# Emerging Technology for Special Needs
## Virtual Reality: Assessing Capabilities of individuals with mental challenges

You see it in the movies, you see it at amusement parks, and you see it in malls. Now it is in medical research. VIRTUAL REALITY. Virtual reality started as science fiction in the movies. Now, after years of research and development, what was once science fiction is reality. Research teams through out the medical community have embraced this relatively new technology. None perhaps more than those researching reduced or abnormal brain function. Doctors treating autism, traumatic brain injuries, and patients with developmental issues are immensely optimistic about the future of their patients. Using virtual reality can give people with lesser abilities the chance to live with a purpose and feel they have meaning (Holden and Todorov, 2002, p.131). Brain damage and brain development are two instances that have potential uses for virtual reality therapy. First we must understand differences between brain damage and brain development. Each type of brain condition requires a different plan of attack. Brain damage is typically caused by trauma to the head area. A serious car accident or fall that results a blunt force trauma to the head will many times cause extensive damage to the brain tissue. The human brain is protected by two layers, the skull and cerebral fluid. Cerebral fluid acts as a cushion for the brain inside the skull. When the head is jolted, the fluid around the brain typically absorbs the energy. If the jolt is severe enough, the cerebral fluid cannot absorb all of the energy and the brain is then affected. This is generally considered a traumatic brain injury (Holden and Dyar, 2002, p62). After the initial trauma, the brains’ reaction is similar to other soft tissue injuries, swelling. If the swelling is great enough, the pressure around the brain begins to increase. Fluid that normally protects the brain now creates a hydraulic effect. Pressure begins to build and damage to the brain can occur. If the medical team can react quickly enough, cranial fluid is drained to reduce the pressure on the brain. Provided the swelling stops before the brain comes in contact with the skull, brain damage can be minimal or non-existant.
This paragraph has a good introduction and direction for discussing the advantages of using technology to people’s special needs. However, it put too much focus on explaining and discussing the medical science part. At last, I thought I was reading a medical journal. I would say technology has become an important life skill and at the same time it also can fit peoples’ special needs. According to the journal, “Teaching Technology in low Socioeconomic Areas”, the author point out that technology can let people do some experiments and do not let themselves in a dangerous situation such as flying an airplane (Dianne, 2007). Further, technology can help people make records or calculate and identify some phenomena. For example, farmers can use technology to get the weather forecast and prevent the damage such as snow or wind-storm (Dianne, 2007). For the business, they do need computers to help them to conduct lots of documents and sometimes use the internet to have distance conferences. Traumatic brain injury (TBI), also called acquired brain injury or simply head injury is caused by a sudden trauma to the brain. TBI can also be the result of an object piercing the skull and entering brain tissue. Symptoms of a TBI can be mild, moderate, or severe, depending on the extent of the damage to the brain. A person with a mild TBI may remain conscious or may experience a loss of consciousness for a few seconds or minutes. Other symptoms of mild TBI include headache, confusion, lightheadedness, dizziness, blurred vision or tired eyes, ringing in the ears, bad taste in the mouth, fatigue, and a change in sleep patterns, mood changes, and trouble with memory, concentration, attention, or thinking. A person with a moderate or severe TBI may show these same symptoms, but may also have a headache that gets worse or does not go away, repeated vomiting or nausea, convulsions or seizures, an inability to awaken from sleep, dilation of one or both pupils of the eyes, slurred speech, weakness or numbness in the extremities, loss of coordination, reduced motor skills and increased confusion, restlessness, or agitation (Brain Trauma Foundation). Individuals will mental disabilities may have similar challenges. Therapists of early childhood development find using virtual reality a benefit when correctly diagnosed. In early childhood mild disability (IQ 60–70) may not be obvious, and may not be diagnosed until children begin school (National Rehabilitation Information Center). Even when poor academic performance is recognized, it may take expert assessment to distinguish mild mental disability from learning disabilities or behavior problems. As they become adults, many people can live independently and may be considered by others in their community as "slow" rather than retarded. Using virtual reality testing can show areas IQ tests do not cover. Testing mechanical skills can show mild retardation in younger subjects where other testing may not be accurate.
Moderate disability (IQ 50–60) is nearly always obvious within the first years of life. These people will encounter difficulty in school, at home, and in the community. In many cases they will need to join special, usually separate, classes in school, but they can still progress to become functioning members of society (National Rehabilitation Information Center). As adults they may live with their parents, in a supportive group home, or even semi-independently with significant supportive services to help them, for example, manage their finances.
The limitations of cognitive function will cause a child to learn and develop more slowly than a typical child. Children may take longer to learn to speak, walk, and take care of their personal needs such as dressing or eating. Learning will take them longer, require more repetition, and there may be some things they cannot learn. The extent of the limits of learning is a function of the severity of the disability. Testing motor skills via virtual reality allows the therapist to recall exact data on hand-eye coordination to determine improvement in the skills. Memory and recall are checked when the subject repeats a set of tasks. This is the point where virtual reality can have a positive impact. With the invention of virtual reality, therapists, researchers, and physicians can assess and predict future abilities of their patients. Most TBI recovery begins with physical therapy. Physical therapy is generally stopped after 6–9 months, despite rehabilitation science evidence of the potential for improving motor function. Rehabilitation currently concentrates on the lower extremities, with less time spent on arm and hand activities. Therefore, 33–66% of TBI survivors will not regain use of their affected limbs (Truelsen, 2003, p. 63). Virtual reality addresses these needs through the intensity and duration of training it can provide, through improved motivation, objective performance measures, and the ability to monitor patients at a distance. Several experimental virtual reality rehabilitation systems exist for different limb segments affected by TBI. University of California Irvine developed a joystick-based system for upper limb tele-rehabilitation (Reikensmeyer, 2002, p. 102). Researchers at MIT used trackers in “teaching-by-example” simulations to remotely train a variety of functional arm movements in patients post physical rehabilitation (Holden and Dyar, 2002, p64). Researchers in the United Kingdom developed the Gentle system that uses a combination of the Haptics Master Robot and virtual reality to train arm movements post TBI (van de Hel, 2001, p. 256). Researchers from University of California Irvine, MIT, and the United Kingdom have helped, through their virtual reality studies, families decide what care and what future their loved ones will have after TBI recovery.
Of course not all brain injuries completely heal. Life in a wheel chair may be the reality of an accident victim. To determine if a powered wheel chair is a viable replacement for a manual chair, a program was developed to asses the users’ ability to maneuver with a powered wheel chair. Training is usually required in order to improve the users’ independent mobility. However, such training in a powered wheelchair can be expensive in terms of staff input and can also be potentially unsafe (Holden and Dyar, 2005, p220). Training is often carried out using a wheelchair loaned to the patient which may not fully meet their needs. Children learning to use powered chairs are often frustrated initially as they have not yet developed comfortable control over the chair, leading to collisions. Sustaining motivation can be difficult, particularly if the child is finding the task difficult. A joystick controlled computer simulation may be a useful solution for training skills similar to those needed to use powered wheelchairs (Desbonnet, 1998, p. 178). A simulated training environment may prove motivating and would reduce the danger of collisions during the training phase as the patient would not actually be moving. Several studies have addressed the value of computer simulations as a means of training physically disabled children to use powered wheelchairs.
In this part, I read logically. It convenience me that virtual reality can help people familiar with using the wheel chair after they practice by using the joystick on computers. However, I am thinking that how this virtual reality help those patient sustain their motivation because it’s not like flying an airplane; people might gain confidence after they familiar with stimulate practice. Instead, these patients have to overcome their life carriers not just knowing how to control the wheel chair. Those with intellectual disabilities from birth are assessed using different tactics and techniques. A focal point in virtual reality is assessing the ability of a mentally challenged person to perform simple tasks such as room organization and grocery shopping or complex activities such as cooking or vocational training.
The virtual environment used to teach food preparation was based on an actual kitchen in which half of the participants were already undergoing training. All participants first underwent a baseline assessment on four food preparation tasks, and the identification of 12 hazards in the kitchen in which they normally trained (Brooks, 2002, p. 622). They then received training on one food preparation task and identifying three hazards in the same kitchen, one food preparation task, and three hazards in the virtual kitchen, and one food preparation task and three hazards in specially designed workbooks. After training, they repeated the baseline assessments on all preparation tasks and hazards in their own kitchen. For all measures, there was no difference according to whether the students were familiar or unfamiliar with the kitchen on which the virtual one was based. Students showed significantly greater improvement on the tasks they had learned in the virtual kitchen than they did on those learned using the workbook and those on which they had no training (Brooks, 2002, p. 623). However, there was no difference between tasks learned in the virtual or the real kitchen. Although there was no difference in the tasks learned, there was a difference in accidents. Minor accidents were recorded in the actual kitchen; setting off smoke alarms due to burned food, slips on wet floors due to spills and a minor cut. By using virtual reality, the chances of accidents were reduced to zero with the same defined outcome.
In conclusion, using virtual reality to train and assess the capabilities and probabilities of brain injured or disabled people promise a bright future. Virtual reality in the hands of professionals is an endless road of potential. Doctors, therapists, and researchers can extend their knowledge and time to cover hundreds of patients simultaneously. Virtual reality offers the ability to use computer enhanced training without the time restraints of appointments or the cost of individual therapy. We have seen how hours working in the virtual world can save days or months in the real world. We must continue our research and development of virtual reality training to those of lesser abilities, giving them purpose and meaning.
I think this is an interesting topic and do attract people to look at. About the editing, I think Mark can make some list or catalogue. For example, it can be divide in to training, medical science or practicing. For teaching food, it can belong to the part of practice or instruction. And for brain damage or disable people, it can belong to a part of practice. I just recommended and make an example. I like this article.
This was a very well thought out and informative chapter. I was unaware and very impressed with the amount of difference virtual reality can make on the world. When someone thinks of virtual reality, it sparks images from sci-fi. It is amazing to see what strides it is taking in the here and now. I found the medical section very interesting, although some seemed a bit over my head. It is wonderful to see science and humanities ongoing efforts to save and better the lives of others. However, the culinary portion where they tested in restaurants was quite eye-opening. To think that virtual reality would be tested in a restaurant was something I was not suspecting. Your work is well researched and very educational. Your thoughts are complete and well constructed. On structure, some of your paragraph seems to contain multiple complete ideas. Complete ideas should be separated into paragraphs. I also noticed that there are a few minor punctuation errors, a comma where a colon or semi-colon could be, but nothing major. It does not interrupt the flow of the article much and is only a minor reading concern and more of a cosmetic one. All in all, it is a very well written and informative article that brings a new light to what technology can do.
References
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2. Holden, M.K., & Dyar, T. (2002). Virtual environment training: a new tool for neurorehabilitation. Neurology Report 26:62–71.
3. Brain Trauma Foundation(2007). Retrieved October 29, 2007, from http://www.braintrauma.org
4. National Rehabilitation Information Center (2007). Retrieved October 29, 2007 from http://www.naric.com
5. Truelsen, T., & Bonita, R. (2003). Stroke in developing countries: a continuing challenge. Stroke Review 7:61–66.
6. Reikensmeyer, D.J., Pang, C.T., Nessler, J.A., et al.(2002). Web-based tele-rehabilitation for the upperextremity after stroke. IEEE Trans Neural Sys Rehab Eng 10:102–108.
7. P. van de Hel, B.J.F., Driessen, M.P., Oderwald, S., et al. (2001). Gentle/s: robot mediated therapy for stroke patients in a virtual world makes exercising more enjoyable and effective. In: Assistive technology—added value to the quality of life. Amsterdam: IOS Press, pp. 256–261.
8. Holden, M.K., Dyar, T., Schwamm, L., et al. (2005). Virtual environment-based tele-rehabilitation in patients with stroke. Presence 14:214–233.
9. Desbonnet M, Cox, SL, Rahman A. `Development and evaluation of a virtual reality based training system for disabled children’, in Proceedings of the 2nd European Conference on Disability, Virtual Reality and Associated Technology, Sharkey, Rose and LindstroÈm (eds), SkoÈ vde, Sweden, 10 ± 11 September 1998; 177 ± 182.
10. Brooks, B.M., Rose, F.D., Attree, E.A., et al. (2002). An evaluation of the efficacy of training people with learning disabilities in a virtual environment. Disability and Rehabilitation 24:622–626.