Think BIG: Brain-Computer Interface Goals for Children with Quadriplegic Cerebral Palsy

There is a pressing need for alternative access technologies that enable children with severe physical disabilities, as current options often require some degree of controlled movement to be used efficiently. Brain-computer interfaces (BCIs) hold significant potential for improving the lives of children with severe physical disabilities, however research must prioritize user-centered approaches and real-world applications to maximize benefits. This paper examines the integration of home-based BCIs for children with quadriplegic cerebral palsy through user-centered design, focusing on the feasibility, usability, and impact on personal goals and activities of daily living. Seven children aged 6–15 years with quadriplegic cerebral palsy and their families participated in this pilot study, using personalized BCI packages and home-based virtual sessions to help them achieve individualized goals in self-care, productivity, and leisure. We utilized a collaborative goal-setting approach and assessed satisfaction and performance changes using the Canadian Occupational Performance Measure (COPM) and the BCI-adapted Quebec User Evaluation of Satisfaction with Assistive Technology (e-QUEST2.0). Significant improvements in performance and satisfaction were observed in the COPM scores, while parents were most satisfied with professional services and least satisfied with the adjustability of the BCI system, as per the eQuest2.0 questionnaire. Despite no significant improvement in BCI consistency across nine sessions, the intervention positively impacted participants' perceived performance and satisfaction in goal-oriented activities. Future research should focus on enhancing BCI design, comfort, and effectiveness while considering user priorities and feedback for personalized goal achievement.