Power of combined modern technology: Multitouch-multiuser tabletops and virtual reality platforms (PowerVR) in social communication skills training for children with neurological disorders: A pilot study.

New technologies such as multitouch-multiuser tabletops (MMT) and virtual reality (VR) provide modern neurorehabilitation options. The aim was to describe the structure of acquired social communication deficits in children with neurological disorders (ND) and implement a new PowerVR method- combined MMT/VR interfaces, into social neurorehabilitation. The study was designed based on the Structured Social Rehabilitation Model. Sixty children with ND aged 8-13 years participated: 28 with epilepsy, 10 with traumatic brain injury (TBI), 3 with tic disorders, 3 with stroke, 16 with other ND. A total of 16 patients (M = 10.5 years, SD = 1.8) completed trainings with pre- and post-intervention assessments. Forty-four patients participated in base-level assessment (M = 10.2 years, SD = 1.6). Two age-matched patients practiced in pairs on MMT and individually in VR. The most impaired components in patients were theory of mind (ToM) skills. A total of 64% of children presented behavioral problems related to executive dysfunctions. Patients lacked conflict resolution (median 38% out of 100%) and empathy skills (25%). After trainings, communication and cooperation, pragmatics, social attention, conflict resolution, and empathy skills improved. Patients' general verbal ToM and understanding false beliefs (p < .005) increased. Children's ability to start conversations improved; they experienced less bullying. Findings suggest that the combined technology-based intervention PowerVR offers increased power for multicomponent training of socio-emotional skills.

Attention profile in children with epilepsy compared to healthy children using computer-based ForamenRehab program.

Attention is a key component in cognitive functioning. Attention impairment is often present in children with epilepsy, which is one of the most common neurological disorders in children and adolescents. Evaluating the attention profiles is important for describing the patients' cognitive weaknesses and planning individual-based cognitive neurorehabilitation. The aim of this study was to assess the attention profiles of children with epilepsy and compare the results to neurologically healthy children. Twenty-nine children with epilepsy aged 8-12 years and 19 neurologically healthy age-matched comparison group participated in assessments with baseline tasks of the Attention module of ForamenRehab computer-program. Four separate attention components were measured - focused, sustained, complex, and tracking - to reveal the most impaired aspects of attention. At the baseline level, patients showed impairments in different attention function components compared to comparison group. Children with epilepsy had significantly lower results in sustained, complex attention, and tracking components (p < 0.05). The patients had similar results with comparison group only in one component - focused attention. All children had quicker visual reaction times compared to their auditory reaction times. The results emphasize the need for attention rehabilitation in children with epilepsy and help to focus on specific components of attention in planning the intervention process.

Positive outcome of visuospatial deficit rehabilitation in children with epilepsy using computer-based FORAMENRehab program.

Children with epilepsy often show deficits in attention and visuospatial functions. Still, very few systematically controlled evidence-based pediatric neurorehabilitation methods exist. The aim was to assess the effectiveness of a computer-based rehabilitation program for visuospatial deficit remediation in children with epilepsy. Fifty-eight children aged 8-12 years participated: 17 children with epilepsy diagnosis in intervention group, 22 patients in waiting-list control group, and 19 healthy age equivalent controls. The intervention group received guided visuospatial functions rehabilitation with FORAMENRehab software twice a week for a 5-week period. Baseline assessments were carried out before and immediately after the intervention period, and as follow-up 1.31 years later. Intervention group showed positive immediate rehabilitation effect in 3 out of 4 visuospatial components: visual organization, visual attention, and visuospatial perception. A long-term rehabilitation effect in the study group was observed in all 4 of the trained components. Also, a positive generalized effect was confirmed by the parents' and children's qualitative feedback with some of the improved skills transferring to children's everyday life. One hundred percent compliance further confirmed the children's motivation to participate and the effectiveness of FORAMENRehab for pediatric neurorehabilitation.

Structured Model of Neurorehab: A Pilot Study of Modern Multitouch Technology and Virtual Reality Platforms for Training Sociocognitive Deficit in Children with Acquired Brain Injury.

Social competence is often impaired in children with acquired brain injury (ABI), but evidence-based rehabilitation has remained undeveloped. This pilot-study aimed to create a structured model for sociocognitive rehabilitation for children with ABI. A total of 32 children aged 8-13 years participated: 22 with ABI -epilepsy, traumatic brain injury, or tic disorder and 10 healthy controls. Interactive computer-based applications were implemented into rehabilitation design using multitouch-multiuser tabletop (MMT) devices: Snowflake MultiTeach (MT) and Diamond Touch Table (DTT), plus MediqVR virtual reality (VR) platform. At baseline, patients demonstrated social incompetence compared to healthy controls. Post-training evaluations showed that rehabilitation on Snowflake MT improved children's executive and cooperation skills. DTT developed new communication and language skills, metacognitive skills, and coping with difficult social situations. This structured model for social competence rehabilitation helps therapists to understand the objectives and tools for improving social and cooperation skills in children with ABI. We provide practical recommendations using next-generation devices, which are effective and motivating for children.

Neurorehabilitation with FORAMENRehab for attention impairment in children with epilepsy.

Epilepsy is a frequent neurological disorder in children and often accompanied with attention impairment. Still, few systematically controlled rehabilitation techniques for children exist. The aim of this study was to design and measure the impact of the FORAMENRehab computer-based intervention method for attention impairment rehabilitation in children with epilepsy. We chose the FORAMENRehab program because it allows separate training for different attention components based on individual needs. Forty-eight children participated in the study. At baseline, all patients underwent neuropsychological examination of attention with the NEPSY test battery. The study group consisted of 17 8- to 12-year-old children with partial epilepsy and attention impairment who received neurorehabilitation over 5weeks (10 sessions) with FORAMENRehab Attention module accompanied by a therapist. Two control groups were included: the first control group of 12 children with partial epilepsy and attention impairment (waiting-list) participated in assessments with baseline tasks before and after the five-week period and received no active training. Additionally, all patients participated in the follow-up assessment 1.31years later. The second control group consisted of 19 typically developing children who only participated in the first assessment. After the intervention, study group patients showed significant improvement in complex attention and tracking (P<0.025). To achieve the effect of intervention in children with partial epilepsy, 10 sessions tailored to individual levels of ability were the minimum. Three attention components - sustained, complex, and tracking - need selective and longer training for more effective remediation. Follow-up assessment revealed a long-term positive effect of intervention. After 1.31years, the study group had significantly improved in three out of the four attention components (P<0.025), whereas the waiting-list group showed improvement in only two aspects of one complex attention component. In conclusion, attention impairment rehabilitation with FORAMENRehab is effective for children with epilepsy. Rehabilitation should focus on training specific components of attention and follow an individual-based rehabilitation process.

Neuropsychological benefits of computer-assisted cognitive rehabilitation (using FORAMENRehab program) in children with mild traumatic brain injury or partial epilepsy: A pilot study.

INTRODUCTION: The number of children with different cognitive difficulties is constantly increasing. Still, too few evidence-based pediatric neurocognitive rehabilitation programs exist. The main aim of the study was to assess the efficiency and usability of computer-assisted FORAMENRehab program for training specific components of attention in children with mild traumatic brain injury (mTBI) and partial epilepsy (PE). The second aim was to specify short- and long-term effects of the intervention. METHODS: Eight children between the ages of 9-12 years with attention impairment (3 with PE and 5 with mTBI) and 18 healthy controls participated. FORAMENRehab Attention software, adapted by the authors, was used for intervention. Strict intervention protocol consisting of patients completing 10 sessions over a 6-week-period to train four components of attention (sustaining, focusing, dividing, tracking) was designed and applied. Follow-up assessments were conducted after the end of the last training and 1.63 years later. RESULTS: After the intervention patients' sustained and complex attention improved. Long-term follow-up revealed continuing positive rehabilitation effects. 100% compliance suggested that the used method is attractive for children. CONCLUSIONS: These preliminary results of the pilot study give reason to presume that the method is effective in attention impairment remediation. However, more thorough research is needed.