Design of therapeutic TagTile games for children with unilateral spastic cerebral paresis

This research focuses on gaining new insight in design methodology, research techniques and game principles in the context of tangible games for therapy of children with unilateral Cerebral Paresis (CP). CP is a disorder of posture and or motor function due to brain damage in the first year of life. In the unilateral type of CP the right or left side of the body is affected. Although CP is incurable the therapy for CP patients is effective in increasing their abilities but can be boring because of its repetitive nature. In a previous research tangible games where created for such therapy and made use of the TagTile (Li, Fontijn and Markopoulos 2008). The TagTile is a system that can localise multiple objects on its surface by using RFID tags. This system gives feedback with full colour LEDs and by playing sounds. The games created on this TagTile in this previous research are not implemented in therapy as the proper movements were not triggered enough and compensating movements were observed often. However, the usage of entertaining interactive tangible games was seen as promising. A set of games created in this research thus aim to provide entertainment and triggering the right movements while preventing compensating movements as much as possible. An iterative process is used to evaluate, improve and validate four created games. Therapists are included in every step in this process. The target group is analysed with a literature survey, interviews and two short ethnographic sessions. A new design technique, acting out movements, is used based on a combination of hands-only scenarios, interaction relabeling and informances. This technique is used to design the first three games. The fourth game is based on a co-design session with therapists. The usage of design techniques in this case led to new insights into design methodology. The use of acting out movement techniques is found to be very useful as the gap between training movements to design is decreased. In this way compensation could be held to a minimum. In a short design session is of half an hour, it was found to be impractical to use Systematic Inventive Thinking, a technique using often reoccurring thinking patterns in design. Interaction relabeling, a technique in which interaction of object are projected to another, is more suitable for such a session. Using informal tests with friends and family is found to be valuable. Although being a totally different target group it is a very effective way in finding bugs and improvements. Using several evaluation sessions and techniques with cooperation of therapists provided useful feedback and triggered several improvements. The usage of a longer evaluation of seven weeks showed important problems in actual usage that were not found in previous evaluation sessions. During the evaluations several criterion to increase fun in games from Malone&Lepper(1987) were investigated. Children like sounds but especially funny, absurd or extreme sounds. The target group does not improve completion time when feedback is given on their performance. Children from the target group have no extraordinary problems with losing a game. An increasing difficulty is not uniformly liked or disliked. All the games combined train all wanted movements and seem to provide the wanted motivation. In a seven week evaluation the games were only used in two sessions although earlier evaluations seemed more promising. The main reasons for not using the games were the effort and time needed to set-up and start the games using an older version of the TagTile. A newer version was used to create the last game. This game and the newer version of the TagTile seem promising and can be used in the therapy as this version needs less preparation time and the game provides motivation and triggers several movements. Lessons on design methodology and research techniques can be valuable in ongoing research on the TagTile as well as other related research and design.