Brain Computer Interface and its use in Autism Treatment

Since its inception, the main purpose of a computer was to perform a set of complex tasks and perform some complex calculations as well. However, computers have developed into more than that. After much effort, computers now can operate through a touch screen or voice commands. Also, computers have become small and compact and have been integrated into our daily lives. Now, computers can be seen in our mobiles, iPods, PDAs, BlackBerrys, etc., and it still continues to develop even further.

The use of mobiles and computers can be defined as human-brain interaction or interface, which is the study and design of an interaction between users and computers. Recently, scientists have discovered a new paradigm of human-computer interaction that could establish a connection between the brain and the computer called the brain-computer interface (BCI). Wang, Vallabhaneni, and He, neuroscientists, defined BCI as a communication method based on neural activity generated by the brain and is independent of its normal output pathways of peripheral nerves and muscles, while others defined BCI as a system that allows its user to control a machine solely with brain activity rather than the peripheral nervous system. However, the most suitable definition is the one where BCI is defined as a non-muscular channel for sending messages or mental commands to an automated system such as a robot, prosthesis, or a cursor on a computer.
The history of BCI dates back to 1929 where Hans Berger, a German neurologist, worked on device that could measure the brain’s electrical activity. That device came to be known as an electroencephalogram (EEG). 40 years later, researchers were able to develop primitive systems that could be controlled by the electrical activity of the brain. The Pentagon’s Advanced Research Project Agency was interested in using this feature to develop devices that could be controlled biological signal based computers. Dr. Jacques Vidal, alongside other colleagues, proved that brain generated signals can be used to communicate the user’s desires.

The main purpose of any BCI is to run an application through the detection of brain signals. This is accomplished by asking the patients to undergo certain tasks that generate a difference in the brain activity. Any BCI based system is composed of six main parts. The first part is the signal acquisition system, whose main function is to obtain brain signals caused by electrical differences. These signals are passed down to the next part, the feature extractor. The feature extractor extracts the main features of any signal. Then the signal goes to the feature translator, which converts the signals into algorithms that can be understood by computers. Finally, the algorithm can be passed to a device or a monitor.

*Adapted from the Bulletin of the Transilvania University of Brasov (2010)

BCI can be used in various fields such as communication for people with severe disabilities such as locked-in-syndrome. Another application of BCI is neural prosthesis, which helps people with disabilities, such as paralysis, to regain mobility through restoring the communication channel between the brain and the limbs.

One of the many applications of BCI is virtual reality (VR), which can be briefly described as machine-generated worlds that allow its users to interact with these worlds. Virtual reality is a derivative of brain-computer interface. It is used in many fields, one of which is cognitive rehabilitation. Virtual reality aims to stimulate or create new worlds. It can be differentiated from normal human-computer interaction through the level of interaction, where VR presents its users with 3-D representations while computers present its users with 2-D representations. Virtual reality can be used in the field of cognitive rehabilitation, where it helps to reduce the effects of phobias and vertigo, and it can be also used to help children with learning disabilities to learn new skills. The main function of VR therapy is for users to confront their most predominant fear. Knowing that the world is harmless, the reconstruction of frightening situations is realistic and enables them to deal with them.

Autism Spectrum Disorder (ASD), commonly known as autism, is defined as a lifelong brain impairment, primarily characterized by learning difficulties, that has no exact cause and influences how people interact with others, while the National Autistic Society defined Autism Spectrum Disorder as a long-term impairment that changes or influences how an individual interacts with other people and how they perceive the outside world.

Autistic people do not view the world and the people in it like most, but rather they see them as objects, which they do not comprehend, causing them to become anxious. The main areas of difficulties in autistic patient concern difficulties with social communication, interaction, and imagination. For autism patients, understanding other people’s verbal and non-verbal language appears to be difficult and they have a very literal understanding. Autism patients suffer difficulties in the social domain, especially when communicating with others. Autistic people have to learn to socialize with others as opposed to naturally acquiring these skills. This is due to the fact that autistic people do not recognize other people’s emotions facial expressions and feelings, and thus they might not be familiar with the unspoken social norms such as initiating an inappropriate conversation or standing extremely close to someone. Furthermore, people with autism experience difficulties figuring out other people’s psychological states and thoughts. The characteristics of autism vary; however, there are several main aspects of the disorder that are common between people with autism: love for routines, sensory sensitivity, special interests, and learning disabilities. Although they face learning difficulties, some people with autism exhibit a form of exceptional skills in various fields such as music, mathematics and art.

Affecting 1 in every 150 children, autism is becoming more prevalent, Mayo Clinic stated that there is not a specific cure for autism; however, there is a set of interventions that aims to boost the child’s language, social, academic and behavioral performance and attempt to exterminate any autism signs. One of the interventions is Applied Behavior Analysis (ABA), which aims to develop the necessary social skills in autistic children by certified and trained therapists ABA can be defined as an approach that is based on the behavior analysis, which is based on the principles on how learning takes place. One of those is positive reinforcement, which rewards the child after he or she performs a certain behavior. In the case of a reward, the behavior or is more likely to be repeated. ABA uses those principles to teach and reinforce positive behaviors and attitudes in children. ABA can be integrated into the everyday life of the family or in classrooms.

The main difference between VR therapy and traditional behavior therapies like ABA is that VR therapy creates realistic situations in labs. In those labs, therapists create situations where the client feels engrossed in that scene. Another difference is that a therapist using VR therapy can see the patient’s fears while, with normal therapies, he must imagine what is going on inside the patient’s head. In VR therapy, therapists can also see how the patients react to certain situations and are able to jump in and offer guidance.

Although considered to be a successful approach for the treatment of autism in children, ABA can be financially expensive for parents and families as it can cost up to $50,000-$60,000 per year, while a VR system can cost up to $7500. Also, ABA requires a huge time commitment from parents and families as it might take at least 25 to 40 hours per week. VR has been used to treat autistic children and it has displayed good results, where the children exhibited improvements in the social domain

While ABA can be an effective autism treatment, it is financially expensive and time consuming.The use of VR therapy for autism treatment is better than ABA due to the fact that it is cost effective, time-saving, provides a safer learning environment, can be individualized, and tasks can be repeated as much as needed to insure the reception of the skill targeted.

Using Virtual Reality is Cost-Effective Compared to Applied Behavior Analysis
ABA can be transforming and yields good results; however, when done on an intense basis, it can cost up to $25,000 per year for schools focused for autism treatment, while in home therapy can cost up to $40,000-$60,000 per year. Amid this financial backdrop, that cost can be pretty expensive for parents, especially those supporting more than one child. As a result, some might deem this approach unnecessary due to the extremely high cost. Those parents start to wonder what other alternatives are available that are cheaper than ABA. In that case, V pops up. “Costs of Virtual Reality Treatment for PTSD” states that a VR therapy –“Virtual Iraq”- which is designed for returning soldiers from Iraq, costs up to $5,000. Also, the potential cost can be somewhere above $5,000. Here we can clearly see the huge gap between the cost of ABA and VR therapy, which is almost equal to $35,000-$55,000. By opting for VR, parents can save up to $35,000-$55,000 annually.

Virtual Reality Saves Time Compared to Applied Behavior Analysis
With a busy schedule, parents who work often do not have much space in their schedules. But when their child suffers from autism, it becomes a different story. Aside from its cost, parents would go for ABA intervention sessions. Those sessions would require roughly 25-40 hours per week, for three or five years, which is a huge time commitment for parents. As a result of this time commitment, the parents would cut down their working hours, which would reduce their income, and as result suffer financially. However, when parents choose VR therapy as a treatment for their child, their time commitment is reduced. VR requires its user to use or interact with a computer or head mounted piece that constitutes a gateway to the world of VR, which requires no parental supervision; thus less or almost no time commitment.

Virtual Reality Provides a Safer Learning Environment
VR has been used in BCI training systems due to its safety and motivational factors. The University of Nottingham has developed a virtual physics lab where the students would carry on experiments, including those involving radioactive materials. It can be inferred that such software was developed in order to insure that no accidents from such harmful material would result. In the case of autistic children, their presence amid a group of people in the street or in a café or with someone else in their environment, such as home, might be a source or anxiety for them, thus making them feel unsafe. In order for autistic children to progress, they have to be taught to develop themselves in the social domain. However, with ABA, they are exposed to much insecurity. VR can be a better environment for teaching children everyday skills, where mistakes or errors during the teaching process are less dangerous and can help children progress from simple interactions to complex or realistic ones.

Virtual Reality Can Be Individualized
Some autistic children cannot tolerate certain levels of distractions, such as visual or acoustic. However, such complications or distractions can be minimized to insure a successful therapy. VR can guarantee that by adjusting input stimulation and by introducing those distractions in a slow and smooth manner so that the patient can adjust to those distractions. VR can see and predict what is going on the child’s brain, and can adjust the therapy accordingly. However, in the case of ABA, the therapist has to imagine what the child is going through and try to modulate the therapy based on their imagination, which is not as accurate as what VR can predict.
Virtual Reality Can Repeat Tasks to Insure the Reception of the Skill

The Journal of Intellectual Disability Research stated that the principles of repetition of tasks are successful in promoting behavior change in children with autism, and that they present a greater potential in generalizing those behaviors in their lives. Also, they also stated that tasks and assignments in VR can be repeated and practiced consistently without the exhaustion associated with human instructions. This will enable autistic children to engage in certain tasks, such as going to a Virtual Café and order a drink, more than once so that the skill of interacting with others can be instilled in them.

Conclusion
BCI is a new paradigm in the technological field, and has numerous applications in various fields. BCI can be used in gaming, military applications, and in the medical field. One type of BCI is VR, which stimulates and creates real world environments using computers. VR can be a useful tool in cognitive rehabilitation, such as autism treatment.

VR is cheaper than the other available treatments, such as Applied Behavior Analysis, from an economic point of view. In terms of time consumption and commitment, VR saves time for parents more than the Applied Behavior Analysis. VR also provides a safer learning environment, where mistakes during the teaching process are less catastrophic. A VR program can be modulated according to every child’s’ preferences to insure a better and a more successful treatment. Moreover, tasks in VR can be repeated as much as possible to ensure that the behavior targeted or skill can be instilled within the child. VR can be considered as a successful approach for the treatment of autism instead of Applied Behavior Analysis.