Virtual reality helps Black autistic youth discuss depression

A Boston College professor has developed a new virtual reality (VR) tool to help Black youth on the autism spectrum discuss depression and other mental health issues.

Ed-Dee Williams, Ph.D., MSW, says his interest in the area was inspired by his older brother, who is autistic. “I really want to bring a better understanding to how Black autistic youth experience depression, and improve access to services and support,” he said.

Research published by the National Library of Medicine noted that the rate of clinical depression is approximately 12% higher among Black autistic youth than their white autistic peers.

In 2023, for the first time, Autism and Developmental Disabilities Monitoring (ADDM) Network data reported by the CDC shows that the percentage of eight-year-old children identified with autism spectrum disorders (ASD) was higher among Black, Hispanic, and Asian or Pacific Islander children compared with white children.

There are differences culturally in how depression is discussed in the household, noted Williams. In addition to facing ableism and the other biases that individuals on the autism spectrum often face, Black autistic youth also deal with racism, discrimination, and societal stresses such as police brutality and violence in schools.

“Experiencing discrimination from both a capability and a racism standpoint means everything is compounded, and that makes their situation unique,” he said.

Because Black autistic youth are more likely to live in poverty, have less access to resources, and not enough support services in schools, they can also have a greater deficiency in social communication skills, noted Williams.

Black autistic youth are often diagnosed two to three years later than white youth, he added, compounding their increased risk for depression.

“We don’t access Black youth well when it comes to depression,” Williams said. “Screenings don’t take into account societal and cultural differences, so signs of depression in Black youth are often overlooked.”

The VR program was developed with Baltimore-based SIMmersion, which has created role-play and training simulation programs for the federal government, universities, and private companies.

The program guides users through a back-and-forth conversation with a special education teacher character, played by an actor. Users can pick common symptoms such as sadness, anger, helplessness, impairment, and guilt, and then work out how to describe them using the simulation.

Users can practice talking about their feelings associated with depression and the severity of their symptoms with three different teacher “personalities.” Each responds in different ways with pre-recorded responses.

One version is easy going and wants to listen, while another is dismissive of the user’s feelings. The third personality is over eager and talks over the user, telling them what they are feeling, rather than listening to their concerns and actually helping.

In the future, Williams plans to add modules to the program to help not only youth but parents, teachers, and mental health specialists communicate about depression with autistic Black youth.

“Parents and children want to talk, but communication challenges happen on both sides,” said Williams. “Kids feel their parents are already overwhelmed, and don’t want to burden them with the knowledge that their child is depressed or suicidal. And, parents may know their child feels depressed but didn’t want them to think they were a burden or couldn’t be themselves [at home].”

Funding for the program has come in part from SIMmersion, as well as Boston College. Williams is also applying for grants, noting that the tool could easily be adapted to other demographic groups.

The initial pilot of the program launched in October. Williams hopes to have 40 autistic Black youth test the program over the next few months and then conduct a randomized control trial to evaluate its effectiveness before it becomes commercially available.