Neuroscientist Maria T. Schultheis, PhD, used to assess driving skills of people with traumatic brain injuries using a paper-and-pencil test. But now, thanks to a virtual reality simulator, Schultheis is able to give them a more realistic test before they head to the road.

With the simulator, participants wear a head-mounted display and sit at a computer with foot petals and a steering wheel. They cruise the highways, dodge rush hour traffic and trundle through residential neighborhoods in a 30-minute program.

For the past three years, Schultheis, a psychologist and clinical research scientist at Kessler Medical Research and Education Corp., has used virtual reality to assess driving skills in people who have sustained traumatic brain injuries (TBI) and strokes. In the future, she plans to use the simulator to assess elderly drivers with and without dementia.

The driving simulator, developed in collaboration with Northeastern University, exposes participants to a variety of driving scenarios, like a car running a four-way stop, a pedestrian suddenly crossing the street directly in the driving path or night driving. "We plug in these different situations and then evaluate how the individual reacts," Schultheis says. "It is closer in estimation to how they will be doing when they are driving in the real world."

Not to mention it's safer. "If they strike a pedestrian [in the simulator], that virtual pedestrian is safe and so is the driver," Schultheis says.

At first, Schultheis was concerned that participants would feel uncomfortable using the new technology and wearing a head-mounted display. However, preliminary research has shown otherwise. A study conducted by Schultheis and Kessler Corp. evaluated the driving simulator's "usability" among 14 adults with acquired brain injury (TBI or stroke). Participants were found to have minimal difficulty when using the simulator and reported that the simulator "feels like they are driving," Schultheis says. Furthermore, participants reported understanding how performance in the simulator might apply to driving ability compared with the traditional psychometric test, she adds. "Most patients feel very comfortable and can learn how to drive through the simulator very easily."

Initial pilot data indicates that when the test is administered they are able to measure specific driving performance measures, Schultheis says. Researchers have found that individuals who "fail" the real world behind-the-wheel driving evaluation also tend to do poorly on the simulator.

Virtual reality and its potential for people with learning or memory disabilities has also been extended to another project for Schultheis and Kessler Corp.--the Virtual Office, a virtual reality simulator that allows participants to handle office tasks, such as taking instructions from a virtual secretary. The simulator, developed in collaboration with the University of Southern California, is meant to help people who have difficulty recalling tasks or responsibilities, planning or multi-tasking, Schultheis says.

Virtual reality offers rich potential for clinical and rehabilitation interventions for people with disabilities, Schultheis says. "I'm optimistic that new students and psychologists will open their minds to all considerations," she says, "and not just rely on traditional approaches."