Validation of the Elements/RE-ACTION System for use with children: Evaluation of performance across developmental stages

The aim of this study was to ascertain the feasibility of using the Elements virtual reality (VR) System for children and determine the construct validity of the assessment mode of the system. These technologies were adapted for use with children, called the Re-Action system, to support motor learning. A mixed-approach design was used. Construct validity was evaluated by contrasting performance on system variables across different developmental stages (Kindergarten, Primary Education, Middle Education and Secondary Education). Four system-generated measures were recorded automatically by the Re-Action system: object placement accuracy, movement speed, movement efficiency, and response errors. These measures were obtained during goal based tasks ranging from predictable to random targets. Children's perceptions of the system were measured via the Short Feedback Questionnaire-Children (SFQ-C) to ascertain the levels of engagement of the children in the system which might support motivation and compliance. Seventy-three children aged between 4 and 16 years undertook 15 minutes of interaction with the system. Differences between developmental stages were identified on randomly presented stimuli indicating that the RE-ACTION system has some sensitivity to developmental trends in performance capacity. Subjective data from the SFQ-C revealed high levels of enjoyment and satisfaction with the tasks. These findings support an earlier case study evaluation of the Re-Action system for use with children with hemiplegia and suggest that the paediatric adaptation of the Elements System has the potential to support understanding of motor learning through childhood. The assessment mode of the system appears to be a valid movement assessment tool for children of different ages with the potential for documenting change as a result of development or intervention.