Video self-modeling

A Video Self-Modeling Intervention Using Virtual Reality Plus Physical Practice for Freezing of Gait in Parkinson Disease: Feasibility and Acceptability Study

BACKGROUND

Despite optimal medical and surgical intervention, freezing of gait commonly occurs in people with Parkinson disease. Action observation via video self-modeling, combined with physical practice, has potential as a noninvasive intervention to reduce freezing of gait.

OBJECTIVE

The aim of this study is to determine the feasibility and acceptability of a home-based, personalized video self-modeling intervention delivered via a virtual reality head-mounted display (HMD) to reduce freezing of gait in people with Parkinson disease. The secondary aim is to investigate the potential effect of this intervention on freezing of gait, mobility, and anxiety.

METHODS

The study was a single-group pre-post mixed methods pilot trial for which 10 participants with Parkinson disease and freezing of gait were recruited. A physiotherapist assessed the participants in their homes to identify person-specific triggers of freezing and developed individualized movement strategies to overcome freezing of gait. 180° videos of the participants successfully performing their movement strategies were created. Participants watched their videos using a virtual reality HMD, followed by physical practice of their strategies in their own homes over a 6-week intervention period. The primary outcome measures included the feasibility and acceptability of the intervention. Secondary outcome measures included freezing of gait physical tests and questionnaires, including the Timed Up and Go Test, 10-meter walk test, Goal Attainment Scale, and Parkinson Anxiety Scale.

RESULTS

The recruitment rate was 24% (10/42), and the retention rate was 90% (9/10). Adherence to the intervention was high, with participants completing a mean of 84% (SD 49%) for the prescribed video viewing and a mean of 100% (SD 56%) for the prescribed physical practice. One participant used the virtual reality HMD for 1 week and completed the rest of the intervention using a flat-screen device because of a gradual worsening of his motion sickness. No other adverse events occurred during the intervention or assessment. Most of the participants found using the HMD to view their videos interesting and enjoyable and would choose to use this intervention to manage their freezing of gait in the future. Five themes were constructed from the interview data: reflections when seeing myself, my experience of using the virtual reality system, the role of the virtual reality system in supporting my learning, developing a deeper understanding of how to manage my freezing of gait, and the impact of the intervention on my daily activities. Overall, there were minimal changes to the freezing of gait, mobility, or anxiety measures from baseline to postintervention, although there was substantial variability between participants. The intervention showed potential in reducing anxiety in participants with high levels of anxiety.

CONCLUSIONS

Video self-modeling using an immersive virtual reality HMD plus physical practice of personalized movement strategies is a feasible and acceptable method of addressing freezing of gait in people with Parkinson disease.

Joint Video Self-Modeling for Persons With Traumatic Brain Injury and Their Partners: A Case Series

Purpose Individuals with traumatic brain injury (TBI) experience impairments to self-regulation and social communication that strain relationships. Video self-modeling (VSM) provides visible and audible, tangible evidence of what they do well and what could improve. Conducting such training in the context of authentic exchanges with their everyday partners may support positive change in social communication. The present investigation sought to evaluate indices of improved social communication. Method A mixed-methods design was employed for this case series investigation. Quantitative measures include pre- and postoutcomes on goal attainment scales (GASs) and measures of conversational effectiveness. Qualitative measures include responsiveness to video-supported prompts, conversational behaviors, and metacognitive statements. Results Participants perceived gains on GAS of 3-4 SDs, as well as perceived improvements on the La Trobe Communication Questionnaire. Those gains were validated by gains on the adapted Measure of Participation in Conversation and Measure of Skill in Supported Conversation. Individuals with TBI and their partners reached consensus on most goals and postintervention La Trobe Communication Questionnaire ratings. Participants made accurate judgments about their behaviors at a high rate, given video review. Conversational behaviors and use of metacognitive statements varied across participants and conversational contexts. Field notes and session transcripts provide evidence that both dyads increased internalization of VSM goals and purpose. Conclusions Joint VSM shows promise as a method for eliciting accurate self-assessments among individuals with TBI and their close partners. Both dyads perceived positive gains in interactions within and outside their dyads. Furthermore, joint VSM and GAS appear to improve self-awareness and internalization of VSM goals and purpose.

Teaching Object Play to Young Children With Disabilities: A Systematic Review of Methods and Rigor

In this systematic review, we examined the rigor and outcomes across 27 object play intervention studies using single-case research methodology. We focused on studies including children age 5 years or younger and examined several descriptive characteristics including materials, instructional packages, and settings. We also analyzed the facilitation and measurement of generalized play and several methodological features including quality, rigor, and visual analysis procedures. Overall, the identified studies demonstrated positive outcomes, although quality and rigor limited interpretations of the outcomes. Previous reviews also have noted strong outcomes and weak to moderate quality for single-case studies. Our results should be interpreted with caution given previous reviews of play intervention studies identified strong outcomes and quality from group-design studies. Additional replications testing robust interventions using single-case research with strong methodological rigor are warranted.

Increasing Joint Attention in Children with Autism and Their Peers

Joint attention (JA) and peer interactions are significantly impaired in children with autism spectrum disorder (ASD). Empirically demonstrated interventions exist to address JA with adults, but few with peers. Training peers through instructions, modeling (both live and video models), role play, and feedback may help facilitate JA in children with ASD. We examined the effects of peer training with live and video models on typically developing (TD) peer strategies to facilitate JA and JA behavior in children with ASD. TD peers showed some improvement in prompting and reinforcing JA. Children with ASD showed overall increases in JA with trained and novel peers that were also observed by parents, professionals, and peers. Findings are discussed with respect to variables to consider when teaching JA to children with ASD and their peers as well as the need to further examine the relationship between peer training and JA in children with autism.

Decreasing disruptive behaviour during routine dental visits: a video modelling intervention for young children

OBJECTIVE

To evaluate the benefits of a collaborative partnership between paediatric dentists and behavioural health providers in which a practical video modelling intervention, with the aim to reduce disruptive behaviours in young children, is implemented.

METHODS

The video was created by a dentist using readily available technology and implemented in a busy practice setting. A clinical sample of 40 children, 3-6 years old, was recruited from a continuous sample of patients seen at the clinic. Participants were randomised into two groups and shown either the brief video model or a control video prior to a routine dental visit. All sessions were videotaped and independently scored by blinded observers. Behavioural data were recorded using 15-second partial-interval recording and included physical and vocal disruptions. Subjective measures of cooperation were also completed by observers and dental professionals.

RESULTS

Independent samples t-tests show that the treatment group had a significantly lower mean percentage of intervals in which disruptive behaviour was observed [t(38) = 2.94, P = 0.008] compared with the control group. Subjective rating scales revealed significantly higher ratings of cooperation for the treatment group from the dentist [t(38) = -5.19, P = 0.000], the dental assistant [t(38) = -4.01, P = 0.001] and the blinded coder [t(38) = -3.54, P = 0.002]. Significant relationships were found between the percentage of actual disruptive behaviour and subjective ratings of the dentist (r = -0.82, P < 0.01).

CONCLUSIONS

Watching a brief dentist-created video model of expected procedures can reduce disruptive behaviour and increase cooperation for young children making their first visit to a busy medical setting.

Teaching Functional Play Skills to a Young Child with Autism Spectrum Disorder through Video Self-Modeling

The researchers used a single-case, multiple probe design across three sets of toys (i.e., farm toy, doctor's clinic toy, and rescue toy) to examine the effects of video self-modeling (VSM) on the functional play skills of a 5-year-old child with autism spectrum disorder. The findings showed a functional relation between VSM and increased percentages of functional play actions across the toy sets. The participant's percentages of the targeted functional play skills for the intervention toys remained high 1 week and 2 weeks after the intervention ceased. Additionally, preliminary generalization results showed slight improvement in the percentages of functional play actions with the generalization toys that were not directly taught. Limitations, practical implications, and directions for future research are discussed.

Effects of Feedforward Video Self-Modelling on Reading Fluency and Comprehension

Being able to read at a fluent rate confers many advantages on an individual in both educational and wider social contexts throughout life. To be a fluent reader means that the individual can sustain high accuracy while reading at a rate appropriate to the material and the setting, and implies the development of automaticity in the cognitive processes involved in reading. Fluency has not, however, been the focus of much research. In this study, an observational learning technique — feedforward video self-modelling (FFVSM) — was used to improve children's reading fluency. Eleven primary (elementary) school children aged between 72 and 108 months, four girls and seven boys, viewed edited video footage of themselves seemingly reading a difficult text at a fluent rate six times over a 2-week period. Reading performance (accuracy, comprehension and rate) was measured at pre- and post-test using the Neale Analysis of Reading Ability, and fluency and comprehension scores were measured across the intervention period using the Science Research Associates Reading Laboratory (SRA) graded reading texts. The results showed that the majority of the children improved their reading fluency, comprehension and accuracy as well as reader self-perception (a proxy measure of self-efficacy). These positive results suggest that FFVSM could be a rapid, cost-effective intervention to be used within educational settings to promote fluent reading.

Video self-modeling is an effective intervention for an adult with autism

With the increases in size and strength that come with adulthood, challenging behaviours among those with autism spectrum disorders (ASD) can become critical. Few studies have explored behavioural interventions in adults with ASD, though recent studies have shown video self-modeling (VSM) to be effective in children with ASD. VSM involves an individual watching videos of himself demonstrating prosocial behaviours, while those behaviours are pointed out and encouraged. In the current study, VSM was used to encourage prosocial behaviours and to reduce problematic behaviour displayed by an adult with ASD. Results reveal a decrease in the tendency to invade others' personal space and make inappropriate loud noises. VSM may be an effective intervention and improve the lives of adults with ASD.