Neural mechanisms of behavioral change in young adults with high-functioning autism receiving virtual reality social cognition training: A pilot study.
Y J Daniel Yang, Tandra Allen, Sebiha M Abdullahi and 3 others
PMID 29517857WHAT IT FOUND
Young adults with high-functioning autism showed higher emotion recognition scores after 10 hours of virtual reality social cognition training over 5 weeks; theory-of-mind gains were less certain.
Key findings
01After VR-SCT, emotion recognition scores increased from a mean of 11.41 to a mean of 12.94 on the ACS-SP scaled score, with P = 0.03 reported by the authors.
02Theory of mind total scores increased from 19.41 to 20.35; the authors reported P = 0.06 on two-tailed testing and P = 0.03 on one-tailed testing.
03Individual improvements in theory of mind were associated with increased activation in the right posterior superior temporal sulcus, while improvements in emotion recognition were associated with decreased activation in the left inferior frontal gyrus/ventrolateral prefrontal cortex.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
There was no control group or randomization; all 17 participants received the training, so pre-post changes cannot be separated from time, practice, or other factors. The sample was small (N = 17) and mostly male (15 of 17), limiting generalizability. All participants were high-functioning, with full-scale IQ 88 to 131, and VR-SCT required IQ at least 80, so findings do not address lower-functioning adults. The intervention was a package combining virtual avatars, coach feedback, and conversation practice, so the contribution of any single component cannot be separated. The theory-of-mind change was marginal on two-tailed reporting (P = 0.06), so it should not be treated as a clear effect. Primary outcomes were limited to emotion recognition and theory of mind; the authors noted that interaction behaviors and conversation skills were not measured. Changes were measured only after the 5-week intervention, with no follow-up to test maintenance or generalization. Some participants lacked available ADOS subdomain scores. The data set overlapped with a previously reported neuroprediction study, although the current analyses focused on different questions.
Declared interests
The authors declared no conflict of interest.
The easy way to misread this
Do not conclude that VR-SCT is an established treatment for adults with autism. This was a 17-person treatment-only pilot with no control group, the theory-of-mind change was marginal on two-tailed reporting, and the intervention combined virtual avatars, coach feedback, and conversation practice so the active component is unclear.