Bci@home: A Home-Based Brain-Computer Interface Program For Children With Quadriplegic Cerebral Palsy and Their Families

OBJECTIVES: Many children with quadriplegic cerebral palsy (CP) are locked-in. Brain-computer interfaces (BCIs) offer a means of control using only brain signals. However, most BCI studies have been conducted in adults in a lab, presenting a crucial translational gap. We aimed to evaluate the feasibility of a home-based BCI program for children with severe quadriplegia and their families. METHODS: Participants were recruited through neurology and neuromotor/physiatry clinics. Inclusion criteria were: (1) severe quadriplegic CP (GMFCS level V), (2) estimated cognitive/intellectual skill at grade 1 level or higher, (3) age 6-18 years, (4) informed consent/assent. Children with unstable epilepsy were excluded. Participants received a BCI@Home package containing an EEG headset, tablet with pre-loaded software, user-specific activities, and setup guide. Participants and their parent/caregiver participated in weekly BCI sessions with online support. Parents completed a survey about their experience. RESULTS: Eight participants (mean age=11.6 years, 38% female) have enrolled in the BCI@Home Program, with durations from 7-86 weeks. Children participated in 170 BCI sessions totaling over 205 hours. Home BCI use was mainly supported by the mother or caregiver. Family-perceived benefits included new opportunities for play, improved accessibility/flexibility, and enhanced safety during COVID-19. Challenges included technical issues, setup, and scheduling. Most parents (88%) reported BCI@Home as useful for interacting with family and self-expression. Parent BCI setup confidence increased by 120% and correlated with the number of sessions (r=0.62). CONCLUSION: Home-based BCI programs are feasible, accessible, and beneficial. Home-based BCI can advance life participation in a patient-centred manner for severely disabled children.