Luciana Picucci

Assistive technology for promoting choice behaviors in three children with cerebral palsy and severe communication impairments

A technology-based program to promote independent choice behaviors by three children with cerebral palsy and multiple disabilities was assessed. The program was based on learning principles and assistive technology (i.e., customized input devices/sensors, personal computers, screening of preferred stimuli according to a binomial criterion). The first purpose of the present study was to provide the participants with a new set-up of assistive technology and to allow them to choose among three categories (i.e., food, beverage and leisure), and to request a specific item out of four in each category, adopting a procedure that minimized (according to a conditional probability criterion) unintentional choices. The second aim of the study was to carry out the effects of the program on detectable mood signs (i.e., happiness index). The study was conducted according to an ABAB sequence with a subsequent post intervention check for each participant. The results showed an increase of engagement and of the happiness index during intervention phases. Psychological as well as educational implications were discussed.

Assessing human reorientation ability inside virtual reality environments: the effects of retention interval and landmark characteristics

The purpose of the present study was to assess the navigational behaviour of adult humans following a disorientation procedure that perturbed their egocentric frame of reference. The assessment was carried out in a virtual reality (VR) environment by manipulating the disorientation procedure, the retention interval, the relative positions of target and landmark. The results of experiment I demonstrated that adding a physical rotation to a virtual disorientation procedure did not yield an additional decrease in searching performance. The results of experiment II showed that shortening the delay between study and test phase decreased the errors more markedly for geometric than landmark ones. An orientation specificity effect due to the manipulation of the relative position between target and landmark was discussed across the experiments. In conclusion, VR seemed to be a valuable method for studying human reorientation. Moreover, the virtual experimental setting involved here promoted knowledge of the relationship between working memory and spatial reorientation paradigm.

Reorientation Deficits Are Associated With Amnestic Mild Cognitive Impairment

Background/Aims: Spatial memory can be impaired in amnestic mild cognitive impairment (aMCI). The present study investigates categorical spatial memory deficits using a virtual navigation-based reorientation task. Methods: Twenty-eight amnestic single domain and 23 amnestic multiple domain patients were compared with 53 healthy elderly controls on the performance of the virtual reorientation test (VReoT). Results: The reorientation performance of participants in both aMCI groups was significantly worse than that of controls suggesting that VReoT detects spatial memory deficits. No significant difference emerged between the 2 groups of patients. A subsequent receiver–operating characteristic analysis showed that a score of 8 had a sensitivity of 80.4% and a specificity of 94.3% (area under the curve = 0.90). Conclusion: The VReoT seemed to be accurate in differentiating patients with aMCI from controls and may represent an evaluation supplement for spatial memory deficits in prodromal stages of Alzheimer’s dementia.

Technology-based orientation programs to support indoor travel by persons with moderate Alzheimer's disease: impact assessment and social validation.

The present study (a) extended the assessment of an orientation program involving auditory cues (i.e., verbal messages automatically presented from the destinations) with five patients with Alzheimers disease, (b) compared the effects of this program with those of a program with light cues (i.e., a program in which strobe lights were used instead of the verbal messages) with the same five patients, and (c) conducted a social validation assessment of the two programs with 70 university psychology students employed as social raters. Results confirmed the effectiveness of the program with auditory cues and showed an equally strong impact of the program with light cues with all five patients. The psychology students involved in the social validation assessment provided significantly higher scores for the program involving light cues on a six-item questionnaire. Those scores suggested that this program was perceived as a practically and socially preferable choice. The implications of the findings for daily contexts dealing with patients with Alzheimers disease are discussed.

Age and sex differences in a virtual version of the reorientation task.

Previous studies on allocentric frame of reference (FoR) have shown a substantial deficit in elderly spatial navigation. (e.g. Moffat and Resnick 2002). We referred to allocentric FoR in terms of the absence of reckoning cues in solving a spatial navigation task. Although age-related effect on navigational behaviour has been already evaluated in previous studies (e.g. Driscoll et al. 2005), rarely the impact of both layout and featural information has been systematically assessed. Acquisition and use of knowledge regarding the environment are fundamental to effective everyday functioning and, consequently, have a critical impact on the quality of life, particularly for elderly adults. A general aim of this study is to investigate the different weight of layout and featural information in a virtual version of reorientation paradigm (VReor) adopting an individual difference perspective. Virtual environments have been successfully employed in research involving both children (e.g. Newhouse et al. 2007) and elderly (Moffat and Resnick 2002). Benefits in the employment of virtual reality technologies can be summed as follows: (a) improvement in experimental control, with the advantage to create realistic, interactive three-dimensional environments, and to collect a large amount of reliable data, (b) maintained ecological validity with respect to real-world settings, (c) opportunity to investigate spatial navigation strategies in samples showing different characteristics, such as aged people and people with cognitive impairments and psychopathological conditions. In line with the aforementioned theoretical framework, this paper accounted for the following ideas: first, the layout information remains stable along lifespan, because it seems to be linked to a more implicit perception of space, the use of featural information is less stable along life-span, and it tends to corrupt earlier with age. Second, males rely predominantly on layout information, while featural information is used equally by both males and females.

Intervention strategies for spatial orientation disorders in dementia: A selective review

Purpose: This article provides a brief overview of the intervention strategies aimed at reducing spatial orientation disorders in elderly people with dementia. Methods: Eight experimental studies using spatial cues, assistive technology programs, reality orientation training, errorless learning technique, and backward chaining programs are described. They can be classified into two main approaches: restorative and compensatory, depending on whether they rely or not on residual learning ability, respectively. Results: A review of the efficacy of these intervention strategies is proposed. Results suggest that both compensatory and restorative approaches may be valuable in enhancing correct way-finding behavior, with various degrees of effectiveness. Some issues concerning (a) variability in participants’ characteristics and experimental designs and (b) practicality of intervention strategies do not permit to draw a definite conclusion. Conclusions: Future research should be aimed at a direct comparison between these two strategies, and should incorporate an extensive neuropsychological assessment of spatial domain.

''Two cues are not better than one'' the integration of geometric and featural information in the reorientation paradigm

A large body of evidence has shown that to navigate in the environment, animals need to define a direction with respect to some frames of reference that specify position of that individual and its direction. In natural environment, usually, a large number of cues could be used in order to establish heading (Gallistel 1990). In a very simple environment without distinctive landmarks, the shape of the environment itself could be used as reference for orientation and navigation. This kind of reference is called geometric cue. Recently, Cheng and Newcombe (2005) had reviewed a large number of works in animals and humans highlighting the characteristics of this kind of spatial information and their relationship with the featural (landmarks) cues. In particular, the reorientation paradigm (e.g. Hermer and Spelke 1996) predicted that adult human promptly solve a searching task by integrating geometric (the layout of the environment) and featural information (a distinctive landmark), while children (within 2 years old) failed to integrate landmark information. Geometrical information seemed to be encapsulated. As pointed out by Fodor (2001) the original results of Hermer and Spelke (1996) could represent an important evidence of modular cognitive functioning in the domain of spatial cognition. Present study intends to discuss the notion of integration among different spatial information, comparing performance of adult humans either in environment with (a) layout information only (rectangular chambers), (b) landmark information only (square chambers with one distinctive landmark) and (c) combination of layout and landmark information (rectangular chambers with one distinctive landmark). It is worthwhile to note that in the environments with layout information only, correct responses are ambiguous, since both correct site and its rotationally equivalent are legal. In contrast, the environments with only landmark information possess unambiguous information since the sense relation between landmark and target (e.g. ‘‘target is on the right of the landmark’’) is adequate to solve the task. Consequently, adding coherent layout information to a landmark cue, leads to expect an improvement of performance with respect to an environment characterized by landmark information only.

Construction of a spatial mental model from a verbal description or from navigation in a virtual environment

A very common everyday experience is the construction of spatial mental representations from navigation, inspection of maps, or even from verbal descriptions. The construction of a spatial representation from a verbal description has been extensively studied, and the characteristics of the representation as well as the processes involved in this construction have been clarified. These spatial representations are usually called spatial mental models, in reference to the Johnson-Laird theory of mental models (1983). Over the last few years, a number of studies have investigated the processes and cognitive abilities involved in the construction of these mental models. Many studies have shown that these representations preserve the spatial relationships between the elements of the described environment (e.g. Schneider and Taylor 1999). One question of recent interest has been to investigate the involvement of working memory in the construction of such representations, and a specific involvement of the visuo-spatial working memory has been evidenced, as well for survey as for route descriptions, even if to a different extend (e.g. De Beni et al. 2005). It has also been shown that imagery instructions help subjects to form a spatial model, and that they then specifically rely on their visuo-spatial working memory to construct their model (Gyselinck et al. 2006). There are many other means to construct a spatial representation of an environment, and the development of new techniques of virtual reality provides new tools to explore the spatial representations. Some studies have compared the spatial mental representations constructed in various ways; learning from a map and reading a verbal description (e.g. Tlanka et al. 2005); navigating in a real environment and learning from a map (Richardson et al. 1999); navigating in a real environment and navigating in a virtual environment (Waller 2000; Chabanne et al. 2003). Results usually show that the representations constructed are comparable. A question is to characterize the mental representations individuals construct when they are immerged in such a virtual environment, and then to examine the processes and cognitive abilities involved in the construction of a spatial model from virtual navigation. The aim of the study reported here is to compare the representation constructed from navigation in a virtual environment with the representation constructed by processing a verbal description of the same environment. Given that gender differences have been found to play a role in many visuo-spatial tasks (Voyer et al. 1995), this variable has been taken into consideration in this study. V. Gyselinck (&) AE S. Nicolas AE P. Piolino C.N.R.S., University R. Descartes, Paris, France e-mail: valerie.gyselinck@univ-paris5.fr

Assistive technologies for promoting inclusion for children with multiple disabilities

The study reported here is aimed at assessing the efficacy of a computer-based alternative and augmentative communication (AAC) program for two children with cerebral palsy and multiple disabilities. The results show that both participants’ communication skills improved during intervention and post-intervention phases. This was confirmed by scores from social validation procedures carried out by undergraduate students; these substantiated the hypothesis of the intervention’s rehabilitation value. These results support the clinical validity of the computer-mediated AAC intervention for children with multiple/profound disabilities.