|
Date: Organization: Summary: Author: |
22 November, 2024 Encore, Cheyenne, Wyoming A select sampling of virtual reality technologies the evolved over the years. Tim Munyon, M.A., B.S. – Developing and delivering training solutions for 30 years. |
Definitions
Augmented Reality (AR) – A partially-immersive environment in which the headset allows users to see their actual surroundings, but the headset adds digital elements to it. For example, users see the room around them, but the headset might add digital shelves, tables, or other interactive elements to the room.
Extended Reality (XR) – An umbrella term that encompasses both AR and VR.
Virtual Reality (VR) – A completely immersive environment in which the headset blocks out all external stimuli and provides 100% of the simulated reality users see. Headset users might be digitally experiencing a roller coaster ride, engaged in battle, exploring historical landmarks, or performing surgery.
The Benefits of VR Interventions for People with IDD
Researchers who study people with IDD participating in VR interventions are publishing their findings in increasing number as the technology develops. There is a consensus among the published papers that an immersive, safe, interactive environment that consists of repeatable actions is highly effective in teaching life skills to people with IDD (Franze, et al.).
The testing often includes two groups: one that uses VR and one that does not. Most recent trials conclude, as Franze, et al., reports after one trial, the VR group, “significantly improved performance in the real-world assessment across timepoints.”
Another study rated the effectiveness of the VR training on, (1) the participants’ ability to complete the tasks in VR, (2) their ability to transfer the learned skills to the real-world, and (3) the individual characteristics of the participants who were able to benefit from the VR training (Michalski, et al.). The testing included a real-world pretest, the training in a VR environment, a real-world posttest, and a delayed text about seven days later. The study concluded that, “VR facilitated the learning of most participants, which led to demonstrations of real-world transfer and skill generalization” (ibid.).
In a study by Si-Nae Ahn, pretest and posttest results determined that a combination of VR and game-based cognitive therapy improved learning outcomes. Ahn stated, “for children with intellectual disabilities, cognitive deficits are a major problem, so it is necessary to perform computer-based cognitive therapy rather than just VR.” The study of 13 children indicated that there was a “significant improvement” of visual-motor integration in the pretest and posttest scores (ibid.).
There is a widespread consensus in published literature that immersion in a VR environment with repeatable tasks increases retention and real-world application of learned skills.
Designing VR Interventions for People with IDD
Virtual reality simulations have evolved into immersive, complex gaming experiences for millions of users. The goal of most of the revenue-generating games is for users to have fun. Intervention planning for people with IDD, however, has focused on improving their independent living skills, physical abilities, behavioral challenges, communication skills, and vocational skills (Yi, et al.).
Considerations for designing VR interventions include (ibid.):
- What is the duration of the VR intervention? How long can the intended users be immersed in a VR environment without becoming frustrated or anxious?
- Will the VR environment result in sensory overstimulation? Should the number of in-game distractions be limited? Sometimes a period of desensitization might be required before or after the intervention is experienced.
- Are people with IDD actually capable of interacting with the 3D models in the environment? How complicated are the interactions? How many sequential steps are required to finish the program?
- Can the VR experience be tailored to the user’s specific type of IDD? Would the user benefit from hints and guidance from a coach watching the headset interaction in real time on a tablet or laptop?
- Do the people with IDD, a parent, or a guardian understand the potential benefits of being immersed in a simulated world? What motivation is going to be helpful from a care giver?
- Will the targeted user be satisfied with the VR intervention? Will it be a positive experience that will leave them interested in additional VR experiences?
- Will people with IDD react to the VR environment with vertigo or nausea? Depending on the severity of the disability, consider designing the VR program so that the user can be seated during the entire experience.
- What kind of access do people with IDD have with VR headsets and Wi-Fi networks? (Bryant)
- What kind of cybersecurity needs to be in place for people with IDD using VR technology? (Ibid.)
VR Intervention for People with IDD
Virtual reality interventions have been used successfully for helping people with IDD over a wide range of common cognitive and motor deficits.
Communication Disabilities
Virtual reality applications are assisting people across a diverse range of disabilities. For example, one study measured outcomes for people with disorders such as aphasia, dysarthria, apraxia of speech, and cognitive-communication impairment that were acquired from brain injury or stroke (Vaezipour, et al.).
Using the VR application designed for communication rehabilitation, SIM:Kitchen, the participants were able to practice speaking in non-threatening environments, some of which eliminated noise and visual distractions, while other environments included the distractions. The virtual conversations took place in digital environments such as supermarkets, post offices, train stations, and so on, providing participants with a realistic speaking experience.
VR environments can allow participants to communicate with a clinician or an avatar that represents a known acquaintance (Bryant). Specific VR interactions can be developed that address targeted social situations with which people with IDD struggle (ibid.).
Dealing with Aftermath of Trauma
Using a grant from the National Science Foundation, Krishna Venkatasubramanian, University of Rhode Island professor, is researching ways to help people with IDD who are experiencing trauma aftermath (LaRoche). The 3-D immersive worlds are teaching people with IDD to divert their attention from negative thoughts, using VR simulations that teach self-regulation and meditation.
Research scientists at the Kessler Foundation are using VR as a tool for traumatic brain injury (TBI) rehabilitation. People with TBI walk on a treadmill, while the VR headset provides the simulated world passing by. The researchers analyze thinking ability and brain activity while the person with TBI navigates the obstacles in the VR program (Jordan).
Learning Household Skills
VR is being used to help people with IDD learn life skills. A university study in Sydney, Australia, taught two groups of people with IDD how to separate household waste into recycling, garden waste, and food waste. One group learned in an immersive VR environment that allowed them to move virtual objects into the labeled bins; the other group simply watched the VR training on a tablet (Franze, et al.). When the training was completed and participants were presented with real world testing, the students who learned with VR outperformed the students who learned watching the training video on a tablet.
Rehabilitation
A group of researchers reviewed 13 articles that tested the effectiveness of virtual reality in rehabilitating people with cerebral palsy, Parkinson’s disease, or stroke (Amirthalingam). The goal of the research was to determine to what degree VR improved motor functions. The articles indicated noteworthy improvements in people with Parkinson’s disease or stroke victims. However, the people with CP did not show improvement in the 13 articles included in the study (ibid.).
A different review of 15 articles about the use of immersive VR in pediatric patients with CP had different results. The research concluded, “Immersive virtual reality emerges as a pivotal technological tool in rehabilitation, seamlessly integrating with conventional therapy within CP rehabilitation programs. Indeed, it not only enhances motivation but significantly increases children’s functional capacity and abilities” (Maggio).
Executive Functions
Executive functions are cognitive skills such as response inhibition (impulse control), working memory, emotional control, sustained attention, task initiation, planning/prioritization, and organization (Platero). A group of researchers tested 15 people with IDD over a 16 week period, and found that immersive VR cognitive training improved their working memory and inhibitory control, although it did not increase their sustained attention (Trigueiro, et al.).
Job Skills
Immersive VR can help people with IDD prepare for a job or learn how to complete the assigned duties after starting a job. One study developed three different VR interventions to help people IDD in three real-life skills: washing one’s hands, cleaning duties, and interacting with customers in a safe, simulated environment (Barbar). The study concluded, “With the right design and approach, VR simulations can provide an engaging and effective way to train and support people with ID in their work and life skills” (ibid.).
Conclusion
Immersive virtual reality interventions are regularly demonstrating improvements in clients with intellectual and developmental disabilities. We encourage parents, guardians, and direct support professionals to be open to treatment plans that include VR as a central part of the treatment intervention.
References
Amirthalingam, J; Paidi, G; Alshowaikh, K; et al. “Virtual Reality Intervention to Help Improve Motor Function in Patients Undergoing Rehabilitation for Cerebral Palsy, Parkinson’s Disease, or Stroke: A Systematic Review of Randomized Controlled Trials.” Cureus. 30 Jul 2021;13(7):e16763. https://doi.org/10.7759/cureus.16763
Barbar, Pinaki Prasanna; Barry, Mike; Peiris, Roshan L. “Understanding Job Coaches’ Perspectives on Using Virtual Reality as a Job Training Tool for Training People with Disabilities.” CHI Conference on Human Factors in Computing Systems (CHI EA ’23), Association for Computing Machinery. https://doi.org/10.1145/3544549.3585915
Bryant, L., Brunner, M., & Hemsley, B. (2019). “A review of virtual reality technologies in the field of communication disability: implications for practice and research.” Disability and Rehabilitation: Assistive Technology, 15(4), 365–372. https://doi.org/10.1080/17483107.2018.1549276
Franze, A., Loetscher, T., Gallomarino, N.C., Szpak, A., Lee, G., Michalski, S.C. “Immersive virtual reality is more effective than non-immersive devices for developing real-world skills in people with intellectual disability.” Journal of Intellectual Disability Research, 21 August 2024. https://doi.org/10.1111/jir.13177
Jordan, Diana. “Exploring a New Dimension: How Virtual Reality Aids Rehabilitation in People With Disabilities.” Kessler Foundation: Blogs, 2023.
Kandalaft, M.R., Didehbani, N., Krawczyk, D.C. et al. “Virtual Reality Social Cognition Training for Young Adults with High-Functioning Autism.” J Autism Dev Disord 43, 34–44 (2013). https://doi.org/10.1007/s10803-012-1544-6
LaRoche, Tony, media contact. “URI professor exploring virtual reality as tool to help adults with intellectual and developmental disabilities deal with trauma’s aftermath.” URI: Rhody Today, 21 October 2024.
Maggio, Maria Grazia; Valeri, Maria Chiara; De Luca, Rosaria; et al. “The Role of Immersive Virtual Reality Interventions in Pediatric Cerebral Palsy: A Systematic Review across Motor and Cognitive Domains” Brain Sciences 14, no. 5: 490. https://doi.org/10.3390/brainsci14050490
Michalski, S.C., Gallomarino, N.C., Szpak, A. et al. “Improving real-world skills in people with intellectual disabilities: an immersive virtual reality intervention.” Virtual Reality 27, 3521–3532 (2023). https://doi.org/10.1007/s10055-023-00759-2
Perra, Alessandra; Riccardo, Chiara Laura; De Lorenzo, Valerio; et al. “Fully Immersive Virtual Reality-Based Cognitive Remediation for Adults with Psychosocial Disabilities: A Systematic Scoping Review of Methods Intervention Gaps and Meta-Analysis of Published Effectiveness Studies.” Int. J. Environ. Res. Public Health 14 January 2023, 20(2), 1527; https://doi.org/10.3390/ijerph20021527
Platero, Ariadne. “What Executive Functioning Is, and Why It Matters at Any Age.” Psychology Today, 01 October 2021.
Reist, Christopher. (2015). “Virtual Reality Exposure for PTSD Due to Military Combat and Terrorist Attacks.” Journal of Contemporary Psychotherapy. 45. https://doi.org/10.1007/s10879-015-9306-3
Trigueiro, Maria; Lopes, Joana; Simoes-Silva, Vitor; et al. “Impact of VR-Based Cognitive Training on Working Memory and Inhibitory Control in IDD Young Adults.” Healthcare 2024, 12(17), 1705; https://doi.org/10.3390/healthcare12171705
Vaezipour, A; Aldridge, D; Koenig, S; et al. “Rehabilitation Supported by Immersive Virtual Reality for Adults with Communication Disorders: Semistructured Interviews and Usability Survey Study.” Rehabil Assist Technol 2023;10:e46959 https://rehab.jmir.org/2023/1/e46959
Yi YJ, Heidari Matin N, Brannan D, Johnson M, Nguyen A. “Design Considerations for Virtual Reality Intervention for People with Intellectual and Developmental Disabilities: A Systematic Review.” HERD: Health Environments Research & Design Journal. 2024;0(0). https://doi.org/10.1177/19375867241271434