This article is part of Upstart, a series of articles about young companies taking advantage of new technologies.
Vijay Ravindran has always been fascinated by technology. At Amazon, he oversaw the team that created and launched Amazon Prime. He later joined The Washington Post as chief digital officer and sold the paper to his former boss, Jeff Bezos, for Donald E. Graham in 2013 Provide suggestions.
By the end of 2015, Mr. Ravindran’s work at the Graham Holdings Company was winding down. But his main focus was his son, who was 6 years old at the time and was being treated for autism.
“Then an amazing thing happened,” Mr Lavender said.
Mr Ravindran was hanging out with a virtual reality headset when his son asked to try it out. After 30 minutes of using the headset in Google Street View, the kid went to his playroom and started acting out what he was doing in virtual reality.
“This is the first time I’ve seen him play like that,” Mr Lavender said. “It ended up being a lightbulb moment.”
Like many children with autism, Mr. Ravindran’s son struggled with pretend play and other social skills. His son’s ability to translate his virtual reality experience into the real world sparked an idea.A year later, Mr. Lavenderin started a company called Floreothe company is developing virtual reality courses designed to help behavioral therapists, speech therapists, special educators and parents working with children with autism.
The idea of using virtual reality to help people with autism has been around for some time, but Mr Ravindran said the widespread availability of commercial virtual reality headsets since 2015 has allowed for much larger research and commercial deployments. Floreo has developed nearly 200 virtual reality lessons designed to help children build social skills and train them for real-world experiences, such as crossing the street or choosing a location in the school cafeteria.
Last year, the company delivered 17,000 classes to U.S. customers as demand for telehealth and distance learning services surged during the pandemic. Autism experts believe the company’s flexible platform could go global in the near future.
This is because the need for behavioral and speech therapy and other forms of intervention to address autism is so great. Diagnosing autism can take months – a critical period in a child’s development when therapeutic intervention is critical. And this treatment can be expensive and requires a significant investment of parents’ time and resources.
The Floreo system requires an iPhone (version 7 or later) and a VR headset ($15 to $30 for low-end models), as well as an iPad, and can be used by a parent, teacher or coach in person or remotely. The plan costs about $50 per month. (Floreo is currently working toward insurance reimbursement and has been approved for Medicaid in four states.)
The child puts on the headset and navigates the virtual reality lessons, while the coach – which can be a parent, teacher, therapist, counselor or personal assistant – monitors and interacts with the child via the iPad.
Lessons cover a wide range of situations, such as visiting an aquarium or going to the grocery store. Many classes involve teaching autistic children to interpret body language, who may have difficulty interpreting nonverbal cues.
Self-advocates for autism point out that behavioral therapy for autism is controversial among people with autism, who argue that it is not a curable disorder and that treatment is often imposed by a non-autistic parent or guardian for children with autism. Behavioral therapy can harm or punish children for behaviors such as restlessness, they say. Rather than allowing autistic people to behave like neurotypical individuals, they argue, society should welcome them and the different ways they experience the world.
“Many of the mismatches between people with autism and society are not the fault of the person with autism, but the fault of society,” said Zoe Gross, director of advocacy for the Autism Self Advocacy Network. “People should be taught to interact with people with different types of disabilities.”
Mr Ravindran said Floreo respects all voices in the autism community, where needs are diverse. He noted that while Floreo is used by many behavioral health providers, it has been deployed in a variety of settings, including schools and homes.
“The Floreo system is designed to be positive and fun, while creating positive reinforcement that helps develop skills that help adapt to the real world,” said Mr. Ravindran.
In 2017, Floreo received a $2 million fast-track grant from the National Institutes of Health. The company first tested whether children with autism would tolerate headphones, and then ran a randomized controlled trial to test the method’s usefulness in helping people with autism interact with police.
Early results are promising: according to a study Published in the Journal of Autism Research (Mr. Lavenderland is one of the authors), 98 percent of the children completed their course, dispelling concerns that sensory autistic children are resistant to headphones.
Ms Gross said she sees potential in virtual reality classes to help people rehearse unfamiliar situations, such as Floreo’s road crossing classes. “There are parts of Floreo that are very exciting: walking through the airport, or trick-or-treating — it’s a social story about something that doesn’t happen often in someone’s life,” she said, adding that she Would love to see a medical procedure lesson.
However, she questions the widespread emphasis in the behavioral therapy industry on using emerging technologies to teach social skills to people with autism.
A second randomized controlled trial using telehealth, conducted by Floreo using another NIH grant, is underway, hoping to show that Floreo’s approach is as effective as face-to-face instruction.
But it was these early successes that made Mr. Ravenderin fully committed to the project.
“There’s just a lot of really excited people,” he said. “When I started showing my family what we had developed, people would just give me a big hug. They would start crying that someone was developing such a high-tech solution for their kids.”
Clinicians who have used the Floreo system say the virtual reality environment makes it easier for children to focus on the skills taught in lessons, unlike the real world, where they can be overwhelmed by sensory stimulation.
Celebrate the Children, a nonprofit private school in Danville, NJ for children with autism and related challenges, hosted one of Floreo’s early pilots; Monie, Co-Founder and Executive Director of the school Kaosgood said the school continued to use the system.
Wearing virtual headsets can be very empowering for students, she said, because they are able to control their environment with slight movements of their heads. “Virtual reality is definitely a real gift to our students and we will continue to use it,” she said.
Kelly Rainey, special instruction manager for the Developmental Disabilities Council of Cuyahoga County, Ohio, said her organization has used Floreo for the past year to help students improve their life and social skills. Her colleague, early childhood intervention specialist Holly Winterstein, said the tools are more effective than the conversation cards therapists typically use. The office started with two headsets, but quickly purchased equipment for each of its eight staff members.
“I do see limitless possibilities,” Ms Winterstein said.
“Floreo’s social skills have always been popular,” said Michea Rahman, a speech-language pathologist who focuses on Houston’s underserved populations who are also Floreo clients. The system “is probably one of the best or best social skills tools I’ve ever used.” (She adds that 85 percent of her patients are Medicaid.)
To date, the company has raised about $6 million. Investors include LifeForce Capital, a venture capital firm focused on healthcare software, and Autism Impact Fund, an early-stage venture capital fund that invests in companies addressing neurological diseases. (Mr. Lavenderland declined to specify whether the company is profitable.)
For Mr. Ravindran, the company has become a mission. “When I started exploring virtual reality as a form of therapy, I didn’t know if it was a hobby project or if it was going to be a business where I put a little money in, hire some people, and leave to do something else, “He says. “At some point, I got to this place, and if I felt like, if I didn’t build it, nobody would build it.”