Renegotiation of Identity after a Brain Injury Using Immersive Virtual Environments

Objective
Identity issues on the consequences of a brain injury have been addressed in research for the last 20 years. However, concrete suggestions for how to implement the issues in practice are still insufficient. This paper addresses how avatar-mediated interactions in immersive virtual environments facilitate re-establishing a weakened identity in social and cultural contexts where the linguistic and communicative development are secondary, yet present.

Methods
A case study embracing two pilot courses in an immersive virtual environment, Second Life, will be presented. The first course is a pedagogical course for speech therapists, and the other is a rehabilitation course for persons suffering from aphasia. The courses were conducted by speech therapists at The Institute for Speech, Language, and Brain Disorders in Aalborg, DK, from 2011 to 2012. The data comprise interviews, video recordings and workshops collected in relation to the authors Ph.D. thesis. The approach of the study is qualitative and phenomenological, with the intention of giving a voice to persons with aphasia.

Results
The research demonstrates that putting rehabilitation into a socio-cultural framework, using non-verbal and verbal communication offers the potential to focus on the WHO´s recommendations to consider impairment as the limitation of opportunities for participation in society. Learning and re-learning language in a social-cultural perspective demands that the rehabilitation activities take place through social interactions with others and is dependent of the feedback people receive from others. Immersive virtual learning environments accommodate a suitable setting for this. Interacting with variety of ICT- mediated and multimodal communication tools and by meeting a variety of perception modes in media-rich web-based social communities, a virtual environment, like Second Life, facilitates cognitive training, renegotiation of identity, and alternative ways and compensation strategies for telling your story and presenting whom you are. Moreover, avatar-mediated interaction in immersive virtual environments contributes to a strengthened renegotiation of identity through shared experiences, a joint repertoire, joint culture and heritage, narratives, and communication. Through embodied interactions, persons suffering from aphasia have shown to be capable of immersing themselves in the interactions and scenarios of Second Life to great extent, leading them to experience a high degree of presence. Furthermore, the settings have shown to be of great importance. The pilot courses took place in a part of Second Life that is designed as a copy of a Danish Town, known from a very popular TV series. The familiarities of the setting revealed to trigger the participants’ autobiographical memory, and made them able to tell their own stories, learn new things, have cultural experiences, and renegotiate their identities.

Conclusions
Avatar-mediated learning has shown to add important possibilities for addressing renegotiations of identity in the rehabilitation of people suffering from aphasia.