Exploring the Impact of Gamification on BCI Performance in Children: The Case for Personalization

Abstract

Background A major challenge with BCI use is the requirement for subject-specific calibration, which is often tedious and unengaging, but necessary to improve performance. This is especially true for children, whose limited attention and motivation may restrict the duration of endurable calibration periods. Several studies have shown that the addition of scoring systems and rewards to tasks, a process known as “gamification”, can increase motivation, attention, and task performance in children. This randomized, prospective, cross-over study aimed to address this challenge by comparing the effects of gamified versus non-gamified calibration environments on classification accuracy and BCI performance on utility-driven tasks. Methods Thirty-two typically developing children (14 female, mean age 11.9 years, range 5.8–17.9) attended two sessions lasting between 1.5-2 hours, to perform two standard paradigms: spelling using visual P300 event-related potentials (P300) and cursor control using sensorimotor rhythm (SMR) modulation, following gamified and non-gamified calibration. Gamified paradigms incorporated elements of game design, such as meaningful stories, quests, points and sounds. The primary outcome was BCI performance, which included performance of the classification model and online accuracy. Motivation, tolerability, and mental workload (NASA-TLX) were evaluated following each paradigm. Results For the P300 paradigm, mean classification accuracy was similar after gamified (96.81 ± 3.46%) and non-gamified (96.52 ± 2.42%) calibration. Mean classification accuracy for the SMR paradigm was 61.81 ± 13.35% with gamification and 59.84 ± 11.36% without gamification (n.s.). Mean online accuracy for SMR cursor control was 63.23% for both conditions. For the P300 spelling task, online performance was significantly lower following gamified training (p < 0.01). There were no significant differences found between classification accuracy, online BCI performance, motivation, tolerability, or perceived mental workload. Conclusion To our knowledge, this is the first study to investigate the effects of gamified calibration paradigms on classification accuracy and BCI performance in children. Our results reinforce the ability of typical children to control advanced BCI systems with performance comparable to adults. Gamified calibration environments may not enhance BCI classification and performance in children though the gamified environments utilized in this study may not have been engaging enough. This work underscores the need for further research to optimize BCI training paradigms for pediatric use.