THE advancement of technology has meant. Technology to help enhance skills for Autistic individuals

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1 RESEARCH TOPICS IN HCI, MARCH Technology to help enhance skills for Autistic individuals Habiba Begum School of Computer Science, University of Birmingham, Edgbaston, Birmingham, West Midlands, B12 2TT Abstract Autism has increased over the decades and technology has advanced with time. This has given researchers the capability to help individuals with autism to learn and practice skills such as communication skills and social skills using technology. Technology can also help in the area of theory of mind. This study seeks to investigate autism and the triad of impairments. The triad of impairments includes communication skills, social skills and mental state. It further looks at what technology can be used to help autistic individuals to enhance their skills. The main technology identified in the use of Computer-Aided Learning (CAL). Social skills are very important to develop as they help us to form friendships and relationships, therefore this paper will seek to identify specifically what applications/tools have been developed to help enhance an autistic individuals social skills. Further work and criticisms are identified and discussed. This includes the methods used to evaluate a software application and the advantages and disadvantages of using Virtual Environments (VEs) and Collaborative Virtual Environments (CVEs). Index Terms Autism, virtual environments, collaborative virtual environments, theory of mind, communication skills, social skills, triad of impairments I. INTRODUCTION THE advancement of technology has meant developers and researchers are now able to help different groups of the population. This includes individuals with a cognitive disorder and individuals with a physical disability. Different people have different needs according to their disorder. This paper focuses on one particular cognitive disorder called Autism Spectrum Disorder (ASD). The number individuals with autism has increased over time. It was found from the statistics Preprint submitted to Research Topics in HCI, March, 2014 gathered by the National Autistic Society (NAS) (as cited in Frith, Morton, & Leslie, 1991), there were approximately 80,000 people in Britain who had autism in Currently, there are approximately 700,000 individuals in Britain with autism; that is 1 in every 100 individuals (The National Autistic Society, 2014). According to research identified by NAS (as cited in Moore, McGrath, & Thorpe, 2000), there are not enough applications available for autistic children. This paper seeks to investigate what impairments are visible in the disorder and what applications have been built to help autistic individuals live normally and help to develop the skills in which they are found to be lacking. Applications to help enhance the individual s understanding and skills is critical for making the individual feel involved in society and not marginalised due to their lack of understanding. Applications can help individual s develop their cognitive, social and communication skills through the use of training software specifically designed to help individuals with autism. II. AUTISM Autism spectrum disorder (ASD), including, Asperger Syndrome (AS), are developmental disorders of the human nervous system (Øhrstrøm, 2011, pp. 54). ASD includes individuals who have high functioning autism (HFA) or AS on one side; these individuals possess characteristics such as narrow interests, impaired social skills, normal or above average intelligence among others. On the other side of the spectrum there are individuals with classic autism with server learning disorders. In the middle there are individuals who have autism and its associated

2 RESEARCH TOPICS IN HCI, MARCH behaviours along with different degrees of learning disorders (Parsons et al., 2000). Asperger Syndrome (AS) is considered a sub-type of ASD (Moore et al., 2000; Parsons et al., 2000). Frith et al. (1991) acknowledged Kanner was the first individual to identify autism in 1943, it is still currently considered to be a behavioural condition. The definition of autism defined by the American Psychological Association (as cited in Frith & Happ, 1994, pp. 116) is, defined at the behavioural level, on the basis of impairments in socialization, communication and imagination, with stereotyped repetitive interests taking the place of creative play. These three major deficits are in literature often referred to as the triad of impairments. Research also identifies people with autism can have other related conditions such as Dyslexia, Dyspraxia, Epilepsy, Attention Deficit Hyperactivity Disorder (ADHD), hearing and visual impairments, Down s Syndrome, Hyperlexia, learning disabilities and among others. It is very common to diagnose an individual with autism with having other accompanying conditions (The National Autistic Society, 2014). To help autistic individuals therapists can help to train and teach autistics to better cope with their conditions and develop skills to minimise the effects of their condition. Occupational therapy is one such service which assesses the specific condition and provides a treatment with activities to help prevent disability and encourage individuals to perform daily activities independently. Occupational therapy can specifically help autistic people to conduct tasks which are performed on a daily basis such as getting involved in social interactions, getting dressed, school activities and playing. The therapist will use techniques and tools such as computer applications/software and social interaction games to encourage interaction (The National Autistic Society, 2014). The National Autistic Society (2014) identify Cognitive Behavioural Therapy (CBT) is a form of psychological therapy to help change the individual s thinking and behaviour. It is the concept of how thinking, feeling and behaving can affect people. Techniques are used to help individual s become more aware of their thinking so that they may change their thinking and their corresponding behaviour. CBT programmes can be designed specifically for that autistic individual. However, CBT requires well trained professionals to deliver the therapy (The National Autistic Society, 2014). Another form of therapy identified by The National Autistic Society (2014) is the daily life therapy. This is a very limited offered specialised education specifically for children with autism. This specialised education in currently in Tokyo, Japan and Boston. Some concepts behind the daily life therapy has also been incorporated into a few schools in the UK. The therapy is a holistic approach and helps children to develop relationships, communicate, relate to others through working on tasks and developing thinking and behavioural skills. This altogether encompasses their development of independence (The National Autistic Society, 2014). There are many different therapies which help individuals with autism. However, these therapies can be expensive for families or carers of autistic people. Therapy sessions may need to be booked, therefore sessions may conflict with other daily plans or routines of the families or carers. Certain types of therapy may not be available in a particular location, therefore putting the autistic person at a disadvantage from receiving the appropriate therapy. Also considering the daily life therapy, a problem which remains is, can the autistic individual practice their learned and developed skills out of the educational environment? and can the skills be transferable? (The National Autistic Society, 2014). On the other hand, the use of computer based applications/software can overcome all of the above disadvantages of therapy. The computer based learning can be conducted at any numerous times of the day. It is much less expensive and affordable. The computer based learning is not location based, therefore allowing for global distribution to all. The computer based learning can help provide different scenarios and situations with different context in which skills can be practised and transferred. The benefits of using such computer based applications is further demonstrated by Lloyd, Forness, and Kavale (as cited in Cheng, Chiang, Ye, & Cheng, 2010), who reviewed 1000 studies which used in-

3 RESEARCH TOPICS IN HCI, MARCH structional methods; it was found computer-assisted learning was much more successful than the use of drugs or social skills training for children with special needs. III. TRIAD OF IMPAIRMENTS Wing identifies (as cited in Frith et al., 1991) the same three main areas of impairments faced by autistic individuals ; including socialisation ( reciprocal interaction ), communication (verbal and non-verbal) and imagination. According to Green (as cited in Moore et al., 2000), autistic individuals are not as imaginative. Jordan, (as cited in Moore et al., 2000) also identified they are not as creative and lack impulse, and often stick to a particular narrow topic of interest ( tunnel vision ). The triad of impairments are further discussed below. Communication: It was pointed out by Jordan (as cited in Moore et al., 2000), autistic individuals have trouble with understanding the importance of communication and therefore trouble with listening to individuals who are trying to communicate with them. This impairment could cause a knock-oneffect in an educational setting and could hinder a child s education and isolate the child. In the case of adults with autism, having limited social skills could hinder their ability to form friendships, as well as keep their job due to their lack of skills in communicating (Parsons et al., 2000). Autistic people cannot handle metaphors or indirect inferences, they take things literally as it is said and do not understand the intentions behind words (Frith et al., 1991; Moore et al., 2000). Frith et al. (1991) identified this was due to their lack of ability to handle mental state expressions ; for example, when asking the autistic individual Can you pass the salt?, the child will simply reply yes, without realising the question included an action behind it (Frith et al., 1991, pp. 116). Theory of Mind: Attwood mentions (as cited in Moore et al., 2000), autistic individuals cannot understand a person s mental state. Frith and Baron-Cohen, (as cited in Moore et al., 2000, pp. 223) found they lack the ability to understand concepts such as pretending, knowing, believing, dreaming, joking, lying and engaging in pretend Fig. 1. Sally Anne Test, illustrated by Scheffler (as cited in Frith et al., 1991) play. This is also referred to as the theory of mind. Theory of mind is defined as the innately given cognitive mechanism allowing a special sort of representation - the representation of mental states (Frith & Happ, 1994, pp. 116). The definition offered by Leslie (as cited in Frith & Happ, 1994, pp. 116) identified the concepts of social understanding and understanding of pretence are connected and include several mental states. This in turn led to the acknowledgement of social and mind impairments autistic individuals have. However, not all autistic individuals lack theory of the mind (Frith & Happ, 1994). It is suggested by Frith et al. (1991), without a normal theory of mind one will find great difficulty in trying to establish social relationships and empathy. An example of not being able to understand false

4 RESEARCH TOPICS IN HCI, MARCH beliefs is provided in figure 1, which presents the simple Sally Anne test. The experiment involves two puppets. Sally has a marble which she places in a basket and leaves the room. Anne removes the marble from the basket and places it inside the box and leaves the room also. Once Sally returns, where will she look for her marble? She will look in the basket for her marble since this is where she last left it. Autistic individuals fail to answer the question correctly, despite knowing the marble was moved by Anne and Sally has no knowledge of this. They do not understand why Sally believed something which was untrue (Frith et al., 1991). Another mental state test conducted is the Inform and Ask function test (figure 2). A normal child will provide the lady with the new information, whereas an autistic child will only provide the information which the lady already knows (Frith et al., 1991). Socialisation and Emotions: (Frith et al., 1991) identified objects and humans are seen as the same to autistic people; the individual can either withdraw from socialising or continue to pester people. They are unaware of their behaviours effecting others around them, therefore making their social interaction bizarre. Autistic individuals do not understand emotions and as such are unable to apply emotions to people and social situations (Cheng et al., 2010; Cheng & Ye, 2010; Moore, Cheng, McGrath, & Powell, 2005; Baron-Cohen, Golan, & Ashwin, 2009). Baron-Cohen et al. (2009) look into whether or not empathy can be taught to autistic children as this is a skill in which this group of people have difficulties with. Before looking at teaching autistic individuals empathy, it is important to understand the concept of empathy. In Baron-Cohen and Wheelwright s definition (as cited in Baron-Cohen et al., 2009, pp. 3567), empathy is the ability to attribute mental states to others, and to respond with an appropriate emotion to the other person s mental states. The definition includes two concepts, the cognitive concept (understanding mental states) and the affective concept (reciprocation to the specific mental state). Baron-Cohen identifies (as cited in Baron-Cohen et al., 2009) the concept of mental states includes thoughts (e.g., person s belief, perceptions, desires etc) and emotions. There are six basic emotions including happy, sad, angry, Fig. 2. Inform and Ask function Test, illustrated by Scheffler (as cited in Frith et al., 1991) afraid, disgusted and surprised (Baron-Cohen et al., 2009, pp. 3567). Griffiths suggested (as cited in Baron-Cohen et al., 2009), there are also other complex emotions which include the use of both the mental state and emotion; these depend on the context of the situation. Swettenham et al., (as cited in Baron-Cohen et al., 2009) found the reason behind the lack of recognition of different emotions is due to the lack of attention to faces, especially eye contact. Baron-Cohen recognised (as cited in Baron-Cohen et al., 2009), despite their deficits in certain skills, autistic individuals have excellent skills in systemizing ; this is the ability to analyse something or to build a system which allows them to predict system behaviours and have control over it. Some of these systems include mechanical related objects, number patterns or rules and computers. This skill could be harnessed to help to

5 RESEARCH TOPICS IN HCI, MARCH teach cognitive empathy (Baron-Cohen et al., 2009). IV. TECHNOLOGIES TO OVERCOME IMPAIRMENTS There are many applications which have been developed over the years to help aid autistic individuals to live and integrate into society. They have also been developed to help provide knowledge of certain areas which they lack skills in such as social skills, communication skills as well as impairments of the mind and understandings of emotion. Baron-Cohen et al. (2009) suggested the use of computer based cognitive empathy teaching is an easy approach as educational applications can be created. Moore et al. (2000) suggested the use of computer-aided learning (CAL) to help teach and guide individuals with autism. Especially since autistic individuals were found to have a natural understanding with computers (Moore et al., 2005). Communication: The use of CAL to enhance skills in linguistics can help to overcome communication problems. Roston (as cited in Moore et al., 2000), mentions the use of a system in which the student and another simulated visual representation of a person have a conversation; in this way the students are practising their conversational skills. Iacono and Miller, (as cited in Moore et al., 2000) suggest using computer or video simulations to help motivate students to communicate. Yates also suggests (as cited in Moore et al., 2000) the use of videos, but to help teach non-verbal communication (e.g., body language, facial expressions). Theory of Mind: Jordan, (as cited in Moore et al., 2000) proposed the use of multimedia simulations to overcome the problem of theory of mind; the use of hypermedia systems could help the individual widen their area of interest. For example, presenting the user with a hypermedia page with their topic of interest and then provide links to understanding specific parts of their topic of interest, which could further go into different but related topics (Moore et al., 2000). Jordan, (as cited in Moore et al., 2000) also found a lack of openmindedness in autistic individuals. Applications such as collaborative learning environments can help to provide students with the means to start conversing about an open debate and become open to ideas (Moore et al., 2000). Socialisation and Emotions: Moore et al. (2000) proposed CAL could be used to teach social rules. Yates, (as cited in Moore et al., 2000) provided an example of personal appearance; the CAL provides rules on how to dress a particular way for different situations and context explaining their differences. The use of simulated social scenarios can be used to provide the user with a number of different situations. Clancy (as cited in Moore et al., 2000) also identifies virtual reality (VR) could be used to teach social skills. Yates further (as cited in Moore et al., 2000) identifies two problems with learning social skills. Firstly, there are many different diverse situations which require different or similar dealings. Secondly, social skills cannot be taught in packages (Moore et al., 2000, pp. 220). For example, Moore et al. (2000) suggests skills such as politeness are broad and need to be taught in smaller units. CAL can overcome these problems, as it can involve a library build up of different scenarios and teaching the skills in smaller units can be achieved (Moore et al., 2000). One benefit Jordan suggests is (as cited in Moore et al., 2000), teaching autistic individuals social skills via a computer based application keeps the individual safe, than if they were to practice their social skills in a real situation and get things wrong. V. ENHANCING SOCIAL SKILLS The particular impairment which will be focused on is social skills, to identify what application have been developed and if they are successful in enhancing the user s social skills. To help individuals with autism develop their social skills there have been many researchers who have suggested or developed an application. Before discussing the use of technology to help enhance social skills, there are several other methods which researchers have identified. Researchers such as Owens et al., (as cited in Baron-Cohen et al., 2009) found the use of Lego therapy could help children with autism experience and gain social skills through building models using Lego in groups of 3. Baron-Cohen et al. (2009)

6 RESEARCH TOPICS IN HCI, MARCH identified this method was found to be indirectly related to computers due to the nature of building systems using sequences. Another interesting form of therapy to help autistic individuals increase their social skills is through the use of trained dogs (Solomon, 2010). The study by Solomon (2010), concluded the use of therapy dogs could help to develop skills in interaction of autistic children, as well as help to develop an emotional connection with the dog and family. Parsons et al. (2000) found previous research which failed to enhance social skills of autistic individuals using techniques such as mentalising or theory of mind. The use of Virtual Environments (VEs) could be used to help enhance a user s social skills in a virtual real world, therefore making it much easier for the user to transition from using their social skills between environments (virtual to real) (Parsons et al., 2000). Parsons et al. (2000) also acknowledged VEs can allow the user s parents or care providers to partake alongside the user; therefore allowing both forms (virtual and real) of social interaction. VEs are very useful to practice social skills as they have the added benefit of providing a safe and secure environment to practice skills, along with other daily tasks that would cause the user great difficulty in the real world (Parsons et al., 2000). It was concluded by the U.K. National Autistic Society (NAS) and the University of Nottingham (as cited in Parsons et al., 2000), the use of VEs could potentially be beneficial in helping to teach autistic individuals life skills. This conclusion was aided by Brown et al. (as cited in Parsons et al., 2000) by the development of a Virtual city by the University of Nottingham were individuals of all ages with a learning disability could practice daily activities around the city. Collaborative Virtual Environments (CVEs) can also be used to enhance social skills. In a CVE there is more than one user and each users avatar can interact with one another, this is represented in Figure 3. The use of CVEs can help autistic individuals as they can be used as a form of assistive technology and an educational tool. Cobb et al. (as cited in Moore et al., 2005) acknowledged CVEs have an advantage which is absent in VEs; in a VE the user can interact with their environment and other programmed Fig. 3. Collaborative virtual environment (Moore et al., 2005) avatars. Therefore, communication and social skills used will be practised in a systematic and predictable manner, whereas with a CVE, the user is interacting with other users in realtime and is free to structure their own conversations. An application developed is the Collaborative Virtual Learning Environment (CVLE)-social interaction system (Cheng & Ye, 2010). This system contains two social scenes, a classroom and an outdoors scene. The student and a teacher are allocated an avatar in order to communicate with each other in a CVLE. The student is shown a 3D fictional story after which the teacher asks a few questions in order to receive an emotional response (e.g. what happened in the pictures?, why do you feel this expression was used? ) (Cheng & Ye, 2010, pp. 1073). The main idea of the system is to see if the student is able to understand and interact with the 3D avatar, as well as recognise non-verbal behaviour of the avatar, such as facial expressions, posture of avatar and gestures. The system also aims to identify if the student s avatar has eye contact and has the appropriate manner and listening skills when speaking to the avatar of the researcher who is also in the CVLE (Cheng & Ye, 2010). Another similar application was developed called the CVLE-3D empathy system (Cheng et al., 2010). It was specifically developed to test if children with autism understood empathy. It uses 3D technology to increase understanding of empathy by presenting real scenarios. The environment in which these scenarios took place was a virtual restaurant. The system allows the child to choose an expressive avatar which represents their emotional state during

7 RESEARCH TOPICS IN HCI, MARCH a specific scenario. The restaurant environment consisted of four scenes, somebody pushing into the line, a stranger occupies an empty seat at the table the subject is eating on, spilled drink on the floor, a customer accidentally slips and falls (Cheng et al., 2010). Results indicated both of these systems proved to have helped participants understanding of empathy and social skills. Baron-Cohen et al. (as cited in Baron-Cohen et al., 2009) created an educational software called the Mindreading DVD ; this is used to help with enhancing one s emotional skills. It teaches emotions which are both basic and complex, including mental states via the use of real faces and vocal audio. There are 412 different emotions and mental states; each of the emotions are conveyed in the software in a way to exploit the autistic individual s enhanced ability of systemising to motivate the software s use. The software allows the individual to replay emotions (proving user control) and pick and choose which emotions they want to see, analyse and remember. Since emotions in the real world are conveyed differently, the software uses 6 different characters to represent diversity to ensure emotions are independent of a particular individual. The emotions also contain categories to help the user identify if the emotion conveyed by the character is indeed sincere or pretend (e.g. the sneaky category). The software allows the user to detect patterns among different emotions with a pre-defined emotion classification in the software (Baron-Cohen et al., 2009). Golan and Baron-Cohen, (as cited in Baron-Cohen et al., 2009) found the results of the software usage indicated an improvement in the users recognition of emotions and mental states; a year later a follow-up showed the users could now form friends and relationships and have shown improvements in their ability to socialise. Moore et al. (2005) look into the role of collaborative virtual environments (CVEs) for autistic individuals. They focus on the ability of autistic individuals to understand emotions represented by avatars. There were 3 stages in their developed system. Figure 4 represents stage 1, the user is asked to identify the emotion displayed by the avatar and is later in Figure 5 asked to select the emotion written in text form for the correct Fig ) Collaborative virtual environment:- Stage 1 (Moore et al., Fig. 5. Collaborative virtual environment:- Stage 1 part 2 (Moore et al., 2005) avatar. Figure 6 represents stage 2 which involves showing the user a scenario in a social context and they are prompted to select the emotion which is used in this particular context. This is important in trying to understand what emotions play part in a particular situation. Figure 7 represents stage 3 of the system which displays an avatar with a specific emotion and the user is prompted to select a situation in which this emotion might occur. The animated use of avatars is used as it was found by Silver and Oakes (2001), systems which included features such as animations, audio s and generally increased interaction were favoured by children with a learning disability (Silver & Oakes, 2001). The system also made use of text-to-speech software so as to enable all individuals to use the system no matter their level of reading skills. Results of the study indicated 90% of the autistic individuals understood the emotions which were displayed by

8 RESEARCH TOPICS IN HCI, MARCH Fig ) Collaborative virtual environment:- Stage 2 (Moore et al., emotions. For example, the CVE created by Moore et al. (2005) only uses 4 basic emotions (happy, sad, angry and frightened). The CVE by Moore et al. (2005) only displays the different emotions using facial expressions. Some emotions might be hard to distinguish between, therefore having the added benefit of displaying an avatar with their body language could help users to further distinguish between emotions, as well as becoming aware of the body languages related to a particular emotion. This area could be further developed and researched to investigate the effects of using a CVE with this feature. George and McIlhagga suggest (as cited in Moore et al., 2005), the system could use emotions ranging on a scale instead of having an absolute labelled emotion. It is also important to mention in the real world social situations are constantly changing and are unpredictable. This could be a problem since autistic individuals have an enhanced ability in systemising, upon which the software application Mindreading DVD was built (Baron-Cohen et al., 2009). However, the Mindreading DVD is commendable in the area of providing diversity within the application (e.g. using a diverse set of characters to portray different emotions). Fig ) Collaborative virtual environment:- Stage 3 (Moore et al., the avatars (Moore et al., 2005). VI. DISCUSSION This research has led to the discovery of many areas which need to be acknowledged. Especially when considering the development of a software for individuals with a specific need as well as the methods which are used to obtain results for a study. This section discusses some of the issues which are present in the studies discussed for social skills and further research areas which researchers could consider. It is identified by Baron-Cohen et al. and Golan and Baron-Cohen (as cited in Baron-Cohen et al., 2009), there are not just 6 basic emotions, but 412 different emotions and other mental states which are acknowledged in the UK. However, some of the different applications only consider a few basic Howlin identifies (as cited in Parsons et al., 2000), the use of too much computer based tasks could lead to the user becoming over-reliant on interacting with the computer rather than interacting with humans. In turn this will cause a knock-oneffect as the user may become fixated with the use of the technology and therefore loose their interest in socialising in the real world; she goes on to suggest practising social skills in a natural setting should be more favoured. The only issue with this approach is that the natural setting will be hard to control and will make the autistic individual feel scared and threatened; many things can go wrong (Parsons et al., 2000). In order to obtain a valid set of results which are representative of this particular population, it is important to have a good number of participants. In the study by Cheng and Ye (2010), their application called the CVLE- Social interaction system was tested on 3 autistic children (1 girl, 2 boys) from the ages of 7-8 years. Again in the study by Cheng

9 RESEARCH TOPICS IN HCI, MARCH et al. (2010), the application called the CVLE-3D empathy system was tested on 3 autistic boys between the ages of 8-10 years. It can be seen from these details not enough female school students are used and so the results obtained are an over representation of male school students. Therefore, differences between genders cannot be viewed. This could essentially be helpful in identifying whether or not females or males with autism have a harder time at learning social skills. Furthermore, both studies concluded the findings were preliminary and neither study applied their results to the rest of the population, but were specific in applying their conclusions to just the participants within the study (Cheng & Ye, 2010; Cheng et al., 2010). In a study by Moore et al. (2005), 34 participants were included (29 boys, 5 girls) between the ages of 7-16 years. Although a huge number of participants were used and could potentially be a representative sample of the population, there is still the issue of an over representative sample of boys. The reason for the over-representative sampling could be due to the out-numbering of boys to girls diagnosed with autism (4 to 1) (Bartley, 2006). Moore et al. (2005) acknowledged CVE can also be used as an educational tool and can be used for group work. This can allow social skills to be gained in a realistic situation. It allows users to practice their social skills and make mistakes without consequences; this will allow the user to feel safe and secure. However, Beardon et al. (as cited in Moore et al., 2005), suggested social skills learnt on the VEs may not be so very well used face-to-face. Social situations in VEs and CVEs can only be represented in so many ways. What about social situations in ones daily life which involve sarcasm or unfriendly encounters? How is the autistic individual taught to deal with such situations? Hadwin, Baron-Cohen, Howlin, and Hill, (as cited in Cheng & Ye, 2010), found teaching emotions in a social situation to children with autism did not improve their ability to apply these emotions to real world settings. However, it was further found by Cheng et al. (2010), the children in their study conducted could identify and understand the different empathic behaviours which were displayed by the 3D characters and were able to further use the learned empathetic behaviours appropriately with other students. It was also found by Parsons and Mitchell (as cited in Cheng & Ye, 2010), teaching social understanding to adults with autism, showed some were able to apply the knowledge to real situations. From these findings it is clear that there are inconsistencies within the results found by different studies. There could be many factors involved such as different age groups, genders, levels of IQ among others. Further research into the use of VEs and CVEs can be the solution to helping individuals with autism enhance their skills, not just in socialisation, but communication skills and mental states. They can be used as assistive technology as they can allow users to communicate with other users via avatars and it is not as threatening when interacting with an individual up front (Parsons et al., 2000; Moore et al., 2005). Parsons and Mitchell (as cited in Moore et al., 2005), acknowledged interactions made on the CVE is slow compared to real interactions and therefore provides time for the autistic user to use their problem solving skills to identify what is appropriate to do in this particular scenario. CVE can be used as a form of social networking for individuals with autism who have trouble communicating face-to-face. Through this social networking individuals can enhance their social skills and understanding (Moore et al., 2005). Other forms of technology could also be used to help improve social skills and communication skills in autistic children such as robots. Wainer, Dautenhahn, Robins, and Amirabdollahian (2010) conducted a study where autistic children played a dyadic video game with an adult and then played the same game but with a child sized autonomous humanoid robot called Kaspar (Figure 8). Kaspar was designed to look like a boy of aged three which could make simple gestures, facial expressions, head movements and blink its eyes. The study investigated whether of not after playing with Kaspar, the child would be more socially engaging and communicate with the adult when playing the game. Results of the study showed an improvement in their collaboration and co-operation with the human adult. In a study conducted by Parsons, Mitchell, and Leonard (2005), an investigation was conducted into whether or not autistic users complied with social conventions in the VE. Two situations were

10 RESEARCH TOPICS IN HCI, MARCH Fig. 11. Socially inappropriate to walk between (Parsons et al., 2005) Fig. 8. Kaspar, the autonomous humanoid robot (Wainer et al., 2010) Fig. 12. Socially appropriate to walk between (Parsons et al., 2005) Fig. 9. Staring point, on route to the café (Parsons et al., 2005) Fig. 10. Approaching café (Parsons et al., 2005) examined, first on the way to a virtual café it is usually the convention to walk on a path and cross the road (Figure 9, Figure 10); secondly when inside the café, is it appropriate for the users to walk in-between two people having a conversation (Figure 11); this was considered an inappropriate behaviour. Two people who were facing back-to-back was an appropriate situation to walk in-between (Figure 12). It was found participants with autism were more likely to not use the crossing and foot path to get to the café, participants felt it fine and acceptable to walk through the flowers and grass to get to the café. The majority of the participants walked between the two people who were having a conversation to get to the bar. The autistic participants did not see how walking between two people in a conversation could be socially inappropriate; it was seen as the straightforward way to get from one place to the other. Therefore, further research is needed to investigate different behaviours used in different context (Parsons et al., 2005). Future studies should consider the behaviour of participants between the real and virtual world. It is

11 RESEARCH TOPICS IN HCI, MARCH suggested by Travis et al. and Loveland et al. (as cited in Parsons et al., 2005), to help children with autism enhance their social skills, techniques such as allowing the child to describe an animated social scene and also allowing the user to compare actual behaviour with measures of verbalizable knowledge and social responsiveness should be used (Parsons et al., 2005, pp. 112). REFERENCES Baron-Cohen, S., Golan, O., & Ashwin, E. (2009, December). Can emotion recognition be taught to children with autism spectrum conditions? Philosophical Transactions of the Royal Society B: Biological Sciences, 364(1535), (PMID: ) doi: /rstb Bartley, J. J. (2006). An update on autism: Science, gender, and the law. Gender Medicine, 3(2), doi: Cheng, Y., Chiang, H.-C., Ye, J., & Cheng, L.- h. (2010, December). Enhancing empathy instruction using a collaborative virtual learning environment for children with autistic spectrum conditions. Computers & Education, 55(4), doi: /j.compedu Cheng, Y., & Ye, J. (2010, May). Exploring the social competence of students with autism spectrum conditions in a collaborative virtual learning environment the pilot study. Computers & Education, 54(4), doi: /j.compedu Frith, U., & Happ, F. (1994, April). Autism: beyond theory of mind. Cognition, 50(13), doi: / (94) Frith, U., Morton, J., & Leslie, A. M. (1991, October). The cognitive basis of a biological disorder: autism. Trends in Neurosciences, 14(10), doi: / (91) R Moore, D., Cheng, Y., McGrath, P., & Powell, N. J. (2005, November). Collaborative virtual environment technology for people with autism. Focus on Autism and Other Developmental Disabilities, 20(4), doi: / Moore, D., McGrath, P., & Thorpe, J. (2000). Computer-aided learning for people with autism a framework for research and development. Innovations in Education & Training International, 37(3), doi: / The national autistic society. (2014). Retrieved , from Øhrstrøm, P. (2011, May). Helping autismdiagnosed teenagers navigate and develop socially using e-learning based on mobile persuasion. The International Review of Research in Open and Distance Learning, 12(4), Parsons, S., Beardon, L., Neale, H., Reynard, G., Eastgate, R., Wilson, J.,... Hopkins, E. (2000). Development of social skills amongst adults with aspergers syndrome using virtual environments: the as interactiveproject.. Parsons, S., Mitchell, P., & Leonard, A. (2005, February). Do adolescents with autistic spectrum disorders adhere to social conventions in virtual environments? Autism, 9(1), (PMID: ) doi: / Silver, M., & Oakes, P. (2001, September). Evaluation of a new computer intervention to teach people with autism or asperger syndrome to recognize and predict emotions in others. Autism, 5(3), (PMID: ) doi: / Solomon, O. (2010). What a dog can do: Children with autism and therapy dogs in social interaction. Ethos, 38(1), doi: /j x Wainer, J., Dautenhahn, K., Robins, B., & Amirabdollahian, F. (2010). Collaborating with kaspar: Using an autonomous humanoid robot to foster cooperative dyadic play among children with autism. In Humanoid robots (humanoids), th ieee-ras international conference on (pp ).