AutPlay® Therapy and the Virtual Sandtray App (VSA)

Research supports that individuals with autism spectrum disorder (ASD) are often drawn to technology more so than their neurotypical peers (Goldsmith & LeBlanc, 2004), and incorporating technology-based interventions (especially those that have shown promise in addressing ASD issues), becomes a logical treatment process. The increasing popularity, affordability, accessibility, and availability of technology devices have influenced research on ASD. Because of the popularity and versatility of technology devices, utilizing these devices as therapy tools has become an acceptable practice. The implementation of technology-based devices provides a variety of possibilities for improving intervention services to children with ASD (Kim & Clarke, 2015).

The Virtual Sandtray App (VSA) was created by Dr. Jessica Stone and is one example of a technology tool that can be used with children and adolescents with ASD. AutPlay® Therapy (Grant, 2017) and the VSA partnered to create an expansion pack within the VSA app which is specifically designed for children with ASD. The expansion pack includes several models/miniatures which were designed or added that better represent children and adolescents with ASD and related conditions. The expansion pack also includes 20 directive tray prompts designed to help increase social skill, emotional regulation, and connection deficits.

Before implementing the VSA with a child with ASD, the therapist should introduce the app to the child explaining basic navigation. The therapist should give the child a tour of the app, show the child the categories and models/miniatures and demonstrate creating a tray. The therapist should explain to the child that models/miniatures can be used literally (a little boy miniature with brown hair can represent a little brother who has brown hair) or they can be used symbolically (a car miniature can represent a little brother because he likes to play with cars). It would be appropriate time to fully explain the concept of symbolism. The child with ASD does not have to fully understand symbolism – if they can understand it on a basic level then they can participate in using the VSA and use the app to increase their symbolic and pretend play skills.

Through the AutPlay® expansion pack, the therapist can use one of the 20 directive tray prompts to align with treatment goals for children with ASD. These prompts are specifically designed to use with the functions of the VSA including models/miniatures and target primary issues such as social skill and emotional regulation deficits. The therapist may want to reiterate the concept of symbolism each time the child is given a directive tray to complete. The therapist may also assist the child in completing trays if the child is struggling with the instructions. The therapist should allow the child time to process (children with ASD tend to have slower processing times) and complete the tray on their own, but the therapist must always be available to implement a psychoeducational approach in helping the child navigate the tray process. The more prep work the practitioner does with the VSA process, the more successful it will be for the child with ASD.

Five benefits of using the VSA with children with ASD:

1) Virtual sandtrays create a strong visual which is the primary learning style for children with ASD. Pictures can be taken of trays, trays can be saved, and children can reference them at home. Additionally, tray pictures can accompany social stories.
2) Some children with ASD have an aversion to real sand due to sensory issues and physical limitations in grasping miniatures. The VSA is an effective alternative for these children.
3) The VSA provides a portable option for sandtray work and can easily be taken into the home setting, a hospital, or a residential setting.
4) The electronic element is engaging to children with ASD and virtual sandtrays can promote skill development such as turn taking, interacting with another person, and group task completion – especially when implementing one of the 20 directive tray prompts designed for children with ASD.
5) The VSA can be shared and used through a telehealth process which allows the therapist and child to interact via a video-based session.

A growing number of research studies (Goldsmith & Leblanc, 2004), including a meta-
analysis review, have been conducted which highlight the use of various technology
interventions for treatment of ASD. Technology-based interventions have proven successful in teaching new skills to children and adolescents with ASD and the VSA and AutPlay® pack provides another option for therapists in their work with children with ASD.

Goldsmith, T. R. & LeBlanc, L. A., (2004). Use of technology in interventions for children with autism, Journal of Early Intensive Behavior Intervention, 1(2), 166-178.

Grant, R. J. (2017). AutPlay therapy for children and adolescents on the autism spectrum: a behavioral play-based approach. Routledge.

Kim, S. & Clarke, E. (2015). Case study: an iPad-based intervention on turn-taking behaviors in preschools with autism, Behavioral Development Bulletin, 20(2), 253-264.

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