Monday, March 9, 2009

Virtual world teaches real-world skills

Game helps people with Asperger's practice socializing

If home is where the heart is, then home for a dozen people with Asperger Syndrome could be a 16-acre island blessed with lush gardens and rolling green hills.

The island is called "Brigadoon," but unlike its literary namesake, this place is real — or real enough in a 21st century way. "Brigadoon" belongs to a public virtual world called "Second Life," a popular online 3-D environment frequented by tens of thousands of users.

Tom Loftus
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If home is where the heart is, then home for a dozen people with Asperger Syndrome could be a 16-acre island blessed with lush gardens and rolling green hills.

The island is called "Brigadoon," but unlike its literary namesake, this place is real — or real enough in a 21st century way. "Brigadoon" belongs to a public virtual world called "Second Life," a popular online 3-D environment frequented by tens of thousands of users.
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"Brigadoon" is a real-world experiment in social skills made virtual, a private enclave limited to a select mixture of caregivers and individuals with Asperger Syndrome, a higher functioning form of autism. The inhabitants, or "Dooners" as they call themselves, enjoy the same privileges as those in the more public arenas of "Second Life." They are free to create their own digital representations of themselves, called "avatars," build virtual houses and seek out friends. And, most importantly, they are free to create a "second life" with a level of social interaction that, for reasons of their condition, has been hard to come by in their real lives.

Is gaming a good thing?
Talk of video gaming can set off feelings of unease among parents — no one wants a kid to be glued to a screen for hours on end. But the stakes for children with Asperger's and other autism spectrum disorders — who have difficulties with social interaction — tend to be higher.

At issue is the importance of developing enriching personal relationships and becoming a part of society. While video games can be educational and entertaining, their reputation as a solitary activity can present an impediment to progress for people with autistic disorders by limiting their exposure to social situations.

Researchers are also concerned that playing video games could simply become one of the many repetitive activities that an affected child engages in.

"One feature that highlights the risk of video games is that the behavior of children with autism can be repetitive. They like sameness and routine," says Sally Ozonoff, an associate professor of psychiatry at the MIND Institute at the University of California, Davis. This preference for repetition and familiarity often limits their experiences and prevents them from learning how to adapt to new situations.

But if used correctly, video game technology could be beneficial. "Children with autism have a natural inclination to video games and television," Ozonoff adds. "The goal is to try to exploit that inclination therapeutically."

New technology in the works
Researchers around the world are now attempting to do just that. At the University of Victoria in British Columbia, cognitive psychologist James Tanaka is using a custom-built game called "Let's Face It!" to teach facial recognition. Actually a suite of mini-games, the program uses photos, sounds and positive feedback as part of a scoring system to encourage kids with autism to learn.

"You can have kids do an exercise, but they usually don't have the richness or the continuity [of the video game]," says Tanaka.

Meanwhile, researchers at the University of Edinburgh and Glasgow Caledonian University are creating video games to study cognitive skills in children with autism using a revolutionary interface: gesture recognition software that registers the players' movements and transfers them to the screen.

"From my work, I know that a lot of children [with autism] have production skills we never would expect," says Maggie McGonigle, leader of the project and an expert on non-verbal communication. "So I'm hoping that language-like skills are locked up in their brain even if they can't speak."

But in the small world of video games with real-life applications for people with autistic disorders, "Brigadoon" stands out.

When "Brigadoon" founder John Lester, an information systems director at Massachusetts General Hospital and research associate at Harvard Medical School, discovered the virtual world "Second Life," one of the first things that came to mind was how he could share the experience.

A decade earlier, Lester had founded Braintalk Communities, a self-help support site dedicated to neurological conditions. "I'm big on creating spaces where patients and caregivers can share experiences and emotional support and essentially help themselves," he says.

"Second Life" was different. Although not exactly a game, it was rooted in 21st century game technology. In gaming parlance, "Second Life" was "immersive," a world that's both three-dimensional (think "Halo 2") and "persistent," meaning the world is always up and running.

"A lot of what's happening in 'Second Life' is social," says Lester. "And I thought that this could be a fantastic place for people dealing with Asperger Syndrome. Give them a simulated environment and let them practice social skills in a three-dimensional space."

Individuals with Asperger's usually aren't comfortable in social situations, but many display an innate understanding of computer technology. These two factors — social deficiencies and computer knowledge — made them perfect candidates to test "Brigadoon."

Last year Lester purchased a virtual island in "Second Life," invited participants from Braintalk Communities to establish a claim, and in July 2004, "Brigadoon" was launched.

Although virtual, it's possible to explore "Brigadoon" like a real-world island. On a recent personal tour, Lester and "Brigadoon" resident Jamison Read, a mother of a son with Asperger's, showed off the sights.

The tour began inside the Temple of Zeus, a meeting place positioned at the top of "Brigadoon's" highest hill. There are meeting places throughout the island — precisely the type of spaces that individuals with Asperger's would avoid in the real world.

"That's what most of the spaces around "Brigadoon" are focused on," says Lester.

The tour led to a valley and past an aquarium inhabited by a jumping shark created by an individual with Asperger's who goes by the online name of Coos Yellowknife. Nearby, a virtual screen mixed snapshots of past "Brigadoon" social events, like a virtual lobster dinner, with photos from the real-world.

"People with Asperger Syndrome get pretty 'beat up' by society," says Read. "Here they can go at their own pace and move into the mainstream."

Read originally joined "Brigadoon" to discover if the game would help her son who has Asperger's. He is still figuring out if he wants to join, but for Read there was something about "Brigadoon" — its whimsy, the ability to be creative with colorful virtual gardens and homes, and its reputation as a safe haven — that compelled her to stay.

"I have learned a lot about [Asperger Syndrome] from the adults here, so I am trying to help my son counter some of the problems he will have as an adult," she says.

"Brigadoon" is still an experiment. It is small in size — just 16-acres if the island existed in the real world — as well as in population. The world may be rich in color, but communication is limited to instant text messaging. When compared to the $10 billion video game industry, "Brigadoon" and its host world "Second Life" register as a mere blip on the radar.

But in a field where the quest to lead an enriching and "normal" life is measured by even the smallest steps, "Brigadoon" may be a sign of how video game technology can be used for good.

Lester is already convinced. "[The inhabitants] have learned a lot about themselves in how they socialize and they've gained confidence," he says.

And, as the "Dooner" named Coos wrote in a "Brigadoon" blog, "We are aliens in this RL [real world]. SL ['Second Life'] has showed me it is OK to be an alien in a strange new world!"

Monday, March 2, 2009

Study uses music to explore the autistic brain's emotion processing

Music has a universal ability to tap into our deepest emotions. Unfortunately, for children with autism spectrum disorders (ASD), understanding emotions is a very difficult task. Can music help them? Thanks to funding from the GRAMMY Foundation Grant Program, researchers at UCLA are about to find out.

Individuals with ASD have trouble recognizing emotions, particularly social emotions conveyed through facial expressions — a frown, a smirk or a smile. This inability can rob a child of the chance to communicate and socialize and often leads to social isolation.

In an innovative study led by Istvan Molnar-Szakacs, a researcher at the UCLA Tennenbaum Center for the Biology of Creativity, music will be used as a tool to explore the ability of children with ASD to identify emotions in musical excerpts and facial expressions.

"Music has long been known to touch autistic children," Molnar-Szakacs said. "Studies from the early days of autism research have already shown us that music provokes engagement and interest in kids with ASD. More recently, such things as musical memory and pitch abilities in children with ASD have been found to be as good as or better than in typically developing children."

In addition, he said, researchers have shown that because many children with ASD are naturally interested in music, they respond well to music-based therapy.

But no one has ever done a study to see if children with ASD process musical emotions and social emotions in the same way that typically developing children do.

In this study, Molnar-Szakacs will use "emotional music" to examine the brain regions involved in emotion processing.

"Our hypothesis is that if we are able to engage the brain region involved in emotion processing using emotional music, this will open the doorway for teaching children with ASD to better recognize emotions in social stimuli, such as facial expressions."

The overarching goal of the study, of course, is to gain insights about the causes of autism. Molnar-Szakacs will use neuroimaging — functional magnetic resonance imaging, or fMRI — to look at and compare brain activity in ASD children with brain activity in typically developing kids while both groups are engaged in identifying emotions from faces and musical excerpts.

"The study should help us to better understand how the brain processes emotion in children with autism; that, in turn, will help us develop more optimal interventions," Molnar-Szakacs said. "Importantly, this study will also help us promote the use of music as a powerful tool for studying brain functions, from cognition to creativity."

Approximately 15 children with ASD, ranging in age from 10 to 13, will participate in the study, which is being conducted under the auspices of the Help Group–UCLA Autism Research Alliance. The alliance, directed by UCLA's Elizabeth Laugeson, is an innovative partnership between the nonprofit Help Group, which serves children with special needs related to autism, and the Semel Institute for Neuroscience and Human Behavior at UCLA, and is dedicated to enhancing and expanding ASD research. The project is also being conducted in collaboration with Katie Overy, co-director of the Institute for Music in Human and Social Development at the University of Edinburgh, Scotland.

"The hope, of course, is that this work will not only be of scientific value and interest, but most of all, that it will translate into real-life improvements in the quality of the children's lives," Molnar-Szakacs said.

Early Intervention Lessens Impact Of Autism

ANN ARBOR, Mich. -- Contrary to popular fears that half of autistic children will never speak, new findings by the University of Michigan show just 14 percent of autistic children are unable to talk by age 9 and 40 percent can speak fluently.

Early intervention leads to better treatment, said Catherine Lord, director of the U-M Autism and Communication Disorders Center. The center has been conducting a sweeping longitudinal study of children with autistic spectrum disorders (ASD) that started when participants were age 2 and followed them over many years with most of that subject group now in their teens.

The number of children diagnosed with the disorder has increased tenfold over the past decade.

Lord, a nationally known pioneer in autism research, played a key role in learning how to properly diagnose 2-year-olds a decade ago and is making new gains diagnosing young children at the U-M center. She is confident the University's research will make it routine to diagnose autism for children just 18 months old and sometimes even younger.

While medications have helped with related conditions such as depression and hyperactivity, the best way to deal with autism is to intervene as early as possible to treat the condition, she said. Children who developed even some very simple speech skills prior to the first time they were evaluated at age 2 were far more likely to overcome the disorder that is now found in one out of every 200 children, she added.

"One third make incredible progress, with almost all children making real gains, even if they continue to have significant difficulties," Lord said. "About 5 percent of the children we have followed do not have symptoms of autism at age 9."

Another 10 percent are doing well but still have some mild social difficulties and or repetitive behaviors or interests. Another 10 percent clearly have behaviors associated with autism but are able to compensate enough to spend much of their time in mainstream activities and classes, she said. The rest do improve, but continue to have behaviors and difficulties associated with the ASD, according to Lord.

The center is also working on research showing autism "is very unlikely caused by a single gene," Lord said, adding that parents of a child with autism have only a 5 to 10 percent chance of having another child with autism. Having a fraternal twin with autism similarly gives the child the same odds of developing the disorder.

However, if one identical twin has autism, there is a 95 percent chance the other identical twin will develop ASD or a related disorder, Lord said.

Autism is a complex developmental disability that typically appears during the first three years of life. Autistic spectrum disorders impact the normal development of the brain processes related to social interaction and communication skills. Children and adults with autism typically have difficulties with verbal and non-verbal communication, social interaction and leisure or play activities.

The center is conducting many studies and is especially looking for children aged 12-24 months old whose parents are concerned about possible ASD or related communication delays as well as children from families with two or more members have the disorder. A study of normal communication development from 12 to 24 months is also under way that should yield important information about the early stages of language development. For more information about participating in the research studies, call the center at (734) 936-8600.