Technology-Enhanced Play for Physical Disabilities
Recruiting in Palo Alto (17 mi)
Age: < 18
Sex: Any
Travel: May Be Covered
Time Reimbursement: Varies
Trial Phase: Academic
Recruiting
Sponsor: University of Manitoba
Disqualifiers: Play therapy, others
No Placebo Group
Trial Summary
What is the purpose of this trial?Play is an important activity for children. Almost all children play, but what is play? It is not easy to define play. In the past, people believed that children played to burn their energy. Now, it is known that play is important for children's growth. Some kids with disabilities cannot play. Many experts use play to teach children specific skills. People often forget that play is a child's right. It is important to help all children play. The first step is to define play and find what features are important in helping a child with a disability play.
There are some models of play. But they are not complete. They do not look at play as a whole. Some models are just about playfulness, and some are about playing with others. Having a model that defines play helps researchers and clinicians think about play and the different parts of it. Then, when a child cannot play, experts can fix the part that is not working. Investigators want to introduce a model of play in this project. Investigators want to edit and complete it in three steps. First, Investigators will ask parents and children with disabilities about things that help or do not help them play; then, investigators will give Lego robots to kids that they will build with help and play with them for a few weeks. And at the end, investigators will ask therapists and other experts about our model of play. This model will be edited during the study.
Will I have to stop taking my current medications?
The trial information does not specify whether participants need to stop taking their current medications.
What data supports the effectiveness of the treatment The Dice Model of Play for physical disabilities?
Research shows that play, especially when enhanced with technology, can be a powerful tool in therapy for children with physical disabilities. For example, virtual reality play-based interventions have been shown to improve self-efficacy (belief in one's ability to succeed) in children with cerebral palsy, suggesting that similar play-based treatments could be beneficial.
12345Is Technology-Enhanced Play for Physical Disabilities safe for humans?
The research on technology-enhanced play, such as powered mobility devices and switch-adapted toys, suggests these interventions are generally safe for children with disabilities. They are designed to improve play and mobility without significant safety concerns, although specific safety evaluations for each device may vary.
16789How does the treatment 'The Dice Model of Play' differ from other treatments for physical disabilities?
The Dice Model of Play is unique because it uses technology-enhanced play, such as robots and information and communication technology (ICT), to support play in children with physical disabilities. This approach focuses on making play accessible and engaging, which is different from traditional therapies that may not prioritize playfulness and the child's intrinsic motivation to play.
110111213Eligibility Criteria
This trial is for children aged 3 to 8 with physical disabilities, living in Winnipeg, who speak and understand English. It aims to help them play, which is vital for their growth but often difficult due to their conditions.Inclusion Criteria
Speaking and understanding English
Living in Winnipeg
I have a physical disability.
+1 more
Exclusion Criteria
I have not been diagnosed with Autism or received play therapy recently.
Trial Timeline
Screening
Participants are screened for eligibility to participate in the trial
2-4 weeks
Phase 1: Interviews
Exploring the alignment of the Dice Model of Play with the experiences of children and their guardians through semi-structured interviews and content analysis
4 weeks
1 visit (in-person)
Phase 2: Practical Application
Children build and play with LEGO robots or conventional toys in a cross-over design, with assessments conducted at the start, switching point, and last session
8 weeks
8 visits (in-person)
Phase 3: Expert Opinions
Online focus groups with professionals to seek expert opinions on the revised Dice Model of Play's clarity, relevance, and applicability
4 weeks
Follow-up
Participants are monitored for safety and effectiveness after treatment
4 weeks
Participant Groups
The study tests a new model of play using Lego robots versus conventional methods. Kids will build and interact with the robots over several weeks while researchers refine a comprehensive model of play based on observations.
2Treatment groups
Experimental Treatment
Group I: robotsExperimental Treatment1 Intervention
Participants will be randomly allocated to groups A or B. Those in group A will co-design and build their LEGO™ robot, using the researcher's assistance, as led by the child. A go-along interview will be conducted during the co-design with the child . The co-design session will be video recorded to provide context, visual data, and to inform the qualitative analysis. Videos will be deleted right after analysis. A research assistant (RA) will visit the participant's home twice a week for 30 to 45 minutes (after school or on the weekend) to play with the child and their built LEGO™ robots for four weeks (4 sessions total).
Group II: conventional toysExperimental Treatment1 Intervention
Group B will engage in the same process of 4 play intervention sessions over four weeks with the research assistant; however, they will receive conventional play tools. The RA will carry a prepared play pack for the play intervention session.
Find a Clinic Near You
Research Locations NearbySelect from list below to view details:
Rehabilitation Centre for ChildrenWinnipeg, Canada
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Who Is Running the Clinical Trial?
University of ManitobaLead Sponsor
Rehabilitation Centre for Children, CanadaCollaborator
References
Toward Evaluation of the Subjective Experience of a General Class of User-Controlled, Robot-Mediated Rehabilitation Technologies for Children with Neuromotor Disability. [2021]Technological advances in game-mediated robotics provide an opportunity to engage children with cerebral palsy (CP) and other neuromotor disabilities in more frequent and intensive therapy by making personalized, programmed interventions available 24/7 in children's homes. Though shown to be clinically effective and feasible to produce, little is known of the subjective factors impacting acceptance of what we term assistive/rehabilitative (A/R) gamebots by their target populations. This research describes the conceptualization phase of an effort to develop a valid and reliable instrument to guide the design of A/R gamebots. We conducted in-depth interviews with 8 children with CP and their families who had trialed an exemplar A/R gamebot, PedBotHome, for 28 days in their homes. The goal was to understand how existing theories and instruments were either appropriate or inappropriate for measuring the subjective experience of A/R gamebots. Key findings were the importance of differentiating the use case of therapy from that of assistance in rehabilitative technology assessment, the need to incorporate the differing perspectives of children with CP and those of their parents into A/R gamebot evaluation, and the potential conflict between the goals of preserving the quality of the experience of game play for the child while also optimizing the intensity and duration of therapy provided during play.
Benefits of a virtual play rehabilitation environment for children with cerebral palsy on perceptions of self-efficacy: a pilot study. [2019]This paper presents the results of a clinical trial of a virtual reality play-based intervention. The results of three single case studies are presented. The virtual reality intervention used the Mandala Gesture Xtreme technology. It was applied to three school-aged children with cerebral palsy. A pre-test-post-test design was used. The relevant outcome of interest was self-efficacy as measured with the Canadian Occupational Performance Measure (COPM). Group scores on the COPM indicated clinically significant changes in self-efficacy for all children. Two of the participants demonstrated the greatest changes in both perceived performance abilities and satisfaction with performance with respect to task specific domain areas. Qualitative comments from the participants revealed a high degree of motivation, interest, pleasure, and opportunity for engagement in play, activities not previously engaged in. Overall, this pilot study suggests the viability of a virtual reality play-based intervention as part of the rehabilitation process for children with cerebral palsy. These results form the basis of a larger scale randomized clinical trial.
A Systematic Review on Clinimetric Properties of Play Instruments for Occupational Therapy Practice. [2020]Play is considered the main occupation for children. Pediatric occupational therapists utilize play either for evaluation or intervention purpose. However, play is not properly measured by occupational therapists, and the use of play instrument is limited. This systematic review was aimed at identifying play instruments relevant to occupational therapy practice and its clinimetric properties. A systematic search was conducted on six databases (Academic Search Complete, CINAHL, MEDLINE, Psychology and Behavioral Science Collection, Scopus, and ASEAN Citation Index) in January 2020. The quality of the included studies was evaluated using Law and MacDermid's Appraisal for Clinical Measurement Research Reports, and psychometric properties of play instruments were evaluated using Terwee's checklist while the clinical utility is extracted from each instrument. Initial search identifies 1,098 articles, and only 30 articles were included in the final analysis, extracting 8 play instruments. These instruments were predominantly practiced in the Western culture, which consists of several psychometric evidences. The Revised Knox Preschool Play Scale is considered the most extensive and comprehensive play instrument for extrinsic aspect, whereas the Test of Playfulness + Test of Environmental Supportiveness Unifying Measure is a promising play instrument for intrinsic aspect on play, where both instruments utilize observation. My Child's Play is a potential questionnaire-based play instrument. However, the current development of play instruments in the occupational therapy field is immature and constantly evolving, and occupational therapists should exercise good clinical reasoning when selecting a play instrument to use in practice.
Play as occupation: implications for the handicapped. [2012]That play is a need-fulfilling and appropriate occupation in the life of every person, and particularly in the life of the handicapped, is the basic assumption of this paper. Play is defined, characterized, and discussed in relationship to its role in the treatment process. Various classical and modern theories of play are presented, with the optimum arousal theory of play presented as most significant in the rehabilitation process of the handicapped individual. The approach to this assumption is basically theoretical, and concludes with pragmatic suggestions for optimizing the meaningful involvement of patients in play.
The clinical utility of the test of playfulness. [2022]Occupational therapists' increased focus on play as an occupation has created a need for play assessments that reflect this perspective. This study examined the clinical utility of the recently developed Test of Playfulness (ToP) (Bundy, 1997a) when used with children with disabilities. Changes in the participant's views of the child, the therapy goals, and the intervention plans after using the ToP were explored. Fourteen paediatric occupational therapists assessed children using the ToP, completed a clinical utility questionnaire and attended a focus group. Participants found the ToP easy to administer and score, however some found interpreting the results difficult. The ToP highlights the interactions between the Child, activity and environment, and illustrates the child's strengths in his/her role as a player. The results suggest the ToP is a useful tool for assessing playfulness. Additional education and research is needed to provide further direction for intervention and incorporation into practice.
Evaluation of mechanical tractor pedal extensions. [2008]Many farmers with disabilities choose to modify their work environments to accommodate their personal abilities; however, modified tractors may present greater risk to the operator as they are often one-of-a-kind designs that have not been subjected to rigorous safety testing. The objective of this research was to evaluate mechanical tractor pedal , extensions from a safety perspective. This objective was achieved by identifying potential hazards associated with the introduction of a pedal extension into the cab environment so that both existing and novel designs could be compared using a common methodology. Based on review of the published literature, 19 potential hazards associated with the introduction of a pedal extension into the cab of a tractor were identified. A hazard self-assessment worksheet (HSAW), created based on the 19 hazards, was validated through a pilot study. The overall inter-rater reliability and concurrent criterion validity proved to be acceptable. With the use of the HSAW six pedal extensions (three existing designs and three novel designs) were evaluated by 14 experts. Statistical analysis of the results did not identify a "best" design; however, several important trends were observed. Four of the six designs tended to block access to the exit path. The two designs that did not block access to the exit path might be considered to be the best designs for the tractors used in this study, but other designs likely would have been acceptable if they had been custom-fit for these tractors. The results of this research suggest that custom fabrication of pedal extensions for each specific tractor will likely yield the safest work environment for those who choose to use this assistive technology.
Why the time is right for a radical paradigm shift in early powered mobility: the role of powered mobility technology devices, policy and stakeholders. [2022]This article explores the changing landscape of early pediatric powered mobility. We specifically focus on key indicators that suggest pediatric powered mobility technology (PMT) practice for very young children is poised for a radical paradigm shift. This shift will challenge the current purview of PMT design and function, how it is obtained, and its introduction to children and their families. We propose that this positive, yet radical shift is essential in achieving a standard of practice in which PMT provides for early exploration and participation for children with disabilities at an age concomitant with their non-disabled peers, and within socially inclusive environments. To sustain this new standard, we must acknowledge the significant disconnect that currently exists between clinical research supporting the use of PMT with very young children, and barriers to widespread device access, effective user-driven design and positive social perception of PMT. In this article, we discuss three areas that are particularly important for both shift and sustained change: the history and current availability of novel and conventional PMT devices, pediatric PMT policies and the role of children and families as primary stakeholders in PMT practices. Within each area, we suggest barriers, facilitators and future directions. Implications for Rehabilitation The time is right for reframing how powered mobility technology for very young children is conceived, designed, and implemented. In order for multiple innovative devices to survive in the powered mobility industry, it is important to continue to show the benefits of early powered mobility use for both traditional and non-traditional users, and also enact and enforce policy that promotes sustainable access and financial support for powered mobility technology. The experiences of children and families and the realities of everyday use of powered mobility technology must be brought to the forefront of a movement toward user-centered design. Advocacy efforts undertaken in partnership with families, clinicians, researchers, and disability communities are essential in recognizing mobility, and access to early powered mobility technology, as a human right.
Feasibility of a Modified Ride-on Car Intervention on Play Behaviors during an Inclusive Playgroup. [2019]Children with mobility related disabilities often experience limited participation and access to social interactions. An emerging pediatric powered mobility device are modified ride-on cars that provide self-directed mobility experiences to children with disabilities. This study aimed to determine: (1) the feasibility of a modified ride-on car intervention during an inclusive playgroup, (2) the effect of a modified ride-on car intervention on the play behaviors of children with and without mobility related disabilities.
Caregiver-reported impact of access to switch-adapted toys on play for children with complex medical conditions. [2023]Play is essential for children's development of motor, social-emotional and cognitive skills. Traditional play activities are often difficult for children with complex medical conditions to access, which threatens their ability to maximize their developmental potential. Switch-adapted toys are a common strategy for expanding the play repertoire of children with disabilities by lowering the barrier to play with electronic toys. The aim of this study is to investigate the relationship between providing switch-adapted toys to children with disabilities and the children's total and self-initiated play time and access to a variety of cognition-appropriate toys, age-appropriate toys and independently accessible toys as reported by their caregivers.
Robots and ICT to support play in children with severe physical disabilities: a systematic review. [2019]Play is an essential part of children's lives. Children with physical disabilities experience difficulties in play, especially those with severe physical disabilities. With the progress of innovative technology, the possibilities to support play are increasing. The purpose of this literature study is to gain insight into the aims, control options and commercial availability of information and communication technology (ICT) and robots to support play (especially play for the sake of play) in children with severe physical disabilities.
An Italian research project to study the play of children with motor disabilities: the first year of activity. [2019]The paper presents the main outline of a new research project carried out by the SIVA research team concerning the development of methodologies to select and use assistive technology to allow children with motor disabilities to play with toys.
Children With Cerebral Palsy Playing With Mainstream Robotic Toys: Playfulness and Environmental Supportiveness. [2020]Purpose: Play is a right for every child and has a key role in child development. Play can be analyzed according to the construct of playfulness, which is the child's disposition to play. Children with cerebral palsy (CP) show difficulties in play and can also experience lower playfulness scores when compared to matched typically developing children. This paper analyses play and playfulness in children with CP using mainstream robotic toys with supporting adult play partners. Methodology: Five mainstream robotic toys were selected and used in play situations with six children with CP interacting with two adult partners. The play situations were coded through the Test of Playfulness (ToP) and the Test of Environmental Supportiveness (ToES), to analyze the role of robotic toys, adult partners and environment in supporting play and playfulness in children with CP. Results: The children obtained high ToP scores, showing that they were intrinsically motivated to be engaged in the play situations. The ToP scores weakly correlated with the ToES scores. To discuss this result, different features of each robot, the role of adults as scaffolder, and the space characteristics in supporting play are presented and discussed. Conclusion: This research field is new: to our knowledge, in the literature only one study focused on the use of one type of mainstream robotic toy to support the playfulness of children with CP. The parallel use of the ToP and the ToES was crucial to observe the complexity of the play situations and the role of playmates and toys during the play process. The role of the adult as play scaffolder has been important to mediate between the child with CP and the environment, toys included: the adult should be strongly aware of this role to better support the child in being in charge of the play situation. Further research is needed.
Designing Out the Play: Accessibility and Playfulness in Inclusive Play. [2018]Play is an important part of child development, yet disabled children are often excluded from the opportunity to play, either due to lack of accessible toys and games, or social pressures. This paper presents a case study reflecting on the development of Button Bash: a switch accessible game intended to encourage inclusive play between disabled and non-disabled children. In particular, the paper focuses on how changes intended to make the game more accessible tended to make it less playful, and reflects on the relationship between playfulness and accessibility.