Speech and Language Therapists' Perspectives of Virtual Reality as a Clinical Tool for Autism: Cross-Sectional Survey

Background: Persistent difficulties with social skills form part of the diagnostic criteria for autism and in the past have required speech and language therapy (SLT) management. However, many speech and language therapists are moving toward neuro-affirmative practices, meaning that social skills approaches are now becoming redundant. Research demonstrates that virtual reality (YR) interventions have shown promise in overcoming challenges and promoting skill generalization for autistic children; however, the majority of these focus on social skills interventions. While YR is emerging as an SLT intervention, its application for autism remains unexamined in clinical practice. Objective: This research aimed to examine speech and language therapists' knowledge and attitudes toward immersive YR as a clinical tool for autistic children and explore the reasons for its limited integration into clinical practice. Methods: A web-based cross-sectional survey was available from April 3, 2023 to June 30, 2023. The survey, consisting of 23 questions, focused on YR knowledge, attitudes, and the support required by speech and language therapists to incorporate YR into clinical practice. Dissemination occurred through the Royal College of Speech and Language Therapists Clinical Excellence Networks to recruit speech therapists specializing in autism. Results: Analysis included a total of 53 responses from the cross-sectional survey. Approximately 92% (n=49) of speech and language therapists were aware of YR but had not used it, and 1.82% (n=1) had used YR with autistic children. Three key themes that emerged were (1) mixed general knowledge of YR, which was poor in relation to applications for autism; (2) positive and negative attitudes toward YR, with uncertainty about autism specific considerations for YR; and (3) barriers to adoption were noted and speech and language therapists required an improved neuro-affirming evidence base, guidelines, and training to adopt YR into clinical practice. Conclusions: While some speech and language therapists perceive YR as a promising intervention tool for autistic children, various barriers must be addressed before its full integration into the clinical toolkit. This study establishes a foundation for future co-design, development, and implementation of YR applications as clinical tools for autistic children. This study is the first to explore clinical implementation factors for the use of YR in SLT field, specifically with autistic children. Poor autism-specific YR knowledge, and mixed attitudes toward YR, highlight that specific barriers must be addressed before the technology can successfully integrate into the SLT clinical toolkit. Speech and language therapists require support from employers, funding, a robust neuro-affirming evidence base, and education and training to adopt YR into practice. Recommendations for a SLT YR education and training program for use with autistic children, are provided.