Virtual Reality Interventions' Effects for Children with Autism Spectrum Disorder
Autism spectrum disorder (ASD) is another complex neurodevelopmental disorder referred to as a persistent impairment, interfering in communication and social interactions (American Psychiatric Association 2013). One of the most pronounced characteristics of this disorder is related to patterns of behaviors repetitive actions or movements and restricted and specific interests (Campisi et al. 2018). The global prevalence of ASD is around 7.6 per 1,000 persons (Baxter et al. 2015), and the impact on daily life or academic activities is huge (Campisi et al. 2018). Since communication and social skills are necessary to function and have autonomy, children with ASD are at a great disadvantage compared to their peers, because communication and social skills are, in fact, remarkable in those children.
Given these features, the diagnostic process for ASD is complex and difficult. There is scarce evidence about the etiology of ASD, but genetic components are present in more than 20% of the cases (Ivanov et al. 2015). Therefore, the earlier the diagnosis is made, the better the prognosis will be. Early intervention should be done as soon as possible in order to avoid severe consequences in all aspects of the children's development (Zwaigenbaum et al. 2015). Since interaction and communication are elements involved in therapeutic approaches for children, these deficiencies along with restrictive interests may be a barrier during the rehabilitation process. In contrast, VR approaches may afford a suitable therapeutic environment with ideal dosages of sensorial, social, and motor stimuli.
Although there are other systematic reviews available, only one systematic review (Mesa-Gresa et al. 2018) about VR for children with ASD fulfilled the purpose of this chapter, since it focused exclusively on children with ASD and interventions based on VR. Unfortunately, this systematic review (Mesa-Gresa et al. 2018) did not synthesize either the VR tools used among studies during interventions or the wide information about the dosage of treatment with those children. The majority of studies were interested in social (45%) and emotional (21%) skills as outcomes. Despite the improvements observed in the majority of studies (30 out 31 studies) in at least one outcome assessed, only in ten studies were these improvements significant. Regarding the level of evidence attested to by this systematic review, the authors (Mesa-Gresa et al. 2018) found only a moderate effect of VR intervention for children with ASD. This implies that despite the improvements observed, moderate evidence is not sufficient to recommend rehabilitation treatment based on VR as a substitute for traditional treatments for this population.
Moreover, this systematic review (Mesa-Gresa et al. 2018) compiled useful and promising information that widens our possibilities for helping children with ASD achieve greater quality of life and functionality. However, stronger evidence is necessary to consider VR as a good choice to treat ASD symptomatology, particularly related to aspects of social and emotional skills. In addition, following the suggestions given by authors of this systematic review, more studies are necessary, and new rehabilitation techniques using VR should be encouraged and developed for children with ASD.
Considering all evidence from the seven systematic reviews retrieved here, VR interventions are promising approaches for the rehabilitation process of children with neurodevelopmental disorders, particularly CP. DCD, and autism spectrum disorder. VR has brought benefits for functional outcomes for these children, such as motor skills, motor performance, balance, walking, social skills, and emotional skills. However, these benefits are not superior to those achieved by traditional interventions, such as conventional physiotherapy. Despite that, better effects of VR interventions appear to be achieved when combined with traditional no-VR interventions, which w'ould increase functional benefits for children with neurodevelopmental disorders while simultaneously maintaining engagement with the therapeutic process. Thus, more investigations regarding VR interventions’ effects for children with neurodevelopmental disorders should be carried out, particularly taking into account the advantages of technology and the unique and complex characteristics and needs of these children.
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