Asperger's patients have been treated by role-playing with real-life therapists. The virtual-reality town at the medical center is a new twist. The University of Texas at Dallas uses a platform from Second Life, the popular virtual world, in which patients go to an "island" customized for therapeutic purposes. The island was built by undergraduates in the university's game-design program, guided by the center's clinicians. Patients design their avatars to look as much like themselves as possible, and can readily access programmed gestures to make their likenesses smile, shrug, or express impatience by tapping their feet. Virtual reality is gaining traction as a form of psychotherapy at many academic medical centers since it allows a wider, more flexible platform, with a broader variety of cues and potential scenarios to build social skills.