Background: Due to hospitalization, medical treatment and/or rehabilitation stays, children and adolescents with diseases of the central nervous system (CNS; e.g. tumors, epilepsies or traumatic brain injuries) often cannot participate in everyday school life to the same extent as their peers. To counteract social isolation and negative consequences (e.g. lack of a sense of belonging, reduced well-being and self-esteem, more frequent class repetitions or low educational attainment) telepresence systems are increasingly being discussed as a way to enable participation for children and adolescents with chronic illnesses. Method: This paper presents different telepresence systems and their advantages and disadvantages, effects of use, and potential difficulties. Conclusion: Telepresence systems offer an innovative and promising perspective to enable patients with CNS-associated diseases to participate in everyday school life.

Background: Children with brain tumors are at increased risk for experiencing loneliness, a lack of close friendships, lower academic achievement, and diminished motivation. To counteract these negative effects, telepresence systems and their ability to maintain school and social participation as well as a sense of belonging are recently being discussed as promising approach. Despite the use of these systems throughout many countries, few scientific studies have examined their effects. Objectives: The aim of this article is to illustrate effects of one telepresence system, called avatar, in pediatric patients with chronic illnesses and to analyze possible benefits and challenges. Patients and Methods: In this report, the case of a 10-year-old girl named Sarah, with a brain tumor (medulloblastoma), is described. The girl received the avatar due to her reduced ability to attend school due to her medical condition. At the time of the study, the avatar had been in use for seven months, acting as a therapeutic tool to promote social inclusion and to keep up with school. Qualitative interviews were conducted with Sarah, her mother and her teacher, illustrating the relationship between social and learning aspects of telepresence systems. Originality and Clinical Relevance: The results indicate that the avatar has the potential to act as an essential supportive means for pediatric patients, maintaining social participation, sense of belonging and academic motivation. The novelty of this telepresence system, the lack of studies in this research area and the probable positive influence emphasize the originality and clinical relevance of this case report.

Kinder und Jugendliche mit chronischen Erkrankungen können aufgrund der Erkrankung und damit verbundenen Folgen oftmals die Schule nur unregelmäßig oder gar nicht besuchen. Um den negativen Folgeerscheinungen, welche mit längerer Schulabwesenheit einhergehen, entgegenzuwirken, werden in den letzen Jahren Telepräsenzsysteme als vielversprechender Ansatz diskutiert. In diesem Artikel wird ein Projekt der Medizinischen Universität Wien, der Universität Klagenfurt, der Heilstättenschule Wien sowie der Firma die Berater vorgestellt, welches sich mit der Frage beschäftigt, wie der Avatar AV1 als Telepräsenzsystem zur Verbesserung der schulischen und sozialen Teilhabemöglichkeiten von Kindern und Jugendlichen mit chronischen Erkrankungen beitragen kann.

BACKGROUND: Due to regular hospital check-ups, inpatient treatments, or a weakened immune system, children with brain tumors experience frequent and long absences from school and social activities. Returning to school presents a challenge for these patients, as they experience reduced health-related quality of life (HRQOL), decreased sense of belonging and a lack of social inclusion in class. To prevent social and emotional problems, telepresence systems such as the Avatar AV1 are described as promising approach for pediatric patients. OBJECTIVES: To sustainably improve social inclusion in times of illness-related absence for these patients, the first study in Austria investigating effects of the use of the Avatar is pursuing both, a qualitative and quantitative approach. METHODS: To examine effects on social inclusion, sense of belonging and HRQOL in pediatric patients, interviews were conducted with patients, their parents, teachers and classmates within the qualitative approach and questionnaires were administered at three times (before -, after 6 months Avatar-use and 3 months after returning the Avatar) within the quantitative approach. The sample consists of pediatric patients (6 to 18 years). RESULTS: Categories from n=24 interviews indicate that a positive attitude towards and identification with the Avatar as well as the patients’ psychological condition and social inclusion into class before the illness play major roles. Preliminary findings from the ongoing longitudinal quantitative survey indicate that the Avatar has significant positive and stabilizing effects on HRQOL, sense of belonging and social inclusion of pediatric patients. CONCLUSION: This study is the first to describe the impact of Avatar use on social inclusion in children with brain tumors. To strengthen the sense of belonging in these children, the pedagogical-interactional component needs to be brought in focus. Through pedagogical-didactical adaptions, a routine handling of and a positive attitude towards the telepresence system, pediatric patients highly benefit from the Avatar.