Towards Effective Virtual Reality Environments for the Behavioural Assessment of Executive Dysfunction

Student thesis: Doctoral ThesisDoctor of Engineering (EngD)


Human-computer interaction is concerned with understanding the goals of people in a target domain, documenting their motivations and challenges to ground investigations into how technology can be used to support their interactions. In this thesis, the domain of interest is that of neurobehavioural rehabilitation services for people with executive dysfunction arising from acquired brain injuries. For the clinical professionals and users of such services, the predominant goal is the reacquisition of functional and socio-cognitive skills to facilitate successful community reintegration.

The gold standard in assessing and training executive skills is to place someone in community settings, to facilitate observation of their behaviours, strategies and emergent deficits. However, this comes with practical difficulties: such activities are irregular, costly and uncontrollable. Virtual reality uses immersive and interactive experiences to psychologically engage users in situations that are impractical to re-create in the real world. It aligns with the goals of neurobehavioural rehabilitation, which seeks to familiarise and observe the behaviours of service users in ecologically valid situations.

In this thesis, we report on user-centred design research conducted with the Brain Injury Rehabilitation Trust to ensure our approach is theoretically sound and practicable. Through analysis of the literature and in situ observations we present an understanding of clinical activities framed through human-computer interaction, to establish clinically grounded frameworks to support clinician-service user interactions. These inform the development of an experimental platform, Virtuality Street, to demonstrate how virtual environments can expose key behavioural correlates of executive dysfunction and facilitate clinical observations of service users.

Having developed an experimental platform that is grounded in clinical practice, we present a lab-based study with neurotypical participants to demonstrate Virtuality Street’s capacity to deliver challenges that are executive in nature, and support the devising of strategies to complete socio-cognitive and functional tasks. We further report on demonstration sessions with clinical professionals involved in acquired brain injury rehabilitation, and three service users approaching the end of their rehabilitative programme. The feedback from these groups support the overarching goal of this clinically motivated research, which is to build towards clinical validation of Virtuality Street as a therapeutic tool.
Date of Award22 Jun 2022
Original languageEnglish
Awarding Institution
  • University of Bath
SupervisorLeon Watts (Supervisor) & Nigel Harris (Supervisor)


  • Virtual Reality
  • VR
  • Executive Dysfunction
  • Acquired Brain Injuries
  • Rehabilitation

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