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Cerebral palsy: how a smart phone app for pre-school children might help with rehabilitation

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What did the project achieve?

“By testing one of our interactive short stories that we’ve designed for use on mobile devices for children with cerebral palsy, we have received useful feedback that has enabled us to create even better, more effective stories,” says Professor Jane Eyre of Newcastle University.

In the UK, estimates suggest one in every 400 children has cerebral palsy, a lifelong condition that affects movement and coordination.1 The most common type of cerebral palsy is called ‘hemiplegic cerebral palsy’, which affects one side of a child’s body.

Professor Eyre’s team hope that interactive stories will provide an engaging way to help young children with hemiplegic cerebral palsy to learn how to better control their hand movements. They initially developed one short story, based on the prize-winning children’s book ‘Jamie and Angus’ by Anne Fine, for use on an android tablet and tested this with children and their families.

“We’re pleased that children enjoyed the story and interacted with the characters using hand gestures,” says Professor Eyre. “But the feedback from children and parents was that the story and controls were too challenging for very young children and that they would prefer a range of stories that slowly increase in difficulty, which they could read over several months.”

The team have now created six more short stories that gradually increase in the complexity of hand gestures needed. They also created two new storybooks that are appropriate for under three-year-olds, which they are now testing.

“As part of a larger project, we’ve also integrated these stories into a cloud-based platform, which we hope will enable parents to download them at any time or place, and also help therapists to monitor their success,” says Professor Eyre.


1.    Wimalasundera, N. & Stevenson V. L., Cerebral palsy. Pract Neurol 2016; 16 (3): 184-94. https://www.ncbi.nlm.nih.gov/pubmed/26837375

This research was completed on

Around one in 1,300 newborn babies has hemiplegic cerebral palsy, the most common form of cerebral palsy.1 Children with this condition have difficulty controlling the movement of one side of their body, especially their arm, hand and fingers. Professor Janet Eyre, of Newcastle University, is designing an application (app) for smart phones and tablets especially for pre-school children with hemiplegic cerebral palsy. She hopes it will be a fun way for young children to develop better control of their movement.

What is the problem and who does it affect?

“From a very young age, children with hemiplegic cerebral palsy tend to favour using just their ‘good’ hand,” explains Professor Eyre “They neglect their impaired hand, hardly ever using it spontaneously during play or activities of daily living. This lack of use, lack of practice, compounds their disability.”

Unfortunately, the children’s tendency to avoid using their impaired hand can have lifelong consequences. Many of the everyday activities we perform, such as doing up a zip, washing the pots and driving a car, depend on our ability to use both hands together – our ‘bimanual dexterity’. “Difficulties using both hands together contribute to low self-esteem and poor quality of life in children with hemiplegic cerebral palsy. They can also stop the children from being fully independent when they grow up, which can have a significant impact on other factors too, including mental health and earning capacity.”

Home-based rehabilitation programmes that begin early in life offer much promise. “Key factors for success with home-based therapy are enjoyment levels – of the child and the family – and how flexibly therapy fits into daily life. Parents tend to be supportive but, unfortunately, children are often reluctant to cooperate, because they can find their exercises meaningless and uninteresting.”

What is the project trying to achieve?

Professor Eyre aims to develop a new, highly motivational, home-based therapy for pre-school children with hemiplegic cerebral palsy. The new therapy centres on a specially designed app for smart phones and tablets.

“Our new app will take the form of an interactive, animated storybook,” explains Professor Eyre. “While their parent or carer reads the story, children will control the onscreen characters by moving their own arms and hands, allowing the story to unfold under the child’s direction. The device’s camera will detect the child’s movements. As the stories develop, they will form the basis of a progressively more complex rehabilitation programme.”

In this phase of the research, the team is developing a prototype app and piloting its use in 20 children aged two to five years. If successful, larger clinical trials could then follow. “We hope this new therapy will be convenient, effective and enjoyed by the whole family,” says Professor Eyre

What are the researchers’ credentials?

Prof Eyre and her colleagues have published widely in this area and are running a number of related studies in their laboratory at present. The team has a breadth of experience across clinical and computing disciplines, which puts them in the perfect position to complete this research successfully.



  1. Boyd R et al. BMC Neurol 2010 Jan 12; 10: 4.


Project Leader Professor Janet A Eyre MB ChB BSc DPhil FRCPCH
Project Team Dr G Morgan BSc MSc PhDDr Jill Kisler MB ChB MRCPCH
Project Location Institute of Neuroscience, Newcastle University
Project Location Other Computing Science, Faculty of Science, Agriculture and Engineering, Newcastle UniversityChild Development Centre, The Newcastle upon Tyne NHS Hospitals Foundation Trust
Project duration 1.5 years
Date awarded 26 July 2012
Project start date 1 April 2013
Project end date 31 August 2016
Grant amount £109,372
Grant code GN2051
Acknowledgements This project supported by a generous grant from The Henry Smith Charity and The James and Grace Anderson Trust.


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