Cognitive Rehabilitation Using Virtual Reality Life Simulation Games

Cognitive Rehabilitation Using Virtual Reality Life Simulation Games

United States
Project Summary
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Concise Summary: Help us pitch this solution! Provide an explanation within 3-4 short sentences.

We are using life simulation games to assist people with cognitive disabilities in developing self-awareness, problem solving, and social awareness.

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Plot your innovation within the mosaic of solutions
Which of these barriers is the primary focus of your work?

Insufficient Evidence that Games Improve Health

Which of the principles is the primary focus of your work?

Cognitive Fitness

If you believe some other barrier or principle should be included in the mosaic, please describe it and how it would affect the positioning of your initiative in the mosaic:

This field has not been completed

What is your signature innovation in one sentence?

We are using life simulation games to assist people with cognitive disabilities in developing self-awareness, problem solving, and social awareness.

Describe your innovation. What makes your idea unique and different than others doing work in the field?

We are working with off-the-shelf games such as The Sims to explore cognitive skills with people who have cognitive disabilities. By simulating real life, The Sims provides a consistent environment which can allow someone to explore real-world situations. We build upon work using The Sims with school-age children with cognitive impairments (de Craene) and low-income youth (Tsikalas). We work primarily with adults transitioning from secondary education into vocational training programs.

What barriers exist that are creating the problem your innovation is hoping to address/change?

People with cognitive impairments often lack insight into the effect of their disabilities, blaming external factors or laziness. This reduces their motivation to address functional difficulties. Also, people with cognitive impairments often live sheltered lives with limited exposure to demands which they will face in the workplace or independent living situations. We hope to provide a mirror for clients to see how their functional impairments can affect "real-life" situations.

Delivery Model: How do you implement your innovation and apply it to the challenge/problem you are addressing.

As part of a Cognitive Skills Enhancement Program, we have clients use The Sims to create a character which is like them, and then explore tasks such as having the character succeed on the job, balance a budget, and make social connections. Goal include improved self-awareness through seeing how their self-identified traits influence the character's behavior, improved planning and problem solving to meet the character's needs, and improved social awareness. We are identifying common activities for all clients to attempt, as well as ways to customize the experience to individual clients' needs and goals.
While we have anecdotally observed clients associating their characters' problems with the client's real-world cognitive issues, continuing and scaling the program will require evidence of real-life clinical benefits. This grant would allow us to dedicate effort to obtaining pilot evidence through a controlled study.

How do you plan to scale your innovation?

We are beginning to disseminate our experiences with The Sims. As we gather evidence (anecdotal or formal) of clinical efficacy, we hope to encourage other programs serving children or adults with disabilities to take advantage of this tool. As our own work matures, we will draft a therapy plan/curriculum for use by other interested rehabilitation counselors or special educators.
In addition, we plan to augment our work with The Sims in our center with on-line content in an online community such as Second Life or The Sims Online. This will provide a means for our staff to work with clients remotely, and potentially the means for people at remote sites to independently take advantage of content created for our clients.
In the meantime, once we are able to collect pilot data of clinical efficacy we will leverage this to support grant applications to NIH or the Department of Education for further clinical studies

Provide one sentence describing your impact.

The Sims has been used with 45 clients to date, with informal observations that indicate improved self-awareness, planning, and social awareness.

What impact has your innovation had to date? Exactly who are the beneficiaries of your innovation?

The beneficiaries to date are clients of the Cognitive Skills Enhancement Program at Hiram G. Andrews. These are young adults (18 and over, typically 19-25) with various cognitive impairments due to disabilities such as learning disabilities, autism, and traumatic brain injury.

How many people have you served directly?


How many people have you served indirectly?

Few if any; arguably, family and friends of our clients. In October we will make our first formal presentation of our work at the State of the Science of the Rehabilitation Engineering Research Center on Advancing Cognitive Technologies. Presentations such as this will hopefully inspire others to consider the use of The Sims for this application.

Please list any other measures reflective of the impact of your innovation

This field has not been completed

What are the main barriers to creating your impact?

We will need to gather evidence that experiences with The Sims are providing actual functional improvements which generalize to real life.
In addition, The Sims offers limited flexibility in terms of the types of problem solving challenges or social situations which can be simulated. One of our goals in exploring Second Life is to develop customized content as a follow-on to work with The Sims; for example, games that work on problem solving skills or role-playing social situations.

How is your initiative financed?

The Cognitive Skills Enhancement Program is funded by the Pennsylvania Office of Vocational Rehabilitation through a contract to the University of Pittsburgh.

Provide information on your finances and organization: annual budget, annual revenue, number of staff:

The Cognitive Skills Enhancement Program and Learning Technologies Program have two full-time staff, four part-time staff, and approximately four student interns at any given time. Staff are employees of the University of Pittsburgh or the Hiram G. Andrews Center.

What is the potential demand for your innovation?

Over 21 million persons in the United States have a cognitive disability. Worldwide, this population is growing with the aging of the population in developed countries and with improved medical care in developing countries.
The Sims will of course not be a good fit for everyone; it will require that someone is able to understand the goals of the game and navigate the difference between the fantasy and real worlds, while having organizational, self-awareness, or social difficulties.

What are the main barriers to financial sustainability?

In the long-term, funding of this work as a clinical service will require evidence of efficacy.

The Story
What is the origin of this innovation? Tell us your story.

Our program was seeking an engaging way to encourage clients to explore the use of the computer. The Sims was chosen as something that had the potential to be fun while also having some educational/therapeutic potential. This potential became more evident as we began exploring the game. Once our clients began playing the game, we began to observe students identifying with the characters (e.g. that the character and the player share difficulties with poor hygiene, tardiness, or shyness; or strengths, such as dedication to their job). We also observed clients using the game to explore real-life or game experiences and how they could be changed by changing the character's behavior. We were then able to work with clients to brainstorm what might be causing their characters' problems and how the client might plan to remedy their problems or work toward their characters' needs and wants.

Please provide a personal bio. Note this may be used in Changemakers marketing material

Dr. Edmund F. LoPresti is a member of the Learning Technology Program at Hiram G. Andrews , where he provides consumer services related to assistive technologies for education and virtual reality technologies for cognitive rehabilitation. He is also president of AT Sciences, LLC, a small business which conducts research and development on intelligent mobility aids and on task guidance software for people with cognitive impairments.

How did you hear about this contest and what is your main incentive to participate? (this is confidential)

Word of mouth.