Brain–Computer Interface as a Potential Access Method for Communication in Non-verbal Children with Cerebral Palsy: A State-of-the-Art Review

Cerebral palsy is an umbrella term that encompasses a group of disorders affecting movement and posture. The primary motor disorder is often accompanied by associated impairments of sensation, cognition, communication, perception, behavior, and/or seizure disorder. One in two children with cerebral palsy have a speech disorder, and one in three are non-verbal. Speech and motor difficulties may mask children’s cognitive capabilities, and recognition of their strengths and difficulties, which may limit the provision of opportunities for learning and development. A Brain–Computer Interface (BCI) may hold the key to unlock the potential in children with disabilities who today have limited means to learn, play, and communicate with currently available technology. Although BCI has been successfully applied on able-bodied adults, little information is currently available on BCI use in children with severe motor impairments who may need technology for supporting their communication. The aims of this state-of-the-art review are to describe the growing research field of BCIs and to share typical clinical applications as well as to provide evidence from the literature supporting the BCI application in children with cerebral palsy. The main engineering, assistive technology and neurorehabilitation databases were searched. Information related to inclusion criteria and study protocols was critically evaluated to determine BCI's successful implementation. This chapter highlights the five factors that can be attributed to the effective use of BCI: characteristics of the BCI, individual characteristics of the BCI user, type of feedback and instruction, and evaluation and ethical considerations and reports on the current use of BCI in children.