Design and Development of One-Switch Video Games for Children with Severe Motor Disabilities

Video games are not just played for fun; they have become a handy instrument for the cognitive, emotional, and social development of children. However, several barriers prevent many children with disabilities from playing action-oriented video games, alone or with their peers. In particular, children with severe motor disabilities, who rely on one-switch interaction for accessing electronic devices, find fast-paced games that require rapid decision-making and timely responses, completely unplayable. This article contributes to lowering such barriers by presenting GNomon (Gaming NOMON), a software framework based on the NOMON mode of interaction that allows the creation of action-oriented single-switch video games. The article reports the results of two studies that evaluate the playability and rehabilitation suitability of GNomon-based video games. The playability of GNomon-based games is evaluated by assessing their learnability, effectiveness, errors, satisfaction, memorability, and enjoyability with a group of eight children with severe motor disabilities. The suitability for pediatric rehabilitation is determined by means of a focus group with a team of speech therapists, physiotherapists, and psychologists from a Local Health Agency in Turin, Italy. The results of the playability study are positive: All children had fun playing GNomon-based video games, and seven of eight were able to interact and play autonomously. The results of the rehabilitation-suitability study also entail that GNomon-based games can be exploited in training hand-eye coordination and maintenance of selective attention over time. The article finally offers critical hindsight and reflections and shows possible new future game concepts.