DESIGN OF A VIRTUAL LEARNING ENVIRONMENT FOR
ROMANIAN PATIENTS WITH DYSLEXIA
Gladiola Andruseac, Hariton Costin and Cristian Rotariu
Faculty of Medical Bioengineering
“Gr. T. Popa” University of Medicine and Pharmacy, Iasi, Romania
Keywords: Virtual learning environment, Learning programs, Special needs, Cognitive disabilities, Dyslexia.
Abstract: The main objective of this paper is bringing into your attention the problem of patients with dyslexia,
aphasia or brain injury and how an e-Learning software can help in recovery of this patients. Dyslexia alters
the life of millions of children and adults worldwide and has serious educational, psychological and social
consequences. Approximately between 5% and 10% of the school-aged children show a type of deficiency
in communicating or learning process, with repercussions in absence rate and school abandonment. Our
works aims at carrying out research, design and implementation of a virtual learning environment (VLE),
for rehabilitating patients with cognitive disabilities, in order to re-integrate them into the educational and
socio-professional environment. In this paper we present a multimedia and interactive learning environment
for the benefit of patients with dyslexia.
1 INTRODUCTION
The European Dyslexia Association estimates that
about 10% of the population suffers from this
disease. This disability makes difficult the
acquisition of the printed words, either on paper or
in electronic format. Despite the fact that such a high
percentage of the world population suffers from
dyslexia and this has become a more and more
acknowledged issue nowadays, it continues to cause
serious problems in the process of education and
integration into the work environment.
The European Union is making efforts for
improving the quality of life for persons with special
needs, for promotion of rights and ensuring an active
participation of these persons in the society.
Our goal is to create a computer-based
environment where the dyslexic individual in
Romania may develop and reach their full potential.
The permanent increasing of costs, the uneven and
non-equitable offer of healthcare services has lead to
growing interest for rendering the medical practice
more efficient through techniques of treatment
optimization. Unfortunately, the dyslexic recovery
requires a long period of time in which the patient
must carry on the therapy by all the available means.
By continuing therapy at home, using an e-learning
platform, it is possible to reduce costs of
hospitalizing, movement, or the honorary of the
therapist and at the same time high-quality services
are ensured.
2 e-LEARNING AND DYSLEXIA
IN ROMANIA
Although this paper would appear to be about the
specifics of how to develop an eLearning
environment
of support to the dyslexic individual, it
is important to set this within a framework of
understanding of the problems, and how to support
the individual in Romania, national and institutional
legislation and policies.
Dyslexia represents an inability in performing
reading, writing, spelling and language development
and may be caused by a combination of deficiencies
at the level of auditory and visual processing,
working memory, storage and retrieval in the lexica
(word banks). Also, dyslexia is a difficulty in the
acquisition of literacy skills that is neurological in
origin. It is often assumed that people with dyslexia,
can think “out of the box” in pictorial and abstract
terms. The manifestation of dyslexia in any
individual will depend upon not only individual
301
Andruseac G., Costin H. and Rotariu C. (2009).
DESIGN OF A VIRTUAL LEARNING ENVIRONMENT FOR ROMANIAN PATIENTS WITH DYSLEXIA.
In Proceedings of the First International Conference on Computer Supported Education, pages 301-304
DOI: 10.5220/0001977403010304
Copyright
c
 SciTePress

cognitive differences, but also the language used (for
instance, the vowels in Romanian are similar but not
identical with those of other languages).
Figure 1: Involvement of dyslexia.
In Romania, like in most legislation across
Europe, dyslexia is not covered specifically, but
comes under the umbrella term of disabilities.
Romania currently has no policies with respect to
dyslexia, and is struggling to come to terms with
disability policies and inclusive education,
particularly with respect to our entry into the EU in
2007. Preoccupations in this field do exist at the
level of logopedic and physical and rehabilitation
medicine in the health system. Even though the use
of technologies for learning has been implemented
in Romania for several years, at this moment there is
no integrated system in Romania to allow therapy
carrying on in the family environment.
In this context, our research is a response to
some society challenges and its implementation will
allow the dyslectic persons to continue their therapy
within their family. The product constitutes an
eLearning platform dedicated to the implementation
of logopedic therapy methods, for subjects in
treatment units or at home.
E-learning has been defined by the EU as “the
use of new multimedia technologies and the internet
to improve the quality of learning by facilitating
access to resources and services as well as remote
exchanges and collaboration.” There is much
evidence to support the benefits of using of
multimedia interfaces for patients with
communication and learning disabilities. The
multimedia resources extend their attractiveness and
suggestiveness. An eLearning software also
introduces dynamic elements which allow a
personalized feedback. E-Learning also enables a
greater degree of mobility to the people, who are
now able to reach learning materials from almost
anywhere and at anytime depending only on the
computer and/or network availability.
For patients with learning and communication
disabilities, it is important for the system to be
adapted to their specific needs. Enabling
technologies can greatly enhance a patient's ability
to access e-learning, but it is vital to match the right
technologies with both the user and the tasks to be
undertaken.
3 MATERIALS AND METHODS
Our VLE is a multimedia and interactive
environment, where dyslectic patients may progress
by means of computer-based virtual environment
which respond with a specific reaction to a given
action of the subject. This eLearning system provide
patients access to a suite of software programs to
teach them basic/essential skills needed for everyday
life. We present a method of improvement (not
substitution) of logotherapy for some neurologic
affection through a virtual learning environment.
3.1 The Components of the e-Learning
System
The system is built around a central system which
ensures: (A) Connection to patient; (B) Two
directional communication patient–system and
administrates; (C) Application programs for
recovery; (D) Databases; (E) User interfaces.
Figure 2: A basic structure of the eLearning system.
3.1.1 VLE Design
The virtual learning environment is running on
Windows Server 2003 with IIS 6.0 and SQL Server
2003. Through http protocol it ensures patient
connection to central system (A). The two-
directional communication patient-system (B) is
done by means of classical audio-video devices
(monitor, speakers, microphone, webcam, etc).
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The VLE also provides personalized, role-based
work environments for all users involved in recovery
process: patients and therapist. It contains a number
of work environments for users groups and can be
customized easily to provide users with the precise
content that they need to do their jobs. And, because
access to the application can be ensured via Web
browsers, users can retrieve information at any time,
from any location.
Figure 3: Samples of work environments for users groups.
The VLE has a skinning architecture which
provides a clear separation between design and
content, enabling patients to change the look and
color of interfaces without requiring any specialist
knowledge of development in HTML, ASP.NET,
CSS, Ajax, etc.
3.1.2 The Recovery Module (RM)
The application programs for recovery (C) constitute
the core of the system and are based on recovery
module (RM). RM represents an electronic version
of conventional logopedic methods used in
rehabilitation medicine. The methods implemented
in RM will be based upon the existent objectives
from face-to-face therapy. Exercises have been
designed, developed and implemented for: (1)
comprehension of sound formation and face mimic
for vowels, consonants, syllables, logatoms and
consonantic combinations (video sequences showing
the therapist’s mouth); (2) reading, writing, speaking
at level of letter, word, expression, phrase,
paragraph, image (description); (3) reading, writing,
speaking in a given context (journals etc.); (4)
memorization of geometrical shapes and colours; (5)
action comprehension; (6) comprehension of digits
(numerical, monetary values, date and time); (7)
significance comprehension and memorization of
traffic signs; (8) comprehension of categories; (9)
comprehension of questions; (10) language
development through synonyms, antonyms,
homonyms; (11) comprehension, memorization and
execution of instructions; (12) comprehension of
spatial instructions (left-right, up-down); (13)
assisted reading exercises; (14) games for cognitive
stimulation (colouring, puzzle, memory).
All exercises from RM will have several degrees
of difficulty and personalized feedback (depending
on patient response to the proposed theme). The
application interactivity is given by the multitude of
possible reply types: the patient may speak, write,
describe, pick up from a list (text or images) or can
move the objects on the screen using the mouse.
A Web application server hosts the RM
applications using ASP.NET and Web Services
components of the .NET Framework version 2.0.
Applications for recovery support browser-based
access using Microsoft Internet Information Services
version 6.0 (at least). Also, each application for
recovery is available as an .exe file which can be
downloaded from the private section of the
eLearning system and it run on local computer.
3.1.3 User’s Management
The eLearning platform use SQL Server 2003 for
user’s management and for their access rights. It
supports
the following features: identification of all
key users and their content management roles; the
ability to assign roles and responsibilities to different
content categories or types.
Programs for database (D) allow design and
development of eLearning platform for:
(a) Patients databases (PDB) – for evidence of
dyslexic patients (personal data, type of affection,
therapy methods, progress, degree of integration in
school or socio-professional environment);
(b) Content Database (CDB) – for digital storing
content useful in recovery (text, images, graphics,
audio and speech signals, video sequences) .
The database communicates with the application
using the ADO.NET component of the .NET
Framework v2.0.
3.1.4 User Interfaces
User interfaces (E) represent the means of
communication of the patient/therapist with the
informatics system. They can act as: (a) Patient
interface (PI) – by which the patient has access to
the recovery modules. The interface constitutes a
friendly means of communication, easy to
understand and it is adaptable depending on the
affection type, level of education and age of the
patient; (b) Therapist interface (TI) – represents the
support for therapy personalization. This interface
will permit the therapist to use his knowledge and
DESIGN OF A VIRTUAL LEARNING ENVIRONMENT FOR ROMANIAN PATIENTS WITH DYSLEXIA
303

experience by implementing his own recovery
methods. Through this interface, the therapist will
store the data regarding the patient evidence (in
PDB) as well as multimedia data – images, video
and audio sequences (in CDB).
3.2 Using e-Learning as a Tool for Patients
Recovery
Synthetically, the benefits of recovery modules are:
(1) from the viewpoint of persons with cognitive
affections: RM will constitute the support for the
correction of reading, writing coordination and logic
mistakes; they receive information using symbols
and multimedia technology; they can test their
knowledge and can have a quick an personalized
feedback (2) from the therapist point of view, RM
will offer support for the application of own
knowledge and experience in the development of a
personalized therapy, offering at the same time an
objective evaluation of the patient’s progresses;
Briefly, the benefits of eLearning system are: (1)
therapy sessions designed for every type of
deficiency and personalized for each patient with
regard to age, level of education; increasing
motivation through therapy based on real-time
feedback; (2) support offered for recovery at home –
we may speak about individual recovery, difficult to
realize in classical recovery (face-to-face). Patients
carry on therapy in their own rhythm, being totally
independent of any clinic, a therapist or a schedule;
(3) by collecting data (initial, intermediate and final)
an objective monitoring of progress is ensured;
From a clinical study by Dr. Katz & Wertz,
computers can be powerful clinical tools and below
are the results of the study which provide that speech
therapy software helps patients regain speech &
language.
Figure 4: Efficacy results.
4 RESULTS AND DISCUSSIONS
Until now we have developed an e-learning platform
made up of the following components: (1) an
eLearning platform for patient’s management and
their rights; (2) a recovery module (RM) which is
interactive and multimedia software for
rehabilitation process of dyslexic person.
This is only a stage and our research will focus
on improvement of health of patients with cognitive
affections through implementation of conventional
methods used in logopedy in an integrated system
which also allows remote monitoring and therapy
(similar to telemedicine systems).
5 CONCLUSIONS
There are many ways to acquire in order to develop
and integrate on an even more competitive
employment market. These ways refers to:
development of spoken language, comprehension of
symbolic representation, grapho-motor abilities,
sequential abilities, development of phonologic,
orthographic and semantic stockage.
The current use of traditional educational
methods leaves apart many persons, especially those
suffering from dyslexia.
While the traditional learning methods have
failed in dyslectic persons, it is believed that the
development of an informatics system for dyslectic
persons would largely contribute to their
rehabilitation progress and to relieve their
difficulties in adapting to the demands of present
society and to the strong competition for jobs on the
employment market.
REFERENCES
Smythe I., (2008). Provision and Use of Information
Technology with Dyslexic Students in University in
Europe, Retrieved from
http://www.welshdyslexia.info/minerva/book.pdf.
Katz, Richard C., & Wertz, Robert T. (1997). The Efficacy
of Computer-Provided Reading Treatment for Chronic
Aphasic Adults. Journal of Speech, Language, and
Hearing Research, (Volume 40, pp 493-507, June
1997).
Draffan E.A. (2003). Dyslexia, Technology and e-
Learning, Retrieved from
http://www.techdis.ac.uk/index.php?p=3_8_20
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