Managing Auditory Sensitivity in Autism Spectrum Disorder:New Technologies for Customized Intervention

Rob Morris - Affective Computing

Thesis Presentation

Motivation

- Auditory sensitivity is extremely common in Autism Spectrum Disorder

- It creates extreme anxiety, and it can interfere with sensory processing and social development

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Current Treatment Options

- Sound-isolators

- Auditory Integration Therapy (AIT)

- Exposure Therapy

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Exposure Therapy

- Method: present stimulus at progressively closer ranges until habituation ensues

- extremely effective for a wide range of disorders

- used with autistic children with auditory sensitivity

- Koegel, Oppendum, & Koegel (2004)

Thesis Presentation

Automating Exposure Therapy

- Virtual Reality Exposure Therapy

- eliminates clinician oversight, but design phase is slow and costly

- Sound sensitivities may be uniquely suited for automated exposure therapy

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Approach

- Create Scratch programs to automate exposure therapy

- Present feared/aversive sounds in a graded, hierarchical fashion

- Incorporate sounds into programs

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Specific Aims

- Serve the whole spectrum - many therapies are only suitable for high-functioning autistic individuals- consider possible motor/verbal difficulties of patient

- Engaging- represent unique interests of the patient- ideally, patient should willingly engage in the treatment

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Specific Aims

- Inexpensive- use free software to keep cost down- e.g., Scratch, Gimp, Audacity

- Humane- consider unique stress levels of autistic individuals

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Evaluation

Uncomfortable Loudness Study

Objective: - pilot test materials - evaluate UCL test - explore pairings of aversive sounds

Participants: - 20 healthy college students without an Autism diagnosis

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Evaluation

Case Studies

Objective: - assess therapeutic potential of the proposed intervention

Participants: - 3 autistic individuals with auditory sensitivity issues

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Uncomfortable Loudness Study

How should aversive sounds be placed in the media programs?

At random?

Paired directly with events in the program?

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Evaluation

Experimental Groups

1) Paired: Aversive sounds paired with positive elements in

2) Randomized: Aversive sounds placed randomly

Both groups received the same amount of exposures. The only difference was how theexposures were placed within the game.

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Evaluation

Experimental Design

Subjects were randomly assigned to either the “paired” or “randomized” group

Pre-test (UCL tests)

Exposure Game

Post-Test (UCL tests)

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Results

Paired: [F(1, 14) = 9.24, p = .009] Randomized: [F(1,14) = .13, p = .726].

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Case Studies

JH:

- 26 yr old male- Audio Sensitivities: coughing sounds- Interests: babies, family photos

CC:

- 22 yr old female- Audio Sensitivities: sneezing and throat-clearing sounds- Interests: Disney princesses

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Case Studies

BL:

- 20 yr old male- Audio Sensitivities: roosters, soda being poured into a can- Interests: Herbie the Love Bug

Identify problem sounds

Search for sounds via freesound.org

Identify preferred media content

Find and download media

Upload into Scratch

Design Scratch program

Assess Interest

Pair sounds with positive reinforcers

Introduce sounds in hierarchical fashion

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Case Study Results

JH:

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Case Study Results

CC: Session 1

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Case Study Results

CC: Session 2

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Case Study Results

BL: Study discontinued

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Conclusions

Specific Aims Upheld:

Serve the whole spectrum

Engaging

Inexpensive

Humane

Intervention shows potential

JH showed signs of complete remission

CC is improving in follow-up sessions

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Future Directions

Assess Therapeutic Efficacy of Intervention

- Increase study enrollment

- Complete 4-6 additional case studies

- Evaluate case studies using single-case across stimulus design

- Conduct rigorous pre- and post-test analyses

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Future Directions

Proliferate Techniques

- Create training videos and forums

- Create team of designers (skilled in Scratch or Flash)