Software for Teaching Social Skills to People with Autism: Great Idea or Expensive Gimmick?
SIMmersion is developing a simulated character to help individuals with Autism Spectrum Disorder practice conversation skills in the hopes of improving employability and quality of life. Adults and adolescents can practice identifying and responding to complex social cues such as tone of voice, body language, and idioms when they speak to Sam Martin™.I took a look at their demo (linked from their front page), and I was very impressed. This is some high end technology - and it looks like it's versatile and believable. I'm told that the technology may run into problems when a user slurs his speech or uses unusual language - but of course I haven't had a chance to find out whether that's really the case.
I have to wonder, though: why the technology? A decent human actor should be better equipped than any software to present a wide range of responses to challenge and build social skills. And, since human interaction is qualitatively different from interacting with a machine, it seems to me to make sense for folks with autism to practice with the real thing. Folks with autism may find a real person more anxiety-provoking than a computer. But successfully coping with that anxiety is key to making successful human connections.
This particular program is just the latest in a string of new applications intended to build social skills through artificial intelligence. If you have a moment, why don't you take a look at the SIMmersion demo and let us know what you think. Is this tool a great idea? Or just an expensive gimmick?
Comments
I think it is a valid tool for HFA’s and Asperger’s folks, who usually like to work on the computer. Maybe it’s a good first step before they try the new skills with a live person. Also, I heard that “Second Life” is very popular with young people on the spectrum.
You say “A decent human actor should be better”, but who has an actor in their home who would spend hours helping?
As the mom of an autistic child, I think this is a fabulous idea.
My son, like many other autistic people, is more comfortable interacting with computers than people. He’s also very motivated to use technology in a way that he is not to interact with people. Motivation and comfort lead to better learning.
Why force someone to tackle anxiety and social skills at the same time? A software program would allow individuals to focus on one at a time. Now if someone would just create programs like this in a kid accessible format…
I agree with Mary. The author is overlooking a number of points, not the least of which is the cost involved in a live actor (who is also always consistent) and therefore unaffordable to almost everyone.
There are many benefits to using technology, especially since children and yound adults on the spectrum enjoy using it! Technology enables repetitive practice, at the learner’s own pace, at the learner’s own time, in a consistent manner that is non-threatening, while being engaging. Presumably, if the learner practices often under these conditions and is inclined to practice more, then it will be more effective.
My company is working on a similar approach with our product called Social Simentor. we have a prototype and will be doing a feasibility study to test its effectiveness with young people with autism. we have already tested it for other cognition issues and the learners thoroughly enjoyed it.
It also has the advantage of being able to quickly produce simulations, to change character types easily, and to create simulations for very specific situations versus more general approaches.
I’m curious Mary…what do you consider a “kid accessible format”?
When I refer to a “decent actor,” I’m not talking about trained Equity talent! I mean Mom or Dad or teachers or social skills coaches who can act out situations.
I do this quite often with my son: I pretend to be someone with whom he has an issue, and I respond to him “in character.” Of course, this isn’t the same thing as actually BEING the person, but it certainly seems to help.
One of the things I think is tough about technological “people” is that, of course, they don’t know the actual situation that the person with autism is facing. For example - Tom (my son) may need to figure out how to manage his angry feelings toward another child for a perceived slight. As his mom, I actually know what the slight was, who the child is, and how that child might respond. I can also discuss Tom’s (often inappropriate) responses to me in the role of that child.
Lisa (autism guide)
Lisa, you are obviously an observant, caring, and responsible parent. I agree with your approach. However, what you are doing is reactive to a situation, versus being proactive by anticipating situations that may arise. These can also be described as life skills, such as interviewing for a job, learning how to respond to a co-worker, asking for a raise, learning to respond to criticism - the list could go on forever! Simulations, using technology, can assist parents in preparing their children for these life skills and allow them to practice before they are confronted by actual scenarios. Technolgy can never replace good parenting, but it can, when used appropriately, augment and reinforce the teaching of life skills which will hopefully lead to greater independence and self-reliance.
Studies have shown that, like Applied Behavior Analysis, technology fails to work in the long term as does one-on-one coaching.
While autistics see the benefits of engaging in social behavior, it is a conscious choice whether or not to engage in it. Most autistics opt out.
The reason: A warm grin, a nice tone, and a firm handshake are the best mask for an outright, blatant, bald-faced lie.
How many people who are reading this have bought lemon cars from the sort of “nice, warm, and friendly” person I have described above? how many of you have had “good friends” who have back-stabbed you? How many have had “nice” boyfriends and girlfriends and husbands and wives who cheated, stole your money, turned out to be abusers, etc.?
Autistics listen to what people say. If what people say at some later date contradicts what they have said earlier, socializing with such people is pointless because such people are liars. Meanwhile, a social person who looks at body posture, facial expressions, and how firm the handshake is gets duped.
Autistics, from what they tell me, recognize that social norms change many times withing a single generation, and that LISTENING TO WHAT PEOPLE SAY is the best method for finding honest and worthwhile friends.
Thomas,
wow … that was sad. Yet, sadder still are the people who can’t even join the conversation to find out the nuances of fake or contrived politeness. However, working in an entry level job will be a lot easier if one is trained in the social niceties that are required by society. Once practiced in this and if in the right cognitive level, some subtleties can be taught.
The polite special education student has a better chance in a mainstream classroom than one we failed to teach. If software can help the teacher with this task, thank goodness. It is certainly labor intensive.
Technology offers some real opportunities for practice, practice, practice.
some is better than none and life is never perfect for anyone at any level.
chris
Hi Chris,
A good response.
But I wanted to restate my point to make it more clear: Autistics who are capable of making conscious choices much prefer to be themselves, even if it means being honest and forthright to their detriment.
There is indeed a direct benefit to using taught behaviors in the appropriate situation. The higher an autistic wants to function within a social unit, the more the autistic will be tempted to use what he or she has been taught.
However, doing such requires giving up one’s individuality. At least, that is what I am getting from the autistics who can make their feelings known. We’re talking not just Aspies here but HFAs and some PDD/NOS folks.
In most instances, it is not some sort of laziness, or a lack of knowledge about what to say or do. It is a refusal to engage in behaviors in a way that they feel is morally and ethically wrong.
From a non-autistic standpoint, such moral quibbles over “white lies” and “guilding the lilly”, hyperbole, exaggeration, etc., are not a big deal and seem very rigid. But autistics see such things as falsity, and so for the sake of clarity, they say what they mean.
When one thinks about it, a job interview is a social dance. If you were an employer, and asked a candidate:
“How well do you know Excel?” would you rather hear:
1) I know everything there is to know about it,
or
2) I’ve been working at it for year, but I’m coming up a bit short on working with formulas.
when the candidate in question really has the skills expressed in answer number two?
If I were an employer, I’d be more inclined to hire an honest worker who immediately owns up to the fact that s/he might need training now and then than a person who might make a major mistake because they are pretending to know more than they do.
Early on in an autistic’s life, autistics are more receptive to learning social norms and mores because the rewards are tempting: Cookies and treats. Praise, etc. But once the leave the school environment and the treats and praise disappear, they realize that what they have in essence been trained to do -and for rewards, no less- is to maintain a poise and a representation of themselves that does not really exist.
More bewildering to them is when they realize that EVERYONE has either been trained or else has an innate instinct for this sort of deception, and so not only do they abandon their training, but they become more introverted as well, only using what they have learned in situations where they see no other way to achieve their goals.
It has been expressed to me by many on the spectrum that a big frustration is to work harder than others and achieve a higher level of output and quality, but to be passed up for a promotion to a higher level because they had poor social skills. If one sees “social skills” as being deceptive in nature, then one can see how frustrating it is that an entire social system is based on this construct, and how terrible it is that honesty and hard work get one nowhere.
THIS is why autistics tend not to excel in life to the degree that non-autistics do. There are of course certain exceptions to the rule, Bill Gates being one of these.
Dear Thomas,
I don’t have time to respond to all of the issues you have brought up here. You definitely have more direct interaction on a personal level than I do. I have been a teacher and administrator for many years and currently work in a residential school for students with special needs. We have kids on the spectrum of all ages. I will say that at the graduation of the 8th graders, I used a tissue when at “open mike comments” a young student stood up and said this was the first time in his life he had friends. So I was left with the impression that this was important in his particular life and we specifically teach how to be a friend. It is a social dance. And fraught with the potential for disappointment and dishonesty. That happens in mainstream relationships all the time. No one is protected from this kind of hurt. But chosing not to interact continues to tear at my heart when I think someone may say they prefer to be alone when they really do want friendship but don’t have the resources or skills to negoitiate that.
and I am currently the HR person who does hire. And yes, I want you to be honest. But we teach our kids who interview to say: “Wow, I don’t know everything I would like to know about Excel. But I know I learn quickly and would take advantage of any training you offer….or some comment like that that communicates willingness and enthusiasm.
And finally, there is a big continuum in level of possibilities that corresponds to the academic and cognitive levels ….I employ a terrific teacher who is clearly on the spectrum; he is very bright and able to really understand his kids…but his cognitive ability allows him to self reflect and adjust his behavior accordingly.
society requires rules and people who live by them…your personal life can be guided by your own rules. If you work for an employer, you must live by those rules.
Technology has been a very important component of the education we provide….we have a plazma smartboard and internet access in every class…it helps the teacher to have multi media and other tech software to make the time more entertaining and as I said before, practice practice practice is often less boring on the computer
have a great day ….your thoughtful comments produced much reflection
chris
Ok…maybe I’m looking at this from a more simplistic view point…but what exactly is the harm in having one more tool as an OPTION for parents to consider for their child? I have to tell you that as a mom of a child with ASD who would rather play ANY video game than engage in many other activities…I would at least consider it. I would rather see my son play a game like that which may help him to have some context for a situation he may encounter than have him play most of the video games out on the market. True, he may still choose not to engage, react in a less than stellar fashion or may totally refuse to act in what is deemed a socially acceptable fashion; however, he would at least have an opportunity to have some experience and context whith which to frame a potential response. I’m sorry, I can not possibly provide a social story or role play every scenario in the human experience for him. While interacting with real people is always preferable in OUR minds…we have to remember the target audience. Sometimes, he just ENJOYS getting away and being the one who can control the situation. (Ever watch a child with ASD set the controls on a game so they have an advantage? Watch closely if you said “no” to that question.) At least in this respect there just possibly MIGHT be some redeeming value to the “treat” of playing a video game other than improving his hand-eye coordination and being able to have some topic of conversation another NT peer can relate to through the universal appeal of video games. I realize that this type of game may diminish that conversation starter; but then again, it might help to keep the conversation going. Just like anything else in the world of Autism–it’s for the indvidual to determine if it works for him or her. All I can add is that at least it’s not blaming the parents (specifically Mom) for something they did, didn’t do or should have thought of for a change!
Hi Chris,
Again, good points. Excellent response. Just wanted to reply to a couple things (and want to add that this blog does not seem to accept http:// links and so you will have to look up the articles cited via “Googling” the titles of them).
You said:
“I will say that at the graduation of the 8th graders, I used a tissue when at “open mike comments” a young student stood up and said this was the first time in his life he had friends. So I was left with the impression that this was important in his particular life and we specifically teach how to be a friend.”
My reply:
Many, if not most, autistics of course want friends if they can have them. I think one of the most basic essentials that human beings want is to connect with one another, although the definition of “friend” can vary from person to person. (With one autistic in particular, I have had to correct the perception that his psychologist was his friend. Nor was a someone who loaned him a book a friend in the sense that we would define a friend.)
You said:
“But chosing not to interact continues to tear at my heart when I think someone may say they prefer to be alone when they really do want friendship but don’t have the resources or skills to negoitiate that.”
My reply:
It is important to demonstrate to others what friendship is, how to be a friend, how to understand when a person is not being friendly, etc. I would not at all discourage this type of training and mentoring.
But something to remember is that even though from your perspective it is sad that some people would prefer to be alone, from THEIR perspective, they may be perfectly happy and self-actualized, and so trying to tell them that their point of view is wrong is not a good thing.
Also, it pays to remember that merely providing and reinforcing the behaviors associated with friendship does not mean that autistics will be “treated” for having been exposed to these lessons. Like any other subject we learn in school, we can make a conscious choice to retain them or abandon them, and, as I have witnessed, many autistic choose to abandon “friendship training” upon completion of the course.
One thing that ought to be noted is that autism is less prejudiced against in some cultures, which makes the integration of autistics into society much easier than in the western world.
In “Ethnic differences in mothers perception of the negative impact of having a child with Autism.” we read that…
“Surprisingly, a race difference was found. The researchers found that African American mothers reported lower negative impact of having a child with autism when compared to Caucasian mothers.”
Although the following four articles teeter on the rim of “junk science” there is some truth to the assertion that:
“Gaze Aversion as a Positive Sign”
in autistics, and then there is this:
“Scientist: Smiling can hurt your health”
And then…
“People who bottle up may fare better after trauma, new research suggests”
And finally…
“Preschool Kids Do Better When They Talk To Themselves, Research Shows”
Going back into the realm of credibility:
“Autistic Children Recognize Stereotypes Based On Race And Sex, Study Suggests”
“Culture Fundamentally Alters the Brain”
“Scans Show Different Growth for Intelligent Brains”
My points:
Despite the fact that (junk) science and in some cases reputable science is now starting to acknowledge that the way autistics perceive and respond to life’s circumstances is potentially beneficial, “culture” requires autistics to be reshaped into something that stands to hurt, not help them.
While it is unrealistic, I suppose, to expect that we would be able to teach the social majority to be more accepting of autistics, I belive it is unfair to expect that autistics conform to a type of social structure that is naturally aversive to them. We can certainly provide the social skills training, but…well…you can lead a horse to water, but you cannot make him drink.
One needs to keep in mind that most of the therapies once relied upon to treat autistics are failing or being outed as frauds or are being shuttered due to mismanagement. The most recent of these was The Dore Group’s Australia division.
“ADHD help firm goes bust owing $1 million”
said:
“The Dore Group promoted drug-free products as being able to assist with a range of neurological conditions including dyslexia, dyspraxia, ADD and ADHD, and Asperger’s syndrome.
“The company’s liquidator today said the firm would be referred to the corporate watchdog and out-of-pocket clients were unlikely to get any money back.”
If you go here to Autism Watch, you can read up on the increasing list of “Quack” remedies that have been scientifically discounted:
Doubtful or Discredited Treatments
Auditory Integrated Training (link to ASAT)
Chelation Therapy (link to Chelation Watch)
Dietary Supplements
Dore treatment (link to Mental Health Watch)
Homeopathy (link to Quackwatch)
Facilitated Communication (posted 9/16/04)
Hyperbaric oxygen
Irlen Method (link to ASAT)
Lupron
Secretin
Sensory Integration (link to ASAT)
Stem cell treatments
Tomatis Method
Legal and Regulatory Actions
Disciplinary Actions against Stephen B. Edelson, MD
Disciplinary Action against Robert Sinaiko, MD
Facilitated Communication Device Marketers Settle FTC Charges (posted 9/16/04)
FDA Seizes Taurine Capsules (posted 10/11/04)
Docket of Omnibus Autism Proceeding
What the Poling Autism Case Means (posted 3/14/08)
Nonrecommended Information Sources
A-CHAMP
Autism Recovery Network
Austism Society of America
Autism Treatment Trust (formrly Action Against Autism)
AutismOne
Defeat Autism Now (DAN)
Forum on Alternative and Innovative Therapies (Lewis Mehl-Madrona, MD, PhD)
Generation Rescue
Genetic Centers of America (Mark R. Geier, MD, PhD)
Institute for Chronic Illnesses
Moms Against Mercury
National Autism Association
National Autistic Society (United Kingdom)
National Vaccine Information Center
Neuro Immuno Therapeutics Foundation (Hugh Fudenberg, MD)
NoMercury
Safe Minds
Talk about Curing Autism (TACA)
The Autism Autoimmunity Project (TAAP)
Unlocking Autism
Whole Child Network
Nonrecommended Books (posted 5/13/05)
I have a direct association with a number of branches of the Autism Society of America, so I have a problem with Autism Watch’s listing the entire organization as being off, although I will freely admit that some branches are way out there.
But the thing is, if we all tried to get into the hearts of autistics on that level, we would make more progress with their development than if we just keep trying to fit them into OUR idea of what is right and correct.
Hi Sharon,
“Ok…maybe I’m looking at this from a more simplistic view point…but what exactly is the harm in having one more tool as an OPTION for parents to consider for their child?”
Absolutely nothing, provided the tool is a credible one that has been proven to work. At this point in time, only intensive behavioral therapy and animal therapy have been proven to work on autistics, but their success is limited. Additionally, only one drug has been approved by the US FDA for autism, and that is Risperdone. It mostly controls anxiety, but little else.
“I have to tell you that as a mom of a child with ASD who would rather play ANY video game than engage in many other activities…I would at least consider it. I would rather see my son play a game like that which may help him to have some context for a situation he may encounter than have him play most of the video games out on the market.”
I can see your point of view, and I happen to agree that these video games are indeed much more potentially useful than any old violent videogame on the market.
“True, he may still choose not to engage, react in a less than stellar fashion or may totally refuse to act in what is deemed a socially acceptable fashion; however, he would at least have an opportunity to have some experience and context whith which to frame a potential response.”
He would indeed.
But one needs to recognize that there is no “magic bullet” for each social situation, and where autistics get confused is when they apply what they are promised is a “sure fire” method in a social situation and get blasted for it.
The biggest of these misfires is “the smile.” My colleague and I were at a French Club picnic in Ontario Canada at a party. We were able to identify an Aspie there, and sure enough, he was indeed diagnosed. A young boy of 8. My colleague, being on the French Club Board of Directors was going around snapping pictures of everyone for publicity and when it came to the boy and his father, his father kept saying “Smile! Smile!”
To which the boy replied: “I AM smiling!”
His father said “That it a SMIRK! Not a SMILE!” Get that off your face and SMILE!” in response to which the boy cried.
But since my colleague and I work with aspies, she was able to tell that the little upturn on the corner of the boy’s face was a smile, and she explained this to the father, who was relieved that she understood. He then went on (in French of course) to speak about what an embarrassment it was that no one understood that his son was smiling when to all who knew him, he was. She asked him why he would force his son to go against his nature, and then his son piped up:
“Yah dad! Why do you force me to go against my nature?” or something to that effect.
After that, the boy was in a much better mood.
“I’m sorry, I can not possibly provide a social story or role play every scenario in the human experience for him.”
And no one can. But let’s remember that the reason such programs and products exist for enrollment or purchase is because the people touting these products or programs know how to do what the parents don’t. A parent can become a great mentor for their children by learning what the professionals do and working with their own kids one on one.
“Just like anything else in the world of Autism–it’s for the indvidual to determine if it works for him or her.”
Yes, but from an Aspie perspective, what these kids are REALLY thinking is “Hey, more video games!” I doubt they are really internalizing much from them. If, for example, their perseverative interest is the game playing itself, they will jettison anything that has nothing to do with their interest and just focus on what they like.
To be fair, this particular piece of software was not originally created for people with autism.
If you take a look at the demo, you’ll see it was created for typical folks who are likely to encounter unusually difficult situations (interviewing witnesses, for example) so that they can practice their techniques. I haven’t actually seen the version intended for people on the autism spectrum. My guess is that it works quite well for typical individuals who are determined to improve their skills - but it may be quite different for a child who is more interested in playing the “game.”
I must say that my son, at least, becomes quite anxious when he’s confronted with a real-life novel interaction - and tends to get rather rude just to avoid engaging. In fact, now that he’s nearly 12 I’ve noticed that he ignores the “rules” of polite interaction (which he had internalized years ago)… not sure if that’s adolescence, increased anxiety, or what! He’s completely different when the situation is more controlled, and he knows what to expect (eg, with family and close friends).
That being the case, I wonder whether he’d master the game without actually mastering the skills or managing the anxiety?
Lisa (autism guide)
you said:
“I must say that my son, at least, becomes quite anxious when he’s confronted with a real-life novel interaction - and tends to get rather rude just to avoid engaging. In fact, now that he’s nearly 12 I’ve noticed that he ignores the “rules” of polite interaction (which he had internalized years ago)… not sure if that’s adolescence, increased anxiety, or what!”
Once kids of any age begin to think abstractly, they also begin to think deeper, and become more independent as a result.
But your son, being on the spectrum, has probably realized that practical instruction that worked when he was younger is not applicable to the more complex social interactions of his current age group, thus he has once more become introverted, which is his natural and most comfortable inclination.
“He’s completely different when the situation is more controlled, and he knows what to expect (eg, with family and close friends).”
yes, and the reason for this is becnause the rules in such situations remain consistent and unchanged, thus he feels that he can better apply what he has learned in the past to those situations.
The degree of applicability of what has been learned to adult situations is almost entirely useless, which is why one tends to see almost a total reversion after therapy ends.
“That being the case, I wonder whether he’d master the game without actually mastering the skills or managing the anxiety?”
If he is video-game savvy, he would do so.
There are games in existence where one has to bargain their way out of complex situations, either through trade or establishing some sort of relationship with the antagonist. I have seen autistics win at such games but fail miserably when similar situations confront them in real life.
The operative word of course is “similar.” No situation is identical, and people are not video games, nor do the respond to people like pre-programmed games would.
Let’s say a person drops something. You pick it up for them and hand it to them. They say “Thank you.”
What is the correct response?
“You’re welcome,” one would think.
But what if the person is saying “Thank you” sarcastically because you have given back to the person something they have thrown away, and they think by giving it back to them you are commenting on their littering in a political activist/environmentalist way?
Then if you say “You’re welcome!” they see it as a further taunt, and they get even more angry at you.
These social nuances happen all the time. More so when one becomes an adult.
In a video game, saying “You’re welcome” to “Thank you” might get you points and so you know to say it every time if you want the points. But in the real world, saying “You’re welcome” could get you punched in the face, and so you refrain from saying it if you can at all help it.
I think it might be very helpful for some kids, fairly high functioning. Ironically, I think my 15-year-old grandson would absorb more from a cartoon character (he talks to “Mario”, etc. a lot.) He would have trouble with an actual human appearing to be a robot; there’s a disconnect. He’s terrible with body language himself though.
I didn’t see any price information, which would be a big factor.
I know it helped my son to play a game with a face at www.learn2do.com when he was young. He could use it over and over and over again. I KNOW it helped him discern facial features of anger, wonder, surprise in a general way based on the slant of the eyebrows, size and shape of the eyes and mouth. YES, I’ll be interested in this product.
Leslie Walker-Hirsch
lesliewh@computer.net
www.lesliewalker-hirsch.com
This has certainly been an interesting discussion!
I have been helping students with autism and other developmental and intellectual and emotional disabilities to learn social skills for more than 25 years. It has been my experience that many students have difficulty and frustration when they want to express their desires or interests or to recount an event that has happened to them and need to create language under pressure to communicate this information. When they get overwhelmed with anxiety or frustration, or time pressure, they often have so much difficulty creating language that they use behavior to communicate instead. Certainly behavior is a strong communication tool, but when the behaviors are so socially undesirable, repulsive or dangerous to themselves and/or others, they are shunned and the talents they may have to offer become unavailable.
Practice, especially in an enjoyable, non-judgmental environment, in producing and remembering language is certainly an important element in learning. Technology never loses patience, rolls its eyeballs when a wrong answer is given, or has other demands placed upon it like a parent would have (such as converse with a spouse, cook a meal, attend to the needs of other children in the family). Software will not replace human contact! NOR SHOULD IT!! It is an additional vehicle to engage a student in practice at coping using language rather than behaviors that allows a student to withdraw instead of learning to manage the situation.
Being socially skilled does not need to consist of lying or gilding the lily. Social skill involves getting what you want and need AND at the same time remaining likeable AND maintaining important relationships.
Perhaps not everyone chooses to learn these skills, but learning anything involves change. We all change as we learn more about ourselves and our world. We learned to use fire and the wheel and that changed how we live and what we expect.