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Updated: Feb 6, 2026

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Development of a Virtual Reality Assessment of Everyday Living Skills
Published on: April 23, 2014
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Development and evaluation of a virtual reality game targeting Central auditory processing skills in children using
Seyma Nur Tabak1, Merve Meral Cetinkaya1, Ali Efe Irali2
1Faculty of Health Sciences, Department of Audiology, Istanbul Aydin University, Istanbul, Türkiye.
Disability and Rehabilitation. Assistive Technology
|February 4, 2026
Summary
This study developed Cooklear, a VR game for children with bilateral cochlear implants to improve speech understanding. The VR game showed usability and led to short-term gains in hearing in noise.
Area of Science:
- Audiology
- Virtual Reality Technology
- Pediatric Rehabilitation
Background:
- Bilateral cochlear implants (CIs) offer significant benefits but challenges remain in auditory processing, especially speech understanding in noise.
- Virtual reality (VR) presents an innovative platform for auditory rehabilitation, potentially enhancing engagement and skill development in pediatric CI users.
- Developing targeted VR interventions is crucial for improving central auditory processing skills in children with CIs.
Purpose of the Study:
- To develop and assess the usability of a VR-based restaurant simulation game, Cooklear, designed to target central auditory processing skills in children aged 10-18 with bilateral CIs.
- To evaluate the effectiveness of this VR intervention on improving speech understanding in noise among pediatric bilateral CI users.
Main Methods:
- A randomized controlled study with two phases: VR game development and usability testing (Phase 1), followed by an effectiveness trial (Phase 2).
- Phase 1 involved children with normal hearing and CIs, parents, and professionals for iterative usability assessment.
- Phase 2 randomized 24 children with bilateral CIs into an intervention group (VR + traditional rehab) and a control group (traditional rehab only), measuring speech understanding in noise using the Turkish Hearing in Noise Test (HINT).
Main Results:
- The VR game, Cooklear, was found to be usable and engaging for pediatric users.
- While normally hearing children scored higher on initial prototypes, children with CIs demonstrated significant improvements.
- The intervention group showed significantly greater improvements in speech understanding in quiet and noise compared to the control group.
Conclusions:
- Cooklear is the first Turkish VR-based aural rehabilitation game for pediatric bilateral CI users, demonstrating usability and short-term effectiveness.
- The study highlights the potential of VR interventions to enhance speech understanding in noise for children with CIs.
- Further research is recommended to explore the impact of VR on broader auditory processing skills.
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