Prior research shows that involving children in the development of technology is valuable, though challenging. Involving child-patients may come with additional difficulties, but as technology is gaining importance in (pediatric) care, it is important to uncover these difficulties. This paper identifies the difficulties of involving child-patients in the development of technology. We do so by reflecting on a project at the Sophia Children’s Hospital, where we involved 17 children (of which 12 child-patients) in developing a mobile application for their participation in pediatric brain care. Our identified challenges are related to the recruitment of child-patients and the need to adapt the organization and content of our design research set-up, based on who we were able to recruit and how we recruited them. By identifying these challenges, we make designers and researchers aware of issues that may arise when involving child-patients in technology development and present guidelines to deal with them.

Introduction: Paediatric patients with disorders that involve brain functioning are particularly vulnerable with respect to including them in shared decision-making. Current tools are mostly paper or digital patient information. We lay the groundwork for improving engagement with a concept that we coined ‘the Self-Portrait’. The main goals were to identify (1) obstacles and (2) design parameters that enable patient participation. Methods: A research-through-design approach was utilized in nine patients with brain-related disorders (4–12 years), 15 parents and 15 medical professionals, involving contextual research (interviews and observations) within the paediatric hospital and patients' homes and codesign. Sensitizing materials and early instances of design solutions were deployed as catalysts for communication. Five rounds of enriched interviews and design reviews were thematically analysed to answer the research questions. Results: Obstacles to child involvement were related to children's level of understanding, the time and energy necessary for information processing and lack of perceived relevance of the information. Patients' engagement is supported by design features that extend the time frame of interaction beyond the consultation, transfer information interactively and give control and influence during the consultation. Conclusion: Obstacles were detected that complicate child engagement, which differ between stakeholders. Promising design features were identified that have the potential to play an important role in enabling active child involvement. These findings show that applying principles of human-centred design research and codesign can bring together patients, parents and medical professionals around a tool that provides a shared language and focus, which are prerequisites to increase child engagement. Patient or Public Contribution: Patients, parents and clinicians contributed as design informants during contextual research and design reviews. Clinicians provided feedback on the initial outcomes of thematic analysis. Two researchers assisted in consensus sessions during the thematic analysis.

The potential space of game designs is astronomically large. This paper shows how game design theories can be translated into a simple, tangible card deck that can assist in the exploration of new game designs within a broader "design space."By translating elements of game design theory into a physical card deck, we enable users to randomly sample a design space in order to synthesize new game design variations for a new play platform ("Lumies"). In a series of iterative design and testing rounds with various user groups, the deck has been optimized to merge relevant game theory elements into a concise card deck with limited categories and clear descriptions. In a small, controlled experiment involving groups of design students, we compare the effects of brainstorming with the card deck or the "Directed Brainstorming"method. We show that the deck does not increase ideation speed but is preferred by participants. We further show that our target audience, children, were able to use the card deck to develop dozens of new game ideas. We conclude that design space cards are a promising way to help adults and children to generate new game ideas by making it easier to explore the game design space.

Design feedback is an essential pedagogical tool that can help young novice designers navigate divergent and convergent paths while designing. However, design feedback is often met with resistance, which counteracts its potential to help novice designers evaluate their design and generate new solution directions. In this paper, we report on the construction and utilization of a design feedback intervention during a real-life design project with a group of primary school children (aged 8–12). The goal of the intervention was to stimulate young novice designers’ creative thinking by guiding the design feedback dialogues with their peers and clients. The intervention was designed according to the following key principles: (1) guide towards a shared understanding of the design through low-level convergent feedback, (2) stimulate critical reflection and evaluation of the design to help identify and internalize possible shortcomings through high-level convergent feedback, and (3) provide a way to move forward by guiding new generative thoughts through high-level divergent feedback. Overall, the results show that the intervention can support young novice designers, their peers, and clients in engaging in constructive feedback dialogues, thereby stimulating their creative thinking. Our main contribution entails a detailed understanding of the successes and obstacles within the feedback dialogues, as guided by the intervention. Based on these results, we propose a set of refined design principles to inform feedback interventions. With this research we hope to give insight in the complexity of design feedback dialogues, while also inspiring design educators to actively try out these key principles.