Toys4Therapy | Designing Playful Smart Toys to Support Home-Based Hand Therapy for Children with Cerebral Palsy
Tamara Veronica Pinos Cisneros is a PhD student in the department Interaction Design. (Co)Promotors are prof.dr.ir. G.D.S.Ludden from the Faculty of Engineering Technology (ET), University of Twente and prof.dr. B.A.M. Schouten from the Eindhoven University and prof.dr. B.J. A. Krose from the Hogeschool from Amsterdam.
Children with cerebral palsy (CP) often require long-term hand therapy to improve and maintain motor function. While effective therapeutic programmes such as Constraint-Induced Movement Therapy and Bimanual Training exist in clinical settings, continuing these exercises at home can be challenging for children and families. Exercises are often repetitive, difficult to integrate into daily routines, and rely heavily on parental supervision, which can negatively affect motivation and long-term adherence. This thesis addresses the gap between clinically designed therapy and the lived realities of family life by investigating how playful, adaptive smart toys can support motivating and meaningful hand therapy at home.
This doctoral research explores how playful, adaptive smart toys can support children with cerebral palsy in performing hand therapy at home in a motivating and meaningful way. Using a Research through Design approach, the research brings together insights from rehabilitation science, play theory, motivation theory, and human–computer interaction.
Central to the thesis is the design and evaluation of the Magic Monster, a smart therapeutic toy that transforms prescribed hand movements into playful interaction. The toy uses sensors and machine-learning techniques to adapt the difficulty of play and feedback and feedforward cues to each child’s abilities, a concept described as self-adaptive play complexity. Longitudinal field studies in children’s homes show how adaptive play can support engagement and sustained participation without increasing caregiver burden.
The thesis concludes with the Smart Toy–CTT (Context–Therapy–Technology) Framework, which provides designers, researchers, and clinicians with a structured approach to developing smart toys for home-based therapy. The work contributes to design research, digital health, and child–computer interaction, and offers practical insights for designing therapeutic technologies that align with family life.


