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Innovative New Therapy Could Help Children With Autism Read Facial Cues

Alex, a 9-year-old participant of the Superpower Glass trial, smiles at his mother while wearing the device. Steve Fisch/Stanford Medicine

A new form of social therapy for children with autism spectrum disorder (ASD) that uses a smartphone app paired with Google Glass shows promise for improving their ability to recognize the emotions underlying facial expressions and increasing initiation of eye contact, according to a pilot study by Stanford University.

Because it is used at home with the child’s family, rather than in appointments with specialists, the technology-based approach could enable more ASD children to receive early intervention – known to be critical for high functioning later in life – and allow them to become at ease in real-world social interactions.

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“We have too few autism practitioners,” lead researcher Dennis Wall said in a statement. “The only way to break through the problem is to create reliable, home-based treatment systems. It’s a really important unmet need.”

Writing in npj Digital Medicine, Wall and his colleagues describe how the system was developed to treat the social deficits of ASD using the same principles as the gold standard therapies of applied behavioral analysis (ABA) and naturalistic developmental behavioral interventions (NDBIs). First, they created and evaluated a Google Glass program that can detect eight universal facial expressions through its camera: happiness, sadness, anger, disgust, surprise, fear, neutral, and contempt. Then, the team incorporated this facial recognition software into an app that uses the device’s screen and speaker to provide audiovisual feedback to the user about the expressions of people in the field of view and engage them in identifying the associated emotions through structured games.

In the current investigation, Wall’s group evaluated the finished system – named “Superpower Glass” – in 14 ASD children aged 3 to 17. The participants and their families were required to complete three or more 20-minute sessions per week for at least one month and up to 4.5 months. Children could choose between a free-play mode and two game modes.

Results from behavioral questionnaires filled out by participants’ parents before and after the trial began showed that 100 percent of children had improvements in ASD social symptoms. Six children had significant enough score decreases that their ASD classification could be changed to a less severe class (four went from “severe” to “moderate”, one from “moderate” to “mild”, and one from “mild” to “normal”).

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Interviews with the families revealed that 12 of the 14 children made more eye contact after using Superpower Glass and all children were willing to wear the device.

Donji Cullenbine, the mother of 9-year-old participant Alex, told the Stanford News Center that the Superpower Glass facilitated a breakthrough that had eluded the family previously.

“I would smile and say things like, ‘You looked at me three times today!’ But it didn’t really move the bar. [The device] was a game environment in which he wanted to win – he wanted to guess right,” she said.

After a few weeks of sessions, Alex happily began to pick up on emotional cues. “He told me, ‘Mommy, I can read minds!’ My heart sang. I’d like other patents to have the same experience.”

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Despite the overwhelmingly positive feedback, the authors are cautious to jump to conclusions about efficacy due to the lack of a control group, which prevented them from accounting for natural changes in the children's behavior over time. A larger, randomized control trial that will evaluate an updated version of the system is in the works.


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