Every move they make

Every move they make

Researchers at Bloorview Kids Rehab help severely disabled children communicate through music
November 1, 2007
The ability to be creative is something most people take for granted. But for children with severe disabilities and limited communication and movement skills, creative expression is something they may not even fathom. Through the work of Tom Chau and his multidisciplinary team at Toronto’s Bloorview Kids Rehab, there’s now a way for disabled children to express themselves through music. With the Virtual Music Instrument (VMI), these children can “play” a musical instrument or compose music simply by moving an eyebrow, a hand, or a finger.

Bloorview Kids Rehab is the largest paediatric rehabilitation centre in Ontario. Its patients include children with cerebral palsy, spina bifida, and muscular dystrophy. Early in 2002, Chau and his team first developed the VMI technology “as a motivating device to encourage interaction and movement for a population of individuals with severe motor issues,” he says. With computer software and a web cam, they encouraged users to exercise by rewarding movement with the creation of musical notes.

By chance, Chau found that using music to reinforce movement by special-needs children also let them show off their musical creativity—a previously unknown talent. Consequently, the VMI encourages not only motor skill development, but creative communication as well. The VMI is the first device that allows disabled children, including those unable to speak, to communicate creatively.

As an intelligent system, the VMI acts as an extension of a child’s body and as a musical instrument. Chau’s software, which works on personal computers, instructs the VMI to adapt to the child’s abilities and physical commands. This alone sets it apart from traditional assistive technologies, which require that the disabled child adapt to the technology, often taking months or even years for successful adoption. “As the user interacts with the technology, the machine learns the abilities and preferences of that user,” Chau explains.

Student Kenneth Tse demonstrating VMI
Student Kenneth Tse demonstrating VMI

Using a web cam, the VMI records a child’s motion, such as hand movements. The onscreen hand moves in tandem with the child’s actual hand. The child can then move his/her hand to select various shape icons on the screen. Each shape represents a sound, a musical note, chords, an instrument, or a piece of music. By moving his/her real hand over the shapes, the child can create music. Adjusting the speed and placement of the hand affects the speed and pitch of the music. By involving movement, no matter how minimal, the VMI promotes exercise along with creativity. In one case, a child reached for a symbol that was placed farther away than usual, and thereby increased her exercise efforts without even realizing it.

The current VMI is also the result of a collaborative effort incorporating user-based design. Essentially, it integrates feedback from the children, their families, occupational and music therapists, and students. “No one discipline could offer a comprehensive solution,” says Chau.


For children with limited motor and communication skills, the VMI has proven effective for increasing movement and creativity. Its innovative design has also made it useful to other groups and for other purposes. “We use it most of the time to reinforce cause and effect, and for basic exploration and play,” says David Hobbs, Senior Rehabilitation Engineer at Australia’s NovitaTech, a major provider of assistive technology for people with disabilities. At NovitaTech, the VMI has also been used to teach concepts such as mathematics. And the company has found that children with behavioural problems and adults who develop age-related disabilities have benefited from the VMI.

Through his ongoing work with disabled children, Tom Chau has also found that the VMI improves their communication skills and self-confidence. “There is a risk of learned helplessness among children with severe motor problems,” he comments. His research has shown that children can be empowered by music and made more confident in social situations. For instance, in November 2006, several children using the VMI participated in a music recital at Toronto’s Royal Conservatory of Music.

Virtual object dialog box
Virtual object dialog box

Chau’s research has helped make Canada a leader in the field of assistive technology. His approach fits with a new perspective on disability advocated by the World Health Organization. This perspective influences both technological and therapeutic approaches to the disabled and mainstream society. “Disability is not necessarily related to the person; it is also a socially or environmentally created issue. This perspective argues that if the environment is modulated, the disability is less of an issue,” says Chau.

Following this philosophy, Chau has developed a software-driven prosthetic hand that responds to the low-frequency vibrations muscles emit when they move. As the prosthesis adapts to the child, it becomes a tool that can help the child complete tasks. For example, professional violinist Adrian Anantawan, whose right forearm is only five inches long, has a custom prosthesis that lets him grip a violin bow. This prosthesis compensates for the violin's design, not for Anantawan’s abilities, and helps him play with the Toronto Symphony Orchestra.

Chau hopes that such assistive technologies will do away with the entire concept of the disabled. “As technology increases in ubiquity, there will be no distinction between the mainstream and the disabled. There will be technology for all, and there won’t be a stigma on technology for the disabled,” he says.


Tom Chau’s work has benefited from the research support of partners such as The Hospital for Sick Children. Funding was supplied by The Kids’ Action Research Foundation (now dissolved), which was a part of the Easter Seals program. The Bloorview Children’s Hospital Foundation supports Chau’s work, as does the Natural Sciences & Engineering Research Council (NSERC).

Learn more

Learn how people live with their health conditions through the World Health Organization’s International Classification of Function, Disability and Health (ICF).