Stakeholder's perspective on brain-computer interfaces for children and young adults with cerebral palsy

Communication Brain-Computer Interfaces (cBCIs) are a promising tool for people with motor and speech impairment, in particular for children and young adults with communication impairments, for example due to cerebral palsy (CP). Here we aimed to create a solid basis for the user-centered design of cBCIs for children and young adults with severe CP by investigating the perspectives of their parents/caregivers and health care professionals on communication and cBCIs. We conducted an online survey on 1) current communication problems and usability of used aids, 2) interest in cBCIs, and 3) preference for specific types of cBCIs. A total of 19 parents/caregivers and 36 health care professionals who interacted directly with children and young adults (8-25 years old) with severe CP, corresponding to Gross Motor Function Classification System level IV or V, participated. Both groups of respondents indicated that motor impairment occurred the most frequently and had the greatest impact on communication. The currently used communication aids included mainly no/low-tech aids and high-tech aids. The majority of health care professionals and parents/caregivers reported an interest in cBCIs, with a slight preference for implanted electrodes over non-implanted ones, and no preference for either of the two proposed mental BCI control strategies. Results indicate that cBCIs should be considered for a subpopulation of children and young adults with severe CP, and that in the development of cBCIs for this group both visual stimuli and sensorimotor rhythms, as well as the use of implanted electrodes, should be considered.