Last post (for now)

Dear Readers -
I will no longer be writing this blog, which has been my pleasure to host since August, 2010. It has been my enduring intent to: blog on active video games, robot therapy and virtual reality for children’s rehabilitation; synthesize evidence from published research into short, accurate, easily readable digests; focus largely on technologies available to clinical therapists, and to provide a link to each article or its abstract. I feel I have been faithful to you in these expectations (of myself); forgive me the occasional lapses in publication frequency.
Regards,
David djordan@cw.bc.ca

The Child Development and Rehabilitation Evidence Centre team http://www.childdevelopment.ca/Evidencecentre.aspx will look at how we can meet the needs of readers through this blog or other means in the future.

Challenges for Adopting Virtual Rehabilitation

Report

Virtual Rehabilitation for Children: Challenges for Clinical Adoption

Glegg S

IEEE Pulse, November 16, 2017

DOI: 10.1109/MPUL.2017.2750838

Link to abstract: http://ieeexplore.ieee.org/document/8110871/

Virtual rehabilitation… “allows clinician to control the characteristics of the virtual environment while modifying the degree of challenge to suit individual patient needs”. A recent cross-Canada survey found challenges like "lack of time, funding, treatment space, appropriate patients, and support staff", along with low therapist self-efficacy. However, also reported are facilitating factors such as the capabilities of the software to accommodate patients with differing skills and availability of an evidence base to support use among other factors. Additionally, games are typically made for an older cohort than the children in pediatric rehabilitation, and that parents may want to limit children’s screen time.

"… Implementation of virtual rehabilitation technology requires support for clinicians as they learn how to optimize applications to benefit these patients."

Cell Phones Rehab Games!

Paired Groups

Motor performance of individuals with cerebral palsy in a virtual game using a mobile phone

de Paula JN, de Mello Monteiro CB, da Silva TD, Capelini CM, de Menezes LDC, Massetti T, Tonks J, Watson S & Nicolai Ré AH

Disabil Rehabil Assist Technol. 2017 Nov 1:1-5.

doi: 10.1080/17483107.2017.1392620. [Epub ahead of print]

Link to abstract: www.ncbi.nlm.nih.gov/pubmed/29092683

This seems a great combination for children with cerebral palsy: Game play encouraged on cell phones for motor improvement.

What? For children with cerebral palsy, does game play on a mobile phone result in motor improvement compared to a control group?

How? Participants with cerebral palsy (GMFCS level I and MACS level I) played 25 repetitions of a maze game on cell phones. They were sex- and age-matched with normally developing children. Then they were introduced to a new maze task for 5 trials.

Findings: "We found a significant improvement in the movement time between the first (trial) attempt relative to the last (trial) attempt for the individuals with CP". They did not retain this speed improvement in the new maze task.

We can all play together

Repeated Measures

Ability-based Balancing using the GMFM in Exergaming for Youth with Cerebral Palsy

MacIntosh A, Switzer L, Hwang S, Schneider A L J, Clarke D, Graham T C N & Fehlings D

Games for Health Journal 6 (6), 2017

DOI: 10.1089/g4h.2017.0053

Link to abstract ncbi.nlm.nih.gov/pubmed/29016199

What? Among differently-abled players with cerebral palsy, can "GMFM Ability-based balancing" result in enjoyable fair play for all?

How? Eight 8-14 year olds with GMFM ability level II and III scores played video games in dyads using three different algorithms to even game play.Each dyad went head-to-head three times, using one of three algorithms to balance the competition between them. The three algorithms were a GMFM ability balance, an idealized balance and a control algorithm. The players were asked if the gameplay was fun and fair.

Findings: GMFM Ability-based balancing resulted in the best fit of play that was both ability-balanced and enjoyable.

The Wizard behind the Robot

Case Reports

Wizard of Oz studies with Children

Hoysniemi J & Read J

Link to article: citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.124.4282&rep=rep1&type=pdf

What? This article reports on case studies about Wizard of Oz robots and children. ‘Wizard of Oz’ refers to the human behind the curtain who animates robot’s interaction with children. The robot is not autonomous but operated to some greater or lesser degree by a human wizard, as close to real time as possible.

Why? Wizard of Oz studies are interested in modelling and examining characteristics of computer-human interactions and the capabilities and limitations of autonomy in robots. These studies allow researchers to efficiently try out ways of interacting that might become programmed behavior in a more autonomous robot. It allows collection of data.

What was found? What is the balance between robot autonomy and the wizard in responses to the participant, and the delay inherent in this. Delays that occur as the wizard prepares a response for the robot to make were recognized as a limitation. Of mention is the notion of deception: whether or not the wizard being hidden or seen was an issue for children. Children mis-attributed autonomy to the present wizard even when there were keyboarding sounds occurring at the same time as the wizard was responding. Is there a responsibility on researchers regarding consent when children don’t understand there is a human behind the robot?

My (robot) friend

Blog post

Making new robot friends: Understanding children’s relationships with social robots

Westlund JMK

Published in mit media lab: Personal Robots Group blog, June 13, 2017

Link to blog: media.mit.edu/posts/making-new-robot-friends/

"Hi, my name is Mox! This story begins in 2013, in a preschool in Boston, where I hide, with laptop, headphones, and microphone, in a little kitchenette. Ethernet cables trail across the hall to the classroom, where 17 children eagerly await their turn to talk to a small fluffy robot."

In this engaging blogpost, the author describes a robot used to explore the nature of relationships children build this social, teleoperated machine. In playtests with children, the author learns they form an understanding of robots that differ from the relationship with the robot’s human operator; from pets, from inanimate possessions and from people. Adult ontologies are not applied by children: person or machine, real or imaginary; no condition excludes the possibility of a friend. Characteristics like expressiveness and responsiveness are found to contribute to connection and learning. Robots can ask questions that encourage the child to greater engagement in a story and cue parents to ask similar questions.

Finally, the author expresses concerns about the ethics of providing engaged machines to children and issues a call to engagement in ‘roboethics’.

Research proposal: Transparency, Teleoperation, and Children’s Understanding of Social Robots, Westlund JMK & Breazeal C

Link to research proposal ieeexplore.ieee.org/document/7451888/

Therapists across Canada Surveyed on VR and Active Video Games

Survey

Virtual Reality and Active Videogame-Based Practice, Learning Needs, and Preferences: A Cross-Canada Survey of Physical Therapists and Occupational Therapists

Levac D, Glegg S, Colquhoun H, Miller P & Noubary F

Games for Health Jorunal Volume 6, Number 4; 2017

DOI:10.1089/g4h.2016.0089

Link to abstract: www.ncbi.nlm.nih.gov/pubmed/28816511

Objective: To conduct a cross-Canada survey to poll therapists on virtual reality and active videogame (VR/AVG) use.

Process: A convenience sample of 1071 therapists was polled online using the ADOPT- VR2 instrument (Assessing the Determinants of Prospective Take-up of Virtual Reality).

Findings: Almost half of the respondents had experience with VR/AVG. Factors that favoured VR/AVG use include the technology’s perceived usefulness and the therapists’ sense of self-efficacy.

Barriers to use include “lack of funds, space, time, support staff and appropriate clients”, and “facilitators included client motivation, therapist knowledge and administrative support”. Most of the respondents indicated an interest in learning more about VR/AVG treatment-based programs.