Interview: Karen Osborne talks about treating Asperger Syndrome through Second Life

Karen Osborne is a research clinician at the University of Texas Center for Brain Health. Her background is in speech pathology. She is now coordinating the project that works on social skills and spoke to me about a new project that works with children and adults who have disabilities that impair their understanding of social cues and interactions, including Asperger syndrome, high functioning autism, ADHD, traumatic brain injury, and schizophrenia. They are using the online community Second Life to create an environment that gives these patients a way to test their social skills that gives them better feedback than previous treatments. It has been in development for two years and has been used with patients since last summer.
Tell me a little bit about your program and how it got started.
In the past, therapists have worked with autistic children through role playing, stories, and rules. But the brain changes not by learning rules but by engaging in activities. Sandy Chapman had the idea to use virtual reality to immerse the patients in the environments that are similar to real life. It is not really role playing because they become the character. It adds a little more realism to the therapy aspect. In role playing it is hard to get past the fact that you’re playing with the therapist, but in virtual reality it is more like meeting for the first time and building a relationship.
Second Life has some wild corners. How do you control the environment?
Right now we’re using a private and secure island on Second Life with only people we let in. Patients can log in and be part of it. They get to create a character that represents themselves as closely as possible.

How do you prepare and evaluate patients for this therapy?
Before they get to the therapy we go through a comprehensive battery of neuro-psychological tests measuring social success. We talk to the patient, parents or family and develop social goals. Then a team of clinicians develops social scenarios to work on those specific goals.
What kinds of social scenarios?
We have a school environment on the island. We can set up a bullying situation and ask, “What are some positive ways you can respond?” We can set up a peer pressure, situation and help the patient go through that.
It sounds like something that would be of help to just about everyone in middle school!
We definitely see the potential for lots of people who may be socially awkward or anyone in middle school if it is used in the right way. We don’t want to throw anyone into Second Life and say, “Have at it!” There are some pretty strange places and people. We definitely want to keep it very secure and a lot more regulated.
Why is Second Life more effective than previous therapies?
You’d be surprised by how real the emotions you feel within Second Life are. If you say something that is kind of embarrassing, you feel that embarrassment. It is a lot more real. It really immerses the patient in an environment that helps you target goals. It simulates real life but it takes an element of that stressor away. Face-to-face can be kind of threatening sometimes. It takes away that element of anxiety and feels a little more comfortable.
Do the patients type their conversations and describe their emotions instead of exhibiting them through facial expressions and tone of voice?
We have voice chat, so they are actually having conversations. It is not easy to express facial expressions but the affect of voice allows you to work on some of that emotion recognition and empathizing with others.
Is this available outside of Texas?
We are compiling a list of people who are interested. It is only in the Dallas area now, but there is potential for being able to put the therapy out there across the nation and world. We will have that capability.

What else are you hoping for in the future?
We are working with a gaming company to develop our own unique gaming system that we will have specialized. Virtual reality can help with recognizing people’s emotions and reactions. It can capture the expressions of people who are acting in the virtual environment, with a whole new level of awareness and insights. Patients or participants will be able to see that they’re not looking as happy or responsive as they should be. The first phase should be developed by the end of the summer, next year for the full extent.