# What Children with Neuromotor Disabilities Need to Play with Technological Games
## 1 Introduction  
The 31 st Article of the Convention on the Rights of the Child recognizes \"the right of the child to rest and leisure, to engage in play and recreational activities appropriate to the age of the child\" [1]. Indeed, gaming activities teach children to move, imagine, think, and solve problems, and they have a fundamental role in the child's cognitive and social development: through play, the child understands their inner and outer world, stimulates their abilities, and learns to accept their limits. According to [PERSON], play can be classified into three types: sensorimotor, symbolic, and rule-based [2]. In particular, sensorimotor play allows children to experience their body in terms of movement; symbolic play has the function of transferring their experiences and fantasies about themselves, objects, and others, which is a fundamental experiential dimension in growth; finally, rule play has the function of releasing children from egocentricity, leading them to structure models of problem solving (indispensable for personal-social growth and maturation). Therefore, play bridges the gap between internal and external reality [3], leading the child from dependence to autonomy, and from the limitless creativity of the 5 year-old child to a system of constraints and rules, which are a fundamental prerequisite for socialization and reality understanding [4]. Notwithstanding the central importance of play in a child's life, little attention is paid to its value for children with disabilities. Approximately 5.1% of children around the world are affected by moderate or severe disabilities (e.g., motor, cognitive, vision disabilities, etc.) [5] and can present different limitations: from a deficit of coordination functions to complex situations in which movements are almost completely prevented. Therefore, these patients have specific needs and requirements and relatively few opportunities to be engaged in independent leisure activities [6]. During recent years, the panorama of available games has grown and been enhanced thanks to the development of new technologies. Nowadays, school-age children use computers, tablets, smartphones, and consoles, and the diffusion of videogames on these devices is growing steadily. As an example, we report a study of 2013 regarding children's use of mobile technologies in the United States [7]; here, the authors showed that 72% of children under 8 years old already use a mobile device for playing, compared to 38% in 2011. In children with disabilities, technology-based play has an important role both in ludic and rehabilitative activities. [PERSON] et al. [8] reported that computer games can have a positive impact on disabled children. Indeed, they offer new opportunities to participate in play, facilitate autonomous and independent free play, enhance and develop children's propensity for playfulness, and enable social interaction. In addition, the interactive nature of games leads to constructive and experiential learning opportunities, promoting patients' engagement and participation in their rehabilitation programs [9]. Therefore, videogames specifically developed for a rehabilitative purpose can be considered an example of application of the gamification principle, which applies game mechanics to non-game contexts to engage audiences [10]. Serious games are an example of games used in rehabilitation, and they are computer/video games designed for a primary purpose other than pure entertainment. Their requirements are defined with the help of physiotherapists and clinicians in order to achieve specific rehabilitation goals. In particular, these games must respond correctly to the player's interactions, proposing challenging but not frustrating scenarios, and should include monitoring mechanisms to simplify the therapist's work [11]. Active Videogames (AVGs) are another example of videogames used for a rehabilitative purpose. AVGs are a specific category of commercial videogames that combine exercises with technology, promoting an indoor physical activity.