Can virtual reality help autistic children navigate the real world?

This article is part of Upstart, a series on young companies using new science and technology.

Vijay Rabindranath is always fascinated by technology. At Amazon, he oversaw the team that created and launched Amazon Prime. Later, he joined the Washington Post as Chief Digital Officer, where he met Donald E. Graham was advised to sell the newspaper in 2013 to his former boss, Jeff Bezos.

Towards the end of 2015, Mr. Rabindranath closed his time at the newly renamed Graham Holdings Company. But her primary focus was on her son, who was then 7 years old and undergoing therapy for autism.

“Then an amazing thing happened,” said Mr Rabindranath.

Mr Rabindranath was walking around with a virtual reality headset when his son asked him to try it out. After spending 30 minutes using the headset in Google Street View, the child goes to his playroom and begins to show what he has done in virtual reality.

“This is the first time I’ve seen him act like that,” said Mr Rabindranath. “It ended as the moment of a light bulb.”

Like many autistic children, Mr. Rabindranath’s son struggled with drama acting and other social skills. Her son’s ability to translate the experience of virtual reality into the real world gave birth to an idea. A year later, Mr. Rabindranath started a company called Florio, which is creating virtual reality lessons designed to help parents who work with behavioral therapists, speech therapists, special educators, and autistic children.

The idea of ​​using virtual reality to help autistic people has been around for some time, but Mr Rabindran said the widespread availability of commercial virtual reality headsets since 2015 has enabled research and commercial installations on a much larger scale. Floreo has created nearly 200 virtual reality lessons designed to train children for real-world experiences, such as building social skills and choosing where to sit across the street or in the school cafeteria.

Last year, as the epidemic exploded in demand for telehealth and remote learning services, the company delivered 17,000 lessons to customers in the United States. Autism experts believe that the company’s flexible platform could go global in the near future.

This is because the demand for behavioral and speech therapy as well as other types of interventions to deal with autism is so huge. It can take months to diagnose autism – a critical time in a child’s development when therapeutic interventions may be important. And such therapies can be expensive and require considerable investment of time and resources by the parents.

The Floreo system requires an iPhone (version 7 or later) and a VR headset (a lower-model price ranges from $ 15 to $ 30), as well as an iPad, which a parent, teacher or trainer can use – personally or remotely. The cost of the program is about $ 50 per month. (Florio is currently working to enable insurance reimbursement, and has received Medicaid approval in four states.)

A child donates a headset and navigates virtual reality lessons, while an instructor – who can be a parent, teacher, therapist, counselor or personal assistant – monitors and communicates with the child via the iPad.

The lessons cover a wide range of situations, such as going to the aquarium or going to the grocery store. Many lessons involve teaching autistic children who may struggle to interpret nonverbal cues, to explain body language.

Autistic self-advocates point out that behavioral therapy for the treatment of autism is controversial among autism sufferers, arguing that it is not a curable disease and that therapy is often imposed on autistic children by their autistic parents or guardians. Behavioral therapy, they say, can harm or punish children, such as for uncomfortable behavior. They argue that instead of conditioning autistic people to behave like neurotypical people, society should welcome a different approach to their and their world experiences.

“Many of the discrepancies between autistic people and society are not the fault of autistic people, but the fault of society,” said Joe Gross, director of advocacy at the Autistic Self Advocacy Network. “People should be taught to communicate with different types of people with disabilities.”

Mr Rabindranath said Florio respects all voices of the autistic community, where diversity is needed. He noted that while Florio was used by many behavioral health providers, it was placed in a variety of contexts, including at school and at home.

“The Florio system is designed to be positive and fun, while the positive reinforcement is designed to help build skills that help you adapt to the real world,” said Mr Rabindran.

In 2017, Florio secured a ট্র 2 million fast track grant from the National Institutes of Health. The company is first testing whether autistic children will tolerate headsets, then conducting a randomized controlled trial to test the suitability of the method to help autistic people communicate with the police.

Preliminary results have been promising: According to a survey published in the Autism Research Journal (Mr. Rabindran was a writer), 98 percent of children have completed their lessons, allaying the concerns of autistic children about their sensitive sensitivity to headsets.

Mrs. Gross said she saw the potential in virtual reality lessons that helped people practice Florey’s lessons in unfamiliar situations, such as crossing the street. “There are some parts of Floreau that can be really exciting: walking through the airport, or joking or getting treated – a social story for something that doesn’t happen often in one’s life,” he said, adding that he wanted to see a medical. Lessons for the method.

However, he questioned the general emphasis of the behavioral therapy industry on the use of emerging technologies to teach social skills to autistic individuals.

A second randomized controlled trial using Telehealth, conducted by Floreo using another NIH grant, is underway, in hopes of showing that Floreo’s method is as effective as personal coaching.

But early success convinced Mr. Rabindranath to be fully committed to the project.

“There were really a lot of excited people.” He said. “When I start showing families what we’ve created, people will just give me a big hug. They will begin to cry that someone is working on a high-tech solution for their children. “

Physicians who have used the Florio system say that the virtual reality environment makes it easier for children to focus on the skills taught in lessons, as opposed to the real world where they may be overwhelmed by sensitive stimuli.

Celebrate the Children, a nonprofit private school in Denville, NJ, hosts one of Florio’s primary pilots for children with autism and related challenges; The school continues to use the system, said Monica Osgood, co-founder and executive director of the school.

He said wearing a virtual headset could be very empowering for students, as they were able to control their environment with the slightest movement of their heads. “Virtual reality is definitely something that is a real gift for our students that we will continue to use,” he said.

Kelly Rainey, a special instruction manager for the Cuahoga County Board of Developmental Disabilities in Ohio, said her organization has used Florio to help students with life and social skills over the past year. Her colleague Holly Winterstein, an early childhood intervention specialist, says the tools are usually more effective than conversation cards used by therapists. The office started with two headsets but quickly purchased equipment for its eight staff members.

“I see infinite possibilities,” said Mrs. Winterstein.

“Floreau’s social skills have taken hold,” said Michia Rahman, a speech language pathologist who focuses on underdeveloped populations in Houston (and Florio customers). The system is “probably one of the best or best social skills tools I’ve ever worked with.” (He added that 85 percent of his patients are Medicaid-based.)

So far, the company has raised about 6 million. Investors include Lifeforce Capital, a venture capital firm that focuses on healthcare software, and Autism Impact Fund, an early-stage venture capital fund that invests in companies that deal with nervous breakdowns. (Mr Rabindran declined to comment on whether the company was profitable.)

For Mr. Rabindranath, the organization has become a mission. “When I started exploring virtual reality as a method of therapy, I didn’t know if it was a hobby project, or if it was going to be a business that I put some money into, hired some people, then went on to do something else,” he said. Said. “At some point, I got to the point where if it felt like, if I didn’t build it, no one would.”

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