VR Therapy: Multisensory Experience
Identifying the User
First session
Abizar Bagasrawala, Wu Di, Danqing Gao and Alex Samland conducted a series of observations with people with autism in April and May of 2017. They observed Nishan DeCosta, a few students at Park School (Evanston) and Ethan Ducayet on separate occasions. The purpose of the sessions was to find one user who would be willing to try a virtual reality headset, who would benefit from this experience and who would be able to give us feedback. We supplemented our observations with conversations with the user’s parents, teachers and/or therapists. This appendix briefly summarizes the methodology used to conduct each observation, the key learnings from each session and the results of the observations.
To briefly summarize our results, we concluded from the session with Nishan DeCosta that he was not at the correct developmental stage to use a VR headset. From sessions at Park school, we shortlisted a few students as potential users. However, we realized that these users were not accessible enough for further user observation and user testing, and concluded that these users would not be suitable for our project. From sessions with Ethan Ducayet, we learned that Ethan would be a suitable and available users.
Methodology
​
The observation with Nishan DeCosta took place in his house on Wednesday, April 12th, between 5 and 6 pm.. Abizar and Wu Di were present. The observation guide prepared for this session could not be followed because it assumed that Nishan would respond to questions, which was not the case. The observation was guided by Emma DeCosta, Nishant’s mother, because she was able to maintain Nishan’s attention and interpret what we observed. We observed Nishan playing a game about laundry on the iPad, reading the story of “Pete the Cat” to him, watching a Youtube video of a social story called “Being Angry and Safe”. and We then observed Nishan trying on the VR headset with a simulation of a bus. Abizar engaged Nishan while Wu Di took notes of the session
​
Information about Nishan
​
Nishan is a 7 year-old child with autism. According to his mother Emma DeCosta, he has the following traits
-
He is quite social and enjoys being around people.
-
He experiences difficulty with language processing and speech.
-
He feels overwhelmed by new environments, and has difficulty with sensory regulation.
Additionally, his mother Emma DeCosta had used social stories with him when his therapist was leaving in order to make it easier for Nishan to cope with the departure.
​
Key learnings
​
In this section, I shall summarize the key learnings from the session. The detailed observations that led to these learnings can be found in Table 2 at the end of the page. On the whole, we learned that Nishan is extremely competent at using his iPad and would be able to quickly learn any new technology. He is able to learn something when it is taught using repetition. In order to engage Nishan, we would need to adopt technology that incorporates aural, tactile and visual components. Additionally, we learned that Nishan would not be able to give us verbal feedback for our project. We would have to have his mother Emma DeCosta or a therapist interpret his reactions to gain feedback from VR. However, after we observed Nishan trying on the VR headset, we learned that he would not be a suitable user for VR because he did not seem engaged or interested enough in it. He also found it difficult to differentiate between virtual reality and reality as he had not reached that developmental stage yet, according to his mother. As such, we would have to look for a different (possibly older) user.
Second session
Objective of sessions
​
Abizar and Danqing conducted three observation sessions at Park school between 9:30 and 10:30 am on April 17, 19 and 21 respectively. No observation guide was prepared as we had only received permission to observe (and not interact with) the students. Special attention was paid to the students’ social skills, learning abilities, use of technology and attention span. We were looking for a student between the ages of 13 and 22 as this was the age range our client was targeting. We had also learnt by working with Nishan that younger children would not be suited to VR. In the classroom, we observed the students do several learning tasks such as “matching pictures to words”, reading social stories, watching videos on Youtube and completing jobs (such as separating blocks according to color).
​
Information of first classroom
​
Abizar observed the first classroom during the first session while Danqing observed this classroom during the second session. The first classroom had 5 students (Student A, B, C, D and E) between the ages of 17 and 21. Student D was not autistic and was not observed during these sessions. Student E was only present during the second session.
​
Information about second classroom
​
Abizar conducted the third observation session in this classroom. There were 5 students (Student F, G, H, I, J) between the ages of 13 and 18. This classroom had greater focus on using technology. The teacher took attendance by projecting the students’ faces onto a projection screen, after which the students in class would say whether the particular student is present or not. Student I was not autistic and was not observed.
​
Key learnings
​
In this section, I shall summarize the key learnings from Park School. The detailed observations that led to these learnings can be found in Table 3 and Table 4 at the end of the page. At the sessions, we were able to observe the spectrum of autism, which helped us understand Dr. Stephen Shore’s quote of “if you've met one person with autism, you've met one person with autism.” The students had different levels of engagement, focus, patience, social abilities, verbal skills, predictability of behavior and adeptness with technology.
We concluded that students B, C, E, F and J would be suitable users for VR because they would either be able to give us feedback about the VR experience, were interested in using technology, or were able to interact with new people and engage in new activities. If a student met 2 of these requirements, we concluded that he/she was suitable for VR. However, due to privacy issues, we were not able to work with these students for our project.
Third session
Before we met Ethan Ducayet on May 7th, we had a phone conversation with Joan Ducayet, Ethan’s mother. We had our first meeting with Ethan at Noyes L station. We took a train to Davis Station and then walked to Forever Yogurt. We ate yogurt, conversed and watched Ethan try the VR headset for 30 minutes there and then walked around in CVS Pharmacy before we took the train back to Noyes. We prepared two rubrics about riding the train and Ethan’s experience in VR that we intended Ethan to fill out. However, he refused to fill out any of these rubrics. Our second meeting was on May 10th at The Garage at Northwestern University. There, we observed Ethan use two applications on the HTC VIVE. For details on Ethan's experiences with VR, click the button on the right or go to User Testing page. The following table will only describe why Ethan is a suitable user for our project:
​
​
Table I1: Observations and interpretations from interaction with Ethan Ducayet
Relevant Observations
​
​
Ethan mentioned that he got his Ventra card in December 2012 and it expires in 2017. He also mentioned several other facts that exhibited attention to detail and excellent memory.
​
​
​
Ethan was able to use his Ventra card, board the train, and exit at the correct stop with apparent ease.
​
​
​
​
​
Ethan mentioned that he doesn’t like social stories because they are not real.
​
​
​
​
Ethan was able to walk into a new environment he had never walked into before (i.e. The Garage) without any outward signs of disorientation or panic. He communicated as he did in our previous interaction with him. However, he insisted on taking the train back even though the rest of the team wanted to walk.
​
​
Ethan agreed to fill out a survey, and typed out his responses in a Google Sheet.
Joan Ducayet’s
(mother of Ethan) inputs
​
Ethan achieved an A in AP computer science.
​
​
​
​
​
​
Ethan carries a basic phone instead of a smartphone while travelling, so that he can remain focussed on the stops.
​
​
​
​
​
After the age of 10, Ethan stopped liking social stories because he realized that people are trying to manipulate his behavior.
​
​
Ethan went to traditional school, Evanston Township High School.
​
​
​
​
​
​
​
​
​
Ethan likes to fill out rubrics. He agreed to eat hamburgers in Chicago when his mother suggested that he can rate the hamburger with a rubric.
Interpretations
​
​
Ethan is able to integrate information from his surroundings and communicate that information. He also has a specific interest in topics such as trains and computers and is able to display his mastery of these fields.
​
​
Ethan is able to take the train and do other day-to-day activities if he can remain focussed upon it. Since Ethan is interested in technology, we believe that he should be able to focus on the VR experience.
​
​
Ethan would require less explicit social therapy than social stories.
​
​
​
​
Ethan is able and ready to learn new experiences. This makes him ready to try the VR headset. One aspect of social therapy we could work on is how to teach Ethan to cooperate with others while making decisions.
​
​
​
​
​
Ethan would be able to give us tangible feedback about the VR experience through online surveys.
CONCLUSION
Ethan Ducayet would be an ideal candidate for a case study because he is interested to try new experiences, excited about new technology and able to give us verbal feedback about the VR experience. His mother Joan Ducayet is supportive of Ethan’s involvement in the project, making it easy for us to schedule meetings with Ethan for user observation and user testing.
Relevant Observations
​
Nishan responded quickly to visual cues in the game and manipulated the virtual objects with great skill.
​
​
Nishan did not respond to our questions.
​
​
​
​
​
​
Nishan looked into the distance while Abizar read out the story “Pete the Cat”. Occasionally, he would touch Abizar’s hair.
​
​
​
Nishan was moving his head around distractedly while we played a video “Being Angry and Safe Social Story Video”.
​
​
​
​
Nishan was willing to put on the VR headset (with the simulation of a bus). Immediately after putting on the VR headset, Nishan starting reaching out and walking around as if to explore the VR space. Nishan frequently took off the headset and looked around. He called out “bus” a couple of times. When asked if he wanted to try the VR headset again, he did put it on but did not seem very excited to do so.
Professor DeCosta’s suggestions
​
​
​
​
​
​
It is difficult to engage Nishan on a topic of our choice. We need to go along with his train of thought in order to engage him.
​
​
​
​
Nishan was paying a moderate amount of attention to the story (compared to his other activities).
​
​
​
​
​
​
​
​
​
​
​
​
Nishan isn’t at a developmental stage in which he is able to differentiate between virtual and the real world. This is why he had to keep removing the headset to reorient himself.
​
​
​
​
Interpretations
​
Nishan is extremely competent at using technology.
​
​
​
Nishan would not be able to give excellent verbal feedback for our project. We would have to have his mother Emma DeCosta or a therapist interpret his reactions to gain feedback from VR.
​
​
Aural engagement is not enough to engage Nishan. It needs to be supplemented with multiple sensory tactile and visual engagement in order to better engage Nishan.
​
​
The audio was too fast to follow, and the scenes changed too rapidly. People on the autistic spectrum find it easier to absorb information when there is repetition, which would probably be the case for Nishan.
​
​
Nishan would not be a suitable user for VR because he did not seem engaged or interested enough in it. He also did not seem to understand that the VR was not reality, as his mother helped us understand.
Details of observation with Nishan
Details of the observation at Park School
Relevant Observations
​
Student A was lying on the ground, making loud noises throughout the sessions and squeezing the teacher’s hand. He completed a few assigned tasks such as solving a puzzle.
​
​
Student B was able to acknowledge my presence and greet me. She was memorizing traffic signs and then paying attention to a social story about traffic signals.
​
​
Student C performed the same activities as Student B. Student C was slower in explaining the social story and gave less correct answers while matching pictures to the correct word.
​
​
​
Student E introduced himself, shook hand with Danqing and talked about his job as a cleaner in Sargent dining hall. He also read the social story about work ethic to the class, and guided his friends to answer the questions.
Teacher's inputs​
​
Student A was newly added to the class and had been giving the staff trouble. He used to have an iPad that had been taken away from him, which was distressing him.
​
​
Student B was very good with language and reading.
​
​
​
​
​
​
​
​
​
​
​
​
​
Student E has the reading ability of a second grader.
Interpretations
​
Student A was restless and unpredictable. He was not a suitable user for VR.
​
​
​
​
Student B was engaged in the activities she performed. She would be a suitable user for VR.
​
​
​
​
Student C was less engaged than Student B, but still appeared to be focussed and patient. Student C would be a suitable user for VR. However, he would not be able to give verbal feedback.
​
​
Student E was very social. He was also talkative and would be able to give verbal feedback. Student E would be a suitable user for VR.
First classroom
Relevant Observations
​
Student F asked me how I fractured my hand, and followed-up with many more questions. He appeared to be engaged while the teacher conducted a “reading assessment with him”.
​
​
​
​
Student G was biting his forearm, hitting the table and making loud scream-like noises.
​
​
Student H was quiet for most of the session. He seemed disengaged from his surroundings. He did not interact with me in any perceivable manner. He also did not engage with the teacher.
​
​
Student J gave me a high-five to greet me and looked at me while I was talking to her. She got all the answers correct in a quiz on road norms. She was able to navigate the different screens on the iPad with ease.
Teacher's inputs​
​
The teacher asked Student F to move behind a curtain while he was solving a puzzle because Student F was easily distracted by other people and things.
​
​
​
​
​
Student G was non-verbal. The teacher asked an assistant to escort Student G outside the room.
​
Student H was non-verbal.
​
​
​
​
​
​
Student J had been promoted a few classes up because she had been learning quickly.
Interpretations
​
Student F needed to have complete separation in order to be focussed. He also was very inquisitive. When engaged he needed to be completely immersed, or else he got distracted. Student F would be a suitable user for VR.
​
​
Student G appears to be impulsive, restless and unpredictable. Student G would not be a suitable user for VR.
​
​
Student H seemed patient. However, he would not be able to give feedback. He also did not seem socially engaged. Student H would not be a suitable user for VR.
​
​
Student J was engaged with social interactions and technology. Student J would be a suitable user for VR.
Second classroom
(you can skip this table if you are looking for the most relevant information)
Table I2. Observation session with Nishan Decosta
Table I3. First observation session at Park School
Table I4. Second observation session at Park School
