Last month, pediatric specialists from across town visited Children’s Hospital Boston for demos of a technology designed to motivate children with cerebral palsy (CP) to do their occupational therapy. Created by a multidisciplinary team from Spaulding Rehabilitation Hospital (SRH) and the Harvard School of Engineering and Applied Sciences (SEAS), the system uses a three-foot wide tabletop touchscreen donated by Microsoft Surface–imagine a giant iPad.
Developer Pa0lo Bonato, PhD, director of the Motion Analysis Laboratory at SRH, who partnered with Chia Shen, director of the SDR (Scientists’ Discovery Room) lab at SEAS, wanted a system that would be fun for children to use, but also deliver legitimate therapeutic value. Pediatric occupational therapists provided feedback on the system during its design and arranged for patients at Children’s Cerebral Palsy Clinic to test it with the help of Occupational Therapist Michelle Coldwell, OTR/L.
Patient Katie Watson, who travels 540 miles roundtrip for her Children’s visits, is already uncomfortable, anxious and in no mood for the frustrating and sometimes painful stretching and dexterity exercises involved in her therapy. But the demo quickly showed that for kids with CP, stretching doesn’t seem like such a chore if you’re reaching for the keys of a virtual piano, or fingerpainting broad swaths of purple and green across an enormous electronic canvas. Trying to coordinate both hands on a task was a little less frustrating when that task was capturing animated butterflies or feeding bones to a cartoon dog.
The table is programmed with custom-developed games and activities that encourage the principal elements of cerebral palsy therapy. CP covers a variety of neurologic disorders with varying symptoms and mobility difficulties–Katie has spina bifida–so adaptability of the touchscreen technology is key. Games can be designed around specific goals, such as stretching, movement, range-of-motion, use of both or arms together or increased visual skills. Even the size of the screen plays a role–it is just wide enough to keep Katie’s attention by blocking out other sensory input.
Alan Dunne, a PhD student in Bonato’s lab visiting from the National University of Ireland in Galway, brought an expertise in sensing technology to the project. For the best therapeutic results, it’s important that children using the touchscreen move properly–reaching and stretching, not leaning. So Dunne developed a lightweight sensor vest for kids to wear while using the table. If a child “cheats” while assembling a puzzle of a tiger, leaning forward to touch the pieces on the screen instead of reaching for them, the pieces scatter to the corners of the screen until he sits back.
The project is still in development, but if Bonato and Shen are able to obtain funding, they’ll build a system where hospitals and clinics can maintain personal progress records for each patient who uses the tabletop system. Visit to visit, patients and their families would be able to track their progress and plan therapy goals, giving kids something positive to look forward to at therapy time.