Can virtual reality help children with autism navigate the real world?

This article is part of Upstart, a series of young companies that take advantage of new science and technology.

Vijay Ravindran has always been fascinated with technology. At Amazon, he oversaw the team that created and launched Amazon Prime. He later joined the Washington Post as chief digital officer, where he advised Donald E. Graham to sell the newspaper to his former boss, Jeff Bezos, in 2013.

By the end of 2015, Mr. Ravindran was ending his time as Graham Holdings Company. But the main focus was on her son, who was then 6 years old and on autism therapy.

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

Sir. Ravindran was walking with a virtual reality headset when he asked his son to try it out. After 30 minutes of using headphones in Google Street View, the child went to his playroom and began acting out what he had done in virtual reality.

“It simply came to our notice then. said Ravindran. “It was a light bulb in my head for a moment.”

Like many children with autism, Mr. Ravindran’s son struggled with apparent games and other social skills. Her son’s ability to translate her virtual reality experience into the real world sparked an idea. A year later, Mr. Ravindran founded a company called Floreo, which is developing virtual reality lessons designed to help behavioral therapists, speech therapists, special educators, and parents working with children with autism.

The idea of ​​using virtual reality to help people with autism has been around for a long time, but Mr. Ravindran said the availability of commercial virtual reality headphones since 2015 has enabled commercial research and expansion on a much larger scale. Floreo has developed nearly 200 virtual reality lessons designed to help children develop social skills and train them for real-world experiences, such as crossing the street or choosing where to sit in the school canteen.

Last year, as the pandemic boosted demand for teleology and distance learning services, the company delivered 17,000 lessons to U.S. customers. Experts in autism believe that the company’s flexible platform could be globalized in the near future.

Therefore, there is a widespread demand for behavioral and speech therapy and other forms of intervention to combat autism. It can take months to get a diagnosis of autism, which can be a time-consuming therapeutic intervention. And this therapy can be expensive and requires a lot of time and resources.

The Floreo system requires an iPhone (version 7 or later) and a VR headset (a low-end model costs between $ 15 and $ 30), as well as an iPad that can be used by a parent, teacher, or coach. in person or remotely. The cost of the program is about $ 50 per month. (Floreo is working to enable insurance reimbursement, and has received Medicaid approval in four states).

A child wears headphones and navigates the virtual reality lesson, while the coach (while it may be a parent, teacher, therapist, counselor, or personal support) monitors and interacts the child via the iPad.

The lessons cover a variety of situations, such as visiting the aquarium or going to the grocery store. Many of the lessons involve teaching autistic children, who have difficulty interpreting non-verbal cues, to interpret body language.

Autistic self-advocates note that behavioral therapy for treatment is debatable among those with autism, arguing that it is not a disease to be cured, and that their autism often imposes therapy on parents or guardians who are not autistic children. Behavioral therapies, they say, can harm or punish children for behaviors such as fidgeting. Instead of making autistic individuals behave like neurotypical individuals, they say that society should accept them and the different ways they experience the world.

“A lot of the disagreement between autism and society is not the autistic’s fault, it’s society’s fault,” said Zoe Gross, defense director of the Autistic Self Advocacy Network. “People need to be taught to interact with people with different types of disabilities.”

Sir. Ravindran said Floreo respects all voices in the autistic community, where needs are diverse. Although Floreo was used by many behavioral health providers, it was widely used in a variety of contexts, including in schools and at home.

“Floreo is designed to be a positive and fun system, and while it creates positive reinforcement, it helps to build skills that help you adapt to the real world,” he said. said Ravindran.

In 2017, Floreo received a $ 2 million grant from the National Institutes of Health. The company is first testing whether autistic children support hearing aids, then conducting a randomized control test to test the usefulness of the method in helping autistic people interact with police.

The initial results have been promising: According to a study published in the journal Autism Research (one of the authors was Mr. Ravindran), 98% of children completed their lessons, lowering their sensitivities to being resistant to hearing aids.

Madam. Gross said he saw potential in virtual reality lessons that helped people rehearse unfamiliar situations, such as Floreo’s lesson on crossing the street. “There are parts of Floreo’s excitement: a walk through the airport, or a trick or a treat – the social story of something that doesn’t happen often in someone’s life,” he said, adding that he would like to see one. a lesson in medical procedures.

However, he questioned the use of emerging technologies in the behavioral therapy industry to teach social skills to people with autism.

A second trial of randomized control using telehealth, using another NIH grant from Floreo, is underway to show that Floreo’s approach is as effective as personal training.

But those initial successes were Mr. Fully committed to the Ravindran project.

“There were a lot of people who were really excited,” he said. “When I started showing what family developed, people gave me a big hug. They would start crying when someone was working on a high-tech solution for their children. ”

Clinicians who have used the flora system say that the virtual reality environment makes it easier for children to focus on the skill taught in the lessons, unlike in the real world, where sensory stimuli can overflow.

Celebrate the Children, a private nonprofit school in Denville, NJ, for children with autism and related challenges, took on one of Floreo’s early pilots; Monica Osgood, co-founder and CEO of the school, said the school continued to use the system.

He said putting up a virtual headset could be very empowering for students because they were able to control their environment with light movements of the head. “Virtual reality is definitely a real gift for our students that we will continue to use,” he said.

Kelly Rainey, a special instructional manager at the Cuyahoga County Developmental Disabilities Board in Ohio, said her organization has used Floreo for the past year to help students with their life and social skills. Her colleague Holly Winterstein, a specialist in childhood intervention, said the tools were more effective than the conversation cards commonly used by therapists. He started the office with two headphones, but quickly bought the equipment for each of his eight employees.

“I see endless possibilities,” Ms. said Winterstein.

“Floreo’s social skills are maintained,” said Michea Rahman, a speech-language pathologist who focuses on underserved populations in Houston (and a Floreo client). The system is “probably one of the best social skills tools I’ve ever worked on.” (He added that 85 percent of his patients rely on Medicaid.)

So far, the company has raised about $ 6 million. Investors include LifeForce Capital, a health software-focused venture capital firm, and the Autism Impact Fund, an initial venture capital fund that invests in companies to address neurological conditions. (Mr. Ravindran refused to determine whether the business was profitable).

Mr. Ravindran has become a business mission. “When I started studying virtual reality as a therapy modality, I didn’t know it was a hobby project, or it was going to be a business, I put in some money, hired some people and then left. to do something else, ”he said. “Once upon a time, I came to this place, where if I felt like it, if I didn’t build it, no one would.”

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