Continued use of an interactive computer game-based visual perception learning system in children with developmental delay

"Intelligent tutoring effects on induced emotions and cognitive load of learning-disabled learners"

PURPOSE

This study addresses the learning requirements of learners with learning difficulties by monitoring their learning experience in an Intelligent Tutoring System. Intelligent Tutoring Systems were developed to enrich the teaching-learning process.

MATERIALS AND METHODS

In the present work, the interface is designed and developed utilizing the potential of Artificial Intelligence to meet their individual needs. Designing an online learning platform for a learners with learning difficulties requires consideration of their learning problems and preferences. The interface was developed focusing on all the requirements of the LD learners. The objective of the present study is to monitor the learning experience in the form of induced emotions and cognitive load of the learners to determine the impact of learning.

RESULTS

83 learners were observed during various stage of learning. The results obtained through the Support Vector machine (SVM) classification technique showed the positive attitude towards intelligent tutoring. The analysis revealed that a total of 0.23% of learners were positively induced. Their learning experience was positive and effective. The cognition load on learners was minimum with single-mode instruction and least disturbed.

CONCLUSIONS

The system was improved based on preference feedback on design features. This helps in improving content design and creating device independent and responsive visual design. The fatigue effect analysis on cognitive load implied that multiple modes of instruction increased drowsiness. Single mode of instruction have a positive impact on the learning process and it reduces the cognitive load of the learners.Implications for RehabilitationThe user interface designed and developed for learners with Dyslexia, Dysgraphia and Dyscalculia has learning disabled-friendly features. These can be used to create a device-independent and responsive design.Learning experience is monitored along with the impact on cognitive load of the learners.The research helps in understanding the stimulation and response of learners with learning disability for different learning conditions.Most existing learning systems are limited to non-learning-disabled learners. The ITS developed during research presents a Universal learning design helpful for all learners with and without learning disability.

Interactive Learning System for Learning Calculus

Background

IT tools has brought a new perspective to collaborative learning where students do not just sit in a chair and swallow lecture content but instead participate in creating and sharing knowledge. However, calculus learning augmented reality application has limitation in promoting a human collaboration in learning.

Purpose

This research develops an interactive application for learning calculus that promotes human-system interaction via augmented reality (AR) and human-human interaction through chat functions. The study examines the effect of both interactivities on learning experience and how that learning experience affects the performance of learning.

Methods

The research adopted a quasi-experimental study design and pre-post test data analysis to evaluate the effect of interactivities on learning experience and consequently the effect of learning experience on learning performance. The subjects were exposed to the developed application for learning the calculus chapter "Solid of Revolution" in a controlled environment. The study validated its research framework through partial least squares path modelling and tested three hypotheses via pre-and post-test evaluation.

Conclusions

The results found that both interactivities affect learning experience positively; human-human interactivity has a higher impact than the human-system interactivity. It was also found that learning performance as part of the learning experience increased from pre-test to post-test.

Technology acceptance of the video game-based swallowing function training system among healthcare providers and dysphagia patients: A qualitative study

Objective

Dysphagia is highly prevalent worldwide, causing serious complications. Video-game based rehabilitation training can increase dysphagia patient motivation and adherence. However, the acceptance of video game systems by patients and healthcare providers is still not fully explored. This study aimed to explore the acceptance of the video game swallowing training system among potential users.

Methods

The in-depth interviews were conducted face-to-face between July and October 2023 at a rehabilitation center in China, with a sample size based on the principle of information saturation. Interviews were audio-recorded and transcribed verbatim, and the data were analyzed using theory-driven thematic analysis methods based on the technology acceptance model.

Results

A total of 19 participants participated in the interviews, which included 11 hospitalized dysphagia patients, three rehabilitation therapists, one doctor, and four nurses. Three themes and seven subthemes were identified. Sufficient training content, interesting interaction between the game and the rehabilitation training, intuitive page design, and efficient training modes were related to the usefulness of the system; user-friendly page design and simple interface could make it easier for participants to use the system. Overall, the availability of the video game system for use without geographical or time limitations led to a high level of participant intention to use the system, but it is still challenging to use it in the real world.

Conclusions

The results of the study showed that participants were generally accepted and willing to use the video game system for dysphagia rehabilitation training. The video game-based swallowing function training system can be helpful in assisting with dysphagia rehabilitation.

The effect of online visual games on visual perception, oculomotor, and balance skills of children with developmental dyslexia during the COVID-19 pandemic

PURPOSE

To evaluate the effect of online visual games on the balance, visual perception, and oculomotor skills of children with developmental dyslexia during the COVID-19 pandemic.

METHODS

In this single-blind randomized clinical trial, 50 children with developmental dyslexia, aged 7 to 11 years, were recruited from rehabilitation centers in Tehran, Iran, using a convenience sampling strategy. Participants were randomly divided into two groups: intervention (25) and control (25), with close matching based on sex, age, IQ, and type of disease. The interventions consisted of web-based online computer games focusing on visual perception and oculomotor skills. Outcome measures included the Test of Visual Perception Skills-Revised, the Pediatric Balance Scale, and videonystagmography. The Wechsler Intelligence Scale for Children-IV and the Reading and Dyslexia Test were used to evaluate IQ and reading skills, respectively.

RESULTS

The intervention group exhibited significant post-intervention improvements in the Test of Visual Perception Skills-Revised, tracking gain, saccade latency, and saccade velocity scores (all P < 0.001). In contrast, the control group showed no significant differences in these tests in pre- and post-intervention (all P > 0.05). Notably, post-intervention comparisons between the groups revealed significant differences in smooth pursuit eye movements (P < 0.001), saccade latency (P = 0.027), and saccade velocity (P < 0.001). The Pediatric Balance Scale scores remained unchanged in both groups post-intervention (intervention: P = 0.317; control: P = 0.999). Game face validity was affirmed with impact scores above 1.5 for all items, suggesting that the games were straightforward, clear, and relevant.

CONCLUSION

Online visual games enhanced oculomotor and visual perception skills in children with dyslexia but did not influence balance skills.

How does therapist guided game-based intervention program effect motor skills in children with Attention Deficit Hyperactivity Disorder?: Single blind randomised study design

BACKGROUND

Virtual reality and game-based approaches to the rehabilitation process also brought an opportunity to design more accessible intervention programs.It was seen that many studies utilized trademarked and commercially available games, which were not originally designed as rehabilitation tools but were administrated by a rehabilitation professional to achieve the maximum therapeutic value.

AIMS

Study aims to investigate the effects of a Self-oriented game based program(SGBP)and Therapist Guided Game-based Intervention Program(TGGIP) on the motor skills of children with Attention Deficit Hyperactivity Disorder(ADHD).

METHODS AND PROCEDURES

This study was designed as a single-blind, randomized, controlled trial. A total of 176 children with ADHD participated in the study and were randomly divided into two groups (TGGIP and SGBP). Intervention in both groups was done with a telerehabilitation methodology.

OUTCOMES AND RESULTS

According to the within-group comparisons of pre- and post-intervention BOT2-BF scores, there were significant increases in all sub-scores and the total score(p < 0.05). The comparison of the BOT2-BF all sub-scores and the total score changes between the groups showed significantly higher in TGGIP.

CONCLUSION AND IMPLICATIONS

TGGIP was found to be more effective compared to SGBP in improving motor skills of children with ADHD.TGGIP that we designed acts as a facilitator for therapists in using trademarked and easily accessible games for structured and supervised virtual reality and game-based rehabilitation.

Motivations for user satisfaction of mobile fitness applications: An analysis of user experience based on online review comments

Considering that mobile fitness applications are one of the necessities in our lives, the user perspective toward the application is a prominent research topic in both academia and industry with the goal of improving such services. Thus, this study applies two different natural language processing approaches, bag-of-words, and sentiment analysis, to online review comments of the applications to examine the effects of user experience elements. The review dataset collected from 16,461 users, after pre-processing, revealed the notable roles of perceived affection and hedonic values in determining user satisfaction with the application, whereas the effect of user burden on satisfaction was marginal. Several implications, as well as limitations of the study, were examined incorporating the findings with the statistical results.

Understanding consumers' continuance intention to watch streams: A value-based continuance intention model

Introduction

Live stream-watching has become increasingly popular worldwide. Consumers are found to watch streams in a continuous manner. Despite its popularity, there has been limited research investigating why consumers continue to watch streams. Previously, the expectation-confirmation theory (ECT) has been widely adopted to explain users' continuance intention. However, most current ECT-based models are theoretically incomplete, since they only consider the importance of perceived benefits without considering users' costs and sacrifices. In this paper, we propose a value-based continuance intention model (called V-ECM), and use it to investigate factors influencing consumers' continuance intention to watch streams.

Methods

Our hypotheses were tested using an online survey of 1,220 consumers with continuance stream-watching experiences.

Results

Results indicate that perceived value, a process of an overall assessment between users' perceived benefits and perceived sacrifices, is proved to be a better variable than perceived benefits in determining consumers' continuance watching intention. Also, compared with other ECT-based models, V-ECM is a more comprehensive model to explain and predict consumers' continuance intention.

Discussion

V-ECM theoretically extends ECT-based studies, and it has potential to explain and predict other continuance intentions in online or technology-related contexts. In addition, this paper also discusses practical implications for live streaming platforms with regards to their design, functions and marketing.

A framework for adopting gamified learning systems in smart schools during COVID-19

The outbreak of COVID 19 has increased the anxiety and stress among teachers and students. This has increased the need for gamified learning systems (GLS) to make the educational process more attractive and increase the engagement as well as the participation of all stakeholders. The use of GLS in teaching and learning has not been deployed effectively in the educational systems in developing countries. The purpose of this study was to examine the predictors of using GLS in Iraqi smart schools. Building on the literature, a framework of GLS is proposed. Data used in this study were collected from 394 teachers and managerial staff in Iraqi smart schools and analysed using Partial Least Square. The findings showed that individuals and organizations are important predictors of using GLS, and their effects on BI are mediated by satisfaction. Readiness and performance expectancy are critical for adopting and using GLS by smart schools. In addition, the findings showed that gamification and self-efficacy are moderating variables. Important implications of the predictability of GLS using a combination of theories as well as the practical suggestions for decision makers to enhance the adoption of GLS among smart schools in Iraq are discussed. In the time of COVID-19, decision makers have suggested increasing gamification features of teaching and learning to reduce anxiety and achieve a better learning process.

Where Exactly Is the Therapist in Virtual Reality and Game-Based Rehabilitation Applications? A Randomized Controlled Trial in Children with Specific Learning Disability

Objective: Children with specific learning disability (SLD) experience problems in visual perception that influence academical skills and activities of daily living. Virtual reality and game-based rehabilitation applications are becoming increasingly popular in rehabilitation, including visual perception rehabilitation. However, the usage of commercially available and easily accessible games as intervention tools raises the question whether rehabilitation conducted with these games is really rehabilitation, or just casual gameplay. Therefore, we aimed to investigate the effects of a nonactively supervised (game-based intervention program [GIP]) and an actively supervised (therapist guided game-based intervention program [TGGIP]) on the visual perception skills of children with SLD. Materials and Methods: This study was designed as a single-blind randomized, controlled trial of a TGGIP on visual perception skills in children with SLD compared with the self-oriented, nonsupervised program (GIP). A total of 138 children with SLD participated in the study and were randomly divided into two groups (TGGIP and GIP). Children's visual perception skills were assessed with Motor-Free Visual Perception Test-3. Results: Both groups showed significant improvements in visual perception after the intervention programs (P < 0.05). However, the TGGIP (a supervised and structured intervention program) was significantly more effective in improving the visual perception skills compared with the GIP (a standard, nonsupervised, and unstructured intervention program) (P < 0.05). Conclusion: We think that the TGGIP methodology that we designed acts as a facilitator for therapists in using trademarked, commercially available, and easily accessible games for structured and supervised virtual reality and game-based rehabilitation applications.

Interactive Digital Game for Improving Visual Perceptual Defects in Children with Developmental Disability: Evaluation of Efficacy and User Satisfaction (Preprint)

Background

Visual–perceptual defects in children can negatively affect their ability to perform activities of daily living. Conventional rehabilitation training for correcting visual–perceptual defects has limited training patterns and limited interactivity, which makes motivation difficult to sustain.

Objective

We aimed to develop and evaluate an interactive digital game system for correcting visual–perceptual defects and evaluate its effectiveness.

Methods

Participants were children aged 5 to 10 years with a diagnosis of visual–perceptual defect associated with a developmental disability. The children were randomized into a digital game group who received the traditional course of rehabilitation combined with an interactive digital game intervention (n=12) and a standard rehabilitation group (n=11) who only received the traditional course of rehabilitation. Each group underwent rehabilitation once a week for 4 weeks. Overall improvement in Test of Visual Perceptual Skills 3rd edition (TVPS-3) score and overall improvement in performance in the interactive digital game were evaluated. Parents and therapists were asked to complete a satisfaction questionnaire.

Results

After 4 weeks, the TVPS-3 score had significantly increased (P=.002) in the digital game group (pre: mean 41.67, SD 13.88; post: 61.50, SD 21.64). In the standard rehabilitation group, the TVPS-3 score also increased, but the increase was not statistically significant (P=.58). Additionally, TVPS-3 score increases were significantly larger for the digital game group compared with those for the standard rehabilitation group (P=.005). Moreover, both parents and therapists were highly satisfied with the system. All 5 themes of satisfaction had mean scores higher than 4 in a 5-point scale questionnaire (mean 4.30, SD 0.56).

Conclusions

The system has potential applications for improving visual–perceptual function in children undergoing medical rehabilitation for developmental disability.

Trial Registration

ClinicalTrials.gov NCT05016492; http://clinicaltrials.gov/ct2/show/NCT05016492

Gamification in E-Learning and Sustainability: A Theoretical Framework

Progress in communication technologies and social isolation caused by the COVID-19 pandemic have supported the acceptance of e-learning. In the e-learning context, gamification has been identified as one of the most promising trends. Many researchers believe in the game elements’ capacity to drive learning, skills acquisition, and changes for more sustainable behavior. However, the literature on the subject is dispersed, addressing behavioral attitudes and elements in an isolated and fragmented way. This study aims to present a framework relating game elements to behavioral attitudes to promote sustainability and ensure quality of learning. The methodology is based on a systematic literature review using the PRISMA protocol, covering the content analysis of 130 articles indexed in the Web of Science database. For the framework construction, the following were identified: behavioral attitudes stimulated by gamification; main game elements and how they relate to each other. Based on this, a framework called 7GOALS (Gamification-Oriented Active Learning Steps) associated with the PDCA (Plan, Do, Check, Act) was established. The proposed structure is multidisciplinary and can be used in any knowledge field that uses gamification. With this, themes such as sustainability can be widely disseminated and leverage changes towards more sustainable behaviors that adhere to the real world.

Affective states in digital game-based learning: Thematic evolution and social network analysis

Research has indicated strong relationships between learners' affect and their learning. Emotions relate closely to students' well-being, learning quality, productivity, and interaction. Digital game-based learning (DGBL) has been widely recognized to be effective in enhancing learning experiences and increasing student motivation. The field of emotions in DGBL has become an active research field with accumulated literature available, which calls for a comprehensive understanding of the up-to-date literature concerning emotions in virtual DGBL among students at all educational levels. Based on 393 research articles collected from the Web of Science, this study, for the first time, explores the current advances and topics in this field. Specifically, thematic evolution analysis is conducted to explore the evolution of topics that are categorized into four different groups (i.e., games, emotions, applications, and analytical technologies) in the corpus. Social network analysis explores the co-occurrences between topics to identify their relationships. Interesting results are obtained. For example, with the integration of diverse applications (e.g., mobiles) and analytical technologies (e.g., learning analytics and affective computing), increasing types of affective states, socio-emotional factors, and digital games are investigated. Additionally, implications for future research include 1) children's anxiety/attitude and engagement in collaborative gameplay, 2) individual personalities and characteristics for personalized support, 3) emotion dynamics, 4) multimodal data use, 5) game customization, 6) balance between learners' skill levels and game challenge as well as rewards and learning anxiety.

Effect of computer-based multisensory program on English reading skills of students with Dyslexia and reading difficulties

The study evaluated the effectiveness of a computer-based Multi-Sensory Program (MSP) on English reading skills as a second language of fourth-grade students with reading difficulties and Dyslexia in the United Arab Emirates (UAE). Pretest-Posttest experimental design was used in this study. The analysis showed that average pretest score in both the experimental and control groups was almost the same and the average post-test score was much higher in the experimental group as compared to the control group. Moreover, results also reveal statistically significant difference in the students' mean scores between the experimental and control groups after the MSP intervention. The study has implications in the UAE and Arab countries and everywhere in the world for students who are learning English as a second language and facing reading difficulties. Besides, the modified MSP used in this study can be adopted and imitated to create a local version in the Arabic language in the Middle East and in other countries that are teaching Arabic as a second language.

Investigating medical professionals' continuance intention of the cloud-based e-learning system: an extension of expectation–confirmation model with flow theory

Purpose

The purpose of this study is to propose an integrated model based on expectation–confirmation model (ECM), flow theory and human–organization–technology fit framework to examine whether human, organizational and technology factors as antecedents to medical professionals' beliefs can affect their continuance intention of the cloud-based e-learning system.

Design/methodology/approach

Sample data for this study were collected from medical professionals at five hospitals in Taiwan. A total of 500 questionnaires were distributed, and 368 (73.6%) useable questionnaires were analyzed using structural equation modeling in this study.

Findings

Synthetically speaking, human, organizational and technology factors, as antecedents to medical professionals' continuance intention of the cloud-based e-learning system have been examined, and the results strongly support the research model with all hypothesized links being significant.

Originality/value

Particularly, it is worth mentioning that the application of capturing both ECM and flow theory for completely explaining three types of factors (i.e. human, organizational and technology factors) as external variables to medical professionals' cloud-based e-learning continuance intention is well documented, that is, information systems (IS) and nonIS determinants are simultaneously evaluated, and extrinsic and intrinsic motivators are both taken into consideration in this study's theoretical development of medical professionals' cloud-based e-learning continuance intention to acquire a more comprehensive and robust analysis.

Health Education Serious Games Targeting Health Care Providers, Patients, and Public Health Users: Scoping Review

BACKGROUND

Serious educational games have shown effectiveness in improving various health outcomes. Previous reviews of health education games have focused on specific diseases, certain medical subjects, fixed target groups, or limited outcomes of interest. Given the recent surge in health game studies, a scoping review of health education games is needed to provide an updated overview of various aspects of such serious games.

OBJECTIVE

This study aimed to conduct a scoping review of the design and evaluation of serious educational games for health targeting health care providers, patients, and public (health) users.

METHODS

We identified 2313 studies using a unique combination of keywords in the PubMed and ScienceDirect databases. A total of 161 studies were included in this review after removing duplicates (n=55) and excluding studies not meeting our inclusion criteria (1917 based on title and abstract and 180 after reviewing the full text). The results were stratified based on games targeting health care providers, patients, and public users.

RESULTS

Most health education games were developed and evaluated in America (82/161, 50.9%) and Europe (64/161, 39.8%), with a considerable number of studies published after 2012. We discovered 58.4% (94/161) of studies aiming to improve knowledge learning and 41.6% (67/161) to enhance skill development. The studies targeted various categories of end users: health care providers (42/161, 26.1%), patients (38/161, 23.6%), public users (75/161, 46.6%), and a mix of users (6/161, 3.7%). Among games targeting patients, only 13% (6/44) targeted a specific disease, whereas a growing majority targeted lifestyle behaviors, social interactions, cognition, and generic health issues (eg, safety and nutrition). Among 101 studies reporting gameplay specifications, the most common gameplay duration was 30 to 45 min. Of the 61 studies reporting game repetition, only 14% (9/61) of the games allowed the users to play the game with unlimited repetitions. From 32 studies that measured follow-up duration after the game intervention, only 1 study reported a 2-year postintervention follow-up. More than 57.7% (93/161) of the games did not have a multidisciplinary team to design, develop, or assess the game.

CONCLUSIONS

Serious games are increasingly used for health education targeting a variety of end users. This study offers an updated scoping review of the studies assessing the value of serious games in improving health education. The results showed a promising trend in diversifying the application of health education games that go beyond a specific medical condition. However, our findings indicate the need for health education game development and adoption in developing countries and the need to focus on multidisciplinary teamwork in designing effective health education games. Furthermore, future health games should expand the duration and repetition of games and increase the length of the follow-up assessments to provide evidence on long-term effectiveness.

A computer vision-based system for monitoring Vojta therapy

A neurological illness is t he disorder in human nervous system that can result in various diseases including the motor disabilities. Neurological disorders may affect the motor neurons, which are associated with skeletal muscles and control the body movement. Consequently, they introduce some diseases in the human e.g. cerebral palsy, spinal scoliosis, peripheral paralysis of arms/legs, hip joint dysplasia and various myopathies. Vojta therapy is considered a useful technique to treat the motor disabilities. In Vojta therapy, a specific stimulation is given to the patient's body to perform certain reflexive pattern movements which the patient is unable to perform in a normal manner. The repetition of stimulation ultimately brings forth the previously blocked connections between the spinal cord and the brain. After few therapy sessions, the patient can perform these movements without external stimulation. In this paper, we propose a computer vision-based system to monitor the correct movements of the patient during the therapy treatment using the RGBD data. The proposed framework works in three steps. In the first step, patient's body is automatically detected and segmented and two novel techniques are proposed for this purpose. In the second step, a multi-dimensional feature vector is computed to define various movements of patient's body during the therapy. In the final step, a multi-class support vector machine is used to classify these movements. The experimental evaluation carried out on the large captured dataset shows that the proposed system is highly useful in monitoring the patient's body movements during Vojta therapy.