Article

ClinicaVR: Classroom-CPT: A virtual reality tool for assessing attention and inhibition in children and adolescents

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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.

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... 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. ...
Article
Full-text available
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.
... 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. ...
Preprint
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.
... 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). ...
Article
Full-text available
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. ...
Preprint
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.
... In terms of presence (or a sense of actually being in a classroom), Nolin et al. (2012) reported a moderate sense of presence with no group differences (i.e., concussion and typical controls), but presence was not correlated with CPT performances. Similarly, Nolin et al. (2016) noted moderate levels of presence in a typical control sample and presence did not correlate with CPT performances. These authors also demonstrated that presence did not differ based upon grade level, gender, or the interaction of these two demographic variables. ...
... GutiérrezMaldonado et al. (2009) did not report commission errors for VR CPT. Control subjects forPollak et al. (2010) were ADHD patients who received placebo medication, experimental subjects had ADHD and received methylphenidate.Nolin et al. (2009Nolin et al. ( ), (2016 were normative studies and did not include experimental/control groups therefore effect sizes could not be calculated.Gilboa, Rosenblum, et al. (2011), Gilboa, Kerrouche, et al. (2015, Areces et al. (2016), Gutiérrez Maldonado et al. (2009), Iriarte et al. (2016), and Mühlberger et al. (2016) did not include 2D CPT. Díaz-Orueta et al. (2014) examined convergent validity for ADHD children and did not include a control group ...
Article
Full-text available
Computerized continuous performance tests (CPTs) are commonly used to characterize attention in attention deficit-hyperactivity disorder (ADHD). Virtual classroom CPTs, designed to enhance ecological validity, are increasingly being utilized. Lacking is a quantitative meta-analysis of clinical comparisons of attention performance in children with ADHD using virtual classroom CPTs. The objective of the present systematic PRISMA review was to address this empirical void and compare three-dimensional (3D) virtual classroom CPTs to traditional two-dimensional (2D) CPTs. The peer-reviewed literature on comparisons of virtual classroom performance between children with ADHD and typically developing children was explored in six databases (e.g., Medline). Published studies using a virtual classroom to compare attentional performance between children with ADHD and typically developing children were included. Given the high heterogeneity with modality comparisons (i.e., computerized CPTs vs. virtual classroom CPTs for ADHD), both main comparisons included only population comparisons (i.e., control vs. ADHD) using each CPT modality. Meta-analytic findings were generally consistent with previous meta-analyses of computerized CPTs regarding the commonly used omission, commission, and hit reaction time variables. Results suggest that the virtual classroom CPTs reliably differentiate attention performance in persons with ADHD. Ecological validity implications are discussed pertaining to subtle meta-analytic outcome differences compared to computerized 2D CPTs. Further, due to an inability to conduct moderator analyses, it remains unclear if modality differences are due to other factors. Suggestions for future research using the virtual classroom CPTs are provided.
... This meant that while the virtual classroom appeared to be immersive, the standard CPT was the only thing the participants could see against a blank background, a considerable difference in the visual environment. This interpretation is supported by following studies not finding a difference in predictions between the virtual classroom presented using an HMD and a standardized CPT presented on a computer monitor (Bioulac et al., 2012;Nolin et al., 2016). ...
... Although this is suitable for many cognitive tasks, it may cause problems for longer performance tests or interviews, where breaks may be difficult to administer. Previous studies have shown low incidences of cybersickness when participants are seated for the duration of the study (Nolin et al., 2016), a procedure that we repeated here. Making the task more complex by requiring participants to move may have increased the incidence of cybersickness beyond the initial two participants in our first study. ...
Article
Full-text available
Virtual reality (VR) is rapidly becoming an inexpensive, mainstream technology. VR technology is superambulatory as it allows participants to be examined under standardized environments and tests anywhere. In addition, it can test participants in different virtual spaces, including environments that are unsafe, inaccessible, costly or difficult to set up, or even nonexistent. We summarize the benefits and potential problems of VR technology, but we also move beyond theoretical approaches and present a customizable, open-source VR system (PSY-VR) that allows scalable psychological testing in modifiable VR environments. This system allows users to modify the environment using a simple graphical interface, without programming expertise. Moreover, as a proof-of-concept, we compare responses in a typical Flanker task between a real laboratory and a painstakingly matched virtual laboratory. Results indicate that the VR responses are comparable to real life testing, demonstrating the utility of VR for psychological assessment studies. The predicted rapid advancement of VR immersive technologies, as well the ease of their integration with physiological metrics ensures that VR-based assessment will be the modus operandi of psychological assessment in the future. This will allow controllable, low-cost assessment on a global scale. Public Significance Statement This study examines whether virtual reality can be used as a replacement for a controlled testing room in psychological assessment. We also present a virtual reality complete system that researchers can modify and use for their own research purposes. Virtual reality can be used to test multiple groups of people around the world in a controlled and unbiased way.
... Here, we aim to identify the mechanisms that link ADHD symptoms with deficits in performance during a widely used probe of attention-the continuous performance task (CPT). A large literature delineates how objective deficits in this demanding task are associated with the symptoms of ADHD 1-4 and that these deficits are partly rectified by psychostimulant medication [5][6][7] . ...
... Here, we aim to identify the mechanisms that link ADHD symptoms with deficits in performance during a widely used probe of attention-the continuous performance task (CPT). A large literature delineates how objective deficits in this demanding task are associated with the symptoms of ADHD [1][2][3][4] and that these deficits are partly rectified by psychostimulant medication [5][6][7] . ...
Article
Full-text available
The mechanisms underpinning attentional deficits are only partially understood. Here we ask if shifts in a child’s field of view (FOV) act as a mediator between symptoms of attention deficit hyperactivity disorder (ADHD) and associated cognitive anomalies, particularly in attentional processes. Real time measurement of shifts in FOV were obtained on 85 children (mean age 9.4 (SD 1.9) years; 45 with DSM 5-defined ADHD) as they completed the continuous performance task in a “virtual classroom”. We extracted measures reflecting focused and selective attention across the task, along with diffusion modelling of latent cognitive processes of information uptake, response conservativeness and non-decision time. Mediation analyses showed that shifts in FOV partially mediated the relationship between hyperactive impulsive symptoms and both poor focused attention and information uptake. Performance accuracy decreased and shifts in FOV increased during the task, but these changes over time did not differ by symptom severity. Employing virtual reality and mediation analysis, we implicate shifts in FOV as a mechanism linking symptoms of ADHD and deficits in focused attention and in the gathering of information to make decisions. The identification of mediating mechanisms might provide new targets for intervention.
... 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. ...
Thesis
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.
... Two studies that used virtual reality to assess cognitive functions in children included the virtual classroom (AULA). AULA has been used to detect attention and inhibition deficits in children with attention hyperactivity deficit disorder [51] and acquired brain injury [52]. Another task supported by virtual reality that was developed for children is Meal-Maker, which involves preparing a menu [53]. ...
... Performance-based naturalistic tasks are observable, rulebased, open tasks performed in an environment that mimics the real world or is the real world (e.g., in an apartment set up to conduct the assessment, a kitchen) [74,75]. As regards the instruments that use naturalistic tasks, we found three tests that used a cooking task in children (Children's Kitchen Task Assessment [52]; DO-EAT [56] and Children's Cooking Task [58] and one test aimed at preschool children (Preschool Executive Task Assessment) [55]. ...
Article
Full-text available
Purpose: Cognitive instrumental activities of daily living are particularly related to executive functions, such as scheduling appointments, monthly payments, managing the household economy, shopping or taking the bus. The aim of this systematic review was to determine the available tests for the assessment of executive functions with ecological validity to predict individuals’ functioning. Materials and methods: An electronic search was conducted in MEDLINE, Cochrane Central, PsyCInfo and IEEE Xplore until May 2019, in addition to a manual search. The PRISMA criteria and the Covidence platform were used to select articles and extract data. Results: After applying the search selection criteria, 76 studies were identified. They referred to 110 tools to assess instrumental activities of daily living. Those that have received most attention are related to menu preparation and shopping. Performance-based measures are the most widely used traditional methods. Most tests were aimed at the adult population with acquired brain damage, cognitive impairment or dementia. There was a predominance of tests based on the Multiple Errands Test paradigm. Conclusions: In recent years, it has increased the number of tools that assess the instrumental activities of daily living based on technologies such as personal or environmental sensors and serious games. IMPLICATIONS FOR REHABILITATION: Assessment of Instrumental Activities of Daily Living through performance-based measures is especially useful for the early detection of dysfunctions or preclinical disability. Difficulties in performing instrumental activities of daily living are closely associated with deficits in executive functions and prospective memory. Activities of Daily Living can be understood as multitasks. The use of virtual reality-based tests was shown to be sensitive to the detection of cognitive deficits in Activities of Daily Living. An advantage of using virtual reality in assessments is that it can help to predict the level of personal autonomy in patients who are in an institutional environment and could be a first approximation to the real environment.
... 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. ...
Article
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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.
... 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. ...
Conference Paper
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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.
... 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). ...
Article
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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.
... (2) nine CG (Medal of Honor: Allied Assault [34,41]; Medal of Honor: Pacific Assault, EA Games [44,49,50]; Rise of Nations, SEGA [34,51]; Brain Age / Dr. Kawashima's Brain Training, Nintendo [37,38,47,48,52,53]; Tetris [34,36,41,[46][47][48]54]; Modern Combat: Sandstrom, Gameloft [32,39,40]; Big Brain Academy, Nintendo [55,56]; Ballance, Atari [44,49]; and The Sims, EA Games [32,43,45]); and (3) 13 AG (Neurofeedback Game [95,96]; VRROOM [116,117] Cujzek and Vranis [35] No RoboMemo, Cogmed Systems [109,110]; ClinicaVR: Classroom-CPT [67][68][69][70][71][72][73]; VR Setup [114,115]; AULA, Nesplora [59,60,122]; Desktop VR System [91,104]; Space Fortress [97,98,111,123]; and Cybercycling [42,90]) were reported in more than one study (see Table 1). ...
Article
Game-based interventions (GBI) have been used to promote health-related outcomes, including cognitive functions. Criteria for game-elements (GE) selection are insufficiently characterized in terms of their adequacy to patients' clinical conditions or targeted cognitive outcomes. This study aimed to identify GE applied in GBI for cognitive assessment, training or rehabilitation. A systematic review of literature was conducted. Papers involving video games were included if: (1) presenting empirical and original data; (2) using video games for cognitive intervention; and (3) considering attention, working memory or inhibitory control as outcomes of interest. Ninety-one papers were included. A significant difference between the number of GE reported in the assessed papers and those composing video games was found (p < .001). The two most frequently used GE were: score system (79.2% of the interventions using video games; for assessment, 43.8%; for training, 93.5%; and for rehabilitation, 83.3%) and narrative context (79.2% of interventions; for assessment, 93.8%; for training, 73.9% and for rehabilitation, 66.7%). Usability assessment was significantly associated with six of the seven GE analyzed (p-values between p ≤ 0.001 and p. = 027). The use of GE that act as extrinsic motivation promotors (e.g., numeric feedback system) may jeopardize patients' long-term adherence to interventions, mainly if associated with progressive difficulty-increase of gaming experience. Lack of precise description of GE and absence of a theoretical framework supporting GE selection are important limitations of the available clinical literature.
... Moreover, the system has been used in a series of studies to examine other clinical populations and the impact of medications and cognitive training activities on attention process performance. More detailed information on the rationale, methodology, and research projects can be found in (Adams, Finn, Flannery, Moes, & Rizzo, 2009;Bioulac et al., 2012Bioulac et al., , 2018Gilboa et al., 2011;M€ uhlberger et al., 2016;Nolin et al., 2016;Parsons, Bowerly, Buckwalter, & Rizzo, 2007, 2019Pollak, Barhoum-Shomaly, Weiss, Rizzo, & Gross-Tsur, 2010;Rizzo et al., 2000Rizzo et al., , 2006. ...
Article
Systematic Representative Design (SRD), enabled by today’s technologies leverages many of the strengths of past designs into a new synthesis affording the capacity for both causal inference and generalizability to everyday life (GEL). In doing so, it could help better integrate past and ongoing empirical research findings in psychology. Generally, the commentaries were positive and thought-provoking. Delightfully, they gave us new opportunities to both clarify misunderstandings as well as further address the feasibility of this approach.
... Moreover, the system has been used in a series of studies to examine other clinical populations and the impact of medications and cognitive training activities on attention process performance. More detailed information on the rationale, methodology, and research projects can be found in (Adams, Finn, Flannery, Moes, & Rizzo, 2009;Bioulac et al., 2012Bioulac et al., , 2018Gilboa et al., 2011;M€ uhlberger et al., 2016;Nolin et al., 2016;Parsons, Bowerly, Buckwalter, & Rizzo, 2007, 2019Pollak, Barhoum-Shomaly, Weiss, Rizzo, & Gross-Tsur, 2010;Rizzo et al., 2000Rizzo et al., , 2006. ...
Article
Causal inference and generalizability both matter. Historically, systematic designs emphasize causal inference, while representative designs focus on generalizability. Here, we suggest a transformative synthesis – Systematic Representative Design (SRD) – concurrently enhancing both causal inference and “built-in” generalizability by leveraging today’s intelligent agent, virtual environments, and other technologies. In SRD, a “default control group” (DCG) can be created in a virtual environment by representatively sampling from real-world situations. Experimental groups can be built with systematic manipulations onto the DCG base. Applying systematic design features (e.g., random assignment to DCG versus experimental groups) in SRD affords valid causal inferences. After explicating the proposed SRD synthesis, we delineate how the approach concurrently advances generalizability and robustness, cause-effect inference and precision science, a computationally-enabled cumulative psychological science supporting both “bigger theory” and concrete implementations grappling with tough questions (e.g., what is context?) and affording rapidly-scalable interventions for real-world problems.
... Однако исследование [39] привело к выводу о незначительном влиянии ВР-игры на постуральную стабильность и вестибулярный рефлекс здоровых детей 4-10 лет, а дискомфорт и вторжение воспоминаний у них меньше, чем у взрослых. Другое исследование, изучавшее симптомы киберболезни у детей 7-16 лет при использовании ВР, не выявило значительного ухудшения состояния обучающихся [40]. ...
Article
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The development and implementation of new information and communication technologies provide new forms of interaction between a computer and a person. One of these forms is virtual reality. The article examines immersive virtual reality and provides an analysis of 71 Russian and foreign works devoted to the latest research in the field of studying the phenomenon of virtual reality from the point of view of pedagogical and psychological sciences. Particular attention is paid to the impact of virtual reality on brain activity, behavior and learning. The study of these issues is necessary to analyze the possibility of using virtual reality in education. The sensation of being in a virtual environment in health and disease is considered, a description of the characteristics of virtual environments used in education is given. It is shown that the use of virtual reality demonstrates excellent opportunities in education, but it can also have some negative psychophysiological effects. The review discusses the data obtained by Russian and foreign researchers on the possible psychological risks of prolonged immersion of children and adolescents in virtual reality and suggests the use of virtual reality only on the basis of preliminary testing or questioning. It is concluded that virtual reality, like any other new phenomenon, requires further study.
... In both the computer and VR versions, participants provided similar levels of prosocial decisions and sociomoral justifications focused on interpersonal relationships and prosocial emotions such as empathy and trust, which correspond to the third stage of moral maturity according to the cognitivedevelopmental approach of sociomoral reasoning (Chiasson et al. 2017;Gibbs 2010). These results are in line with several studies on cognitive and sociocognitive assessment indicating that dynamic stimuli and immersive environments can be used to measure constructs that are comparable to more traditional experimental tools (e.g., paper-pencil tasks) Corriveau et al. 2018;Hanten et al. 2011;Lalonde et al. 2013;Nolin et al. 2016). However, even though both tasks elicited similar results, they were not entirely equivalent. ...
Article
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Sociocognitive evaluation is an important component of comprehensive neuropsychological assessment. However, concerns have been raised as to whether traditional assessment methods such as paper-and-pencil questionnaire adequately represent real-life abilities. Virtual reality (VR) has the potential to increase ecological value by providing experimental conditions that are similar to those in a real-world environment. This project aimed to explore the potential benefits of using VR in the assessment of adolescent sociocognitive skills, specifically with regard to sociomoral decision-making and reasoning. A computer-based version and a VR version of the So-Moral task were used to compare the performance of adolescents aged 12–25 (n = 30) on sociomoral skills. In both versions, participants were presented with everyday sociomoral dilemmas and were asked to explain how they would react (sociomoral decision-making) and why (sociomoral maturity). The Interpersonal Reactivity Index and the Immersive Tendencies Questionnaire were completed to investigate the association between sociomoral skills, empathy and sense of presence. In both versions of the task, participants provided similar levels of sociomoral decision-making ( F(1,26)=2.05, p = 0.16) and maturity (F(1,26)=1.92 , p = 0.18). Empathy was associated with presence (r = 0.39, p = 0.048) and with sociomoral maturity (r = 0.46, p = 0.01) only when assessed in VR, explaining a significant 21% of the variability in outcome. Together, these results support the notion of a disparity between static and dynamic sociocognitive assessment tools and suggest that the association between sociocognitive skills and underlying social or affective substrates may be susceptible to stimuli saliency and presentation.
... VR-immersed classrooms have further been tested with geography lessons and received strong positive feedback [11]. VR is also frequently used to investigate distraction, attention and inhibition of children in school [6,17]. ...
Conference Paper
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Educational VR applications, mainly designed for children, are often used to showcase the benefits of VR. While such applications highlight a lot of the potentials for future learning environments, we miss a deep and critical reflection of the negative impacts that those mixed-reality technologies may have on children. We believe that it is very important for us technologists to minimize the risks for this particular vulnerable user group. In the light of the recent debates on abusive ethical, social and political issues of mixed-reality technologies, we outline how developers can mitigate the negative impacts of educational VR applications designed for children such as social isolation and an overestimation of abilities.
... VR-based testing made it possible to find that under conditions of distraction, individuals with ASD are compromised in their ability to activate external distractor inhibition despite the fact that their response time may not suffer. Additionally, Nolin et al. (2016) found a strong concurrent validity between their ClinicaVR: Classroom-CPT and the traditional VIGIL-CPT, and, more specifically, strong correlations were observed between correct responses, commission errors and reaction times, and, interestingly, head movements registered in the VR test correlated with most variables of the traditional VIGIL-CPT, showing that constructs measured by both tests (sustained attention, selective attention, and impulsivity/inhibition) were very similar and supporting the usage of VR-based tests as a way to perform neuropsychological assessment in a way that is more close to real life functioning of test respondents. ...
Article
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A cognitive assessment strategy that is not limited to examining a set of summary test scores may be more helpful for early detection of emergent illness such as Alzheimer’s disease (AD) and may permit a better understanding of cognitive functions and dysfunctions in those with AD and other dementia disorders. A revisit of the work already undertaken by Kaplan and colleagues using the Boston Process-Approach provides a solid basis for identifying new opportunities to capture data on neurocognitive processes, test-taking strategies and response styles. Thus, this critical review will combine traditional process-based assessment strategies with support provided or offered by newer technologies that have the potential to add value to data collection and interpretation. There is now considerable interest in neuropsychological test administration using computer/digital technology, both in research and in clinical settings. To add value, any computerized version of an existing cognitive test should respect the administration procedure for which normative data were obtained, should be time-saving in terms of scoring and interpretation, and should, we argue, facilitate gathering information about the processes and strategies followed in test completion. This article will offer an overview of the steps needed when implementing computerization of neuropsychological tests using a Process-Based Approach (PBA) to these technology-based adaptations and will discuss further developments in this area by linking it to future technological developments that may be possible in the area of neuropsychological assessment. Additionally, an overview of neuropsychological tests that may benefit from computerization will be presented, together with suggestions on the specific processes, strategies and features that may be captured with the aid of such computerization. Finally, hypotheses on how virtual reality could be an asset for the future of the PBA to neuropsychological assessment will also be discussed.
... Moreover, the system has been used in a series of studies to examine other clinical populations and the impact of medications and cognitive training activities on attention process performance. More detailed information on the rationale, methodology, and research projects can be found in (Adams, Finn, Flannery, Moes, & Rizzo, 2009;Bioulac et al., 2012Bioulac et al., , 2018Coleman et al., 2019;Gilboa et al., 2011;M€ uhlberger et al., 2016;Nolin et al., 2016;Parsons, Bowerly, Buckwalter, & Rizzo, 2007, 2019Pollak, Barhoum-Shomaly, Weiss, Rizzo, & Gross-Tsur, 2010;Rizzo et al., 2000Rizzo et al., , 2006. ...
Article
Systematic Representative Design and Clinical Virtual Reality Sharon Mozgai, Arno Hartholt & Albert “Skip” Rizzo* University of Southern California Institute for Creative Technologies Los Angeles, California *contact author The authors of the paper, “Causal Inference in Generalizable Environments: Systematic Representative Design”, boldly announce their core point in the opening line of the abstract stating that, “Causal inference and generalizability both matter.” While a surface glance might suggest this to be a simple notion, a closer examination reveals the complexity of what they are proposing. This complexity is apparent when one considers that the bulk of human experimental research has always been challenged in its inability to concurrently deliver on both of these aims. This is no slight on the tens of 1000’s of human researchers and behavioral scientists who have devoted long careers to highly controlled human psychological and social science laboratory research. Rather, it reflects the sheer enormity of the challenges for conducting human studies designed to specify human function with physics-informed lab methods, while at the same time producing results that lead to enhanced understanding and prediction of how people will operate in the complex and ever-changing contexts that make up everyday life. At the core of this issue is a methodological and philosophical challenge that is relevant to all areas of human subjects’ research, beyond the social science focus of the Miller et al. (2020) paper. It is our aim to discuss the central topics in their paper through the lens of our own work using Virtual/Augmented Reality and Virtual Human simulation technologies for clinical and training applications. The Miller et al. (2020) piece is dense with diverse theoretical viewpoints in support of their analysis of the causal inference vs. generalization dilemma and proposes a remedy that integrates these aims by leveraging mixed reality technologies. The authors engage the reader in a tour de force of classical (and current) theory and research aimed at dissecting this timeless challenge in the field of experimental psychology in the social sciences. This challenge can be stated simply in terms of goals that are synergistic in the ideal, but competing in the pragmatic: How does one conduct solid scientific human research under controlled laboratory conditions, which at the same time creates generalizable knowledge about thinking, feeling, behaving, and interacting in everyday life? To address this challenge, the authors propose the application of simulation technology as a new approach that optimizes representativeness to the organism-in-situation, to which they aim to generalize. This is not a newly recognized challenge. Over the last century, psychology has strived to establish its place in the “hard” sciences via the rigorous application of the scientific method aiming to measure, understand, and modify (or treat) human cognition, emotion, behavior, and social interaction under highly controlled experimental conditions. However, such laboratory-based research conditions are often lacking in context and bears little resemblance to the dynamic stimulus complexity of the everyday world. Not only does reality richly vary from moment-to-moment and place-to-place, but since humans are not clones, they also vary dramatically in genetically endowed capabilities, limitations, and predispositions. Thus, while the knowledge generated under very constrained laboratory-based conditions, where the rich diversity of human response and function is reduced to mean values, can describe phenomenon with strong internal consistency (to the highly controlled and reality-constrained/limited experimental setting), it often produces limited generalizability for understanding and/or predicting human function in everyday life. The Behaviorist movement strived to apply rigor to this experimental challenge by maintaining a militant focus on observable behavior as the only variable of interest in any attempt to study humans in a scientific fashion. And in some sense that view has endured, whether explicitly stated or implicit in the value that researchers place on behavioral measures in counterpoint to what some view as the fuzzy and variably-biased nature of introspective self-report data. However, the relevance of verbal declarations of perspective, intent, cognitive appraisal/analysis, and emotional expression in everyday life cannot be denied or discounted, and thus the various waves of cognitive-behavior approaches have succeeded in “sneaking the mind back into psychology”, to the dismay of old school behaviorists. However, the good news as Miller et al. (2020) clearly state, is that recent advances in modern simulation technologies (Virtual Reality (VR), Augmented Reality (AR), Virtual Human (VH) intelligent agents, etc.), have now provided new opportunities for creating research tools that aim to support a more predictive and ecologically relevant analysis of human function in everyday life. VR simulations can now present research participants with highly controlled, systematically deliverable stimulus presentations/challenges while they are immersed within the context of a functionally relevant simulation of the “real” world. AR provides similar opportunities for human research via its capacity to insert and naturally embed stimuli within a user’s perception of an everyday context. Moreover, the birth of intelligent VH agents that are capable of engaging users in credible interactions within VR/AR environments and give researchers the ability to create experimental manipulations that would be difficult or even impossible to systematically control in real life, have the potential to revolutionize how research is conducted in psychology and the social sciences. Miller et al. (2020) propose that such technological capability will support their view of Systematic Representative Design (SRD) as “…a synthesis of two major designs: representative design (Brunswik, 1943; Brunswik, 1955a, 1955b) and classic experimental or systematic designs (Shadish et al., 2002) with roots in Wundt (1902).” SRD is described as an approach that supports an integrated human research methodology that can provide both valid cause-effect results, along with the added value of supporting inferences that enhance the generalizability of research findings to everyday life (GEL). Moreover, this theoretical framework can be seen to underlie the emergence of VR/AR/VH clinical research and practice (Rizzo & Koenig, 2017). Such a perspective formalizes the conceptual drivers that inspired early researchers in the use of these technologies for therapeutic purposes since the mid-90’s when the vision for Clinical VR use drove significant excitement and pioneering research, in spite of the immaturity of the technology. (Note: for the rest of this paper the term VR will be used to generally include AR and VH, unless otherwise specified.
... 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. ...
Preprint
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.
... 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]. ...
Article
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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.
... The virtual classroom was administered to all participants. The virtual classroom uses a virtual reality head mounted display (HMD) system for the assessment of attention processes, and is specifically designed to measure sustained attention, impulsivity, and distractibility (Nolin et al., 2016). The virtual classroom was used on a Pentium 4 level laptop computer with 1 GB RAM and a 128 MB DirectX 9-compatible NVIDIA 3D graphics card. ...
Article
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Computerized cognitive interventions to improve working memory also purport to improve ADHD-related inattention and off task behavior. Such interventions have been shown to improve working memory, executive functioning, and fluid reasoning on standardized neuropsychological measures. However, debate continues as to whether such programs lead to improvement on ecologically relevant outcomes, such as classroom behavior. This study sought to propose a novel, ecologically relevant approach to evaluate the effectiveness of working memory training on real-world attention performance. Participants included 15 children, aged 6–15, identified as having attention problems were assessed via the virtual classroom continuous performance task (VCCPT) before and after completing 5 weeks of Cogmed working memory training. The VCCPT is a validated measure of sustained and selective attention set within a virtual reality (VR) environment. Several key areas of attention performance were observed to improve, including omission errors, reaction time, reaction time variability, and hit variability. Results suggest that working memory training led to substantial improvements in sustained attention in a real-life scenario of classroom learning. Moreover, the use of psychometrically validated VR measurement provides incremental validity beyond that of teacher or parent report of behavior. Observing such improvements on ecologically relevant measures of attention adds to the discussion around how to evaluate the effectiveness of working memory training as it pertains to real-life improvements and serves to inform consumer awareness of such products and their claims.
... 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. ...
... 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. ...
Article
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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.
... 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). ...
Article
Full-text available
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.
... Similarly, several previous researches have also demonstrated the discriminant validity of VR for attention assessment in children with ADHD. 18,19 Moreover, the present study investigated the relationship between VR test results and IVA-CPT, which is frequently used as a measurement of attention and impulse control in children with ADHD. The level of visual attention on the IVA-CPT is associated with the correct items and the total time of the VR test. ...
Article
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Background and objective: The development of objective assessment tools for attention deficit hyperactivity disorder (ADHD) has become a hot research topic in recent years. This study was conducted to explore the feasibility and availability of virtual reality (VR) for evaluating symptoms of ADHD. Methods: School-aged children were recruited. The children with ADHD or without ADHD were assigned into the ADHD group or Control group, respectively. They were all evaluated using the Conners' Parent Rating Scale (CPRS), Child Behavior Checklist (CBCL), Integrated Visual and Auditory Continuous Performance Test (IVA-CPT), and a VR test. Results: The correct items, incorrect items, and the accuracy rate of the VR test of the children with ADHD were significantly different with those of the children in the Control group. The correct items, incorrect items, total time, and accuracy of the VR test were significantly correlated with the scores of IVA-CPT (auditory attention and visual attention), CPRS (impulsion/hyperactivity and ADHD index), and CBCL (attention problems and social problems), respectively. Discussion: The results supported the discriminant validity of the VR test for evaluating ADHD in school-age children suffering from learning problems. The VR test results are associated with the commonly used clinical measurements results. A VR test is interesting for children and therefore it attracts them to complete the test; whilst at the same time, it can also effectively evaluate ADHD symptoms.
... As a consequence, along the last years several alternate cognitive evaluation instruments were proposed, including the digitalization of classical tests [13], gamification [14] and virtual reality [15][16][17][18][19][20][21][22] among others. Indeed, a previous authors' contribution consisted of a battery composed of seven games to perform cognitive evaluation in a non-intrusive and ecological way. ...
Article
Introduction: Alzheimer's disease is a degenerative brain disease and the most common cause of dementia. Today, 47 million people live with dementia worldwide. This number is projected to increase to more than 131 million by 2050, as populations age. Therefore, the World Health Organization considers serious cognitive deterioration a public health priority. Objectives: Advanced cognitive evaluation mechanisms are needed to help make an early diagnosis. These new mechanisms should overcome the limitations of current neuropsychological tests, including delayed detection; being perceived as intrusive; being non-ecological; being dependent on confounding factors; or their administration being expensive, among others. A promising novel approach consists of the introduction of serious games based on virtual reality and machine learning able to assess cognitive traits relevant to the diagnosis of mild cognitive impairment and Alzheimer's disease. Methods: As a result of a preliminary pilot experiment, promising evidence was obtained about the predictive power of this solution. However, for these new serious games to be effective, evidence has to be gathered on the player experience by senior adults, avoiding the limitations of traditional tests at the same time. This study addresses these aspects with the participation of 74 senior users and 15 test administrators. Results: Main findings confirm the usability and playability of Panoramix, a game battery designed according to the principles discussed above, its technological acceptability and its accessibility. For example, in relation to acceptability, the game battery was scored 4.39 in a 5-point scale, while its average usability score was 4.45 regardless of socio-cultural level or previous experience with digital technologies. In addition, health professionals confirm both, usability and playability, levels with an average score of 6.5 in a 7-point scale. Participants' willingness of using this kind of systems for cognitive evaluation was also confirmed. Conclusion: Promising results obtained pave the way for additional work to confirm the diagnostic validity according to clinical standards of these new cognitive assessment tools.
... Estas pruebas informatizadas ahorran tiempo, mejoran significativamente la precisión y la velocidad en la obtención de puntuaciones y permiten registrar variables y puntuaciones que superan las capacidades humanas (Etchepareborda, paiva-barón y abad-mas, 2009). como señalan parsey y Schmitter-Edgecombe (2013) y Nolin et al. (2016), la aplicación clínica de la realidad virtual también ha proporcionado nuevas oportunidades para la evaluación, como la adecuación o personalización a poblaciones específicas, a dominios cognitivos específicos y a configuraciones únicas. ...
Article
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os niños con trastorno por déficit de atención y/o hiperactividad (tdah) se caracterizan por manifestar pautas persistentes de inatención, impulsividad e hiperac-tividad, así como por un deterioro en otras funciones cog-nitivas, como la velocidad de procesamiento, aunque esta cuestión no ha sido del todo clarificada. El objetivo de este estudio fue determinar si existían diferencias en el tiempo de reacción y la variabilidad intraindividual en éste (vtr) entre niños con y sin tdah. a la muestra de 474 niños (209 con tdah y 265 controles) se le aplicó la prueba aula en un diseño cuasi-experimental, se empleó análisis no paramétricos. Los resultados revelaron que los niños con tdah combinado manifestaban mayor tiempo de reacción en aciertos y errores por comisión, mientras que los sub-tipos combinado e inatento mostraban mayor vtr que el grupo de controles. Se evidencia que la vtr es un marcador fundamental del tdah.
... 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. ...
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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
... 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. ...
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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.
... 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). ...
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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.
... 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). ...
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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.
... 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). ...
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... [13,14] Researches published over the past few years on VR have been studied, and it has been found that 24 studies have confirmed the efficacy of this method in the treatment of mental disorders. [15,16] VR technology provides new opportunities for expanding new clinical research, evaluation, and interventional tools. Implementation of tests, training, teaching, and treatment of VR, which are difficult but not impossible, are expanding and evolving along with traditional and classical methods. ...
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While neuropsychology has successfully employed traditional test methods in the past, rapid advances in technology are now occurring in almost every area of life. These advances affect how people live and how tasks are performed. It is imperative that neuropsychologists examine the ways in which technology can augment clinical practice. The focus of this chapter is to review the ways in which current and developing technologies can bring new capabilities and efficiencies to the assessment process.
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