There are a lot of children with developmental delay, and the number is increasing very fast. The number of them are estimated about 6,000,000 in the United States, 3,000,000 in the India, 600,000 in the Japan, and 300,000 in the South Korea. However, the number of the children who cannot receive cognitive treatments are very high: 93.7% for the United States, and 90% for the South Korea. Also, children who can receive cognitive rehabilitation routinely are very few. These imply the low accessibility of cognitive rehabilitation. There are many difficulties for the cognitive rehabilitation for these children: children have different developmental velocity, therefore standard curriculum does not exist; cognitive rehabilitation is needed one child to one therapist; the price of cognitive rehabilitation is very expensive; and data for the development of children are rare due to the difficulty of collecting.
Now, Rehacom is the most widely used computer based cognitive rehabilitation program worldwide. Rehacom was developed in 1986 in Germany. It has many limitations: the price of the program is very expensive that only big hospitals with lots of patients only can own it; children who do not know letters and who cannot use computer feel difficult to use the program; the program is developed targeting children who use English; the program is not very interesting for the children; and the locations of input and output are different.
Dobrain is a game developed to aid cognitive enhancement of children with cognitive age of 36-72 months. A team with more than 15 years of clinical experience developed more than 9,600 contents. There are many advantages of the program. It can be linked with any smart device at home and in rehabilitation centers. Therefore, the cognitive development programs can be applied to children up to 7 days a week. The contents of the program consist of animation with games, therefore it can be used easily in children. Touch screen system is used and one point touch, drag and drop, and rub techniques are need, which the children can adjust easily.
Therefore, the aim of this study is to evaluate the effect of Dobrain in cognitive, language, and fine motor functions in normal developing children and in children with developmental delay.

 Supportive Care

Children in the intervention group execute Dobrain for 40 minutes a session, 2 sessions a week, for 12 weeks (total 24 sessions). Whether the children use the program or not is remotely observed. During the period, normal developing children maintain private educations and children with developing delay maintain medicine and rehabilitation programs including physical therapy, occupational therapy, and speech therapy. 
Children in the control group do not execute Dobrain for 12 weeks. During the period, normal developing children maintain private educations and children with developing delay maintain medicine and rehabilitation programs including physical therapy, occupational therapy, and speech therapy.

Arm Label

Target Number of Participant

Arm Type

Arm Description

Children in the intervention group execute Dobrain for 40 minutes a session, 2 sessions a week, for 12 weeks (total 24 sessions). Whether the children use the program or not is remotely observed. During the period, normal developing children maintain private educations and children with developing delay maintain medicine and rehabilitation programs including physical therapy, occupational therapy, and speech therapy.

Arm Label

Target Number of Participant

Arm Type

Arm Description

Children in the control group do not execute Dobrain for 12 weeks. During the period, normal developing children maintain private educations and children with developing delay maintain medicine and rehabilitation programs including physical therapy, occupational therapy, and speech therapy.

Gender

Age

Description

(Normal developing children)
Children were assessed for inclusion in the study according to the following criteria: (1) children with 5-6 years old, (2) children who maintain private educations, (3) children who are confirmed to develop normally by examinations and specialists, and (4) children whose caregivers provided a written informed consent. 

(Children with developmental delay)
Children were assessed for inclusion in the study according to the following criteria: (1) children with 5-18 years old, (2) children with cognitive age of 5-6 years, (3) children who maintain medicine and rehabilitation programs including physical therapy, occupational therapy, and speech therapy, and (4) children whose caregivers provided a written informed consent.

(Normal developing children)
Exclusion criteria were as follows: (1) children with severe visual impairment, (2) children with poor medical condition who could not execute Dobrain, and (3) children who underwent Korean Wechsler Primary and Preschool Scale Intelligence, K-WPPSI (K-WPPSI) in 6 months.

(Children with developmental delay)
Exclusion criteria were as follows: (1) children with severe visual or motor impairment, (2) children with poor medical condition who could not execute Dobrain, and (3) children who underwent Korean Wechsler Primary and Preschool Scale Intelligence, K-WPPSI (K-WPPSI) in 6 months.

Korean Wechsler Primary and Preschool Scale Intelligence-IV (K-WPPSI-IV)

Before and after intervention period

Pediatric Evaluation of Disability Inventory (PEDI)

Before and after intervention period

Goal Attainment Scale (GAS)

Before and after intervention period

Bruininks-Oseretsky Test of Motor Proficiency-2 (BOT-2)

Before and after intervention period

PEP-R (Psycheducational Profile Revised)

Before and after intervention period

Korea-Child Behavior Checklist (K-CBCL)

Before and after intervention period

Analysis of quality of life of main caregiver

Before and after intervention period

Analysis of satisfaction and side effects

After intervention period