University of New Orleans ScholarWorks@UNO University of New Orleans Theses and Dissertations Dissertations and Theses Spring 5-18-2018 Mental Health Practitioners Perceptions’ of Presence in a Virtual Reality Therapy Environment for Use for Children Diagnosed with Autism Spectrum Disorder Panagiotis Markopoulos University of New Orleans, [email protected] Follow this and additional works at: https://scholarworks.uno.edu/td Part of the Education Commons, Medicine and Health Sciences Commons, and the Social and Behavioral Sciences Commons Recommended Citation Markopoulos, Panagiotis, "Mental Health Practitioners Perceptions’ of Presence in a Virtual Reality Therapy Environment for Use for Children Diagnosed with Autism Spectrum Disorder" (2018). University of New Orleans Theses and Dissertations. 2472. https://scholarworks.uno.edu/td/2472 This Dissertation is protected by copyright and/or related rights. 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Mental Health Practitioners Perceptions’ of Presence in a Virtual Reality Therapy Environment for Use for Children Diagnosed with Autism Spectrum Disorder A Dissertation Submitted to the Graduate Faculty of the University of New Orleans in partial fulfillment of the requirements for the degree of Doctor of Philosophy in Counselor Education by Panagiotis Markopoulos B.A. & M.A. National and Capodistrian University, Athens/Greece, 2007 B.A. Western Kentucky University, United States, 2008 M.A. Eastern Kentucky University, United States, 2012 May 2018 © 2018, Panagiotis Markopoulos ii Dedication I dedicate my dissertation research work to my parents, as well as to the autism research. Special feelings of gratitude to my beloved parents Aggelo and Eleftheria Markopoulou for their unconditional love and support. Without your love and ongoing courage, I would not have been able to make it so far. You both taught me how to be a humble person, kind to others, never give up in life, and always be optimistic. I love you, mom and dad. I also dedicate this dissertation work to Dr. Roxane L. Dufrene for chairing my research study. Thank you for your ongoing hard work, mentorship love, believing in me and my research, as well as for taking the time to teach me how to become a researcher. I will always be grateful to you. Lastly, I dedicate this work to Dr. Bianca M. Puglia for her non-stop mentorship, love, wisdom, and for helping me to become the good clinician I am today. I will always be grateful to you. iii Acknowledgments Thank you to all my friends for your love, support and encouragement. I will be forever grateful. Thank you to my faculty committee members Drs. Ann M. O’Hanlon and Zarus E. Watson for your time, feedback and ongoing guidance. iv Table of Contents List of Tables ..................................................................................................................... ix List of Figures .................................................................................................................... xi Abstract ............................................................................................................................. xii Chapter I: Introduction .........................................................................................................1 Purpose of Study ..................................................................................................................3 Significance of the Study .....................................................................................................4 Cognitive Development Theory ......................................................................................6 Counseling application of CDT ..................................................................................8 Problem Statement ...............................................................................................................9 Overview Methods and Research Questions .....................................................................10 Overview Methods ........................................................................................................10 Research Questions .......................................................................................................11 Limitations and Delimitations ............................................................................................12 Assumptions of the Study ..................................................................................................13 Definition of Terms............................................................................................................13 Chapter II: Literature Review ............................................................................................19 The Birth of Autism: Then and Now .................................................................................19 DSM History of Autism ................................................................................................22 Societal Perceptions of ASD .........................................................................................24 Characteristics of ASD ......................................................................................................26 Age, Gender and Ethnicity Characteristics ...................................................................26 Medical and Clinical Characteristics ............................................................................27 Cognitive Development Theory as a Framework for ASD ...............................................30 CDT and ASD ...............................................................................................................35 Therapeutic Interventions Used with ASD ........................................................................37 Cognitive Behavioral Therapy ......................................................................................37 Applied Behavioral Analysis ........................................................................................39 Program for Education and Enrichment of Relationship Skills Program .....................40 Early Start Denver Model .............................................................................................41 Sensory Integration Therapy .........................................................................................41 Picture Exchange Communication System ...................................................................42 Auditory Integration Therapy .......................................................................................42 Speech-Language Therapy ............................................................................................43 Verbal Behavior Therapy ..............................................................................................44 Developmental Individual-Differences Relationship-Based Model .............................44 Relationship Development Intervention Program .........................................................45 Social Communication/Emotional Regulation/Transactional Support Model ..............46 A New Treatment Era in Mental Health: Technology .......................................................47 Professional Ethics When Using Technology ...............................................................48 Mental Health Practitioners Use of Technology ...........................................................51 Types of Therapy Provided Using Technology ............................................................53 Distance therapy ........................................................................................................53 Telehealth ..................................................................................................................56 Virtual reality ............................................................................................................58 Research using VREs ...............................................................................................59 v Head-mounted displays ............................................................................................61 Virtual Reality and ASD ...............................................................................................63 Research using VREs with ASD ..............................................................................64 Summary ............................................................................................................................69 Chapter III: Research Design .............................................................................................70 Introduction ...................................................................................................................70 Pilot Study ..........................................................................................................................70 Purpose ..........................................................................................................................70