The Use of Virtual Worlds Among People with Disabilities

Kel Smith

Anikto LLC, Philadelphia, PA, USA


With their emphasis on 3D graphics and complex interface controls, it would appear that virtual worlds have little to offer people with disabilities. On the contrary, multi-user virtual environments, such as Linden Lab's Second Life platform, serve as a form of augmented reality where users transcend physiological or cognitive challenges to great social and therapeutic benefit. A number of intriguing developments exist within the accessibility sector that make barrier-free access an important aspect of the interaction experience. Examples include haptic input devices for the blind, virtual regions developed according to Universal Design principles, communities dedicated to people with cognitive disorders, the use of the avatar as counselor, and customizable personae that either transcend or represent a disabled person's self-identity. This paper investigates research methods and case studies affiliated with virtual environments, as well as the ways inclusive design removes barriers to access for users with disabilities.

1. Introduction

"We need to confront the life-killing stereotype that says we're all about suffering. We need to bear witness to our pleasures."1

– Harriet McBryde Johnson

When Second Life achieved mainstream attention at the close of 2006, collective attitudes regarding virtual worlds were still evolving. For many people, the first mention of virtual worlds usually brings to mind an unsavory connotation: social deviants living vicariously through their avatars, operating more in tune with a futuristic cartoon landscape than their real lives. Mainstream attention over the past few years has heightened public scrutiny and suspicion. What are we to make of these bizarre environments in which people interact through digital humanoid proxies?

A virtual world is a simulated three-dimensional (3D) environment accessed through a computer. More than a flat website and utilizing the same technological aspects as games, virtual worlds are delivered via an interconnected network of servers that provide the platform framework. Participants then interact with their environment through a presentation layer consisting of such features as animated avatars, customizable objects, instant chat messaging and voice-activation. The use of virtual worlds has been explored for many purposes spanning entertainment, socialization, education and commerce industries.

Virtual worlds are sometimes considered an extrapolation of serious games – a software or hardware player application developed with gaming technology or design principles, intended for use beyond pure entertainment. These programs have been developed and deployed for such purposes as education, marketing, advertisement, workplace training, or health awareness. The main difference between a game and a virtual world is in the objective: game players expect to be confronted with obstacles that are intentionally built into the software, while users of virtual worlds seek to engage and navigate their way through an environment empathetic to achieving user-centered goals.

Second Life, a platform created by Linden Lab, is the virtual world that attracts the most attention and name recognition. There are other applications that boast greater numbers of simultaneous users, such as Blizzard's World of Warcraft, which focus more on gameplay than social interaction, as well as multi-user virtual environments that provide tools for peer-to-peer collaboration.

From an assistive technology standpoint, it would appear that gaming interfaces and virtual worlds have little to offer people with disabilities. The experience is largely visual in nature, with user interfaces requiring extensive hand/eye coordination to precisely control an avatar's movements. Some applications use non-persistent sound and fading messages to deliver information. For users who are unaccustomed to this level of multitasking, the resulting cognitive load can be topically severe.

A surprising context has emerged from a sometimes overlooked group of users, however, with a new form of social literacy beginning to take shape. People with a wide range of disabilities – visual impairments, motor skill disorders, degenerative illness, limited mobility, and cognitive difficulties – utilize virtual technology to great social and therapeutic benefit. For these users, avatar-driven 3D environments serve as more than a game. Virtual worlds operate as a form of augmented reality, one where it's possible to transcend a user's physiological or cognitive challenges into something extraordinary.

2. Types of Virtual World Users

To fully understand virtual worlds, it's important to recognize how people use gaming software. Users can fall into any of three categories: augmentationists, immersionists, or experimentalists.2 All have applications of relevance to people with disabilities.

Augmentationists view the virtual world as a means to enhance their real life existence. They use their avatars as extensions of their identities and are more willing to disclose their real life identities to others in-world. Many who conduct business online, such as attorneys who practice aspects of virtual law, feel comfortable representing themselves with an avatar who closely resembles their real life appearance.3 A practical example of an augmentationist would be someone with a physiological disability who chooses to represent him- or herself as authentically as possible. This user will go so far as to outfit his or her avatar with a wheelchair, dark glasses, a guide dog, or other visual attributes signifying a disability.

First-time users tend to start off as pure augmentationists, but they do not remain that way for long.4 Within a short time, it's possible for a person to become proficient at making choices regarding her or his avatar's appearance and functionality. Some users with disabilities will take advantage of this feature by making the experience easier to navigate. For example, a visually-impaired resident of Second Life may dress her avatar in light colors to make her location on the screen easier to track.

It is at this point that augmentationists become immersionists – people who view virtual worlds as an alternative parallel to their real life existence. These types of users generally keep their real life identities separate from that of their avatars with the intention that the two streams never cross paths. An example of an immersionist might be someone with Asperger's syndrome who exploits the anonymity of virtual worlds to practice social interaction skills.

Some avatars employ drastic means to differentiate their virtual experience from real life. Rather than depict themselves as "broken" with wheelchairs and canes, they choose to discard any attributes common to disability. For people with disabilities that prevent them from engaging such physical activities as walking, running, surfing and dancing, virtual worlds present a unique opportunity for users to take part in these experiences. Interestingly, these case studies have been cited as evidence that augment rehabilitation therapy helps patients struggling with the loss of a limb. Research demonstrates that the brain's perception to pain can be reduced when it is "tricked" into operating a replicative appendage.5

A third group of virtual world users are the experimentalists, who use virtual worlds as a controlled laboratory to conduct training or educational sessions. Experimentalists may take the form of trainers or counselors working with patients dealing with substance abuse, or perhaps someone who seeks to gain empathy by undergoing a simulated experience. The Sacramento Mental Health Center in Second Life provides a virtual replica of their real-world facility, including an authentic representation of a schizophrenic episode. With visual hallucinations and subliminal voices providing an accurate depiction, the site provides visitors an opportunity to directly experience what someone with schizophrenia may go through.6

Virtual therapy is another example of an experimentalist. New Ways is a private practice located in the Sunshine Therapy Garden in Second Life's Hauwai region, sponsored by the Netherlands emotional support organization Sensoor. Residents arrive during regularly scheduled hours and discuss with trained volunteers in-world and real life problems. Although roleplay is prevalent among users of Second Life, some residents do treat their "sessions" as authentic therapy to discuss issues of loneliness, depression or other problems.7 There is some evidence that talking to an anonymous counselor via instant messaging helps people to speak more freely than they would during a face-to-face session.8

Figure 1: New Ways is a private practice, located in Second Life, that provides free counseling sessions with a virtual therapist.

Figure 1: New Ways is a private practice, located in Second Life, that provides free counseling sessions with a virtual therapist.

3. Human-Computer Interaction in Virtual Worlds – Interfaces for the Deaf and Blind

In a 2001 paper, Marc Prensky introduced the concept of digital immigrants and digital natives to better identify new methodologies in education. According to Prensky, there exists a demarcation between present and past generations with respect to their fluency and familiarity with ubiquitous computing. Those who have grown up with the Internet, email and multiplayer games comprise the group called "natives," while others (the "immigrants") must constantly adapt their mental model to compensate.9 Digital natives are also more comfortable using complex game interfaces and tend to build their social fabric using online means.10

Inspired by these ideas, a professional games programmer and research fellow at the University of Sussex named Gareth White devised the term digital outcasts – users who are left behind due to technology that rapidly advances but remains inaccessible.11 Even though recent surveys indicate more than a fifth of casual gamers have a disability,12 gaming hardware has not maintained pace with the need to accommodate users with disabilities. Few games support the use of input devices that make affordances for the blind, since this user group is not primarily considered during the game development lifecycle. However, with thousands of dollars spent in the US alone on alternative means of input for the blind, the need for accommodation has gained mainstream visibility within the gaming community.13

As part of a study at the University of Sussex, White has conducted a series of interviews among blind and visually impaired individuals to identify how they navigate and orient themselves within virtual spaces. The study revealed significant barriers to entry in Second Life, particularly in areas where information was presented graphically rather than with textual equivalents. Many interviewed participants suggested tagging objects with metadata that could be interpretable by screen-readers. Although Linden Lab has released test-to-speech functionality as part of their source code, only a few interface elements provide this interoperability by default.14

Among White's investigations are the development of a haptic interface system, extensible to Second Life, that maps keyboard movements through a Logitech Wingman Strike Force 3D joystick. A haptic interface is a digital input that utilizes a user's sense of touch through a network of embedded sensory perceptors. A few such devices have already entered the consumer marketplace. One example is the Novint Falcon, a 3D touch joystick intended for the consumer market attached to the main body via three motorized arms on hinges. The devices offers players the ability to "hold" or "pick up" in-world objects, with an effect realistic enough to simulate weight and texture, and its use has been investigated as a possible alternative to the keyboard.15

These developments have cultivated some exciting research in the ways people with disabilities adapt to 3D graphic environments, especially for users with low vision who rely on Braille displays and speech-recognition software. Members of an Italian research team have been working with the Second Life source code to create two avatar controls called Blind Walk and Blind Vision, which sense vibrations from objects through a sonar probe. Orientation, proximity and collision benchmarks have been tested with blindfolded users.16

The use of sound, both synthetic and natural, increases the fidelity of 3D spatialization within immersive environments. In 2007 a group of IBM students joined with the National Council for the Blind of Ireland to create a prototype for Active Worlds, an online virtual environment similar to Second Life. Making use of 3D audio space, the team developed a suite of tools to help users navigate the world via sound. A text-to-speech functionality reads back any dialog that appears in a text field, and residents are provided audible clues to alert them of nearby objects or approaching avatars.17

Virtual world users with hearing impairments may one day benefit from an IBM platform called SiSi (Say It Sign It), which translates spoken or written words into British Sign Language. SiSi uses speech recognition technology to animate an avatar in real time during chats, speeches and digital broadcasts. The Royal National Institute for Deaf People has endorsed the use of SiSi with plans to integrate translation features into future iterations.18

Figure 2: TextSL provides a way for blind users to access Second Life using the JAWS screen-reader.

Figure 2: TextSL provides a way for blind users to access Second Life using the JAWS screen-reader.

For people who rely on screen-reading software, there are a number of interesting developments currently in execution. An application called TextSL provides the ability to interact with Second Life using the JAWS screen-reader.19 IBM's alphaWorks division introduced a Web-based ARIA called Virtual Worlds User Interface for the Blind, which interprets semantic data contributed by sighted users to be read back as text.20 And in the summer of 2009, a coalition of four groups called Virtual Helping Hands (VHH) announced the release of "Max," a virtual guide dog for users of Second Life. Like a real guide dog, Max helps visually impaired users avoid colliding with objects and other avatars, assists with navigation, reads signs and interprets chat information – all by translating metadata using text to speech technology. Employing a keyboard-controlled interface, the prototype gives an avatar owner constant feedback on the immediate surroundings, facilitating not only navigation but also orientation and proximity to items of interest.21

Figure 3: 'Max' is a virtual guide dog that allows blind Second Life users to navigate environments, objects and other avatars using text-to-speech technology.

Figure 3: "Max" is a virtual guide dog that allows blind Second Life users to navigate environments, objects and other avatars using text-to-speech technology.

Developments such as Max, which are reliant on textual information, bring to mind the importance of textual interoperability across virtual environments (not unlike the assigning of ALT text to Web images). Care must also be taken to ensure that blind users are not deluged with an overabundance of granular details for each object in an environment. Sighted users have the ability to selectively filter visual information, thus employing a degree of cognitive judgment that machines may lack.22 The best-designed virtual experiences are those that dissolve into behavior using interfaces that communicate information effectively without disrupting the natural flow of interaction.23

4. People With Cognitive Disabilities

Virtual worlds have found an enthusiastic audience among people who have difficulty processing memory, experience mild to severe interaction anxiety, have limited attention spans and cannot effectively control their emotions. Through text chatting, avatar gestures or speech-to-text features, users are able to practice a variety of social interactions in virtual worlds. They can take part in a conversation, exercise common etiquette or work on overcoming social awkwardness. Perhaps more importantly, people also have the opportunity to meet and discuss their experiences with others.

The Autism Society of America island in Second Life houses an information library, a meeting room, videos, a bulletin board, student artwork and scheduled events. Participation includes group discussions for parents and guardians who are raising a child diagnosed with autism spectrum disorders (ASD), a term used to define a number of developmental conditions which affect a child's ability to communicate and interact with others.

Brigadoon is an island in Second Life designed to guide users as they become familiar with the virtual experience. One therapist mentions that Brigadoon provides a safe environment to build the confidence necessary to explore other parts of Second Life, as well as venturing into the real world to test newly-discovered social skills.24

Figure 4: View of bulletin board in the Autism Society of America's island in Second Life. The ASA hosts in-world meetings and events.

Figure 4: View of bulletin board in the Autism Society of America's island in Second Life. The ASA hosts in-world meetings and events.

Asperger's is a condition that effects people who have highly-functional learning skills but are deficient in other activities, such as dating or interviewing for a job. Emotional subtleties and body language clues, which other people take for granted in common everyday usage, can be misinterpreted or completely unnoticed by a person with Aperger's.25 Researchers from the Center for Brain Health at the University of Texas have conducted brain-imaging and neurocognitive tests on people with Asperger's before and after virtual therapy sessions. Subjects tested after participation demonstrated improvements in social interaction, were less likely to make inappropriate comments and gained confidence making connections.26Since many with Asperger's do not like to make eye contact with others, they can socialize without the stress of a physical meeting.27

One of the risks of using virtual worlds is that people with cognitive disabilities sometimes cannot distinguish between the realms of practice and putting into action. There are sexual and economic aspects to Second Life, for example, that can be dangerous when patients lack the ability to comprehend appropriateness in different situations. On the one hand, people can socialize free of risk. On the other, people with devious intentions have the opportunity to exercise a dearth of morality in ways they wouldn't otherwise attempt.

Users of virtual worlds often cite the buffer of anonymity that protects their identity, safely behind the fictitious persona of an avatar. Perhaps it is this buffer that helps people be more honest when speaking to others, or that allows them to open up during a virtual therapy session. Being assured of one's anonymity may cultivate the trust necessary to freely discuss one's troubles and wishes. It is also interesting to note that the difficulties one has in-world often manifest from those in real life, as behavioral traits tend to transcend from one paradigm to the other.

Figure 5: View of the Autism Society of America's library in Second Life.

Figure 5: View of the Autism Society of America's library in Second Life.

A common thread among those interviewed for this paper was the importance of removing the misconceptions many people have about autism. One parent mentioned that the symptoms and severity of ASD can vary greatly from person to person, and that ASD is often is diagnosed as attention-deficit hyperactivity disorder (ADHD). Also of note are the degree to which ASD can manifest one's life and resulting outlook. One parent described the struggles her autistic son had with dyslexia, dysgraphia, dyscalculia and femoral anteversion, while another avatar insisted "I am on spectrum, and I like my way of thinking. I think society is what needs to change." Virtual worlds operate as both a community builder and an educational platform, with participants responding to the presence of ASD in deeply personal ways.

5. Finding Community in Virtual Worlds – Physical and Substance Abuse Therapy

There are an increasing number of people suffering from physical injuries who have successfully used virtual worlds as part of their rehabilitation, and some credit the technology with helping them reclaim their lives. Researchers are only now beginning to appreciate the impact that virtual worlds are having in helping patients adapt to their disability.

Wheelies is a virtual nightclub frequented by people with many forms of disability. Sign-language displays and wheelchair-friendly dances provide a sense of inclusion. Avatars can visit the Accessible Builds demonstration site and preview such items as handicap-friendly avatar housing and life-size board games. GimpGirl provides a valuable resource for women with disabilities as a forum for advocacy and companionship. Among the activities at GimpGirl's Second Life environment are social events, art happenings and outreach sessions. The members of GimpGirl frequently present in public, both in-world and in real life, on topics related to women living with disabilities.

Figure 6: Wheelies is a nightclub in Second Life frequented by participants with disabilities, who often depict their avatars with wheelchairs and guide dogs.

Figure 6: Wheelies is a nightclub in Second Life frequented by participants with disabilities, who often depict their avatars with wheelchairs and guide dogs.

Through the sponsorship of a Boston day-care program called Evergreen, nine adults with cerebral palsy share ownership of a Second Life avatar named Wilde Cunningham. The group members, ranging from 30 to 70 years of age, take turns controlling Wilde as they navigate their in-world lives in parallel. Observers have reported an improvement in the group's confidence after six months of participation.28

Often forgotten within the context of accessibility are those patients who have recently become disabled – for example, people recovering from traumatic brain injuries. Virtual worlds play a large part in recovery because they provide a forum for meaningful involvement. In real life, people with disabilities sometimes feel isolated and stigmatized by others; there is always a feeling that they are nothing more than a source of aggravation to their families or caregivers, even though they may be highly functional and appreciative within their respective communities. With the degree of autonomy afforded by virtual worlds, users have the opportunity overcome perceptions that limit their capability.

Rehabilitative virtual communities tend to work best when avatar "patients" are permitted to make mistakes. Some users objectify their avatars as a means of distancing themselves, which in some cases can weaken therapies applied in real life. However, there is equal evidence that viewing oneself rationally and objectively is critical to self-growth.29 For example, one can find an alcohol rehab center in Atlanta fully replicated within Second Life, where the in-world environment and therapists' avatars strongly resemble those in real life. David E. Stone, the center's Chief Technology Officer, has mentioned the "online disinhibition" that allows frustrations to be conveyed more honestly in the digital space, which he feels has helped patients respond to therapy with greater impact.30

6. Uses of Virtual Worlds in Higher Education for the Learning Disabled

One of the more intriguing implementations of virtual worlds can be recently found in higher education. Universities are beginning to investigate the use of Second Life as part of their curriculum, particularly for students with disabilities who may benefit from a more collaborative and immersive learning environment. For example, students who have difficulty understanding a concept presented in text may have more success working through visual material at their own pace.31

Colleges are also using Second Life to provide virtual walkthroughs during orientation sessions, which can help incoming students with learning disabilities feel more at ease. Bowling Green State University, for example, offers virtual office hours and access to faculty members in advance of students' arrival on campus.32 There is a belief that students with learning disabilities may be more comfortable asking for help if their anonymity is ensured. The result is a sense of community felt among participants, who might otherwise have trouble adapting without assistance.

There are some challenges in the use of virtual worlds for educational purposes. Students with learning disabilities require timely and structured feedback sessions, something that virtual environments do not provide by default. Instructors must take the time and effort to fully understand all aspects of the in-world experience. There is the risk that a student with learning disabilities may feel overwhelmed with the amount and degree of sensorial clutter, thus obfuscating the intended educational value of the virtual content. These challenges may be mitigated by emphasizing the use of virtual worlds as a component to learning, rather than as a replacement for classroom instruction.33

7. Universal Design in Virtual Worlds

August 2008 marked the launch of Virtual Ability Island, an environment in Second Life created by the Alliance Library System (ALS) and Virtual Ability, Inc. (VAI). Funded by a grant from the National Library of Medicine, the island provides a place for residents to explore topics related to disability and general wellness.34

Virtual Ability Island was designed visually and experientially in accordance with Universal Design principles. Widely scaled ramps make movement easier for avatars in wheelchairs, bright high-contrast signs are angled to be more easily read by users with visual impairments, and smoothly landscaped walkways ease motor skill fatigue. This makes it easier for first-time users who may have difficulty navigating virtual worlds with a mouse and keyboard. For people who rely on voice recognition software or alternative input devices, objects on the screen can be more precisely controlled.

Figure 7: The welcome area of the Virtual Ability Island offers flat, wide pathways for avatars in wheelchairs.

Figure 7: The welcome area of the Virtual Ability Island offers flat, wide pathways for avatars in wheelchairs.

Creating specification guidelines with Universal Design principles in mind has several benefits. Anything that can make the screen easier to read or the cursor easier to move improves the overall user experience. Game interfaces are frequently designed to accommodate a high level of customization, and accessibility is a component of that architecture.35

It's also important to consider the various ways users of virtual worlds approach their respective disability. People who have had an impairment since birth consider it a part of how they perceive themselves, and some prefer to have their avatar appear that way. The appearance of accessibility – such as an avatar depicted with a wheelchair or guide dog – can be very important to users who view their disability as an integral part of their identity.

Simon Stevens, owner of a well-known disability consultancy in Coventry, UK, and a Second Life avatar named Simon Walsh, chooses to present himself in-world with a wheelchair. "I don't know how to be non-disabled and I’ve never wanted to be," he told the Times Online in March 2008. "It's important that people know; it's part of who I am, plus I'm a disability consultant in Second Life, too, so I've got to look the part."36 In such cases, the appearance of accessibility is simply a matter of self-respect which is extended to how people interact with their environment. For example, a virtual ramp that is too steep may draw criticism from residents who question whether such a ramp would accommodate wheelchair usage in real life.

Vivian Sobchack, media theorist and film critic, once wrote that "even the most ordinary images find their value, their substance, their impetus, in the the agency and investments of our flesh." She was speaking about decorporealization - that point in which a media object, such as a photograph, depicts a persona that is at once representative and interchangeable with our identity of self. The more closely a user can identify with her avatar, the more likely she can transcend herself to a context of extraordinary proportion.37

Figure 8: View of the ramps leading to Helen Keller Day in Second Life.

Figure 8: View of the ramps leading to Helen Keller Day in Second Life.

Creating a virtual world with Universal Design principles in mind serves as a visual reminder to help users better understand the needs of the disabled. The appearance of accessibility in a physical space, either in a virtual world or in real life, will make a person more likely to use the service and not balk from it. Inclusive behaviors leverage the uniqueness of different viewpoints to cultivate empathy, thus depreciating the concept that people with disabilities are societal outsiders.

Universally Designed virtual worlds strengthen the sense of community among both disabled and non-disabled participants. Many users remark "I always wanted a group to understand me," projecting an idealized view that suddenly becomes manifest upon entering in-world. Users with disabilities have the same expectations for accessibility, no matter in what context it appears – digital or physical – and the success of any facility is largely subject to meeting these benchmarks.

8. Future Developments

Virtual world technologies are being increasingly used in business and educational contexts for planning meetings and presentations, which brings to mind issues of accessibility. Virtual worlds are considered a new paradigm in which to operate, and many advocates are just now coming to grips with the challenges and possibilities available to users with disabilities. It is encouraging to see Linden Lab release the source for its client application of Second Life under a GPL license, which allows anyone to extend or modify the code and explore further possibilities with the technology.

With greater interoperability between avatars and platforms, one could argue that virtual environments should be governed by the same design principles as other media. There may come a day when virtual worlds follow the Web Content Accessibility Guidelines (WCAG 2.0) of the W3C, just like text-based websites and other online properties. The Dublin Core Metadata Initiative is one possible avenue towards a metadata standard applicable to virtual environments. Also encouraging is the recent support of HTTP-in methods for objects within Second Life.38 As more external services are enabled to transmit and receive data in-world, scripted objects can be more universally and easily interpreted by assistive devices that rely on text inputs.

9. Conclusion

In an article published in the Spring 2009 issue of Access: The inclusive design journal, Diane Carr reported on the reaction of the Deaf community when Second Life added a feature enabling verbal interaction via microphone input. The assumption was that voice would now become the "normal" way to converse in-world. Thus was created a controversy between deaf protesters objecting to voice functionality and non-disabled users, who viewed the protesters as "martyrs" requiring "special measures" to cope in Second Life.39

Such discussions reinforce the importance of considering the social and cultural factors of accessibility. The difference between virtual worlds and other computer programs is the degree to which users identify with their profile, as well as how fiercely they connect and defend their respective communities of practice. Often these aspects of behavior transcend from the offline world to the virtual. As Carr writes, "We need to consider the expectations and assumptions about disability – or any other aspect of identity – that are carried into virtual worlds from our everyday lives."40

While technological innovations are exciting and certainly important, it's necessary to keep in mind the benefit that barrier-free virtual environments provides. There is therapeutic value in distraction and the role it plays as a form of pain management. People with disabilities have the opportunity to escape their bodies, if they so choose, or to celebrate their unique gifts among peers. The art historian Amelia Jones once described a notion of the body as "transcending ... through pure thought—or, more recently, via free-floating Internet subjectivities … heighten(ing) the tension between subject and object; (putting) into play the new relations of signification produced by the emergence of digital representation."41

Figure 9: Scene from Second Life's Wheelies island. Many avatars meet here to discuss topics of mutual interest, both in-world and in real life.

Figure 9: Scene from Second Life's Wheelies island. Many avatars meet here to discuss topics of mutual interest, both in-world and in real life.

Fantasy is, in and of itself, a Universally Designed entity because it applies to disabled and nondisabled people alike. Everyone dreams about what they cannot do, whether it is the ability to fly in space, wake up in the morning free of pain, or have a conversation with someone other than a home care nurse. For people with disabilities, virtual worlds operate in symbiosis with real life to meld digital and analog realms into one holistic experience. We are reminded of a prediction made in the mid-1990's by the writer Nicholas Negroponte: "Computing is not about computers any more. It is about living."42

10. Acknowledgements

The author thanks Alice Krueger, MS, Allison Selby, MS and Dr. David Toub, MD, MBA for their insightful feedback.

11. Notes

  1. Johnson, H.M. (2006), "Too Late to Die Young: Nearly True Tales from a Life", New York: Picador. p. 253.
  2. Duranske, B.T. (2008), "Virtual Law", Chicago: ABA Publishing, pp. 20-23.
  3. Ramachandran, V.S. (2006). "On my mind." In Seed, Downloaded January 10, 2009
  4. Deeley, L. (2008), "Is this real life, is this just fantasy?" In The Times online. Downloaded December 30, 2008
  5. "Sensoor emotional support." (2008), Downloaded February 10, 2009
  6. Mollman, S. (2008), "Avatars in rehab: getting therapy in virtual worlds", In Downloaded July 12, 2008
  7. Prensky, M. (2001), "Digital natives, digital immigrants", Downloaded February 20, 2008,%20Digital%20Immigrants%20-%20Part1.pdf.
  8. Hinton, A. (2006), "Clues to the future", Downloaded April 24, 2008
  9. White, G. (2008), "Haptics", In Second Life for the Visually Impaired, Downloaded February 7, 2009
  10. Ingham, T. (2008), "20% of casual gamers are disabled", Downloaded February 7, 2009
  11. White, G., Fitzpatrick, G. and McAllister, G. (2008), "Toward accessible 3D virtual environments for the blind and visually impaired", Downloaded October 3, 2008
  12. De Pascale, M., Mulatto, S. and Prattichizzo, D. (2008), "Bringing haptics to second life", In SIRSLab, Downloaded October 2, 2008
  13. Adams-Spink, G. (2007), "Technique links words to signing", In BBC News online, Downloaded May 20, 2008
  14. Carter, W.S. and Corona, G.D. (2008), "Virtual worlds user interface for the blind", Downloaded December 11, 2008
  15. Linden, P. (2009), "Beautiful visions beyond sight: guide dogs and Helen Keller Day in Second Life", Downloaded June 30, 2009
  16. Carter, W.S. and Corona, G.D. (2008), "Exploring methods of accessing virtual worlds", Downloaded January 17, 2008
  17. Dyck, J., Pinelle, D., Brown, B. and Gutwin, C. (2003), "Learning from games: HCI design innovations in entertainment software", Downloaded April 24, 2008
  18. Deeley, L. (2008), "Is this real life, is this just fantasy?" In The Times online. Downloaded December 30, 2008
  19. Brady, J. (2008), "How 'second life' therapy helps Asperger's patients", In WFAA online. Downloaded May 20, 2008
  20. Stein, R. (2007), "Limits, inhibitions disappear online", In Seattle Times online. Downloaded May 20, 2008
  21. Phillips, A. (2007), "Asperger's therapy hits second life", In ABC News online. Downloaded December 29, 2008
  22. B., J.M. (2008), "Wilde Cunningham: a heartwarming story", In Nobody Important. Downloaded December 29, 2008
  23. Brady, J. (2008), "How 'second life' therapy helps Asperger's patients", In WFAA online. Downloaded May 20, 2008
  24. Mollman, S. (2008), "Avatars in rehab: getting therapy in virtual worlds", In Downloaded July 12, 2008
  25. McKinney, S., Horspool, A. Willers, R., Safie, O. and Richlin, L. (2008), "Using Second Life with learning-disabled students in higher education", in Innovate Online, Downloaded January 2, 2009
  26. Legrand, R. (2008), "Virtual ability island: introducing people in SL in a gentle way", From Mixed Realities, Downloaded August 16, 2008
  27. Dyck, J., Pinelle, D., Brown, B. and Gutwin, C. (2003), "Learning from games: HCI design innovations in entertainment software", Downloaded April 24, 2008
  28. Deeley, L. (2008), "Is this real life, is this just fantasy?" In The Times online. Downloaded December 30, 2008
  29. Jones, C. (ed.), Jones, Amelia (2006), "Sensorium: Embodied Experience, Technology, and Contemporary Art", Cambridge: MIT Press, p. 133.
  30. Nino, T. (2009), "Second Life objects to become HTTP-aware", In Massively online, Downloaded July 10, 2009
  31. Carr, D. (2009), "Virtually Accessible", in Access: The Inclusive Design Journal, Downloaded February 16, 2009
  32. Jones, C. (ed.), Jones, Amelia (2006), "Sensorium: Embodied Experience, Technology, and Contemporary Art", Cambridge: MIT Press, p. 133.
  33. Negroponte, N. (1996), "Being Digital", New York: Vintage Books, pp. 101-102.

12. References