The use of Interactive Spatial Audio as a Means of Addressing Auditory Hypersensitivity in Autistic Young People

Individuals diagnosed with autism spectrum disorder (ASD) are characterised as having impairments in social-emotion interaction and communication, alongside displaying repetitive behaviours and a limited range of interests. Additionally, they can frequently experience difficulties in processing sensory information with prevalence in the auditory domain. Often triggered by everyday environmental sounds, auditory hypersensitivity can lead to self-regulatory fear responses such as crying and isolation from sounds. Rather than a physiological pain reaction, literature suggests that these hypersensitivities are established in an irrational fear of the sounds. This has subsequently led to several successful interventions that increase habituation to problematic auditory stimuli through controlled, safe and graduated exposure. In recent years this therapy has been embedded into serious computer game mechanics, delivering exposure-based training within an engaging and motivating virtual environment. The research presented in this thesis investigates the use of three-dimensional spatial audio as an approach to rendering realistic simulations of adverse stimuli within a virtual reality game environment developed to reduce auditory hypersensitivity in autistic children and adolescents ($8-19$ years old). This was achieved through empirical studies assessing the effectiveness of reducing the negative emotional associations towards auditory stimuli presented using binaural based spatial audio. With additional emphasis evaluating the VR intervention environment and game mechanics. Findings indicate that playing the game produced as part of this doctoral project over the course of 4-weeks can be effective in reducing negative emotions linked to problematic sounds in autistic young people. Furthermore, comparative results suggest that these reductions can be significantly improved upon when using binaural based spatial audio instead of stereo audio rendering. This therefore supports the use of three-dimensional sound as an audio rendering technique to target auditory hypersensitivity in autistic individuals, ultimately improving their quality of life.