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A Virtual Reality Scenario for All Seasons: The Virtual Classroom

  • Albert A. Rizzo, Todd Bowerly, J. Galen Buckwalter, Dean Klimchuk, Roman Mitura and Thomas D. Parsons...

Treatment and rehabilitation of the cognitive, psychological, and motor sequelae of central nervous system dysfunction often relies on assessment instruments to inform diagnosis and to track changes in clinical status. Typically, these assessments employ paper-and-pencil psychometrics, hands-on analog/computer tests, and rating of behavior within the context of real-world functional environments. Virtual reality offers the option to produce and distribute identical “standard” simulation environments in which performance can be measured and rehabilitated. Within such digital scenarios, normative data can be accumulated for performance comparisons needed for assessment/diagnosis and for treatment/rehabilitation purposes. In this manner, reusable archetypic virtual environments constructed for one purpose can also be applied for applications addressing other clinical targets. This article will provide a review of such a retooling approach using a virtual classroom simulation that was originally developed as a controlled stimulus environment in which attention processes could be systematically assessed in children with attention-deficit/hyperactivity disorder. This system is now being applied to other clinical targets including the development of tests that address other cognitive functions, eye movement under distraction conditions, social anxiety disorder, and the creation of an earthquake safety training application for children with developmental and learning disabilities.

Corresponding author
Please direct all correspondence to: Albert A. Rizzo, PhD,University of Southern California Institute for Creative Technologies, 13274 Fiji Way, Marina del Rey, CA 90292; Tel: 310-301-5018, Fax: 310-574-5725; E-mail:, Web:
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1.Glantz, K, Rizzo, AA, Graap, K. Virtual reality for psychotherapy: current reality and future possibilities. Psychotherapy: Theory, Research, Practice, Training. 2003;40:5567.
2.Rizzo, AA, Schultheis, MT, Kerns, K, Mateer, C. Analysis of assets for virtual reality applications in neuropsychology. Neuropsychol Rehabil. 2004;14:207239.
3.Weiss, P, Jessel, AS. Virtual reality applications to work. Work. 1998;11:277293.
4.Pugnetti, L, Mendozzi, L, Motta, A, Cattaneo, A, Barbieri, E, Brancotti, S. Evaluation and retraining of adults' cognitive impairments: which role for virtual reality technology? Comput Biol Med. 1995;25:213227.
5.Rizzo, AA. Virtual Reality applications for the cognitive rehabilitation of persons with traumatic head injuries. In: Murphy, HJ, ed. Proceedings of the 2nd International Conference on Virtual Reality And Persons With Disabilities. Northridge, Calif: California State University, Northridge; 1994:18.
6.Rizzo, AA, Wiederhold, M, Buckwalter, JG. Basic issues in the use of virtual environments for mental health applications. In: Riva, G, Wiederhold, B, Molinari, E, eds. Virtual Reality in Clinical Psychology and Neuroscience. Amsterdam, Netherlands: IOS Press; 1998:2142.
7.Rizzo, AA, Buckwalter, JG, van der Zaag, C. Virtual environment applications for neuropsychological assessment and rehabilitation. In: Stanney, K, ed. Handbook of Virtual Environments. New York, NY: L.A. Earlbaum; 2002:10271064.
8.Rose, FD, Attree, EA, Johnson, DA. Virtual reality: an assistive technology in neurological rehabilitation. Curr Opin Neurol. 1996;9:461467.
9.Rose, FD, Brooks, BM, Rizzo, AA. Virtual reality in brain damage rehabilitation: review. Cyberpsychol Behav. 2005;8:241262.
10.Krueger, MW. The experience society. Presence Teleoper Virtual Environ. 1993;2:162168.
11.Neisser, U. Memory: what are the important questions? In: Gruneberg, MM, Morris, PE, Sykes, RN, eds. Practical Aspects of Memory. London, UK: Academic Press; 1978:324.
12.Wilson, BA. Cognitive rehabilitation: how it is and how it should be. J Int Neuropsychol Soc. 1998;3:487496.
13.Christiansen, C, Baum, C. Person-environment occupational performance: a conceptual model for practice. In: Christiansen, C, Baum, C, eds. Occupational Therapy: Enabling Function and Well-Being. 3rd ed. Thorofare, NJ: SLACK; 2004:4671.
14.Barkley, RA. Attention Deficit Hyperactivity Disorder: A Handbook for Diagnosis and Treatment. New York, NY: Guilford Press; 1990.
15.Colegrove, R, Homayounjam, H, Williams, J, Hanken, J, Horton, NL. The problem of overreliance upon behavioral checklists in the diagnosis of ADHD. Paper presented at:: The 107th Annual Conference of the American Psychological Association; August 4-8, 2001; Washington, DC.
16.Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, DC: American Psychiatric Association; 1994.
17.Greenhill, LL. Diagnosing attention-deficit/hyperactivity disorder in children. J Clin Psychiatry. 1998;59(suppl 7):3141.
18. Virtual Research Systems, Inc. Web site. V8 Head Mount Display page. Available at: December 9, 2005.
19. Ascension Technology Corporation Web site. Flock of Birds product page. Available at: Accessed December 9, 2005.
20.Hix, D, Gabbard, JL. Usability engineering of virtual environments. In: Stanney, K, ed. Handbook of Virtual Environments. New York, NY: L.A. Earlbaum; 2002:681700.
21.Brown, DJ, Standen, PJ, Proctor, T, Sterland, D. Advanced design methodologies for the production of virtual learning environments for use by people with learning disabilities. Presence Teleoper Virtual Environ. 2001;10:401415.
22.Kennedy, RS, Lane, NE, Berbaum, KS, Lilienthal, MG. Simulator sickness questionnaire: an enhanced method for quantifying simulator sickness. Int J Aviation Psychol. 1993;3:203220.
23.Rizzo, AA, Bowerly, T, Buckwalter, JG, et al.The virtual classroom: a virtual reality environment for the assessment of attention deficit hyperactivity disorder. The ADHD Report. 2001;9:913.
24.Rizzo, AA, Bowerly, T, Buckwalter, JG, et al.Virtual environments for the assessment of attention and memory processes: the virtual classroom and office. In: Sharkey, P, Lanyi, CS, Standen, P, eds. Proceedings of the 4th International Conference on Disability, Virtual Reality and Associated Technologies. Reading, UK: University of Reading; 2002:312.
25.Randall, K, Kerns, KA, Rizzo, AA, Yeh, S. The Stroop in a virtual reality: is it virtually the same? J Int Neuropsychol Soc. 2005;11(S1):9.
26.Stroop, JR. Studies of interference in serial verbal reactions. J Exp Psychol. 1935;18:643661.
27.Adams, R, Finn, P, Flannery, K, Moes, L, Matano, B, Rizzo, A. A virtual reality ADD classroom and the BASC: a preliminary investigation of convergent validity. J Int Neuropsychol Soc. 2005;11(S1):151.
28.Duchowski, A, Medin, E, Cournia, N, et al.3-D eye movement analysis. Behav Res Methods Instrum Comput. 2002;34:573591.
29.Lavine, RA, Sibert, JL, Gokturk, M, Dickens, B. Eye-tracking measures and human performance in a vigilance task. Aviat Space Environ Med. 2002;73:367372.
30.Sneed, SJ. Eye response assessment of selective attention in adolescents with attention deficits [dissertation]. Diss Abstr Int. 1999;2963:AA19930088.
31.Kamphaus, RW, Reynolds, CR. BASC Monitor for ADHD Manual and Software Guide. Circle Pines, Minn: American Guidance Service, Inc; 1998.
32.Ollendick, TH, Hirshfeld-Becker, DR. The developmental and psychopathology of social anxiety disorder. Biol Psychiatry. 2002;51:4458.
33.Hofmann, SG, Albano, AM, Heimberg, RG, Tracey, S, Chorpita, BF, Barlow, DH. Subtypes of social phobia in adolescents. Depress Anxiety. 1999;9:1518.
34.Rizzo, AA, Kim, G. A SWOT analysis of the field of Virtual Rehabilitation and Therapy. Presence Teleoper Virtual Environ. 2005;14:128.
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CNS Spectrums
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  • EISSN: 2165-6509
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