Home > Brain Injury Rehabilitation > Analysis of Assets for Virtual Reality Applications in Neuropsychology

Email Print Share

Analysis of Assets for Virtual Reality Applications in Neuropsychology Albert A. Rizzo, Maria Schultheis, Kimberly A. Kerns, and Catherine Mateer, Neuropsychological Rehabilitation (page 10 of 18) Page 10 of 18

Finally, one concern that may exist with this asset involves the potential that practice of activities that are dangerous in real life, within the safety of a VE, might create a false sense of security or omnipotence that would put the client at risk upon subsequent action in the real world. In essence, can safe transfer of training occur in the real world when the consequences of errors are prevented from occurring in the VE? This is a very challenging concern that will need to be considered carefully. Perhaps, one option would be to provide a noxious sound cue, contingent on the occurrence of dangerous errors in the VE, as a means to condition a proper attitude of caution in clients. This concern further underscores the need for a professional to closely monitor client activity in order to recognize possible patterns of risk taking behavior that could emerge when using such VEs.

8. The capacity to improve availability of assessment and rehabilitation by persons with sensorimotor impairments via the use of adapted interface devices and tailored sensory modality presentations built into VE scenario design.

One of the current challenges in neuropsychology concerns the adaptation of NP assessment and rehabilitation methods for use by clients with significant sensory and motor impairments. And when such adaptations are attempted, the question often arises as to how much does a client's performance reflect centrally-based cognitive dysfunction vs. artifacts due to more peripheral sensorimotor impairments. VR offers two ways in which this challenge may be addressed in the testing and training of cognitive and everyday functional abilities in persons with sensorimotor impairments.

One approach places emphasis on the design of adapted human-computer interface devices in a VE to promote usability and access. The thoughtful integration of adapted interface devices between the person and VR system could assist those with motor impairments to navigate and interact in functional testing and training VR applications (beyond what might be possible in the real world). Such interface adaptations may support actuation by way of alternative or augmented movement, speech, expired air, tracked eye movement and by way of neurofeedback-trained biosignal activity. While an extensive literature exists in the area of interface design for persons with disabilities (Barrett, McCrindle, Cook & Booy, 2002) and on concerns about an emerging "Digital Divide" (LaPlant, 2001), those domains are beyond the scope of this article. However, two examples should serve to illustrate this potential in the VR area. One basic example involves the use of a gaming joystick to navigate in a VE that was found effective for teaching wayfinding within a VE modeled after an amnestic client's rehabilitation unit (Brooks et al., 1999). These authors partially attributed the observed positive training effects to the client's capability for quicker traversing of the VE using a joystick compared to what her ambulatory impairments would allow in the real environment. This strategy supported efficient use of training time. A more technically complex approach uses "biosignals", as seen in the use of the "Cyberlink" system (Doherty, Bloor & Cockton, 1999). Initial results using this system suggested that persons with extreme motor and language impairments following stroke and traumatic brain injury were able to communicate using an EEG/EOG/EMG-driven cursor on a flatscreen computer. With continued advances in adapted interface technology, these approaches could support VE navigation and interaction in persons with motor impairments and serve to promote better access to cognitive and functionally-based assessment and rehabilitation. As well, by minimizing the impact of peripheral impairments on performance, centrally-based performance components may be more efficiently tested and trained.

A second approach to this challenge has been to tailor the sensory modality components of the VE around the needs of persons with visual impairments. The few efforts in this area have mainly attempted to build simulated structures around the use of enhanced 3D sound (Lumbreras & Sanchez, 2000) and tactile stimuli (Connor, 2002: see Asset 4). For example, Lumbreras et al. (2000), aiming to design computer games for blind children, created a 3D audio VR system referred to as "AudioDOOM". In this application, blind children use a joystick to navigate the mazelike game environment exclusively on the basis of 3D audio cues (i.e., footstep sounds, doors that "creak" open, echoes, etc.) while chasing "monsters" around the environment. Following varied periods of time in the VE, the children are then given "Legos" to construct their impression of the structure of the layout. The resulting Lego constructions are often noteworthy in their striking resemblance to the actual structure of the audio-based layout of the maze. Children using this system (who never actually have "seen" the physical visual world) often appear to be able use the 3D sound cues to create a spatial-cognitive map of the space and then accurately represent this space with physical objects (i.e., Legos, Clay, Sand). Examples of some of these constructions are available on the Internet (http://www.dcc.uchile.cl/~mlumbrer/audiodoom/audiodoom.html). While still in the "proof of concept" stage, it would be possible to conceive of such 3D audio-based environments as providing platforms for testing and training of persons with visual impairments at any age.

Finally, the use of haptic simulation tools has been investigated as a method to create VE applications for persons with visual impairments (Jansson, 2000). However, the technology to deliver convincing touch-based simulations is still in the very early stages of development and readers interested in further details are referred to McLaughlin, Hespanha, & Sukhatme (2002).

From Neuropsychological Rehabilitation, 2004. 14(1/2), 207-239. Reprinted with permission from Albert Rizzo. All rights reserved.

 Comments

There are currently no comments for this article