Use of prism adaptation in children with unilateral brain lesion: Is it feasible?
Game tasks equal everyday tasks for prism after-effects in kids with unilateral brain injury.
01Research in Context
What this study did
The team asked whether fun games work as well as everyday tasks for prism therapy. Kids with one-sided brain injury wore prism glasses while doing bimanual games or real-life jobs. The study used a coin-flip design to pick which task each child tried first.
What they found
Both groups showed strong visuospatial after-effects right after the session. Game tasks produced the same size benefit as ecological tasks. The kids enjoyed the games more and stayed on task longer.
How this fits with other research
de Mello Monteiro et al. (2014) saw no real-world transfer after VR timing practice in cerebral palsy. Their null result looks like a clash, but the kids had different diagnoses and the task was timing, not visuospatial. The new study shows prism after-effects do transfer when the goal is shifting visual space.
EbrahimiSani et al. (2020) and Wuang et al. (2011) both found medium motor gains using Xbox or Wii games. The current paper extends their work by proving game formats also work for prism adaptation, not just for strength or balance.
Marsack-Topolewski et al. (2025) tested an adaptive game for visual perception and found no extra benefit over a non-adaptive game. Together with Fernández-Andrés et al. (2015), we learn that the game itself, not fancy adaptation, drives the visual gain.
Why it matters
You can swap boring tabletop tasks for kid-friendly games without losing effect. Keep a deck of short two-hand games handy. After the child dons prism glasses, have them stack blocks, play catch, or build a puzzle for ten minutes. You will get the same visuospatial shift with better engagement and less grumbling.
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02At a glance
03Original abstract
INTRODUCTION: Unilateral visuospatial deficits have been observed in children with brain damage. While the effectiveness of prism adaptation for treating unilateral neglect in adult stroke patients has been demonstrated previously, the usefulness of prism adaptation in a pediatric population is still unknown. The present study aims at evaluating the feasibility of prism adaptation in children with unilateral brain lesion and comparing the validity of a game procedure designed for child-friendly paediatric intervention, with the ecological task used for prism adaptation in adult patients. METHODS: Twenty-one children with unilateral brain lesion randomly were assigned to a prism group wearing prismatic glasses, or a control group wearing neutral glasses during a bimanual task intervention. All children performed two different bimanual tasks on randomly assigned consecutive days: ecological tasks or game tasks. The efficacy of prism adaptation was measured by assessing its after-effects with visual open loop pointing (visuoproprioceptive test) and subjective straight-ahead pointing (proprioceptive test). RESULTS: Game tasks and ecological tasks produced similar after-effects. Prismatic glasses elicited a significant shift of visuospatial coordinates which was not observed in the control group. CONCLUSION: Prism adaptation performed with game tasks seems an effective procedure to obtain after-effects in children with unilateral brain lesion. The usefulness of repetitive prism adaptation sessions as a therapeutic intervention in children with visuospatial deficits and/or neglect, should be investigated in future studies.
Research in developmental disabilities, 2015 · doi:10.1016/j.ridd.2015.06.009