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The Virtual Environments Laboratory at the University of Southern California (USC) has initiated a research program aimed at developing virtual reality (VR) technology applications for the study, assessment, and rehabilitation of cognitive/functional processes. This technology is seen to offer many advantages for these aims and an introductory section of this article will discuss the specific rationale for VR applications in the area of clinical neuropsychology. A discussion of attention processes will follow and issues for the development of a head-mounted display (HMD) VR system for the study, assessment, and possible rehabilitation of attention disorders will then be presented. Our efforts to target this cognitive process are supported by the widespread occurrence and relative significance of attention impairments seen in a variety of clinical conditions across the human lifespan. Most notably, attention difficulties are seen in persons with Attention Deficit Hyperactivity Disorders (ADHD), Traumatic Brain Injury (TBI), and as a feature of various neurodegenerative disorders (i.e., Alzheimer's Disease, Vascular Dementia, etc.). Virtual Environment (VE) technology appears to provide specific assets for addressing these impairments that are not available using existing methods. VEs delivered via HMDs are well suited for these types of applications as they serve to provide a controlled stimulus environment where cognitive challenges can be presented along with the precise delivery and control of “distracting” auditory and visual stimuli. This level of experimental control allows for the development of attention assessment tasks that are more similar to what is found in the real world and could improve on the ecological validity of measurement and treatment in this area. A recent project in our lab has involved the development of a virtual "classroom" specifically aimed at the assessment of Attention Deficit Hyperactivity Disorder (ADHD). The system uses a Virtual Research V8 HMD, Ascension Systems head, hand, and leg tracking, and is run on an SGI Onyx platform. The scenario consists of a standard rectangular classroom environment containing student desks, a teacher's desk, a virtual teacher, a blackboard, a large window looking out onto a playground with buildings, vehicles, and people, and a pair of doorways on each end of the wall opposite the window through which activity occurs. Within this scenario, normal and ADHD-diagnosed children will be assessed for reaction time performance on immersive visual and 3D audio attention tasks. At the same time, a series of typical classroom distracters are systematically manipulated within the VE (i.e., ambient classroom noise, paper airplane flying around the room, human avatars walking into the room, activity occurring outside the window). Head turning and general motor movement are also recorded to assess hyperactive behavior components that are often seen with this disorder. The article will then present a review of ADHD issues, provide specifics regarding the methodology for our current pilot work targeting ADHD and non-diagnosed groups, and discuss our future plans for this application. It is believed that this project targets a cognitive variable that is well matched to the current strengths and limitations that exist with presently available virtual reality technology.
Rizzo et al. (Thu,) studied this question.