No full-text available
To read the full-text of this research,
you can request a copy directly from the authors.
ClinicaVR: Classroom-CPT: A virtual reality tool for assessing attention and inhibition in children and adolescents
Abstract
Having garnered interest both in clinic and research areas, the Virtual Classroom (Rizzo et al., 2000) assesses children's attention in a virtual context. The Digital MediaWorks team (www.dmw.ca) has evolved the original basic classroom concept over a number of iterations to form the ClinicaVR Suite containing the Classroom-CPT as one of its components. The present study has three aims: investigate certain validity and reliability aspects of the tool; examine the relationship between performance in the virtual test and the attendant sense of presence and cybersickness experienced by participants; assess potential effects of gender and age on performance in the test. The study was conducted with 102 children and adolescents from Grade 2 to Grade 10. All participants were enrolled in a regular school program. Results support both concurrent and construct validity as well as temporal stability of ClinicaVR: Classroom-Continuous Performance Test (CPT). Gender exerted no effect on performance, while age did. The test did not cause much cybersickness. We recommend ClinicaVR: Classroom-CPT as an assessment tool for selective and sustained attention, and inhibition, in clinic and research domains.
... The main focus of this research stream is learning effectiveness. Our review showed that teaching in interactive VR environments provides either on par or better learning effectiveness compared to traditional teaching (Dube and Ince, 2019;Frydenberg and Andone, 2018;Nolin et al., 2016;Stull et al., 2013). The transformational effect of immersive VR in education has mainly been in the medical field through the recreation of traditional methods in VR for health professions (Blumstein et al., 2020;Brusamento et al., 2019;Kyaw et al., 2019), and even patients . ...
... Aircraft maintenance (Oviatt et al., 2000;Sutcliffe et al., 2005); review of industrial VR training (Stone, 2001); human-centered design in VR training (Stedmon and Stone, 2001) Interactivity Navigability Medical training Dental motor skill training (Perry et al., 2017); blended learning for interprofessional training (Liaw et al., 2019); advanced cardiac life support (Katz et al., 2020); trauma training (Patel et al., 2020) Interactivity Navigability Other training applications Scenario-based prototyping (Strohmann et al., 2019) Create-ability Interactivity Education applications Medical education Health professions education (Brusamento et al., 2019;Kyaw et al., 2019); medicine (Zajtchuk and Satava, 1997); gamification (Chávez et al., 2020); nursing education (Chen et al., 2020) Create-ability Interactivity Navigability Other education applications Choreography (Dube and ˙I nce, 2019); organic chemistry (Stull et al., 2013); neuropsychological assessment in a virtual classroom (Nolin et al., 2016); VR educational systems (Hachaj and Baraniewicz, 2015;Frydenberg and Andone, 2018;Sanchez-Sepulveda et al., 2020); technology acceptance (George et al., 2020) Create-ability Interactivity ...
... VR is considered a potential methodology to enhance ecological validity by creating realistic experimental settings that allow participants to be immersed with the stimuli rather than being passive observers (Bernard et al., 2018). However, VR-based behavioral research can also be subject to issues related to ecological validity due to poor experimental design, interpretation, and potential differences between the real world and the virtual environment (Cao et al., 2019;Nolin et al., 2016;Simon and Greitemeyer, 2019). ...
Immersive virtual reality (VR) that utilizes head-mounted displays (HMD) is one of the key emerging technologies of the 21st century and has drawn keen attention from consumers, practitioners, and scholars in various disciplines. Nevertheless, the information systems (IS) discipline has neglected immersive VR, given that only a handful of studies have been published in mainstream IS journals. However, the recent advancements in immersive VR technology provide new opportunities for organizations and IS researchers. In light of these points, we reviewed the immersive VR literature to provide a holistic view of opportunities and challenges for organizations and future research directions for the IS field. By examining the technical capabilities of immersive VR and the previous literature, we identified five affordances: embodiment, interactivity, navigability, sense-ability, and create-ability. Our review of the 151 studies from the IS and related fields synthesized how these affordances were utilized in various research domains. Guided by the affordance-actualization theory, we also identified the strategic opportunities and challenges that come with implementing VR. The actualization of immersive VR affordances in organizations is indeed a fruitful area for IS scholars as there are various venues to move the IS field as well as the VR research in the organizational context forward.
... As also reported by [236], eye movements should be examined along with head movements to understand attention and interaction more in-depth, since eyes can move differently. In addition, [237] studied the relationship between performance, sense of presence, and cybersickness, whereas [238] examined attention, more particularly ADHD with continuous performance task in a virtual classroom. However, both works are more in the clinical domain, which are relatively different from an everyday classroom setup. ...
... Bailenson et al. [232] and Blume et al. [233] studied learning outcomes according to sitting positions and offer compelling evidence that students seated in the front have better learning outcomes. Few studies, however, took head movements into consideration [253,235,237,236] in such setups. In [235], the immersive VR classroom was used as a tool to study attention measures for attention deficit/hyperactivity disorder (ADHD), whereas in [237] reliability of virtual reality and attention was studied with continuous performance task (CPT) for clinical research. ...
... Few studies, however, took head movements into consideration [253,235,237,236] in such setups. In [235], the immersive VR classroom was used as a tool to study attention measures for attention deficit/hyperactivity disorder (ADHD), whereas in [237] reliability of virtual reality and attention was studied with continuous performance task (CPT) for clinical research. Social interaction using head movements was studied in [236] with users' head movements found to shift between the interaction partner and target. ...
With developments in computer graphics, hardware technology, perception engineering, and human-computer interaction, virtual reality and virtual environments are becoming more integrated into our daily lives. Head-mounted displays, however, are still not used as frequently as other mobile devices such as smart phones and watches. With increased usage of this technology and the acclimation of humans to virtual application scenarios, it is possible that in the near future an everyday virtual reality paradigm will be realized. When considering the marriage of everyday virtual reality and head-mounted displays, eye tracking is an emerging technology that helps to assess human behaviors in a real time and non-intrusive way. Still, multiple aspects need to be researched before these technologies become widely available in daily life. Firstly, attention and cognition models in everyday scenarios should be thoroughly understood. Secondly, as eyes are related to visual biometrics, privacy preserving methodologies are necessary. Lastly, instead of studies or applications utilizing limited human participants with relatively homogeneous characteristics, protocols and use-cases for making such technology more accessible should be essential. In this work, taking the aforementioned points into account, a significant scientific push towards everyday virtual reality has been completed with three main research contributions.
... This study answers urgent research issues and provides constructive theoretical contributions. For the first time, this study re-examines the polarity of tourists' sentiments towards virtual tourism from a crisis perspective, thereby responding to the theoretical boundaries of previous arguments on virtual tourism (Wagler & Hanus, 2018;Nolin et al., 2016). Furthermore, our research contributes to clarifying the time decay of the sentiment intensity of virtual tourists and provides a theoretical framework for the formation mechanism of tourists' sentiments. ...
... Moreover, virtual tourists can obtain a sense of enjoyment and subjective well-being (Sylaiou et al., 2010;Tussyadiah et al., 2018;Kim & Hall, 2019). However, it may also experience physical fatigue and doubts about authenticity (Nolin et al., 2016;Dueholm & Smed, 2014). Therefore, the factors that influence tourists' level of virtual experience have been widely discussed (Bogicevic et al., 2019;Huang, Wei, & Leung, 2020;Martins et al., 2017). ...
... The reason for such instability is that virtual tourism is still not separate from tourists' usual environment and has a very limited ability to engage multiple senses in virtual experiences, which makes it difficult to maintain stable and lasting positive sentiment. Therefore, when virtual tourism and on-site tourism coexist, tourists' sentiments towards virtual tourism will decrease as the crisis gradually disappears, further highlighting the special role of crisis situations and responding to the findings about negative sentiments in the existing literature (Cheong, 1995;Nolin et al., 2016). Second, one interesting finding is that there is an obvious time differentiation in the public sentiment heat of virtual tourism, which has gone through four stages of evolution: anticipation period-high heat period-repeated period-low heat period. ...
There are numerous arguments regarding the attitudes of different tourists and scenic destination managers regarding virtual tourism. However, it remains difficult to understand the public's attitude towards virtual tourism in a crisis situation. In this way, under the influence of COVID-19, this study explores the public sentiment and drivers of virtual tourism using Python and the grounded theory method. The results reveal that tourists' positive sentiment in virtual tourism dominates, with few tourists showing negative or neutral sentiment polarity. Furthermore, there is an obvious law of time decay in the intensity of public sentiment. Especially as the crisis fades, the supplementary effect of virtual tourism on on-site tourism weakens. Moreover, project design, experience quality, travel convenience, travel cost, travel motivation and destination attractiveness are the critical factors affecting tourist sentiment. The findings provide implications for the sustainable development of both destination and virtual tourism in a new world order post-COVID-19.
... Cybersickness is a condition that indicates symptoms of nausea, disorientation and oculomotor during and/or after experiencing virtual environments in head-mounted displays, large screens, and curved screen systems (LaViola 2000;Nolin et al. 2016;Rebenitsch and Owen 2016). Nausea is referred to as general discomfort, stomach awareness, even vomiting. ...
... Students identified several potential usages for HMDs such as relaxing/feeling calm, being able to explore somewhere virtually before visiting the real place and developing learning opportunities. HMDs were reported as enjoyable, physically and visually comfortable, easy to use 30 Nolin et al. (2016) Research article * The majority of neuropsychological studies using virtual reality have dealt with adults while studies with children and adolescents are relatively scarce. Of the few studies which have been conducted with children, data were mostly generated using the Virtual Classroom Clinica. ...
... Internet and offline gaming overuse and addiction are serious concerns for ADHD youth Wang and Yu 2018;Kim et al. 2020). VR systems are also recommended as an assessment tool for selective and sustained attention (Nolin et al. 2016). Besides, training in 3D VEs is expected to improve generalization of acquired self-regulation skills, executive functions and school performance of students with ADHD (Blume et al. 2017). ...
Virtual reality technologies (VRTs) are high-tech human–computer interfaces used to develop digital content and can be applied to multiple different areas, often offering innovative solutions to existing problems. A wide range of digital games is being also developed with VRTs and together with their components, the games' structural elements are appealing to children and engaging them more in virtual worlds. Our research interest is directed towards children's development and the effects of VRTs within gaming environments. Contemporary psychology studies perceive human development as a holistic and lifelong process with important interrelationships between physical, mental, social and emotional aspects. For the objectives and scope of this work, we examine children development across three domains: physical, cognitive and psychosocial. In this context, the authors review the literature on the impact of VRTs on children, in terms of software and hardware. Since research requires an wide-ranging approach, we study the evidence reported on the brain and neural structure, knowledge, behaviour, pedagogy, academic performance, and wellness. Our main concern is to outline the emerging ethical issues and worries of parents, educators, ophthalmologists, neurologists, psychologists, paediatricians and all relevant scientists, as well as the industry’s views and actions. The systematic review was performed on the databases Scopus, IEEE Xplore, PubMed, and Google Scholar from 2010 to 2020 and 85 studies were selected. The review concluded that findings remain contradictory especially for the psychosocial domain. Official recommendations from organizations and well-documented researches by academics on child well-being are reassuring if health and safety specifications and particularly the time limit are met. Research is still ongoing, constantly updated and consist of a priority for the scientific community given that technology evolves.
... Although, the majority of their work did not involve immersive VR systems, the results highlighted the potential value of this technology to assess cognitive function while maintaining decent ecological validity (Brahnam et al., 2011;Rizzo et al., 2004) Whether neuropsychological tests involve computer-based testing or not, neuropsychology testing arguably suffers from low to moderate ecological validity because the subjects are tested in isolation from real-life complexity. For example, testing normally occurs in a quiet room free of distractions, which does not represent the challenges that people face in everyday life (Chaytor & Schmitter-Edgecombe, 2003;Nolin et al., 2016;Parsons et al., 2007). Rizzo et al. (2004) has suggested VR as a possible means to enhance the ecological validity of neuropsychology testing because it is capable of introducing visual complexity by simulating a real environment (e.g., adding distractions, interaction with 3-D objects, etc.), therefore allowing greater control and replicability during diagnostic testing (Rizzo et al., 2004). ...
... Immersive virtual reality technology has been used in the area of child neuropsychology mostly as an assessment tool to evaluate attention processes in children (Nolin et al., 2016) with attention hyperactivity disorder (ADHD) and acquired brain injury (Díaz-Orueta et al., 2014;Gilboa et al., 2015;Neguț et al., 2016;Rodríguez et al., 2018). It had also been used as a training tool for attention enhancement for children with ADHD (Bioulac et al., 2012;Blume et al., 2017) and with behavioral problems (Cho et al., 2002), and as a neuromotor rehabilitation tool for children with cerebral palsy (Bortone et al., 2018). ...
... Similarly, Nolin et al. (2016) conducted a concurrent validity and reliability study that explored the relationship between performance on the standard VIGIL-CPT, presented on a computer monitor, and ClinicaVR: Classroom-CPT, an IVR version of the same test. Interestingly, the ClinicaVR test adds distractions for the children to cope with during testing by placing children inside a virtual classroom, rather than in a quiet office typical of CPT testing. ...
In recent years, immersive virtual reality technology (IVR) has seen a substantial improvement in its quality, affordability, and ability to simulate the real world. Virtual reality in psychology can be used for three basic purposes: immersion, simulation, and a combination of both. While the psychological implementations of IVR have been predominately used with adults, this review seeks to update our knowledge about the uses and effectiveness of IVR with children. Specifically, its use as a tool for pain distraction, neuropsychological assessment, and skills training. Results showed that IVR is a useful tool when it is used either for immersive or simulative purposes (e.g., pain distraction, neuropsychological assessment), but when its use requires both simulation (of the real world) and immersion (e.g., a vivid environment), it is trickier to implement effectively.
... IVRs-once programmed-provide cost-and time-efficient, highly reproducible testing settings with maximum control of confounding and manipulated variables while simultaneously providing an authentic experience (for examples in the classroom context, see Refs. [43][44][45] ). Advocates of IVR as an experimental tool highlight evidence that users' behaviour in IVR settings is similar to real-life behaviour 46,47 . ...
... To this end, there are empirical findings that support the idea that IVR can provide an authentic and valid research environment. For instance, there is evidence that students' individually different reactions to distractions in real-world classrooms are similar in an IVR classroom, and the respective differences (e.g., associated with ADHD diagnoses) can be reproduced in an IVR classroom simulation 45,74,75 . More generally speaking, children have been found to be particularly (both cognitively and behaviourally) responsive to IVR environments and tend to perceive the simulations as more real and feel a higher level of presence, which makes them act more spontaneously while thinking less about the world outside of the IVR environment 48,76,77 . ...
Higher-achieving peers have repeatedly been found to negatively impact students’ evaluations of their own academic abilities (i.e., Big-Fish-Little-Pond Effect). Building on social comparison theory, this pattern is assumed to result from students comparing themselves to their classmates; however, based on existing research designs, it remains unclear how exactly students make use of social comparison information in the classroom. To determine the extent to which students (N = 353 sixth graders) actively attend and respond to social comparison information in the form of peers’ achievement-related behaviour, we used eye-tracking data from an immersive virtual reality (IVR) classroom. IVR classrooms offer unprecedented opportunities for psychological classroom research as they allow to integrate authentic classroom scenarios with maximum experimental control. In the present study, we experimentally varied virtual classmates’ achievement-related behaviour (i.e., their hand-raising in response to the teacher’s questions) during instruction, and students’ eye and gaze data showed that they actively processed this social comparison information. Students who attended more to social comparison information (as indicated by more frequent and longer gaze durations at peer learners) had less favourable self-evaluations. We discuss implications for the future use of IVR environments to study behaviours in the classroom and beyond.
... One meta-analysis went further and reported not only data on clinical efficacy but synthesized and presented descriptively data on safety, enjoyment and sense of presence reported in the included studies (Gilboa et al. 2018). In terms of safety, many studies conducted to date which have used the VR classroom to assess attention among children reported no or minimal adverse effects (Adams et al. 2009;Bioulac et al. 2012;Mühlberger et al. 2020;Nolin et al. 2009Nolin et al. , 2016Pollak et al. 2010Pollak et al. , 2009Rizzo et al. 2000). A few did not report data on safety Diaz-Orueta et al. 2014;Iriarte et al. 2016;Rodriguez et al. 2018), and one reported that two children experienced simulator sickness symptoms, as they reported at least one severe symptom (Negut et al. 2017). ...
... A few did not report data on safety Diaz-Orueta et al. 2014;Iriarte et al. 2016;Rodriguez et al. 2018), and one reported that two children experienced simulator sickness symptoms, as they reported at least one severe symptom (Negut et al. 2017). Of the above studies, one study included measures of presence and reported no significant correlations between attention performance and presence (Nolin et al. 2016). Pollak et al. (2009Pollak et al. ( , 2010 included several items to measure enjoyment, success, discomfort and perceived difficulty between VR classroom and computerized CPT. ...
Attention is the ability to actively process specific information within one’s environment over longer periods of time while disregarding other details. Attention is an important process that contributes to overall cognitive performance from performing every day basic tasks to complex work activities. The use of virtual reality (VR) allows study of the attention processes in realistic environments using ecological tasks. To date, research has focused on the efficacy of VR attention tasks in detecting attention impairment, while the impact of the combination of variables such as mental workload, presence and simulator sickness on both self-reported usability and objective attention task performance in immersive VR has not been examined. The current study tested 87 participants on an attention task in a virtual aquarium using a cross-sectional design. The VR task followed the continuous performance test paradigm where participants had to respond to correct targets and ignore non-targets over 18 min. Performance was measured using three outcomes: omission (failing to respond to correct targets), commission errors (incorrect responses to targets) and reaction time to correct targets. Measures of self-reported usability, mental workload, presence and simulator sickness were collected. The results showed that only presence and simulator sickness had a significant impact on usability. For performance outcomes, simulator sickness was significantly and weakly associated with omission errors, but not with reaction time and commission errors. Mental workload and presence did not significantly predict performance. Our results suggest that usability is more likely to be negatively impacted by simulator sickness and lack of presence than performance and that usability and attention performance are linked. They highlight the importance of considering factors such as presence and simulator sickness in attention tasks as these variables can impact usability.
... Concurrent validity has been demonstrated through significant correlations of virtual-classroom error and accuracy scores with parent ratings of attention and hyperactivity symptoms (Adams et al., 2009;Parsons et al., 2007) and measures from a traditional CPT task administered outside the virtual classroom (e.g., Conners' s CPT II; Parsons et al., 2007). Retest reliability after 1 month was strong in a group of healthy children (Nolin et al., 2016), but reliability studies in clinical groups are lacking. Importantly, most studies have shown that participants generally reported no or minimal discomfort or cybersickness (Adams et al., 2009;Moreau et al., 2006) and a moderate sense of presence (Nolin et al., 2016) in the virtual classroom. ...
... Retest reliability after 1 month was strong in a group of healthy children (Nolin et al., 2016), but reliability studies in clinical groups are lacking. Importantly, most studies have shown that participants generally reported no or minimal discomfort or cybersickness (Adams et al., 2009;Moreau et al., 2006) and a moderate sense of presence (Nolin et al., 2016) in the virtual classroom. ...
... 52 53 Adults with ASD have been found to experience social isolation, loneliness and so-54 cial anxiety (e.g., [5]) due to their deficient social skills such as atypical gaze/poor eye 55 contact, less conversational involvement, appropriate affect, reduced verbal fluency 56 (e.g., [6], [7]), poor understanding of social cues, and difficulties in initiating and main- 57 taining social conversation/communication [8]. The social skills deficits in individuals 58 with high-functioning ASD are mainly attributed to impairments in cognitive compo- 59 nents such as Executive Functions (EF) (e.g., [9]) or cognitive processing speed (e.g., [10]). 60 Indeed impaired EF is another salient characteristic of the spectrum [11] which refers to 61 high-order, goal-directed cognitive processes that control behaviour, thought and emo- 62 tions. ...
... The VR Everyday Assessment Lab assesses every-144 day memory (prospective and episodic), attention (visuospatial and auditory), and EF 145 (planning and multitasking), and has been found a valid and substantially more pleas-146 ant testing experience [48], which indicates everyday functionality of adults [49], [50]. 147 The ClinicaVR: Classroom-CPT is a VR classroom that examines selective and sustained 148 attention, and inhibition, which has been validated in children and adolescents [59]. Re-149 garding interventions in ASD, there is preliminary evidence postulating its feasibility 150 for being adopted in clinical and educational environments [54], [60]. ...
Poor social skills in autism spectrum disorder (ASD) are associated with reduced independence in daily life. Current interventions for improving the social skills of individuals with ASD fail to represent the complexity of real-life social settings and situations. Virtual reality (VR) may facilitate social skills training in social environments and situations proximal to real life, however, more research is needed for elucidating aspects such as the acceptability, usability, and user experience of VR systems in ASD. Twenty-five participants with ASD attended a neuropsychological evaluation and three sessions of VR social skills training, incorporating 5 social scenarios with three difficulty levels for each. Participants reported high acceptability, system usability, and user experience. Significant correlations were observed between performance in social scenarios, self-reports, and executive functions. Working memory and planning ability were significant predictors of functionality level in ASD and the VR system’s perceived usability respectively. Yet, performance in social scenarios was the best predictor of usability, acceptability, and functionality level in ASD. Planning ability substantially predicted performance in social scenarios, postulating an implication in social skills. Immersive VR social skills training appears effective in individuals with ASD, yet an error-less approach, which is adaptive to the individual’s needs, should be preferred.
... Au delà de la multi-sensorialité, la multimodalité permet au concepteur de combiner de manière séquentielle ou simultanée plusieurs canaux afin de transmettre des informations à l'utilisateur. Les applications de la Réalité Virtuelle ont été consacrées à d'autres activités médicales telles que la rééducation [112], ou pour créer des environnements pour faciliter la réadaptation des enfants atteints de troubles de l'attention. qui est souvent utilisé pour la simulation de la rivière. ...
... ClinivaVR: Salle de cours et emplacement des distracteurs[112].Si l'un des usages de la Réalité Virtuelle est de simuler des activités irréalisables dans un contexte réel, elle est également utilisée pour simuler des situations nécessitant habituellement l'accès à des ressources rares coûteuse, ou limitées. Les ressources limitées peuvent inclure non seulement des ressources au sens traditionnel du terme, mais aussi des équipements sci-entifiques et même les laboratoires qui les contiennent. ...
C'est en grande partie grâce au jeu sérieux Fold'It, que les approches par simulation interactive et par jeu sérieux ont pu convaincre de leur pertinence dans le domaine de la biologie moléculaire. Ce jeu sérieux a été conçu pour résoudre et adresser de manière ludique et collaborative la problématique du repliement de protéine. Au-delà de l'énorme potentiel pédagogique, un groupe de joueurs de Fold'It a réussi le challenge de trouver la structure d'une protéine du VIH, démontrant l'utilité d'une telle méthodologie. Inspirés par cette avancée méthodologique en biologie moléculaire en matière de simulation interactive, et convaincu de son potentiel pour de nombreuses applications en mécanique des fluides, ce travail de thèse fut consacré à étudier dans quelles mesures et dans quelles conditions une approche par simulation interactive par jeu sérieux pouvait être appliquée au domaine de la mécanique des fluides. La progression des méthodes numériques en mécanique des fluides alliée à la puissance de calcul toujours plus importante permet en effet de d'envisager un transfert méthodologique par la construction d'une plateforme de la simulation des fluides interactives incluant des fonctionnalités de conception de modèles avec conditions initiales, de visualisation et de contrôle interactif du fluide et de son environnement pendant une simulation en cours. Ce travail de thèse a donc eu pour objectif de concevoir et d'évaluer une approche par simulation interactive et par jeux sérieux consacrés à la mécanique des fluides. La première étape de ce travail fut donc d’implémenter une plateforme dédiée, conjointement à une étude bibliographique continue sur l'usage des simulations interactives et des jeux sérieux en général et en mécanique des fluides. Au-delà de l'aspect technologique et du challenge sous-jacent, différentes pistes ont été explorées pour aboutir à une architecture matérielle et logicielle très contraintes. Il s'agit en effet d'offrir les performances requises par l'interactivité, de s'assurer de la conservation de la pertinence physique d'un phénomène simulé lors de son édition interactive, de respecter les usages pour que cette approche puisse susciter l'adhésion de la communauté. Ce travail a abouti à une proposition d'une architecture modulaire basée sur l'outil de conception de jeu vidéo Unity 3D, offrant une grande flexibilité pour la conception de fonctionnalités de visualisation et d'interaction, associé à une infrastructure permettant de coupler cet outil avec n'importe quel code de simulation de fluide opensource. Cette approche a été appliquée à une méthode de calcul de type Lattice-Boltzmann, fortement parallélisable et peu sensible aux perturbations interactives durant une simulation en cours avec l'adaptation de Palabos. Enfin, l'usage de nouvelles méthodologies par calcul asynchrone a été exploré, car susceptibles de compléter le besoin de performances déjà fournies par les approches fortement parallèles. Sur cette base ont été menées trois expérimentations pour mesurer l'intérêt de méthodologie interactives et par jeux sérieux. La première expérimentation fut de comparer la performance entre la simulation conventionnelle et la simulation interactive. Une seconde expérimentation a été menée afin de mesurer la plus-value de l'immersion en termes d'expérience utilisateur et de performance. Enfin, la troisième expérimentation a cherché à mesurer l'impact du niveau de dégradation des résultats induit par les calculs asynchrones, sur la prise de décision, pour anticiper l'usage de ce type de méthodologies pour adresser les problématiques de performance relative au contexte interactif.
... El tercer proceso cognitivo más evaluado por medio de RV es la atención. Si bien existen varias alternativas de plataformas dirigidas a evaluar solo este proceso cognitivo o en compañía de otros, como la inhibición, tal como lo han hecho Rizzo (2002); Nolin et al. (2016) y Horan et al. (2020, la plataforma que mayor goza de reconocimiento y que actualmente se encuentra disponible de manera comercial es la de Iriarte et al. (2012) denominada "AULA Nesplora". Esta es una de las propuestas que gozan de mayor evidencia científica actualmente, encontrándose estandarizada para sujetos de habla española. ...
... Otros aspectos importantes para tener en cuenta al momento de utilizar RV son los efectos secundarios de la exposición conocida como el malestar del simulador o enfermedad cibernética, donde trabajos como los de Corriveau et al. (2020) ISSN: 0718-4123 2021, Vol. 15 Nº2 196 -213 DOI: 10.7714/CNPS/15.2.216 212 refieren bajos síntomas, aunque Nolin et al. (2016) comentan que lo más común es la fatiga visual, la fatiga general y nauseas, con menor frecuencia. Sin duda, la RV en los próximos años ganará un espacio cada vez un espacio más amplio en las investigaciones sobre evaluación neuropsicológica. ...
Los instrumentos de evaluación neuropsicológica actual carecen de validez ecológica. como tecnologias, especialmente la realidad virtual (RV), ha incursionado en el mundo de la evaluación cognitiva. La presente revisión de tema tiene como objetivo determinar el tipo de RV implementada para la evaluación neuropsicológica, También, evidenciar cuales son los procesos cognitivos evaluados por medio esta tecnología yardaeterminar preocupaciones son los escenarios de la vida cotidiana que mas implementan al diseñar entornos virtuales para mejorar la validez ecológica de la evaluación. Se da cuentaó una revisión bibliográfica internacional de los trabajos publicados en la base de datos PAGSudmed durante el periodo de tiempo de 2000 al primer semestre de 2021. Se incluyeron un total de 44 trabajos. El 52,3% trabajos implementa RV Inmersiva, seguida por la RV No Inmersiva con el 43, 2% y por del mes pasado RV semi-inmersiva, con 4, 5%. LaRV ha demostrado ser una herramienta prometedora paraca la evaluación de diferentes procesos cognitivos.
... From the perspective of changes in validation, it seems that there are two main streams. The first perspective is about transplanting existing traditional tests into VR, such as the Stroop test [29,50,57,67,69,70,73] and the trail-making task [76]. This includes most of the usability validation studies in data set 2. Because the Stroop test is a simple and ocular task, it has been considered suitable to convert into a VE. ...
... The increase in uncategorized studies in period 4 could also be seen in the same context. Most of the uncategorized studies examined the sense of presence and cybersickness [44,47,54,58,63,67,75,77]. These are indeed the two major problems for wider acceptance of VR for more age groups and for obtaining more ecological validity. ...
Background
In neuropsychology, fully immersive virtual reality (VR) has been spotlighted as a promising tool. It is considered that VR not only overcomes the existing limitation of neuropsychological tests but is also appropriate for treating executive functions (EFs) within activities of daily living (ADL) due to its high ecological validity. While fully immersive VR offers new possibilities of neuropsychological tests, there are few studies that overview the intellectual landscape and academic trends in the research related to mainly targeted EFs with fully immersive VR.
Objective
The objective of this study is to get an overview of the research trends that use VR in neuropsychological tests and to analyze the research trends using fully immersive VR neuropsychological tests with experimental articles.
Methods
This review was carried out according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Articles were searched in three web databases using keywords related to VR, EFs, and cognitive abilities. The study was conducted in two steps, keyword analysis and in-depth systematic review. In the web database search from 2000 to 2019, 1167 articles were initially collected, of which 234 articles in the eligibility phase were used to conduct keyword analysis and a total of 47 articles were included for systematic review.
Results
In keyword analysis, the number of articles focused on dementia including the keywords “MCI,” “SCD,” and “dementia” were highlighted over the period, rather than other symptoms. In addition, we identified that the use of behavioral and physiological data in virtual environments (VEs) has dramatically increased in recent studies. In the systematic review, we focused on the purpose of study, assessment, treatment, and validation of usability and structure. We found that treatment studies and uncategorized studies including presence and cybersickness issues have emerged in the recent period. In addition, the target symptoms and range of participants were diversified.
Conclusions
There has been a continuously increasing interest in dealing with neuropsychology by using fully immersive VR. Target cognitive abilities have been diversified, as well as target symptoms. Moreover, the concept of embodied cognition was transplanted in this research area.
... Bailenson et al. [4] and Blume et al. [5] studied learning outcomes according to sitting positions and offer compelling evidence that students seated in the front have better learning outcomes. Few studies, however, took head movements into consideration [13,31,34,39] in such setups. In [13], the immersive VR classroom was used as a tool to study attention measures for attention deficit/hyperactivity disorder (ADHD), whereas in [31] reliability of virtual reality and attention was studied with continuous performance task (CPT) for clinical research. ...
... Few studies, however, took head movements into consideration [13,31,34,39] in such setups. In [13], the immersive VR classroom was used as a tool to study attention measures for attention deficit/hyperactivity disorder (ADHD), whereas in [31] reliability of virtual reality and attention was studied with continuous performance task (CPT) for clinical research. Social interaction using head movements was studied in [39] with users' head movements found to shift between the interaction partner and target. ...
Recent developments in computer graphics and hardware technology enable easy access to virtual reality headsets along with integrated eye trackers, leading to mass usage of such devices. The immersive experience provided by virtual reality and the possibility to control environmental factors in virtual setups may soon help to create realistic digital alternatives to conventional classrooms. The importance of such settings has become especially evident during the COVID-19 pandemic, forcing many schools and universities to provide the digital teaching. Researchers foresee that such transformations will continue in the future with virtual worlds becoming an integral part of education. Until now, however, students’ behaviors in immersive virtual environments have not been investigated in depth. In this work, we study students’ attention by exploiting object-of-interests using eye tracking in different classroom manipulations. More specifically, we varied sitting positions of students, visualization styles of virtual avatars, and hand-raising percentages of peer-learners. Our empirical evidence shows that such manipulations play an important role in students’ attention towards virtual peer-learners, instructors, and lecture material. This research may contribute to understanding of how visual attention relates to social dynamics in the virtual classroom, including significant considerations for the design of virtual learning spaces.
... Likewise, its use could improve cognitive and daily skills, besides academic results. • Nolin et al. [20] recommended virtual reality as an assessment tool because of the selective and sustained attention it creates in children. • Passig et al. [21] indicate that teaching in a virtual reality environment contributes to children's cognitive modifiability. ...
Designing serious games in virtual reality (VR) may raise a health and safety concern as to whether children should use this technology. This paper attempts to clarify this issue by studying VR impact on children’s physical, cognitive and psychosocial development. With a supervised and controlled use over time, it is found that VR could cause physical problems as motion sickness and visual fatigue. To avoid these issues, a series of VR design guidelines are collected so researchers can follow them to develop serious games for children. To avoid motion sickness, developers have to: 1) regulate free movement in the virtual environment and add visual effects or references, 2) help to maintain a stable body posture during the game, 3) bring interactive objects closer and allow their manipulation in non-gravity condition, 4) adjust the difficulty of the tasks and make them as interactive as possible, and 5) implement quality visual and sound content. Regarding the reduction of visual fatigue, developers need to: 1) regulate and supervise the game time, 2) choose an HMD that offers good graphic definition, and 3) design the user interface to be easily understandable and legible.KeywordsVirtual realityChildrenMotion sicknessVisual fatigue
... The VR Everyday Assessment Lab assesses everyday memory (prospective and episodic), attention (visuospatial and auditory), and EF (planning and multitasking), and has been found a valid and substantially more pleasant testing experience [53], which indicates everyday functionality of adults [54], [55]. The ClinicaVR: Classroom-CPT is a VR classroom that examines selective and sustained attention, and inhibition, which has been validated in children and adolescents [64]. Regarding interventions in ASD, there is preliminary evidence postulating its feasibility for being adopted in clinical and educational environments [59], [65]. ...
p>Poor social skills in autism spectrum disorder (ASD) are associated with reduced independence in daily life. Current interventions for improving the social skills of individuals with ASD fail to represent the complexity of real-life social settings and situations. Virtual reality (VR) may facilitate social skills training in social environments and situations proximal to real life, however, more research is needed for elucidating aspects such as the acceptability, usability, and user experience of VR systems in ASD. Twenty-five participants with ASD attended a neuropsychological evaluation and three sessions of VR social skills training, incorporating 5 social scenarios with three difficulty levels for each. Participants reported high acceptability, system usability, and user experience. Significant correlations were observed between performance in social scenarios, self-reports, and executive functions. Working memory and planning ability were significant predictors of functionality level in ASD and the VR system’s perceived usability respectively. Yet, performance in social scenarios was the best predictor of usability, acceptability, and functionality level in ASD. Planning ability substantially predicted performance in social scenarios, postulating an implication in social skills. Immersive VR social skills training appears effective in individuals with ASD, yet an error-less approach, which is adaptive to the individual’s needs, should be preferred. </p
... The VR Everyday Assessment Lab assesses everyday memory (prospective and episodic), attention (visuospatial and auditory), and EF (planning and multitasking), and has been found a valid and substantially more pleasant testing experience [53], which indicates everyday functionality of adults [54], [55]. The ClinicaVR: Classroom-CPT is a VR classroom that examines selective and sustained attention, and inhibition, which has been validated in children and adolescents [64]. Regarding interventions in ASD, there is preliminary evidence postulating its feasibility for being adopted in clinical and educational environments [59], [65]. ...
p>Poor social skills in autism spectrum disorder (ASD) are associated with reduced independence in daily life. Current interventions for improving the social skills of individuals with ASD fail to represent the complexity of real-life social settings and situations. Virtual reality (VR) may facilitate social skills training in social environments and situations proximal to real life, however, more research is needed for elucidating aspects such as the acceptability, usability, and user experience of VR systems in ASD. Twenty-five participants with ASD attended a neuropsychological evaluation and three sessions of VR social skills training, incorporating 5 social scenarios with three difficulty levels for each. Participants reported high acceptability, system usability, and user experience. Significant correlations were observed between performance in social scenarios, self-reports, and executive functions. Working memory and planning ability were significant predictors of functionality level in ASD and the VR system’s perceived usability respectively. Yet, performance in social scenarios was the best predictor of usability, acceptability, and functionality level in ASD. Planning ability substantially predicted performance in social scenarios, postulating an implication in social skills. Immersive VR social skills training appears effective in individuals with ASD, yet an error-less approach, which is adaptive to the individual’s needs, should be preferred. </p
... The VR Everyday Assessment Lab assesses everyday memory (prospective and episodic), attention (visuospatial and auditory), and EF (planning and multitasking), and has been found a valid and substantially more pleasant testing experience [53], which indicates everyday functionality of adults [54], [55]. The ClinicaVR: Classroom-CPT is a VR classroom that examines selective and sustained attention, and inhibition, which has been validated in children and adolescents [64]. Regarding interventions in ASD, there is preliminary evidence postulating its feasibility for being adopted in clinical and educational environments [59], [65]. ...
Poor social skills in autism spectrum disorder (ASD) are associated with reduced independence in daily life. Current interventions for improving the social skills of individuals with ASD fail to represent the complexity of real-life social settings and situations. Virtual reality (VR) may facilitate social skills training in social environments and situations proximal to real life, however, more research is needed for elucidating aspects such as the acceptability, usability, and user experience of VR systems in ASD. Twenty-five participants with ASD attended a neuropsychological evaluation and three sessions of VR social skills training, incorporating 5 social scenarios with three difficulty levels for each. Participants reported high acceptability, system usability, and user experience. Significant correlations were observed between performance in social scenarios, self-reports, and executive functions. Working memory and planning ability were significant predictors of functionality level in ASD and the VR system’s perceived usability respectively. Yet, performance in social scenarios was the best predictor of usability, acceptability, and functionality level. Planning ability substantially predicted performance in social scenarios, postulating an implication in social skills. Immersive VR social skills training in individuals with ASD appears an appropriate service, yet an error-less approach, which is adaptive to the individual’s needs, should be preferred.
... First developed in the 1960s, VR is increasingly used in education and training worldwide from teaching mathematical concepts (e.g. [28,29]), to learning about thermodynamics [30], to enhancing writing skills of pupils with English as an Additional Language (EAL) [31], as an intervention tool for pupils with autism [32], as an assessment tool for pupils with ADHD [20] and as an effective tool for demonstrating vocational skills [33]. ...
This small-scale study explores the attitudes of fifty initial teacher education (ITE) subject methods tutors towards the use of virtual reality (VR) in education and considers whether VR could be a catalyst for reviewing the partnership model within ITE programmes. In addition, this study offers a novel solution to ITE tutors’ challenges when managing their own technological and pedagogical development alongside preparing student teachers for technology-enhanced learning (TEL). Building on previous research on ITE tutors’ use of TEL across the island of Ireland, this paper discusses the synergy between the cognitive apprenticeship model and reverse mentoring that upends the classic co-operating teacher/student teacher hierarchy and positions all partners in ITE programmes as learning leaders at key points in the partnership process. An online survey comprising 51 items was administered to a purposive sample of 50 ITE tutors from four ITE providers, two in Ireland and two in Northern Ireland (NI), who were selected due to their developing interest in the use of virtual reality in teacher education. Data analysis using SPSS combined with thematic analysis of open-ended responses revealed that although the majority of ITE subject methods tutors conveyed open-minded and willing attitudes to embrace VR in the future, they identified a number of systemic issues that need to be addressed first. These include the disconnect between innovative pedagogical practices presented in university-based modules and the stark reality of technological deficits in some classrooms; the pedagogical and resource-based ‘readiness’ of ITE tutors to embed VR in their subject-specific teaching; and the need for curriculum-focused, VR resources for school-based use. As a result of this study, an incremental, cyclical approach to growing the body of knowledge around VR pedagogy is proposed in conjunction with new forms of collaboration between the partners in ITE.
... Nechita and Rezeanu (2019) report that multisensory-enhanced museum spaces can enhance empathy by allowing learners to experience a variety of historical settings from a first-hand perspective. Teaching in interactive VR environments provides equal or better learning outcomes compared to traditional teaching (Newman and McLean, 2004;Stull et al., 2013;Nolin et al., 2016;Frydenberg and Andone, 2018;Felnhofer et al., 2018;Dube and Ince, 2019). However, the transformative effect of immersive VR in education has mainly been reported in the medical field (Thompson, 2009;Kim et al., 2015;Kim et al., 2017;Brusamento et al., 2019;Kyaw et al., 2019;Blumstein et al., 2020). ...
This article reviews the potential functions and approaches of museum education in alleviating psychological anxiety, particularly the psychological anxiety experienced by adolescents during the COVID-19 pandemic. We outline the main forms of museum education, highlighting how it supports the potential functions of art therapy for psychological anxiety. Thereafter, we review the representative research on museum art therapy practice for different populations to invite discussion, dialogue, and awareness of future directions for museum education and suggest gaps in the research that require further study.
... In addition, the development of information technology has improved the quality of virtual tourism experience (González-Rodríguez et al., 2020), attracting more virtual tourists (Sigala, 2020). Virtual tourism provides a convenient choice for tourists to visit protected historical sites or hard-to-reach places (such as space) through the way of immersion, imagination, and interaction (Nolin et al., 2016;Wagler and Hanus, 2018), especially creating barrier-free tourism activities for the disabled, the elderly, and other restricted people (Cho et al., 2002), which break through time and space constraints and economic shackles to a certain extent (Ritchie et al., 2011;Bonetti et al., 2018;. ...
The Metaverse is a new application of the internet and social form which integrates a myriad of new technologies. It can not only create a parallel space that is closely connected to the real world while highly independent, but also bring the immersive experience of virtual scenarios without delay. The virtual tourism space situations that integrate realistic visual, audio, and temperature sensations can restore the real tourism environment to the greatest extent, and improve tourists’ perception and satisfaction with the experience. The purpose of this experimental lab study is to examine the effects of the virtual tourism audio-visual conditions and environmental temperature on tourists’ thermal sensation and temperature comfort. VR equipment and microclimate simulation technology was applied in a 3 × 2 × 2 experimental design ( n = 180), simulating the virtual tourism scenarios. Electrocardiogram devices were also employed to assess participants’ physiological indicators. Study results suggest that: (1) Virtual tourism spatial situations (environmental temperature and audio-visual conditions) significantly affect participants’ thermal sensation and part of the physiological indicators; (2) Virtual tourism spatial situations (environmental temperature and audio-visual conditions) significantly affect participants’ temperature comfort; and (3) Physiological responses (indicators) mediate the effect from tourism spatial situations to temperature comfort. The study mainly contributes to the literature about virtual tourism experience and spatial situations under the concept of the Metaverse, as well as provides theoretical and managerial implications for the development of “immersive” virtual tourism scenarios.
... It is due to visual fatigue that problems with focusing, far vision, and near vision are created. As a result of motion sickness, you may feel sleepy, nauseated, or dizzy (Nolin et al., 2016). ...
The use of extended reality (XR) technologies, namely Augmented Reality (AR), Virtual Reality (VR) and Mixed Reality(MR) in education, has attracted much attention in recent years. Since the middle of the 20th century, virtual reality (VR) has been a part of our lives. Today, technology has made virtual reality accessible to everyone. In the last ten years, virtual reality equipment has become suitable for individual use and has started to be used by large numbers of people. Virtual reality can now be used for educational purposes, including education virtual laboratories. The studies were carried out to reveal the advantages of virtual reality compared to traditional media tools, as well as the conclusion that a successful instructional design process plays a major role in the success of technology in education. In line with what has been mentioned, we review in this paper the historical development of virtual reality technologies, followed by the use of Extended reality technology in the field of education, including virtual laboratories. This paper is to argue and present evidence from extensive research that VR can be a valuable tool in engineering, such as virtual laboratories. As a result of the review we conducted, we were able to conclude that VR has a positive pedagogical and cognitive impact on engineering education, thus increasing students' understanding of the subjects, their grades and performance, and overall satisfaction with their education. Furthermore, VR, as a replacement for physical laboratories, can reduce university liability, infrastructure, and costs. It was also discovered that VR applications for education currently lack the integration of learning theories and objectives in engineering education. In this research, we aim to provide recommendations and guidelines for researchers who want to work in the field of virtual reality and to offer suggestions for virtual laboratories.
... As also reported by [192], eye movements should be examined along with head movements to understand attention and interaction more in-depth, since eyes can move differently. In addition, [193] studied the relationship between performance, sense of presence, and cybersickness, whereas [194] examined attention, more particularly ADHD with continuous performance task in a virtual classroom. However, both works are more in the clinical domain, which are relatively different from an everyday classroom setup. ...
Virtual reality (VR) is not a new technology but has been in development for decades, driven by advances in computer technology. Currently, VR technology is increasingly being used in applications to enable immersive, yet controlled research settings. Education and entertainment are two important application areas, where VR has been considered a key enabler of immersive experiences and their further advancement. At the same time, the study of human behavior in such innovative environments is expected to contribute to a better design of VR applications. Therefore, modern VR devices are consistently equipped with eye-tracking technology, enabling thus further studies of human behavior through the collection of process data. In particular, eye-tracking technology in combination with machine learning techniques and explainable models can provide new insights for a deeper understanding of human behavior during immersion in virtual environments. In this work, a systematic computational framework based on eye-tracking and behavioral user data and state-of-the-art machine learning approaches is proposed to understand human behavior and individual differences in VR contexts. This computational framework is then employed in three user studies across two different domains. In the educational domain, two different immersive VR classrooms were created where students can learn and teachers can train. In terms of VR entertainment, eye movements open a new avenue to evaluate VR locomotion techniques from the perspective of user cognitive load and user experience. This work paves the way for assessing human behavior in VR scenarios and provides profound insights into the way of designing, evaluating, and improving interactive VR systems. In particular, more effective and customizable virtual environments can be created to provide users with tailored experiences.
... Therefore, this allows to collect the complete response of the subjects in this virtual environment. In this sense, although VR has been used, and validated, to measure memory [106] and student performance [107], very few studies have identified VR-based lighting design guidelines that can improve students' cognitive performance. However, this study establishes that VR can be used to analyse subjects' cognitive performance in a memory task using different lighting scenarios. ...
Classroom lighting conditions affect students' academic performance due to the influence of light on learning. Illuminance is a lighting parameter recognised as an important factor in interior lighting. The objective of this study is to analyse the effect that a classroom's illuminance exerts on university students' memories; memory is one of the fundamental cognitive processes in learning. Forty subjects performed a psychological memory task in three immersive virtual environments (IVEs) with different illuminance levels, 100 lx, 300 lx and 500 lx. Their neurophysiological responses were monitored during the tasks through electroencephalogram, heart rate variability and electrodermal activity analysis. The results showed that classroom illuminance influences students' memories at psychological and neurophysiological levels. As illuminance increased, their performance in the memory tests deteriorated, and neurophysiological activation diminished; the best results were obtained with an illuminance level of 100 lx. These results may have important consequences for the energy efficiency of educational centres and provide information about the cognitive implications of lighting for learning in virtual environments.
... For all these reasons, alternative cognitive assessment mechanisms were explored in recent years, including the digitization of classic tests [12], gamification [13] or virtual reality [14][15][16][17][18][19][20][21], among others. In particular, our proposal is based on the introduction of serious games, immersive virtual reality and artificial intelligence (AI), more specifically machine learning algorithms [22,23]. ...
The high prevalence of Alzheimer-type dementia and the limitations of traditional neuropsychological tests motivate the introduction of new cognitive assessment methods. We discuss the validation of an all-digital, ecological and non-intrusive e-health application for the early detection of cognitive impairment, based on artificial intelligence for patient classification, and more specifically on machine learning algorithms. To evaluate the discrimination power of this application, a cross-sectional pilot study was carried out involving 30 subjects: 10 health control subjects (mean age: 75.62 years); 14 individuals with mild cognitive impairment (mean age: 81.24 years) and 6 early-stage Alzheimer’s patients (mean age: 80.44 years). The study was carried out in two separate sessions in November 2021 and January 2022. All participants completed the study, and no concerns were raised about the acceptability of the test. Analysis including socio-demographics and game data supports the prediction of participants’ cognitive status using machine learning algorithms. According to the performance metrics computed, best classification results are obtained a Multilayer Perceptron classifier, Support Vector Machines and Random Forest, respectively, with weighted recall values >= 0.9784 ± 0.0265 and F1-score = 0.9764 ± 0.0291. Furthermore, thanks to hyper-parameter optimization, false negative rates were dramatically reduced. Shapley’s additive planning (SHAP) applied according to the eXplicable AI (XAI) method, made it possible to visually and quantitatively evaluate the importance of the different features in the final classification. This is a relevant step ahead towards the use of machine learning and gamification to early detect cognitive impairment. In addition, this tool was designed to support self-administration, which could be a relevant aspect in confinement situations with limited access to health professionals. However, further research is required to identify patterns that may help to predict or estimate future cognitive damage and normative data
... However, in our study, no significant differences were observed in task-irrelevant movements between the two groups. This result is inconsistent with previously published meta-analytic results, indicating a higher level of movement in children with ADHD (Parsons et al., 2007;Diaz-Orueta et al., 2014;Nolin et al., 2016). The reason for these inconsistent results is unclear, but may be because VR generally enhances the attention level of children with ADHD through motivation and entertainment (Rizzo et al., 2004;Dovis et al., 2012;Larson et al., 2014), and the inclusion or exclusion of distractions causes or diminishes performance differences between ADHD and HC participants (Mansfield et al., 2003;Rizzo et al., 2004;Rizzo et al., 2006;Mazurek and Engelhardt, 2013;Eom et al., 2019). ...
Background
Attention deficit hyperactivity disorder (ADHD) is clinically diagnosed; however, quantitative analysis to statistically analyze the symptom severity of children with ADHD via the measurement of head movement is still in progress. Studies focusing on the cues that may influence the attention of children with ADHD in classroom settings, where children spend a considerable amount of time, are relatively scarce. Virtual reality allows real-life simulation of classroom environments and thus provides an opportunity to test a range of theories in a naturalistic and controlled manner. The objective of this study was to investigate the correlation between participants’ head movements and their reports of inattention and hyperactivity, and to investigate how their head movements are affected by different social cues of different sensory modalities.
Methods
Thirty-seven children and adolescents with ( n = 20) and without ( n = 17) ADHD were recruited for this study. All participants were assessed for diagnoses, clinical symptoms, and self-reported symptoms. A virtual reality-continuous performance test (VR-CPT) was conducted under four conditions: (1) control, (2) no-cue, (3) visual cue, and (4) visual/audio cue. A quantitativecomparison of the participants’ head movements was conducted in three dimensions (pitch [head nods], yaw [head turns], and roll [lateral head inclinations]) using a head-mounted display (HMD) in a VR classroom environment. Task-irrelevant head movements were analyzed separately, considering the dimension of movement needed to perform the VR-CPT.
Results
The magnitude of head movement, especially task-irrelevant head movement, significantly correlated with the current standard of clinical assessment in the ADHD group. Regarding the four conditions, head movement showed changes according to the complexity of social cues in both the ADHD and healthy control (HC) groups.
Conclusion
Children and adolescents with ADHD showed decreasing task-irrelevant movements in the presence of social stimuli toward the intended orientation. As a proof-of-concept study, this study preliminarily identifies the potential of VR as a tool to understand and investigate the classroom behavior of children with ADHD in a controlled, systematic manner.
... In particular, several video game versions of the CPT are available, such as MOXO-CPT (29), Kinect-based CPT (30), virtual reality-based CPT (31), the virtual classrooms ClinicaVR: Classroom CPT (32), and AULA Nesplora (33), as well as general purpose games such as EndeavorRX (34), Empowered Brain, and The Secret Trail of the Moon (35). ...
Objective
To carry out a quasi-systematic review of the use of serious video games for health as a cognitive rehabilitative tool in patients diagnosed with attention-deficit hyperactivity disorder.
Method
A quasi-systematic review of serious video games used as an evaluative and rehabilitative tool in patients with ADHD was conducted. It included behavioral patterns in the use of video games and addiction problems in this population. For its elaboration the PRISMA GUIDES were followed. The search was carried out in three PubMed databases, MEDLINE, and PsycInfo using the keywords: [game OR serious game OR computer game) AND (psychotherapy OR rehabilitation OR intervention OR mental disorders) AND (adhd)], [(adhd) AND (Video game addiction)]. All articles written in English, Spanish, or Portuguese from January 1970 to June 2021 were included: those in which reference was made to the use of video games and/or new technologies as a therapeutic and evaluative tool in children and adults diagnosed with ADHD, as well as those that referred to behavioral and clinical patterns in the use of video games.
Results
We found 605 articles of which 128 were reviewed (44 observational studies, 26 quasi-experimental studies, 26 experimental studies, 8 systematic reviews, 9 narrative texts, 6 case reports, 7 pilot studies, 8 systematic reviews, and 2 meta-analyses). Serious video games can be used to ameliorate ADHD symptoms while improving adherence to treatment. Some serious video games show high accuracy properties assessing ADHD features.
Conclusion
Serious video games for health are increasingly being used as a cognitive rehabilitation tool in patients with attention-deficit hyperactivity disorder (ADHD).
Systematic Review Registration
[ www.crd.york.ac.uk/prospero ], identifier [CRD42021247784].
... Researchers and practitioners alike are looking for alternative ways to support young adults and children with ADHD cope with the challenges that come with their neurodiversity. However, the majority of studies in relation to games and ADHD that can be found in literature report on the use of these tools for assessment rather than support or intervention (Rizzo et al., 2001;Nolin, Stipanicic, Henry, Lachapelle, Lussier-Desrochers & Allain, 2016;Parsons, Duffield, & Asbee, 2019). ...
Mental health and neurodevelopmental disorders are common among children and young adults. They can negatively affect children's social behaviour, development, and performance in school. This chapter discusses three common mental health and neurodevelopmental disorders and how serious immersive games could support this group. Serious immersive games are games that are designed with a certain purpose in mind and make use of immersive technologies like virtual or augmented reality. As games are a vital element of youth culture, the authors claim that immersive game elements could be utilized to engage a larger group with the health system and offer safe and motivating environments. This chapter shows that work exists to explore the use of games or immersive technologies in mental health support. However, the authors also show that there are shortcomings in the current research and propose research directions to address those.
... On a cognitive level, in a large systematic review, VR has been found moderately successful in improving social development in adolescents with autism spectrum disorders (Mesa-Gresa et al., 2018). VR has also been used to measure and assess attention in both typical and neuroatypical children and adolescents (Diaz-Orueta et al., 2012;Nolin et al., 2016). Exposure therapy in VR has been found effective to reduce anxiety about public speaking in adolescents (Kahlon et al., 2019). ...
Adolescent mental health is a growing public health issue, with 30% of teens reporting increased stress and 20% of adolescents suffering from depression. Given the scarcity and lack of scalability of mental health services available, the use of self-administered, evidence-based technologies to support adolescent mental health is both timely and imperative. We conducted a mixed-methods pilot study with 31 adolescents ages 14–19 (m = 17.97) to explore the self-administration of a nature-based virtual reality tool. Participant use of the VR environment ranged from 1 to 10 sessions (m = 6.6) at home over a 2-week period while reporting their daily stress and mood levels. All participants completed all of the study protocols, indicating our protocol was feasible and the VR environment engaging. Post-study interviews indicated that most participants found the VR tool to be relaxing and helpful with stress. The themes of Calm Down, Relaxation, and Escape emerged to articulate the participants’ experiences using the VR environment. Additionally, participants provided rich data regarding their preferences and activity in the VR environment as well as its effect on their emotional states. Although the sample size was insufficient to determine the impact on depression, we found a significant reduction in momentary stress as a result of using the VR tool. These preliminary data inform our own virtual reality environment design, but also provide evidence of the potential for self-administered virtual reality as a promising tool to support adolescent mental health.
... Sleepy, nausea, dizziness are other effects of motion sickness. (Nolin et al., 2016) have proved that fatigue and eye-strain are the most common effects of VR usage, whereas burping and nausea are the least ones. ...
Educators of the 21st century have to be techno-friendly to cater to students' needs who embrace the latest technologies. Using visual-based methods like PowerPoint presentations, videos, animation, etc., has helped the students retain information compared to the traditional methods. One of the breath-taking advancements in visualizing technology is Virtual Reality (VR). This paper provides an overview of Virtual Reality (VR) technology and its applications in education. During this study, to better understand VR's contributions to education, a systematic review of the literature was conducted from Scopus, IEEE, and Google Scholar databases. The paper aims to highlight the core concepts, the origination of the technology, its impact, associated problems, and future directions of VR concerning education and the methods considered by notorious researchers. Identified gaps in the chosen literature works were also highlighted, and suggestions to overcome the identified gaps were summarized.
... ough this mainly involves using virtual reality to replicate surgical procedures, it may also stimulate other medical procedures, including recovery [18]. Nolen et al. [19] built digital teaching-learning simulations to aid in the recovery of children with ADHD. Furthermore, Chang et al. [20] looked at the ability of virtual reality to inspire patients with severe health problems. ...
Since half of the century, technology has dominated the modern era. The rapid advancement of technology has reached generating artificial intelligence and artificial realities. So, virtual reality is an emerging technology and is applicable in education as well. Virtual reality is a computer-generated simulation, where people can interact within an artificial environment. Moreover, in an educational setting, such an environment provides students with a chance to get experiential learning. This paper has a systematic literature review on emerging technologies, such as virtual reality as a pedagogical tool for enhancing students’ experiential learning. This review aims to explore and understand the effect of virtual reality on students’ experiential learning by reviewing twenty-six selected articles. The selected studies have followed various methodologies and are from different contexts. This review study aims to present a systematic literature review for understanding and exploring the effect of virtual reality as a pedagogical tool for enhancing students’ experiential learning. Nine themes were identified, which are (a) virtual reality as pedagogical tool, (b) virtual reality as emerging educational technology tool, (c) virtual reality as digital transformation, (d) virtual reality as teaching-learning model, (e) virtual reality as architectural pedagogy, (f) virtual reality for communication skills, (g) virtual reality for reading and writing skills, (h) virtual reality for social learning, and (i) virtual reality for experiential learning. Thus, it is found that virtual reality is used as a pedagogical tool for various subject areas for encouraging involvement. It is helpful in medical, engineering, language, and social learning, as it provides a chance to get first-hand experience of the environment. Also, it helps learners to engage in a presented virtual environment and experience the sense of presence in it and enhances students’ experiential learning. Therefore, this review found virtual reality as an essential pedagogical tool for strengthening students’ experiential learning.
1. Introduction
This review study aims to present the literature review about virtual reality as a pedagogical tool for enhancing students’ experiential learning. This study has intended to cover the brief description of the concept of virtual reality in general and specifically virtual reality as a tool of pedagogy which is one of the applications of virtual reality. This paper has presented a review of twenty-six research papers on virtual reality. The term virtual is used frequently in today’s world, which directs the listener’s attention towards technology or computer-based program. Virtual refers to imaginative sort of objects and activities which are not performed or observed on physical grounds. However, this term of virtual reality was initially introduced in the 1980s to declare the power of technology to develop an artificial world. Nevertheless, people’s attention in recent times goes directly towards cyberspace after listening to the term virtual reality. This association of virtuality to technology has taken time, and the field is now known to most people worldwide.
In educational settings, school level students do not get enough access to computers and the Internet. Furthermore, if some students access computers and technology, they could not get proper teacher support to learn technological skills. Thus, while reaching to university level, their technological skills are found to be poor. After becoming part of a university, those same students get access to proper teacher support and tasks to be completed on computers. Still, advanced technologies are not used commonly. However, the application of virtual reality helps enhance experiential learning among students. Also, helping students experience the world virtually is an effective and efficient way to practice in educational settings.
The school setting does not support even essential technological integration. However, higher education institutions are continuously trying to bring innovation in the teaching-learning process and technological advancement in education settings; additionally, some institutions also offer virtual learning environments for their students. Nevertheless, the implementation of virtual reality is rarely observed. Although students learn about virtual reality and its applications, they could not get a chance to experience it in most cases. However, some get the experience of the virtual environment. This systematic literature review purports to provide insights about virtual reality and its usability for enhancing experiential learning. With the help of this systematic literature review, empirical findings will be presented to reveal the practicality and usability of virtuality in an educational context. Also, some pedagogical dimensions of virtual reality will be presented to help educators in implementing it.
Moreover, the enhancement of experiences and experiential learning among students can be promoted if teachers learn the pedagogical dimension. Thus, this study aims to present a systematic review of studies to provide an insight about experiential learning to be enhanced by practicing virtual reality as a pedagogical tool. This review of empirical studies will help in understanding the effects of virtual reality. This is one of the unique literature reviews of its nature, highlighting the significant gaps in knowledge, methodology, and implementation challenges educators face to integrate the virtual reality (VR) approach for the teaching and learning process.
2. Methodology
2.1. Process of Study and Literature Search
Peer-reviewed journal papers that met all of the inclusion requirements were part of a presented systematic review. An initial scoping analysis established seven databases, related keywords, and search terms that could be integrated into a systematic literature review. For literature searching, the simple process of using keywords was used. As the study entitles virtual reality as a pedagogical tool for enhancing experiential learning, searching terms and keywords such as virtual reality, virtual reality as a pedagogical tool, experiential learning, and virtual reality for experiential learning were searched from Google, Google Scholar, Sage, Emerald, Elsevier, Eric, and Taylor and Francis databases. Through this search, almost 67 articles were found, out of which 26 most relevant articles were selected for this review.
2.2. Selection Process and Inclusion Criteria
After the search results, there were 67 articles, and the chosen articles were 26. Those 26 articles were chosen based on the relevant themes of virtual reality as a pedagogical tool and virtual reality for enhancing experiential learning. Also, based on the year of study from 2009 to 2020, the articles from famous and authentic publishers were selected, but conference papers, thesis, and reports were not included. Then, those articles were sorted based on the topic and relevant themes (Table 1).
S. no.
Themes
1
Virtual reality as pedagogical tool
2
Virtual reality as emerging educational technology tool
3
Virtual reality as digital transformation
4
Virtual reality as teaching-learning model
5
Virtual reality as architectural pedagogy
6
Virtual reality for communication skills
7
Virtual reality for reading and writing skills
8
Virtual reality for social learning
9
Virtual reality for experiential learning
... Adams, Finn, Moes, Flannery and Rizzo (2009) implemented a "continuous performance test" (measuring sustained attention) in a VR classroom environment with realistic distractions, detecting a marginally significant difference in performance between a group of children diagnosed with ADHD and an age-matched control group. Others have similarly used virtual classroom settings for assessment of attention capabilities of adolescents and children (Iriarte et al., 2016;Nolin et al., 2016;Rizzo et al., 2006). ...
Virtual Reality has long been proposed to combine the reliability of controlled laboratory settings with the ecological validity of real life. While the technological development steadily pushes towards even more realistic renderings of the real world – the elusiveness of social and emotional elements gradually becomes more evident. This is not the least true for behavioral studies in rich socio-cultural contexts.
This paper examines the outcomes of a study on distractions, taking place in a socially rich context – the classroom. The study made use of a Virtual Reality environment simulating a junior high school lesson, where the distraction condition consisted of peers watching nonrelevant content on their laptops. In the control condition these laptops were closed.
No significant distraction effects were found, neither on learning nor behavior. Given the strong support in the literature for such effects, the study design, including technical aspects, is scrutinized and discussed. We specifically highlight the difficulty of simulating a social relationship between the participant and agents in VR, which in this case makes the distraction stimulus significantly weaker. It is argued that the distraction effect of nearby peers’ laptop-use relies (partly) on shared attention with social agents with an established social relation and common interests.
... Through VR, researchers can control lighting characteristics without the interference of other environmental visual variables such as natural light or the observer's position with respect to the object being observed. It is important to note that, although virtual classrooms have been used, and validated, to measure levels of attention, memory and even student performance [47], very few studies have been undertaken to identify lighting design guidelines that optimise students' cognitive performance. This paper proposes that VR be used to simulate lighting environments and be incorporated into the performance of tasks that can evaluate participants' cognitive performance (attention and memory). ...
Lighting plays a fundamental role in learning spaces as it influences students’ performance. Nowadays, new technologies and new teaching methods in higher education mean that very different visual tasks are performed in the classroom, so further research is necessary to identify what lighting is best suited to these new tasks. The objective of the study is to analyse the impact that variations in levels of illuminance and Correlated Colour Temperature (CCT) of classrooms have on the cognitive functions (attention and memory) of university students. The cognitive performance of 90 participants was evaluated based on attention and memory tasks. The participants had to view nine virtual classroom configurations, with three different illuminance settings (100 lx, 300 lx and 500 lx) and three CCTs (3000 K, 4000 K and 6500 K). The results showed that attention and memory tasks require different level of illumination. While attention improves with higher light levels, memory improves with lower light levels. Higher CCTs generate better performance in both attention and memory tasks. These results highlight the link between lighting and students’ cognitive responses. This study and its methodology can be useful for architects and researchers as they establish lighting design guidelines capable of improving students’ cognitive processes.
... Virtual reality is a technology that is increasingly adopted in various fields of application, and although it has always been popularized in the field of video games, fields such as medicine and education are increasingly oriented towards the use of virtual reality devices as part of the improvement of their processes and user experience [28,29]. Virtual reality allows users to interact with 3D representations generated by a computer [30,31] and the user is able to experience an immersive environment [32], that is, the user can have the feeling of realism at all times by interacting with all elements of the system and receive visual and sensory feedback in real-time through additional input/output devices such as the headset, sensors, controls, etc. [33,34]. ...
Today, the world is experiencing the COVID-19 health contingency, which prevents people from being exposed to one another and restricts physical contact. Under this context, the use of technology has become an essential tool to face the challenges of daily life, and virtual reality can be an alternative in the development of solutions that effectively support the acquisition of learning skills and knowledge transmission through the execution of tasks designed by multi-disciplinary groups. In addition, it can encourage the user to continue with the acquisition of learning skills in a friendly and fun way in a health and education context. This work proposes the use of virtual reality environments as an alternative to support the learning process in children with special educational needs such as Attention Deficit Hyperactivity Disorder (ADHD) and other associated disorders that occur in basic education. These proposed reality environments are designed under the Lean UX process model and their contents are designed according to expert therapeutic guidelines. As a result of this proposal, a case study is presented in which the user experience is evaluated through the use of an interactive environment to support the special educational needs of elementary school children attending an educational institution in Mexico.
... For example, Peperkorn et al. [41] presented large spiders in a VR environment where presence seemed to be a direct influence, and they appeared to be mutually dependent. Nolin et al. [42] built a virtual classroom to examine school children's attention and analyze the relationship between presence and learning achievements. Parong and Mayer [43] compared three types of VR displays and the results supported the cognitive theory of multimedia learning and demonstrated the value of creative learning strategies in immersive VR environments. ...
The learning objectives of environmental education emphasize investigation in real life to enhance students’ skills and experiences in solving practical problems. This study used the virtual reality (VR) technology to develop a virtual ecological environment for learning about the Taipei tree frog, supported by situated learning and game-based learning design to enhance students’ learning interest and motivation. Users can wear the head-mounted display (HMD) to explore the virtual environment for learning the Taipei tree frog’s ecological behavior, such as foraging and mating as well as its habitats and predators. A teaching experiment was conducted to investigate students’ learning effectiveness and the senses of presence and anxiety after using the virtual ecological environment. The experimental group (wearing the HMD) contained 40 students, the control group (using the desktop VR) contained 40 students, and both groups were used as samples to learn about the Taipei tree frog. The results indicated that using HMD VR and desktop VR could both enhance learning achievements, but the learning effectiveness of the former was significantly higher than that of the latter. The levels of anxiety for both groups were about the same, but the level of presence for the experimental group was higher than that of the control group because the HMD VR provided a more immersive experience than the desktop VR. The virtual ecological environment can save the time and effort of travelling to the natural habitat for observing the Taipei tree frog, and the design of role-playing game (RPG) can enhance learners’ interest and motivation. Therefore, it is a useful tool for promoting environmental education.
... As also reported by [55], eye movements should be examined along with head movements to understand attention and interaction more in-depth, since eyes can move differently. In addition, [44] studied the relationship between performance, sense of presence, and cybersickness, whereas [38] examined attention, more particularly ADHD with continuous performance task in a virtual classroom. However, both works are more in the clinical domain, which are relatively different from an everyday classroom setup. ...
... As also reported by [55], eye movements should be examined along with head movements to understand attention and interaction more in-depth, since eyes can move differently. In addition, [44] studied the relationship between performance, sense of presence, and cybersickness, whereas [38] examined attention, more particularly ADHD with continuous performance task in a virtual classroom. However, both works are more in the clinical domain, which are relatively different from an everyday classroom setup. ...
With rapid developments in consumer-level head-mounted displays and computer graphics, immersive VR has the potential to take online and remote learning closer to real-world settings. However, the effects of such digital transformations on learners, particularly for VR, have not been evaluated in depth. This work investigates the interaction-related effects of sitting positions of learners, visualization styles of peer-learners and teachers, and hand-raising behaviors of virtual peer-learners on learners in an immersive VR classroom, using eye tracking data. Our results indicate that learners sitting in the back of the virtual classroom may have difficulties extracting information. Additionally, we find indications that learners engage with lectures more efficiently if virtual avatars are visualized with realistic styles. Lastly, we find different eye movement behaviors towards different performance levels of virtual peer-learners, which should be investigated further. Our findings present an important baseline for design decisions for VR classrooms.
... VR facilitates the creation of dynamic, immersive environments with three-dimensional stimuli in which attention can be tested in an environment comparable to that experienced in the real world, improving ecological validity (6). In the field of assessment, numerous studies have confirmed that continuous performance tests embedded in VR (VR-CPT) are as sensitive and accurate as traditional CPT (7)(8)(9). In addition, the efficacy of MPH has been verified through VR-CPT (10) and the effectiveness of VR rehabilitation programs, such as VR neurofeedback or cognitive training, have been demonstrated (6,11). ...
Virtual reality (VR) neuropsychological tests have emerged as a method to explore drug effects in real-life contexts in attention deficit hyperactivity disorder (ADHD) children. Functional near-infrared spectroscopy (fNIRS) is a useful tool to measure brain activity during VR tasks in ADHD children with motor restlessness. The present study aimed to explore the acute effects of methylphenidate (MPH) on behavioral performance and brain activity during a VR-based working memory task simulating real-life classroom settings in ADHD children. In total, 23 children with ADHD performed a VR n-back task before and 2 h after MPH administration concurrent with measurements of oxygenated hemoglobin signal changes with fNIRS. Altogether, 12 healthy control (HC) subjects participated in the same task but did not receive MPH treatment. Reaction time (RT) was shortened after MPH treatment in the 1-back condition, but changes in brain activation were not observed. In the 2-back condition, activation of the left dorsolateral prefrontal cortex (DLPFC) and bilateral medial prefrontal cortex (mPFC) was decreased alongside behavioral changes such as shorter RT, lower RT variability, and higher accuracy after MPH administration. Bilateral mPFC activation in the 2-back condition inversely correlated with task accuracy in the pre-MPH condition; this inverse correlation was not observed after MPH administration. In ADHD children, deactivation of the default mode network mediated by mPFC reduced during high working memory load, which was restored through MPH treatment. Our results suggest that the combination of VR classroom tasks and fNIRS examination makes it easy to assess drug effects on brain activity in ADHD children in settings simulating real-life.
This entry reviews common methods for assessing adolescents' mental disorders, including interviews, questionnaires, and observation methods. Cultural issues regarding application of these assessments across ethnic groups are discussed. These cultural considerations include (1) how differences in cultural values may affect the experience and expression of psychopathological symptomatology, (2) how assessment items are framed and understood in specific cultural contexts, (3) how social norms and cultural values may generate specific response biases depending on the response options offered, and (4) concern over the translation and cross‐cultural adaptation of assessment instruments.
The global energy crisis has created an urgent demand to decrease the energy that buildings consume. In universities, the situation is complicated as campuses need to have a high level of comfort and, therefore, consume more energy than other building types. Lighting accounts for a high percentage of this energy expenditure and urgent measures are required to reduce this consumption and, thus, costs. A further complication is that lighting has been shown to have an important influence on cognitive learning processes. One such process is memory, which has a fundamental influence on modern society. In this study, we analyse the psychological responses of 143 students in a memory task in a virtual classroom using three illuminance levels (100 lx, 300 lx and 500 lx) and four colour temperatures (3000 K, 4000 K, 6500 K and 10500 K). The results showed that lighting conditions influence memory. The combination of 100 lx and 6500 K produced the best memory performance. The results showed that varying lighting parameters can significantly reduce the energy expenditure of educational centres and, in turn, provide better cognitive outcomes for students.
Poor social skills in autism spectrum disorder (ASD) are associated with reduced independence in daily life. Current interventions for improving the social skills of individuals with ASD fail to represent the complexity of real-life social settings and situations. Virtual reality (VR) may facilitate social skills training in social environments and situations similar to those in real life; however , more research is needed to elucidate aspects such as the acceptability, usability, and user experience of VR systems in ASD. Twenty-five participants with ASD attended a neuropsychological evaluation and three sessions of VR social skills training, which incorporated five social scenarios with three difficulty levels. Participants reported high acceptability, system usability, and user experience. Significant correlations were observed between performance in social scenarios, self-reports , and executive functions. Working memory and planning ability were significant predictors of the functionality level in ASD and the VR system's perceived usability, respectively. Yet, performance in social scenarios was the best predictor of usability, acceptability, and functionality level. Planning ability substantially predicted performance in social scenarios, suggesting an implication in social skills. Immersive VR social skills training in individuals with ASD appears to be an appropriate service, but an errorless approach that is adaptive to the individual's needs should be preferred .
According to national health services, between 5–10% of school-aged children are diagnosed with Attention Deficit Hyperactivity Disorder (ADHD). ADHD can influence the well-being and performance of children in formal education. Children with ADHD can show hyperactivity or impulsiveness and might struggle with their executive functioning, including planning of tasks, remembering instructions or focusing their attention. Virtual reality (VR) games can offer realistic, simplified and safe experiences where children with ADHD could experience learning situations tailored to their unique learning needs. Games are already successful in transmitting learning contents for ADHD diagnosed individuals and VR technology is increasingly incorporated in education. The review of literature explores the use of VR games to support learning of children with ADHD in formal education and shows how certain immersive game elements addressing specific ADHD learning needs could be derived, providing insights into possible game requirements and the first prototype.KeywordsExecutive functionHyperactivityImpulsivenessInattentionMultidisciplinary thinkingVirtual realityGames
Natural security refers to all aspects of security related to a reliable, sufficient, affordable and sustainable supply of natural resources, and energy to meet the needs of society by protecting the environment, human health, and living things. Effects derived from climate change are one of the biggest challenges encountered in terms of natural security. Simulation games play a vital role in building a sustainable world. This study investigates the games for topics like natural security, energy security, carbon capture and storage, renewable energy and waste. A review of the literature showed forty-three studies which focused on the objective of the study. Most of the games were used in education and used to transfer knowledge in the field of waste. The paper points out the importance of natural security and the need to develop more games in natural security and its related fields to build a regenerative economy.
Virtual reality is an emerging technology that can support the teaching and learning process by allowing the user to acquire knowledge in an immersive and interactive way. Virtual environments can help students to build their learning through experiences abstracted from reality by representing different concepts and interacting with well-defined elements within virtual scenarios. This work proposes the production and use of virtual reality environments as a support for the acquisition of skills within the teaching-learning process of children in basic education, including children with special educational needs. A proposed model is presented under the instructional design that considers technological platforms, multidisciplinary teams for the production of virtual reality environments according to the needs of users, and thus offers both teachers, parents, and students solutions that can promote the acquisition of learning skills through the execution of various tasks designed to encourage the user to the acquisition of learning skills in an immersive, safe, and fun way.
Immersive virtual reality (IVR) provides great potential to experimentally investigate effects of peers on student learning in class and to strategically deploy virtual peer learners to improve learning. The present study examined how three social-related classroom configurations (i.e., students' position in the classroom, visualization style of virtual avatars, and virtual classmates' performance-related behavior) affect students' visual attention toward information presented in the IVR classroom using a large-scale eye-tracking data set of N = 274 sixth graders. ANOVA results showed that the IVR configurations were systematically associated with differences in learners' visual attention on classmates or the instructional content and their overall gaze distribution in the IVR classroom (Cohen's d ranging from 0.28 to 2.04 for different IVR configurations and gaze features). Gaze-based attention on classmates was negatively related to students' interest in the IVR lesson (d = 0.28); specifically, the more boys were among the observed peers, the lower students' situational self-concept (d = 0.24). In turn, gaze-based attention on the instructional content was positively related to students' performance after the IVR lesson (d = 0.26). Implications for the future use of IVR classrooms in educational research and practice are discussed.
Antecedentes: El Trastorno por Déficit de Atención/Hiperactividad (TDAH) es una de las afecciones más frecuentes en la población de edad escolar con una prevalencia del 5%, manifestándose de tres formas: la presentación combinada, predominante con falta de atención y la presentación predominante hiperactiva/impulsiva. Objetivos del estudio: este estudio tuvo como objetivo realizar una revisión sistemática de la literatura para analizar la efectividad de aquellos programas de intervención basados en tecnologías como la realidad virtual, realidad aumentada, juegos serios y videojuegos para niños y adolescentes diagnosticados con TDAH. Metodología: se realizó una búsqueda sistemática en las bases de datos PubMed, ScienceDirect y Scielo de aquellos estudios publicados entre 2016 y 2021. De un total de 183 artículos identificados, 21 cumplieron con los criterios inclusión o exclusión. Se siguieron los parámetros de Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), y para reducir los sesgos se utilizó el checklist JBI Critical Appraisal Checklist for Analytical Cross-Sectional Studies (JBI-CSS). Resultados: la literatura encontrada demuestra la efectividad de las tecnologías en el diagnóstico, evaluación y rehabilitación de niños y adolescentes con TDAH. Conclusiones: implementar herramientas basadas en tecnología permiten mejorar la motivación la muestra, manejar diferentes estímulos que proporcionan entornos de aprendizaje, contribuir a la mejora de la sintomatología tanto en el ambiente escolar como en la vida cotidiana y mejorar habilidades no sólo cognitivas sino conductuales en los participantes.
Classroom design influences the cognitive processes that determine learning. However, the effects of classroom geometry have been little studied, in part due to the difficulty of modifying physical spaces for experimental purposes. Today, virtual reality allows researchers to very closely control many environmental conditions while collecting psychological and neurophysiological metrics of the user experience. The objective of the present study is to analyse the influence of classroom width on the attention and memory performance of university students. The performance of 90 subjects in three classroom width settings (8.80, 8.20, and 7.60 m), implemented in virtual reality, was evaluated through measures of their attention- and memory-related psychological and neurophysiological responses. The results showed that wider classrooms are associated with poorer performance and lower emotional arousal. This demonstrates a link between the geometric variables of classrooms and the cognitive and physiological responses of students. In general, the present study and its methodology can help architects and researchers develop design guidelines that can improve students’ cognitive processes.
Introducción. Existen diferentes pruebas que evalúan la atención y pueden contribuir a realizar un diagnóstico diferencial entre el TDAH y los Trastornos de Aprendizaje (TA), pero se han encontrado pocos estudios sobre la validez convergente y predictiva de dichas pruebas. El objetivo de este estudio es estudiar la validez convergente de las pruebas de atención EMAV, Caras, d2, AGL, CPT-II y CSAT y valorar su utilidad a la hora de identificar a personas diagnosticadas de TDAH frente a personas con TA según los criterios DSM-5. Método. Se estudió la validez convergente de los instrumentos mediante correlaciones no paramétricas, y su capacidad predictiva mediante regresión logística binaria. Se utilizó una muestra clínica de 437 niños, 234 tenían un diagnóstico de TDAH y 203 niños manifestaron TA en los que se descartó un diagnóstico de TDAH. Resultados. Los resultados indican que las medidas de atención selectiva mostraron correlaciones débiles entre sí, al igual que ocurrió con las de atención sostenida. Además, las correlaciones entre pruebas de ambos tipos fueron de la misma magnitud, lo que pone en tela de juicio si las pruebas miden lo que dicen medir. Por otro lado, lo que mejor predijo el diagnóstico diferencial de TDAH respecto a TA fue el índice de confianza del CPT-II en todas las edades. Además, en niños de entre 6 y 16 años, también resultó bastante informativo el percentil de aciertos de la prueba Caras y para niños de entre 8 y 16 años, el índice de concentración del d2.
Purpose
The current golden standard for attention deficit hyperactivity disorder (ADHD) diagnosis is clinical diagnosis based on psychiatric interviews and psychological examinations. This is suboptimal, as clinicians are unable to view potential patients in multiple natural settings – a necessary condition for objective diagnosis. The purpose of this paper is to improve the objective diagnosis of ADHD by analyzing a quantified representation of the actions of potential patients in multiple natural environments.
Design/methodology/approach
The authors use both virtual reality (VR) and artificial intelligence (AI) to create an objective ADHD diagnostic test. Diagnostic and statistical manual of mental disorders, 5th Edition (DSM-5) and ADHD Rating Scale are used to create a rule-based system of quantifiable VR-observable actions. As a potential patient completes tasks within multiple VR scenes, certain actions trigger an increase in the severity measure of the corresponding ADHD symptom. The resulting severity measures are input to an AI model, which classifies the potential patient as having ADHD in the form inattention, hyperactivity-impulsivity, combined or neither.
Findings
The result of this study shows that VR-observed actions can be extracted as quantified data, and classification of this quantified data achieves near-perfect sensitivity and specificity with a 98.3% accuracy rate on a convolutional neural network model.
Originality/value
To the best of the authors’ knowledge, this is the first study to incorporate VR and AI into an objective DSM-5-based ADHD diagnostic test. By including stimulation to the visual, auditory and equilibrium senses and tracking movement and recording voice, we present a method to further the research of objective ADHD diagnosis.
This study evaluated the predictive value of neuropsychological variables as compared to three other types of variables (demographic, medical, and emotional) in predicting three outcomes (occupational function:OccF; activity impairment:AI; and pension impairment percent) in 483 head-injured ambulatory workers. OccF was equally well-predicted by neuropsychological or demographic variable-families. A1 was best predicted by neuropsychological or emotional variable-families, and pension impairment percent was predicted equally well by all but emotional variable-families. Cross-validation showed good stability of the level of prediction. Discriminant analysis correctly classified 72% of subjects as Un/Employed. Neuropsychological test performance is related to important behavior in outpatient brain-injury survivors.
Virtual reality (VR) technology offers new opportunities for the development of innovative neuropsychological assessment and rehabilitation tools. VR-based testing and training scenarios that would be difficult, if not impossible, to deliver using conventional neuropsychological methods are now being developed that take advantage of the assets available with VR technology. If empirical studies continue to demonstrate effectiveness, virtual environment applications could provide new options for targeting cognitive and functional impairments due to traumatic brain injury, neurological disorders, and learning disabilities. This article focuses on specifying the assets that are available with VR for neuropsychological applications along with discussion of current VR-based research that serves to illustrate each asset. VR allows for the precise presentation and control of dynamic multi-sensory 3D stimulus environments, as well as providing advanced methods for recording behavioural responses. This serves as the basis for a diverse set of VR assets for neuropsychological approaches that are detailed in this article. We take the position that when combining these assets within the context of functionally relevant, ecologically valid virtual environments, fundamental advancements can emerge in how human cognition and functional behaviour is assessed and rehabilitated.
The Virtual Environments Laboratory at the University of Southern California (USC) has ini- tiated a research program aimed at developing virtual reality (VR) technology applications for the study, assessment, and rehabilitation of cognitive/functional processes. This technol- ogy is seen to offer many advantages for these aims and an introductory section of this arti- cle will discuss the specific rationale for VR applications in the area of clinical neuropsy- chology. A discussion of attention processes will follow and issues for the development of a head-mounted display (HMD) VR system for the study, assessment, and possible rehabilita- tion of attention disorders will then be presented. Our efforts to target this cognitive process are supported by the widespread occurrence and relative significance of attention impair- ments seen in a variety of clinical conditions across the human lifespan. Most notably, at- tention difficulties are seen in persons with Attention Deficit Hyperactivity Disorders (ADHD), Traumatic Brain Injury (TBI), and as a feature of various neurodegenerative disor- ders (i.e., Alzheimer' s Disease, Vascular Dementia, etc.). Virtual Environment (VE) technol- ogy appears to provide specific assets for addressing these impairments that are not available using existing methods. VEs delivered via HMDs are well suited for these types of applica- tions as they serve to provide a controlled stimulus environment where cognitive challenges can be presented along with the precise delivery and control of " distracting" auditory and vi- sual stimuli. This level of experimental control allows for the development of attention as- sessment tasks that are more similar to what is found in the real world and could improve on the ecological validity of measurement and treatment in this area. A recent project in our lab has involved the development of a virtual " classroom" specifically aimed at the assess- ment of Attention Deficit Hyperactivity Disorder (ADHD). The system uses a Virtual Re- search V8 HMD, Ascension Systems head, hand, and leg tracking, and is run on an SGI Onyx platform. The scenario consists of a standard rectangular classroom environment containing student desks, a teacher' s desk, a virtual teacher, a blackboard, a large window looking out onto a playground with buildings, vehicles, and people, and a pair of doorways on each end
The assessment of Attention-Deficit/Hyperactivity Disorder (ADHD) in-volves the use of different instruments, and one of the most frequently used is the Continuous Performance Test (CPT). Virtual reality allows for the achiev-ing of the presentation of stimuli with high levels of control. In addition, it fa-cilitates the presentation of distracters with a high level of resemblance to ele-ments which in fact can be found in the real world by placing them in a similar context. Thus, it is possible to assume that a higher ecological validity can be found in CPT tests performed in this manner as compared to the traditional CPT test. During the last years Rizzo developed a virtual reality based CPT called "the Virtual Classroom". Several studies show that "Virtual Class-room" is an effective measure to identify attention difficulties in children with ADHD. Our research team developed a virtual CPT, similar to the "Virtual Classroom", that allows to execute four different tasks: an auditory task with non-distractive stimuli, an auditory task with distractive stimuli, a visual task with non-distractive stimuli and a visual task with distractive stimuli. In this study, we offer additional data supporting the validity of using this type of technology for the assessment of ADHD.
The more replicated findings about gender difference in cognitive performance suggest female superiority on visuomotor speed and language ability and male superiority on mechanical and visuospatial tasks. Generally, group strengths found in the early school years become more established at adolescence and remain stable through adulthood. The current study tested whether the patterns established in the early years remained among 30 adult subjects. We also utilized a series of exploratory analyses to determine if observed gender differences were impacted by the covariance present between all cognitive tests. Results suggest that although the patterns established in the early years remain stable through time for males, the established patterns for females are altered with age. Our findings are compelling in supporting a male advantage on visuospatial tasks among older adults. These findings are discussed in terms of common variance between test instruments as a possible source of difference. Our finding that the gender effect tended to increase when common variance was controlled argues that this meth-odology may enhance the ability to detect domain specific effects.
This study assesses the influence of body participation on the sense of presence and emotions, and the relationship between the two dependent variables in playing a group game in a virtual environment. A total of 56 volunteers were asked to play a virtual game in a 360-degree stereoscopic immersive interactive visualization environment using either body movement or a joystick. Presence was measured with the post hoc SUS Presence Questionnaire. The pictorial tool of Self-Assessment Manikin was employed for measuring emotions of arousal and valence. Both arousal and valence positively correlated with presence. However, body participation did not significantly affect reported presence or the above-mentioned emotions.
This paper presents the current status and use of virtual reality (VR) for children with attention deficit hyperactivity disorder (ADHD), autism and cerebral palsy. This literature review explores how VR systems have been used as treatment tools to address the primary impairments of these disorders. Three major classes of VR display systems are identified that can be characterized by the type of human-computer interaction provided: (1) feedback-focused interaction, (2) gesture-based interaction, and (3) haptic-based interaction. The demonstrated effectiveness and potential effectiveness of each class are discussed in the context of remediating the primary impairments of children with ADHD, autism and cerebral palsy. Three major themes for future research are discussed to support continued research interest in using VR in pediatric neurorehabilitation.
In Parkinson's disease executive functions are altered. We used a Virtual Reality version of the Multiple Errand Test in order to evaluate decision-making ability in 12 patients and 14 controls. Patients with Parkinson's disease, even if not-demented, showed strategies full of errors, suggesting that impulse control disorder, very frequent in course of disease, could precede cognitive dysfunctions.
Brain damage is a major cause of disability that often leads to deficits in Executive Functions (EF) with dramatic consequences on activities of daily living. While rehabilitation approaches of the dysexecutive syndrome are still limited, Virtual Reality (VR) has shown its potential to propose innovative intervention strategies based on ecologically valid functional tasks. The purpose of this paper is to present the design process of the Therapeutic Virtual Kitchen (TVK) in which ecological and adaptable virtual tasks may be configured by the therapists for patients' assessment and rehabilitation. The outcomes of a preliminary test of feasibility among members of our laboratory and Kerpape Rehabilitation Center are reported and discussed.
This study compared the performance of 8 children who have sustained a traumatic brain injury on the traditional VIGIL Continuous Performance Test and the Continuous Performance Test included in the Virtual Classroom. Results supported the hypothesis, showing that the Continuous Performance Test from the Virtual Classroom showed more sensitivity concerning inhibition deficits. More precisely, children showed more commission errors and longer reaction time. These results can be explained by the ecological character of the Virtual Classroom, meaning that this instrument is close to real-life experiences and requires more attention and inhibition resources.
Continuous performance tests are known to typically measure sustained attention but usually also yield parameters that potentially measure other subprocesses of attention. The aim of the present study was to test the factor structure of the Conners's Continuous Performance Test (CCPT) in a heterogeneous clinical sample consisting of subjects considered to fail in different subfunctions of attention.
CCPT records from 376 patients were factor analyzed, yielding five factors indicating a differentiation between focused attention, hyperactivity-impulsivity, sustained attention, vigilance, and change in control.
The study warns against reducing CCPT performance to one overall score of attention. The study further emphasizes the need to reserve the concept of sustained attention for measures of change as a function of time on task. The differentiation between sustained attention and vigilance and the concept of change in mental control during the test are possible methodological contributions of the study.
Virtual reality (VR) has finally come of age for serious applications in the behavioral neurosciences. After capturing the public imagination a decade ago, enthusiasm for VR flagged due to hardware limitations, an absent commercial market and manufacturers who dropped the mass-market products that normally drive technological development. Recently, however, improvements in computer speed, quality of head-mounted displays and wide-area tracking systems have made VR attractive for both research and real-world applications in neuroscience, cognitive science and psychology. New and exciting applications for VR have emerged in research, training, rehabilitation, teleoperation, virtual archeology and tele-immersion.
Virtual reality (VR) is an evolving technology that has been applied in various aspects of medicine, including the treatment of phobia disorders, pain distraction interventions, surgical training, and medical education. These applications have served to demonstrate the various assets offered through the use of VR.
To provide a background and rationale for the application of VR to neuropsychological assessment.
A brief introduction to VR technology and a review of current ongoing neuropsychological research that integrates the use of this technology.
VR offers numerous assets that may enhance current neuropsychological assessment protocols and address many of the limitations faced by our traditional methods.
Given the high incidence of brain injury in the population, brain damage rehabilitation is still a relatively undeveloped field. Virtual reality (VR) has the potential to assist current rehabilitation techniques in addressing the impairments, disabilities, and handicaps associated with brain damage. The main focus of much of the exploratory research performed to date has been to investigate the use of VR in the assessment of cognitive abilities, but there is now a trend for more studies to encompass rehabilitation training strategies. This review describes studies that have used VR in the assessment and rehabilitation of specific disabilities resulting from brain injury, including executive dysfunction, memory impairments, spatial ability impairments, attention deficits, and unilateral visual neglect. In addition, it describes studies that have used VR to try to offset some of the handicaps that people experience after brain injury. Finally, a table is included which, although not an exhaustive list of everything that has been published, includes many more studies that are relevant to the use of VR in the assessment and rehabilitation of brain damage. The review concludes that the use of VR in brain damage rehabilitation is expanding dramatically and will become an integral part of cognitive assessment and rehabilitation in the future.
Treatment and rehabilitation of the cognitive, psychological, and motor sequelae of central nervous system dysfunction often relies on assessment instruments to inform diagnosis and to track changes in clinical status. Typically, these assessments employ paper-and-pencil psychometrics, hands-on analog/computer tests, and rating of behavior within the context of real-world functional environments. Virtual reality offers the option to produce and distribute identical "standard" simulation environments in which performance can be measured and rehabilitated. Within such digital scenarios, normative data can be accumulated for performance comparisons needed for assessment/diagnosis and for treatment/rehabilitation purposes. In this manner, reusable archetypic virtual environments constructed for one purpose can also be applied for applications addressing other clinical targets. This article will provide a review of such a retooling approach using a virtual classroom simulation that was originally developed as a controlled stimulus environment in which attention processes could be systematically assessed in children with attention-deficit/hyperactivity disorder. This system is now being applied to other clinical targets including the development of tests that address other cognitive functions, eye movement under distraction conditions, social anxiety disorder, and the creation of an earthquake safety training application for children with developmental and learning disabilities.
Using electroencephalography (EEG), psychophysiology, and psychometric measures, this is the first study which investigated the neurophysiological underpinnings of spatial presence. Spatial presence is considered a sense of being physically situated within a spatial environment portrayed by a medium (e.g., television, virtual reality). Twelve healthy children and 11 healthy adolescents were watching different virtual roller coaster scenarios. During a control session, the roller coaster cab drove through a horizontal roundabout track. The following realistic roller coaster rides consisted of spectacular ups, downs, and loops. Low-resolution brain electromagnetic tomography (LORETA) and event-related desynchronization (ERD) were used to analyze the EEG data. As expected, we found that, compared to the control condition, experiencing a virtual roller coaster ride evoked in both groups strong SP experiences, increased electrodermal reactions, and activations in parietal brain areas known to be involved in spatial navigation. In addition, brain areas that receive homeostatic afferents from somatic and visceral sensations of the body were strongly activated. Most interesting, children (as compared to adolescents) reported higher spatial presence experiences and demonstrated a different frontal activation pattern. While adolescents showed increased activation in prefrontal areas known to be involved in the control of executive functions, children demonstrated a decreased activity in these brain regions. Interestingly, recent neuroanatomical and neurophysiological studies have shown that the frontal brain continues to develop to adult status well into adolescence. Thus, the result of our study implies that the increased spatial presence experience in children may result from the not fully developed control functions of the frontal cortex.
Evaluating the ecological validity of neuropsychological tests has become an increasingly important topic over the past decade. In this paper, we provide a comprehensive review of the research on the ecological validity of neuropsychological tests, as it pertains to everyday cognitive skills. This review is presented in the context of several theoretical issues facing ecological validity research. Overall, the research suggests that many neuropsychological tests have a moderate level of ecological validity when predicting everyday cognitive functioning. The strongest relationships were noted when the outcome measure corresponded to the cognitive domain assessed by the neuropsychological tests. Several other factors that may moderate the degree of ecological validity established for neuropsychological tests are in need of further exploration. These factors include the effects of the population being tested, the approach utilized (verisimilitude vs. veridicality), the person completing the outcome measure (significant other vs. clinician), illness severity, and time from injury until evaluation. In addition, a standard measurement of outcome for each cognitive domain is greatly needed to allow for comparison across studies.
This study explored how children's sustained attention develops and the effect of manipulating task parameters on sustained attention. The sample comprised 57 children (5-12 years) who completed CogState and Score! (Test of Everyday Attention for Children). Novel variability and traditional indices indicated rapid development from 5-6 to 8-9 years on all measures and a developmental plateau from 8-9 to 11-12, with growth evident on some measures. Findings suggest that sustained attention improves to age 10, then plateaus with only minor improvements. Further, performance was generally poorer on high load tasks compared to low load, with the same developmental pattern uncovered.
Many studies showed the ability of movies and imagery techniques to elicit emotions. Nevertheless, it is less clear how to manipulate the content of interactive media to induce specific emotional responses. In particular, this is true for the emerging medium virtual reality (VR), whose main feature is the ability to induce a feeling of "presence" in the computer-generated world experienced by the user. The main goal of this study was to analyze the possible use of VR as an affective medium. Within this general goal, the study also analyzed the relationship between presence and emotions. The results confirmed the efficacy of VR as affective medium: the interaction with "anxious" and "relaxing" virtual environments produced anxiety and relaxation. The data also showed a circular interaction between presence and emotions: on one side, the feeling of presence was greater in the "emotional" environments; on the other side, the emotional state was influenced by the level of presence. The significance of these results for the assessment of affective interaction is discussed.
It has been suggested that virtual reality may provide a medium for producing neuropsychological measures with greater ecological validity. The present study examined the usefulness of virtual reality (VR) to assess learning and memory in individuals with traumatic brain injury (TBI). A total of 20 TBI participants were compared with 20 healthy controls on their ability to learn and recall 16 target items presented within a VR-based generic office environment. The results indicated that VR memory testing accurately distinguished the TBI group from controls. Additionally, non-memory-impaired TBI participants acquired targets at the same rate as HC participants. Finally, there was a significant relationship between the VR Office and a standard neuropsychological measure of memory, suggesting the construct validity of the task. These findings suggest that the VR Office provides a viable medium for measuring learning and memory. The present results provide preliminary support for the ecological validity of the VR Office, which ultimately can improve assessment of real-world functioning following TBI.
In this initial pilot study, a controlled clinical comparison was made of attention perforance in children with attention deficit-hyperactivity disorder (ADHD) in a virtual reality (VR) classroom. Ten boys diagnosed with ADHD and ten normal control boys participated in the study. Groups did not significantly differ in mean age, grade level, ethnicity, or handedness. No participants reported simulator sickness following VR exposure. Children with ADHD exhibited more omission errors, commission errors, and overall body movement than normal control children in the VR classroom. Children with ADHD were more impacted by distraction in the VR classroom. VR classroom measures were correlated with traditional ADHD assessment tools and the flatscreen CPT. Of note, the small sample size incorporated in each group and higher WISC-III scores of normal controls might have some bearing on the overall interpretation of results. These data suggested that the Virtual Classroom had good potential for controlled performance assessment within an ecologically valid environment and appeared to parse out significant effects due to the presence of distraction stimuli.
Nineteen boys aged 8 to 14 with a diagnosis of ADHD and 16 age-matched controls were compared in a virtual reality (VR) classroom version of a continuous performance task (CPT), with a second standard CPT presentation using the same projection display dome system. The Virtual Classroom included simulated "real-world" auditory and visual distracters. Parent ratings of attention, hyperactivity, internalizing problems, and adaptive skills on the Behavior Assessment System for Children (BASC) Monitor for ADHD confirmed that the ADHD children had more problems in these areas than controls. The difference between the ADHD group (who performed worse) and the control group approached significance (p = .05; adjusted p = .02) in the Virtual Classroom presentation, and the classification rate of the Virtual Classroom was better than when the standard CPT was used (87.5% versus 68.8%). Children with ADHD were more affected by distractions in the VR classroom than those without ADHD. Results are discussed in relation to distractibility in ADHD.
