Leveraging Virtual Reality in ABA

By: Emily Debacher, M.S. Ed., BCBA, LBA-CT

Currently we live in very uncertain times. However, one thing that will always remain certain is that the medical field will continually need highly qualified professionals. As it relates to our field of Applied Behavior Analysis (ABA), leaders in our field are thinking outside of the box to figure out alternative ways to adequately train preservice clinicians to work with individuals who exhibit challenging behaviors. 

Traditionally, parents and preservice clinicians are trained in-person, working hands-on with the client with a skilled professional closely observing and providing instructional feedback. Behavior Skills Training (BST) is considered the gold standard when it comes to training new therapists, clinicians, and parents. BST is a four-step process which includes delivery of instructions, modeling, rehearsal, and feedback. This process is evidence-based which means it has been proven an effective means to teach ABA interventions through years of research.

Many children who have been diagnosed with Autism Spectrum Disorder (ASD) exhibit severe Self-Injurious Behavior (SIB) and/or severe aggression towards others. When teaching preservice clinicians, staff, and caregivers how to implement interventions even when using BST, there is still a high risk of either the trainee, the client, or both parties getting injured. Even though BST is the gold standard for teaching implementation of interventions, that does not mean the delivery of such training can’t be modernized using technology.

Researchers Clay et al. (2021) saw a need to make training easier and safer for all involved parties. The article entitled Feasibility of Virtual Reality Behavior Skills Training for Preservice Clinicians outlines their findings.. The authors of this article tested the efficacy of using Virtual Reality (VR) in combination with BST to train 13 college students who had no background or prior experience with ABA interventions on how to use Functional Communication Training (FCT).  FCT is a method of teaching communication to replace difficult behaviors, (e.g. training a client who pinches his mom to get a snack to instead use a picture cue to access that same snack).

Virtual Reality has never been used with BST before, however, computerized BST training has been used and proven effective for teaching trainees how to implement safety skills procedures. In order to conduct the current study, the authors needed to create a VR platform for autism training. The researchers developed a VR program called AutSim© Virtual Reality Simulation for Autism Training. AutSim© actually lets the trainee feel like they are working in a real setting. It was important for the creators to ensure the training experience would be authentic, so when the trainees go to apply the newly acquired skills in the field, they would be able to do so confidently, effectively, and safely. 

The current study yielded strong results and efficacy across the board. The results of the study indicate that virtual reality in conjunction with BST was effective in training participants to use FCT for both attention-maintained and escape-maintained behaviors. Ten participants were able to reach mastery criteria for training related to attention-maintained behaviors, and five participants were able to reach mastery criterion for escape-maintained behaviors.  Based on the Interobserver Agreement (IOA) results, correct responding from trainees was 85% and higher.  Having IOA scores of 80% or above is important because IOA is the report of two independent observers using the same data collection method to prove that the behavior in question (trainees learning and implementing the proper skills through VR) actually occurred. This helps ensure the efficacy of the results yielded by the study. 

The current research also has a high social validity rating gathered from survey reports completed by participants which means the training procedure is seen as socially acceptable by clients, clinicians and parents.  Overall, this study proved VR to be a cost effective, socially valid, way of training pre-service clinicians without risking anyone’s health or safety. 

Sources:

Clay, C. J., Balakrishnan, B. A., Hopfenblatt, J. P., & Kahng, S. (2021). Feasibility of virtual reality behavior skills training for preservice clinicians. Journal of Applied Behavior Analysis, 54(1), 1-19. doi:https://doi.org/10.1002/jaba.809

Disclaimer:  This content may contain general information relating to various conditions and treatment and is for informational purposes only.  The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment.  Information is gathered and shared from reputable sources; however, ABLE Home Health Care, LLC, nor the author of this content, is responsible for errors or omissions of the underlying content.  ABLE gives no assurance or warranty regarding the accuracy or applicability of the content.  Readers are encouraged to confirm the information contained herein with other sources.  No individuals, including those under our active care, should use the information, resources or tools contained within the content for self-diagnosis or self-treatment.