Microsoft, UW develop program to treat autism syndrome online

By Allison Linn
The Associated Press

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Someone asks you about your day, and you don't know how to respond. A teacher calls on you in class and, even though you know the answer, you tremble with anxiety.

For thousands of children suffering from Asperger's Syndrome, the social interaction of a typical day is like a terrifying visit to a foreign country where you don't speak the language or know the customs.

Programs to treat this high-functioning autism are available, but the wait can be as long as three years in more remote parts of the country.

Meanwhile, the longer a child goes without treatment, the worse it gets. Kids can grow even more introverted, finding refuge in their own world because they can't understand what's going on outside.

Asperger's Syndrome Asperger's Syndrome, a high-functioning form of autism, was first identified in the 1940s by Viennese physician Hans Asperger. But it wasn't until the 1990s that parents and medical professionals began widely recognizing the neurobiological disorder. Experts say it's hard to know exactly how many kids have Asperger's, although there have been more diagnoses in Seattle and the Bay Area than anywhere else in the country. The syndrome often starts to surface at around 18 months old and grows more pronounced as a child grows older. Although children with Asperger's often have strong verbal skills and normal intelligence, many display some autistic-like behavior and have pronounced deficits in social and communication skills. Symptoms can include: • Difficulty making eye contact and an inability to use and understand other forms of nonverbal communication, such as body language or facial expressions. • Difficulty making friends or interacting socially with others, especially peers. • An obsessive interest in a particular topic. • A strong desire for order and ritual and an inability to easily cope with unexpected changes in routine. • Some kids also suffer from depression, anxiety and obsessive-compulsive disorder. Children with the syndrome also may adhere strongly to specific, nonfunctional routines or rituals or display stereotyped and repetitive movements, such as hand or finger flapping, rocking or complex full-body motions. As with other forms of autism, there is treatment but no known cure. Researchers have found success treating some people with Asperger's with a combination of one-on-one therapy and social-skills groups. But since programs aren't yet widely available nationwide, some kids can be forced to wait a year or more for treatment.   The Associated Press

"These kids really need social interaction because they don't get any better just sitting in the basement," said Helen Powell, whose 15-year-old son has Asperger's.

In Seattle, which along with the Bay Area has the highest reported cases of Asperger's, researcher Felice Orlich is working with Microsoft to help speed up the wait for those kids.

"The majority of kids who come (for treatment) just want to make friends and they don't know how," said Orlich, a clinical neuropsychologist with the University of Washington. "They just don't get it."

Microsoft Research and the Seattle university's Autism Center have developed a program called KidTalk that aims to teach much-needed social skills online. A pilot-test program begins in about a month.

KidTalk looks much like a typical computer chat room, with lines of text from different participants running down one side of the screen and smiley-face icons representing the participants on the other.

But instead of just letting the kids chat, the program presents them with a script for social interaction, such as a birthday party, and asks them to perform specific social tasks.

Kids who participate well are rewarded with points and smiling faces. Those who don't chat or chat too much will see their oversized face icon move away from the group.

A therapist moderates the session and can send messages to the participants privately, offering tips and rewards.

Initially, Orlich hopes the program will reinforce social skills kids learn in their eight-week face-to-face social-skills group, freeing up therapists who now do follow-up sessions to treat new kids.

Eventually, she hopes to use it to treat kids in more remote areas. Over time, the researchers believe it could turn into an inexpensive way to treat more kids better and faster.

Kids who suffer from Asperger's — far more serious than social unease — may not even be able to simply introduce themselves, let alone follow the subtle social context of a typical party.

Beverley Merrell's 17-year-old son, Scott, has learned the rote motion of sticking out his hand when a new person is introduced but doesn't seem to grasp why people shake hands when they meet.

"It's different than teaching normal kids any kind of social skills because they don't know how to go out and use it," she said.

Isolated and frustrated, many kids also suffer from depression and obsessive-compulsive disorder and can grow angry, even violent, at even the most minor change in routine. One parent remembers her son's violent outburst over misplaced silverware on the dinner table.

Most also tend to focus fanatically on one topic — Merrell's son is obsessed with Winston Churchill — and their inability to veer from that topic makes it hard to interact with kids their own age.

While some get one-on-one therapy, many parents say group therapy is particularly helpful because kids learn to interact with kids their own age.

"You have to engage in give and take and you have to let each person have their way," Powell said.

Parents and researchers think online therapy might be more comfortable to Asperger's sufferers, who find solace in the familiar, rules-based structure of computer interaction. Many also feel much less anxiety when they can organize their thoughts and type them, rather than speak.

But some parents worry the cocoon of the online environment will only reinforce their child's isolation.

Alice Cho Snyder's 14-year-old son went through the University of Washington's eight-week treatment program but said it wasn't enough time for him to absorb the social lessons. Still, she doesn't know if online interaction would help.

"The whole thing about Asperger's is that they need to understand more about the nonverbal-language skills," she said. "The nonverbal language that you use, which is all the facial expressions and the body language, is not something you can really learn (online)."