The development, testing and evaluation of an accessible haptic gaming system and controller for children with cerebral palsy


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The development, testing and evaluation of an accessible haptic gaming system and controller for children with cerebral palsy by David Hobbs, Max Hughes, Dr. Brett Wilkinson, Sandy Walker, A/Prof Ray Russo, A/Prof Susan Hillier and Prof. Karen Reynolds

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The development, testing and evaluation of an accessible haptic gaming system and controller for children with cerebral palsy

  1. 1. An accessible, haptic gaming system for children with cerebral palsy Dr. Brett Wilkinson Presenting the work of: Mr David Hobbs
  2. 2. Presentation Outline • What is the issue? – An overview of hand sensory impairment in children with cerebral palsy (CP) – Can sensory awareness be improved through technology? • A novel system for sensory intervention – Game system (software) – Accessible controller design (hardware) • Questions & discussion
  3. 3. The Literature • Tizard, Paine & Crothers (1952,1954) published the first papers (CP hemiplegia) – 106 children, 57 had some type of sensory impairment – “The sensory impairment is in some cases the major reason for disuse of the arm that is affected with hemiplegia” • 24 studies published from 1952 – 2012 – Only one Australian study (Auld et al., 2012) • Sensory impairment is common; prevalence rates varying from 42% to 97% (Tachdjian et al., 1958; Van Heest et al., 1993) • Sensory impairments also present in the ‘non-affected’ (dominant) hand (Cooper et al., 1995; Arnould et al., 2007; Wingert et al., 2008; Holmstrӧm, et al., 2010; Auld et al., 2012)
  4. 4. Conclusions and Study Aim • Sensory impairment is now generally acknowledged in this population – “The question arises as to whether the patient with a sensory loss can be trained to overcome the loss or to compensate for it” (Kenney, 1963) – ‘Sensory Story’ (interactive, personalised, hands-on, “touch-and-feel”) (Barrett & Jones, 1967) • Q: Can impaired tactile sensory function in the hands of children with CP be influenced using technology?
  5. 5. If so, how? • Children don’t typically exercise – they play – Can we capitalise on a child’s willingness to play rather than work – turn therapy into play? • An ideal intervention requires: – – – – Buy in (‘cognitive investment’) Engagement (motivation) The opportunity to experience Exposure (high ‘dosage’) • Can ‘serious games’ help? – Can they provide a ‘sensory experience’?
  6. 6. Most children love to play computer games
  7. 7. Computer Game Inaccessibility • Children with CP face two major obstacles when they want to play commercial gaming systems: Hardware Software
  8. 8. ‘Serious Games’ and CP • Applications include: – Improving self-confidence (Reid, 2002) – Improving mobility (Deutsch et al., 2008) – Providing aerobic exercise (Ballaz et al., 2011) “… a meaningful and engaging therapeutic activity, such as using computer games controlled by leaning the upper body, … can improve sitting ability” (Wade & Porter, 2012)  Improving postural control (Wade & Porter, 2012) – Trunk to pelvis coupling (Barton et al., 2013) Copyright © Informa UK, Ltd., Disability and Rehabilitation: Assistive Technology
  9. 9. The Design Challenge • To develop a suite of interactive, entertaining, ‘commercial quality’, fun computer games appropriate for children with CP (software) that can be played with… • … an accessible, intuitive, ‘cool’ and easy to use controller (hardware)
  10. 10. Tactile Sensory ‘Rehab Games’ • Games tailored to engage and stimulate – Custom games provide complete control – Engage with appealing colours, sounds, animations (integrated sensory approach), challenging game-play – Afferent sensory stimulation (feedback) on palms and finger tips via the controller, in tune with visual/auditory feedback and game play (contextually relevant feedback) – Record all game sessions (game metrics) – calculate ‘dosage’ (game-play time and stimulation amount) – Random – no two games are alike – Forced bimanual use
  11. 11. The Gaming System • • • • XNA Game Studio Limited interaction (joystick only) Thorough ideation and design process Student development – Motivation to develop quality (not grades) – Award winning software project
  12. 12. The Gaming System
  13. 13. The Gaming System
  14. 14. The Gaming System
  15. 15. User Evaluation of Games • Two rounds of evaluation with typically developed children – 4-13 years of age – 14-16 years of age • Played all games, repeated favourite games at will • In-game logging • During and post-game feedback
  16. 16. User Evaluation of Games • Primary children: – 362 games (avg. 11.7; range 4-21) • Secondary children – 246 games (avg. 14.5; range 6-28) Question (‘yes’ response only) Primary School cohort (n=31) High School cohort (n=17) Enjoyed playing the game? 88% 88% Would play same game again? 85% 77% Would buy game? 74% 38% 7.3 (5.9 – 8.7) 7.0 (4.5 – 8.2) Average interest in game (/10)
  17. 17. User Evaluation of Games • A 12-year old girl with CP (right side hemiplegia) volunteered to test and critique our games (December 2011) • Comments: – “the [sensory stimulation] of the controller when you hit something was very creative and easily felt” – “the games I played, which were exciting and mostly creative, were quite fun to play” – “I had the best 2 weeks of my life playing the games”
  18. 18. ‘Controller’ Specs • • • • • • • • No (game-play) buttons Bimanual control Independent sensory stimulation to both hands Self-centring and wired An easily accessible ‘out-of-game’ button Durable, suitable for table, and potentially, lap use Based on an Xbox 360TM controller technical package Provide a mechanism for strapping a single hand to either side of the controller (restraint)
  19. 19. Two designs
  20. 20. User evaluation • • • • • • Mouse-like Handhold Planar sliding Good 2D Good isolation Conflict in control with 3D games
  21. 21. Award Winning Designs • Both designs allowed intuitive engagement with game system – Target population evaluation was positive • Both designs won individual awards at industrial design exhibitions • One proved greater appeal, robustness and intuitiveness
  22. 22. Prototype Controller Designs • • • • • • ‘Wow!’ ‘Natural’ ‘Intuitive’ ‘Creative’ Easy to use Would like one Mr Max Hughes
  23. 23. Final Prototype Design Restraint strap Bimanual use No buttons Sensory stimulation ‘External’ button Mr Max Hughes
  24. 24. Final Controller Design
  25. 25. Final Controller Design • Improved haptic isolation • Improved strapping mechanism • Built-in proximity sensors (oval pad) • Textured oval pad • Rim/edge lighting (LEDs) Mr Max Hughes
  26. 26. Conclusion • ‘Orby’ is currently being manufactured • 15 games: developed, tested & evaluated • Stage 2 (RCT) has begun – 15 participants currently enrolled • Provisional patent filed for overall system – Looking for commercial partners – Tangential and complimentary markets being explored
  27. 27. Acknowledgements • The Software & Hardware Teams – Brad Wesson, Martin Henschke, Hamza Khaliq, Mai Nassier, Sidharth Arur, Matthew Kuckhahn, Jingyu Liu, Yao Dai, Yongqun Yu, Yun Chen, Chad Lundstrom & Karnung Liang (Flinders) and Max Hughes, Tom Whitby & Sandy Walker (UniSA, School of Art, Architecture and Design) • Games and Controller Evaluations – The two schools and the two children with CP who tested the system ‘in-home’ (games) – The children with CP who volunteered to test the prototype controllers (hardware) • Our participants to date and the SACPR
  28. 28. Acknowledgements Project Funders and supporters • Flinders University – School of Computer Science, Engineering and Mathematics (CSEM) and – Faculty of Science & Engineering
  29. 29. Questions Mr David Hobbs Dr Brett Wilkinson