Between 2013 and 2017 WESC Foundation collaborated with the University of Lincoln to develop gamified vision therapy for young people with partial visual field loss caused by brain injury.
Specialised computer software had been used previously to improve functional vision for adults with visual field loss caused by stroke. Stroke patients who had participated in therapy improved their functional vision through repetitive training on visual search exercises but were required to commit to these exercises daily for many weeks. Due to the repetitive and tiresome nature of the exercises we decided to redesign the therapy as a computer game to make it more engaging for young people, and then tested its therapeutic effectiveness.
The design and development process itself revealed a number of interesting findings as we engaged students, therapists, and community groups as co-designers. We asked students to play-test early versions of the game fortnightly and used their feedback to guide the development process. As players must use their vision to participate in vision therapy but individuals have different visual abilities it was necessary to develop a number of algorithms and options to adapt the game’s difficulty to match the player’s ability. This allowed us to balance the challenge required for therapy to be effective with the challenge required to stop players getting bored and the potential for players to become frustrated. Visual elements of the game that were part of the narrative and not part of the therapy itself were enhanced with sound for accessibility, while immediate audio-visual feedback let players know how well they were doing.
A pilot study to test therapeutic effectiveness
Once we had developed a complete prototype of the game we tested its therapeutic effectiveness in a pilot research study. We recruited eight young people between 7 and 21 years old with partial visual field loss caused by brain injury to participate. They were given the game to play at home for six weeks without supervision from the research team, and completed a number of assessments before and after training designed to test visual search ability on table-top tasks. The main outcome of the study was that young people engaged with the gamified vision therapy initially but played less and less as the weeks went on, down to an average of twice a week. The therapeutic outcomes of the study indicated that performance on visual search exercises within the game plateaued by the third week but they transferred to improvements of 24% on the table-top tests of visual search skills.
Outcomes and summary
This project demonstrated that gamified vision therapy can engage young people with partial visual field loss long enough to see measurable effects in their functional vision. However, a larger randomised controlled trial would be required to rule out confounding factors and validate these findings for the wider clinical population.
Academic publications arising from this study
- (2017) Review of rehabilitation and habilitation strategies for children and young people with homonymous visual field loss caused by cerebral vision impairment. Published in: British Journal of Visual Impairment (volume 35, issue 3, pages 197-210). doi: 10.1177/0264619617706100
- (2015) Participatory design of therapeutic video games for young people with neurological vision impairment. Published in: Proceedings of the 33rd Annual ACM Conference on Human Factors in Computing Systems (pages 3533-3542). doi: 10.1145/2702123.2702261.
- (2014) Designing games for the rehabilitation of functional vision for children with cerebral visual impairment. Published in: CHI ‘14 Extended Abstracts on Human Factors in Computing Systems (pages 1207-1212). doi: 10.1145/2559206.2581219.