The Influence of Augmented Reality on Emotional Processing and Empathy in Children with Autism Spectrum Disorder (ASD)
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Abstract
Background: Children with autism spectrum disorder frequently experience difficulty recognizing facial expressions, interpreting emotional cues, and responding appropriately to social situations, which can affect communication, classroom participation, family interaction, and peer relationships. Augmented reality may support emotional learning by providing structured, visual, interactive, and repeated practice within a therapist-guided environment. Objective: To evaluate the influence of augmented reality-based emotional training on emotional recognition, empathy response, and social interaction among children with autism spectrum disorder in Peshawar, Pakistan. Methods: A controlled pre-test and post-test study was conducted among 40 children with diagnosed autism spectrum disorder aged 6–12 years. Participants were divided into an augmented reality plus routine therapy group and a routine therapy-only control group, with 20 children in each group. The intervention was delivered for eight weeks, with three sessions per week. Emotional recognition, empathy response, and social interaction were assessed before and after the intervention using structured tasks, therapist-rated assessment, observation, and caregiver feedback. Results: After eight weeks, the augmented reality group showed greater improvement than the control group across all outcomes. Emotional recognition improved from 13.4 ± 4.2 to 22.6 ± 3.8 in the augmented reality group compared with 13.1 ± 4.4 to 15.0 ± 4.2 in the control group. Empathy response increased from 16.7 ± 5.1 to 28.4 ± 4.6 compared with 16.2 ± 5.4 to 18.0 ± 5.2, while social interaction improved from 12.9 ± 4.0 to 21.8 ± 4.3 compared with 12.6 ± 4.1 to 14.3 ± 4.0. Conclusion: Augmented reality-based emotional training was associated with greater short-term improvement in emotional recognition, empathy-related responses, and social interaction among children with autism spectrum disorder when used alongside routine therapy. The findings support augmented reality as a practical adjunctive tool for structured socio-emotional learning in rehabilitation and special education settings.
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1. Lord C, Elsabbagh M, Baird G, Veenstra-Vanderweele J. Autism spectrum disorder. Lancet. 2018;392(10146):508-520. doi:10.1016/S0140-6736(18)31129-2.
2. Zeidan J, Fombonne E, Scorah J, Ibrahim A, Durkin MS, Saxena S, et al. Global prevalence of autism: A systematic review update. Autism Res. 2022;15(5):778-790. doi:10.1002/aur.2696.
3. Maenner MJ, Warren Z, Williams AR, Amoakohene E, Bakian AV, Bilder DA, et al. Prevalence and characteristics of autism spectrum disorder among children aged 8 years — Autism and Developmental Disabilities Monitoring Network, 11 Sites, United States, 2020. MMWR Surveill Summ. 2023;72(2):1-14. doi:10.15585/mmwr.ss7202a1.
4. Hodges H, Fealko C, Soares N. Autism spectrum disorder: Definition, epidemiology, causes, and clinical evaluation. Transl Pediatr. 2020;9(Suppl 1):S55-S65. doi:10.21037/tp.2019.09.09.
5. Smith T, Iadarola S. Evidence base update for autism spectrum disorder. J Clin Child Adolesc Psychol. 2015;44(6):897-922. doi:10.1080/15374416.2015.1077448.
6. Wong C, Odom SL, Hume KA, Cox AW, Fettig A, Kucharczyk S, et al. Evidence-based practices for children, youth, and young adults with autism spectrum disorder: A comprehensive review. J Autism Dev Disord. 2015;45(7):1951-1966. doi:10.1007/s10803-014-2351-z.
7. Grynszpan O, Weiss PL, Perez-Diaz F, Gal E. Innovative technology-based interventions for autism spectrum disorders: A meta-analysis. Autism. 2014;18(4):346-361. doi:10.1177/1362361313476767.
8. Berenguer C, Baixauli I, Gómez S, Andrés MEP, De Stasio S. Exploring the impact of augmented reality in children and adolescents with autism spectrum disorder: A systematic review. Int J Environ Res Public Health. 2020;17(17):6143. doi:10.3390/ijerph17176143.
9. Khowaja K, Banire B, Al-Thani D, Sqalli MT, Aqle A, Shah A, et al. Augmented reality for learning of children and adolescents with autism spectrum disorder: A systematic review. IEEE Access. 2020;8:78779-78807. doi:10.1109/ACCESS.2020.2986608.
10. Dechsling A, Orm S, Kalandadze T, Sütterlin S, Øien RA, Shic F, et al. Virtual and augmented reality in social skills interventions for individuals with autism spectrum disorder: A scoping review. J Autism Dev Disord. 2022;52:4692-4707. doi:10.1007/s10803-021-05338-5.
11. Zhang M, Ding H, Naumceska M, Zhang Y. Virtual reality technology as an educational and intervention tool for children with autism spectrum disorder: Current perspectives and future directions. Behav Sci. 2022;12(5):138. doi:10.3390/bs12050138.
12. Bai Z, Blackwell AF, Coulouris G. Using augmented reality to elicit pretend play for children with autism. IEEE Trans Vis Comput Graph. 2015;21(5):598-610. doi:10.1109/TVCG.2014.2385092.
13. Chen CH, Lee IJ, Lin LY. Augmented reality-based self-facial modeling to promote the emotional expression and social skills of adolescents with autism spectrum disorders. Res Dev Disabil. 2015;36:396-403. doi:10.1016/j.ridd.2014.10.015.
14. Chen CH, Lee IJ, Lin LY. Augmented reality-based video-modeling storybook of nonverbal facial cues for children with autism spectrum disorder. Comput Human Behav. 2016;55:477-485. doi:10.1016/j.chb.2015.09.033.
15. Cihak DF, Moore EJ, Wright RE, McMahon DD, Gibbons MM, Smith CC. Evaluating augmented reality to complete a chain task for elementary students with autism. J Spec Educ Technol. 2016;31(2):99-108. doi:10.1177/0162643416651724.
16. Escobedo L, Tentori M, Quintana E, Favela J, Garcia-Rosas D. Using augmented reality to help children with autism stay focused. IEEE Pervasive Comput. 2014;13(1):38-46. doi:10.1109/MPRV.2014.19.
17. Lorenzo G, Gómez-Puerta M, Arráez-Vera G, Lorenzo-Lledó A. Preliminary study of augmented reality as an instrument for improvement of social skills in children with autism spectrum disorder. Educ Inf Technol. 2019;24:181-204. doi:10.1007/s10639-018-9768-5.
18. Liu R, Salisbury JP, Vahabzadeh A, Sahin NT. Feasibility of an autism-focused augmented reality smartglasses system for social communication and behavioral coaching. Front Pediatr. 2017;5:145. doi:10.3389/fped.2017.00145.
19. Vahabzadeh A, Keshav NU, Abdus-Sabur R, Huey K, Liu R, Sahin NT. Improved socio-emotional and behavioral functioning in students with autism following school-based smartglasses intervention. Behav Sci. 2018;8(10):85. doi:10.3390/bs8100085.
20. Sahin NT, Keshav NU, Salisbury JP, Vahabzadeh A. Second version of Google Glass as a wearable socio-affective aid: Positive school desirability, high usability, and theoretical framework in a sample of children with autism. JMIR Hum Factors. 2018;5(1):e1. doi:10.2196/humanfactors.8785.
21. Keshav NU, Vahabzadeh A, Abdus-Sabur R, Huey K, Salisbury JP, Liu R, et al. Longitudinal socio-emotional learning intervention for autism via smartglasses. Educ Sci. 2018;8(3):107. doi:10.3390/educsci8030107.
22. Nag A, Haber N, Voss C, Tamura S, Daniels J, Ma J, et al. Toward continuous social phenotyping: Analyzing gaze patterns in an emotion recognition task for children with autism through wearable smart glasses. J Med Internet Res. 2020;22(4):e13810. doi:10.2196/13810.
23. Yeung MK. A systematic review and meta-analysis of facial emotion recognition in autism spectrum disorder. Neurosci Biobehav Rev. 2022;133:104518. doi:10.1016/j.neubiorev.2021.104518.