HOW AUTISM THERAPY ONLINE HELPS A LITTLE GIRL: HAYLEY’S STORY

A performance animation technology, delivered as an engaging autism therapy online, offers new hope for parents of autistic children.

Hayley, a 7-year-old autistic girl who loves art, music and dance, was having trouble sharing her thoughts, staying focused, and taking those first steps towards independence. Although her parents had explored numerous options in the past, the inflexible routines and worksheets of other therapies just wouldn’t mesh with Hayley’s visual learning style. Now they look back with pride at the decisions they made leading up to her success.

Having seen impressive results with previous clients, Hayley’s therapist, University of Nevada Reno Autism Clinic Director Dr. Debra Vigil, CCC-SLP, recommended Invirtua, an autism telehealth solution. Dr. Vigil got Hayley’s parents in contact with Gary Jesch, a live animation pioneer who started Invirtua in 2015. And soon after, Hayley and Invirtua’s friendly interactive animated dinosaur were off on their first Avatar Adventure together!

In Invirtua Avatar Adventures, Gary shows up in the home-based video call as a green dinosaur cartoon called Kikof, who becomes a “sidekick” for autistic students like Hayley. Through joint sessions with Dr. Vigil’s graduate student, Lizett Montes-Lopez, and the live-animation controlled in real time by Gary, Hayley was able to make rapid gains in her communication skills.

We’d like to share Hayley’s story with you, to show how Invirtua can help autistic children thrive, and how proud their parents are of them when they do.

[Note: Some quotes from Hayley’s parents and counselors have been edited slightly for clarity.]

Hayley – Creative, Energetic, Artistic

Hayley is a seven-year-old autistic girl with a creative spirit. Her parents are Raul and Marisela, both researchers at the University of Nevada, Reno. At home, Hayley is always dancing, singing, and performing ballet. Hayley’s mom is proud of her accomplishments, saying that “in music and in art, Hayley receives ‘A’s all the time!”

Hayley can be amazingly imaginative and expressive, impressing teachers and classmates alike. But she sometimes struggles when attempting to share her thoughts with others or remain focused on a single task.

Hayley’s dad goes on to mention his daughter’s improvements in the classroom: “She has been very stable, she would stay in class and make an effort to learn, and now, Hayley’s school named her ‘Coyote of the Week,’ meaning she gets along well with others! Everyone is very proud of her!”

Here’s how Invirtua embraced Hayley’s learning style to make Avatar Adventures the most effective autism therapy for her.

“ABA therapy goes in modules, goes by the book, and Hayley hates that,” says Hayley’s dad. “That’s something I brought up to the ABA therapists, and I respect the need for structure, but I have told them ‘you have to allow naturalistic approaches.’”

As Hayley’s mom sees it, therapy “has to be more interactive for Hayley. If it’s not interactive—with toys or something else, she’s not going to have the will to participate.” For Dr. Vigil and Lizett, creating a counseling plan that Hayley would enjoy was key.

How Invirtua Worked for Hayley

With oversight from Dr. Vigil, Gary Jesch and his avatars at Invirtua have been working with kids at the University of Nevada, Reno School of Medicine, Dept. of Speech Pathology & Audiology since 2016.

Every autistic child who enters “InvirtuaLand” is different. Content, goals and timelines are structured around each client’s interests and needs. This approach extends to the avatars in each program. Before a client’s sessions begin, Gary gathers information about both the child and its parents, and then chooses an appropriate avatar based on the results, so the autism therapy can be more effective.

For Hayley, Gary decided to appear as Kikof, the dinosaur, since he and Dr. Vigil felt its vibrant, energetic design and animations would speak to Hayley’s inner artist.

Gary also selected one of the six instructional frameworks for ASD children (ages 5 – 16) that Invirtua offers – learning social skills. These programs can focus on the client’s conversational, social, or motivational development. (More about Invirtua’s instructional programs can be found here.)

In Hayley’s case, her Avatar Adventure included both conversational and social components. Lizett, with Dr. Vigil’s instruction and guidance, developed lesson plans that helped Hayley learn to maintain trains of thought, initiate conversations and pay attention to others. These lessons were aided by Kikof, who transformed Hayley’s sessions into exciting weekly outings with a virtual friend.

How Invirtua Made Remote Sessions Fun

Invirtua’s learning framework came at a time when Hayley’s parents and Dr. Vigil had to move Hayley’s therapy sessions to a home-based video call experience, instead of sessions at the university clinic. Thanks to Kikof, Hayley was able to enjoy the learning process, even with her autism therapy online.

“I was skeptical about therapy over the computer,” says Hayley’s dad. “It’s not my style. I like to go to the clinic see the sessions from behind the glass door. I like that style, but I didn’t have a choice.” Raul’s concerns were quickly replaced by optimism, once he observed Invirtua’s work firsthand. “I didn’t know there was going to be Kikof, an extra therapeutic component,” he says. “It was exciting. Hayley forgot the inconvenience of using the computer. Kikof motivated her to be in therapy.”

What Challenges Was Hayley Facing?

To fully understand how much progress Hayley has made while on her Avatar Adventure, we should first take a look at the challenges she faced. We’ve grouped the focus of Hayley’s sessions into three sections below: Joint Attention, Expression, and Attentiveness.

The Challenge of Joint Attention

When her Avatar Adventure began, Hayley had trouble understanding the behavior of those around her. Lizett notes that “Hayley doesn’t realize that other people have different thoughts than her. She gets caught up in her own world.”

To help Hayley step out of her own world, Gary and Lizett aimed to foster a behavior called joint attention. According to Dr. Vigil, “Joint attention is the ability for a young child to be able to understand they are actually paying attention to the same thing that someone else is.  Autistic kids don’t always understand that they need to pay attention to the same thing that someone else is paying attention to, in order to have a conversation or to share.”

 “We want Hayley to be aware of what’s happening around her because if she’s aware of what’s happening around her, then she’ll be successful in the classroom, because she knows what’s going on.” — Hayley’s mom, Marisela

 

Joint attention is also a crucial skill for academic success. Young students who cannot direct their attention to the topic at hand face a greater risk of falling behind. Hayley’s mom, Marisela, puts it this way: “We want Hayley to be aware of what’s happening around her because if she’s aware of what’s happening around her, then she’ll be successful in the classroom, because she knows what’s going on.”

The Struggle with Expression

In the same way that Hayley has trouble understanding others, she sometimes struggles when attempting to express her own ideas. Dr. Vigil points out that three years ago, when Hayley was four years old, she was primarily nonverbal. Now at age seven, the concern is not so much with the presence of Hayley’s speech, but with the clarity of it.

Hayley’s experiences with communication have much in common with those of other autistic patients, according to Dr. Vigil. “The big part of autism is the social aspect of it. It’s crucial to get autistic children to understand that the language they use is for making a social connection.” In other words, she says,  many young autistics struggle with expressing what they mean or what they are thinking.

The Hard Time with Attentiveness

During the beginning of Hayley’s autism telehealth sessions with Invirtua, she had a hard time staying focused. Dr. Vigil noted that this made working with Hayley remotely a challenge, saying that “Hayley would just be sitting there and then she gets up and walks away or she starts getting fixated on something and is not paying attention.”

Hayley’s parents told Dr. Vigil that they wanted their daughter to be more independent. When discussing a plan to help Hayley become more self-reliant, Dr. Vigil stated that “children have to understand their own power to be able to come up with a language that they need to express their wants and desires.” Put another way, to take responsibility for her own behavior, Hayley needs to realize she has the ability to do so in the first place.

How Did Invirtua Help?

Hayley’s Avatar Adventure has helped her become more social, more expressive, and even more reflective. Although, as someone on the autism spectrum, she still faces challenges on a daily basis, she’s now better equipped to confront them with courage. Here’s how Hayley has grown since she started with Invirtua.

She Shows More Willingness to Share

Not long after becoming familiar with Kikof, Hayley started opening up during online autism therapy sessions. Dr. Vigil says that Hayley “started asking questions about Kikof.” Hayley wanted to share feelings of excitement with the avatar. Dr. Vigil goes on to point out that “there is that three-way connection with respect to joint attention: the child and the other and then whatever event or object is being shared. That three-way interaction is exactly what she had with Kikof.”

Hayley’s mom says that Hayley was not only happy participating with Kikof, but had even started to bond with the avatar. Hayley’s newfound eagerness to identify with others extended to her family as well. Marisela shared that “Recently, Hayley said she ‘looked like daddy. I don’t look like you, mommy. Why?’ She’s paying attention to what people look like!”

For Hayley, becoming more willing to share represents a major step towards moving outside her own world. Hayley is now relating her own experiences and traits to those of Kikof and her family members. This sort of connection not only allows her to better express her own feelings. It also provides room for her to consider how her actions affect those around her.

“There was one time where we were doing a scenario, and Hayley realized that the way she acts — like her tantrums — could cause her mom to be upset, and she realized she doesn’t want to make her mom feel sad. ‘I am not going to act this way.’ Hayley said.

I feel like going through social scenarios, social scripts helped Hayley realize that her actions affect how others might feel.” — Lizett

Lizett remembers one online autism therapy session in particular: “There was one time where we were doing a scenario, and Hayley realized that the way she acted — like her tantrums — could cause her mom to be upset. And she realized she doesn’t want to make her mom feel sad. ‘I am not going to act this way,’ Hayley said. I feel like going through social scenarios, social scripts helped Hayley realize that her actions affect how others might feel.”

She Learned Clearer Communication

Along with displaying a greater desire to communicate, the clarity of Hayley’s expressions improved during her time working with Lizett and Kikof. Lizett frequently observed Hayley making an effort to express herself clearly so that others could follow her sentences.

 “Sometimes you couldn’t follow Hayley’s train of thought. I think that Kikof helped her focus because she was trying to communicate with Kikof. Hayley really wanted to keep that train of thought, so she could share things with Kikof.” — Dr. Vigil

Dr. Vigil believes Hayley’s improvement with respect to expression is directly linked to the inclusion of Kikof in her sessions. Dr. Vigil says that, before Invirtua, “sometimes you couldn’t follow Hayley’s train of thought. I think that Kikof helped her focus because she was trying to communicate with Kikof. Hayley really wanted to keep that train of thought, so she could share things with Kikof.”

She Became Able to Improve Her Focus

By the time her Avatar Adventure concluded, Hayley had become considerably more attentive. As Dr. Vigil puts it, “Before (and it happens still to a certain degree), Hayley would just sort of get lost. But there were a lot of times were she was able to—in that half hour period—stay with the therapy for the entire time, and that extended.”

 “In playing Kikof, we managed to secure her Hayley’s attention the entire thirty minutes that Kikof was there. It was pretty rare for her to break off that part of the session.” — Gary Jesch

Hayley’s ability to focus during sessions was further aided by the presence of Kikof. Lizett says, “I do believe that Hayley, as we were preparing for Kikof, would be more focused. As Kikof came on the screen in the Zoom session, she was able to greet him. She was motivated to practice because she wanted to see Kikof.” Gary, who played Kikof, adds that “in playing Kikof, we managed to secure Hayley’s attention the entire thirty minutes that Kikof was there. It was pretty rare for her to break off that part of the session.”

As Invirtua helped Hayley become more attentive during telehealth sessions, her sense of independence grew. By being able to focus on her feelings, she is learning to manage social stress independently.

Raul says that “compared to six months ago, Hayley’s tantrums have become less frequent: Less yelling and less tantrums because Hayley is responding to social stress by herself—less reacting and more thinking.”

Hayley’s dad goes on to mention his daughter’s improvements in the classroom: “She has been very stable, she would stay in class and make an effort to learn, and now, Hayley’s school named her ‘Coyote of the Week,’ meaning she gets along well with others!”

Despite the added hurdles that come with moving autism therapy online, Invirtua’s engaging learning framework meant that Hayley was able to truly connect with Kikof, forming a friendship that neither of them will soon forget.

Hayley’s mom sums up the experience neatly. “Seeing therapy in this positive way is good for Hayley because she has to sit down and she needs to pay attention to the screen to realize what’s being said to her,” Marisela says. “I know counseling over the computer is different, but it’s nice that Hayley is able to sit down and pay attention and try to participate.”

Andrew Ciampi is an author based in the state of Washington. His areas of interest include the autism spectrum, emerging technologies (practical or otherwise), and the transportation/trucking sector. You can find his professional writings here on Invirtua and at Relaymile.com.

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