Understanding Engagement in Home-Based Interactive Computer Play: Perspectives of Children With Unilateral Cerebral Palsy and Their Caregivers

Aims: This study aimed to understand engagement of children in a home-based computer program, Move it to improve it (Mitii), designed to enhance motor, cognitive and visual perceptual skills. Methods: Participants were 10 children with unilateral cerebral palsy involved in the 20-week Mitii program (mean age = 11 years; 5 males) and their caregivers. Semi-structured interviews were audio recorded, transcribed verbatim and analyzed independently by two researchers. Themes were identified using an inductive approach to identify themes, and mapped against an engagement framework. (King etal., 2014). Results: Key themes were: (1) Child/family characteristics: children's interest captured through novelty and technology, motivation declines as novelty wears off, children require finely tuned programs, strong family support facilitates engagement, and children develop confidence and ownership; (2) Intervention characteristics: increased therapy frequency with reduced caregiver involvement, Mitii becomes therapy and competes with other interests; convenience within family routine, lack of real-time feedback and technical issues, and therapist guidance is essential; and (3) Service provider characteristics: initial and ongoing therapist input, family-friendly therapy approach, and tailored strategies to sustain engagement. Conclusions: Therapists should be cognisant of factors that may impact on children's engagement in home-based computer programs and devise individual strategies with families to support sustained engagement.