Can Second Life therapy help with autism?

For people with Asperger's syndrome and other autism spectrum disorders, social interactions can prompt excruciating anxiety. Cognitive neuroscientist Sandra Bond Chapman, PhD, is working to help them with a virtual, interactive platform that fosters their ability to communicate more comfortably and effectively with others.

With a therapist's guidance, patients enter a protected area in Second Life designed to help them practice communicating and negotiating in realistic settings. (The area—which is simply a location within the cyberworld—is secured so patients can't enter the main part of Second Life, which Chapman believes could be overly confusing and disorienting for them.) As in Second Life, both patient and therapist create avatars, or virtual representations of themselves. The therapist's avatar—backed by a real therapist watching from a different room—enters the scene when the client needs help. More avatars, created with the help of the client's friends, relatives or other clinicians, can inhabit the scenes as well.

Depending on the issues a person needs to work on, various challenges arise. A boy with Asperger's who has difficulty making friends, for instance, may enter a lunchroom where his task is to find a lunch mate. But he may encounter two children already engaged in conversation, which can both raise his anxiety and—with the therapist's help, if necessary—propel him to use skills he has difficulty with, such as initiating small talk or seeking out another friend. Meanwhile, an adult may enter an apartment where she must confront her roommate's sloppy housekeeping.

Chapman, chief director of the Center for BrainHealth at the University of Texas at Dallas (www.centerforbrainhealth.org), is developing the project with her colleagues, brain-imaging specialist Daniel Krawczyk, PhD, also at the center, and schizophrenia expert Carol Tamminga, MD, in the university's department of psychiatry.

While Chapman's work to date has involved mostly people with Asperger's and autism, the team wants to expand its scope to see if a similar intervention could help people with other conditions that include a social-deficit component. To this end, they have recently launched a pilot study to test different versions of the intervention with 45 adults with either Asperger's syndrome, high-functioning schizophrenia or brain injury, as well as 45 children with either autism or Asperger's syndrome, attention-deficit hyperactivity disorder or brain injury. Scenarios will be tailored to fit the unique needs of each population and each individual, says Chapman. The work is funded by the Lattner Family Foundation, the Wacker Foundation and the Sparrow Foundation.

Given the promising results so far with people with Asperger's, Chapman—whose work with patients with autism conditions began some 30 years ago—says it's the first time she's really felt hopeful about helping her clients improve how they communicate and build relationships.

"We now know that the brain doesn't learn just by teaching someone rules," she says. "It's only by real-life experiences, by training the brain in social situations, that people can develop some competence in these areas."

So far, it looks like the virtual world may be a great place to do that, she says.

—T. DeAngelis