BIRMINGHAM, Ala. — After finishing a shift stocking coffee beans at grocery stores around Birmingham, 27-year-old Sarah Stewart sits down in her mother’s office chair, straps on a set of virtual reality goggles, and steps into an entirely digital world.
Using a specialized program created by the digital health company Floreo, Sarah selects an exercise that requires her to virtually organize a pantry and refrigerator, placing grocery items into their correct locations. Sarah, who has multiple disabilities including autism, uses the virtual reality platform to rehearse common, everyday tasks and navigate real-world challenges in a controlled, risk-free environment.
“Learning how to deal with these challenges is an important life skill as an adult,” said Sarah’s mother, Margaret Stewart, as she watched her daughter navigate the virtual environment.
In a typical Floreo session, a participant wears a VR headset to complete interactive tasks, sort objects, or respond to situational questions. Meanwhile, a coach or caregiver monitors the user’s progress in real time on an external screen, allowing them to adjust prompts, modify the difficulty of the questions, and provide immediate feedback.
Virtual reality has rapidly emerged as an increasingly common and accessible technological tool for individuals on the autism spectrum. Growing research suggests that when specific therapeutic software programs are combined with positive reinforcement and clinical best practices, they can significantly help users improve both social competencies and essential daily life skills.
Securing access to such tools, however, is not always straightforward. Margaret managed to work through Alabama’s complex Medicaid waiver process to have the state cover the costs of the Floreo program for her daughter. Even so, she noted that other families she knows have faced substantial roadblocks and have been unable to secure state funds to pay for the intervention.
For families living in Alabama, obtaining specialized services for individuals with autism can present a persistent challenge. Navigating the system often requires dealing with lengthy wait times, low reimbursement rates for providers, and notoriously complicated waiver application processes. Furthermore, while Floreo qualifies for insurance or state-backed reimbursement under Medicaid waiver programs in certain states, families frequently must still make a compelling case to caseworkers detailing why these specialized classes are strictly necessary for development.
The platform was developed by Vijay Ravindran, who founded Floreo after his own son was diagnosed with autism. The company provides a broad range of structured lessons and interactive programs specifically intended to help individuals with autism build self-confidence as they confront complex real-world situations.
“One of the elements of some forms of therapy is rewards-based motivation, but the rewards can be disconnected,” Ravindran explained, discussing the design philosophy behind the platform. “Here, you can get immediate feedback within the animation or from the coach.”
Responding to ongoing feedback from parents, educators, and clinicians, Floreo has continuously expanded its library to address delicate scenarios that individuals with autism might encounter in public life, including interacting with law enforcement during police stops, handling bullying, and maintaining online safety.
“They are age-appropriate, but they are also developmentally appropriate,” Ravindran said. “That’s where the expertise of the caregiver, teacher, therapist comes in, and their sense of where they are at developmentally.” He noted the inherent flexibility of the system, adding, “A lesson that might take one kid 30 seconds might take another kid 6 minutes, and that’s okay.”
On any given day, Sarah works through specific curriculum modules focusing on critical safety measures, such as crossing the street at the correct pedestrian signals and practicing safe communication protocols when interacting with police officers. She also engages with interactive recreational modules where she matches animals, learns historical facts about figures like Jane Goodall, and practices asking targeted questions to resolve hypothetical problems.
Logan Harrell, a direct support professional who assists Sarah throughout her daily routines, sits across the desk from her during her tech sessions, helping to guide the process. Harrell has found the virtual reality software to be a highly effective supplement as they work together on professional development and social engagement skills.
“Are you ready to be in the driver’s seat?” Harrell asked, queueing up a fresh lesson on the computer screen.
“Rock and roll,” Sarah replied with enthusiasm.
The practical benefits of the virtual training frequently extend far beyond the computer chair. Margaret Stewart has noticed tangible improvements in her daughter’s daily routines around the house and community.
“I’ve overheard her using some of those same phrases she learned, successfully,” Margaret said. “She comes into the kitchen and sees me unloading groceries and says, ‘Oh, that goes there.’ That’s been really encouraging.”
Beyond her training sessions, Sarah maintains an active and engaged presence in her local community. She loves being around people and serves proudly on her church’s hospitality team. She frequently shares small talk and candy with individuals she meets throughout her day and has recently joined a local bowling league.
Her parents continually look for new avenues to help her expand her capabilities and cultivate greater personal independence.
“There are some programs that simulate work experiences, which, although she already has a job, a lot of the skills she does in there can help her be more successful,” Margaret said, reflecting on her daughter’s ongoing growth. “We can’t assume that she can’t do something, if we don’t try to give her all of the support she needs to be successful.”
While Floreo is already commercially available on the consumer market, the company is also pursuing formal regulatory authorization. Developers are currently working to secure approval from the U.S. Food and Drug Administration (FDA) for a specific clinical product known as FloreoRX, which is being studied as an investigational medical device.
FloreoRX utilizes a standardized sequence of targeted lessons delivered across a structured 12-week period, designed specifically to foster measurable improvements in social skills and social connectivity. The company previously completed a clinical trial evaluating FloreoRX with 125 patients. According to company data, participants who utilized the software program demonstrated greater overall behavioral improvements compared to control groups utilizing sham interventions. Company representatives note that the evaluation stands as one of the largest prospective, multi-site randomized controlled trials ever conducted on a virtual reality-based intervention for children and young adults with autism.
“There’s obviously a lot of scrutiny,” Ravindran acknowledged, addressing the vast and varied landscape of autism therapies and behavioral support services, some of which have faced criticism for low or inconsistent quality standards. “We’re building something that is science-backed that can accelerate outcomes.”
Traditional interventions for individuals with autism often include educational training videos, but these resources tend to be passive in nature and can prove difficult for users to translate effectively into dynamic, real-world scenarios. While traditional in-person therapy remains a cornerstone of developmental care, not every family has the logistical means to access dozens of hours of direct intervention each week. Additionally, certain long-standing behavioral models, such as applied behavior analysis, have drawn criticism from advocacy groups and may not represent an ideal fit for every individual’s unique needs.
At the same time, experts note that virtual reality is not without its challenges. Some users experience sensory overload, motion sickness, or cognitive fatigue following extended sessions inside a VR headset. To mitigate these issues, Ravindran emphasized that his development team works closely in tandem with families, licensed clinicians, and individuals on the autism spectrum to ensure that the programs remain as comfortable and effective as possible.
“Asking parents to do even more work with their kids is asking a lot. They’re already pushed to the limit in so many ways,” Ravindran said. “So it’s important that solutions are comprehensive and really address the three-pronged nature of support for children with developmental delays and special needs—that it’s clinical, that it’s educational and that it’s home-based, and all three have to work together and reinforce each other.”
Ravindran stressed that the software is explicitly not designed to serve as mere entertainment, nor is it intended to replace a qualified human therapist or special education teacher. Instead, the technology is positioned as an auxiliary intervention tool that can be precisely tailored to meet an individual’s specific developmental goals.
“We’re trying to give them superpowers,” Ravindran said of the families and caregivers supporting individuals with autism. “We’re trying to take the thing they care about doing, which is teaching skills to individuals, and supersize it, accelerate it.”
