Improving reaching in preschool children with cerebral palsy through regulated feedback

The education of multi-handicapped preschool children with cerebral palsy is a challenging task. Some preschool children with multiple disabilities can become productive with the aid of devices that improve mobility, communication, and activities of daily living, thus promoting educational opportunities that would otherwise be severely constrained. Reaching is critical for children with cerebral palsy who may be reliant on technology to interface with their world. This research describes the use of biomechanical principles to facilitate reaching in preschool children with cerebral palsy by modifying the trajectory of the arm. A computerized system was developed that allowed a child with cerebral palsy to practice reaching for targets placed in the workspace of the arm, and receive regulated and specific sensory feedback concerning the performance of each reach. The system calculates quantitative trajectory parameter values for each reach and converts them into a feedback reward. In this way principles of contingent learning are utilized to enable preschool children with cerebral palsy to modify their reaches to approximate normative values. A validation study of the system with normal children and children with cerebral palsy showed that the system discriminated reaching in the two groups, and improved certain reach parameters in the preschool children with cerebral palsy who underwent a trajectory training as an experimental intervention