Giulia Cappagli

Auditory and proprioceptive spatial impairments in blind children and adults.

It is not clear what role visual information plays in the development of space perception. It has previously been shown that in absence of vision, both the ability to judge orientation in the haptic modality and bisect intervals in the auditory modality are severely compromised (Gori, Sandini, Martinoli & Burr, 2010; Gori, Sandini, Martinoli & Burr, 2014). Here we report for the first time also a strong deficit in proprioceptive reproduction and audio distance evaluation in early blind children and adults. Interestingly, the deficit is not present in a small group of adults with acquired visual disability. Our results support the idea that in absence of vision the audio and proprioceptive spatial representations may be delayed or drastically weakened due to the lack of visual calibration over the auditory and haptic modalities during the critical period of development.

Encoding audio motion: spatial impairment in early blind individuals

The consequence of blindness on auditory spatial localization has been an interesting issue of research in the last decade providing mixed results. Enhanced auditory spatial skills in individuals with visual impairment have been reported by multiple studies, while some aspects of spatial hearing seem to be impaired in the absence of vision. In this study, the ability to encode the trajectory of a 2-dimensional sound motion, reproducing the complete movement, and reaching the correct end-point sound position, is evaluated in 12 early blind (EB) individuals, 8 late blind (LB) individuals, and 20 age-matched sighted blindfolded controls. EB individuals correctly determine the direction of the sound motion on the horizontal axis, but show a clear deficit in encoding the sound motion in the lower side of the plane. On the contrary, LB individuals and blindfolded controls perform much better with no deficit in the lower side of the plane. In fact the mean localization error resulted 271 ± 10 mm for EB individuals, 65 ± 4 mm for LB individuals, and 68 ± 2 mm for sighted blindfolded controls. These results support the hypothesis that (i) it exists a trade-off between the development of enhanced perceptual abilities and role of vision in the sound localization abilities of EB individuals, and (ii) the visual information is fundamental in calibrating some aspects of the representation of auditory space in the brain.

Devices for visually impaired people: High technological devices with low user acceptance and no adaptability for children.

Considering that cortical plasticity is maximal in the child, why are the majority of technological devices available for visually impaired users meant for adults and not for children? Moreover, despite high technological advancements in recent years, why is there still no full user acceptance of existing sensory substitution devices? The goal of this review is to create a link between neuroscientists and engineers by opening a discussion about the direction that the development of technological devices for visually impaired people is taking. Firstly, we review works on spatial and social skills in children with visual impairments, showing that lack of vision is associated with other sensory and motor delays. Secondly, we present some of the technological solutions developed to date for visually impaired people. Doing this, we highlight the core features of these systems and discuss their limits. We also discuss the possible reasons behind the low adaptability in children.

Auditory Spatial Recalibration in Congenital Blind Individuals

Blind individuals show impairments for auditory spatial skills that require complex spatial representation of the environment. We suggest that this is partially due to the egocentric frame of reference used by blind individuals. Here we investigate the possibility of reducing the mentioned auditory spatial impairments with an audio-motor training. Our hypothesis is that the association between a motor command and the corresponding movements sensory feedback can provide an allocentric frame of reference and consequently help blind individuals in understanding complex spatial relationships. Subjects were required to localize the end point of a moving sound before and after either 2-min of audio-motor training or a complete rest. During the training, subjects were asked to move their hand, and consequently the sound source, to freely explore the space around the setup and the body. Both congenital blind (N = 20) and blindfolded healthy controls (N = 28) participated in the study. Results suggest that the audio-motor training was effective in improving space perception of blind individuals. The improvement was not observed in those subjects that did not perform the training. This study demonstrates that it is possible to recalibrate the auditory spatial representation in congenital blind individuals with a short audio-motor training and provides new insights for rehabilitation protocols in blind people.

Evaluation of the Audio Bracelet for Blind Interaction for improving mobility and spatial cognition in early blind children - A pilot study.

This study was designed to assess the effectiveness of the Audio Bracelet for Blind Interaction (ABBI) system for improving mobility and spatial cognition in visually impaired children. The bracelet is worn on the wrist and the key feature is to provide an audio feedback about body movements to help visually impaired children to build a sense of space. Nine early blind children took part at this study. The study lasted 12 weeks. Once per week each child participated in a 45-minutes ABBI rehabilitation with trained professionals. He also had to use it one hour per day at home alone or with one relative. The mobility and spatial cognition abilities were measured before and after a 12-weeks rehabilitation program with three different tests. Results showed that the use of the Audio Bracelet for Blind Interaction allowed the early blind children to significantly improve their mobility and spatial abilities. Although an extended study including a larger number of participants is needed to confirm these data, the present results are encouraging. They do suggest that ABBI could be used for rehabilitate the sense of space in visually impaired children.

Auditory spatial localization: Developmental delay in children with visual impairments

For individuals with visual impairments, auditory spatial localization is one of the most important features to navigate in the environment. Many works suggest that blind adults show similar or even enhanced performance for localization of auditory cues compared to sighted adults (Collignon, Voss, Lassonde, & Lepore, 2009). To date, the investigation of auditory spatial localization in children with visual impairments has provided contrasting results. Here we report, for the first time, that contrary to visually impaired adults, children with low vision or total blindness show a significant impairment in the localization of static sounds. These results suggest that simple auditory spatial tasks are compromised in children, and that this capacity recovers over time.

What Do You Like? Early Design Explorations of Sound and Haptic Preferences

This study is done within the framework of a project aimed at developing a wearable device (a bracelet) intended to support sensory motor rehabilitation of children with visual impairments. We present an exploratory study of aesthetic/hedonistic preferences for sounds and touch experiences among visually impaired children. The work is done in a participatory setting, and we have used mixed methods (questionnaires, workshop and field trial using a mobile location based app for story creation) in order to get a more complete initial picture of how enjoyable training devices should be designed for our target users.

Multisensory Rehabilitation Training Improves Spatial Perception in Totally but Not Partially Visually Deprived Children

Since it has been shown that spatial development can be delayed in blind children, focused sensorimotor trainings that associate auditory and motor information might be used to prevent the risk of spatial-related developmental delays or impairments from an early age. With this aim, we proposed a new technological device based on the implicit link between action and perception: ABBI (Audio Bracelet for Blind Interaction) is an audio bracelet that produces a sound when a movement occurs by allowing the substitution of the visuo-motor association with a new audio-motor association. In this study, we assessed the effects of an extensive but entertaining sensorimotor training with ABBI on the development of spatial hearing in a group of seven 3–5 years old children with congenital blindness (n = 2; light perception or no perception of light) or low vision (n = 5; visual acuity range 1.1–1.7 LogMAR). The training required the participants to play several spatial games individually and/or together with the psychomotor therapist 1 h per week for 3 months: the spatial games consisted of exercises meant to train their ability to associate visual and motor-related signals from their body, in order to foster the development of multisensory processes. We measured spatial performance by asking participants to indicate the position of one single fixed (static condition) or moving (dynamic condition) sound source on a vertical sensorized surface. We found that spatial performance of congenitally blind but not low vision children is improved after the training, indicating that early interventions with the use of science-driven devices based on multisensory capabilities can provide consistent advancements in therapeutic interventions, improving the quality of life of children with visual disability.

Corrigendum: Auditory Spatial Recalibration in Congenital Blind Individuals

[This corrects the article on p. 76 in vol. 11, PMID: 28261053.].

The Impact of Early Visual Deprivation on Spatial Hearing: A Comparison between Totally and Partially Visually Deprived Children

The specific role of early visual deprivation on spatial hearing is still unclear, mainly due to the difficulty of comparing similar spatial skills at different ages and to the difficulty in recruiting young blind children from birth. In this study, the effects of early visual deprivation on the development of auditory spatial localization have been assessed in a group of seven 3–5 years old children with congenital blindness (n = 2; light perception or no perception of light) or low vision (n = 5; visual acuity range 1.1–1.7 LogMAR), with the main aim to understand if visual experience is fundamental to the development of specific spatial skills. Our study led to three main findings: firstly, totally blind children performed overall more poorly compared sighted and low vision children in all the spatial tasks performed; secondly, low vision children performed equally or better than sighted children in the same auditory spatial tasks; thirdly, higher residual levels of visual acuity are positively correlated with better spatial performance in the dynamic condition of the auditory localization task indicating that the more residual vision the better spatial performance. These results suggest that early visual experience has an important role in the development of spatial cognition, even when the visual input during the critical period of visual calibration is partially degraded like in the case of low vision children. Overall these results shed light on the importance of early assessment of spatial impairments in visually impaired children and early intervention to prevent the risk of isolation and social exclusion.