Social Communication Training Using a Computer Graphics Avatar in a Real City Street Environment for Individuals with Autism Spectrum Disorder

Individuals with autism spectrum disorder (ASD) tend to avoid social communication, which can lead to impaired social functioning. Thus, we developed a social communication training system using a computer graphics (CG) avatar in a simulated city street environment (SCR). We aimed to examine whether SCR effectively reduced anxiety and enhanced self-confidence and motivation to communicate in a real-world setting. Twenty-three participants with ASD were randomly assigned to either the SCR group (n = 14), which received SCR training plus classroom-based communication guidance (CGT), or the control group (n = 9), which received only CGT. Both groups underwent a 5-day intervention. Before the intervention, immediately after, and 1-month post-intervention, all participants engaged in a real-life interpersonal communication task to assess the generalization of training effects. Anxiety, self-confidence, and motivation to communicate with unfamiliar people were measured using self-report and observer-rated questionnaires (assessed by two trained research assistants). Compared with the control group, the SCR group showed a greater reduction in anxiety (p = 0.041) and a significant increase in self-confidence (p = 0.006) and motivation to communicate (p = 0.011) in the self-report questionnaire. In the observer-rated questionnaire, the SCR group demonstrated a greater anxiety reduction (p = 0.002), an increase in self-confidence (p = 0.012), and a near-significant improvement in motivation to communicate (p = 0.095). These findings support the effectiveness of SCR in promoting generalization in real-life communication situations. Future studies with larger sample sizes and diverse settings are required to validate these findings.