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Sharon Kirshner BOT, MSc , Patrice L (Tamar) Weiss PhD , Emanuel Tirosh MD

Measuring the Effect of Affective Stimuli on Autonomic Responses and Task Performance in a Virtual Environment in Children with and without Cerebral Palsy. Sharon Kirshner BOT, MSc , Patrice L (Tamar) Weiss PhD , Emanuel Tirosh MD. University of Haifa Ethics Committee Approval no. 057/08.

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Sharon Kirshner BOT, MSc , Patrice L (Tamar) Weiss PhD , Emanuel Tirosh MD

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  1. Measuring the Effect of Affective Stimuli on Autonomic Responses and Task Performance in a Virtual Environment in Children with and without Cerebral Palsy Sharon KirshnerBOT, MSc, Patrice L (Tamar) WeissPhD, Emanuel TiroshMD University of Haifa Ethics Committee Approval no. 057/08

  2. . . . When performing everyday activities what is the impact, if any, of environmental sensory stimuli on the child’s emotional response ? on task performance?

  3. Affective Stimuli May affect the individual on many levels: emotional, behavioral, physiological, choices (Stroebele & De Castro, 2004) Can capture and divert attention regardless of their relevance to ongoing tasks (Dolcos and McCarthy, 2006)

  4. Cerebral Palsy (CP) • Primary disorders in the development of motor & postural control due to damage to brainbefore, during or after birth. • Often accompanied by disturbances of other body systems. (Rosenbaum et al., 2007) Decreased Participation in Daily Activities

  5. Video Capture VR Affective Stimuli Cerebral Palsy vs. Typical Controls ? Anxiety Task Performance Total time Errors / success Autonomic Functions Skin conductance Heart rate variability

  6. Study Goals Through developing a functional VE (Meal-Maker) for children with CP: • To evaluate the impact of affective stimuli during virtual meal-making on: - autonomic responses - task performance • To examine differences between children with CP and typically developing peers

  7. Subjects

  8. Emotional Meal-Maker (EMM) The EMM is a modification of the virtual Meal-Maker kitchen environment (Kirshner, Weiss, & Tirosh, 2011) • Task Instructions: • To prepare as many repetitions of each meal as possible • To continue to prepare meals even when pictures (affective stimuli) appear

  9. EMM- Affective Stimuli • Six different pictures from the International Affective Picture System (IAPS) (Lang, Bradley, & Cuthbert, 1999) Pleasant Neutral Unpleasant

  10. Part 1: Baseline questionnaires, practice using Meal-maker • Part 2: • Emotional-Meal-Maker Recording of Autonomic Activity Study Procedure Behavioural Questionnaires (state /trait anxiety, sensory profile) MM Task Break (5 min) Calm State Counterbalanced • Skin conductance • Heart rate variability • (LF:HF) Passive Visual Slide Display EMM task SFQ-child Questionnaire SAM ratings(valence & arousal)

  11. Autonomic Functions Raw ECG Skin Conductance Marker Filtered ECG R R LF : HF ratio

  12. Outcome 1a: Differences between the Groups • Children with CP had lower EMM performance scores (p= 0.041) • Children with CP had higher LF:HF ratio during calm state compared to typical controls (p= 0.033) • Typical controls had significantly higher SCL during activity than during calm-state (P= 0.002)

  13. Outcome 1b: Differences between the Groups Children with CP had significantly greater LF:HF responses than typical controls in meals with negative stimuli (p= 0.011) * CP TD

  14. Outcome 2: • Differences within each Group No significant differences where found within either group as a function of affective stimuli: • Autonomic responses (LF:HF responses / SCL) • Task performance

  15. Discussion:1) Differences between Groups Children with CP : • may have sympathetic activity dominance (greater LF:HF) • may have less ability to adapt to a changing environment than typically developing children (autonomic system regulation) (Yang et al., 2002; Zamuner, 2011) • may be more sensitive to stress compared to typically developing peers

  16. Discussion: • 2) Differences within Groups Lack of significant differences in autonomic responses and performance as a function of affective stimuli may be related to the interplay between emotion & cognition (e.g., Dennis, 2010; Kreibig et al., 2010; O'Toole et al., 2011) • Recommendation: To examine the effect of stimuli properties in future studies (e.g., exposure time, type)

  17. VR Technology This study supports the use of video-capture meal-making VE as a platform for the investigation of emotional aspects of behaviour of children with and without CP

  18. Thank You Acknowledgments: Eugene Mednikov, Andrey Markus, Dr. Keren Or-Chen, Sandra Zukerman, GalitAmsalem, Saskia Blum-Draat . Special thanks to all children and their families for their enthusiastic participation.

  19. Correlations between Trait Anxiety and Autonomic Functions Only for children with CP.

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