PROJECT SUMMARY/ABSTRACT Introduction: The Motivating Occupational Virtual Experiences In Therapy for kids (MOVE-IT) SBIR Phase I program will support intensive rehabilitation for pediatric hemiplegia through mixed-reality games that inspire high-dosage, task-directed upper extremity (UE) movements. Although dosage of training is almost uniformly associated with better outcomes in UE rehabilitation [1], [2], [3], [4], achieving the repetitions necessary to achieve lasting results through neuroplasticity is a formidable challenge. The MOVE-IT system will employ mixed-reality games that combine virtual- and real-world physical elements to provide therapists with a turn-key solution that engages patients in repetitive practice, facilitating evidence-based approaches including constraint- induced movement therapy (CIMT) and bimanual intensive therapy (BIM) [5]. This highly innovative solution employs modern video game engine technology, low-cost human motion tracking, and a robotic ?smart toy? to create games that promote adherence. Players are immersed in engaging storylines and multi-modal experiences that nourish the basic psychological needs underpinning human motivation. A web-based provider dashboard will enable therapists to track patient status, manage difficulty settings, as well as generate reports that document activity and progress via game-derived metrics that will be validated as part of the proposed Phase I activity. Problem to be addressed: Pediatric hemiplegia can result from Cerebral Palsy (CP) or acquired brain injury (including pediatric stroke, trauma, tumor, or other disease), and adversely affects motor functions essential to self-care, play, exploratory learning, and other daily activities [6]. CP, in particular, impacts more than 1 in 300 children in the U.S. [7], 60% of whom will experience some level of impairment in UE function [8]. Long-Term Goals: Provide a system for both clinical and home use that facilitates delivery of evidence-based therapies for hemiplegia, such as CIMT and BIM, while improving patient participation and adherence to these regimes. Reduce the cost of, and improve access to, state-of-the-art rehabilitation. Provide validated means for therapists to gauge and track patient progress in both clinical and home-based treatment programs. Phase I Summary: Barron Associates Inc. (award-winning innovators in video game therapy and advanced human-computer interfaces) has partnered with pediatric rehabilitation specialists at the University of Virginia (UVa) to create a highly innovative system that combines virtual world-based games with a robotic smart toy. The combination provides a mixed-reality experience that includes sight, sound, and touch. Phase I tasks include prototype development and demonstration of concept feasibility in testing with pediatric patients at the UVa Children?s Hospital. Commercial Opportunity: The MOVE-IT system will provide a low-cost, turn-key support tool for evidence- based, intensive therapies for use in rehabilitation in both clinics and home-based programs.