Brain-computer interface at Toronto’s Children’s Hospital tests potential for merging mind with machines

Six-year-old Gisele Alnaser receives encouragement from her father Naser Alnaser at Holland Bloorview Kids Rehabilitation Hospital in Toronto. Gisele tries out a brain-interface headset to turn on and off a music video on the laptop with her thoughts.Deborah Baic/The Globe and Mail


Gisele Alnaser smiles at the sound of baby shark, a popular children’s song, takes over a quiet meeting room. As the music plays from a pair of laptop speakers, her joyous laughter gives way to the eyes full of excitement from the handful of people in the room.

Then, for a moment, everything is silent. Gisèle, in her jubilation, lost her concentration.

“Make it play again! Clap, clap, clap”, Gisèle’s mother, Samah Dawish, the six-year-old said encouragingly. With a determined look on the girl’s face, there are only seconds left before the melody returns.

“Woooo, good job! »

The research team helps Gisèle in the experiment.

Gisele did not use her hands or her voice to control the playback. Instead, as one of 34 children testing a cutting-edge brain-computer interface (BCI) at Holland Bloorview Kids Rehabilitation Hospital, she used her mind.

Gisèle, who was born with a mutation in a gene – CAMK2B – which plays an essential role in brain development, has experienced developmental delays that severely limit her mobility and verbal communication.

Since last year, she has been training on the Epoc-X helmet, a BCI device from biotech company Emotiv.

Comprised of a series of sensors attached to a lightweight, helmet-like frame, the Epoc-X connects to a laptop computer and picks up brainwaves through conductivity with the wearer’s head. Software called Mindset, designed by Holland Bloorview, then decodes these signals and converts them into actionable commands for the computer to execute.

Research engineer Leslie Mumford, left, and occupational therapist Susannah Van Damme, right, put the Epoc-X helmet on Giselle during a workout. In the middle is Gisèle’s mother, Samah Dawish.

The helmet’s sensor pads, designed to pick up signals from the wearer’s brain, soak in a saline solution.

When wearing the helmet, children like Gisele are both users and data collection points, providing the Mindset software with information it can use to assess and predict the desired actions a wearer wishes to perform through the device.

To do this, the software combines two techniques. The first is to teach users “activation thoughts”, or images and ideas that can be linked to a virtual action. Gisele’s activating thought in many cases is clapping, which she uses to trigger the pause and play button on the baby shark video.

Susannah Van Damme, occupational therapist and program coordinator at Holland Bloorview’s BCI Clinic, says everyone will have a different preference for orders.

For example, some may choose prompts that directly reflect the action they’re trying to take, as opposed to indirect prompts, such as Gisele’s clap command to start the video.

“If I were to think about playing tennis and how I would move my arm to swing the racket to hit the ball, that could be my active command,” says Van Damme.

The second part of the equation is what she calls “quiet brain” activity, or periods when the user of a BCI device completely clears their mind of thoughts. Mindset software uses this to differentiate between actionable and non-actionable thoughts.

Ultimately, Van Damme says the BCI Clinic’s goal is to refine the software so children like Gisele can use technology to better control their environment.

“The kids who will benefit the most from a brain-computer interface are those who can’t access Siri or Alexa via voice and who have trouble typing on a computer,” she says.

“That way, they just need to be able to use their thought patterns to accomplish what they want to accomplish.”

Gisele’s parents echo Ms. Van Damme enthusiastically, describing the excitement of seeing their daughter express her needs through BCI technology.

“To be honest, it’s all a bit exciting,” says Naser Alnaser, Gisèle’s father, who, like Ms. Dawish, works in IT and has a professional appreciation for communications-based technology.

“Sometimes you get a little emotional seeing your daughter unable to start a song or even communicate if she is hungry or thirsty. You see, she can actually interact, she can play the things she likes, she can talk to you, if she wants to.

Adam Haggarty, a 15-year-old with cerebral palsy, tries out the interface as his mother, Joan, looks on. Adam has enough mobility to control a motorized wheelchair by hand.

Ms. Van Damme adds paint to a ball that Adam controls remotely to create blue and orange patterns.


Another person at the BCI clinic is Adam Haggarty, 15, who has cerebral palsy and uses a manually operated wheelchair.

Adam can communicate verbally and has a good degree of mobility. Still, he’d like to do a lot of things he can’t, like being able to open doors without having to reach for a wall button.

In a demonstration of the technology, Adam plays Alex Jumps, a simple video game created by Holland Bloorview’s BCI designer Jason Leung that features a character running from left to right on a 2D landscape. Using BCI, Adam controls when the character jumps to avoid obstacles and traps.

Although intrigued by its potential, Adam has trouble with the technology. He finds the current single action functionality of the “on and off” options to be limiting and says he wishes he could take complex actions faster.

He also understands that for technology to improve, the software needs to analyze more users, which means his participation is crucial.

Luckily for the Holland Bloorview team, Adam finds the technology and ambition of what they’re trying to achieve engaging enough to stay invested in.

It’s interesting to “decode electricity into a real thought, like integrating a brain into a computer, which is actually kind of a scary thought at the same time,” he says.

Adam controls a car with the interface.

Dr. Tom Chau, vice president of research at Holland Bloorview, says the technology is still in its infancy and still needs to be highly customized to work. “We realize that every child is unique and has their own preferences and abilities, so it’s not going to be a single brain-computer interface that will work for every child.”

Looking ahead, Dr. Chau points to the next big development from the BCI Clinic: a way for users to type and communicate with their minds.

Beyond that, he says the potential uses for BCI devices are “truly limitless,” citing examples like being able to play an instrument or drive cars using BCI-controlled robotics.

“There really are no limits in terms of what can be activated, because it’s basically a connection to the outside world that you can control,” says Dr Chau. “Once it’s enabled, and it’s robust, there really is no limit to what you can do.”

Video: The interface in action

What if you could use a computer with just your mind? Children at Holland Bloorview Kids Rehabilitation Hospital are trying out a brain-computer interface to do just that. The Globe and Mail took a look.

The Globe and Mail