Speech and Language Therapists knowledge and attitudes towards Virtual Reality as a clinical tool for autism

Background: Persistent difficulties with social skills form part of the diagnostic criteria for autism and in the past have required Speech and Language Therapy (SLT) management. However, many Speech and Language Therapists are moving towards neuro-affirmative practices, meaning that social skills approaches are now becoming redundant. Research demonstrates that Virtual Reality (VR) interventions have shown promise in overcoming challenges and promoting skill generalisation for autistic children, however the majority of these focus on social skills interventions. While VR is emerging as an SLT intervention, its application for autism remains unexamined. Therefore, this research examines SLTs knowledge and attitudes towards VR as an intervention for autistic children and explores the reasons for its limited integration into clinical practice.

Aims: To explore Speech and Language Therapists’ knowledge and attitudes towards immersive virtual reality as a clinical tool for autistic children.
Methods and Procedures: An online mixed methods questionnaire was available from 3rd April 2023 until 30th June 2023. The survey, consisting of 23 questions, focused on VR knowledge, attitudes and the support required by SLTs to incorporate VR into clinical practice. Dissemination occurred through the Royal College of Speech and Language Therapists Clinical Excellence Networks to recruit Speech Therapists specialising in autism.
Outcomes & Results: Analysis included a total of 53 responses. Approximately 92% of SLTs were aware of VR but had not used it, and 1.8% had used VR with autistic children. Three key themes emerged: (1) Mixed general knowledge of VR, which was poor in relation to applications for autism; (2) Positive and negative attitudes towards VR, with uncertainty about autism specific considerations for VR. Barriers to adoption noted; and (3) SLTs require an improved neuro-affirming evidence base, guidelines, and training to adopt VR into clinical practice.

Conclusions & Implications: While some SLTs perceive VR as a promising intervention tool for autistic children, various barriers must be addressed before its full integration into the clinical toolkit. This study establishes a foundation for future co-design, development, and implementation of VR applications as clinical tools for autistic children.

What is already known on this subject
Speech and Language Therapy (SLT) intervention for autistic children has a key role in neuro-affirming pragmatic goals. Given that, VR builds upon strong visual skills, it shows promise as an SLT tool for pragmatics. Despite this, VR has not yet been adopted into clinical practice.

What this study adds
This study is the first to explore VR as a clinical tool for autism in the SLT field. Poor autism specific VR knowledge, and mixed attitudes towards VR, highlight that specific barriers must be addressed before the technology can successfully integrate into the SLT clinical toolkit.

Clinical Implications of this study
SLTs require support from employers, funding, a robust neuro-affirming evidence base and education and training to adopt VR into practice. The study emphasises the need for clinical guidelines and recommends future VR research should be co-designed with autistic end users to facilitate a strength-based application, which focussed on autistic children’s priorities. Recommendations for a SLT VR education and training programme are provided.