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Computerized smartglasses are being developed as an assistive technology for daily activities in children and adults with autism spectrum disorder (ASD). While smartglasses may be able to help with educational and behavioral needs, their usability and acceptability in children with ASD is largely unknown. There have been reports of negative social perceptions surrounding smartglasses use in mainstream populations, a concern given that assistive technologies may already carry their own stigma. Children with ASD may also have a range of additional behavioral, developmental, and social challenges when asked to use this emerging technology in school and home settings.
The usability and acceptability of Glass Enterprise Edition (Glass), the successor to Google Glass smartglasses, were explored in children with ASD and their caregivers.
Eight children with ASD and their caregivers were recruited to attend a demonstration session with Glass smartglasses the week they were publicly released. The children had a wide range of ability, including limited speech to speaking, and represented a full range of school ages (6 to 17 years). Children and caregivers were interviewed about their experience of using the smartglasses and whether they would use them at school and home.
All 8 children succeeded in using Glass and did not feel stressed (8/8, 100%) or experience any overwhelming sensory or emotional issues during the session (8/8, 100%). All 8 children (8/8, 100%) endorsed that they would be willing to wear and use the device in both home and school settings. Caregivers felt the experience was fun for the children (8/8, 100%), and most caregivers felt the experience was better than they had expected (6/8, 75%).
A wide age and ability range of children with ASD used Glass immediately after it was released and found it to be usable and acceptable. Despite concerns about potential stigma or social acceptability, all of the children were prepared to use the technology in both home and school settings. Encouragingly, most caregivers noted a very positive response. There were no behavioral, developmental, or social- or stigma-related concerns during or after the session. Smartglasses may be a useful future technology for children with ASD and are readily accepted for use by children with ASD and their caregivers.
Autism spectrum disorder (ASD) is a childhood-onset developmental disorder, with an estimated 3.5 million people being diagnosable with ASD in the United States alone [
Smartglasses can deliver a large range of experiences, including augmented and virtual reality [
There are a number of important differentiating factors to consider when smartglasses are compared to handheld devices. Handheld devices such as tablets and smartphones require one or both hands to hold the device and encourage a heads-down posture (
The emergence of a new crop of smartglasses is encouraging, especially because the initial public reaction to the widely recognized original Google Glass resulted in some negative social reactions. Modern smartglasses vary in terms of physical dimensions, functionality, and intended user group. For the purposes of this report, we decided to investigate the acceptability and usability of the most recently released lightweight smartglasses, Glass Enterprise Edition (Glass). Glass was released by X (a subsidiary of Alphabet Inc, formerly known as Google X) in July 2017. Glass is an assistive-reality technology, and it is the successor to Google Glass, one of the most recognizable smartglasses in the world [
It would seem that the Enterprise Edition (which has updates to the form factor, usability, central processor, display, audio system, and other features) would represent a substantial advantage for assistive technology apps and algorithms for ASD. However, it remains unknown whether people with ASD would actually desire to wear the new device. Assistive apps for people with ASD on the original Google Glass have been shown to be tolerable [
Head-worn computers encourage users to be heads-up and allow them to be hands-free in contrast to screen-based technologies such as phones and tablets. (A) Demonstrative example of a person using a tablet while her sibling uses Glass Enterprise Edition, days after it was released. Both siblings have autism spectrum disorder. Tablet use encourages a heads-down stance, suboptimal posture, and visual disconnection from the social world. (B) The Glass Enterprise Edition device from multiple views.
Given that the initial entry of Google Glass and other smartglasses raised privacy concerns and some negative public reaction, the announcement of a major new release of head-worn computing [
As with any assistive technology, it is important to investigate and understand the attitudes of children and young adults with ASD, especially because children with special needs are often forced to use devices and systems they do not actually like or want to be associated with [
Many people with ASD use assistive technology to help them with communication skills, social and emotional skills, and adaptive/daily activities and living skills [
There have only been a handful of reports on the use of smartglasses in people with ASD [
The human face, a complex and dynamic system, is our most powerful means of social communication [
The relative effect of this obscuring of the facial region may be dependent on the size of the individual’s face relative to the smartglasses, which may correlate with the age of the individual given that biologic age determines an individual’s head size [
Given these reports and considerations, the physical presence of smartglasses may affect social communication, and it may be sensible to attempt to minimize such facial obscuration to enhance social communication between people with ASD and their family members.
The presence of face-worn smartglasses may also influence social relationships, of the adults or children who wear them, as they alter a user’s facial appearance. Unlike many other assistive technologies, they are not easy to hide. Wearing smartglasses may not only alter how the user perceives the world but may alter how the world perceives the user. Facial appearance plays a key role in determining how people interact with one another [
The perceptual impact of smartglasses and their ability to augment a child’s cognitive and emotional functioning may have a central and influential role in childhood development if we consider Bronfenbrenner and Ceci’s bioecological model [
Furthermore, use of smartglasses by future school-age children and adolescents should prompt a discussion of Erikson’s 4th and 5th psychosocial stages [
Following this stage is Erikson’s 5th psychosocial stage that occurs in adolescence, described as a psychosocial crisis between identity versus role confusion [
Learning happens continuously in childhood, and the use of smartglasses technology may provide a digital means of enabling learning to occur, as in Vygotsky’s zone of proximal development (ZPD) [
School-age children with ASD are at risk of being stigmatized [
We gave 8 children with ASD an opportunity to try the Glass smartglasses in a controlled, recorded environment and to explore its features, usability, and visual characteristics. We observed and recorded the interaction of the children with the device. We also conducted a postsession semistructured interview with the children and their caregivers, who accompanied the child and observed the whole session. Our sample represented a broad age range and severity spectrum of ASD.
The use of the Brain Power Autism System running on multiple head-worn computing devices by children and adults with autism was approved by Asentral Inc Institutional Review Board, an affiliate of the Commonwealth of Massachusetts Department of Public Health. The study was performed in accordance with relevant guidelines and regulations.
Eight children with clinically diagnosed ASD and their caregivers were entered into this study. The participants represented a wide range of school-aged children, ages 6.7 to 17.2 years (mean 11.7 [SD 3.3] years), including 7 males and 1 female. Participants were recruited from a user research database created from Web-based research interest forms. Written consent for study participation was obtained from the legal guardians, and children from age 7 to 17 years provided written assent. In this report, every participant was accompanied by a parent or guardian caregiver to the session, and participants and caregivers could exit the session at any time and for any reason. It was explained that the main aim of the study was to understand the acceptability and usability of modern smartglasses technology in children with ASD.
Caregivers rated the participant level of overall ASD functioning according to a subjective 7-point scale (1=lowest-functioning/severe to 7=highest-functioning/mild). Caregivers also rated speaking ability on a similar scale (1=nonspeaking to 7=fully conversational). Participants represented a large range of overall ASD functioning (range 4 to 7 out of 7; mean 5.6 [SD 1.1]) and speaking ability (range 4 to 7 out of 7; mean 5.5 [SD 1.3]).
Participants and their caregivers were orientated to the testing room where they had an opportunity to learn about the Glass smartglasses and to physically wear and use them. They were provided with any assistance they required to properly place the smartglasses on their heads and align it with their eyes, although little assistance was needed. They were able to use any of the apps on the smartglasses. Testing sessions were recorded via video and photographs. All participants and/or caregivers gave written consent for their images and video to be used in current and future research analyses.
Following the testing, participants and caregivers went into a separate room where they were questioned about their experience as part of a semistructured interview. The participants were asked to compare their experience of Glass with previously tested assistive devices and gamified apps related to ASD. As previously noted, the participants were recruited from a research database for technology-related studies in ASD, and all had seen and tried the original Google Glass. Participants were asked if they became stressed when using the device and if the session was an overwhelming sensory or emotional experience for them. The questions were adapted or simplified based on the child’s speaking ability and were repeated if needed. Study staff interacted with the child and caregiver and spent time ensuring the questions were understood, considered, and accurately answered.
Participants were then asked whether they would consider wearing and using the device for 1 hour each day in their school and separately asked the same question about using the device at home. The caregiver was also interviewed in order to rate whether they felt the experience was fun for the participant and whether they felt the experience with the smartglasses went better than they had expected.
Individuals who had a known history of epilepsy or seizure disorder were not asked to take part in this study. Individuals who had any uncontrolled or severe medical or mental health condition that would make participation in the study predictably hazardous were also not invited to participate.
All 8 children, who represented the full range of school ages (6 to 17 years), successfully wore, interacted with, and explored one or more Glass smartglasses (
All participants noted that they did not feel stressed (8/8, 100%,
Children on the autism spectrum using and exploring the Glass Enterprise Edition device during a testing session at Brain Power. Each of the 8 participants, who represent the entire range of school ages, range from mild to moderate autism severity, and demonstrate a wide breadth of speaking ability (from moderate impairments in speech to being fully conversational), rated Glass Enterprise Edition as desirable to wear on their heads and use daily in the often-complex social environment of school and at home.
Participant responses following use of smartglasses.
Question | Yes |
No |
Neutral or undetermined response |
Would you wear the smartglasses for 1 hour each day at school? | 8 (100) | 0 (0) | 0 (0) |
Would you wear the smartglasses for 1 hour a day at home? | 8 (100) | 0 (0) | 0 (0) |
Did you feel stressed while wearing the smartglasses? | 0 (0) | 8 (100) | 0 (0) |
Did you feel overwhelmed (emotionally/sensory)? | 0 (0) | 8 (100) | 0 (0) |
Caregiver responses following use of smartglasses.
Question | Yes |
No |
Neutral or undetermined response |
Was it fun for your child to use Glass? | 8 (100) | 0 (0) | 0 (0) |
Did the experience go better than you anticipated? | 6 (75) | 0 (0) | 2 (25) |
Smartglasses are an emerging technology that could hold much promise as an assistive technology for children and young adults with ASD. It is important to seek the opinions of children with ASD and their caregivers when considering the use of a new assistive device. This is especially true of smartglasses given their high level of visibility, prior reports of negative social perceptions, and the potential interplay of such devices with social communication and child development. Children with ASD and their caregivers may be particularly discerning about factors that could impact the use and social acceptance of such technologies in educational settings such as schools and in the home environment.
The results demonstrate that Glass was acceptable and desirable by all participants, who spanned the full range of school ages (6 to 17 years). It was encouraging to find that all 8 school-aged children with ASD felt that using these smartglasses was not a stressful experience and denied being overwhelmed in a sensory or emotional way. Additionally, it was also promising to see that all of the children expressed a willingness to use these devices in both school and home settings. Caregivers noted that children had fun using the device, and most caregivers felt their expectations of how the children would interact with the smartglasses were surpassed.
These results are important for a number of reasons. Children with ASD are frequently not involved in providing design or usability feedback to interventions and technologies developed for them. Involving children when choosing an assistive device is crucial to ensure that the device is socially appropriate for the environment, which will likely lead to greater compliance in wearing the device. It also appears that these children are accepting of new technologies, even on relatively uncommon and highly visible platforms such as head-mounted computers. The children who participated in this study were more open to using Glass in a public environment than many adults have been [
The unanimous willingness of participants to wear the smartglasses in school is also important. The school setting is a place of high risk relative to social integration and stigma that could result from an undesirable or socially inappropriate device or behavior. This is one reason we chose the question of acceptability of the device at school as a high-bar test for how desirable and acceptable this new device may be. However, a limitation of this work is that we asked for the opinion of the target users, and such an opinion is necessarily based on a prediction. It may be hard to predict how a device or behavior will actually be received in the complex and changing social hierarchy of a school environment. Additionally, children with ASD may have extra challenges in predicting the emotional reactions and behaviors of their classmates, especially if they are in an integrated school environment with neurotypical or typically developing children their same chronological age. For all these reasons, further research is needed to test the acceptability within school environments.
These results suggest that a smartglasses platform may be an acceptable base for assistive software apps that could promote self-sufficiency. For instance, they may have a desirable new platform for gamified, social-emotional self-coaching apps based in neuroscience and artificial intelligence that have been deployed on other head-worn computer platforms [
This paper represents the first published work, to our knowledge, using Glass (Enterprise Edition). It also represents the first published use of Glass as an assistive or assessment device for people with different abilities or intellectual disabilities or challenges. This work extends our previous research on the use of the original Google Glass as an aid to people with ASD [
The authors thank Google, Inc. for a generous grant and also the Glass team at X (formerly Google X) for technical guidance on Glass software development. This work was supported by the Office of the Assistant Secretary of Defense for Health Affairs through the Autism Research Program under Award No. W81XWH 17-1-0449. Early work to transform smartglasses into biomedical sensors was supported in part by the United States Army Medical Research and Materiel Command under Contract No. W81XWH-14-C-0007 (awarded to TIAX, LLC). Opinions, interpretations, conclusions, and recommendations are those of the authors and are not necessarily endorsed by the Department of Defense. The authors would also like to acknowledge Krystal Huey for her help with study coordination.
autism spectrum disorder
Glass Enterprise Edition
zone of proximal development
This report was supported by Brain Power, a neurotechnology company developing a range of artificially intelligent wearable technologies. Brain Power has engineering and technical partnerships with major technology companies and also receives funding support from federal and congressional sources.
NS is the inventor of the Brain Power Autism System. NS, JS, NK, and AV designed and undertook the intervention. The writing of this technology report was led by AV, and all authors contributed.