Brain-Computer Interfaces for Children With Complex Communication Needs and Limited Mobility: A Systematic Review

Abstract

Brain-computer interfaces (BCIs) represent a new frontier in the effort to maximize the ability of individuals with profound motor impairments to interact and communicate. While much literature points to BCIs' promise as an alternative access pathway, there have historically been few applications involving children and young adults with severe physical disabilities. As research is emerging in this sphere, this article aims to evaluate the current state of translating BCIs to the pediatric population. A systematic review was conducted using the Scopus, PubMed, and Ovid Medline databases. Studies of children and adolescents that reported BCI performance published in English in peer-reviewed journals between 2008 and May 2020 were included. Twelve publications were identified, providing strong evidence for continued research in pediatric BCIs. Research evidence was generally at multiple case study or exploratory study level, with modest sample sizes. Seven studies focused on BCIs for communication and five on mobility. Articles were categorized and grouped based on type of measurement (i.e., non-invasive and invasive), and the type of brain signal (i.e., sensory evoked potentials or movement-related potentials). Strengths and limitations of studies were identified and used to provide requirements for clinical translation of pediatric BCIs. This systematic review presents the state-of-the-art of pediatric BCIs focused on developing advanced technology to support children and youth with communication disabilities or limited manual ability. Despite a few research studies addressing the application of BCIs for communication and mobility in children, results are encouraging and future works should focus on customizable pediatric access technologies based on brain activity.

Workshops of the eighth international brain–computer interface meeting: BCIs: the next frontier

“…BCIs have the potential to enhance, restore, or replace function in children with neurodevelopmental disorders, neurodegenerative disorders, and severe motor disabilities caused by stroke, spinal cord injury, or other acquired injuries [154][155][156][157]. However, few studies have investigated BCIs for children [158][159][160][161] and these studies show conflicting results; it remains unclear whether children -especially those with neurological disabilities -can effectively use BCIs.…”

“…Recommended strategies are gamification [163][164][165][166][167] and close interdisciplinary collaboration between diverse experts. (2) Discussed the interfacing, signal-processing, and physiological challenges encountered during the design of BCIs for kids -Developing BCIs for children presents unique signal acquisition, data analysis, and reporting challenges [154]. Signal acquisition hardware for pediatric BCIs needs to be more portable, lighter, more comfortable, and easier to use (e.g.…”

Challenges of brain-computer interface facilitated cognitive assessment for children with cerebral palsy

“…This non-invasive BCI design (Figure 1, left) presents stimuli on a computer screen, senses brain activity using electroencephalogram (EEG) electrodes, and interprets the EEG to determine to which single stimulus the user is paying 10.3389/fnhum.2022.977042 attention. Although BCI has been successful for able-bodied adults and adults with acquired impairments, little is known about BCI use by children with severe multiple impairments who need technology for communication (Orlandi et al, 2021).…”

A systematic review of research on augmentative and alternative communication brain-computer interface systems for individuals with disabilities

“…Although there have been multiple review chapters and articles on the current state of the science for AAC-BCI systems over the past 10 years, most have been non-systematic overviews of system types, algorithms, and applications, often describing results from studies that did not include participants with disabilities (Pasqualotto et al, 2012;Akcakaya et al, 2013;Alamdari et al, 2016;Chaudhary et al, 2016Chaudhary et al, , 2021Rezeika et al, 2018;Wang et al, 2019;Vansteensel and Jarosiewicz, 2020). Existing systematic reviews of AAC-BCI literature have focused on specific system types, such as non-visual interfaces (Riccio et al, 2012), or on the performance of specific end-user populations, such as people with ALS (Marchetti and Priftis, 2014) or cerebral palsy (Orlandi et al, 2021). We conducted a systematic review to evaluate the current state of AAC-BCI research involving participants with disabilities, with no restrictions on disability etiology or on AAC-BCI system type.…”