What does neurotechnology mean for children?

In the past decade, neurotechnology – techniques and devices aimed at monitoring and modulating functions of the brain and nervous system – has become a popular tech buzzword, promising to accompany artificial intelligence (AI) and nanotechnology in ushering in a world where science fiction has become science fact. In the next five to ten years, neurotechnologies could potentially transform everyday life for some children of the next generation, offering significant benefits but bringing with it significant risks.

This developing technology can directly intervene in the interactive pathways developed by our brain cells to act as messengers between our brain and body. Initially, one area of exploration was to help restore sensory and cognitive functions when existing pathways were damaged, for example allowing people who have been paralyzed to communicate via computers just with their thoughts. But neurotechnology now refers to any technique or device designed to interact with the human brain’s neuronal activity, including the capacity to record, analyze or modulate brain activity.

What is neurotechnology?

The technology makes use of three core enabling techniques – ‘brain scanning’ techniques, such as EEG and MRI devices seen in hospitals; neurostimulation and neuromodulation to activate and regulate activity in particular areas of the brain and the nervous system; and neurofeedback to alter the brain's electrical waves– in combination with a device called a brain-computer interface (BCI).

These BCIs can be invasive or non-invasive. Invasive BCIs are implanted inside the brain, on the brain’s surface, under the skin or under the skull. Requiring surgery, these devices are only used in clinical settings and are regulated as medical devices. Examples include prostheses designed to replace or restore lost or damaged brain functions, like the cochlear implants designed to recover or boost hearing.

More common today are non-invasive BCIs, which can be worn as, for example, a helmet or a headband and record electrical activity from the brain. These devices are used in clinical settings but also beyond.

The technology has now converged with AI and nanotechnology, improving our knowledge of the brain through rapid image and data analysis. These convergences are rapidly transforming the field of neurotechnology, influencing many areas, from clinical research to commercially provided applications that claim to improve health, wellness and performance.

What are the benefits, what are the risk?

Neurotechnologies offer substantial benefits for improving children’s health and, in light of recent developments and emerging products, can contribute even more. They could help support the diagnosis, treatment and rehabilitation of children affected by diseases and disorders that target the brain and nervous system. These benefits could also apply to children’s families and caregivers, resulting in trickle-down effects for children in their care. Some children with neural disabilities could benefit from novel therapies and assistive technologies.

But, accompanying the promise and potential of neurotechnology, there are risks for children.

To begin with, children’s developing brains present unique vulnerabilities. Childhood is a critical time for developing brain functions and cognitive capacities, from self-control, memory and reasoning, to problem-solving and decision-making. Important changes occur across sensitive time periods, which vary depending on age and developmental stages. These critical times can also vary from one child to another. Neurotechnological interventions during childhood may have a lifelong impact.

Neurotechnologies, combined with other data-capture technologies such as wearables, increase the possibility of interference with children’s physical and mental integrity, even as these are being formed. Modern surveillance could be used to infer insights about children’s mental states, predict and influence health and behaviours, and exploit or influence cognitive and sensory experiences, thoughts and emotions at every step of their development. In this digital ecosystem, including in immersive environments, neurotechnologies could produce new ways to know and decide what will make the next generation click, buy, love and hate.

Progressively, the large amounts of behavioural, biometric and neural data collected about children may give tremendous power to those holding, analyzing or gaining access to the datasets, including the potential ability to track children’s inner development and even mould them to specific ways of being. These actors would range from states and police forces to marketing and insurance companies, and even potentially cybercriminals. Various child rights are at risk of violation, including the right to privacy; freedom of thought, conscience and religion; and access to diverse sources of information.

Risks stemming from the misuse of neurotechnology are particularly significant for children because childhood is a critical time for brain development and identity formation. Children’s understanding of neurotechnologies and their ability to provide meaningful, informed consent will differ depending on their age, evolving capacities and variations in developmental stages – thus creating variations in their level of protection. Parents, families or guardians may also ignore children’s evolving capacities when making neurotechnology-related decisions about their health.

Beyond the issue of consent, parents or caregivers may think that they are acting in the best interests of their children by imposing the use of certain neurotechnologies, for instance, in the hope of improving their children’s intellectual capacities so they do better at school. Even with good intentions, these actions – not by external stakeholders but from within the family unit – may result in the infringement of children’s rights.

Neuroscientists specializing in paediatric care have emphasized the unknowns around using neurotechnologies with children in situations where there is a lack of robust oversight. Current knowledge about the use of neurotechnologies is largely based on adult studies, the results of which cannot be extrapolated to children. Even clinical trials with children cannot necessarily be generalized to other groups of children. We lack long-term, follow-up studies to help determine how neurotechnologies may affect children’s health over time.

Research is especially lacking in the use of neurotechnologies with young children, including infants. Children with disabilities have not been the subject of many clinical trials, despite the significant potential benefits. Neurotechnological trials require highly cooperative patients and can be challenging to implement in children with neurodevelopmental disorders. Devices made to interact with the brain need to be designed for and with diverse groups of children.

Experts in neurotechnology and bioethics recommend proceeding with caution. They agree that larger-scale, more representative and in-depth clinical trials are needed to evaluate neurotechnologies’ safety, efficacy and usability for children. They emphasize that these techniques should be tested in studies supervised by institutions, reviewed by ethics boards and conducted by practitioners with expertise in paediatric medicine. These actions can help uphold children’s best interests, fulfil needs currently unmet in the medical field and bring forward novel and safe treatments.

Where neurotechnology is today

Despite the risks and the critical gaps in knowledge surrounding them, some neurotechnologies are spilling over from the medical domain into the consumer market, labelled as electronic devices. For instance, wearable devices in the form of headsets or headbands are being commercialized – claiming to stimulate people’s cognitive capacities or enable hands-free ways to play video games.

Examples include Muse and Emotiv Epoc X from the United States of America. Muse is a brain-sensing headband that aims to measure brain activity using EEG, providing real-time feedback to help users improve their mindfulness and meditation practices. Emotiv Epoc X is a consumer-grade EEG headset that allows a real-time read-out of brain activity. The device also purports to function as a BCI, with which users can control objects on a screen just by thinking.

Within educational settings, both the Muse and Emotiv headsets are being tested in limited, small-scale studies to introduce students to neuroscience – including how the brain develops and learns. Other non-invasive BCI technologies are being tested experimentally in the classroom, under the supervision of neuroscientists and teachers because of the potential risks.

For example, the Aerie Enrichment Program and Wheeler Science Department in Boston have piloted wearable BCIs to educate K-12 students on the structure and functions of the brain, and to explain how data about brain activity can be captured. Students at the Wheeler School have used the BCI headbands to play games on a computer screen, extracting raw EEG signals to observe the effects of music on the brain.

What it means for children

Some of these devices aimed at children and youth claim to improve concentration or learning. Such applications are labelled as electronic – not medical – devices and not all of them receive the necessary oversight to ensure children are safe.

To safeguard promising medical benefits and protect children outside the medical domain, the field of neurotechnology needs to better anticipate and mitigate possible risks from runaway applications that lack proper testing, ethical supervision and regulation. Engineers and ethicists in the field have warned that even well-meaning applications may lead to potential misuse and unintended consequences.

In the medical and clinical context, a data ecosystem tracking and connecting children’s neural and biological data (with behavioural and psychological insights) from the infant to adult stage may help detect their susceptibilities to rare, chronic and mental illnesses. Techniques and devices adapted to children may improve early and real-time diagnosis of neurodevelopmental disorders. They could also help democratize precision medicine, bringing innovative diagnostic tools to homes and nurseries.

Neurotechnologies may also contribute to adapting and personalizing education if combined with human mentorship and connection, while respecting inclusion and diversity. Brain monitoring may be used in the classroom to better understand the conditions in which children learn best, helping to conceive more personalized and effective teaching strategies. BCI devices may monitor students’ mental workload, alerting them when they are tired or stressed and suggesting ways to relax or optimize their study time.

And the synergy between medical neurotechnology and the video game industry may normalize the use of BCI devices by consumers, with a potential focus on children. Increasingly, collaborations between neuroscientists and video game engineers aim to improve the design of BCI devices for neurostimulation and neurofeedback and may support their use with children in clinics. Video games demand focus and motivation from the user for optimum performance, so they may facilitate the training required for children to use BCI-based treatments.

As the fields of medical and commercial neurotechnology are progressing quickly, urgent action is needed to ensure the safe development and use of these technologies for children. If international laws, human and child rights, rules and governance mechanisms are not utilized to establish robust ethical guidance and develop and enforce adequate regulation in the present and near future, the increasing availability and normalization of neurotechnology may lead to harmful implications for children.

Some preliminary recommendations

The following actions must be taken in collaboration with children and the full range of concerned companies and other key stakeholders working on neurotechnology, neuroethics and children’s rights – including policymakers, lawyers, international organizations, civil society organizations and academia.

First, groups of interdisciplinary experts, including in neurotechnology, neuroethics, child rights and child protection, should collaborate with children and adolescents to develop – and even pilot – child-centred recommendations aimed at addressing potential harms from irresponsibly or misused neurotechnologies. They may need to focus on rapid developments at the convergence of AI and BCIs.

At the same time, experts in neurotechnology, neuroethics, philosophy and international law have proposed using an interdisciplinary approach to examine existing human rights frameworks as part of a normative and legal gap analysis. Experts in child rights and adjacent child protection frameworks must be included in these efforts, for thorough analysis of how existing child rights frameworks need to be strengthened to adequately protect children and their neural data from potential misuse of neurotechnologies, including outside the medical domain.

Responsibly and ethically including children’s diverse views and concerns through meaningful and participatory engagement will lead to a better understanding of children’s needs, concerns and ethical expectations, bringing varied perspectives to product and policy development. These insights could be applied to neurotechnology and neuroethics. Efforts should focus not only – or not mainly – on medical applications but also on the many other societal areas that may utilize neurotechnology and involve children in the near and long term.

Finally, to help inform precautionary policies and regulations, experts and practitioners can be enlisted to map the convergence between different technologies and trends ­– such as AI, neurotechnology, cybersecurity and immersive digital environments – and develop future scenarios and case studies.

They could employ foresight practices to outline and analyze potential risks related to neurotechnology and AI, thereby providing an understanding of converging fields that hold significant promise but also have the potential to threaten crucial aspects of children’s lives and rights.

The full potential benefits and risks around neurotechnology may still be decades away, but the profound repercussions on society and children warrant attention – right now.

This piece is adapted from Neurotechnology and Children: How is neurotechnology impacting children today, and what could it mean for them in the future? which was developed as part of a partnership between UNICEF and the Government of Finland. Read the full report.