In a new pilot study, adults with autism showed real-life, functional improvements following a virtual reality (VR) treatment approach in which they were gradually exposed to their fears. The VR treatment was coupled with cognitive behavioral therapy (CBT).
Fears and phobias are common in people with autism spectrum disorder (ASD), and these can have a significant impact on their ability to carry out daily activities.
Graded exposure to anxiety-causing stimuli is a recognized approach for treating fears and phobias in the non-autistic population. But it has been assumed that this method would present special difficulties for people with ASD, as real-life exposure could potentially be too upsetting to allow treatment to take place.
To address this, the research team developed an anxiety-targeting intervention that combined cognitive behavioral therapy with immersive virtual reality exposure. Following successful trials of this intervention with young people on the autism spectrum, the researchers conducted the new pilot study using the same intervention with autistic adults.
For the study, eight ASD adults (aged 18–57 years) received one psychoeducation session and then four 20-minute sessions of graded exposure with a therapist in an immersive VR room. Each participant completed all sessions; this shows that the intervention is both practical and acceptable, say the researchers.
Outcomes were monitored at 6 weeks and 6 months post-intervention. The findings show that 5 of the 8 participants were classified as “intervention responders,” and at 6 months post-intervention, they were experiencing real-life functional improvements.
These preliminary findings, published in the journal Autism in Adulthood, suggest that VR-graded exposure alongside CBT may be an effective treatment for autistic adults with phobias.
“Phobias commonly co-occur with autism and often cause significant distress,” said Christina Nicolaidis, M.D., M.P.H., associate professor of medicine and public health at Portland State University in Oregon and editor-in-chief of Autism in Adulthood.
“While results are very preliminary, it is exciting to see innovative strategies for an issue that has been so hard to treat. Emerging Practices papers, such as this one, look towards the future by highlighting new avenues of research that have potential for improving quality of life for autistic adults.”
Research suggests that approximately half of children with ASD meet criteria for at least one anxiety disorder. Of all types of anxiety disorders, specific phobia is the most common, with prevalence estimates ranging from 31 percent to 64 percent.