In human vision, the useful field of view (or UFOV) is the portion of the field of view from which information can be extracted without eye or head movements.Ball, K., V.G. Wadley, and J.D. Edwards, Advances in technology used to assess and retrain older drivers. Gerontechnology, 2002. 1(4): p. 251-261. UFOV size generally decreases with age,Sekuler, A.B., P.J. Bennett, and M. Mamelak, Effects of aging on the useful field of view. Exp Aging Res, 2000. 26(2): p. 103-20. most likely due to decreases in visual processing speed, reduced perception, and difficulty ignoring distraction.Cosman, J. D., Lees, M. N., Lee, J. D., Rizzo, M., & Vecera, S. P. (2012). Impaired attentional disengagement in older adults with useful field of view decline. Journals of Gerontology Series B: Psychological Sciences, 67(4), 405-412. UFOV performance is correlated with important real-world issues, including risk of an automobile crash.Owsley, C., Ball, K., McGwin Jr, G., Sloane, M. E., Roenker, D. L., White, M. F., & Overley, E. T. (1998). Visual processing impairment and risk of motor vehicle crash among older adults. Jama, 279(14), 1083-1088. Clay, O. J., Wadley, V. G., Edwards, J. D., Roth, D. L., Roenker, D. L., & Ball, K. K. (2005). Cumulative meta-analysis of the relationship between useful field of view and driving performance in older adults: Current and future implications. Optometry and vision science, 82(8), 724-731.Performance can be improved by computer-based training.Edwards, J. D., Wadley, V. G., Vance, D. E., Wood, K., Roenker, D. L., & Ball, K. K. (2005). The impact of speed of processing training on cognitive and everyday performance. Aging & mental health, 9(3), 262-271. Edwards, J. D., Wadley, V. G., Myers, R. S., Roenker, D. L., Cissell, G. M., & Ball, K. K. (2002). Transfer of a speed of processing intervention to near and far cognitive functions. Gerontology, 48(5), 329-340. Edwards, J. D., Valdés, E. G., Peronto, C., Castora-Binkley, M., Alwerdt, J., Andel, R., & Lister, J. J. (2015). The efficacy of InSight cognitive training to improve useful field of view performance: A brief report. Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 70(3), 417-422.:
History
UFOV assessment and training programs were primarily developed by Karlene Ball of the University of Alabama at Birmingham, and Daniel Roenker of Western Kentucky University. The first versions of the assessment and training programs were produced at Northwestern University by Robert Sekuler and Ball.Sekuler, R. and K. Ball, Visual localization: age and practice. J Opt Soc Am A, 1986. 3(6): p. 864-7; Ball, K.K., et al., Age and visual search: expanding the useful field of view. J Opt Soc Am A, 1988. 5(12): p. 2210-9. These programs were originally made available through Visual Awareness Inc. Ball, K.K. Visual Resources Inc. (1990). Method for diagnosing deficiencies in and expanding a person's useful field of view. (U.S. Patent No. 4,971,434). United States Patent and Trademark Office.
Assessment
The traditional UFOV assessment is a computer-based visual test containing three subtests.Edwards, J. D., Ross, L. A., Wadley, V. G., Clay, O. J., Crowe, M., Roenker, D. L., & Ball, K. K. (2006). The useful field of view test: normative data for older adults. Archives of Clinical Neuropsychology, 21(4), 275-286. Edwards, J. D., Vance, D. E., Wadley, V. G., Cissell, G. M., Roenker, D. L., & Ball, K. K. (2005). Reliability and validity of useful field of view test scores as administered by personal computer. Journal of clinical and experimental neuropsychology, 27(5), 529-543.
Processing Speed: Determines threshold for discriminating stimuli presented in central vision. Divided Attention: Same as 1, but with the addition of a concurrent peripheral target location task. Selective Attention: Same as 2 but with the addition of distracters.
The threshold scores are combined to produce an overall performance score.Aust, F., & Edwards, J. D. (2016). Incremental validity of useful field of view subtests for the prediction of instrumental activities of daily living. Journal of Clinical and Experimental Neuropsychology, 38(5), 497-515.https://doi.org/10.1080/13803395.2015.1125453
Note: UFOV is not the same as a visual field or perimetry test that examines the ability of the visual system to process light falling on various regions of the retina. Perimetry tests check for the integrity of the visual system while UFOV tests the ability to pay attention to the information in the visual field particularly when under situations of increased demand for attention.
Impact Performance on the UFOV assessment is correlated with several real-world functions:
Several studies have shown that a reduction in UFOV is correlated with an increased risk of an automobile accident, with poor performers about twice as likely to have an automobile crash as good performers.Ball, K., and C. Owsley Identifying correlate of accident involvement for the older driver. Hum Factors, 1991. 33(5): p. 583-95.; Ball, K., C. Owsley, and M. Sloane, Visual and cognitive predictors of driving problems in older adults. Exp Aging Res, 1991. 17(2): p. 79-80.; Ball, K., et al., Visual attention problems as a predictor of vehicle crashes in older drivers. Invest Ophthalmol Vis Sci, 1993. 34(11): p. 3110-23.; Goode, K.T., et al., Useful Field of View and Other Neurocognitive Indicators of Crash Risk in Older Adults. Journal of Clinical Psychology in Medical Settings, 1998. 05(4): p. 425-440. Drivers with poor UFOV performance take longer to cross intersections and initiate crossing later.Pietras, T.A., et al., Traffic-entry behavior and crash risk for older drivers with impairment of selective attention. Perceptual and Motor Skills, 2006. 102(3): p. 632-44. The UFOV assessment is one of the best visual or cognitive predictors of crash rates, surpassing visual acuity tests (used at most Department of Motor Vehicle test sites).Owsley, C., et al., Visual risk factors for crash involvement in older drivers with cataract. Arch Ophthalmol, 2001. 119(6): p. 881-7.; Owsley, C., et al., Visual processing impairment and risk of motor vehicle crash among older adults. JAMA, 1998. 279(14): p. 1083-8. Poor UFOV performers have more collisions during obstacle navigation while walking.Broman, A.T., et al., Divided visual attention as a predictor of bumping while walking: the Salisbury Eye Evaluation. Invest Ophthalmol Vis Sci, 2004. 45(9): p. 2955-60. People with poor UFOV performance have higher rates of falls causing injuries.Vance, D.E., et al., Predictors of falling in older Maryland drivers: a structural equation model. J Aging Phys Act, 2006. 14(3): p. 254-69.
Cognitive Speed of Processing Training
Performance can be improved by computer-based training.Speed-of-processing and driving simulator training result in improved driving performance.DL Roenker, GM Cissell, KK Ball, VG Wadley, JD Edwards Human factors 45 (2), 218-233 Ball, K., et al., Effects of cognitive training interventions with older adults: a randomized controlled trial. JAMA, 2002. 288(18): p. 2271-81. Multiple studies have shown that improved UFOV performance generalizes to several real-world functions. UFOV training has been shown to:
Reduce dangerous driving maneuvers by 36% when measured 18 months following training.Roenker, D.L., et al., Speed-of-processing and driving simulator training result in improved driving performance. Hum Factors, 2003. 45(2): p. 218-33. The same study showed faster reaction times equating to an additional 22 feet more stopping distance at 55 mph. Reduce at-fault automobile crashes by 51% in the five-year period following training.Ball, K., et al., The Effects of Training on Driving Competence – Crash Risk, in Transportation Research Board Annual Meeting. 2009: Washington DC, USA. Reduce the risk of driving cessation by 40%.Ball, K., Edwards, J. D., Ross, L. A., & McGwin, Jr, G. (2010). Cognitive training decreases motor vehicle collision involvement of older drivers. Journal of the American Geriatrics Society, 58(11), 2107-2113. Help maintain driving distance and driving in difficult situations such as in the dark, in rain, and rush hour traffic and prolongs safe driving mobility.Edwards, J.D., et al., The Longitudinal Impact of Cognitive Speed of Processing Training on Driving Mobility. Gerontologist, 2009. Edwards, J.D., P.B. Delahunt, and H.W. Mahncke, Cognitive Speed of Processing Training Delays Driving Cessation. J Gerontol A Biol Sci Med Sci, 2009. Reduce the risk of serious health-related quality of life decline measured at 2 and 5 years.Wolinsky, F.D., et al., The ACTIVE cognitive training trial and health-related quality of life: protection that lasts for 5 years. J Gerontol A Biol Sci Med Sci, 2006. 61(12): p. 1324-9.; Wolinsky, F.D., et al., The effects of the ACTIVE cognitive training trial on clinically relevant declines in health-related quality of life. J Gerontol B Psychol Sci Soc Sci, 2006. 61(5): p. S281-7. Reduce subsequent annual predicted medical care expenditures at one year (by $244) and five years (by $143 p.a.).Wolinsky, F.D., et al., The ACTIVE cognitive training trial and predicted medical expenditures. BMC Health Serv Res, 2009. 9: p. 109. Reduce decline in instrumental activities of daily living measured at 5 yrs post UFOV training.Willis, S.L., et al., Long-term effects of cognitive training on everyday functional outcomes in older adults. JAMA, 2006. 296(23): p. 2805-14. Reduce the risk of the onset of clinically significant depression symptoms by 38% measured at 1-year follow-up.Wolinsky, F.D., et al., The effect of speed-of-processing training on depressive symptoms in ACTIVE. J Gerontol A Biol Sci Med Sci, 2009. 64(4): p. 468-72. Improve performance on timed activities of daily living, such as reading medicine instructions, counting change, looking up a phone number, and finding items in a cupboard.Edwards, J.D., et al., The impact of speed of processing training on cognitive and everyday performance. Aging Ment Health, 2005. 9(3): p. 262-71.; Edwards, J.D., et al., Transfer of a speed of processing intervention to near and far cognitive functions. Gerontology, 2002. 48(5): p. 329-40. Increased ability to identify lexical information in older adults.Grabbe, J. W., & Allen, P.A. (2013). Age-Related Sparing of Parafoveal Lexical Processing. Experimental Aging Research, 39, 419-444.
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