Virtual reality games are quickly gaining popularity among children. However, regulators and researchers still remain largely unaware of the potential risks inherent to this technology. In this post, Jennifer Pavlick explores the available research to date, outlining potential risks for children, as well as the possibilities for playing and learning. Jennifer is the editor of the Parenting for a Digital Future blog and has just completed her MSc at the London School of Economics in the Department of Sociology. [Header image credit: S.C. Air National Guard, Public domain]

Children are becoming aware of virtual reality (VR) in increasing numbers: in autumn 2016, 40% of those aged 2-15 surveyed in the US had never heard of VR, and this number was halved less than one year later. While the technology is appealing and exciting to children, its potential health and safety issues remain questionable, as there is, to date, limited research into its long-term effects.

In 2017, following a study by the University of Leeds, The Guardian reported on the potential risks that VR might pose to children’s health. Dubit hosted a workshop at Bafta where they presented findings from their recent report, Children and virtual reality: Emerging possibilities and challenges (a podcast recording is available here), after observing how children engaged with Google Cardboard, Oculus Rift and HTC Vive devices.

Engaging children in familiar and new settings

VR poses vast opportunities for learning, creativity, critical thinking and collaborative engagement. Dubit found that children and parents alike were excited to try VR, and children understood the specific intentions of VR content best when they had previously seen footage of VR games on YouTube.

Dylan Yamada Rice’s research finds VR to be a predominantly social experience for children, contrary to the notion that technology encourages children to be isolated; many were excited about multi-player experiences and interacting socially. They were more confident engaging with content that took place in a familiar setting, for example, in a kitchen context or with Job Simulator, or in a place they had heard of before, like Hollywood or Google Earth, where they could bring their own narratives to the game.

In more unfamiliar settings, they needed more assistance, with adults explaining what to expect and how to interact. Many were excited to break rules or participate in ways that they cannot in real life. Describing the experience after trying VR for the first time, one child said, “I felt shocked at first, like I was on the TV.”

Health and safety risks

As a young technology there are still many unknowns about the long-term risks and effects of VR gaming, although Dubit found no negative effects from short-term play for children’s visual acuity, and little difference between pre- and post-VR play in stereoacuity (which relies on good eyesight for both eyes and good coordination between the two) and balance tests. Only 2 of the 15 children who used the fully immersive head-mounted display showed some stereoacuity after-effects, and none of those using the low-cost Google Cardboard headset showed any. Similarly, a few seemed to be at risk of negative after-effects to their balance after using VR, but most showed no problems.

A Leeds team tested VR on adults and found that images in the three-dimensional binoculars often required the user’s eyes to change direction and depth, creating a mismatch between focusing and eye alignment. This creates a ‘surprise’ to the senses and places pressure on the individual’s visual system to minimise any confusion. These sensations caused headaches and sore eyes in the short term for the adults, and the team predict that these issues might be particularly troubling for children, whose brains are not yet fully developed. No one has since arrived at a suitable solution to this issue.

The task for game designers

While more research is needed to understand the health effects of VR, we know a lot about specific game attributes that may ease children’s experience with audio, visual and balance senses. To this end, game designers and industry should create more usable VR technology suited specifically for children.

Mark Mon-Williams explains that one solution to headaches and sore eyes would be to avoid presenting three-dimensional binocular images all together, although this would come at the expense of more creative projects that require these three-dimensional projections. Even if not altogether avoided, however, designers must create systems that minimise the ‘surprise’ experienced by the user to minimise any side effects.

Sean Thompson of Dubit provides suggestions to game designers based on his research, including comfortable head positioning, the importance of easing viewers into depth perception in the VR world, minimising busy scenes to avoid headaches, and keeping transitions smooth to avoid dizziness and nausea. He also explores the requirements to play on a phone versus a tablet screen, and the importance of creating an engaging space for VR users.

  • Games should create a visual reference point such as a shadow or ‘feet’ so that children can look down and check their position and have some place to return to.
  • The ‘action area’ should be restricted to 70 degrees horizontally and 45 degrees vertically to reduce neck strain or dizziness.
  • Children should not have to reach or stoop for objects in the game too often – design games with children’s dimensions in mind!
  • Sounds and signposts should be created to guide users in the VR world.
  • A preview of the experience on YouTube should be published so children can see the game and become familiar with it before trying it.
  • Children should be given something familiar to latch on to; for example, when playing Fairy Garden they went up into the air via a giant beanstalk leaf, which increased their comfort level with the experience.
  • Game designers may choose to adopt parentally controlled ‘time out’, like TV exec and digital media specialist Marc Goodchild’s model that forces children to take breaks in an effort to reduce motion sickness and encourage a healthy relationship with the technology.

The role of parents and educators

While much of a child’s experience with VR may still be in museums, schools or other educational spaces under the guidance of trained adults, as the technology becomes more available in domestic settings, to ensure health and safety at home, parents and carers need to:

  • Allow children to preview the game on YouTube, if available.
  • Provide children with time to readjust to the real world after playing, and give them a break before engaging with activities like crossing roads, climbing stairs or riding bikes, to ensure that balance is restored.
  • Check on the child’s physical and emotional wellbeing after they play.

Effective regulation

Regulation will play a crucial role in keeping up with health risks as well as assuring that content is appropriate. PEGI assesses whether content in a video game is appropriate for children of a certain age, and as of now, these classifications also accommodate VR technologies.

Because VR games entail a further dimension of participation and engagement, users will want to be made aware of each game’s specific characteristics in terms of content and form, including any potential health risks. Additionally, VR games require a clear code of conduct.

Issues such as ‘bullying’ between players do not fit the PEGI age classifications, and so it is up to game publishers and device manufacturers to continue to inform the public. Parents should be encouraged to take an active role in choosing games, making VR no different from already existing video games.

Conclusion: Playing for the future

  • Children enjoy VR for entertainment, gaming and education, but predominantly as a social activity. Unlike the stereotypes of many technological devices, VR provides learning opportunities through multi-player engagement.
  • With strategies to ease children’s experiences using VR, and simultaneous unknowns about health, educators and parents must weigh the benefits against the potential risks, and choose whether to be enthusiastic or risk-averse.
  • Regulation is lacking, and it is unclear who is responsible (the companies?) for ensuring health guidelines, as well as behavioural and social codes, to ensure participant safety. For now, it is parents, industry, academia and child health professionals who bear the risks.

This post gives the views of the authors and does not represent the position of the LSE Parenting for a Digital Future blog, nor of the London School of Economics and Political Science.