
0119U002003, “Adaptive system for individualization and personalization of
professional training of future specialists in blended learning” – the state registration
number: 0120U101970 [30; 33] and with the support of the NGO “Special Parenthood.
Protecting the Rights of Special Families”. Methods used in the research process:
method of theoretical analysis of literary sources, analysis of current experience of
psychological and pedagogical support of the integrative process of adaptation and
development of children with autism spectrum disorders, generalization and
conceptualization of leading domestic and foreign studies, the introduction of VR
technology / psychophysical development of a child with ASD, analysis of studies of
the practical experience of triad interaction “specialists – parents – child with ASD”
[15] in the process of development and integration child in society.
Table 1. Information on tools for exploring pervasive development.
Diagnostic area List of psychodiagnostics tools
CHAT
M-CHAT (age – 16-30 months)
CASD (screening of children 1-16 years old)
Questionnaire for children “CSBS DP™ Infant-Toddler Checklist”
Screening procedures
(screening of drawings)
for development
ASQ (screening of children and adults)
research
CAST (screening of children 4-11 years old)
ASDS (screening of children 5-18 years old)
SCQ (screening of adults and children from 4 years old)
CARS-2
Basic tools for the ADI-R
diagnosis and dynamics ADOS
of autistic disorders CARS 2
Additional tools
BSID-II
Cognitive functioning WPPSI-IV
and school skills SBT-4
(quantitative MSEL
assessment) KABC
M-P-R
Development Profile II “Screening tools for assessing of general
Cognitive functioning
development”
and school skills
The well-being profile of prerequisites for development in children
(qualitative assessment)
under 36 months of age, revised edition
Assessment of the development level of adaptive behavior is one of
the main tools of the clinical diagnostic program. VABS assessments
Assessment of the level
may be conducted for this purpose. The scale is valid for children aged
of social adaptation
0 to 18 years, adults – 19 to 99 years
(adaptive behavior)
SIB-R
ASQ: SE
Other additional tools of the clinical diagnostic program
For assessment of BOS
behavior EOS
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Diagnostic area List of psychodiagnostics tools
ROWPVT
EOWPVT
For assessment of SICD-R
speech development PRE-CELF
PLS
RDLS
For assessment of Sensory profile for children aged 3-10 years old
sensory development Sensory profile of toddlers
and sensory disorders Analysis of sensory behavior
Tools or special screening available in Ukraine
ADI-R
ADOS-2
The Modified Checklist for Autism in Toddlers (M-CHAT)
Checklist for Autism in Toddlers –CHAT)
CASD (screening of children from1to 16 years old)
SCQ (screening of children and adults from 4 years old)
STAT – The Screening Test for Autism in TwoYear-Olds
WISC-IV
International Performance Scale Leiter-3
РЕР-3
Bayley Scales of Infant Development-II
Mullen Scales of Early Learning)
Conners-3
Table 1 presents a thorough list of psychodiagnostics programs, clinical diagnostic
programs and screening programs. The presented list of psychodiagnostics methods is
presented in the unified clinical protocol of primary, secondary (specialized), tertiary
(highly specialized) medical care and medical rehabilitation “Autism spectrum
disorders (general developmental disorders)”, developed taking into account modern
requirements of evidence-based medicine and psychological care. The document
considers the features of the diagnosis and treatment of autism spectrum disorders in
Ukraine from the standpoint of ensuring the continuity of medical and psychological
care. The relevant list of psychodiagnostics bases is developed on the basis of adapted
clinical guidelines “Autism in children” and “Autism in adults”, which are based on the
principles of evidence-based medicine and psychological principles, taking into
account modern international guidelines reflected in clinical guidelines:
1. NICE CG 128 – Autism: recognition, referral and diagnosis of children and young
people on the autism spectrum (2011);
2. NICE CG 142 – Autism: recognition, referral, diagnosis and management of adults
on the autism spectrum (2012);
3. Practice Parameter for the Assessment and Treatment of Children and Adolescents
With Autism Spectrum Disorder, the American Academy of Child and Adolescent
Psychiatry (AACAP) Committee on Quality Issues (2014);
4. Diagnostic criteria for research. The ICD-10 Classification of Mental and Behavioral
Disorders, WHO, 1992. You can read the adapted clinical guidelines at link
http://www.dec.gov.ua/mtd/reestr.html.
269
Diagnosis of ASD is based on medical history, clinical examination of the patient,
standard psychological assessment, as well as interviews with the subject and
caregivers. Clinical evaluation of the patient should be aimed at identifying disorders
of social interaction, communication, limited repetitive behavior and stereotyped
movements. The patient’s age and level of development should be taken into account
when choosing tools for the study of pervasive disorders of the client. The use of special
standardized evaluation procedures (table 1) complements but does not replace clinical
judgment. Psychologists and psychiatrists should consider ethnic, cultural, or
socioeconomic factors that may influence assessment. They also coordinate appropriate
multidisciplinary assessment of children with ASD. The purpose of the assessment is
to standardize the detection of signs of ASD and compare them with the “Research
Diagnostic Criteria” International Classification of Diseases – 10 and diagnostic criteria
DSM-V. DSM-V diagnostic criteria are used as additional. This assessment provides a
diagnosis of RAS from 2 years. Formalized assessment is performed using the Semi-
Structured Parental Interview (ADI-R) and the Semi-Structured Assessment of Autistic
Behavior (ADOS). Functional diagnosis of ASD includes assessment of cognitive
levels functioning, speech functions, school skills, development of fine and gross motor
skills, visual-motor coordination and the level of functioning of the child in the field of
adaptive behavior with the use of tools for the study of pervasive disorders of client
development. Diagnosis of autism is made according to certain criteria, in comparison
with which a psychologist, correctional teacher, speech therapist, doctor can assess the
behavior and condition of the child [24]. Early diagnosis and timely treatment and
psychological and pedagogical assistance will improve the quality of life of a child with
ASD [19]. Given the priority perspectives of the use of innovative computer
technologies in psycho-diagnostic practice in the process of research of children with
ASD, the use of a computer complex for psycho physiological testing is a priority - the
HC- Psycho test. Today, there are a number of efficient approaches to constructively
support children with ASD and the development of adaptive, sensory, emotional-
volitionary and cognitive capabilities of the child [41].
Table 2. Classification of approaches for correction, development and education of children
with ASD.
Name of approach General characteristics and areas
Behavioral approaches
The ABA method primarily focuses on positive reinforcement
ABA – Applied behavior strategies, which are essential support for children in difficulty
analysis (authors: Ivar Lovaas, in learning or developing new skills. Also, ABA therapy deals
Donald Baer, Sidney W. Bijou, with the correction of problem behavior, which impedes the
Jim Hopkins, Jay Birnbrauer, normal functioning of the child, through the process of so-called
Todd Risley, and Montrose “functional assessment of behavior”. ABA therapy is used to
Wolf) improve language and communication skills, as well as
attention, memory and academic skills.
The verbal-and-behavioral approach is based on studies related
VBA (Verbal behavior to the field of applied behavior analysis and the theory of
analysis) behavioral scientist B. F. Skinner. The VBA develops the
child’s ability to learn a functional language.
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Name of approach General characteristics and areas
PRT is aimed at developing motivation, social initiative and
PRT – Pivotal Response
ability to respond to multiple signals, self-government. It
Treatment (authors: Dr Lynn
contributes to further facilitating the perception of educational
and Robert Koegle)
information.
1. Maximizing the independence of the child.
2. Helping the child to interact effectively with others
3. Increasing and developing intellectual skills, school skills
and individual abilities
TEACCH – Treatment and 4. Stimulating generalization of skills (new skills the child will
Education of Autistic and be able to use most often and effectively in different situations
Related Communication at home, in the garden, at school).
Handicapped Children (author: 5. Developing feelings of self, understanding of self
Eric Schopler) (development of emotional sphere).
Work with children is in the following areas: imitation;
perception; great motor skills; fine motor skills; coordination of
eyes and hands; elementary cognitive activity; language; self-
service; social relationships.
Developmental approaches
This approach aims at normalizing the affective development of
a child with ASD. The approach involves establishing
emotional contact with the child and engaging him/her in
Emotionally-meaningful
interaction with her loved ones and making sense of what is
approach (developed by
happening. Development in emotional community with a close
experts of the Institute of
adult allows the child to become more enduring, active and
Correctional Pedagogy of
interested, joint reflection and organization of life experience
RAE)
gives him/her greater freedom and constructiveness in contacts
with the environment, opens the possibility of advancement in
the development of the cognitive sphere.
“Floortime” is a technique focused on the development of a
child’s initiative in play and social interaction. The concept of
DIR Floortime (author: Stanley DIR and the “Floortime” technique are based on the assumption
Greenspan) that by working with emotional or affective manifestations, we
can have a beneficial effect on the basic capacities responsible
for relationships, thinking and communication.
The essence of the approach is to create a comfortable
environment for the child, which includes both a positive
psychological attitude to him/her from loved ones and
willingness to contact him/her in accordance with his/her needs,
interests and organization of environment, which contributes to
Son-Rise (authors: Barry and
the gradual, consistent development of the child’s research and
Samaria Kauffman)
cognitive activity. The idea of the program is to develop
relationships with the child through play therapy. The purpose
of the program is to change the attitude of the parents towards
their child from negative to positive, which is capable of
changing himself/herself.
The main purpose of this approach is to develop the necessary
skills for children in everyday life, including communicative
Daily life therapy (author: Kiyo
ones. Adaptive behavior training and correction of maladaptive
Kitakhara)
behaviors are done through physical activity, emotional
regulation, and academic skills in the group.
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Name of approach General characteristics and areas
RDI is a method of behavioral therapy based on a child’s
motivation for communication, interaction and friendship. The
RDI – The Interpersonal approach is based on studies of the human brain that confirm
Relationship Development that the brain is able to adapt to any problem. People with
Program (authors: Stephen disabilities can adapt and learn to function in a “normal” way.
Gatstin and Rachelle Shealy) The purpose of the RDI technique is to complete a step-by-step
accelerated path of development for a normally developed
child.
Sensory-and-perceptual approaches
The method is aimed at stimulating the work of the sensory
receptors in the coordination of different sensory systems.
Sensory integration (author:
Sensory-and-integration therapy is a rigorously dosed and
Gene Aires)
clearly constructed specific training system of impaired
function in a specially organized therapeutic environment.
Tomatis therapy is a means of audio-vocal training. Tomatis
Tomatis therapy (author:
therapy is a means of stimulating brain activity through the use
Alfred Tomatis)
of music based on any polyphonic sound.
Eclectic approaches
SCERTS is an innovative educational model for working with
children with ASD and their families. It provides specific
guidelines for helping your child become a competent and
confident social communicator while preventing problematic
behaviors that interfere with learning and relationship
development. The approach also aims to help families, teachers,
and therapists work together as a team, closely coordinated to
make the most progress in supporting a child. The abbreviation
Model SCERTS (authors: “SCERTS” stands for:
Barry M. Prizant, Amy M. SC – Social Communication is development of spontaneous,
Weatherby, Emily Rubin and functional communication, emotional expression, safe and
Amy Laurent) trusting relationships with children and adults;
ER – Emotional regulation is development of the ability to
maintain a well-regulated emotional state to cope with daily
stress and to be the most open to learning and interaction;
TS – Transactional Support is development and implementation
of support that helps partners respond to their child’s needs and
interests, change and adapt the environment, and provide tools
to enhance learning (e.g., image sharing, writing schedules, and
sensory support).
The method is based on a “cognitive-and-developmental
systemic approach for children with ASD”. Miller’s method
employs two basic strategies for the development process: one
The Miller Method (author:
involves the transformation of behavioral systems that are
Arnold Miller)
abnormal, into functional behavior; the other – systematic and
regular use in the process of developing occupations of certain
activities involving objects and people.
Table 2 constructively describes the main classical psychocorrectional and
psychotherapeutic approaches that are actively used in the process of psychological and
pedagogical support of children with ASD. Appropriate approaches are reflected in
various correction programs, such as:
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1. Programs and techniques for young children:
─ “Early Bird” Program
─ Denver Model for Early Intervention for Children with Autism – “Early Start Denver
Model”
─ ASSERT program
─ “Carolina” program for infants and young children with special needs.
2. Programs and Methods for Preschool Children:
─ “Behavior Modification in Autistic Children: A Guide for Parents and Professionals”
─ Teaching Developmentally Disabled Children: “The Me Book” by Lovaas
─ The program “Support for autistic and underdeveloped children. A compendium of
exercises for professionals and parents under the TEACCH program” [18]
3. Programs and techniques for school-age children and children with functional
autism:
─ Orientation in the Social World – “Navigating the Social World” [41]
─ “Mind Reading” Program – Teaching Children with Children’s Autism Syndrome,
Understanding Another Person)
─ “Teach Me Language” Program – Teach Me To Speak
4. Programs and techniques for children with ASD who have communication
problems:
─ Picture exchange communication system (PECS)
─ Facilitated communication
Integrated implementation of modern AR technologies, free software, unlike other
means of psychological and pedagogical support, allows to realize aspects important
for the rehabilitation process of children with ASD: first, differentiation, because there
are no two identical children with ASD; second, the ability to work with meaning; third,
the visibility [26]. Using tablets and special software is a good teaching and
communication method for children with ASD who find it difficult to get in touch with
others, and sometimes even with loved ones. With technique, a person with autism feels
calmer, they do not need to worry about their behavior and fear questions that an autistic
child does not know the answers to. It is believed that a child with ASD will not be able
to talk to peers and adults after computer lessons.
An analysis of the research and theoretical and methodological reviews revealed four
major components of the beneficial effects of AR technologies on the process of
psychological and pedagogical support of children with autism spectrum disorders:
cognitive, motivational, emotional and social ones. Computer training has seen an
increase in speed and increased concentration of attention; improved learning,
memorization, executive functions, creativity; problem solving skills appear.
Motivational benefits include improved work efficiency and persistence. Emotional
benefits are mood enhancement and adaptive regulation of negative emotions
management strategies such as anger, anxiety, and depression. The introduction of AR
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technologies is driving such positive social changes as enhancing cooperation, support,
mutual assistance, and improving behavior and activity [38]. It is important for AR
developers to support the learning of a child with ASD, taking into account and
applying the principles of accessibility and ease of use of web content, as outlined, for
example, in the ISO / IEC40500: 2012 standard offered by the World Wide Web
Consortium (W3C). Considering the principles of universal design for correction and
development support (Universal Design for Learning, UDL), it is advisable to further
visualize the content. Accordingly, in the process of selecting AR technologies for the
further implementation in the process of psychological and pedagogical support of
children with ASD, we were guided by the following criteria: accessibility,
instructiveness, understandability, visualization, complexity, availability of correction-
developmental and psychological construct, logic, systematic, structural properties,
available clear interface, the ability to implement an individual approach, and multi-
functionality [21]. To summarize, we suggest dividing AR technologies of
psychological and pedagogical support for people with autism spectrum disorders into
those that will support communication skills, social communication and traditional ones
themselves.
AR technologies to improve communication skills. According to recent scientific
studies, about 25% of children with ASD are non-verbal, i.e. they have limited or do
not use speech to communicate. The Makaton Charity is a language program that
enables people with disabilities to communicate. It is a unique language program using
gestures, symbols and oral speech that helps to communicate people with
communicative difficulties. The use of gestures makes communication possible for
people who do not speak or their speech is indistinct. Symbols can help communicate
with those who are unable to gesture or prefer graphic expression. With the exception
of verbal language, all communication is considered Assistive and Augmentative /
Alternative Communication (AAC) [9; 27; 36; 37; 38; 40]. Therefore, when a child
with ASD has severe verbal problems, supportive and alternative communication
strategies may be able to express themselves. The complexity of communication has a
significant impact on the quality of life, education, development of social relations. The
use of appropriate AR technology makes communication possible for people who do
not speak or their speech is indistinct. Symbols help communicate to those who cannot
gesture or prefer graphic expression. The program also teaches children to
communicate with adults and peers, hear and understand others, inform about their
needs and desires. Gesticulation stimulates the lingual areas of the brain, which
promotes the development of the child’s articulation apparatus [35]. As a result, the
emergence of a form of communication in the child’s life leads to social development
and reduces the manifestation of behavioral disorders. It can be used by preschool
teachers, teachers, speech therapists, psychologists and other specialists. A support of
alternative communication covers advanced technologies and may be low-tech, such as
the Picture Exchange Communication System (PECS) or high-tech, such as Voice
Output Communication Aids (VOCAs) [11]. VOCAs are portable electronic devices
that can produce a synthetic language for the user and can be used with graphic symbols
as well as text. VOCAs can be used effectively by ASD children. Chien Hsu Chen [10]
274
described the effectiveness of this technology and focused on the design features of
such AR technologies in the psycho-pedagogical support.
The most popular alternative online communication tools for Apps are SceneSpeak,
which creates interactive displays and stories with voices and text broadcasts added to
stories and devices using the Milo language to help children develop communication
skills by creating an interactive history journal. In turn, it should be said that there are
hundreds and thousands of developments, both online and mobile, so it is urgent to
choose the best application for the user. One way to get a more informed view of the
available AR technologies is to explore web resources that look at developments and
applications for people with ASD. For example, DART (Development Autism
Research Technology) reviews about 100 programs and has its own 5-point rating scale.
DART also offers a very useful wheel of applications for selecting the proper Apps for
PWD (Sue Fletcher-Watson researcher) [14]. Examples and comparisons of some well-
known developments in communication technology by The University of Bath, one of
the UK’s leading universities, are SMART-ASD: Matching Autistic People with
Technology Resources [42]. An even greater level of visualization can be achieved with
the example of PECs using the augmented reality technology suggested by Taryadi and
Kurniawan [18]. This technology offers a new system for developing communication
skills, a sensory system, and an emotional-volitional sphere that uses augmented reality
technology for PECS training techniques. This helps teach kids how to use new images
or objects with the proper keywords or phrases, resulting in faster engagement and
better social adaptation.
AR technologies for stimulating the development of social skills. Learning
technologies based on the iPad and other mobile technologies are common to acquire
social skills. Kolomoiets [28], Brandão [25] and other researchers offer the use of
augmented reality technology in support of children with ASD to increase their
motivation and involvement in interactive learning activities to improve their cognitive
and social skills. Particular attention is paid to the use of augmented reality for learning
and reproducing social skills, but with a minimal number of “dangerous” environments
that can be carefully designed and controlled, and support more realistic and less
didactic interactions. The Internet and Multimedia Technology Innovation Center
(AIM Tech Center) at Hong Kong City University has developed a training program to
study the effectiveness of virtual reality technology for teaching emotional and social
skills. The program has six augmented reality scenarios depicting the everyday lives of
typical Hong Kong children, research described by Yuan et al. [43] of the University
of Kansas created the augmented reality technology, “Animated Visual Amplifiers for
Social Skills” (AViSSS). This system has enabled people with ASD to work on social
skills using different environments and situations. The participants should simulate
behavior or select specific objects. This platform has given them the opportunity to deal
with various social situations without tension or anxiety related to the real world. In the
context of the analysis of modern mobile and computer applications based on
augmented reality use, the most common and accessible ones should be identified. In
2013, Autism Soft was founded, which develops specialized software for people with
ASD, mainly for tablets. The developers emphasize that their programs are built on the
needs of future users. At the moment, the company has introduced two software
275
products: Autism Communicator and Visual Schedule. Autism Communicator is an
application for children with autism that provides non-verbal communication with other
people through cards. Visual Schedule is the first planner for children with ASD. All
the events in it are complemented by vivid illustrations: drawings, photographs, etc.
This form of timetable gives a clear structure of the sequence of events, removes the
anxiety of the child in the future, and takes his activity to a new level. Both applications
run on the iOS platform, but in late July 2015, Autism Communicator migrated to the
Android platform. Appropriate technologies can be actively used in conjunction with
behavioral approaches [29] within the framework of psychological and pedagogical
support for a child with ASD, namely as an element of the ABA, Pivotal Response
Treatment, TEACCH (Treatment and Education of Autistic and Related
Communication Handicapped Children) method, and as a component of the SCERTS
model. The implementation of ABA Math, an application-based behavioral analysis
technique developed by Loveas [42], helps autistic children to learn arithmetic
mechanically. For each example (for example, 1 + 2 = 3), the program creates different
situations for the child in discrete tests until the student is able to cope with the task.
Appropriate technology is an important mechanism for the development of mnemonic
abilities of the child, facilitates the learning process. The ABA Math program is a
synergistic factor in the complex implementation of eclectic approaches in the process
of accompanying a child with ASD, namely, as a component of the SCERTS model,
Miller method, as a multifunctional component of the development of the cognitive and
emotional-and-volitional spheres of the personality. It is quite innovative to use special
training programs developed by Palito [42] in training and psychological support of
children with ASD, which completely eliminated the mouse and keyboard, leaving only
the space bar command. Children can manage their own learning. The programs are
divided into topics. For example, the Colors! is devoted to the study of color, its
differentiation. Children learn to understand what colors some objects have, what colors
are the main ones, which are derived.
Within the implementation of AR technologies, appropriate developments can be
effectively used in the development of Emotional-Meaning Approach (DIR Floortime,
Daily life therapy), Sensory-Perceptual Approach (Sensory Integration) and Behavioral
Approach (TEACCH (Treatment and Education of Autistic). These programs are
focused not only on the development of competence, cognitive and mnemonic functions
in a child with ASD, but also on the development of emotional-and-volitional
regulation, self-organization, self-control, and the formation of constructive adaptive
mechanisms of interaction with others [16].
Autistic children think of images, poorly memorize the sequence, so to teach them
it is necessary to correlate the word and the subject and record the sequence. For this
purpose, it is very convenient to use a computer. It is much easier for them to correlate
a word with a picture if they see a word and a picture printed on the screen. Some do
not understand abstract drawings, so we recommend that you first work with real
objects or photos [17]. Educational games in the “Logo” environment are addressed to
children of primary and secondary school age. Many different programs have been
developed for autistic children using ABA therapy and high-quality imaging. But, as a
rule, they are designed for iOS devices. For example, Autism Emotion is a free and
useful program for autistic toddlers to train them to recognize emotions. This program
276
can be actively used in the process of correctional and developmental work with a child
with ASD. An appropriate program promotes the development of positive motivation,
the correction of emotional rigidity, the formation of elements of empathy and the skills
of establishing cause-and-effect and causal relationships between the relevant case and
the life situation that a child with ASD is facing.
The use of Smart Board in psycho-correction work with children with ASD is seen
as an augmented reality platform for empowering autistic children to play with their
siblings, classmates, and friends, and building the communication process [7]. Children
with autism are often described as thinking with visual images, so by embodying the
imaginary image with augmented reality, it can help them understand the concept of
imagination and effective engagement, and expand their personal social experience.
The open play environment and augmented reality system work as a playground for
imaginary play to help children with ASD visualize a particular activity algorithm in
their mind. The use of modern AR technologies gives an opportunity to take into
account the individual characteristics and capabilities of each child with ASD (for
example: individual pace of activity, methods of learning knowledge, interests, etc.); to
save personal resources; to correct developmental disabilities. The use of computer
programs and augmented reality technologies promotes effective interaction, formation
of positive motivation; development of intellectual and creative abilities, cognitive
abilities [29].
An interdisciplinary pilot study aimed at the implementation of AR technologies in
the concept of traditional psycho-correction effects on a child with ASD has developed
and tested a psycho-correction program based on the SCERTS model and augmented
reality elements at each session. The corresponding research was carried out in the
process of cooperation with parents who raise children with ASD and are members of
the Special Parenthood PO “Protecting the Rights of Special Families”. In the course
of the research, a preliminary theoretical and methodological analysis of the
effectiveness of the introduction of psycho-correction programs and elements of
augmented reality in the process of supporting a child with a disorder of the autism
spectrum was used. The following techniques were used in the psycho-diagnostic unit:
“C.A.R.S Autism Rating Scale”, “Routine Interview “, “M. Durand Behavioral
Motivation Survey Scale”, “The Communication Matrix”. The total number of
participants in the psycho-correction program is 29 children. As a result of the
distribution, two groups were formed: soft and moderate autistic manifestations had 17
children (62.7%) belonging to Group 1, severe autistic manifestations – 10 children
(37.3%) belonging to Group 2. The psycho-correction program consisted of four units,
and an element of augmented reality was introduced into the structure of each lesson:
1. Developing parental competence: understanding the signals of the child,
recommendations for the development of social and everyday skills and
communication, developing attention, the ability to structure their space and activity.
2. Updating the adaptive capacity of the child with ASD, development of social skills.
3. Adaptive behavior training and correction of maladaptive behaviors.
4. Teaching children the skills of additional and alternative communication in
subgroups.
277
Classes with children with ASD were held at the Laboratory of Psychology of Health
of the Department of Psychology and the STEAM-Laboratory of the Department of
Informatics and Cybernetics, Bohdan Khmelnytsky Melitopol State Pedagogical
University (fig. 2).
а)
b)
Fig. 2. Elements of implementation of complex psycho-correction program using AR
technologies (a – traditional psycho-correction techniques and methods; b – means of
introduction of elements of AR technologies in psycho-correction process).
Observation of the behavior of children during the lessons showed that the multimedia
computer program and AR technologies contribute to the emergence of motivational
effect in children with ASD (the main task in teaching children with ASD is the
development of social motivation). The data of the results of primary and secondary
psycho diagnostic procedures were processed and accumulated in table 3.
Table 3. Psycho-diagnostic results before and after psycho-correctional exposure using AR
technologies.
Subgroups
Prior to correctional impact After correctional impact
of subjects
Group 1 1. Domination of the fourth and fifth 1. The number of children with
levels of communication (78.6%) manifestations of atypical, stereotypical
2. Manifestations of atypical behavior decreased by 39.6%
stereotypical behavior (75.8%) 2. Completely managed to overcome
3. Behavioral hazards (Auto behaviors that were dangerous to themselves
Aggression) (11.8%) (auto aggression)
4. Most children demonstrated 3. Children learned to use PECS cards and
“achievement” as the predominant information resources, which helped to
type of behavioral motivation (52.3%) increase their communication level by
5. Attention motivation behavior 12.6%
(19.3%) 4. After the psycho-correction program, the
6. The manifestations of atypical children had gestures of “congratulations,”
behavior of children were motivated “goodbye,” “give,” “yes,” “no.” The group
by insufficiency or excess of sensory learned how to use a visual interactive
feelings (14.1%) schedule and developed own
communication cards
278
Subgroups
Prior to correctional impact After correctional impact
of subjects
Group 2 1. Domination of the first and second 1. The number of children with
levels of communication (85.6%) manifestations of atypical, stereotypical
2. Manifestations of atypical behavior decreased by 48.6% (p≤0.05)
stereotypical behavior that impedes 2. It was completely possible to overcome
task accomplishment (98%) the manifestations of behavior that was
3. Behavioral hazards (auto dangerous (auto aggression)
aggression) (44.1%) 3. After corrective actions, 54.70% of the
4. Only 9.7% of respondents showed children in this group reached the third level
motivation for “achievement” of communication
5. Attention motivation behavior 4. Children learned to use the gesture
(4.8%) system, they used the following gestures:
6. The manifestations of atypical “greetings”, “goodbyes”. They learned to
behavior of children were motivated use the subject interactive timetable. A
by insufficiency or excess sensory “give” gesture and pointing gesture, as well
sensations (30.7%) as functional gestures, were formed
As a result of such correctional work, children learned how to use PECS cards and
gestures, use visual timetables and AR technologies to explain and express their
emotional states, improve interaction with loved ones, expand social interaction
experiences and instrumental skills in adaptive living and independent living skills.
Prior to the corrective program, most children had atypical behaviors. After the
corrective interventions, the number of children with atypical behavior in both groups
decreased. Through a comprehensive integrative psycho-correction program using AR
technologies, we were able to completely overcome behaviors that were dangerous to
ourselves or others. In both groups the level of communication interaction increased
significantly.
3 Conclusions and prospects for further research
In the process of employing AR technologies, autistic children learn to overcome
difficulties, control their activities, evaluate results. When deciding on a computer-
programmed case-study, the child strives for positive results, subordinates his actions
to the goal. Thus, the use of modern AR technologies in the process of implementation
of psychological and pedagogical support of a child with ASD helps to develop such
strong-willed qualities as independence, alertness, concentration, personal control. The
results of the pilot empirical research aimed at integrating the combination of traditional
psychological-pedagogical methods and AR technologies in the process of psycho-
corrective work with children with ASD, confirmed the need to introduce a component
of additional reality in the process of supporting such children. According to the results
of psycho-correcting influence and complex use in each lesson an element of
augmented reality in children increased motivation, significantly developed
communication skills, social skills and ability of organizing and self-regulation of their
own actions and emotional reactions, and a manifestation of atypical, even auto-
aggressive behavior has decreased. Combining AR technologies and traditional
approaches achieves individuality and maximizes the effectiveness of corrective action.
279
Educational and corrective work should be directed mainly to the development of
emotional contact and interaction of the child with adults and with the environment,
affective development, the formation of internal adaptive mechanisms of behavior,
which in turn, increases the overall social adaptation of the autistic child. Thus, the use
of AR technologies in psychological and pedagogical support allows children with
ASD to feel confident in themselves, helps them to adapt, promotes general
socialization; develops skills of constructive interpersonal and communicative
interaction. Prospects for further research are the development and testing of a
comprehensive model of implementation of AR technologies in the psychological and
pedagogical construct of accompanying children with disorders of the autism spectrum
according to the nature and degree of disorders of interaction with the external
environment, as well as the type of autism itself and individual characteristics of the
child.
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