My Sunny

“Sunny, the light supporting your sunshine” – The VR companion that helps children on the autism spectrum overcome their fears

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The Issue: Challenges of Dental Care and Anesthesia in ASD

Providing dental care for children on the autism spectrum (ASD) is uniquely challenging because these individuals often face persistent difficulties in social communication and may be hypersensitive to the sensory stimuli found in a dental office [1] [14]. Consequently, behavioral challenges and a lack of cooperation are the most common indications for the use of general anesthesia during pediatric dental procedures [1] [14]. While anesthesia provides optimal conditions for treatment, there is increasing concern regarding its long-term effects on the developing brain. Preclinical and clinical data suggest that repeated exposure to anesthetic agents in early childhood, particularly before the age of three or four, may lead to neurodevelopmental deficits, including increased risks of learning disabilities, attention problems, and behavioral disturbances [15] [16] [3]. The FDA has issued warnings stating that lengthy or repetitive anesthesia exposure may negatively affect brain development in young children [8] [9] [16]. This highlights an urgent need for non-pharmacological interventions that can reduce the necessity for anesthesia by improving patient cooperation and emotional regulation.

Our Findings: The Potential of Virtual Reality (VR) for Autism

Virtual Reality (VR) has emerged as a groundbreaking tool for both educational and therapeutic interventions for individuals with autism. VR provides a safe, highly controllable, and less stressful environment where children can practice essential skills without the anxiety of real-world consequences [4] [7]. Research shows that children with autism often have an affinity for technology and respond well to visual-spatial information, making VR an ideal medium for teaching adaptive behaviors [4]. Furthermore, VR is frequently used by parents and health practitioners to help children meditate and regulate their emotions through immersive distraction and relaxation techniques [5] [12]. These exercises, specifically diaphragmatic breathing, have been proven to help individuals regain composure during frustration and manage behavioral responses during emotional crises [13] [12]. Studies also indicate that children with ASD often prefer interacting with animated characters or puppets rather than human figures, as these agents deliver simplified social cues and increase motivation [11].

The Solution: Building a Virtual Dental Experience

Through our research, we recognized that anesthesia is a well-documented problematic that has the potential to be aided through VR-based sensory shielding and distraction techniques [1] [10]. In our case, we focused on a VR-based simulation in the duration of the hackathon. We developed a prototype demo where the child is welcomed into a virtual dental room by a friendly plushy character that serves as a social partner. This choice is supported by evidence that expressive, non-human partners attract the attention of children with ASD at levels comparable to typically developing children [11]. The plushy demonstrates how the dental chair reclines, a motion and sensation that frequently causes distress or sensory overload, to help the child become more comfortable with the experience. Additionally, the demo incorporates a breathing regulation exercise, which is a proven method for achieving relaxation and lowering anxiety within immersive environments [12] [13]. Furthermore, to empower caregivers, we built a Figma prototype for a Parent Monitoring Dashboard. This allows parents to observe the child's immersive experience in real-time on a separate device and intervene if they see signs of panic. This is important since similar practices are shown to help parents learn coaching techniques and manage their own stress during the visit [6] [5]. By focusing on the "hardest part" of the visit, the prototype aims to create a positive memory of the session, which can increase the child's willingness to return for future treatment [9].

Future Potential and Terrain Study

While our current prototype focuses on the most challenging aspects of a dental visit, the project has the potential for significant expansion. Immersive 3D scenarios can be tailored to individual needs to help children deal with a wide range of daily living tasks and sensory challenges [4]. Through thorough user research and terrain studies, further challenges could be explored and aided, such as navigating waiting rooms or tolerating the loud sounds of dental tools. Evidence suggests that skills learned in VR have a high potential for successful generalization and transfer to real-world environments, ultimately enhancing the oral health-related quality of life for children on the spectrum [7] [4]. By integrating VR as a complementary tool in the dentist setting, we can potentially provide more accessible, comfortable, and less traumatic dental care.

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