Game Therapy – Treatment through video games

Video games, these days are no more what they used to be till a few years ago. Breaking away from its stereotyped image, gaming is being taken quite seriously these days and there exists a vast market catering to it. There is a huge demand for gaming consoles, like Xbox, PlayStation and Wii, peripherals from Razer or Steel Series and even high-end gaming systems, like the Dell Alienware range or systems from MSI and Asus. However, it is difficult to assess if anyone would have imagined that gaming could have its far reaching effects, even in the medical field. On one side, several teenagers face the ire from their parents for whiling away time with video games, on the other side there are several others, for whom, video gaming isn’t just about mere entertainment.

What is Game therapy?
Today, gaming has gone wireless and way beyond ‘connected cords and cables.’ Several researches have proven that gaming can help treat/assist patients. First came the Nintendo Wii that allowed you bring outdoor games like golf, bowling and more to your drawing room, while ensuring that you are physically active and not simply playing the game through an avatar on the screen. Now, we have the Microsoft Kinect and PlayStation Move, designed on the similar lines. Basically, these sensor-based gaming consoles, along with specially designed games, serve as an effective tool for treatment. For instance, a paralytic patient can play certain games, which will help improve his flexibility, reach and self confidence. It can help people who have suffered from paralysis and stroke, children suffering from autism, dyslexia and more, and also serves as a distraction for recovering burn victims and as an alternative for anaesthesia in case of minor surgery.

A child at the Jumpstart Centre, Mumbai...



Game Therapy in India
Game therapy is still a complete new concept in India. It’s well below the nascent stage. There could be several reasons for this. The most clichéd one is we are a developing country with a large population oblivious to the latest technologies. Then, gaming consoles are popular only with a certain priviledged segment of society. Considering the PC penetration in India, computer games are still slowly, yet steadily picking pace, and console gaming is popular only among the small gaming community and enthusiastic teens in the country. Another reason is likely to be lack of awareness, not many therapists and people are aware about implementing gaming as a therapy. Moreover, without much awareness, it may not be considered as a mode of treatment by many common people and patients too.

However, it is not that gaming therapy hasn't set foot in the country. We came across the Jumpstart Therapy Centre in Mumbai (Prabhadevi and Navi Mumbai) which implements video game therapy to treat children suffering from developmental challenges like Autism, Cerebral Palsy, Dyslexia, ADHD, Learning Disorders, and Intellectual Challenges. The Centre guides parents and trains children who have these developmental challenges through modern gaming consoles, like Nintendo Wii, PlayStation 2 and specially designed software for the iPad 2. Dr. Saif Bijliwala, Psychiatric Occupational Therapist and Director of the Jumpstart Therapy Centre was kind enough to tell us about the treatment through gaming technologies. Dr. Bijlivala uses Nintendo Wii games, like "Wii Fit", and "dance mat” and reveals that the wii Sports has become a favourite among children. “The Wii Fit is a great tool to develop dynamic balance, posture, cordination, weight shift, spatial skills, logical thinking and strategy planning,” he points out.

Gaming therapy for children..



Besides Wii, he believes that the computer also offers an amazing variety of avenues for use in therapy. They use about 150 computer related learning software and have also incorporated touchscreen monitors to facilitate learning among children. He also talks about the new "camera mouse", whereby children can use their head or eye movements to play games, instead of manipulating the mouse with their hand of finger. It has been especially beneficial for children with severe Cerebral palsy or related manual co-ordination disorders.

“Multi-sensory stimulation achieved through multimedia is an excellent tool for stimulating the nervous system to respond appropriately. At Jumpstart Therapy Centre. We use play station 2, along with the eyetoy function. The instructions, music, and visuals on the screen elicit specific movement responses, which need to be accurate in space and time. We encourage patients to participate and excel in these games thus helping them to develop valuable visio-motor perceptual skills, spatial orientation, development of strategy planning skills etc. In the process of therapy in concurrence with the clients need, we use various softwares games like Play 3, Sing star, Anti gravity etc,” reveals D. Bijlivala.

Basically, kids enjoy these games, and the therapy isn’t like a boring or monotonous chore. The iPad 2 is used with software designed for individuals with special needs. So, a typical curriculum will have Physical-Motor, Language, Cognitive, Psycho-social and Activities of Daily living as core subjects. Using gaming and other multi-media helps develop primarily the first four skills mentioned above, Dr. Bijlivala maintains that since the treatment is for children, they opt for lively and visually appealing content that could keep kids glued to the screens.

As aforesaid, game therapy, for several reasons, hasn’t picked pace in India. It is yet to set its foot completely in our country. Microsoft Kinect, which is believed to do wonders is yet unexplored here. Game therapy can be used to treat grave issues, which remains unexplored in India.

Using specially crafted games



Developing special games
Just like in case of children with developmental challenges, game therapy has shown positive effects with those suffering from serious ailments, like paralysis and stroke. One cannot use any hardcore game, but there are specially designed games. The Institute for Creative Technologies, University of Southern California has been researching and treating patients with paralysis. Here Kinect-based games are used to assist patients who have suffered paralysis. And not just any Kinect game. It's more about using a Kinect to extend the range of movement of the patient. There are patients who, upon the use of game therapy have shown signs of improvement. Ray Pizarro is one such patient who was paralyzed in an accident 10 years ago. The game therapy requires him to grab gems in a virtual mine environment and the motion-capture technology tracks his movements, as he exercises muscles and improves his mobility in physical therapy with this game. "My posture improved because you have to sit up up right in order to be able to reach properly. My endurance has improved, and also my reaching ability and range of motion because they do force you to reach out a little more than you're used to comfortably,” he said in a report earlier.

These special games are built by a research team at the University of Southern California's Institute for Creative Technologies (ICT). Belinda Lange who leads the team incorporates gesture sensing technology, which responds to physical movement from the patient. "We're leveraging the technologies behind the current video games, so using something like the Microsoft Kinect that can track people in a very low cost way and without having to hold any devices,” she says.

Gaming for treatment...



So, developing games that suit specific needs of a patient is of primary importance. And, seemingly, this is going to take some time in India. But it would be nice if developers could start building games that could assist such therapies. Here again, the hindrance is - do they have a market to cater? Moreover, there is also lack of awareness about existence of such therapy games and software.

Gaming paves way for innovation
Sensor-based gaming consoles are becoming increasingly popular. They let you actively and physically participate in games, instead of merely being the controller an avatar on the TV connected to your gaming console. However, these consoles are used way beyond mere gaming. Just like using gaming as a therapy, they also allow building newer products to help the disabled.



What caught our attention are the Kinectacles and Kinect Bridge showcased at the Microsoft Garage Fair. This tech event has been put up to encourage newer innovations at Microsoft. So, basically Microsoft employees can work on newer technologies and further explore the existing ones in their spare time.

Rishabh Verma showcases Kinectacles at MS Garage Fair...



The ingenious built the Kinectacle, which are glasses designed for the visually challenged, while the Kinect Bridge is for those who suffer from hearing impairment. Kinectacles is a set-up using the Kinect sensor, which scans the area in front of it and the software processes the scanned data to inform the visually disabled about possible interruptions, obstructions on his way. Kinect Bridge enables real-time communication between a speech impaired person with another person who does not know sign language, using Microsoft Kinect for Windows. It uses Kinect to recognize hand and body gestures, convert them into text or speech and transmit it to the user who does not know sign language, and vice versa. This way, a speech impaired person interacts in his/her natural way using sign language and the other person does not need to learn sign language to communicate with the speech impaired user. These devices are aimed at offering real time communication between speech impaired and the other who doesn’t know the sign language.

We spoke to the Microsoft employees and makers of these products - Rishabh Verma from the team that built Kinecatcles and Bangaru Venkatesh from the team that built Kinect Bridge. Well, both haven’t thought of commercializing the products and are working primarily on technical details. The initial prototypes of these products are ready and the teams are working on further enhancements.

We asked them if they have heard about game therapy and this is what they had to say, “We have read about some people around the world who are exploring the option of using video games and motion sensing devices to assist/treat patients but not aware of any commercial product available in the market which is specifically designed to do so. But the idea sounds promising.”

While talking about the challenges faced while crafting such products, they revealed that such products are designed for people with very specific and special needs and requirements. “While all of us read and research about the requirements, it remains a challenge to get into the head and skin of the user to understand if the product would really empower and enable them,” reveal Rishabh and Venkatesh.

While gaming has become the talk of the town, game therapy is yet to make its presence felt. As we see, the concept of game therapy sounds promising and could help many patients. Moreover, if the right games are made available with the readily available consoles in the market, patients can continue the treatment in their homes without the need to visit therapy centers.

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