目的 评估沉浸式虚拟现实(IVR)干预孤独谱系障碍(ASD)儿童青少年适应性能力的可行性、可接受性、安全性及有效性。方法 2023年9月－2024年8月招募33例8~16岁ASD受试者,参与为期平均8周,每周1次,每次1h的IVR干预。通过问卷、访谈、任务完成时间进行评估。结果 28例(84.8%)ASD受试者完成了干预。可接受性方面,100%的受试者及其监护人对干预的设置满意并对内容感兴趣;临场感量表(IPQ)结果显示,首次干预后的总分处于可接受范围内(0.41±0.85),但末次干预后总分显著下降至0.26±0.98,差异有统计学意义(t＝2.150,P＝0.041)。安全性方面,受试者和监护人报告的不适症状比例分别为39.4%和33.3%,主要表现为头晕;首次干预后模拟器眩晕问卷(SSQ)总分处于可接受范围内(19.77±12.07),末次干预后总分为17.36±13.11,差异无统计学意义(t＝1.060,P＝0.298)。有效性方面,自制日常生活技能问卷总分显著提升(t＝3.788, P＝0.001),各场景下IVR任务的完成时间显著降低(P<0.001)。结论 该IVR系统对ASD儿童青少年安全、可行、有效,未来研究应设置对照、扩大受试者范围、引入更多客观评估,并优化系统以减轻干预过程中产生的晕动症,提升其可用性。
Abstract
Objective To evaluate the feasibility, acceptability, safety, and effectiveness of immersive virtual reality (IVR) interventions in improving adaptive skills in children and adolescents with autism spectrum disorder (ASD). Methods From September 2023 to August 2024, 33 ASD participants aged 8 - 16 years were recruited to undergo an IVR intervention lasting an average of 8 weeks, with one session per week and each session lasting 1 hour. Assessments were conducted using questionnaires, interviews, and task completion time. Results Finally 84.8% of participants completed the intervention. In terms of acceptability, 100% of participants and their guardians were satisfied with the intervention setup and found the content engaging. The Presence Questionnaire (IPQ) results showed that the total score after the first intervention was within an acceptable range (0.41±0.85), but it significantly decreased to 0.26±0.98 after the final intervention(t=-2.150, P=0.041). Regarding safety, 39.4% of participants and 33.3% of guardians reported mild discomfort, primarily dizziness. The Simulator Sickness Questionnaire (SSQ) total score after the first intervention was within an acceptable range (19.77±12.07), and it was 17.36±13.11 after the final intervention, with no statistically significant difference (t=1.060, P=0.298). In terms of effectiveness, the total score of the self-designed daily living skills questionnaire significantly improved (t=3.788, P=0.001), and the completion times for IVR tasks across various scenarios significantly decreased. Conclusions The IVR system is safe, feasible, and effective for children and adolescents with ASD. Future studies should include control groups, expand the participant pool, incorporate more Objective assessments, and optimize the system to reduce motion sickness and enhance usability.
关键词
孤独谱系障碍 /
沉浸式虚拟现实 /
适应性能力 /
可行性 /
安全性
Key words
autism spectrum disorder /
immersive virtual reality /
adaptive ability /
feasibility /
safety
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基金
国家重点研发计划“重大慢性非传染性疾病防控研究”重点专项子课题(2017YFC1309903);上海市公共卫生体系建设三年行动计划(2020-2022)重点学科建设计划(GWV-10.1-XK19);上海市浦东新区卫生健康委员会优秀青年医学人才培养项目(PWRq2021-09)
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