Many adults, particularly those with claustrophobia, experience significant anxiety when undergoing an MRI. Imagine being a child with Autism Spectrum Disorder (ASD) — with sensitivity to sounds, touch, and changes in the environment — and needing an MRI on a regular basis.
This presents a challenge for children, parents, and clinicians. When a child with ASD requires an MRI, he or she is commonly sedated to ensure they remain still throughout the scan. There are many inherent risks associated with sedation.
Researchers at the Marcus Autism Center, an affiliate of Children’s Healthcare of Atlanta, utilized an MRI simulator to train the children on what to expect. But children with ASD frequently lack the ability to generalize experiences, and the MRI simulator at Marcus did not closely resemble the actual MRI scanner. This limited the benefits of the training session, and the transition felt like a completely new experience.
Brad Fain’s experience in universal design led him to think there were better solutions. Former director of the Center for Consumer Product Research and Testing at the Georgia Tech Research Institute (GTRI), Fain started with the goal of making the simulator experience match that of the real machine, but he also wanted to explore how to make the environment less frightening for children.
The goal of universal design, he said, is removing barriers in the environment so that everyone can access and use it. “If you design something for a population with special needs, then likely you will benefit the entire population who needs access to that technology as well,” said Fain, who is now executive director of the Georgia Tech Center for Advanced Communications Policy.
GTRI Senior Research Associate Megan Denham led Fain’s team in studying the best approach to making children more comfortable with the procedure. Initially, the team discussed creating a “skin” for the MRI machine with a child-friendly design that reflected children’s interests, such as rocket ships. But by asking the kids what they liked, it was clear that they had different interests.
“The theme that emerged from talking with these kids and families wasn’t so much about a particular design,” said Denham. “It was the desire for control over their environment.” In stressful situations, the children liked to go to their rooms, where they had things set up the way they wanted them.
The team, which included research scientists Andrew Baranak, Chris Bartlett, and Amanda Foster, searched for a solution that could be customized to each patient, be consistent in both the simulator and procedure locations, and change when needed. They came up with the idea of letting each child choose the color of the lights in the rooms.
“Every day they can choose a different color that matches their mood,” said Denham. “It also provides interactions between the trainers, clinicians and the kids, asking them, ‘What color would you like your room today?’” It encourages each child to interact with the environment.
The team also revamped the training simulator, working with a movie prop company to create one that better matched a real MRI machine. “Basically walking into those rooms, the children get an almost identical experience looking at the two units,” she said. “Then they can control the environment.”
Patients from the Marcus Center are not the only ones who may benefit. Other researchers and clinicians can utilize the ambient lighting system to improve the experience for their pediatric and adult patients.
Fain noted that the project is a great example of user-centered design — or patient-centered design, in this case. “We put the patient in the center of the process and then build the technology around them, as opposed to putting the technology in the center and trying to make the patient fit.”
This work was supported by a research collaboration between Children’s and Georgia Tech through the Children’s Healthcare of Atlanta Pediatric Technology Center Quick Wins program. Quick Wins funds projects designed to find fast solutions to unmet needs clinicians face in day-to-day patient care.
“The collaboration has been solid,” Fain said. “They are very motivated because they have a need. We are very motivated because we have this really interesting problem to work on. They’ve helped us understand their problems and we’ve brought solutions they didn’t have before.”