Steven Battersby

Designing location-based learning experiences for people with intellectual disabilities and additional sensory impairments

The research reported here is part of a larger project which seeks to combine serious games (or games-based learning) with location-based services to help people with intellectual disabilities and additional sensory impairments to develop work based skills. Specifically this paper reports on where these approaches are combined to scaffold the learning of new routes and ultimately independent travel to new work and educational opportunities. A phased development methodology is applied in a user sensitive manner, to ensure that user feedback drives the ongoing development process. Methods to structure this include group feedback on conceptual storyboards, expert review of prototypes using usability heuristics relating to the main system goals, and finally co-discovery methods with student pairs exploring all three modes of the system in real world contexts. Aspects of developmental and cognitive psychological theories are also reviewed and it is suggested that combining games-based learning approaches with location-based services is an appropriate combination of technologies for an application specifically designed to scaffold route learning for this target audience.

Patients' Use of a Home-Based Virtual Reality System to Provide Rehabilitation of the Upper Limb Following Stroke

Background A low-cost virtual reality system that translates movements of the hand, fingers, and thumb into game play was designed to provide a flexible and motivating approach to increasing adherence to home-based rehabilitation. Objective Effectiveness depends on adherence, so did patients use the intervention to the recommended level? If not, what reasons did they give? The purpose of this study was to investigate these and related questions. Design A prospective cohort study, plus qualitative analysis of interviews, was conducted. Methods Seventeen patients recovering from stroke recruited to the intervention arm of a feasibility trial had the equipment left in their homes for 8 weeks and were advised to use it 3 times a day for periods of no more than 20 minutes. Frequency and duration of use were automatically recorded. At the end of the intervention, participants were interviewed to determine barriers to using it in the recommended way. Results Duration of use and how many days they used the equipment are presented for the 13 participants who successfully started the intervention. These figures were highly variable and could fall far short of our recommendations. There was a weak positive correlation between duration and baseline reported activities of daily living. Participants reported lack of familiarity with technology and competing commitments as barriers to use, although they appreciated the flexibility of the intervention and found it motivating. Limitations The small sample size limits the conclusions that can be drawn. Conclusions Level of use is variable and can fall far short of recommendations. Competing commitments were a barrier to use of the equipment, but participants reported that the intervention was flexible and motivating. It will not suit everyone, but some participants recorded high levels of use. Implications for practice are discussed.

An interface to virtual environments for people who are blind using Wii technology ‐ mental models and navigation

Accessible games, both for serious and for entertainment purposes, would allow inclusion and participation for those with disabilities. Research into the development of accessible games, and accessible virtual environments, is discussed. Research into accessible Virtual Environments has demonstrated great potential for allowing people who are blind to explore new spaces, reduce their reliance on guides and aid development of more efficient spatial maps and strategies. Importantly, Lahav and Mioduser (2005, 2008) have demonstrated that, when exploring virtual spaces, people who are blind use more and different strategies than when exploring real physical spaces, and develop relatively accurate spatial representations of them. The present paper describes the design, development and evaluation of a system in which a virtual environment may be explored by people who are blind using Nintendo Wii devices, with auditory and haptic feedback. The nature of the various types of feedback is considered, with the aim of creating an intuitive and usable system. Using Wii technology has many advantages: it is mainstream, readily available and cheap. The potential of the system for exploration and navigation is demonstrated. Results strongly support the possibilities of the system for facilitating and supporting the construction of cognitive maps and spatial strategies. Intelligent support is discussed. Systems such as the present one will facilitate the development of accessible games, and thus enable Universal Design and accessible interactive technology to become more accepted and widespread.

A study to evaluate a low cost virtual reality system for home based rehabilitation of the upper limb following stroke

Abstract Stroke survivors with continuing impairment in their upper limb find it difficult to access the early intensive, task specific practice that research has shown is necessary for motor recovery. A systematic review of studies that investigate the effects of robot-assisted therapy on motor and functional recovery in patients with stroke, found significant improvement in upper limb motor function, but the systems reviewed are expensive, require technical support, and are hospital or laboratory based. This paper describes the development of a low cost home based system together with a suite of games which would allow patients to practice the movements required for activities of daily living at the frequency required. The ongoing feasibility study is described.

Design guidelines for interactive multimedia learning environments to promote social inclusion

PURPOSE There is a continuing need for guidelines to aid in the design of Interactive Multimedia Learning Environments (IMLE) to promote effective learning. The project introduced in this paper looks at an important subset of this problem, the design of interactive learning environments to promote social inclusion. METHOD A consortium of six partners contributed toward defining learning material to develop a range of work based skills, including horticulture, IT and catering. These were then developed into IMLE prototypes. Formative evaluation of these prototypes then revealed a range of usability problems, which were grouped into generic types and frequency of occurrence. RESULTS The most important and frequently occurring problems were used to distil a set of design guidelines for the development of effective IMLE. The results from this usability content analysis were also used to refine the initial prototypes to improve their usability and effectiveness. CONCLUSIONS These guidelines, termed the Greenhat Design Guidelines, can be adopted for use by all multimedia developers aiming to promote the social inclusion of vulnerable or socially disadvantaged groups of people. The refined IMLE can be accessed via the Greenhat Server to improve the employment-related skills of socially excluded people.

Systematic evaluation of current control devices used by people with intellectual disabilities in non-immersive virtual environments.

Virtual environments have a role to play in facilitating the acquisition of living skills in people with intellectual disabilities, improving their cognitive skills and providing them with entertainment. However, the currently recommended devices to allow navigation in and interaction with the environments are difficult to use. Using a methodology established in an earlier study, the study aims to systematically document the performance of users with the currently recommended devices in order to (i) inform the design of a usable control device or devices and (ii) act as a baseline against which they can be evaluated. 40 people with severe intellectual disabilities aged 21-67 years used four environments with an equal number of sessions with the different devices being evaluated. Results indicate that when forward movement is provided by the software using the mouse for both navigation and interaction allows better performance both initially and after exposure than using the fire button on the joystick. When the user had to initiate forward movement with the navigation device, the joystick allowed better performance than the arrows on the keyboard. Preventing slippage of the joystick base would make its use much easier and it is suggested that separate devices are retained for navigation and interaction.

A low cost virtual reality system for home based rehabilitation of the arm following stroke: a randomised controlled feasibility trial

Objective: To assess the feasibility of conducting a randomised controlled trial of a home-based virtual reality system for rehabilitation of the arm following stroke. Design: Two group feasibility randomised controlled trial of intervention versus usual care. Setting: Patients’ homes. Participants: Patients aged 18 or over, with residual arm dysfunction following stroke and no longer receiving any other intensive rehabilitation. Interventions: Eight weeks’ use of a low cost home-based virtual reality system employing infra-red capture to translate the position of the hand into game play or usual care. Main measures: The primary objective was to collect information on the feasibility of a trial, including recruitment, collection of outcome measures and staff support required. Patients were assessed at three time points using the Wolf Motor Function Test, Nine-Hole Peg Test, Motor Activity Log and Nottingham Extended Activities of Daily Living. Results: Over 15 months only 47 people were referred to the team. Twenty seven were randomised and 18 (67%) of those completed final outcome measures. Sample size calculation based on data from the Wolf Motor Function Test indicated a requirement for 38 per group. There was a significantly greater change from baseline in the intervention group on midpoint Wolf Grip strength and two subscales of the final Motor Activity Log. Training in the use of the equipment took a median of 230 minutes per patient. Conclusions: To achieve the required sample size, a definitive home-based trial would require additional strategies to boost recruitment rates and adequate resources for patient support.

Control of Virtual Environments for People with Intellectual Disabilities

Computer-based learning has enjoyed an increasing role in mainstream education with the development of more powerful personal computers available at a lower price. Computer delivered instruction has also started to make a contribution to the education of children with intellectual disabilities (e.g. Dube, Moniz and Gomes, 1995). It enables pupils to take charge of their own learning (Hawkridge and Vincent, 1992). Interactive software encourages active involvement in learning and gives the user the experience of control over the learning process (Pantelidis, 1993) and the learner can work at their own pace, attempting the same task over and over again, making as many mistakes as they like (Salem-Darrow, 1996).

The Use of Motion Tracking Technologies in Serious Games to Enhance Rehabilitation in Stroke Patients

Stroke is the main cause of long term disability worldwide. Of those surviving, more than half will fail to regain functional usage of their impaired upper limb. Typically stroke upper limb rehabilitation exercises consist of repeated movements, which when tracked can form the basis of inputs to games. This paper discusses two systems utilizing WiiTM technology, and thermal and visual tracking respectively to capture motions. The captured motions are used as inputs to specially designed games, which encourage the users to perform repeated rehabilitation movements. This paper discusses the implementation of the two systems, the developed games, and their relative advantages and disadvantages. It also describes the upcoming testing phase of the project. more than half will fail to regain functional usage of their impaired upper limb (Feys et al., 1998). UK National Clinical Guidelines recommend participation focused rehabilitation substituting medical rehabilitation services with suitable social and leisure activities (Royal College of Physicians, 2004). DOI: 10.4018/ijgbl.2011100106 International Journal of Game-Based Learning, 1(4), 60-73, October-December 2011 61 Copyright

Our people has got to come to terms with that: changing perceptions of the digital rectal examination as a barrier to prostate cancer diagnosis in African-Caribbean men

African‐Caribbean men in the United Kingdom in comparison with other ethnicities have the highest incidence rate of prostate cancer. Psychosocial aspects related to screening and presentation impact on mens behavior, with previous studies indicating a range of barriers. This study explores one such barrier, the digital rectal examination (DRE), due to its prominence within UK African‐Caribbean mens accounts.