JMIR Publications

ABSTRACT

Background:

The lack of social role-based behaviors, such as guiding and assisting others, is a major barrier to employment success for individuals with autism spectrum disorder (ASD). Enhancing self-efficacy is essential for improving social role-based behaviors. To enhance the self-efficacy of social role-based behaviors, we developed a training system that enables users to perform social role-based behaviors, including guiding and assisting others, using a computer graphics avatar in a real bustling commercial facility (TCR).

Objective:

This study aimed to evaluate the feasibility of TCR and its potential to reduce anxiety and enhance self-confidence, motivation, metacognition, and self-efficacy in performing social role-based behaviors in real-world interactions among individuals with ASD.

Methods:

Thirty-eight participants were randomly assigned to either the TCR group (n=20, received TCR alongside communication guidance from teachers [CGT] in a classroom setting) or the control group (n=18, received only CGT). Both groups underwent a 5-day intervention. We created a real-world setting in which participants performed role-based behaviors to evaluate whether the intervention could be generalized to daily life situations. Anxiety, self-confidence, motivation, metacognition, and self-efficacy related to performing social role-based behaviors were assessed in all participants in the TCR and control groups two weeks before the intervention (day 0), immediately before the intervention (day 14), during the intervention (day 28), immediately after the intervention (day 42), and two weeks after the intervention (day 56) by the participants themselves and by two research assistants who were unaware of the study’s objectives. Data were analyzed using descriptive statistics and inferential statistics, as appropriate.

Results:

Compared with the control group, the TCR group showed a greater reduction in anxiety (P=.020) and a significant increase in self-confidence (P<.001), motivation (P<.012), metacognition (P=.003), and self-efficacy (P=.008) related to performing social role-based behaviors. In the observer-rated questionnaire, the TCR group demonstrated greater anxiety reduction (P=.002), increased self-confidence (P=.025), motivation (P<.001), metacognition (P=.003), and self-efficacy (P=.006), related to performing social role-based behaviors in the observer-rated questionnaire.

Conclusions:

These findings support the feasibility of TCR in promoting self-efficacy for social role-based behaviors in real-life communication situations. Future studies with larger sample sizes and more diverse settings are required to validate these findings.