Usability and User Experience of an Individualized and Adaptive Game-Based Therapy for Children with Cerebral Visual Impairment

Developing a novel game-based therapy requires expert feedback as well as full participation by the eventual end-users of the therapy. In this pilot study, we aimed to investigate (1) usability, (2) user experience, and (3) gameplay log-data of newly developed visuoperceptual games in children with cerebral visual impairment (CVI) (developmental age between 3-12 years) during three short sessions. The mini-games integrate three key features: (1) entry-level individualization defined by the child’s visuoperceptual profile, (2) in-game adaptivity, and (3) gameplay log-data. We observed children’s interaction with the mini-games and measured their user experience using the This-or-That method, the laddering technique, and the Relative Enjoyment Scale for Primary School Children adapted for children with CVI. Finally, we evaluated children’s gameplay using their log-data. While children appreciated the games highly, several usability issues occurred regarding effectiveness, understandability, and game development. Importantly, integrating gameplay log-data optimized usability testing by providing fine-grained information on gameplay performance. By synthesizing information gained, we derive design implications for the further development, prototyping, and more thorough testing of similar games. Based on usability observations, we report nine design implications including tailored interactions/gestures/instructions, language, providing player control, time to familiarize, balancing help and challenge, autonomy, avoiding fine motor skills and multiple action sequences, and integrating visual consistency. Moreover, five design implications based on user experience and enjoyment highlight the importance of reward, challenge, immersive realistic experiences, immediate feedback, and a rich media experience, supporting “flow” theory.