Handwriting Quality: Psychometric Properties of Two Evaluation Scales With a Czech Sample.

IMPORTANCE: Approximately 7% to 30% of children contend with handwriting issues (HIs) in their school years. However, research studies to define and quantify HIs, as well as practical assessment tools, are lacking. OBJECTIVE: To confirm the validity and reliability of two screening scales for HIs: the Handwriting Legibility Scale (HLS) and the Concise Assessment Scale of Children's Handwriting (BHK). DESIGN: Structural equation modeling (SEM) and confirmatory factor analysis (CFA) of five different models were used to examine the construct and discriminant validity of both scales. Furthermore, internal consistency and interrater agreement were evaluated. The association among scales, grades, and children's self-evaluation was also explored. SETTING: Elementary schools and state counseling centers in the Czech Republic. PARTICIPANTS: On a voluntary basis, 161 children from elementary schools and state counseling centers in the Czech Republic were enrolled. The variable of children with typical handwriting development versus HIs was missing for 11 children. Thus, for discriminant validity analysis, 150 data records from children were used. OUTCOMES AND MEASURES: The HLS and BHK were used to evaluate the handwriting quality of the transcription task. The Handwriting Proficiency Screening Questionnaires for Children was used for children's self-evaluation. RESULTS: The study confirmed the validity and reliability of the shortened BHK and HLS. A strong relationship was found between the BHK and HLS, grades, and children's self-evaluation. CONCLUSIONS AND RELEVANCE: Both scales are recommended for occupational therapy practice worldwide. Further research should focus on developing standards and providing sensitivity studies. What This Article Adds: Both the HLS and the BHK are recommended for occupational therapy practice. Practitioners should also take the child's well-being into consideration in handwriting quality assessment.

"CityQuest," A Custom-Designed Serious Game, Enhances Spatial Memory Performance in Older Adults.

Spatial cognition is known to decline with aging. However, little is known about whether training can reduce or eliminate age-related deficits in spatial memory. We investigated whether a custom-designed video game involving spatial navigation, obstacle avoidance, and balance control would improve spatial memory in older adults. Specifically, 56 healthy adults aged 65 to 84 years received 10 sessions of multicomponent video game training, based on a virtual cityscape, over 5 weeks. Participants were allocated to one of three training conditions: the main intervention, the "CityQuest" group (n = 19), and two control groups, spatial navigation without obstacle avoidance ("Spatial Navigation-only" group, n = 21) and obstacle avoidance without spatial navigation ("Obstacles-only" group, n = 15). Performance on object recognition, egocentric and allocentric spatial memory (incorporating direction judgment tasks and landmark location tasks, respectively), navigation strategy preference, and executive functioning was assessed in pre- and post-intervention sessions. The results showed an overall benefit on performance in a number of spatial memory measures and executive function for participants who received spatial navigation training, particularly the CityQuest group, who also showed significant improvement on the landmark location task. However, there was no evidence of a shift from egocentric to allocentric strategy preference. We conclude that spatial memory in healthy older participants is amenable to improvement with training over a short term. Moreover, technology based on age-appropriate, multicomponent video games may play a key role in cognitive training in older adults.

Crowded environments reduce spatial memory in older but not younger adults.

Previous studies have reported an age-related decline in spatial abilities. However, little is known about whether the presence of other, task-irrelevant stimuli during learning further affects spatial cognition in older adults. Here we embedded virtual environments with moving crowds of virtual human pedestrians (Experiment 1) or objects (Experiment 2) whilst participants learned a route and landmarks embedded along that route. In subsequent test trials we presented clips from the learned route and measured spatial memory using three different tasks: a route direction task (i.e. whether the video clip shown was a repetition or retracing of the learned route); an intersection direction task; and a task involving identity of the next landmark encountered. In both experiments, spatial memory was tested in two separate sessions: first following learning of an empty maze environment and second using a different maze which was populated. Older adults performed worse than younger adults in all tasks. Moreover, the presence of crowds during learning resulted in a cost in performance to the spatial tasks relative to the 'no crowds' condition in older adults but not in younger adults. In contrast, crowd distractors did not affect performance on the landmark sequence task. There was no age-related cost on performance with object distractors. These results suggest that crowds of human pedestrians selectively capture older adults' attention during learning. These findings offer further insights into how spatial memory is affected by the ageing process, particularly in scenarios which are representative of real-world situations.

Trending Paths: A New Semantic-Level Metric for Comparing Simulated and Real Crowd Data.

We propose a new semantic-level crowd evaluation metric in this paper. Crowd simulation has been an active and important area for several decades. However, only recently has there been an increased focus on evaluating the fidelity of the results with respect to real-world situations. The focus to date has been on analyzing the properties of low-level features such as pedestrian trajectories, or global features such as crowd densities. We propose the first approach based on finding semantic information represented by latent Path Patterns in both real and simulated data in order to analyze and compare them. Unsupervised clustering by non-parametric Bayesian inference is used to learn the patterns, which themselves provide a rich visualization of the crowd behavior. To this end, we present a new Stochastic Variational Dual Hierarchical Dirichlet Process ( SV-DHDP) model. The fidelity of the patterns is computed with respect to a reference, thus allowing the outputs of different algorithms to be compared with each other and/or with real data accordingly. Detailed evaluations and comparisons with existing metrics show that our method is a good alternative for comparing crowd data at a different level and also works with more types of data, holds fewer assumptions and is more robust to noise.

Multisensory aversive stimuli differentially modulate negative feelings in near and far space.

Affect, space, and multisensory integration are processes that are closely linked. However, it is unclear whether the spatial location of emotional stimuli interacts with multisensory presentation to influence the emotional experience they induce in the perceiver. In this study, we used the unique advantages of virtual reality techniques to present potentially aversive crowd stimuli embedded in a natural context and to control their display in terms of sensory and spatial presentation. Individuals high in crowdphobic fear navigated in an auditory-visual virtual environment, in which they encountered virtual crowds presented through the visual channel, the auditory channel, or both. They reported the intensity of their negative emotional experience at a far distance and at a close distance from the crowd stimuli. Whereas auditory-visual presentation of close feared stimuli amplified negative feelings, auditory-visual presentation of distant feared stimuli did not amplify negative feelings. This suggests that spatial closeness allows multisensory processes to modulate the intensity of the emotional experience induced by aversive stimuli. Nevertheless, the specific role of auditory stimulation must be investigated to better understand this interaction between multisensory, affective, and spatial representation processes. This phenomenon may serve the implementation of defensive behaviors in response to aversive stimuli that are in position to threaten an individual's feeling of security.

A Feasibility Study with Image-Based Rendered Virtual Reality in Patients with Mild Cognitive Impairment and Dementia.

Virtual Reality (VR) has emerged as a promising tool in many domains of therapy and rehabilitation, and has recently attracted the attention of researchers and clinicians working with elderly people with MCI, Alzheimer's disease and related disorders. Here we present a study testing the feasibility of using highly realistic image-based rendered VR with patients with MCI and dementia. We designed an attentional task to train selective and sustained attention, and we tested a VR and a paper version of this task in a single-session within-subjects design. Results showed that participants with MCI and dementia reported to be highly satisfied and interested in the task, and they reported high feelings of security, low discomfort, anxiety and fatigue. In addition, participants reported a preference for the VR condition compared to the paper condition, even if the task was more difficult. Interestingly, apathetic participants showed a preference for the VR condition stronger than that of non-apathetic participants. These findings suggest that VR-based training can be considered as an interesting tool to improve adherence to cognitive training in elderly people with cognitive impairment.

Familiar environments enhance object and spatial memory in both younger and older adults.

Recent evidence suggests that familiarity with an environment may protect against spatial memory decline for familiar objects in older adults. We investigated whether a familiar context also reduces age-related decline in spatial memory for novel objects. Twenty-four younger and 23 older participants viewed a virtual rendering of a local environment along two different routes, each through a well-known (West) or lesser-known (East) area within the environment. Older and younger participants reported being more familiar with one (i.e. West) area than the other. In each trial, participants were presented with one route and were instructed to learn ten novel objects and their locations along the route. Following learning, participants immediately completed five test blocks: an object recognition task, an egocentric spatial processing (direction judgement) task, an allocentric spatial processing (proximity judgement) task and two pen-and-paper tests to measure cognitive mapping abilities. First we found an age effect with worse performance by older than younger adults in all spatial tasks, particularly in allocentric spatial processing. However, our results suggested better memory for objects and directions, but not proximity judgements, when the task was associated with more familiar than unfamiliar contexts, in both age groups. There was no benefit of context when a separate young adult group (N = 24) was tested, who reported being equally familiar with both areas. These results suggest an important facilitatory role of context familiarity on object recognition, and in particular egocentric spatial memory, and have implications for enhancing spatial memory in older adults.