Interacting with virtual characters, objects and environments: investigating immersive virtual reality in rehabilitation.

PURPOSE: This pilot study aimed to (a) investigate opportunities for immersive Virtual Reality (VR) technology in communication, physical, and visual rehabilitation by examining the interaction of people without disabilities in a range of structured virtual environments; and (b) validate research protocols that might be used to evaluate the physical, visual, and verbal interaction of users in virtual worlds, and their safety while using the technology. METHODS: Thirteen adults identifying as people without disability were exposed to VR via a head-mounted display. A video-review method was used to qualitatively code and analyse each participant's communication, movement, orientation, and support needs. RESULTS: All participants oriented to their virtual environments sufficiently to use applications. Their spoken language was effective for interaction, although unconventional social behaviours were also observed. Two participants reported minor adverse reactions consistent with mild cybersickness. CONCLUSION: The results provide insight into the types of environments and characters that support the greatest communicative, physical, and visual interaction in immersive VR. The tested protocols are useful to assess safety when using VR, and to observe communicative, physical, and visual interaction with virtual environments and characters. Implications for future research and use of VR with people with communication, physical and visual disability are discussed.

Safe use of virtual reality in rehabilitation requires careful assessment. Comprehensive observational protocols were sufficient to manage safety concerns.Rehabilitation applications need rapid responsivity in verbal interactions to ensure users are immersed in interactions.Non-verbal cues from virtual avatars best direct user attention in the environment.Novice virtual reality users largely controlled technology using their dominant hand. They could control VR successfully with one hand.

ABRACADABRA literacy instruction for children with Down syndrome via telepractice during COVID-19: A pilot study.

BACKGROUND: COVID-19 has resulted in some educators and allied health practitioners transitioning to online delivery of literacy instruction. As far as we are aware, no studies have investigated online delivery of comprehensive literacy instruction for children with Down syndrome. AIMS: In this pilot study, we explore the efficacy of online delivery of ABRACADABRA (a free literacy web application) for children with Down syndrome, alongside supplementary parent-led shared book reading, during the COVID-19 pandemic. SAMPLE: Six children with Down syndrome, aged 8-12 years, participated in this within-participants design study. METHODS: Participants acted as their own controls with outcome variables measured at three timepoints: baseline, pre-instruction and post-instruction. Children participated in 16-18 hrs of one-to-one literacy instruction online over a 6-week instruction phase, along with twice weekly parent-led shared book reading activities. RESULTS: Outcomes from standardized assessments revealed statistically significant improvements in word- and passage-level reading accuracy skills over the instruction phase (pre-instruction to post-instruction) compared with the no-instruction control phase (baseline to pre-instruction). Improvements in reading comprehension skills were inconsistent across assessment measures and statistical analyses. CONCLUSION: Children with Down syndrome can benefit from comprehensive literacy instruction delivered via telepractice. Our study provides critical initial evidence of successful service delivery during a global pandemic and beyond.

Exploring the Effects of Literacy Instruction for Children With Cerebral Palsy: A Systematic Review.

PURPOSE: Some children with cerebral palsy (CP) have difficulty acquiring conventional reading and writing skills. This systematic review explores the different types of literacy instruction and their effects on the reading and writing skills of children with CP. METHOD: Relevant studies published between 2000 and 2020 were identified using electronic databases and terms related to CP and literacy. Data on participant characteristics, instruction characteristics, and instruction outcomes were extracted. A standardized measure of effect size was used to quantify reported treatment effects. RESULTS: The systematic search identified 2,970 potentially relevant studies, of which 24 met inclusion criteria. These studies included 66 children with CP aged 5-18 years. One of the included studies utilized a group research design, whereas the remaining used single-subject designs. Studies investigated literacy instruction methods designed to teach phonics, sight-word recognition, reading fluency, reading comprehension, spelling, or written expression skills, or multicomponent instruction (instruction methods encompassing three or more of these skills). Most instruction methods were associated with gains in reading and writing skills with medium to large effects; however, our analysis of methodological rigor suggests that these findings need to be interpreted with caution. CONCLUSIONS: We propose that literacy instruction utilizing evidence-based principles can be effective for children with CP, provided instruction is accessible and allows children to demonstrate and receive feedback on their skills; however, further research is greatly needed. Clinical implications and priorities for future research are discussed. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.21357558.

Collaborative co-design and evaluation of an immersive virtual reality application prototype for communication rehabilitation (DISCOVR prototype).

PURPOSE: Virtual reality (VR) lends itself to communication rehabilitation by creating safe, replicable, and authentic simulated environments in which users learn and practice communication skills. The aim of this research was to obtain the views of health professionals and technology specialists on the design characteristics and usability of a prototype VR application for communication rehabilitation. MATERIALS AND METHODS: Nine professionals from different health and technology disciplines participated in an online focus group or individual online interview to evaluate the application and use of the VR prototype. Data sources were analysed using a content thematic analysis. RESULTS: Four main themes relating to VR design and implementation in rehabilitation were identified: (i) designing rehabilitation-focused virtual worlds; (ii) understanding and using VR hardware; (iii) making room for VR in rehabilitation and training; and (iv) implementing VR will not replace the health professional's role. DISCUSSION: Health professionals and technology specialists engaged in co-design while evaluating the VR prototype. They identified software features requiring careful consideration to ensure improved usability, client safety, and success in communication rehabilitation outcomes. Continuing inclusive co-design, engaging health professionals, clients with communication disability, and their families will be essential to creating useable VR applications and integrating these successfully into rehabilitation. Implications for rehabilitationHealth and technology professionals, along with clients, are integral to the co-design of new VR technology applications.Design of VR applications needs to consider the client's communication, physical, cognitive, sensory, psychosocial, and emotional needs for greater usability of these programs.Realism and authenticity of interactions, characters, and environments are considered important factors to allow users to be fully immersed in virtual simulations to enhance rehabilitation.

A trial of online ABRACADABRA literacy instruction with supplementary parent-led shared book reading for children with autism.

BACKGROUND/AIMS: The COVID-19 pandemic has highlighted the need for accessible support for children with developmental disabilities. This study explored online literacy instruction with supplementary parent-led shared book reading (SBR) for children with autism. METHODS: Twenty-one children with autism (5-12 years) completed a battery of assessments (T1) before being assigned to ability matched Instruction (n = 10) and Control groups (n = 11). Instruction group participants completed 16 h of ABRACADABRA instruction working with a researcher 1:1 online and SBR activities at home with a parent over 8 weeks. All participants were reassessed after the instruction period (T2) and parents of children in the Instruction group were interviewed regarding their views and experiences. RESULTS: Quantitative analyses showed no significant improvements in reading for Instruction group children relative to Control group children. However, each child successfully participated in 16 online instruction sessions and qualitative data revealed that parents were generally positive about the program, with some observing improvements in their child's literacy skills and reading confidence. CONCLUSIONS AND IMPLICATIONS: While it appears children with autism can participate in online literacy instruction, sixteen hours of online ABRACADABRA instruction with parent-led SBR may not be effective in improving their reading skills. Further research is required to explore whether more intensive and/or extended online instruction may be feasible and effective, and to improve uptake of parent-led book reading activities at home.

Literacy instruction for autistic children who speak languages other than English.

LAY ABSTRACT: Many autistic children across the globe speak languages other than English. However, much of the research about teaching children with autism to read and write is derived from studies including people who speak English and no other languages. Here, we review the research on teaching children with autism to read and write in languages other than English. We did this because the world's languages, and the ways they are represented in written form, vary greatly. A broader overview that encompasses languages other than English can help us better understand how learning to read and write can be supported for autistic children around the world. The studies included in our review highlight some potential differences in effective literacy teaching for autistic children learning to read and write using different writing systems. The studies we reviewed tended to include relatively small samples of autistic children, among other limitations. We hope that our review will increase awareness and research efforts in the area of autism and global literacy.

Nanoscape, a data-driven 3D real-time interactive virtual cell environment.

Our understanding of cellular and structural biology has reached unprecedented levels of detail, and computer visualisation techniques can be used to create three-dimensional (3D) representations of cells and their environment that are useful in both teaching and research. However, extracting and integrating the relevant scientific data, and then presenting them in an effective way, can pose substantial computational and aesthetic challenges. Here we report how computer artists, experts in computer graphics and cell biologists have collaborated to produce a tool called Nanoscape that allows users to explore and interact with 3D representations of cells and their environment that are both scientifically accurate and visually appealing. We believe that using Nanoscape as an immersive learning application will lead to an improved understanding of the complexities of cellular scales, densities and interactions compared with traditional learning modalities.

The Promise of Comprehensive Early Reading Instruction for Children With Autism and Recommendations for Future Directions.

Purpose Children with autism have an increased likelihood of reading difficulties. The reasons for this are numerous and varied, but many children with autism can learn to read when they are provided with evidence-based early reading instruction. Method Here, we provide an overview of some of the factors that impact early reading development for children with autism and a rationale for the provision of comprehensive early reading instruction consistent with the recommendations of the National Reading Panel (NRP). We discuss research on NRP instruction for children with autism, including some of our own empirical studies. We also discuss some areas of research that were not emphasized by the NRP but that we view as important. We offer recommendations that extend beyond NRP guidelines in order to advance knowledge and improve practice. Conclusions Comprehensive early reading instruction holds great promise for children with autism, but there are gaps in our understanding that need to be addressed. These include the most effective method(s) for tailoring reading instruction to the needs of the individual while optimizing delivery to small groups of children, supporting skills and making other accommodations not outlined by the NRP, and consideration of bilingualism and of reading instruction in languages other than English, among other issues. While our focus in this review article is early reading instruction for children with autism who use oral language, we acknowledge that there is a major gap in the literature concerning reading instruction for those who do not use oral language. We hope that this review article will be helpful to clinicians, educators, and researchers alike, as well as children with autism and their families, friends, and support networks.

Women's Psychological Aggression Toward an Intimate Male Partner: Between the Impulsive and the Instrumental.

The purpose of this article is to explore some underlying mechanisms of women's psychological aggression in intimate partner violence (IPV), as a phenomenon that requires better understanding and intervention, even in cases when it does not lead to physical violence. Psychological aggression is known to be the most prevalent pattern of IPV for both genders, and its impact on many survivors is known to be equal and sometimes worse than that of physical harm. Despite the fact that most aggressive conflicts between couples do not escalate into physical violence, research mainly addresses psychological aggression in the context of its correlation with it. This article is based on qualitative interviews with 30 women who were in bidirectional abusive heterosexual relationships, who were at least psychologically aggressive toward their male intimate partner, and who were willing to be interviewed about this experience. Results of the phenomenological psychological method of analysis of the interviews are presented, focusing on the women's personal accounts for using psychological aggression. These accounts are further analyzed from two perspectives: (a) the bimodal classification of impulsive, as opposed to instrumental, aggression; and (b) the client's perceived need-to-control the partner as opposed to the ability to exercise self-control. The article also discusses implications for theory and practice, especially in the refining of relevant intervention goals with psychologically aggressive women.

Indigenous Australians with autism: A scoping review.

LAY ABSTRACT: Aboriginal and Torres Strait Islander people with developmental disabilities such as autism are among the most marginalised people in Australian society. We reviewed research involving Indigenous Australians with autism based on a search of the peer-reviewed and grey literature. Our search identified 1457 potentially relevant publications. Of these, 19 publications were in line with our main areas of inquiry: autism spectrum disorder diagnosis and prevalence, carer and service provider perspectives on autism, and autism support services. These included 12 journal publications, 3 conference presentations, 1 resource booklet and 1 thesis dissertation. Findings suggest similar prevalence rates for autism among Indigenous and non-Indigenous Australians, although some Aboriginal and Torres Strait Islander people with autism may not receive a diagnosis or may be misdiagnosed. We also discuss research on the perspectives of Aboriginal and Torres Strait Islander carers and Indigenous and non-Indigenous service providers, as well as barriers and strategies for improving access to diagnosis and support services.

An acoustic study of lexical stress contrastivity in children with and without autism spectrum disorders.

In this exploratory study, we examined stress contrastivity within real word productions elicited via picture naming in 20 children with autism spectrum disorders (ASD) and 20 typical peers group-wise matched on age and vocabulary. Targets had a dominant pattern of lexical stress beginning with a strong-weak pattern (SW: 'caterpillar', 'butterfly') or a non-dominant pattern of lexical stress beginning with a weak-strong pattern (WS: 'tomato', 'potato'). Children produced each target twice (n = 320 productions). Acoustic measures were made for the duration, fundamental frequency, and intensity of the first two vowels for each word production. For vowel duration and fundamental frequency, children with ASD and typical peers produced a similar magnitude of stress contrastivity for SW and WS words. However, there was a significant group difference in the way contrastivity in intensity was realised for WS words whereby children with ASD produced less stress contrastivity than typical peers. Bayesian analyses were in line with our interpretation of our frequentist analyses.

The Role of Personalized Virtual Reality in Education for Patients Post Stroke-A Qualitative Case Series.

BACKGROUND: Education is essential to promote prevention of recurrent stroke and maximize rehabilitation; however, current techniques are limited and many patients remain dissatisfied. Virtual reality (VR) may provide an alternative way of conveying complex information through a more universal language. AIM: To develop and conduct preliminary assessments on the use of a guided and personalized 3D visualization education session via VR, for stroke survivors and primary caregivers. METHODS: Four poststroke patients and their 4 primary caregivers completed the 3D visualization education session as well as pre- and postintervention interviews. Each patient had a different stroke etiology (i.e., ischemic thrombotic stroke, ischemic embolic stroke, hemorrhagic stroke, and transient ischemic attack followed by ischemic stroke, respectively). This new approach uses preintervention interview responses, patient MRI and CT datasets, VR head mounted displays, 3D computer modeling, and game development software to develop the visualization. Pre- and postintervention interview responses were analyzed using a qualitative phenomenological methodology approach. RESULTS: All participants safely completed the study and were highly satisfied with the education session. In this subset of participants, prior formal stroke education provision was limited. All participants demonstrated varied improvements in knowledge areas including brain anatomy and physiology, brain damage and repair, and stroke-specific information such as individual stroke risk factors and acute treatment benefits. These improvements were accompanied by feelings of closure, acceptance, and a greater motivation to manage their stroke risk. CONCLUSIONS: Preliminary results suggest this approach provides a safe and promising educational tool to promote understanding of individualized stroke experiences.

Efficacy of ABRACADABRA literacy instruction in a school setting for children with autism spectrum disorders.

BACKGROUND: There is evidence indicating that instruction using ABRACADABRA (ABRA) - a free web application designed to promote literacy development - may benefit children with autism spectrum disorders (ASD) when administered on an individualized basis in children's homes. AIMS: Here, we investigated the efficacy of ABRA instruction administered in small groups of children with ASD within a school setting. METHODS AND PROCEDURES: Children were aged 5.83-8.42 years (n = 23). Some children were assigned to an instruction group and received a minimum of 20 h of ABRA instruction over 9 weeks (n = 11). The other children comprised an age- and ability-matched control group (n = 12) and received business as usual literacy instruction. Outcome measures included word-level accuracy, passage-level accuracy, and passage-level comprehension, all assessed using standardized tests that were independent of ABRA. OUTCOMES AND RESULTS: ANOVAs comparing pre- versus post-instruction raw scores showed statistically significant improvements in word- and passage-level reading accuracy for the instruction group relative to the control group, with large effect sizes. Gains in reading comprehension for the instruction group were not statistically significant and, in a posthoc correlational analysis, appeared to be related to children's socialisation skills (r = .62). CONCLUSIONS AND IMPLICATIONS: Literacy instruction using ABRA is associated with improvement in reading accuracy for children with ASD when administered in small groups within a school setting. Children with ASD may require additional supports to make gains in reading comprehension when literacy instruction using ABRA is delivered in groups.

The influence of group values and behavior on adolescent male perceptions of and use of homophobic language.

INTRODUCTION: The pervasive and derogatory use of homophobic language is a threat to safe, respectful, and inclusive school environments. Group membership has been shown to influence how students use homophobic language. Previous qualitative studies have largely approached the use of this language from the theoretical framework of hegemonic masculinity. In contrast, the current study actively challenged all assumptions about the use of this language. METHOD: This study was conducted in a public high school located in a rural conservative Christian community in the Intermountain West (USA). Using hermeneutic qualitative methodology to assess individual perceptions of homophobic language, 20 randomly selected 12th-grade male students (17-18 years of age) were individually interviewed. RESULTS: Three distinct groups emerged during our interviews: students on the debate team, students who strongly identified with a conservative religion, and students on popular athletic teams. Membership in specific peer groups influenced how students participated in or abstained from using homophobic language. Contrary to the prevailing research that pairs religiosity with negatively biased attitudes toward LGBTQIA, in this study, participants' religious beliefs appeared to be associated with respecting others' feelings and a decreased likelihood of using homophobic language. CONCLUSIONS: After summarizing this study's findings, we conclude with implications for practice. To more effectively deter the use of homophobic language, we encourage school-based interventions that target specific groups of adolescents and consider the social context in which homophobic language occurs.

Journey to the centre of the cell: Virtual reality immersion into scientific data.

Visualization of scientific data is crucial not only for scientific discovery but also to communicate science and medicine to both experts and a general audience. Until recently, we have been limited to visualizing the three-dimensional (3D) world of biology in 2 dimensions. Renderings of 3D cells are still traditionally displayed using two-dimensional (2D) media, such as on a computer screen or paper. However, the advent of consumer grade virtual reality (VR) headsets such as Oculus Rift and HTC Vive means it is now possible to visualize and interact with scientific data in a 3D virtual world. In addition, new microscopic methods provide an unprecedented opportunity to obtain new 3D data sets. In this perspective article, we highlight how we have used cutting edge imaging techniques to build a 3D virtual model of a cell from serial block-face scanning electron microscope (SBEM) imaging data. This model allows scientists, students and members of the public to explore and interact with a "real" cell. Early testing of this immersive environment indicates a significant improvement in students' understanding of cellular processes and points to a new future of learning and public engagement. In addition, we speculate that VR can become a new tool for researchers studying cellular architecture and processes by populating VR models with molecular data.

Violently reactive women and their relationship with an abusive mother.

This article sheds light on the abuse of mothers toward their daughters and its potential influence on the violent behavior of the latter as adults. It contributes to the scarce knowledge on the effects of abuse of each parent on their children by gender. The article is part of a larger study describing the experience of 30 women in Israel who were abusive or violent toward their male partners. It presents the stories of 14 women from the sample who, when sharing their memories of childhood and family-of-origin, spoke of an abusive relationship with their mothers. The various types of these relationships are presented along a continuum based on the severity of violence and emotional detachment of the mothers toward the interviewees, ranging from physical and emotional distancing, through chronic expressions of bitterness and criticism, and ending with severe physical violence. The findings are analyzed through the prism of social construction, relating to the interviewees' use of the psychodynamic discourse when accounting for their past and present abusive relationships. Some limitations and clinical implementations of the study, and needs for further research, are addressed.

Male social workers working with men who batter: dilemmas in gender identity.

Research into the impact of dealing with intimate partner violence has focused mainly on women who treated victims. The present article explores the interaction between male social workers and battering men. The sample included 15 male social workers who worked with battering men in social services. Data collection was performed through semistructured interviews. The main theme emerging from the interviews describes the reconstruction and renegotiation of the worker's professional and personal self in light of his experiences with violent clients. Two major motifs describing their experience emerged: The first is self-doubt arising from adopting a broad definition of violence, thus creating increased sensitization to and inclusion of a wide range of behaviors under the term violence . The second motif is related to compromising with reality by renegotiating their identity as aggressive, at times, but not violent. Findings were discussed in the light of the constructionist perspective.