Virtual reality and its role in removing the barriers that turn cognitive impairments into intellectual disability

Early expectations of the contribution that virtual reality (VR) could make to education far exceeded actual applications. This was largely due to the initial immaturity of the technology and a lack of evidence base on which to base design and utilisation. While the early developments in computer based learning largely concentrated on mainstream education, leaving those with special needs behind, the potential of VR as an educational tool was exploited for those with intellectual disabilities right from the start. This paper describes the empirical evidence that has contributed to the development of educational virtual reality for those with intellectual disabilities: studies on transfer of learning from the virtual to the real world; how teachers might support those using VR; the design of virtual environments and what input/control devices best facilitate use of desktop VR. Future developments and ethical issues are also considered

Virtual reality in the rehabilitation of people with intellectual disabilities

Virtual reality (VR) possesses many qualities that give it rehabilitative potential for people with intellectual disabilities, both as an intervention and an assessment. It can provide a safe setting in which to practice skills that might carry too many risks in the real world. Unlike human tutors, computers are infinitely patient and consistent. Virtual worlds can be manipulated in ways the real world cannot be and can convey concepts without the use of language or other symbol systems. Published applications for this client group have all been as rehabilitative interventions. These are described in three groups: promoting skills for independent living, enhancing cognitive performance, and improving social skills. Five groups of studies are reviewed that utilize virtual technology to promote skills for independent living: grocery shopping, preparing food, orientation, road safety, and manufacturing skills. Fears that skills or habits learnt in a virtual setting would not transfer to the real world setting have not been supported by the available evidence, apart from those studies with people with autistic spectrum disorders. Future directions are in the development of more applications for independent living skills, exploring interventions for promoting motor and cognitive skills, and the developments of ecologically valid forms of assessment

The tutoring role of mentors working with adults and elderly people with learning disabilities using virtual environments

This article outlines the potential of virtual training environments in the rehabilitation of adults and elderly people with learning disabilities. Before such virtual training environments are developed, tutoring roles for mentors working with adults and elderly people must be investigated. This is because this group of people has far less expectation of and experience with computers than younger people with learning disabilities, for whom virtual training environments have already proved effective. Effective tutoring strategies employed, together with appropriate and well-designed virtual training environments, will be the outcomes of two methods suggested in this article

Effect of playing computer games on decision making in people with intellectual disabilities

People with intellectual disabilities have difficulty making decisions and this may hinder their independence and inclusion in society. Interactive computer software may give them the opportunity to practice the underlying components of this skill. This study aimed to discover if repeated sessions playing a computer game involving aspects of decision making, such as collecting relevant information and controlling impulsivity, would improve performance in two non-computer based tests of decision making. 12 adults with intellectual disabilities were randomly assigned to either an intervention group or control group. They were all exposed to 10 twice weekly sessions, playing either the intervention game or the control game, which involved simple reaction time only. After repeated sessions, the intervention group showed a significant improvement in game score, with researcher assistance significantly decreasing. At follow up, the intervention group showed a significant decrease from baseline in the number of guesses made before guessing correctly on both of the decision making tests. The decrease observed in the control group failed to reach significance

A systematic evaluation of current control devices used by people with intellectual disabilities in non-immersive virtual environments

Virtual environments have a role to play in facilitating the acquisition of living skills in people with intellectual disabilities, improving their cognitive skills and providing them with entertainment. However, the currently recommended devices to allow navigation in and interaction with the environments are difficult to use. Using a methodology established in an earlier study, the study aims to systematically document the performance of users with the currently recommended devices in order to (i) inform the design of a usable control device or devices and (ii) act as a baseline against which they can be evaluated. 40 people with severe intellectual disabilities aged 21–67 years used four environments with an equal number of sessions with the different devices being evaluated. Results indicate that when forward movement is provided by the software using the mouse for both navigation and interaction allows better performance both initially and after exposure than using the fire button on the joystick. When the user had to initiate forward movement with the navigation device, the joystick allowed better performance than the arrows on the keyboard. Preventing slippage of the joystick base would make its use much easier and it is suggested that separate devices are retained for navigation and interaction

An evaluation of the use of a computer game in improving the choice reaction time of adults with intellectual disabilities

People with intellectual disabilities have difficulty making decisions and this may hinder their independence and inclusion in society. Interactive computer software may give them the opportunity to practice the underlying components of this skill. This study aimed to discover if repeated sessions playing a computer game involving aspects of decision making, such as collecting relevant information and controlling impulsivity, would improve performance in two non-computer based tests of decision making. 12 adults with intellectual disabilities were randomly assigned to either an intervention group or control group. They were all exposed to 10 twice weekly sessions, playing either the intervention game or the control game, which involved simple reaction time only. After repeated sessions, the intervention group showed a significant improvement in game score, with researcher assistance significantly decreasing. At follow up, the intervention group showed a significant decrease from baseline in the number of guesses made before guessing correctly on both of the decision making tests. The decrease observed in the control group failed to reach significance

Emerging issues and current trends in assistive technology use 2007-1010: practising, assisting and enabling learning for all

Following an earlier review in 2007, a further review of the academic literature relating to the uses of assistive technology (AT) by children and young people was completed, covering the period 2007-2011. As in the earlier review, a tripartite taxonomy: technology uses to train or practise, technology uses to assist learning and technology uses to enable learning, was used in order to structure the findings. The key markers for research in this field and during these three years were user involvement, AT on mobile mainstream devices, the visibility of AT, technology for interaction and collaboration, new and developing interfaces and inclusive design principles. The paper concludes by locating these developments within the broader framework of the Digital Divide

Feasibility study into self-administered training at home using an arm and hand device with motivational gaming environment in chronic stroke

© 2015 Nijenhuis et al. Open Access. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.BACKGROUND: Assistive and robotic training devices are increasingly used for rehabilitation of the hemiparetic arm after stroke, although applications for the wrist and hand are trailing behind. Furthermore, applying a training device in domestic settings may enable an increased training dose of functional arm and hand training. The objective of this study was to assess the feasibility and potential clinical changes associated with a technology-supported arm and hand training system at home for patients with chronic stroke. METHODS: A dynamic wrist and hand orthosis was combined with a remotely monitored user interface with motivational gaming environment for self-administered training at home. Twenty-four chronic stroke patients with impaired arm/hand function were recruited to use the training system at home for six weeks. Evaluation of feasibility involved training duration, usability and motivation. Clinical outcomes on arm/hand function, activity and participation were assessed before and after six weeks of training and at two-month follow-up. RESULTS: Mean System Usability Scale score was 69 % (SD 17 %), mean Intrinsic Motivation Inventory score was 5.2 (SD 0.9) points, and mean training duration per week was 105 (SD 66) minutes. Median Fugl-Meyer score improved from 37 (IQR 30) pre-training to 41 (IQR 32) post-training and was sustained at two-month follow-up (40 (IQR 32)). The Stroke Impact Scale improved from 56.3 (SD 13.2) pre-training to 60.0 (SD 13.9) post-training, with a trend at follow-up (59.8 (SD 15.2)). No significant improvements were found on the Action Research Arm Test and Motor Activity Log. CONCLUSIONS: Remotely monitored post-stroke training at home applying gaming exercises while physically supporting the wrist and hand showed to be feasible: participants were able and motivated to use the training system independently at home. Usability shows potential, although several usability issues need further attention. Upper extremity function and quality of life improved after training, although dexterity did not. These findings indicate that home-based arm and hand training with physical support from a dynamic orthosis is a feasible tool to enable self-administered practice at home. Such an approach enables practice without dependence on therapist availability, allowing an increase in training dose with respect to treatment in supervised settings. TRIAL REGISTRATION: This study has been registered at the Netherlands Trial Registry (NTR): NTR3669 .Peer reviewe