VR for speech therapy with children with cerebral palsy is feasible at home - with kids rating it higher than clinicians do
How this was rated
Feasibility study with 28 children for assessment and 3 for the tele-rehabilitation arm. Appropriate for a feasibility question; not designed to estimate effects. Results support 'can this be done' rather than 'does it work better'.
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This pilot feasibility study tested the VRRS (Khymeia) system for speech therapy assessment with 28 children with cerebral palsy at IRCCS Stella Maris Foundation (Pisa, Italy), and followed three children with unilateral CP through a home-based tele-rehabilitation program. VRRS is a non-immersive 2D touch-screen platform (the same system used in Cappadona 2023), not a head-mounted VR system. Both assessment and home delivery worked. Children consistently rated the system higher than clinicians on usability and acceptability.
Tele-delivered VR speech therapy is feasible for children with cerebral palsy, with strong engagement from children themselves. Clinicians should plan for hardware and workflow adaptations; the system's child-friendliness is a genuine asset but does not remove the need for therapist customization.
Key findings
- VRRS showed good usability and acceptability for speech therapy assessment in children with CP
- Children rated satisfaction higher than clinicians on both usability and acceptability scales
- All 3 tele-rehabilitation participants improved on reading speed (>0.3 syllables/second) and reading accuracy (40-75% error reduction)
- Writing abilities improved in the tele-rehabilitation participants
- Authors identified need for pediatric-specific hardware and software adaptations
Background
Children with cerebral palsy often have complex speech, language, and learning needs that are best supported by regular, sustained intervention. Access is a recurring barrier - specialist clinicians may be distant, and families face significant logistical demands. Tele-rehabilitation has grown substantially, but whether immersive or structured VR systems are practical at home for this population had not been well tested.
What the researchers did
Mangani and colleagues at Stella Maris Foundation used the VRRS (Khymeia) system to conduct single-session speech assessments with 28 children with cerebral palsy in clinic, then extended the protocol to home-based tele-rehabilitation with 3 children over 3 months. Usability and acceptability were measured for children and clinicians; intervention outcomes included reading speed, reading accuracy, and writing.
What they found
Assessment feasibility was good across the full sample - both clinicians and children rated the system usable and acceptable, though children’s scores were consistently higher. The three children who completed home-based tele-rehabilitation all improved on reading speed (above 0.3 syllables per second) and showed 40-75% reductions in reading errors. Writing also improved. Clinicians noted hardware and software limitations that required workarounds.
Why this matters
Two things stand out. First, a VR system developed for adults was workable with children, which suggests that pediatric use is design-feasible, not only efficacy-contingent. Second, the acceptability gap between children and clinicians is consistent with broader literature - children engage readily with VR, while clinicians see the friction points. For teams considering VR in pediatric SLT, this pattern matters: child buy-in does not automatically produce clinician buy-in.
Limitations
Small sample for the tele-rehabilitation arm. No control group. Outcomes measured over 3 months with no longer-term follow-up. Findings specific to the VRRS system.
Implications for practice
For therapists working with children with CP at a distance: home-based VR-supported speech therapy is workable and motivating for children. Expect to spend setup time on hardware fit and workflow. Clinician experience lags child experience - this is an important design signal, not a reason to dismiss the approach.
Implications for research
The clinician-child acceptability gap deserves further study - whether it reflects fixable workflow issues or deeper interface design problems. Controlled comparisons of home-based VR speech therapy versus standard tele-therapy in CP populations would strengthen the evidence base.
Cite this study
If you reference this study in your work, the canonical citation formats are:
@article{mangani2024,
author = {Mangani, G. and Barzacchi, V. and Bombonato, C. and Barsotti, J. and Beani, E. and Menici, V. and Ragoni, C. and Sgandurra, G. and Del Lucchese, B.},
title = {Feasibility of a Virtual Reality System in Speech Therapy: From Assessment to Tele-Rehabilitation in Children with Cerebral Palsy},
journal = {Children},
year = {2024},
doi = {10.3390/children11111327},
url = {https://withvr.app/evidence/studies/mangani-2024}
}TY - JOUR
AU - Mangani, G.
AU - Barzacchi, V.
AU - Bombonato, C.
AU - Barsotti, J.
AU - Beani, E.
AU - Menici, V.
AU - Ragoni, C.
AU - Sgandurra, G.
AU - Del Lucchese, B.
TI - Feasibility of a Virtual Reality System in Speech Therapy: From Assessment to Tele-Rehabilitation in Children with Cerebral Palsy
JO - Children
PY - 2024
DO - 10.3390/children11111327
UR - https://withvr.app/evidence/studies/mangani-2024
ER - Know of research that should be in this hub? If a relevant peer-reviewed study is not listed here, send the reference to hello@withvr.app. The hub is kept up to date as the literature grows.
Funding & independence
No withVR BV involvement in funding, study design, or authorship. Summary prepared independently by withVR using the published paper.