孤独症谱系障碍数字化治疗研究进展

Progress in digital therapy of autism spectrum disorder

摘要

孤独症谱系障碍(ASD)是一组以社会交往和互动障碍、狭隘兴趣及重复性行为为主要特征的神经发育性疾病。近年来,随着数字化技术的发展和成熟,虚拟现实、增强现实、混合现实、人工智能等数字化技术拓展了ASD的诊治模式。本文旨在总结数字化技术治疗ASD儿童的研究现状及应用进展,以期为ASD的治疗提供新思路。

Abstract

Autism spectrum disorder (ASD) is a group of neurodevelopmental disorders characterized by impairments in social communication and interaction, as well as restricted interests and repetitive behaviors.In recent years, with the advancement and maturation of digital technologies, virtual reality, augmented reality, mixed reality, and artificial intelligence have expanded the diagnostic and therapeutic approaches for ASD.This article aims to summarize the current research status and application progress of digital technologies in the treatment of children with ASD, with the goal of providing new perspectives for ASD intervention.

关键词

孤独症谱系障碍 / 数字化技术 / 神经发育障碍

Key words

autism spectrum disorder / digital technology / neurodevelopmental disorders

[1] Hirota T, King BH.Autism spectrum disorder: A review[J].JAMA, 2023, 329(2): 157-168.
[2] Shaw KA. Prevalence and early identification of autism spectrum disorder among children aged 4 and 8 years—Autism and Developmental Disabilities Monitoring Network, 16 Sites, United States, 2022[J]. MMWR. Surveillance Summaries, 2025:74.
[3] Zhou H, Xu X, Yan W, et al.Prevalence of autism spectrum disorder in China: A nationwide multi-center population-based study among children aged 6 to 12 years[J].Neurosci Bull, 2020, 36(9): 961-971.
[4] 程靖益, 王可, 杨亭, 等.学龄前孤独症谱系障碍儿童家庭疾病负担全国多中心调查[J].教育生物学杂志, 202, 9(4): 266-271,312.
Cheng JY, Wang K, Yang T, et al.National multi-center study on family disease burden of preschoolers with autism spectrum disorder[J].Journal of Bio-education, 2021, 9(4): 266-271,312.(in Chinese)
[5] Meadan H, Ostrosky MM, Triplett B, et al.Using visual supports with young children with autism spectrum disorder[J].Teach Except Child, 2011, 43(6): 28-35.
[6] Bossenbroek R, Wols A, Weerdmeester J, et al.Efficacy of a virtual reality biofeedback game (DEEP) to reduce anxiety and disruptive classroom behavior: Single-case study[J].JMIR Ment Health, 2020, 7(3): e16066.
[7] Crowell C, Sayis B, Benitez JP, et al.Mixed reality, full-body interactive experience to encourage social initiation for autism: Comparison with a control nondigital intervention[J].Cyberpsychol Behav Soc Netw, 2020, 23(1): 5-9.
[8] Mittmann G, Zehetner V, Hoehl S, et al.Using augmented reality toward improving social skills: Scoping review[J].JMIR Serious Games, 2023, 11: e42117.
[9] Yang YJD, Allen T, Abdullahi SM, et al.Neural mechanisms of behavioral change in young adults with high-functioning autism receiving virtual reality social cognition training: A pilot study[J].Autism Res, 2018, 11(5): 713-725.
[10] Soltani Kouhbanani S, Khosrorad R, Zarenezhad S, et al.Comparing the effect of risperidone, virtual reality and risperidone on social skills, and behavioral problems in children with autism: A follow-up randomized clinical trial[J].Arch Iran Med, 2021, 24(7): 534-541.
[11] Zhao J, Zhang X, Lu Y, et al.Virtual reality technology enhances the cognitive and social communication of children with autism spectrum disorder[J].Front Public Health, 2022, 10: 1029392.
[12] de Moraes ÍAP, Monteiro CBM, Silva TDD, et al.Motor learning and transfer between real and virtual environments in young people with autism spectrum disorder: A prospective randomized cross over controlled trial[J].Autism Res, 2020, 13(2): 307-319.
[13] Kaimara P, Oikonomou A, Deliyannis I.Could virtual reality applications pose real risks to children and adolescents? A systematic review of ethical issues and concerns[J].Virtual Real, 2022, 26(2): 697-735.
[14] Chen YJ, Cheng SF, Lee PC, et al.Distraction using virtual reality for children during intravenous injections in an emergency department: A randomised trial[J].J Clin Nurs, 2020, 29(3-4): 503-510.
[15] Chu L, Shen L, Ma C, et al.Effects of a nonwearable digi-tal therapeutic intervention on preschoolers with autism spectrum disorder in China: Open-label randomized controlled trial[J].J Med Internet Res, 2023, 25: e45836.
[16] Quintero J, Baldiris S, Rubira R, et al.Augmented reality in educational inclusion.A systematic review on the last decade[J].Front Psychol, 2019, 10: 1835.
[17] Liu R, Salisbury JP, Vahabzadeh A, et al.Feasibility of an autism-focused augmented reality smartglasses system for social communication and behavioral coaching[J].Front Pediatr, 2017, 5: 145.
[18] Zhen B, Blackwell AF, Coulouris G.Using augmented reality to elicit pretend play for children with autism[J].IEEE Trans Vis Comput Graph, 2015, 21(5): 598-610.
[19] Lee IJ, Chen CH, Wang CP, et al.Augmented reality plus concept map technique to teach children with ASD to use social cues when meeting and greeting[J].Asia Pac Educ Res, 2018, 27(3): 1-17.
[20] Lee IJ.Kinect-for-windows with augmented reality in an interactive roleplay system for children with an autism spectrum disorder[J].Interact Learn Environ, 2020, 28(2): 1-17.
[21] Chen CH, Lee IJ, Lin LY.Augmented reality-based video-modeling storybook of nonverbal facial cues for children with autism spectrum disorder to improve their perceptions and judgments of facial expressions and emotions[J].Comput Hum Behav, 2016, 55: 477-485.
[22] Escobedo L, Tentori M, Quintana E, et al.Using augmented reality to help children with autism stay focused[J].IEEE Pervasive Comput, 2014, 13(3): 38-46.
[23] Cihak DF, Moore EJ, Wright RE, et al.Evaluating augmented reality to complete a chain task for elementary students with autism[J].J Spec Educ Technol, 2016, 31(2): 99-108.
[24] Sahin NT, Keshav NU, Salisbury JP, et al.Second version of Google Glass as a wearable socio-affective aid: Positive school desirability, high usability, and theoretical framework in a sample of children with autism[J].JMIR Hum Factors, 2018, 5(1): e1.
[25] Liu J, Bian YL, Yuan YR, et al.Designing and deploying a mixed-reality aquarium for cognitive training of young children with autism spectrum disorder[J].Sci China Inf Sci, 2021, 64(5): 154101.
[26] Liu W, Zhang Y, Zhang B, et al.Self-guided DMT: Exploring a novel paradigm of dance movement therapy in mixed reality for children with ASD[J].IEEE Trans Vis Comput Graph, 2024, 30(5): 2119-2128.
[27] Crowell C, Sayis B, Benitez JP, et al.Mixed reality, full-body interactive experience to encourage social initiation for autism: Comparison with a control nondigital intervention[J].Cyberpsychol Behav Soc Netw, 2020, 23(1): 5-9.
[28] Pas ET, Johnson SR, Larson KE, et al.Reducing behavior problems among students with autism spectrum disorder: Coaching teachers in a mixed-reality setting[J].J Autism Dev Disord, 2016, 46(12): 3640-3652.
[29] Van den Berk-Smeekens I, De Korte MWP, Van Dongen-Boomsma M, et al.Pivotal response treatment with and without robot-assistance for children with autism: A randomized controlled trial[J].Eur Child Adolesc Psychiatry, 2022, 31(12): 1871-1883.
[30] Barua PD, Vicnesh J, Gururajan R, et al.Artificial intelligence enabled personalised assistive tools to enhance education of children with neurodevelopmental disorders—A review[J].Int J Environ Res Public Health, 2022, 19(3): 1192.
[31] So WC, Cheng CH, Lam WY, et al.A robot-based play-drama intervention may improve the joint attention and functional play behaviors of Chinese-speaking preschoolers with autism spectrum disorder: A pilot study[J].J Autism Dev Disord, 2020, 50(2): 467-481.
[32] So WC, Cheng CH, Law WW, et al.Robot dramas may improve joint attention of Chinese-speaking low-functioning children with autism: Stepped wedge trials[J].Disabil Rehabil Assist Technol, 2023, 18(2): 195-204.
[33] Burns RB, Lee H, Seifi H, et al.Endowing a NAO robot with practical social-touch perception[J].Front Robot AI, 2022, 9: 840335.
[34] Mengoni SE, Irvine K, Thakur D, et al.Feasibility study of a randomised controlled trial to investigate the effectiveness of using a humanoid robot to improve the social skills of children with autism spectrum disorder (Kaspar RCT): A study protocol[J].BMJ Open, 2017, 7(6): e017376.
[35] Huijnen CAGJ, Lexis MAS, Jansens R, et al.Roles, strengths and challenges of using robots in interventions for children with autism spectrum disorder (ASD)[J].J Autism Dev Disord, 2019, 49(1): 11-21.
[36] Alabdulkareem A, Alhakbani N, Al-Nafjan A.A systematic review of research on robot-assisted therapy for children with autism[J].Sensors (Basel), 2022, 22(3): 944.
[37] So WC, Cheng CH, Miranda C, et al.Using a social robot to teach gestural recognition and production in children with autism spectrum disorders[J].Disabil Rehabil Assist Technol, 2017, 12(6): 583-595.
[38] Holeva V, Nikopoulou VA, Lytridis C, et al.Effectiveness of a robot-assisted psychological intervention for children with autism spectrum disorder[J].J Autism Dev Disord, 2022, 52(8): 3555-3571.
[39] Veronesi C, Trimarchi B, Botticelli N, et al.Use of the PARO robot as a social mediator in a sample of children with neurodevelopmental disorders and typical development[J].Clin Ter, 2023, 174(2): 132-138.
[40] Bharatharaj J, Al-Jumaily A, Rajesh Elara M, et al.Investigating the effects of robot-assisted therapy among children with autism spectrum disorder using bio-markers[J].IOP Conf Ser: Mater Sci Eng, 2017, 234: 012017.

基金资助

美国中华医学会国际合作项目(22-471)