Access to Eye-Gaze Control Technology for Children with Cerebral Palsy

Children with cerebral palsy (CP), whose disability may limit speech production and motor skills, are often considered good candidates for the use of eye-gaze technology to access communication, learning and play. At present, little is known about the skills needed to control this technology, which can make it difficult for clinicians to make decisions, or to manage expectations around progress. This is further complicated by the emergence of “teaching” software packages, claiming to improve basic skills such as cause and effect. Children with CP are known to be at a higher risk of vision disorders, including those related to functional vision – how a child functions in vision related activities. These skills (in particular fixation and gaze switching) are similar to those required to make use of eye-gaze technology, so are likely to impact on children’s performance.This thesis uses typically developing children to provide baseline information and to observe how they respond to tasks which were incrementally lowered in terms of cognitive demand. Over three rounds of experiments a pattern emerged that children aged 32 months were able to use it with only minimal instruction. The impact of teaching on performance was also investigated in this section of the study.A group of children with CP were recruited to investigate the most effective way of assessing functional vision skills in this group, with results indicating behavioural measures were most effective.A final study with children with CP used the activities above to look at the performance of this group on eye-gaze tasks. Results suggested good functional gaze control skills were related to better performance on a novel eye-gaze task. The findings suggest that some children may be at a “developmental advantage” if their functional vision and cognitive skills are more developed.