Each Week OT expert, Sarit Tresser will be giving an in-depth insightful analysis into the various ways Health Games aid both children and adults with disabilities. Tune in to receive first-hand input from a professional in the field of child development
This post applies to children between the ages of 3 to 5.
Two years ago, I joined a physiotherapist at the Child Development Institute, where I work. Steve (pseudonym), sweet 3 year old that was born with cerebral palsy and was diagnosed as hemiplegic. This was the first time we had experienced working with Timocco with a child so young with cerebral palsy. Due to his young age and lack of clarity regarding his cognitive condition, we were not sure how he would react to Timocco. At the First encounter with the system I it set-up for a small ranges of motion and a basic level of difficulty for learning and familiarity with the virtual environment. Steve reacted to the software as we did not expect and did not dare to wish for. He was fascinated and excited,engaged and involved in the activity with all his body. Not only is he experienced success, expressed joy and shared his experience with his mother (looking at her with a smile on his face every time he managed to pop a balloon in the game), what is surprising and really exciting was the fact that he was able to quickly understand the connection between the movements of his hands and the response received on the screen and Learn quickly the skills needed to play the game. Understanding the game indicated a good conceptual ability and high-level abstract thinking. At this point I should point out that the boy’s mother doubted her son’s cognitive abilities and insisted to send him to the special education institute/ facility/system/. The Remarkable success with Timocco reflected to the mother her son’s high level of learning ability and hinted about his cognitive functioning. Later incorporated/integrated into a ‘regular education.
A week later, when Steve came to the clinic and saw that I’m joining the PT session again, immediately made the connection to Timocco and responded happily. He rose to his feet (during the week installed a brace on his feet to allow him to walk independently) and started walking excitedly, almost running, towards the room. This meeting Steve already was familiar with the system, he was better organized with his body and I could slightly raise the difficulty level of the game and offer him a wider range of options.
Steve’s story is an example of the power of virtual reality in its ability to increase the motivation of the patient and his involvement in treatment.
How do we adapt the virtual environment for a child with Hemiplegia?
At the Initial exposure to the virtual environment, we will represent the child a simple activity with a clear and positive feedback. Preferably, a game he can not fail. In the case of Timocco, the balloons game is suitable for this purpose because it does not allow the child to make a mistake. At first we will not demand the child to work with a particular hand, but allow him to experience the game the way he desires (most likely he will choose to work with his strong hand).
Next, we want to encourage the child to start using his weak hand, the software allows several ways to achieve this goal. the most recommended way is to determine within the Timocco software the “bilateral coordination” option. This option demands from the child to work with both hands together in a coordinated manner. In this way we will encourage the child to work two – sided without triggering frustration. Typically, children respond to the challenge because they are highly motivated to succeed in the game and are willing to put an effort into the training since it is meaningful to them. In this situation the children’s motivation is internal , so it moves them to action and allows them to deal with difficulty. Unlike the situation in which the therapist or parent find themselves urge the child to use his weak hand over and over again, and gain very little cooperation because the child follows orders instead of finding the internal meaning of what he is asked to do.
Later on in the therapy we will give the child to use only one glove, to be wear on the hand we want to strengthen.
Highly recommended to put the camera at a high place (like the top of the screen) in order to encourage the child to play while raising both hands up in the air for strengthening the shoulder girdle.
Next post will be dedicated to older hemi children, ages 6-9 .