Eye movements and stress during eye-tracking gaming performance in children with dyskinetic cerebral palsy

Abstract

Most children with dyskinetic cerebral palsy (CP), due to motor impairments of varying severity, face challenges with speech and using widely available computer interfaces like a mouse, joystick, or touchscreen. Eye-tracking technology, which enables computer access through eye movements, offers a promising solution for enhancing their independence in daily activities, such as communication, play, education, and leisure.

This study explored two key aspects of eye-tracking use: (1) the quality of eye movements, and (2) user experience, measured by stress levels. We included 12 children with dyskinetic CP and 23 typically developing peers, asking them to play 10 eye-tracking games of varying difficulty. We recorded their eye-tracking performance times, eye movements (fixations and saccades), and stress levels during both rest and gaming.

Our findings reveal that children with dyskinetic CP took twice as long to complete the 10 eye-tracking games compared to their typically developing peers. However, the quality of the eye movements and stress levels during gaming were similar across both groups. Notably, children with dyskinetic CP with prior eye-tracking experience performed even more closely to their typically developing peers, highlighting the importance of providing eye-tracking training opportunities as early as possible.