Technology is increasingly present in pediatric rehabilitation, but children should never be treated as smaller versions of adults.
Tablets, interactive screens, motion tracking, projection systems, mixed reality, virtual reality and artificial intelligence can create engaging therapeutic experiences for children.
But their use must consider age, development, body size, sensory profile, attention, cognition, communication, diagnosis, emotional regulation, tolerance and family context.
This leads to an important principle: Pediatric digital rehabilitation should be age-adapted, not automatically age-excluded.
The correct question is not simply: “Is this child old enough to use technology?” It is: “Which level of technology is appropriate for this child, this therapeutic objective and this moment in development?”
What is pediatric rehabilitation?
Pediatric rehabilitation supports children whose health condition affects development, movement, communication, cognition, sensory processing or participation.
Children may require rehabilitation because of cerebral palsy, developmental coordination disorder, autism spectrum disorder, genetic conditions, traumatic injury, neurological conditions, developmental delay, musculoskeletal disorders, sensory disabilities or acquired brain injury.
The rehabilitation team may include pediatricians, rehabilitation physicians, occupational therapists, physiotherapists, speech and language therapists, psychomotor therapists, psychologists, neuropsychologists, orthoptists, nurses and educators.
The child and family remain central to the process.
Children do not interact with technology like adults
Technology may be motivating for children.
But children also differ in understanding instructions, attention span, physical proportions, visual development, balance, impulse control and emotional responses.
A rehabilitation technology that works well for a 16-year-old may be inappropriate for a 5-year-old.
The interface, session duration and level of immersion must therefore be adapted.
A pediatric technology continuum
Digital rehabilitation should not be reduced to a single device.
A useful continuum is: tablet → computer/large screen → interactive projection → mixed reality → immersive VR.
These levels are not a hierarchy where VR is automatically “better.”
The objective is to choose the simplest technology that adequately supports the therapeutic goal.
Level 1 — Tablet and touchscreen
Tablets may be useful for cognitive tasks, fine motor interaction, communication, visual attention, home exercises and simple sequencing.
They are familiar and accessible for many families.
They also make home-based follow-up easier.
But prolonged passive screen use should not be confused with therapist-guided active rehabilitation.
Level 2 — Large screens and computer-based exercises
A larger display allows visual feedback, interactive games, movement tasks and cognitive training.
It can be useful when a child benefits from digital content but does not tolerate a headset.
Level 3 — Projection and camera-based rehabilitation
Projection can be particularly interesting in pediatrics.
The child remains inside the real physical environment.
Their movement can control games, virtual objects, targets and interactive scenarios.
This avoids placing equipment on the child’s head.
It can support reaching, stepping, balance, coordination, motor planning and group activities.
For some children, this may be preferable to full immersion.
Level 4 — Mixed reality
Mixed reality keeps part of the physical world visible.
Virtual objects are added to the environment.
This may help children remain aware of the therapist, aware of the room and connected to real objects.
It can create a gradual transition toward greater immersion.
Level 5 — Full immersive VR
Immersive VR provides the greatest level of environmental control.
It can simulate rooms, playgrounds, supermarkets, streets, social situations and functional activities.
But full immersion is not automatically appropriate for every child.
Age, comfort, equipment, balance and clinical purpose matter.
Children under 12 and VR: the discussion is changing
A common statement is: “Children under 12 should not use VR.”
That is now too simplistic.
Commercial platforms themselves are changing, and some current ecosystems support younger users under specific parent-managed and safety frameworks.
This does not mean that every child under 12 should use VR.
It means that age alone should no longer be treated as a universal technological exclusion criterion.
The clinical question remains individual.
Research already includes children younger than 12
Scientific literature on pediatric VR already includes children below the age of 12.
This is important because it shows that pediatric VR research is not limited to teenagers.
But the existence of research does not mean unrestricted use is safe.
What do we know about safety?
Current evidence suggests that short supervised exposures can be feasible in selected pediatric contexts.
Reported problems are generally mild but can include cybersickness, dizziness, nausea, visual discomfort, irritability and fatigue.
Evidence about repeated or long-term exposure remains more limited.
This is therefore not a reason to say: “VR is completely safe for every child.”
It is a reason to say: short, supervised pediatric use can be feasible in selected contexts, but caution and better safety research remain necessary.
Screen exposure and therapeutic exposure are not identical
Concerns about screen exposure in children are legitimate.
However, passive sedentary entertainment and a short supervised rehabilitation task are not exactly the same exposure.
A child passively watching videos for a prolonged period is different from a child performing reaching, balance, walking, motor planning, communication or problem-solving during an interactive therapeutic activity.
Therapeutic intent does not remove the need for limits.
It means the exposure should be evaluated according to purpose, intensity, duration, movement, supervision and developmental appropriateness.
Very young children require extra caution
For preschool-aged children, especially those under 5, caution should be particularly high.
This is partly because of rapid visual development, limited ability to report discomfort, attention, headset ergonomics, balance and screen-time recommendations.
For many young children, tablet, projection, movement-based games or mixed reality may be more appropriate than full immersive VR.
The headset needs to fit the child
Pediatric VR is also an ergonomic issue.
The clinician should consider headset weight, facial fit, interpupillary distance, strap adjustment, controller size, visual comfort, balance and play-area safety.
A technically compatible headset is not automatically a well-fitted pediatric device.
Shorter sessions can be better sessions
Children may tolerate immersion differently from adults.
Useful practice can therefore involve short exposures, regular breaks, gradual progression and checking comfort.
The objective is not to maximize headset time.
The objective is to obtain enough therapeutic practice without unnecessary discomfort or fatigue.
Follow the child, not the device
A child may show discomfort, irritability, withdrawal, nausea, visual fatigue or loss of attention.
These signs matter.
The therapist should be able to pause, reduce difficulty, switch device, stop immersion or return to a physical activity.
Technology should remain flexible.
VR and cerebral palsy
Cerebral palsy is one of the most studied pediatric rehabilitation populations in VR research.
Research suggests potential benefits in domains such as gross motor function, balance, upper-limb coordination, activities of daily living and motivation.
However, study designs, devices and protocols vary considerably, so results should not be generalized to every child or every VR system.
Non-immersive VR has also been studied and can support motor rehabilitation.
This reinforces an important point: full immersive VR is not required to obtain therapeutic value from virtual rehabilitation.
Autism and sensory profiles
Children with autism may respond very differently to immersive technology.
Some may appreciate predictable environments, reduced real-world complexity, controlled social scenarios and repetition.
Others may find headset pressure, audio, visual stimulation or loss of environmental visibility uncomfortable.
The technology should be adapted to the child’s sensory profile.
It should not be assumed that autism automatically makes VR suitable or unsuitable.
Developmental Coordination Disorder: from early screening to rehabilitation
Developmental Coordination Disorder (DCD) is a neurodevelopmental condition affecting the acquisition and execution of coordinated motor skills.
Children may experience difficulties in areas such as balance, handwriting, dressing, ball skills, running, bilateral coordination, hand-eye coordination, motor planning and participation in school or playground activities.
Technology can have an important role before rehabilitation even begins.
Structured digital motor tasks may help professionals identify patterns suggesting that a child should receive further assessment.
This creates a potential pathway from early screening → professional assessment → intervention → follow-up.
However, screening should never be confused with diagnosis. A digital tool can support the identification of motor-coordination difficulties, but diagnosis requires appropriate clinical assessment and interpretation.
DCDCare: a European case study in digital pediatric screening and rehabilitation
A concrete example of this approach is DCDCare, a joint initiative led by Remotion in Hauts-de-France, France, together with LumenArt in the South Netherlands.
DCDCare was selected through the European DIGIT-PRE programme, supported under the EU Interregional Innovation Investments (I3) framework.
The official challenge addressed by the project was “Early detection and intervention in Developmental Coordination Disorder.”
The project ran officially from March 2024 to October 2025.
DCDCare is important for Remotion because it represents more than the development of another therapeutic game. It brought together pediatric rehabilitation, early screening, motion analysis, interactive environments, European cross-border collaboration, clinical feedback, regulatory work and market deployment within one project.
From screening to rehabilitation within the same ecosystem
DCDCare was conceived to support both screening and rehabilitation.
The screening approach uses fun and structured motor activities to help identify potential coordination difficulties.
The system can combine real-time performance information with scoring logic informed by established motor-assessment approaches, including MABC-2 standards.
Depending on the activity, the technology can capture or structure information relating to:
- balance;
- hand-eye coordination;
- gross motor coordination;
- spatial awareness;
- task accuracy;
- movement timing;
- repetitions;
- task completion.
The objective is not to automatically diagnose DCD.
It is to provide professionals with an additional, engaging and measurable layer that can help identify children who may benefit from further standardized assessment.
An immersive room rather than a headset-only solution
One of the distinctive aspects of DCDCare is that the concept was never limited to a VR headset.
The solution centres on an immersive and interactive rehabilitation room combining technologies from Remotion and LumenArt.
The environment can integrate:
- motion sensing;
- interactive wall projections;
- interactive floor projections;
- responsive lighting;
- gamified rehabilitation exercises;
- virtual reality for selected activities.
The room reacts to the child’s movement.
Instead of interacting with a conventional interface, the child can use their body to control therapeutic tasks distributed through the environment.
This makes the project especially relevant to pediatric rehabilitation, where a headset may not always be the most appropriate interface.
What was Remotion’s contribution?
Within DCDCare, Remotion contributed its expertise in:
- gamified rehabilitation;
- pediatric motor exercises;
- motion-sensing interaction;
- virtual reality;
- therapeutic scenario design;
- clinical and therapist-centred product development.
LumenArt contributed its expertise in interactive lighting and immersive-room design.
The collaboration therefore combined digital rehabilitation + movement sensing + immersive projection + responsive lighting + VR.
This cross-border combination was one of the reasons the project fitted the DIGIT-PRE model: two SMEs from different European regions combining complementary technologies around a concrete healthcare challenge.
Why DIGIT-PRE mattered
DIGIT-PRE was not only a funding programme.
The selected companies entered an innovation support pathway providing access to expertise in areas including:
- regulation;
- ethics;
- intellectual property;
- business modelling;
- market access;
- investment;
- testing and validation.
DCDCare received European funding through the DIGIT-PRE programme, within the EU Interregional Innovation Investments (I3) framework.
For Remotion, the value of this support went beyond funding alone. It provided an opportunity to structure a pediatric digital-health project within a European innovation and validation pathway, with access to expertise in regulation, ethics, intellectual property, business modelling, market access, testing and validation.
From a screening assistant toward a medical-device pathway
According to the European Commission’s I3 reporting, DCDCare evolved through DIGIT-PRE from a non-medical screening assistant toward a medical device under development.
This evolution illustrates an important difference between developing an engaging application and developing a health technology intended for clinical use.
The second requires work on:
- clinical relevance;
- validation;
- regulatory positioning;
- ethics;
- risk management;
- professional workflow;
- market access.
Testing with therapists in France and Tunisia
DCDCare was progressively confronted with real professional feedback rather than remaining an internal prototype.
European Commission reporting states that more than 30 therapists in France and Tunisia participated in testing and training.
This work helped explore questions such as:
- Are the exercises clinically understandable?
- Are they usable with children?
- Can therapists adapt difficulty?
- Which movement data are actually useful?
- How should screening information be presented?
- How can technology integrate into an existing clinical workflow?
This therapist-centred iteration is important to the Remotion development philosophy: technology should be shaped by clinicians and end users, rather than designed first and clinically justified afterwards.
Clinical work and international deployment
The European Commission reports that clinical trials were launched in Tunisia as part of the project’s development pathway.
The same reporting also describes a first commercial deployment in a clinic in the United Arab Emirates.
This created a trajectory spanning several regions:
France + Netherlands → European innovation programme → therapist testing in France and Tunisia → clinical work in Tunisia → first commercial deployment in the UAE.
For a pediatric digital-health project, this progression is particularly valuable because it tests not only the technology but also its ability to adapt across different clinical and cultural environments.
What DCDCare taught Remotion
DCDCare reinforced several principles that are now relevant to Remotion’s broader pediatric strategy.
1. Technology can support earlier identification.
Digital motor tasks can help reveal patterns that justify further professional assessment.
2. Screening is not diagnosis.
Technology should support professional reasoning rather than automatically label a child.
3. Assessment and rehabilitation can share the same technological ecosystem.
The same motion-sensing and interactive technologies can support structured assessment tasks and later therapeutic exercises.
4. Pediatric technology does not have to mean a headset.
Projection, movement sensing, lighting, tablets and VR can coexist.
5. Clinical feedback must influence product development.
Therapists need to help determine which exercises, metrics and workflows are genuinely useful.
6. Validation and regulation are part of product development.
A healthcare technology cannot be evaluated only by how engaging or technically impressive it is.
From early signal to participation
The long-term objective of digital screening is not to produce another score.
The meaningful pathway is:
early signal → professional assessment → diagnosis when appropriate → individualized intervention → follow-up → participation in everyday life.
This is especially important in developmental conditions, where early difficulties can influence education, play, self-care, confidence and participation.
Technology should help us notice difficulties earlier—not label children earlier.
Learn more about the project at dcd.care.
AI in pediatric rehabilitation
AI can support adaptive difficulty, movement recognition, personalized exercise selection, automated feedback and content generation.
For example, a system might detect that a child is consistently successful and slightly increase task complexity.
But pediatric AI should be particularly cautious.
Children’s movement and development change rapidly.
An algorithm trained primarily on adults may not interpret pediatric movement correctly.
Technology should support play
Children learn through play.
Digital rehabilitation should therefore not turn therapy into constant testing.
A good pediatric system can embed movement, repetition, cognition, communication and social interaction inside playful activities.
The therapeutic objective remains present, but the child experiences a meaningful activity.
Three pediatric use cases
Child with cerebral palsy
A therapist wants to work on standing balance, reaching and weight shifting.
The child may begin with projection-based activities.
If appropriate, later sessions might incorporate more immersive environments.
The target remains the same. The interface evolves according to tolerance and goals.
Child with developmental coordination disorder
The therapist may create activities involving catching, sequencing, stepping, bilateral coordination and timing.
Motion tracking can provide immediate feedback.
Child with neurodevelopmental difficulties at home
The therapist may prescribe selected tablet exercises.
The family does not need to reproduce the entire clinic setup.
This supports continuity between therapy and home.
The Qatar pediatric rehabilitation discussion
This multi-level approach was an important part of Remotion’s pediatric discussions in Qatar.
Rather than proposing only one VR-headset solution, the concept included different modes of delivery.
For younger children or children for whom full immersion may not be appropriate, therapeutic interaction can use projection + camera tracking in the clinic and tablet-based exercises at home.
More immersive solutions can be considered when clinically appropriate.
This approach reflects an important design philosophy: the therapeutic content should be able to move between technologies.
Remotion and pediatric rehabilitation
This is particularly relevant to Remotion because the platform is designed to work across different types of interfaces.
A therapeutic concept could potentially be delivered through tablet → screen → projection → VR depending on the clinical context.
For example, a reaching task may be presented on a tablet for a simple home exercise, through camera tracking on a large screen, through projection for whole-body movement or in VR for a more immersive scenario.
The therapeutic objective can remain consistent while the technology changes.
This makes pediatric digital rehabilitation more inclusive.
Family involvement
Pediatric rehabilitation rarely involves only the child.
Parents and caregivers may need to understand the therapeutic objective, session duration, warning signs, home-use instructions and when to stop.
Home-based technology should not create an expectation that parents become therapists.
It should support the clinical plan.
Metrics should remain child-centered
Digital systems may measure repetitions, range of motion, accuracy, reaction time and completion rate.
But the child-centered questions remain: Is the child participating more? Is the child more independent? Is the task becoming easier in daily life? Is the child engaged without becoming exhausted?
From digital scores to development
| Digital measure | Possible value | Important limitation |
|---|---|---|
| Repetitions | Practice dose | Quantity ≠ quality |
| Accuracy | Task success | May not transfer |
| Range of motion | Motor ability | Compensation possible |
| Reaction time | Processing | Age dependent |
| Game score | Motivation/performance | Not a clinical outcome alone |
| Session duration | Tolerance | Longer is not automatically better |
| VR completion | Immersive-task performance | Must transfer to reality |
| Home app use | Adherence | Use ≠ functional improvement |
The progression should remain: digital performance → functional ability → development → participation.
A practical pediatric safety checklist
- Is the device appropriate for this child’s age and region?
- Does the headset physically fit?
- Can the child understand the task?
- Can the child communicate discomfort?
- Is balance sufficient?
- Is the environment physically safe?
- Is exposure short and supervised?
- Is there a clear therapeutic objective?
- Is a less immersive alternative available?
- Can the activity transfer to real-world function?
The future of pediatric rehabilitation
The future is unlikely to be: every child in a VR headset.
It is more likely to be an adaptive ecosystem where therapists select the most appropriate interface.
A child may use projection during therapy, tablet exercises at home, mixed reality for functional play or VR for selected immersive tasks.
At Remotion, this is the direction that makes the most clinical sense: one therapeutic logic, multiple levels of immersion.
The technology adapts to the child + age + sensory profile + family + therapist + therapeutic objective.
Not the opposite.
The best pediatric technology is therefore not the most immersive.
It is the technology that enables the child to participate safely, meaningfully and developmentally appropriately.
Frequently asked questions
Can children under 12 use VR?
Some current platforms support selected younger users under parent-managed frameworks, and pediatric research includes children under 12. This does not mean immersive VR is appropriate for every child.
Is VR safe for children?
Current evidence suggests that short supervised exposures can be feasible, but pediatric safety evidence remains limited, particularly regarding repeated exposure. Mild cybersickness can occur.
Is VR appropriate for children under 5?
Full immersive VR should be approached especially cautiously in very young children. Other interfaces such as projection, tablet or interactive movement may often be more appropriate.
Does therapeutic VR count as screen time?
It still involves digital exposure, but an active, supervised therapeutic task is not identical to passive sedentary screen entertainment. Duration and developmental appropriateness remain important.
Does pediatric rehabilitation require a headset?
No. Non-immersive VR, screens, tablets and projection systems can also support rehabilitation.
Can VR help children with cerebral palsy?
Research suggests potential benefits in several motor and functional domains, but results depend on the intervention and individual child.
Should technology replace play?
No. Pediatric technology should support play, development and participation rather than replacing physical and social experiences.
Selected references and further reading
- Bexson C, Oldham G, Wray J. Safety of virtual reality use in children: a systematic review. European Journal of Pediatrics. 2024.
- Li F et al. Effects of Virtual Reality Intervention on Motor Function and Activities of Daily Living of Children and Adolescents With Cerebral Palsy: A Systematic Review and Meta-analysis of Randomized Controlled Trials. 2025.
- Mesa-Burbano AE et al. Effects of Virtual Reality Use on Children with Cerebral Palsy and Its Applications in Health: A Systematic Review. 2025.
- Effectiveness of Non-Immersive Virtual Reality on Gross Motor Function, Balance, and Functional Independence in Children with Cerebral Palsy: A Systematic Review with Meta-Analysis. 2025.
- Efficacy of Virtual Reality Interventions for Motor Function Improvement in Cerebral Palsy Patients: Systematic Review and Meta-Analysis. 2025.
- World Health Organization. Guidelines on physical activity, sedentary behaviour and sleep for children under 5 years of age.
- Meta Horizon OS Developers. Building a safer Meta Quest for families.