Assessing the utility of Virtual Reality technology to challenge Intolerance of Uncertainty in adolescents with Autistic Spectrum Disorder and implications for educational settings

  • Deborah Drury

Student thesis: Doctoral ThesisDoctor of Philosophy


This study assessed the utility of Virtual Reality (VR) technology to challenge Intolerance of Uncertainty (IU) in adolescents with Autistic Spectrum Disorder (ASD). IU has utility in explaining anxiety in neurotypical populations but research considering its presentation and effect on anxiety levels in ASD populations has only been given attention in recent years. The objective of this study was to provide practical mechanisms to alleviate anxiety associated with IU which could be utilised in educational settings, including those pertaining to Special Educational Needs (SEN), and more particularly ASD-support contexts.

A specially tailored VR programme was designed to immerse ASD adolescents and a typically developing (TD) comparison group in a range of scenarios which had high levels of predictability and sameness. These scenes were subsequently disrupted through the introduction of ‘wrongality’ (i.e. things that go wrong during the virtual experience) in order to assess participants’ ability to deal with uncertainty. During the ‘wrongality’ stage, coping strategies were introduced with solution-based alternatives to empower children for similar challenges they could face in physical world situations. The benefit of running the programme in a Virtual Learning Environment (VLE) offered the opportunity for tasks normally viewed as potentially stressful to be rehearsed in a safe and non-threatening space.

Two post-primary schools with 21 adolescents aged between 11 – 14 years participated in the study. In order to monitor anxiety levels in terms of coping with IU and provide comparative data to investigate the efficacy of VR therapies for children on the autistic spectrum, 11 were typically developing children and 10 had a formal diagnosis of ASD. Data was recorded through a range of qualitative methods: questionnaires, semi-structured interviews, focus groups, as well as detailed observations throughout the VR interventionist programme.

Key findings arising from this study showed higher levels of anxiety related to coping with uncertainty amongst ASD participants compared to TD participants. In addition, the offer of compromise solutions in VR lowered anxiety levels as participants had the capacity to choose alternatives which led to a reported sense of self-empowerment. The use of avatars (or virtual ‘non-player characters’) supported the children throughout this process as they began to feel empowered to make their own choices, reinforcing the relevance of Vygotskian and Deweyian principles of learning within the twenty-first century context of Virtual Learning Environments. The virtual world was viewed as a calm, safe and comfortable space within which to practise unpredictable situations, and a strong belief in the utility of VR was shared across all participants in terms of its potential capacity to transfer skills learned in a virtual world environment to physical-world settings.

These conclusions are summarised in the study’s ‘Drury Model’ which not only confirms Intolerance of Uncertainty as a relevant construct in ASD research but demonstrates the capacity of VR technology as an effective treatment tool with utility to alleviate anxieties related to IU.
Date of AwardDec 2020
Original languageEnglish
Awarding Institution
  • Queen's University Belfast
SponsorsKeith Drury Art
SupervisorLaura Dunne (Supervisor)


  • Virtual Reality
  • Autism
  • Intolerance of Uncertainty
  • Autistic adolescents
  • anxiety

Cite this