Design and Development of One-Switch Video Games for Children with Severe Motor Disabilities

Video games are not just played for fun; they have become a handy instrument for the cognitive, emotional, and social development of children. However, several barriers prevent many children with disabilities from playing action-oriented video games, alone or with their peers. In particular, children with severe motor disabilities, who rely on one-switch interaction for accessing electronic devices, find fast-paced games that require rapid decision-making and timely responses, completely unplayable. This article contributes to lowering such barriers by presenting GNomon (Gaming NOMON), a software framework based on the NOMON mode of interaction that allows the creation of action-oriented single-switch video games. The article reports the results of two studies that evaluate the playability and rehabilitation suitability of GNomon-based video games. The playability of GNomon-based games is evaluated by assessing their learnability, effectiveness, errors, satisfaction, memorability, and enjoyability with a group of eight children with severe motor disabilities. The suitability for pediatric rehabilitation is determined by means of a focus group with a team of speech therapists, physiotherapists, and psychologists from a Local Health Agency in Turin, Italy. The results of the playability study are positive: All children had fun playing GNomon-based video games, and seven of eight were able to interact and play autonomously. The results of the rehabilitation-suitability study also entail that GNomon-based games can be exploited in training hand-eye coordination and maintenance of selective attention over time. The article finally offers critical hindsight and reflections and shows possible new future game concepts

How a Diverse Research Ecosystem Has Generated New Rehabilitation Technologies: Review of NIDILRR’s Rehabilitation Engineering Research Centers

Over 50 million United States citizens (1 in 6 people in the US) have a developmental, acquired, or degenerative disability. The average US citizen can expect to live 20% of his or her life with a disability. Rehabilitation technologies play a major role in improving the quality of life for people with a disability, yet widespread and highly challenging needs remain. Within the US, a major effort aimed at the creation and evaluation of rehabilitation technology has been the Rehabilitation Engineering Research Centers (RERCs) sponsored by the National Institute on Disability, Independent Living, and Rehabilitation Research. As envisioned at their conception by a panel of the National Academy of Science in 1970, these centers were intended to take a “total approach to rehabilitation”, combining medicine, engineering, and related science, to improve the quality of life of individuals with a disability. Here, we review the scope, achievements, and ongoing projects of an unbiased sample of 19 currently active or recently terminated RERCs. Specifically, for each center, we briefly explain the needs it targets, summarize key historical advances, identify emerging innovations, and consider future directions. Our assessment from this review is that the RERC program indeed involves a multidisciplinary approach, with 36 professional fields involved, although 70% of research and development staff are in engineering fields, 23% in clinical fields, and only 7% in basic science fields; significantly, 11% of the professional staff have a disability related to their research. We observe that the RERC program has substantially diversified the scope of its work since the 1970’s, addressing more types of disabilities using more technologies, and, in particular, often now focusing on information technologies. RERC work also now often views users as integrated into an interdependent society through technologies that both people with and without disabilities co-use (such as the internet, wireless communication, and architecture). In addition, RERC research has evolved to view users as able at improving outcomes through learning, exercise, and plasticity (rather than being static), which can be optimally timed. We provide examples of rehabilitation technology innovation produced by the RERCs that illustrate this increasingly diversifying scope and evolving perspective. We conclude by discussing growth opportunities and possible future directions of the RERC program

Adaptable videogame platform for interactive upper extremity rehabilitation

The primary objective of this work is to design a recreational rehabilitation videogame platform for customizing motivating games that interactively encourage purposeful upper extremity gross motor movements. Virtual reality (VR) technology is a popular application for rehabilitation therapies but there is a constant need for more accessible and affordable systems. We have developed a recreational VR game platform can be used as an independent therapy supplement without laboratory equipment and is inexpensive, motivating, and adaptable. The behaviors and interactive features can be easily modified and customized based on players\u27 limitations or progress. A real-time method of capturing hand movements using programmed color detection mechanisms to create the simulated virtual environments (VEs) is implemented. Color markers are tracked and simultaneously given coordinates in the VE where the player sees representations of their hands and other interacting objects whose behaviors can be customized and adapted to fit therapeutic objectives and players\u27 interests. After gross motor task repetition and involvement in the adaptable games, mobility of the upper extremities may improve. The videogame platform is expanded and optimized to allow modifications to base inputs and algorithms for object interactions through graphical user interfaces, thus providing the adaptable need in VR rehabilitation

A systematic review of game technologies for pediatric patients

[EN] Children in hospital are subjected to multiple negative stimuli that may hinder their development and social interactions. Although game technologies are thought to improve children's experience in hospital, there is a lack of information on how they can be used effectively. This paper presents a systematic review of the literature on the existing approaches in this context to identify gaps for future research. A total of 1305 studies were identified, of which 75 were thoroughly analyzed according to our review protocol. The results show that the most common approach is to design mono-user games with traditional computers or monitor-based video consoles, which serve as a distractor or a motivator for physical rehabilitation for primary school children undergoing fearful procedures such as venipuncture, or those suffering chronic, neurological, or traumatic diseases/injures. We conclude that, on the one hand, game technologies seem to present physical and psychological benefits to pediatric patients, but more research is needed on this. On the other hand, future designers of games for pediatric hospitalization should consider: 1. The development for kindergarten patients and adolescents, 2. Address the psychological impact caused by long-term hospitalization, 3. Use collaboration as an effective game strategy to reduce patient isolation, 4. Have purposes other than distraction, such as socialization, coping with emotions, or fostering physical mobility, 5. Include parents/caregivers and hospital staff in the game activities; and 6. Exploit new technological artifacts such as robots and tangible interactive elements to encourage intrinsic motivation.This work is supported by the Spanish Ministry of Economy and Competitiveness and the European Development Regional Fund (EDRF-FEDER) with Project TIN2014-60077-R.El Jurdi, S.; Montaner-Marco, J.; García Sanjuan, F.; Jaén Martínez, FJ.; Nácher-Soler, VE. (2018). A systematic review of game technologies for pediatric patients. Computers in Biology and Medicine. 97:89-112. https://doi.org/10.1016/j.compbiomed.2018.04.019S891129

Future bathroom: A study of user-centred design principles affecting usability, safety and satisfaction in bathrooms for people living with disabilities

Research and development work relating to assistive technology 2010-11 (Department of Health) Presented to Parliament pursuant to Section 22 of the Chronically Sick and Disabled Persons Act 197

Virtual Reality: An Evidence-Based Guide for Occupational Therapy

Problem: Virtual reality (VR) is an emerging technology that serves to position the user in control of a virtual environment to maximize interest and function. VR is a context for intervention included in the Occupational Therapy Practice Framework: Domain and Process 3rd edition (OTPF-3; AOTA, 2014). It is crucial that occupational therapy (OT) practitioners enhance their knowledge about VR technology used by their clients to provide effective client-centered practice (AOTA, 2010). There is a lack of organization of the literature and research evidence regarding the use of VR as an intervention modality. While there has been a significant increase in recent literature supporting the use of VR in OT, there is a need for manuals and resources to guide clinicians in using VR as a therapeutic modality (Levac & Miller, 2013; Proffitt & Lange, 2015). Methods: An extensive literature review for articles regarding the use of the Xbox Kinect and Nintendo Wii within OT was conducted using five databases. Relevant data was extracted from each article related to the use of the Xbox Kinect or Nintendo Wii in intervention to synthesize the findings into charts. The construction of the charts followed the organization of the OTPF-3 (AOTA, 2014). Product: The authors of this product created an evidence-based resource to guide OT practitioners\u27 use of VR. The intended purpose of this product, Virtual Reality: An Evidence-Based Guide, is to assist OT practitioners\u27 adaptation and/or modification of VR activities to address individual client needs. Using this product as a guide to current knowledge and evidence regarding intervention in the context of VR, OT practitioners will be better equipped to make safe and effective choices. To further support development of literature regarding VR, the authors of this product recommended areas for future research

Use of an agile bridge in the development of assistive technology

Engaging with end users in the development of assistive technologies remains one of the major challenges for researchers and developers in the field of accessibility and HCI. Developing usable software systems for people with complex disabilities is problematic, software developers are wary of using user-centred design, one of the main methods by which usability can be improved, due to concerns about how best to work with adults with complex disabilities, in particular Severe Speech and Physical Impairments (SSPI) and how to involve them in research. This paper reports on how the adoption of an adapted agile approach involving the incorporation of a user advocate on the research team helped in meeting this challenge in one software project and offers suggestions for how this could be used by other development teams