JMIR Publications

ABSTRACT

Background:

In order to overcome midline crossing difficulties, children require treatment from an occupational therapist. Due to the recent COVID-19 pandemic and resulting lockdowns, many children could not access occupational therapists, or had to decrease sessions. This puts additional pressure on parents or caretakers to assist children with interventions at home, or children do not get the needed treatment at all. This is challenging because caretakers are not qualified to handle this, and occupational therapists do not get adequate feedback on the child’s progress if home treatments do take place.

Objective:

Given that many children cannot visit occupational therapists as often, or at all, during various stages of the COVID-19 lockdowns, the first objective of this paper is to adapt a simple serious game into a telehealth solution. Children will play the game at home under the supervision of a caretaker or guardian and results are stored online. An online dashboard is generated where occupational therapists can monitor a child’s progress, get valuable additional feedback about the child’s behaviour during treatment and can easily change the variables of the game to target specific difficulties a child might experience. The second objective is to evaluate whether the implemented telehealth solution is feasible as a treatment option for midline crossing difficulties and thus fit for purpose.

Methods:

To meet the first objective, engineering and game development stakeholders formed a team with an occupational therapist and through a collaborative design process combined with an agile programming approach a telehealth solution was designed to assist remote monitoring of the serious game play. For the second objective, six different occupational therapists were introduced to the game, had the opportunity to play the game and then gave feedback during structured interviews.

Results:

A telehealth system was designed that makes use of different levels in the serious game, where each level addresses a different need of the therapy process. All results are saved online and occupational therapists can access a dashboard that will display the results of each child. Additionally, observed behavioural information will also be saved to assist the occupational therapist in making decisions regarding changes to the intervention. During the interviews, occupational therapists indicated that the dashboard will support their treatment plan and is indeed a feasible solution.

Conclusions:

The telehealth solution, incorporating a serious game, is a feasible method to treat crossing the midline problems remotely. The therapists commented on the convenience of integrating both assessment and treatment into the same application as it assists the therapists when grading a child. The therapists collectively agreed that the quantitative aspect that the serious game creates by providing measurable and standardized data proves advantageous when compared to traditional methods of assessment and treatment.