SoundModVR: Sound Modifications in Virtual Reality to Support People who are Deaf and Hard of Hearing

Different studies have shown that deaf and hard of hearing (DHH) students face many difficulties in learning applied disciplines in science, engineering, technology, and mathematics. The development of videos or avatars to aid in the teaching of programming for positively affects DHH students. The use of sign language increases the understanding of DHH, therefore, it will be utilized in the proposed virtual and Augmented reality environment which will hopefully improve students’ performance in learning about computer programming as well as enhance their engagement and facilitate the accessibility of learning for learners suffering from deafness in Saudi Arabia. This thesis aims to help deaf and hearing-impaired students in Saudi Arabia to tackle applied subjects like computer programming and equip them for careers in the technological field. Computer programming is an integral component in this field that can greatly assist in developing technological solutions. The study reveals important considerations in the creation of a virtual learning environment for DHH students to learn computer programming and showed that DHH students performed well, understood the topics, and could write a small program. The research methodology shows how to create an avatar for teaching computer programming using Arabic sign language. This gives DHH students opportunities to join the scientific world as they were previously unable to do so. Three expert signers evaluated the proposed Arabic Sign Language (ArSL) dictionary with 450 technological terms and added 114 new signs to the signer dictionary. Therefore, to make an overall evaluation, Augmented Reality (AR) as a knowledge technology will be applied through the 6 unit of the proposed “Java programming” course. Accordingly, 6 designed flashcards will be used, one flashcard for each course unit to retrieve summarized knowledge discovery of this unit. Also, many tools will be used to support augmented reality such as Vuforia and Unity library.

IntroductionNew digital technologies hold promise for equalising access to information and communication for the Deaf community. SMS technology, for example, has helped to equalise deaf peoples’ access to information and made it easier to communicate with both deaf and hearing people (Tane Akamatsu et al.; Power and Power; Power, Power, and Horstmanshof; Valentine and Skelton, "Changing", "Umbilical"; Harper). A wealth of anecdotal evidence and some recent academic work suggests that new media technology is also reshaping deaf peoples’ sense of local and global community (Breivik "Deaf"; Breivik, Deaf; Brueggeman). One focus of research on new media technologies has been on technologies used for point to point communication, including communication (and interpretation) via video (Tane Akamatsu et al.; Power and Power; Power, Power, and Horstmanshof). Another has been the use of multimedia technologies in formal educational setting for pedagogical purposes, particularly English language literacy (e.g. Marshall Gentry et al.; Tane Akamatsu et al.; Vogel et al.). An emphasis on the role of multimedia in deaf education is understandable, considering the on-going highly politicised contest over whether to educate young deaf people in a bilingual environment using a signed language (Swanwick & Gregory). However, the increasing significance of social and participatory media in the leisure time of Westerners suggests that such uses of Web 2.0 are also worth exploring. There have begun to be some academic accounts of the enthusiastic adoption of vlogging by sign language users (e.g. Leigh; Cavander and Ladner) and this paper seeks to add to this important work. Web 2.0 has been defined by its ability to, in Denise Woods’ word, “harness collective intelligence” (19.2) by providing opportunities for users to make, adapt, “mash up” and share text, photos and video. As well as its well-documented participatory possibilities (Bruns), its re-emphasis on visual (as opposed to textual) communication is of particular interest for Deaf communities. It has been suggested that deaf people are a ‘visual variety of the human race’ (Bahan), and the visually rich presents new opportunities for visually rich forms of communication, most importantly via signed languages. The central importance of signed languages for Deaf identity suggests that the visual aspects of interactive multimedia might offer possibilities of maintenance, enhancement and shifts in those identities (Hyde, Power and Lloyd). At the same time, the visual aspects of the Web 2.0 are often audio-visual, such that the increasingly rich resources of the net offer potential barriers as well as routes to inclusion and community (see Woods; Ellis; Cavander and Ladner). In particular, lack of captioning or use of Auslan in video resources emerges as a key limit to the accessibility of the visual Web to deaf users (Cahill and Hollier). In this paper we ask to what extent contemporary digital media might create moments of permeability in what Krentz has called “the hearing line, that invisible boundary separating deaf and hearing people”( 2)”. To provide tentative answers to these questions, this paper will explore the use of participatory digital media by a group of young Deaf people taking part in a small-scale digital moviemaking project in Sydney in 2009. The ProjectAs a starting point, the interdisciplinary research team conducted a video-making course for young deaf sign language users within the Department of Media, Music and Cultural Studies at Macquarie University. The research team was comprised of one deaf and four hearing researchers, with expertise in media and cultural studies, information technology, sign language linguistics/ deaf studies, and signed language interpreting. The course was advertised through the newsletter of partner organization the NSW Deaf Society, via a Sydney bilingual deaf school and through the dense electronic networks of Australian deaf people. The course attracted fourteen participants from NSW, Western Australia and Queensland ranging in age from 10 to 18. Twelve of the participants were male, and two female. While there was no aspiration to gather a representative group of young people, it is worth noting there was some diversity within the group: for example, one participant was a wheelchair user while another had in recent years moved to Sydney from Africa and had learned Auslan relatively recently. Students were taught a variety of storytelling techniques and video-making skills, and set loose in groups to devise, shoot and edit a number of short films. The results were shared amongst the class, posted on a private YouTube channel and made into a DVD which was distributed to participants.The classes were largely taught in Auslan by a deaf teacher, although two sessions were taught by (non-deaf) members of Macquarie faculty, including an AFI award winning director. Those sessions were interpreted into Auslan by a sign language interpreter. Participants were then allowed free creative time to shoot video in locations of their choice on campus, or to edit their footage in the computer lab. Formal teaching sessions lasted half of each day – in the afternoons, participants were free to use the facilities or participate in a range of structured activities. Participants were also interviewed in groups, and individually, and their participation in the project was observed by researchers. Our research interest was in what deaf young people would choose to do with Web 2.0 technologies, and most particularly the visually rich elements of participatory and social media, in a relatively unstructured environment. Importantly, our focus was not on evaluating the effectiveness of multimedia for teaching deaf young people, or the level of literacy deployed by deaf young people in using the applications. Rather we were interested to discover the kinds of stories participants chose to tell, the ways they used Web 2.0 applications and the modalities of communication they chose to use. Given that Auslan was the language of instruction of the course, would participants draw on the tradition of deaf jokes and storytelling and narrate stories to camera in Auslan? Would they use the format of the “mash-up”, drawing on found footage or photographs? Would they make more filmic movies using Auslan dialogue? How would they use captions and text in their movies: as subtitles for Auslan dialogue? As an alternative to signing? Or not at all? Our observations from the project point to the great significance of the visual dimensions of Web 2.0 for the deaf young people who participated in the project. Initially, this was evident in the kind of movies students chose to make. Only one group – three young people in their late teens which included both of the young women in the class - chose to make a dialogue heavy movie, a spoof of Charlie’s Angels, entitled Deaf Angels. This movie included long scenes of the Angels using Auslan to chat together, receiving instruction from “Charlie” in sign language via videophone and recruiting “extras”, again using Auslan, to sign a petition for Auslan to be made an official Australian language. In follow up interviews, one of the students involved in making this film commented “my clip is about making a political statement, while the other [students in the class] made theirs just for fun”. The next group of (three) films, all with the involvement of the youngest class member, included signed storytelling of a sort readily recognisable from signed videos on-line: direct address to camera, with the teller narrating but also taking on the roles of characters and presenting their dialogue directly via the sign language convention of “role shift” - also referred to as constructed action and constructed dialogue (Metzger). One of these movies was an interesting hybrid. The first half of the four minute film had two young actors staging a hold-up at a vending machine, with a subsequent chase and fight scene. Like most of the films made by participants in the class, it included only one line of signed dialogue, with the rest of the narrative told visually through action. However, at the end of the action sequence, with the victim safely dead, the narrative was then retold by one of the performers within a signed story, using conventions typically observed in signed storytelling - such as role shift, characterisation and spatial mapping (Mather & Winston; Rayman; Wilson).The remaining films similarly drew on action and horror genres with copious use of chase and fight scenes and melodramatic and sometimes quite beautiful climactic death tableaux. The movies included a story about revenging the death of a brother; a story about escaping from jail; a short story about a hippo eating a vet; a similar short comprised of stills showing a sequence of executions in the computer lab; and a ghost story. Notably, most of these movies contained very little dialogue – with only one or two lines of signed dialogue in each four to five minute video (with the exception of the gun handshape used in context to represent the object liberally throughout most films). The kinds of movies made by this limited group of people on this one occasion are suggestive. While participants drew on a number of genres and communication strategies in their film making, the researchers were surprised at how few of the movies drew on traditions of signed storytelling or jokes– particularly since the course was targeted at deaf sign language users and promoted as presented in Auslan. Consequently, our group of students were largely drawn from the small number of deaf schools in which Auslan is the main language of instruction – an exceptional circumstance in an Australian setting in which most deaf young people attend mainstream schools (Byrnes et al.; Power and Hyde). Looking across the Hearing LineWe can make sense of the creative cho

Virtual reality (VR) as an intervention has appeared in the literature and in clinical settings across many different populations. To expand the use of this care option, it is worth considering the ways in which a VR application may benefit individuals with life-limiting illness in hospice and palliative care settings. The incorporation of VR as a therapy option may aid in symptom management and support people nearing the end of life in focusing on aspects of their overall well-being. The goals of this study were to: 1) explore virtual reality as an intervention to improve symptom severity in hospice-eligible patients, 2) correlate self-reported presence scores to changes in symptom severity and 3) find evidence for feasibility of this type of intervention with a hospice eligible population. Participants partook in targeted, individualized VR experiences unique and personal to each participant; allowing them to revisit personally significant places where they experienced positive, meaningful memories during youth and adulthood. Due to difficulties in recruitment, a sample for sufficient statistical analysis was not achieved. However, the study yielded two takeaways: 1) evidence for feasibility and acceptability of this type of longitudinal intervention for hospice and palliative populations, 2) and VR sessions to meaningful places suggested potential symptom improvement and increased presence in VR with repeated sessions. Future research efforts should aim to expand on the use of VR in hospice-eligible populations.

Dementia-friendly communities promote community coherence and reduce the risk of ageism in the community. This study examined the effects of a Virtual Reality (VR) educational program on participants' attitudes towards dementia and their sense of community related to supporting community-dwelling older adults. We delivered an educational program using a virtual reality platform that provided a first-person perspective of people with dementia in the courtyards of two convenience stores in the Tokyo Metropolitan Area, Japan. We investigated attitudes towards dementia and participants' sense of community before and after the educational program. There were 42 study participants (average age=48years). The total scores of attitudes towards dementia and sense of community changed positively from pre- to postintervention (P=.004 and <.001, respectively). This educational program for understanding dementia could enhance people's support of community members living with dementia.

AimsEating disorders (ED) have significant physical and psychosocial impacts, and the highest mortality rates of any psychiatric illness. About a third of patients with Anorexia Nervosa or Bulimia Nervosa do not recover and develop persistent ED. Development of novel treatments is a priority to prevent adverse effects on young people's physical, relational and educational development. Virtual reality (VR) has shown promising efficacy as an innovative mental health treatment, and has potential therapeutic value within ED. People with lived experience (PWLE) and clinicians have demonstrated enthusiasm for a VR café intervention to practice social and food-related challenges. A VR café would enable gradual exposure to challenges in a protected environment, aiming to support people with ED to return to real-life cafés and social eating. This study aims to explore the opinions of key stakeholders to help inform the development of a VR café scenario as an adjunctive treatment for ED.MethodsWe conducted semi-structured focus groups and 1:1 interviews with PWLE aged 14–25 years (n = 15), parents/carers (n = 4), and clinicians (n = 6). Participants were recruited via social media, advertisement via ED charities, posters in public places, and snowballing. Following completion of an online screening survey, eligible individuals were invited to participate using purposive sampling to ensure diversity of ages, ethnicities, genders, ED diagnoses, and health professional roles. Data were analysed thematically.ResultsPreliminary analysis indicates that PWLE, parents/carers and clinicians expressed mostly positive opinions regarding a VR café adjunctive treatment. Expressed concerns related to themes of intervention efficacy, translation of learnt skills to real life, and use of VR technology. Most participants agreed a VR café intervention should be a repeated experience (many suggested graded exposure), realistic, and maximally individualised. All stakeholder groups identified a similar range of challenges to experience within a VR café, with themes including choosing food, other people, eating socially or alone, and the café environment. Differences in specific aspects of the scenario that might make challenges harder or easier reflected the unique experiences of individual participants.ConclusionThese findings build upon previous research demonstrating support from PWLE, parents/carers, and clinicians for the development of a VR café adjunctive treatment for ED. Themes identified are largely consistent across stakeholder groups and relate to the design of a VR café scenario and its implementation as a treatment. This analysis enables the perspectives of key stakeholders to be incorporated into the design of a novel VR café intervention to optimise efficacy and acceptability.

Down's syndrome (also known as trisomy 21) is a genetic disorder caused by the presence of a third copy of chromosome 21 in a baby's cell. With education and proper care the quality of life of these people can be improved, and with the right support people with Down's syndrome can have an active role in the community. In this paper we examine how a virtual reality serious game, the EnCity game, could engage and encourage young people with Down's syndrome to have a more active involvement in the community. Players should complete mini games related to everyday tasks (e.g. preparing a meal, shopping in the supermarket, paying a bill, buying a ticket to visit a museum or gallery), and through these mini-games players will gain the appropriate training and encouragement for leading their lives without requiring help from their families or social services.

This chapter provides a brief review of how virtual reality technologies (VRTs) have been used within research-contexts to support people on the autism spectrum. One area of innovation and research that has evolved since the mid-1990s to aid people with an ASD is that of the use of virtual reality technology (VRT). Research has focused on helping develop personal, social, functional, and pre- vocational/vocational skills. This chapter will provide a review of literature in this field in addition to distilling the key affordances, issues and challenges identified in this evolving area of research. This review will focus on the potentially useful application of VRTs to train and support people with an ASD in developing life-skills (i.e., social skills, job skills, independent living skills) and where there has been successful implementation in applied contexts. The chapter will then describe a project the authors undertook, that sought to ask questions surrounding the role of head-mounted displays and the impact these might have for this population. As more affordable and accessible wearable devices (e.g., Oculus Rift™) are commercially available, we suggest that questions surrounding the acceptability and practicality quickly need to be addressed if we are to develop a sustainable line of inquiry surrounding HMDs and VRTs for this specific population. Therefore this chapter will report, in a rich, descriptive and illustrative manner, the process we engaged to work with a range of participants with ASD (here range refers to low-high functioning ASD with a wide range of IQ) to assess and measure the acceptability of, and experiences within, HMD VRTs (immersion, presence, ecological validity, and any negative effects). We will discuss, in some detail, the ethical approaches the research team took in using HMDs with this population (as this is sometimes a neglected aspect of this type of research), and suggest some guidance for future scholars/practitioners working in this field. Finally, based on our preliminary study, this chapter will conclude with how we think HMDs and VRTs might be used in the future to help enable ASD populations address some of the challenges faced on a daily basis. Here we are primarily concerned with the challenges, but also the contexts in which this technology can be applied, with specific focus on moving research from labs to real-life (and potentially beneficial) contexts.

Background Individuals with neurodevelopmental disorders (NDDs) face challenges in employment. Emerging technologies such as augmented reality (AR), virtual reality (VR), and mixed reality (MR) offer innovative, immersive training environments, enhancing skills, and media literacy while providing cost-effective, engaging solutions. Objective The review investigates how AR, MR, and VR technologies can support individuals with NDDs in workplace and training. Methods A systematic review of studies across 6 databases was conducted. Selection criteria focused on studies published after 2016, involving immersive AR/MR/VR technologies, targeting NDDs in workplace contexts. Data extraction utilized qualitative content analysis. Results The analysis of 10 studies showed that AR and VR improved work performance and motivation in most cases, with features like assistive prompts and simplified interfaces aiding usability. No studies involving MR were identified. Key barriers included sensory overload and difficulties interacting with AR-/VR-elements, but these were not universal. AR was noted for workplace integration, and VR was linked to fewer reported complications compared to AR. A lack of standardized research frameworks and focus on mainstream labour markets was identified. Conclusions AR and VR are promising tools for vocational training but require better accessibility, adaptability, and inclusion in broader labour market contexts to maximize their impact.

Background/Objective: Post-intensive care syndrome (PICS) is a multifactorial, multidimensional condition common among patients who survive critical illness with protracted intensive care unit (ICU) length of stay. Survivors often present physical, cognitive, and psychological impairments that can arise during ICU hospitalization. Virtual reality has emerged as a promising tool in the healthcare field, as it offers innovative solutions to the challenges faced by critically ill survivors. We think that VR might help support people recovering from PICS at home, and this study aims to explore the benefits across the spectrum of PICS to describe the technological characteristics that could support and augment these interventions and present clinical recommendations. Methods: This systematic review searched PubMed, the Cochrane library, Science Direct, and Scopus databases up to July 2025. In this study we included randomized controlled trials (RCTs) examining the impact of VR on PICS. The methodological quality was assessed with the PEDro scale for RCTs and with NOC for non-RCTs. Results: A total of five studies met the inclusion criteria and were included. Three were RCTs, one non-RCT, and one series of cases. The studies presented good methodological quality. Virtual reality was found to be safe for critically ill survivors. All aspects of PICS were examined, with positive results in recovery of psychological disorders, such as anxiety and PTSD, and muscle strength as assessed by hand grip and cognition. The main limitation could be the limited number of RCT studies due to the novelty of the intervention. Conclusions: Virtual reality technology could be safely implemented in the field of post-ICU recovery and effectively assist the rehabilitation of physical, cognitive, and mental disorders of ICU patients. The protocol was registered in the Open Science Framework registry.

The number of people worldwide that suffer with Dementia is estimated at 46 million people and is set to increase to 131.5 million by 2050 at a combined cost estimated at $818bn. Caring for our elderly population living with dementia raises issues over resources in terms of financial aid and time. This paper reviews from existent research projects how Virtual Reality (VR), and Augmented Reality (AR), have been used as cognitive aids to the person living with Dementia (PwD), specifically in the early stages of the condition. The purpose of these interventions being to provide PwD with strategies to maintain their independent living. Within VR and AR, gamification approaches have also been used to provide support through the delivery of calming experiences, use as memory aids, and also cognitive stimulation. VR has also been used as a learning tool enabling carers to gain a better understanding to the challenges PwD face every day. The end of this paper identifies a number of design challenges that exist going forward and includes possible future directions that may be taken.

Neurodevelopmental disorders represent a cluster of conditions first diagnosed during childhood or adolescence (i.e., including intellectual disability, autism spectrum disorders, motor deficits, and communication deficits). The main characteristic of neurodevelopmental disorders is the presence of a deficit or a delay in the acquisition of skills that may affect different areas of evolution (e.g., cognitive, affective, and motor). These clinical conditions make the child or adolescent passive, isolated, and unable to carry out daily activities. Additionally, challenging behaviors and emotional disruption may be acknowledged. Accordingly, negative outcomes on personal well-being may be recognized. To enhance the well-being of those persons, assistive technology-based interventions (AT) may be useful. Among the new assistive technology are virtual reality, telemedicine, telerehabilitation, serious games, computer-brain interface, and other new technologies aimed at specific rehabilitation objectives. This document aims to give the reader a framework of reference to the literature on the most recent contributions available on the technology-based programs used to improve the well-being of individuals with neurodevelopmental disorders such as: serious games, virtual reality, wearable technologies, and telerehabilitation. The results were argued and several options were outlined. The studies reviewed on the eight classes of new technologies showed the accessibility, effectiveness, and suitability of the implemented technologies to enable adaptive skills for participants with NDD. Some helpful solutions for both future research and practice have been evidenced.

As we all know there is no treatment that can stop or delay the progression of dementia. The treatment we use is only symptomatic. EFNS (European Federation of Neurological Societies) recommendations for dementia prevention by Sorbi et al. (2012) concluded that there is no treatment, no lifestyle, which could have an effect on prevention or delay of onset of different forms of dementia until today. The future studies in prevention must recruit younger people, larger sample, and for longer period. The last 10years we have run, in collaboration with organizations in different European countries, many projects in order to support patients with neurodegenerative diseases, mainly patients with dementia and their caregivers. The first project was a 2-year prospective cohort study of antidementia drug non-persistency in mild-to-moderate Alzheimer's disease (AD) in Europe: predictors of discontinuation and switch in the ICTUS (Impact of Cholinergic Treatment USe) study, an FP5 project with 1380 patients. Five studies were published. The second project was DESCRIPA study, an FP5 project to DEvelopment of Screening guidelines and clinical CRIteria for Predementia Alzheimer's disease, with 881 patients with mild cognitive impairment (MCI). LLM (Long Lasting Memories) and VRADA (A virtual reality application for the exercise of dementia and Alzheimer patients) are two projects that include body and cognitive exercise for health for the elderly and patients with mild cognitive impairment. The next is the RECAGE (REspectful Caring for the AGitated Elderly) project (Horizon 2020), a prospective cohort study for coping with behavioral and psychological symptoms of dementia. With six European universities we finished a very interesting FP6 project, the AddNeuroMed one, which gives even now information about the progression of normal elderly MCI and AD patients, in collaboration with other consortia. A very interesting Innovative Medicines Initiative (IMI) project about digital biomarkers was entitled Remote Assessment of Disease and Relapse-Alzheimer's Disease (RADAR project). The main goal of this project was the development and validation of technology-enabled, quantitative and sensitive measures of functional decline in people with early-stage AD. A running project is an Erasmus+ one in the higher education field, "Genetic counseling in European universities: The case of neurodegenerative diseases" (GECONEU project). The target of this study is to develop an online course for university students focusing on genetic counseling, and support people and society to better understand the aims of genetic testing and the usefulness of genetic counseling by involving students in an innovative learning and teaching setting. AD-gaming, BRIDGE, iCONNECT (Intergenerational CONtact between studeNts and people with dEmentia through CreaTive education), E.L.So.M.C.I (English Lessons with the Use of Songs for People with Mild Cognitive Impairment), Games4CoSkills, and De-Sign are all Erasmus+ projects that aim to improve the quality of life of patients with MCI or dementia. Story2remember, Dementia right, ASPAD (Augmentation of the Support of Patients suffering from Alzheimer's Disease and their caregivers), INFOCARE (Supporting Informal Caregivers of People with Dementia), S.IN.CA.L.A (Supporting Informal Carers: A Whole-Family and Life course Approach), and PIA (Peer support workers as an Innovative force in Advocacy in dementia care) are all Erasmus+ projects for training and supporting caregivers of patients with dementia.

BackgroundThe postnatal period is associated with many new needs for mothers.ObjectiveThe aim of this study was to find technological solutions that meet the needs of mothers during the year following childbirth.MethodsTwo co-creation workshops were undertaken with parents and professionals. The aim of the first workshop was to create a list of all the criteria the proposed solution would have to address to meet the needs of mothers after childbirth. The aim of the second workshop was to create solutions in response to the criteria selected during the first workshop.ResultsParents and health professionals want solutions that include empathy (ie, to help fight against the feelings of abnormality and loneliness), that help mothers in daily life, that are personalized and adapted to different situations, that are educational, and that assures some continuity in their contact with health professionals. In practice, we found that parents and professionals think the solution should be accessible to everyone and available at all times. To address these criteria, technology experts proposed different solutions, such as a forum dedicated to the postpartum period that is supervised by professionals, a centralized website, a system of videoconferencing, an online exchange group, a “gift voucher” system, a virtual reality app, or a companion robot.ConclusionsThe human component seems to be very important during the postnatal period. Nevertheless, technology could be a great ally in helping mothers during the postpartum period. Technology can help reliably inform parents and may also give them the right tools to find supportive people. However, these technologies should be tested in clinical trials.

Most of the spatial information needed by sighted people to construct cognitive maps of spaces is gathered through the visual channel. Unfortunately, people who are blind lack the ability to collect the required spatial information in advance. The use of virtual reality as a learning and rehabilitation tool for people with disabilities has been on the rise in recent years. This research is based on the hypothesis that the advance supply of appropriate spatial information (perceptual and conceptual) through compensatory sensorial channels within a virtual environment may assist people who are blind in their anticipatory exploration and cognitive mapping of the unknown space. In this long-term research we developed and tested the BlindAid system that combines 3D audio with a Phantom® haptic interface to allow the user to explore a virtual map through a hand held stylus. The main goals of this research were to study the cognitive mapping process of people who are blind when exploring complex virtual maps and how they apply this spatial knowledge later in real space. The findings supply strong evidence that interaction with the BlindAid system by people who are blind provides a robust foundation for the participants' development of comprehensive cognitive maps of unknown real spaces.