Can a DVD Teach Kids with Autism to Understand Emotions?

Makers of an animated series say it can offer hope—and big functional improvements.

By Melissa Lafsky|Wednesday, March 04, 2009

While a bouncy tune chirps in the background, Sally, an animated cable car with a live-action human face, makes her way over a viaduct, beaming as a narrator explains how “very happy” she is to carry her passengers to their destination. Midway across, her cable clamp malfunctions, leaving her stuck high above a waterway running through a quiet village. Charlie, a happy-go-lucky tram with the face of a thirtysomething man, is her only hope of rescue. In careful, simple language, the narrator explains that Sally is afraid during the experience, while Charlie is happy when he succeeds in delivering her from danger. As each emotion is named, the characters grin, frown, or grimace accordingly.

No, it’s not the latest Disney project or Thomas the Tank Engine rip-off. It’s a new therapy for autism. Simon Baron-Cohen, one of the world’s preeminent autism experts, developed the DVD, and he says his research shows that it brings significant improvements to children with autism, a syndrome that has stubbornly resisted treatment after treatment. Called The Transporters, the DVD aims to teach kids on the higher level of the autistic spectrum a key skill that many of them find nearly impossible: how to understand emotions.

The number of children diagnosed with autism spectrum disorder is increasing at an astounding rate, rising approximately tenfold in the past two decades. While the cause of this huge increase is still being debated—is it an actual rise in cases or simply an expansion in awareness and diagnosis?—more and more resources are being directed toward treating the rising number of children with the disorder.

Unfortunately, there aren’t many proven effective ways to spend those resources. Many parents are focusing on physical methods of treatment, such as medications and special diets, and some are even coughing up thousands—to the point of taking out second mortgages and emptying savings accounts—on often controversial and possibly risky treatments such as chelation, and hyperbaric oxygen chambers. But a method that has gained significant support from researchers and parents alike is behavioral therapy, or the study and analysis of autistic behavior with an eye toward offsetting key symptoms of the disorder.

With this in mind, The Transporters was created as a tool to target one of the largest symptoms of autism: the inability to recognize or comprehend emotions. Each episode involves a simple plotline, like a surprise birthday party, and focuses on a different emotion, beginning with the most basic—happiness, sadness, anger, fear, and surprise—and moving to the more sophisticated, like disgust, tiredness, pride, and shame. Every time a character reacts to his or her situation and presents an emotion, the narrator names it. For instance, once Charlie overcomes his vertigo and comes to Sally’s aid during her moment of peril, he says he feels “very proud” of his accomplishment, and his beaming face is shown close-up.

“In autism, there’s a lot of research showing difficulties in generalization—you can teach kids to repeat back the names [of emotions], but it’s difficult to achieve a level where they can apply what they’ve learned to new situations,” says Baron-Cohen, director of the Autism Research Center at the University of Cambridge. “What we’ve set out to do is provide them a means of reaching that level on their own, where they learn to see emotions in varying contexts.”

Baron-Cohen says the video works because of his theory of systemizing: All human brains have a need to understand how systems works, a need that is set at different levels for different people. An autistic person, who appears lost in his or her own world, has a brain set to hypersystemizing. As such, children with autism love trains and other single-direction, systematic vehicles and tend to watch them carefully, both in reality and on TV.

Every detail in The Transporters is meant to cater to the autistic mind and teach kids how to understand other people’s emotions. Casting was based on an actor’s ability to produce clear emotional expressions, and a panel of 20 judges, mostly psychologists, was used to evaluate whether each face that appears in the episodes in fact represents the emotion to which it is matched. The eight characters—all vehicles that move slowly and follow predictable, one-way tracks—are animated, but each has a real human face superimposed on it so that any emotions expressed will be “real.” The characters interact with each other in four simple, predictable locations: a junction, a harbor, an observatory, and a quarry. “Past studies show that children with autism like mechanical objects and predictability,” Baron-Cohen says. “Here, we merged the two, keeping everything mechanical and linear—back and forth is the only possible movement, and the only characters are machines.”

The final product, 15 five-minute episodes along with 30 interactive quizzes and a written guide for parents, was released in the U.K. in January of 2007 and received an enthusiastic response: 40,000 copies were offered, free of charge, to families with autistic children between ages 2 and 8, and every one of the copies had been claimed within three months. An American version of the DVD was released in January 2009 and has received significant interest from schools, autism clinics and societies, and libraries, as well as an undisclosed number of parents.

While past research has indicated that a tool like this could make substantial headway in teaching kids to read expressions, Baron-Cohen and his colleagues also tested the DVD in a peer-reviewed study that will be published this year in the Journal of Autism and Developmental Disorders. The data were based on three groups of around 20 children each, all between the ages of 5 and 8. Groups 1 and 2 were made up of high-functioning autistic children, all of similar age, with similar IQs, language skills, and parental education levels. Group 3 was made up of nonautistic children of a similar age.The first group watched the video for 15 minutes every day for four weeks, while the second and third groups did not watch it at all. Group 1 was then tested on basic recall of the faces they’d seen, recognition of expressions by Transporters characters in situations not shown in the DVD, and expressions on completely new faces.

The first group was found to have improved on all three levels. In fact, most of the children in Group 1 improved significantly more than Group 2, and even caught up with the “normal” group in their ability to recognize emotions.

Parents using the DVD have gushed about its effectiveness on the Transporters Web site and various autism blogs. Some parents even cite the series’ effects as a near miracle. “It’s been astonishing,” said Caron Freeborn, a mother in Cambridge, England, whose older son, Jude, was diagnosed with autism when he was 3. While he has learned to speak with the help of a psychologist and child development expert, his understanding of emotions is extremely limited. Around five months ago his mother purchased the DVD on recommendations from local autism groups, and he now watches with a parent around twice a week.

“Before, the only emotions Jude understood were happy and sad, and he didn’t understand that other people could feel happy or sad when you didn’t,” Freeborn says. “Now he has a much more complex understanding of happy and sad, and he’s even starting to understand disgusted, which is useful since he has a younger brother.” Plus there’s the emotional side benefit Freeborn says the video has brought to her family: a better relationship between Jude and his father. “He’ll sit with his dad and properly watch and talk about it, so it’s not just about accessing the emotions on the program but also making a connection between him and his dad,” Freeborn says.

Meanwhile, some in the scientific community have had more tepid reactions, with experts raising questions about the DVD’s effectiveness in treating the disorder. “The idea is that the kids will be interested in the video because it capitalizes on systematic thinking—these are mechanical cars running on lines, so their motion is predictable,” says Mark Strauss, director of the Infant & Toddler Development Lab at the University of Pittsburgh and a leading researcher in the cognitive abilities of autistic children. “[But] a lot of things in the video were very unpredictable—the cuts and the motions and the action. Even as an adult, I found it difficult to follow.”

Jim Tanaka, a professor of psychology at the University of Victoria in British Columbia and a leading face recognition researcher, questions whether aspects of the facial expressions in the series are too subtle to resonate with autistic children. “Kids with autism have appreciable deficits in emotion recognition, particularly with making discriminations in the eyes,” he says. “[But] they’re good at making discriminations in the mouth area. The social emotions in The Transporters are pretty subtle, and may not get kids to see those eye differences.”

Also in question is whether the results shown in Baron-Cohen’s study represent just a temporary bump in improvement versus a deep and lasting increase in emotional recognition. “There are a lot of questions about whether it works, both for low-functioning versus high-functioning [children], in terms of maybe just giving a momentary improvement early on,” Strauss says.

One way to find out, of course, is through bigger and more detailed studies. Baron-Cohen’s results were based on a small sample over a short time period and were unusually positive—notable particularly since the research team consisted of the Transporters developers themselves.

“This is a truly remarkable response to a very short intervention,” says Jeanette McAfee, founder and director of California’s Social Solutions Clinic and author of Navigating the Social World: A Curriculum for Individuals with Asperger’s Syndrome, High Functioning Autism and Related Disorders. “As always, there is a need for larger studies to assure that the results are reproducible.”

“The results…are promising,” Tanaka says, “[but] they deserve independent test and replication.”

Others defend the research findings, noting that Baron-Cohen’s methods and status as an interested party are hardly atypical. “Almost all treatments proposed [for autism] have been studied initially by the creators of those treatments,” says Catherine Lord, director of the University of Michigan Autism and Communication Disorders Center. “And almost always treatments have not worked as well when carried out by others. But it is to his credit that he studied its effectiveness at all. Many treatments offered to families of children with autism spectrum disorder have virtually no data to support them.”

Most experts agree that there’s really no harm that can come from watching the DVD, though they warn that getting the maximum results may depend on whether or not parents reinforce the lessons through one-on-one conversations about the episodes and emotions. “Don’t plop the kid in front of it without any further discussion,” Strauss says.

Researchers also stress that The Transporters isn’t meant to be a miracle cure but rather a useful step in treating one major symptom of a complex disorder. “I would encourage families not to see this, or any other treatment, as a simple solution,” Lord says, “but to take advantage of its creative approach to engaging children to set goals and build strategies…to build real social behaviors with real people.”

For their part, parents say that any potential source of improvement is better than none at all and that even a minor jump in development can be huge for an autistic child. “The thing about autism is that any step that is made in improving a child’s relationship with the world is going to be a small step, but at the same time it’s a massive step,” Freeborn says. “It’s not a quick fix, but The Transporters doesn’t imply that it’s going to be a quick fix. It recognizes how a child with autism learns, which is very differently than anyone else.”

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