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Eye movements and stress during eye-tracking gaming performance in children with dyskinetic cerebral palsy
Saranda Bekteshi1, Petra Karlsson2, Lieselot De Reyck1
1KU Leuven, Bruges Campus, Department of Rehabilitation Sciences, Research Group for Neurorehabilitation, Bruges, Belgium.
Insights
Children with dyskinetic cerebral palsy (CP) took longer to complete eye-tracking games than typically developing peers. Eye-tracking tasks did not increase stress in children with CP, highlighting the need for early training opportunities.
Area of Science:
- Pediatric Neurology
- Rehabilitation Medicine
- Human-Computer Interaction
Background:
- Children with dyskinetic cerebral palsy (CP) often face challenges in motor control and coordination.
- Eye-tracking technology offers potential for alternative interaction methods for individuals with motor impairments.
- Understanding the performance and physiological responses during eye-tracking tasks is crucial for effective implementation.
Purpose of the Study:
- To compare eye movement patterns and stress levels during eye-tracking gaming between children with dyskinetic CP and typically developing children.
- To investigate the associations between eye-tracking performance, eye movements, stress, and participant characteristics in these groups.
- To evaluate the impact of eye-tracking tasks on stress and effort in children with dyskinetic CP.
Main Methods:
- A cohort study involving 12 children with dyskinetic CP and 23 typically developing children (ages 5-13).
- Participants engaged in 10 eye-tracking games using Tobii X3-120 and Tobii Pro Lab for data collection.
- Stress was measured via heart rate variability (HRV) using Bittium Faros360°, and performance by gaming completion time.
Main Results:
- Children with dyskinetic CP took significantly longer to complete games (p < 0.001), with experience improving performance (r=-0.63, p=0.029).
- No significant differences were observed in fixation or saccade eye movement variables between the groups.
- Heart rate variability did not change from rest to performance in children with dyskinetic CP, unlike in typically developing children.
Conclusions:
- Children with dyskinetic CP require more time for eye-tracking game completion, underscoring the importance of early eye-tracking training.
- Eye-tracking tasks appear to be a low-stress activity for children with dyskinetic CP.
- Standard clinical measures of CP severity did not correlate with eye movement or stress variables.
Aim:
This study aimed to explore eye movements and stress during eye-tracking gaming performance in children with dyskinetic cerebral palsy (CP) compared with typically developing children, and associations between eye-tracking performance, eye movements, stress, and participants' characteristics.
Method:
This cohort study included 12 children with dyskinetic CP aged 5 to 12 years (mean age 8 years 7 months, standard deviation [SD] 2 years 3 months) and 23 typically developing children aged 5 to 13 years (mean age 9 years 0 months, SD 2 years 7 months). Participants played 10 eye-tracking games. Tobii X3-120 and Tobii Pro Lab were used to record and analyse eye movements. Stress was assessed through heart rate variability (HRV), recorded during rest, and eye-tracking performance using the Bittium Faros360° ECG Holter device. Eye-tracking performance was measured using gaming completion time. Fixation and saccade variables were used to quantify eye movements, and time- and frequency-domain variables to quantify HRV. Non-parametric statistics were used.
Results:
Gaming completion time was significantly different (p < 0.001) between groups, and it was negatively correlated with experience (rs = -0.63, p = 0.029). No significant differences were found between groups in fixation and saccade variables. HRV significantly changed from rest to eye-tracking performance only in typically developing children and not in children with dyskinetic CP.
Interpretation:
Children with dyskinetic CP took longer to perform the 10 games, especially the inexperienced users, indicating the importance of the early provision of eye-tracking training opportunities. It seems that eye-tracking tasks are not a source of increased stress and effort in children with dyskinetic CP.
What This Paper Adds:
Participants with dyskinetic cerebral palsy (CP) took twice as long to perform 10 eye-tracking games than typically developing peers. Participants with dyskinetic CP with previous eye-tracking experience performed the games faster. Fixation and saccade variables were not significantly different between children with and without dyskinetic CP. Heart rate variability showed no differences between rest and performance in participants with dyskinetic CP. Gross Motor Function Classification System, Manual Ability Classification System, and Viking Speech Scale levels were not correlated to the eye movements or stress variables.
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