Preparing participants for the use of the tongue visual sensory substitution device

PURPOSE

Visual sensory substitution devices (SSDs) convey visual information to a blind person through another sensory modality. Using a visual SSD in various daily activities requires training prior to use the device independently. Yet, there is limited literature about procedures and outcomes of the training conducted for preparing users for practical use of SSDs in daily activities.

METHODS

We trained 29 blind adults (9 with congenital and 20 with acquired blindness) in the use of a commercially available electro-tactile SSD, BrainPort. We describe a structured training protocol adapted from the previous studies, responses of participants, and we present retrospective qualitative data on the progress of participants during the training.

RESULTS

The length of the training was not a critical factor in reaching an advanced stage. Though performance in the first two sessions seems to be a good indicator of participants' ability to progress in the training protocol, there are large individual differences in how far and how fast each participant can progress in the training protocol. There are differences between congenital blind users and those blinded later in life.

CONCLUSIONS

The information on the training progression would be of interest to researchers preparing studies, and to eye care professionals, who may advise patients to use SSDs.IMPLICATIONS FOR REHABILITATIONThere are large individual differences in how far and how fast each participant can learn to use a visual-to-tactile sensory substitution device for a variety of tasks.Recognition is mainly achieved through top-down processing with prior knowledge about the possible responses. Therefore, the generalizability is still questionable.Users develop different strategies in order to succeed in training tasks.

Training-induced plasticity enables visualizing sounds with a visual-to-auditory conversion device

Sensory substitution devices aim at restoring visual functions by converting visual information into auditory or tactile stimuli. Although these devices show promise in the range of behavioral abilities they allow, the processes underlying their use remain underspecified. In particular, while an initial debate focused on the visual versus auditory or tactile nature of sensory substitution, since over a decade, the idea that it reflects a mixture of both has emerged. In order to investigate behaviorally the extent to which visual and auditory processes are involved, participants completed a Stroop-like crossmodal interference paradigm before and after being trained with a conversion device which translates visual images into sounds. In addition, participants' auditory abilities and their phenomenologies were measured. Our study revealed that, after training, when asked to identify sounds, processes shared with vision were involved, as participants’ performance in sound identification was influenced by the simultaneously presented visual distractors. In addition, participants’ performance during training and their associated phenomenology depended on their auditory abilities, revealing that processing finds its roots in the input sensory modality. Our results pave the way for improving the design and learning of these devices by taking into account inter-individual differences in auditory and visual perceptual strategies.

Lingual electrotactile discrimination ability is associated with the presence of specific connective tissue structures (papillae) on the tongue surface

Electrical stimulation of nerve endings in the tongue can be used to communicate information to users and has been shown to be highly effective in sensory substitution applications. The anterior tip of the tongue has very small somatosensory receptive fields, comparable to those of the finger tips, allowing for precise two-point discrimination and high tactile sensitivity. However, perception of electrotactile stimuli varies significantly between users, and across the tongue surface. Despite this, previous studies all used uniform electrode grids to stimulate a region of the dorsal-medial tongue surface. In an effort to customize electrode layouts for individual users, and thus improve efficacy for sensory substitution applications, we investigated whether specific neuroanatomical and physiological features of the tongue are associated with enhanced ability to perceive active electrodes. Specifically, the study described here was designed to test whether fungiform papillae density and/or propylthiouracil sensitivity are positively or negatively associated with perceived intensity and/or discrimination ability for lingual electrotactile stimuli. Fungiform papillae number and distribution were determined for 15 participants and they were exposed to patterns of electrotactile stimulation (ETS) and asked to report perceived intensity and perceived number of stimuli. Fungiform papillae number and distribution were then compared to ETS characteristics using comprehensive and rigorous statistical analyses. Our results indicate that fungiform papillae density is correlated with enhanced discrimination ability for electrical stimuli. In contrast, papillae density, on average, is not correlated with perceived intensity of active electrodes. However, results for at least one participant suggest that further research is warranted. Our data indicate that propylthiouracil taster status is not related to ETS perceived intensity or discrimination ability. These data indicate that individuals with higher fungiform papillae number and density in the anterior medial tongue region may be better able to use lingual ETS for sensory substitution.

Multisensory inclusive design with sensory substitution

Sensory substitution techniques are perceptual and cognitive phenomena used to represent one sensory form with an alternative. Current applications of sensory substitution techniques are typically focused on the development of assistive technologies whereby visually impaired users can acquire visual information via auditory and tactile cross-modal feedback. But despite their evident success in scientific research and furthering theory development in cognition, sensory substitution techniques have not yet gained widespread adoption within sensory-impaired populations. Here we argue that shifting the focus from assistive to mainstream applications may resolve some of the current issues regarding the use of sensory substitution devices to improve outcomes for those with disabilities. This article provides a tutorial guide on how to use research into multisensory processing and sensory substitution techniques from the cognitive sciences to design new inclusive cross-modal displays. A greater focus on developing inclusive mainstream applications could lead to innovative technologies that could be enjoyed by every person.

Mixing up the Senses: Sensory Substitution Is Not a Form of Artificially Induced Synaesthesia

Sensory Substitution Devices (SSDs) are typically used to restore functionality of a sensory modality that has been lost, like vision for the blind, by recruiting another sensory modality such as touch or audition. Sensory substitution has given rise to many debates in psychology, neuroscience and philosophy regarding the nature of experience when using SSDs. Questions first arose as to whether the experience of sensory substitution is represented by the substituted information, the substituting information, or a multisensory combination of the two. More recently, parallels have been drawn between sensory substitution and synaesthesia, a rare condition in which individuals involuntarily experience a percept in one sensory or cognitive pathway when another one is stimulated. Here, we explore the efficacy of understanding sensory substitution as a form of 'artificial synaesthesia'. We identify several problems with previous suggestions for a link between these two phenomena. Furthermore, we find that sensory substitution does not fulfil the essential criteria that characterise synaesthesia. We conclude that sensory substitution and synaesthesia are independent of each other and thus, the 'artificial synaesthesia' view of sensory substitution should be rejected.

Does Proprioception Influence Human Spatial Cognition? A Study on Individuals With Massive Deafferentation

When navigating in a spatial environment or when hearing its description, we can develop a mental model which may be represented in the central nervous system in different coordinate systems such as an egocentric or allocentric reference frame. The way in which sensory experience influences the preferred reference frame has been studied with a particular interest for the role of vision. The present study investigated the influence of proprioception on human spatial cognition. To do so, we compared the abilities to form spatial models of two rare participants chronically deprived of proprioception (GL and IW) and healthy control participants. Participants listened to verbal descriptions of a spatial environment, and their ability to form and use a mental model was assessed with a distance-comparison task and a free-recall task. Given that the loss of proprioception has been suggested to specifically impair the egocentric reference frame, the deafferented individuals were expected to perform worse than controls when the spatial environment was described in an egocentric reference frame. Results revealed that in both tasks, one deafferented individual (GL) made more errors than controls while the other (IW) made less errors. On average, both GL and IW were slower to respond than controls, and reaction time was more variable for IW. Additionally, we found that GL but not IW was impaired compared to controls in visuo-spatial imagery, which was assessed with the Minnesota Paper Form Board Test. Overall, the main finding of this study is that proprioception can influence the time necessary to use spatial representations while other factors such as visuo-spatial abilities can influence the capacity to form accurate spatial representations.