Developing videogames and play for hospitalised children

In exploratory network meetings, we identified a lack of videogames that meet the specific needs of hospitalised children. Hospital play tends to be based on 'traditional' toys and games, with limited innovation in digital play, such as children using tablets/ smart phones brought in by family visitors to access video games. We have identified apps designed for children to communicate pain levels and other symptoms to doctors (e.g. Small Talk Intensive Care, SmallTalk Pain Scale, Answers: YesNo, Speak Aid, Easy Speak, AutoVerbal Talking Soundboard PRO). However, there is considerable scope for development in the videogames industry that could use expertise from humanities and the arts to co-create digital play opportunities that respond to the specific needs of hospitalised children, to stimulate their play experiences, imaginations and creativity when confined to medical and recovery spaces. There is potential for significant impact from scoping the challenges to research and innovation in the videogames sector.
The network integrates three strands of membership to promote interdisciplinarity and combine academic and industry expertise:

Strand 1: Academic researchers in the arts and humanities Specialists in children's play and graphic representation of medical conditions and emotions across cultures and visual media:
Elizabeth Wood specialises in researching traditional and digital forms of play, with a focus on children's choices and agency in free play activities (Wood, 2013; 2008; Wood and Hall, 2011). Dylan Yamada-Rice specialises in researching children's understanding and use of images, their changing multi-modal communication practices, and the expression of emotions in the visual mode (Yamada-Rice 2013; 2012; 2011). Matthew Cheeseman (http://eine.tumblr.com/page/2) will build on knowledge from The Phoenix Art Project (funded by NESTA and Sheffield Crucible theatre), which uses graphic forms to facilitate literary tropes such as humour, metanarrative, ambiguity and metaphor in order to address psychological, taboo and medical problems in imaginative, affecting, complex and contradictory ways (Cheeseman et al, 2013). Richard Finn is a PhD student in the School of English, researching the conceptual structure and reader experience of mental health graphic narratives.

Strand 2: Children's videogames designers: Industry experts in the design and production of videogames for children age 3-18: Nigel Little, Distinctive Games http://www.distinctivegames.com/; Emma O'Kelly De Conejera, and Steve Taylor, Stripy Designs http://www.stripeydesign.com/.

Strand 3: Hospital play specialists: Christina Lloyd and Kevin Hartshorn, Sheffield Children's Hospital.

Digital play is a significant area for creative development, and has strategic importance to the NHS Trusts that manage the five children's hospitals in England: Alder Hey, Liverpool; Children's Hospital, Sheffield; Great OrOrmond Street, London; Royal Manchester Children's Hospital; Birmingham Children's Hospital. For videogames designers this is a complex but new niche market, which requires considerable knowledge about children's play choices and preferences and about hospital play contexts and practices, including ethics. Hospital play specialists and videogames designers will benefit from methodological innovations developed by the academic members of the network, including emotional representation in graphic form, linked to spaces and places (Cheeseman & Finn); emotional representations in environmental images and their appeal to children (Yamada-Rice) and children's multimodal communication practices in traditional and digital play forms (Wood). In order to co-produce these kinds of videogame(s), knowledge exchange amongst the network members (and invited workshop participants) is crucial. Important strategic and creative areas need to be explored in order to inform future developments, and build on existing practice (e.g Create Explore Learn).

This project includes considerable commitment, including in-kind contributions, by the network contributors from Sheffield Children's Hospital (Lloyd and Hartshorn), and the industry experts videogames designers (Little, Conejera, Taylor). Further in-kind commitments will be secured as the project develops to include wider collaborations on proposals for research and development funding.
The significance of the collaboration is the longer-term potential for co-production and co-creation of commercially viable ideas for developing videogames for children in hospital. This is an under-developed area, and presents numerous challenges to videogames designers, who need knowledge about ethics, age of children, nature of the illness [including treatments and therapies], length of stay in hospital, degree of mobility and access to play activities. Videogames designers wil also benefit from understanding multi-professional relationships and professional cultures in hospital contexts, as well as parents' and children's experiences.
The immediate beneficiaries will be the members of the three strands, specifically developing university-industry collaborations and accelerating the potential for innovations in hospital play. The exchange of professional knowledge, cultures, and practices will specify the research challenges in hospital play (including ethical protocols and creative ways of approaching future research with children and play specialists).Hospital play and therapeutic specialists will benefit from communicating the ways in which functional and free play activities can be integrated into children's experiences in ways that enhance their well-being. Children and families will also benefit from their involvement in Workshop Four, and from subsequent development of any commercial outputs of videogames.
Targets for the NHS Trusts include improving children's experiences of preparing for, and being in hospital, particularly for repeated treatment and therapies. The Workshop activities will inform the development of playful/functional apps, which will be of direct benefit to NHS targets, and to the multi-professional communities of practitioners who work with young people. The project will contribute to enhancing the work of hospital play specialists in educating medical professionals about how to relate to young children in playful and age-appropriate ways.
The wider beneficiaries will be the invited contributors to the four workshops, and the organisations that they represent in the videogames industry, arts, media, hospital play and therapeutic professions, as well as academics and students. Impact will emerge will arise from knowledge exchange activities, workshop summaries on the project website, and plans for future research and funding applications (Workshop 4). There will be scope for scaling-up the outcomes by linking to other research sites in hospital play (such as Professor Joce Nuttall's networks with hospitals in Auckland, Melbourne and London. Prof Nuttall has already expressed interest in developing research collaborations). Future collaborations will afford further potential for improving strategies for sustaining children's development in holistic ways during hospitalization.
In academia, the project will contribute to the University of Sheffield's trans-disciplinary research agenda, specifically linking the arts and humanities with medicine, medical humanities, arts therapies, and developing innovative ethical approaches to trans-disciplinary research methods. The network activities will inform research-led teaching, notably in undergraduate programmes (Dr Cheeseman - Graphic Novels and the Love of Superpower), as well as advanced methodologies and research ethics with M and D level students.
There is considerable potential for opportunities for scaling up and transferable learning to the wider videogames sector, and innovative high quality cross-disciplinary research projects.