Interactive Virtual Workday Training for Autism

Overseen By Matthew J Smith, PhD

Age: Any Age

Sex: Any

Trial Phase: Academic

Sponsor: University of Michigan

Disqualifiers: Traumatic brain injury, Vision, Hearing, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

Duration: 6 weeks

300 Participants Needed

Trial Summary

Will I have to stop taking my current medications?

The trial information does not specify whether participants need to stop taking their current medications.

What data supports the effectiveness of the treatment Work Chat: An Interactive Virtual Workday for autism?

The ViRCAS study shows that virtual reality-based teamwork training can help autistic individuals improve their collaboration skills, suggesting that similar virtual workday training could be effective. Additionally, video modeling interventions have been shown to enhance job skills in autistic individuals, indicating that interactive virtual training might also be beneficial. ^{1 2 3 4 5}

Is the Interactive Virtual Workday Training for Autism safe for humans?

The available research does not provide specific safety data for the Interactive Virtual Workday Training for Autism or its related programs like WorkChat. However, the development process involved feedback from autistic youth and their teachers, suggesting a focus on user-centered design, which may imply consideration of safety and usability. ^{2 4 6 7 8}

How does the Interactive Virtual Workday Training for Autism treatment differ from other treatments for autism?

This treatment is unique because it uses virtual reality (VR) to create a shared virtual space where autistic and neurotypical individuals can practice teamwork skills. Unlike traditional methods, it offers a collaborative platform with embedded strategies and multimodal data analysis to assess and improve teamwork skills, which is not typically available in other autism treatments. ^{2 9 10 11 12}

What is the purpose of this trial?

Nearly 50,000 youth with autism spectrum disorder (ASD) transition from high school to adult life each year with only 25% of these transition-age youth with ASD (TAY-ASD) getting jobs within 2 years of graduation. TAY-ASD's ability to sustain employment is even more challenging due in part to their social cognitive deficits (e.g., poorly reading social cues) that disrupt communicating with customers, coworkers, and supervisors. Research shows nearly 90% of job dismissals among TAY-ASD are attributed to poor work-based social functioning (e.g., poorly communicating with upset customers). The subsequent unemployment has damaging effects on their mental, physical, and economic health. A critical gap in federally-mandated services to support youth with ASD as they transition from school-to-adult life is the lack of evidence-based practice to enhance work-based social functioning. Given that TAY-ASD report computerized training tools (developed by the investigators and others) are highly acceptable and improve their real-world outcomes, the investigators propose to address this critical barrier to sustained employment by developing and evaluating a novel and scalable computerized training tool to enhance participant conversations with customers, coworkers and supervisors at work. The investigators propose to develop and test the effectiveness of Social Cognitive and Affective Learning for Work (Work Chat: An Interactive Virtual Workday), a computerized training tool. Work Chat will have three tiers of instruction designed to help TAY-ASD prepare for effective workplace communication. Tier 1 will adapt existing evidence-based practices to design an e-learning curriculum that trains social cognitive strategies to help guide work-related conversations (e.g., reading social cues or regulating emotions during supervisor feedback). In Tier 2, SIMmersion's PeopleSim® technology will enable TAY-ASD to apply social cognitive strategies learned in Tier 1 to repetitively practice simulated conversations with a fictional customer, coworker, or supervisor. In Tier 3, SIMmersion will innovate PeopleSim to exist in an interactive 3-D environment to create a virtual workday with interconnected activities were the actions made early in the day influence conversations later in the day (e.g., a poor customer interaction may result in constructive feedback from a supervisor). Phase I (Feasibility) was completed with application HUM00177878. Phase II (Efficacy) Aims: Aim 1) Complete Work Chat development using an iterative process that includes initial and ongoing individual-level feedback from Phase I participants and the community and scientific advisory boards to complete the product that will be evaluated in Aims 2-3. Aim 2) Conduct a Randomized Controlled Effectiveness-Implementation hybrid trial in a school setting to evaluate Work Chat. The investigators will recruit and randomly assign n=338 TAY-ASD (90% of sample frame) enrolled in school-based standard transition services (STS) to the Work Chat group (STS+SW) or a STS group (STS). The hypothesis is that STS+SW, compared to STS, will show greater gains in: (H1) social cognition and (H2) work-based social functioning; as well as (H3) reduced anxiety about work-based social encounters, and (H4) greater sustained employment by 9-month follow-up. The investigators will test mechanistic hypotheses (H5a-b) that social cognitive ability (H5a) and work-based social functioning (H5b) mediate the effect of treatment (STS+SW vs. STS) on sustained employment. For the implementation evaluation, the investigators will conduct a multilevel, mixed-method process evaluation of Work Chat's acceptability, appropriateness, and feasibility. Aim 3) Use community participatory research methods to prepare for commercialization. The investigators will conduct a parallel multilevel, mixed method implementation evaluation that focuses on the Work Chat delivery system regarding its feasibility, sustainability, scalability, and generalizability by conduct focus groups with delivery staff and administrators. These groups will discuss potential facilitators and barriers to Work Chat implementation, adoption, and sustainability.

Research Team

Matthew J Smith, PhD

Principal Investigator

University of Michigan

Eligibility Criteria

This trial is for young adults aged 18-26 with Autism Spectrum Disorder (ASD) who can read at a 4th-grade level or higher. Participants must either have an ASD diagnosis confirmed by parent report on the Social Responsivity Scale or have an ASD record with MCTI.

Inclusion Criteria

You have been diagnosed with autism spectrum disorder (ASD) by a doctor, or have taken a test called the Social Responsivity Scale 2nd Edition (SRS-2) and scored 65 points or higher.

You can read and understand at a 4th grade level or above.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Development and Iterative Feedback

Complete Work Chat development using an iterative process with feedback from Phase I participants and advisory boards

Not specified

Treatment

Participants receive the Work Chat intervention over a series of weeks, estimated at 15-18 hours of training

6 weeks

Follow-up

Participants are monitored for sustained employment and other outcomes

9 months

Treatment Details

Interventions

• Work Chat: An Interactive Virtual Workday

Trial Overview The 'Work Chat: An Interactive Virtual Workday' tool is being tested to improve workplace communication skills in individuals with ASD. It includes e-learning, simulated conversations using PeopleSim technology, and a virtual workday environment where early actions affect later interactions.

Participant Groups

Group I: Standard Transition Services + Work Chat Experimental Treatment 1 Intervention

This arm will receive services as usual plus the Work Chat intervention over a series of a few weeks. We estimate approximately 15-18 hours of training will occur.

Group II: Standard Transition Services Active Control 1 Intervention

This arm will receive services as usual.

Who Is Running the Clinical Trial?

University of Michigan

Lead Sponsor

Trials

1,891

Recruited

6,458,000+

SIMmersion, LLC

Industry Sponsor

Trials

8

Recruited

1,000+

National Institute of Mental Health (NIMH)

Collaborator

Trials

3,007

Recruited

2,852,000+

Michigan State University

Collaborator

Trials

202

Recruited

687,000+

Michigan Career and Technical Institute (MCTI)

Collaborator

Trials

1

Recruited

300+

University of Pittsburgh

Collaborator

Trials

1,820

Recruited

16,360,000+

Findings from Research

Remote interventions like the SPAN program can significantly enhance motivation and engagement in autistic adolescents and young adults during intervention processes.

Feedback from 15 stakeholders helped shape adaptations of SPAN for autistic AYA, leading to the development of a new SPAN-ASD website and intervention manual, with plans for future usability testing and pilot studies.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Social Participation and Navigation: Formative Evaluation of a Remote Intervention for Autistic Adolescents and Young Adults. Lamash, L., Gal, E., Bedell, G.[2023]

The study involved 40 children aged 9 to 15 with autism spectrum disorder, comparing a communication app to the Picture Exchange Communication System (PECS) for facilitating dentist-patient interactions.

The app significantly reduced the number of attempts needed to communicate effectively and decreased the number of dental appointments required for preventive care compared to PECS, indicating its greater efficacy in this context.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Communication Application for Use During the First Dental Visit for Children and Adolescents with Autism Spectrum Disorders. Zink, AG., Molina, EC., Diniz, MB., et al.[2019]

Video modeling (VM) is an effective evidence-based practice for teaching job skills to autistic individuals, with a strong overall effect size of 0.91 based on a meta-analysis of 20 studies involving transition-aged youth and young adults.

Most studies on VM were conducted in controlled or school-based settings rather than competitive integrated employment (CIE) environments, highlighting the need for further research in real-world job settings to better understand its effectiveness for autistic employees earning regular wages.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A Meta-Analysis of Video Modeling Interventions to Enhance Job Skills of Autistic Adolescents and Adults. Bross, LA., Travers, JC., Huffman, JM., et al.[2023]

The Footsteps app was developed to improve data collection practices among one-to-one aides working with children with autism, addressing challenges like labor-intensive methods and lack of supervisor feedback.

In testing with 10 aides and supervisors, 90% rated the app's usability as good or excellent, indicating strong potential for enhancing data collection and monitoring client progress in behavioral interventions.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Making Progress Monitoring Easier and More Motivating: Developing a Client Data Collection App Incorporating User-Centered Design and Behavioral Economics Insights. Nuske, HJ., Buck, J., Ramesh, B., et al.[2023]

References

1. United States pubmed.ncbi.nlm.nih.gov

Social Participation and Navigation: Formative Evaluation of a Remote Intervention for Autistic Adolescents and Young Adults. [2023]

2. United States pubmed.ncbi.nlm.nih.gov

Design of a Desktop Virtual Reality-Based Collaborative Activities Simulator (ViRCAS) to Support Teamwork in Workplace Settings for Autistic Adults. [2023]

3. United States pubmed.ncbi.nlm.nih.gov

Communication Application for Use During the First Dental Visit for Children and Adolescents with Autism Spectrum Disorders. [2019]

4. United States pubmed.ncbi.nlm.nih.gov

A Meta-Analysis of Video Modeling Interventions to Enhance Job Skills of Autistic Adolescents and Adults. [2023]

5. Australia pubmed.ncbi.nlm.nih.gov

Investigation of training and support needs in rural and remote disability and mainstream service providers: implications for an online training model. [2019]

6. Switzerland pubmed.ncbi.nlm.nih.gov

Making Progress Monitoring Easier and More Motivating: Developing a Client Data Collection App Incorporating User-Centered Design and Behavioral Economics Insights. [2023]

7. Netherlands pubmed.ncbi.nlm.nih.gov

Enhancing pre-employment transition services: A type 1 hybrid randomized controlled trial protocol for evaluating WorkChat: A Virtual Workday among autistic transition-age youth. [2023]

8. England pubmed.ncbi.nlm.nih.gov

Workplace accommodations for adults with autism spectrum disorder: a scoping review. [2021]

9. United States pubmed.ncbi.nlm.nih.gov

Reducing the need for personal supports among workers with autism using an iPod Touch as an assistive technology: delayed randomized control trial. [2021]

10. Switzerland pubmed.ncbi.nlm.nih.gov

A new group-based online job interview training program using computer graphics robots for individuals with autism spectrum disorders. [2023]

11. United States pubmed.ncbi.nlm.nih.gov

Enhancing job-site training of supported workers with autism: a reemphasis on simulation. [2021]

12. Switzerland pubmed.ncbi.nlm.nih.gov

Group-Based Online Job Interview Training Program Using Virtual Robot for Individuals With Autism Spectrum Disorders. [2022]