Google Glass helps kids with autism read facial expressions.
Wearing a device that identifies other people’s facial
expressions can help children with autism develop better social skills, a
Stanford pilot study has demonstrated.
Alex took part in a pilot study in which a smartphone app
paired with Google Glass was shown to help children with autism understand
emotions conveyed in facial expressions.
Children with autism were able to improve their social
skills by using a smartphone app paired with Google Glass to help them
understand the emotions conveyed in people’s facial expressions, according to a
pilot study by researchers at the Stanford University School of Medicine.
Prior to participating in the study, Alex, 9, found it
overwhelming to look people in the eye.
Gentle encouragement from his mother, Donji Cullenbine,
hadn’t helped. “I would smile and say things like, ‘You looked at me three
times today!’ But it didn’t really move the bar,” she said. Using Google Glass
transformed how Alex felt about looking at faces, Cullenbine said. “It was a
game environment in which he wanted to win — he wanted to guess right.”
The therapy, described in findings published online Aug. 2
in npj Digital Medicine, uses a Stanford-designed app that provides real-time
cues about other people’s facial expressions to a child wearing Google Glass.
The device, which was linked with a smartphone through a local wireless
network, consists of a glasses-like frame equipped with a camera to record the
wearer’s field of view, as well as a small screen and a speaker to give the
wearer visual and audio information. As the child interacts with others, the
app identifies and names their emotions through the Google Glass speaker or
screen. After one to three months of regular use, parents reported that
children with autism made more eye contact and related better to others.
The treatment could help fill a major gap in autism care:
Right now, because of a shortage of trained therapists, children may wait as
long as 18 months after an autism diagnosis to begin receiving treatment.
“We have too few autism practitioners,” said the study’s
senior author, Dennis Wall, PhD, associate professor of pediatrics and of
biomedical data science. Early autism therapy has been shown to be particularly
effective, but many children aren’t treated quickly enough to get the maximum
benefit, he said. “The only way to break through the problem is to create
reliable, home-based treatment systems. It’s a really important unmet need.”…
Typically developing children learn to recognize emotions by
engaging with people around them. For children with autism, it’s different.
“They don’t pick those things up without focused treatment,” Wall said.
In the study, 14 families tested the Superpower Glass setup
at home for an average of 10 weeks each. Each family had a child between the
ages of 3 and 17 with a clinically confirmed autism diagnosis.
The families used the therapy for at least three 20-minute
sessions per week. At the start and end of the study, parents completed
questionnaires to provide detailed information about their child’s social
skills. In interviews, parents and children also gave feedback about how the
program worked for their families.
The researchers designed three ways to use the
face-recognizing program: In “free play,” children wear Google Glass while
interacting or playing with their families, and the software provides the
wearer with a visual or auditory cue each time it recognizes an emotion on the
face of someone in the field of view. There are also two game modes. In “guess
my emotion,” a parent acts out a facial expression corresponding to one
of the eight core emotions, and the child tries to identify it. The game helps
families and researchers track children’s improvement at identifying emotions.
In “capture the smile,” children give another person clues about the emotion
they want to elicit, until the other person acts it out, which helps the
researchers gauge the children’s understanding of different emotions.
Families told the researchers that the system was engaging,
useful and fun. Kids were willing to wear the Google Glass, and the devices
withstood the wear and tear of being used by children.
Twelve of the 14 families, including Alex’s, said their
children made more eye contact after receiving the treatment. A few weeks into
the trial, Alex began to realize that people’s faces hold clues to their
feelings. “He told me, ‘Mommy, I can read minds!’” Cullenbine said. “My heart
sang. I’d like other parents to have the same experience.”
Families whose children had more severe autism were more
likely to choose the game modes rather than free play, the researchers
reported.
The children’s mean score on the SRS-2, a questionnaire
completed by parents to evaluate children’s social skills, decreased by 7.38
points during the study, indicating less severe symptoms of autism. None of the
participants’ SRS-2 scores increased during the study, meaning nobody’s autism
symptoms worsened. Six of the 14 participants had large enough declines in
their scores to move down one step in the severity of their autism
classification: four from “severe” to “moderate,” one from “moderate” to “mild”
and one from “mild” to “normal.”
The results should be interpreted with caution since the
study did not have a control arm, Wall said. However, the findings are
promising, he added.
Parents’ comments in interviews helped illustrate the
improvements, he said. “Parents said things like ‘A switch has been flipped; my
child is looking at me.’ Or ‘Suddenly the teacher is telling me that my child
is engaging in the classroom.’ It was really heartwarming and super-encouraging
for us to hear,” Wall said.
His team is currently completing a larger, randomized trial
of the therapy. In addition, they also plan to test the therapy in children who
have just been diagnosed with autism and are on a waiting list for treatment.
Stanford University has filed a patent application for the technology.
Jena Daniels, Jessey N. Schwartz, Catalin Voss, Nick Haber,
Azar Fazel, Aaron Kline, Peter Washington, Carl Feinstein, Terry Winograd &
Dennis P. Wall. Exploratory study examining the at-home feasibility of a
wearable tool for social-affective learning in children with autism. npj
Digital Medicinevolume 1, Article number: 32 (2018) https://www.nature.com/articles/s41746-018-0035-3#Abs1
Although standard behavioral interventions for autism
spectrum disorder (ASD) are effective therapies for social deficits, they face
criticism for being time-intensive and overdependent on specialists. Earlier
starting age of therapy is a strong predictor of later success, but waitlists
for therapies can be 18 months long. To address these complications, we
developed Superpower Glass, a machine-learning-assisted software system that
runs on Google Glass and an Android smartphone, designed for use during social
interactions. This pilot exploratory study examines our prototype tool’s
potential for social-affective learning for children with autism. We sent our
tool home with 14 families and assessed changes from intake to conclusion
through the Social Responsiveness Scale (SRS-2), a facial affect recognition
task (EGG), and qualitative parent reports. A repeated-measures one-way ANOVA
demonstrated a decrease in SRS-2 total scores by an average 7.14 points
(F(1,13) = 33.20, p = <.001, higher scores indicate higher ASD severity).
EGG scores also increased by an average 9.55 correct responses
(F(1,10) = 11.89, p = <.01). Parents reported increased eye contact and
greater social acuity. This feasibility study supports using mobile
technologies for potential therapeutic purposes.
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