BCI@Home: Brain Computer Interface Solutions to Enable Youth Living With Severe Disabilities

Preliminary research has proven that children with severe physical disabilities can operate home BCI systems. Despite the incredible impact of BCI on child well-being, access is currently limited to those who are close to major centres with the resources to frequently access tertiary care sites. A home-based BCI program is necessary to make this technology equitably available so that every child can realize their fundamental human right to participate in life.

The objectives are to: (1) Evaluate the effectiveness of a home BCI program for enabling children with disabilities to achieve personalized life participation goals; (2) Evaluate the equitable reach of implementation of a home BCI program.

This is a prospective, family-centered, single arm hybrid effectiveness-implementation trial that uses mixed methods. Implementation and effectiveness outcomes will be examined in parallel to ensure the program remains effective as its reach expands.

Implementation Methods: The trial uses systematic implementation science methods focused on the sustainable uptake of research into real-world practice. The four phases of the Quality Implementation Framework will guide implementation. Phase one focuses on identifying adaptations/strategies. Our transdisciplinary team will co-create four strategies to begin: 1) ready access to technical support, 2) scheduling flexibility, 3) broad choice of BCI activities, and 4) culturally safe care. Phase two focuses on creating a structure for implementation by formalizing plans and teams. The third phase, ongoing structure, will include monitoring and adapting strategies as needed during sequential participant enrolment. Phase four, improve future applications, will be done through evaluation outlined in outcomes below.

Home Program: Families will first complete an in-person visit to review available activities, set their first goals, and learn to use BCI independently. A BCI "kit" will be given to each family, with a headset and the equipment and software required to pursue their identified goals. Following this, families will participate in 12 virtual sessions over 3-6 months. Scheduling will be flexible to accommodate complex family needs. Daily online support will be provided via a messaging application. Participants who choose to continue using BCI beyond 12 sessions will be provided kits and supported.