Top! Together to play!

Video games for rehabilitation

Tecnologie e strumenti:
Salute e cura
Fondazione TOG

TOP! is a game suite for children between 3 and 12 years old with complex neurological diseases, offering rehabilitation and learning sessions based on interactive games and activities, made possible by the eye-tracking system. The system can be customised to each child's characteristics, specific motor needs or responses to the instrumentation. The integrated data collection and analysis platform allows quantitative and qualitative analysis of the rehabilitation process and enables the creation of statistics along the child's entire rehabilitation pathway. The games are divided into 3 groups: training games for ocular interaction, cognitive games of systematic exploration of different levels of complexity and more purely playful games aimed at entertainment and releasing aggression.

The video games suite TOP!

TOP! Together to Play, is a suite of video games based on the eye-tracking system that facilitates the rehabilitation of children aged 3 to 12 years with complex neurological problems and enables the collection of data for quantitative and qualitative analysis of the rehabilitation process. TOP! can be customised to each child's characteristics, specific motor needs or specific responses to the instrumentation.

The need

Children with complex neurological diseases have significant cognitive difficulties, which are aggravated by motor disability. For this reason, they often have no possibility of speaking, expressing themselves or transmitting their emotions and communicative potential. TOP! favours a rehabilitation programme designed precisely for the most complex children who have no other means of expression than using their eyes. The challenge was in fact to understand their cognitive abilities and consequently to stimulate their potential.

The importance of play and the opportunities of eye-tracking technology

The combination of eye-tracking technology and play as a form of engagement makes TOP! an innovative tool for child-friendly rehabilitation. On the one hand, the games, which are simple and appealing, work on learning and the development of basic cognitive functions in a precise and sequential manner, drawing on Prof. Feuerstein's cognitive method. On the other hand, the technological system, designed with the support of Dotdotdot, allows the eye-tracker to be calibrated to the individual child in 5 simple steps and enables the control and management of the individual play session by modifying parameters such as time, fixation or speed, for tailor-made rehabilitation.

"The entry of tools such as eye-tracking into rehabilitation can provide us with more targeted cues for defining intervention goals. As gaze is one of the main means of knowledge and communication, the latest generation of eye pointers can offer a further contribution to current observational and evaluative methodologies in children with multiple disabilities" - Sabrina Signorini, Head of the Centre for Neuro-ophthalmology in the Age of Development at the Mondino Foundation

TOP! games are inspired by traditional street games

The games are divided into training, cognitive and entertainment, and are designed to meet different levels of complexity.

3 Training games where the child, through eye interaction, is asked to respond to cause/effect inputs, such as chasing figures on the screen.

4 Cognitive games involving the systematic exploration of space and the logical collection of visual data, such as "Hide and Seek" in which the child has to look at footprints sequentially to find opponents or "Witch Command Colour" in which the child develops the ability to classify and discern between classes of objects.

3 Games designed to engage the child in purely entertaining activities aimed at releasing aggression, such as "Cushioning", "Sack Race" and "Poison Ball".

App functionality

The TOP! platform is distributed free of charge as a Windows application and works with the Tobii eye-tracker. No PC interaction is required: only the interfaces controllable by the care-receiver via the eye-tracker are presented on the screen, minimising distractions.

The tablet app has the function of a 'control panel' and allows the start of the games and the calibration of the eye-tracker, the control of the session and the management of the game phases, such as adding, removing or moving elements, varying the dynamics, pausing, soliciting attention with sound and visual reminders and increasing or decreasing the difficulty levels. In addition, the app allows the care-giver to visualise in real time where the care-receiver is in the scene.

Qualitative and quantitative data collection

The data collection phase, following the play sessions, is crucial for monitoring the child's progress. All sessions can be recorded and visualised, statistics can be calculated - e.g. of the time the child looks at the screen, or the percentage of fixations and saccadic movements - with reference to the individual child or in comparison with other patients. The data collection is intended for scientific research and a dashboard will be implemented to return the data to therapists in the form of easily searchable and comparable visualisations.

Case study