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Löthberg M, Wirström E, Meyer J, Girdler S, Bölte S, Jonsson U. 'If I Don't Have My Support Worker in the Room…': A Multi-perspective Mixed Methods Study of Remote Daily Living Support for Neurodivergent Young Adults. J Autism Dev Disord 2024:10.1007/s10803-024-06425-z. [PMID: 38837062 DOI: 10.1007/s10803-024-06425-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/25/2024] [Indexed: 06/06/2024]
Abstract
PURPOSE Information technology is increasingly being employed for providing support and interventions in disability and health service contexts. This study aimed to investigate service users' and support workers' perspectives on remote support in daily living for young adults with neurodevelopmental conditions. METHODS Using a convergent mixed methods approach, we integrated qualitative and quantitative findings from survey responses and focus groups. Young service users (aged 18 to 29) diagnosed with ADHD and/or autism (n = 35) and support workers (n = 64) from four municipalities in Sweden responded to a survey designed to tap into their lived experiences and views. The topic was explored further in focus groups with young service users (n = 7) and support workers (n = 3). Open-ended survey questions were analyzed using qualitative content analyses and complemented with information from the focus groups, while closed survey questions were summarized descriptively. Inferences were merged in a joint display. RESULTS While participants reported having access to digital devices, service routines for remote contact were not in place. Service users were more hesitant than support workers in endorsing remote support, expressing concerns that this approach would be inferior to in-person support (e.g., owing to miscommunications and insufficient social and emotional contact). Still, both groups expressed that remote contact may at times be a beneficial complement to in-person meetings, increasing accessibility and user choice. CONCLUSION Service providers planning to implement remote support elements should explore the demand, acceptability, and organizational readiness for this approach. Moving forward, user engagement will be crucial to meet individual preferences, values, and needs.
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Affiliation(s)
- Maria Löthberg
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women's and Children's Health, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden.
| | - Eda Wirström
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women's and Children's Health, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
- Department of Social Psychiatry and Individual Support, Municipality of Uppsala, Uppsala, Sweden
| | - Jenny Meyer
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women's and Children's Health, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
- Department of Medical Sciences, Child and Adolescent Psychiatry, Uppsala University, Uppsala, Sweden
| | - Sonya Girdler
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women's and Children's Health, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
- Curtin Autism Research Group, Curtin School of Allied Health, Curtin University, Perth, Australia
| | - Sven Bölte
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women's and Children's Health, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
- Child and Adolescent Psychiatry, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
- Curtin Autism Research Group, Curtin School of Allied Health, Curtin University, Perth, Australia
| | - Ulf Jonsson
- Center of Neurodevelopmental Disorders (KIND), Centre for Psychiatry Research, Department of Women's and Children's Health, Karolinska Institutet & Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
- Child and Adolescent Psychiatry, Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden
- Department of Medical Sciences, Child and Adolescent Psychiatry, Uppsala University, Uppsala, Sweden
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Anixt JS, Ehrhardt J, Duncan A. Evidence-Based Interventions in Autism. Pediatr Clin North Am 2024; 71:199-221. [PMID: 38423716 DOI: 10.1016/j.pcl.2024.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
Pediatricians have a critically important role in the care of children with autism, including conducting developmental screening to support early diagnosis and intervention, advising families about evidence-based treatments for autism spectrum disorder, and supporting families' emotional health as they care for a child with a developmental disability. The purpose of this article is to provide pediatricians with information about evidence-based autism treatments and how to determine which interventions are appropriate for children across the autism spectrum at different ages and developmental stages.
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Affiliation(s)
- Julia S Anixt
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA; Division of Developmental and Behavioral Pediatrics, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MLC-4002, Cincinnati, OH 45229, USA.
| | - Jennifer Ehrhardt
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA; Division of Developmental and Behavioral Pediatrics, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MLC-4002, Cincinnati, OH 45229, USA
| | - Amie Duncan
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USA; Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, MLC-4002, Cincinnati, OH 45229, USA
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Zhao W, Xu S, Zhang Y, Li D, Zhu C, Wang K. The Application of Extended Reality in Treating Children with Autism Spectrum Disorder. Neurosci Bull 2024:10.1007/s12264-024-01190-6. [PMID: 38498091 DOI: 10.1007/s12264-024-01190-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 12/06/2023] [Indexed: 03/19/2024] Open
Abstract
Autism Spectrum Disorder (ASD) is a common neurodevelopmental disorder in children, characterized by social interaction, communication difficulties, and repetitive and stereotyped behaviors. Existing intervention methods have limitations, such as requiring long treatment periods and needing to be more convenient to implement. Extended Reality (XR) technology offers a virtual environment to enhance children's social, communication, and self-regulation skills. This paper compares XR theoretical models, application examples, and intervention effects. The study reveals that XR intervention therapy is mainly based on cognitive rehabilitation, teaching, and social-emotional learning theories. It utilizes algorithms, models, artificial intelligence (AI), eye-tracking, and other technologies for interaction, achieving diverse intervention outcomes. Participants showed effective improvement in competency barriers using XR-based multimodal interactive platforms. However, Mixed Reality (MR) technology still requires further development. Future research should explore multimsodal interaction technologies combining XR and AI, optimize models, prioritize the development of MR intervention scenarios, and sustain an optimal intervention level.
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Affiliation(s)
- Weijia Zhao
- First Clinical Medical College, Anhui Medical University, Hefei, 230032, China
| | - Song Xu
- School of Biomedical Engineering, Anhui Medical University, Hefei, 230032, China
| | - Yanan Zhang
- School of Mental Health and Psychological Sciences, Anhui Medical University, China, Hefei, 230032, China
| | - Dandan Li
- Research Center for Translational Medicine, The Second Hospital of Anhui Medical University, Hefei, 230000, China.
| | - Chunyan Zhu
- School of Mental Health and Psychological Sciences, Anhui Medical University, China, Hefei, 230032, China
- Research Center for Translational Medicine, The Second Hospital of Anhui Medical University, Hefei, 230000, China
- Institute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei, 230088, China
| | - Kai Wang
- School of Mental Health and Psychological Sciences, Anhui Medical University, China, Hefei, 230032, China
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, 230032, China
- Collaborative Innovation Center of Neuropsychiatric Disorders and Mental Health, Hefei, 230032, China
- Institute of Artificial Intelligence, Hefei Comprehensive National Science Center, Hefei, 230088, China
- Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, 230032, China
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Razzak R, Li J, He S, Sokhadze E. Investigating Sex-Based Neural Differences in Autism and Their Extended Reality Intervention Implications. Brain Sci 2023; 13:1571. [PMID: 38002531 PMCID: PMC10670246 DOI: 10.3390/brainsci13111571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 10/27/2023] [Accepted: 11/02/2023] [Indexed: 11/26/2023] Open
Abstract
Autism Spectrum Disorder (ASD) affects millions of individuals worldwide, and there is growing interest in the use of extended reality (XR) technologies for intervention. Despite the promising potential of XR interventions, there remain gaps in our understanding of the neurobiological mechanisms underlying ASD, particularly in relation to sex-based differences. This scoping review synthesizes the current research on brain activity patterns in ASD, emphasizing the implications for XR interventions and neurofeedback therapy. We examine the brain regions commonly affected by ASD, the potential benefits and drawbacks of XR technologies, and the implications of sex-specific differences for designing effective interventions. Our findings underscore the need for ongoing research into the neurobiological underpinnings of ASD and sex-based differences, as well as the importance of developing tailored interventions that consider the unique needs and experiences of autistic individuals.
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Affiliation(s)
- Rehma Razzak
- Department of Computer Science, Kennesaw State University, Marietta, GA 30060, USA; (R.R.); (S.H.)
| | - Joy Li
- Department of Software Engineering and Game Development, Kennesaw State University, Marietta, GA 30060, USA;
| | - Selena He
- Department of Computer Science, Kennesaw State University, Marietta, GA 30060, USA; (R.R.); (S.H.)
| | - Estate Sokhadze
- Department of Neurology, Duke University School of Medicine, Durham, NC 27710, USA
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Zhang J, Wu J, Qiu Y, Song A, Li W, Li X, Liu Y. Intelligent speech technologies for transcription, disease diagnosis, and medical equipment interactive control in smart hospitals: A review. Comput Biol Med 2023; 153:106517. [PMID: 36623438 PMCID: PMC9814440 DOI: 10.1016/j.compbiomed.2022.106517] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 12/23/2022] [Accepted: 12/31/2022] [Indexed: 01/07/2023]
Abstract
The growing and aging of the world population have driven the shortage of medical resources in recent years, especially during the COVID-19 pandemic. Fortunately, the rapid development of robotics and artificial intelligence technologies help to adapt to the challenges in the healthcare field. Among them, intelligent speech technology (IST) has served doctors and patients to improve the efficiency of medical behavior and alleviate the medical burden. However, problems like noise interference in complex medical scenarios and pronunciation differences between patients and healthy people hamper the broad application of IST in hospitals. In recent years, technologies such as machine learning have developed rapidly in intelligent speech recognition, which is expected to solve these problems. This paper first introduces IST's procedure and system architecture and analyzes its application in medical scenarios. Secondly, we review existing IST applications in smart hospitals in detail, including electronic medical documentation, disease diagnosis and evaluation, and human-medical equipment interaction. In addition, we elaborate on an application case of IST in the early recognition, diagnosis, rehabilitation training, evaluation, and daily care of stroke patients. Finally, we discuss IST's limitations, challenges, and future directions in the medical field. Furthermore, we propose a novel medical voice analysis system architecture that employs active hardware, active software, and human-computer interaction to realize intelligent and evolvable speech recognition. This comprehensive review and the proposed architecture offer directions for future studies on IST and its applications in smart hospitals.
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Affiliation(s)
- Jun Zhang
- The State Key Laboratory of Bioelectronics, School of Instrument Science and Engineering, Southeast University, Nanjing, 210096, China,Corresponding author
| | - Jingyue Wu
- The State Key Laboratory of Bioelectronics, School of Instrument Science and Engineering, Southeast University, Nanjing, 210096, China
| | - Yiyi Qiu
- The State Key Laboratory of Bioelectronics, School of Instrument Science and Engineering, Southeast University, Nanjing, 210096, China
| | - Aiguo Song
- The State Key Laboratory of Bioelectronics, School of Instrument Science and Engineering, Southeast University, Nanjing, 210096, China
| | - Weifeng Li
- Department of Emergency Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China
| | - Xin Li
- Department of Emergency Medicine, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, 510080, China
| | - Yecheng Liu
- Emergency Department, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, 100730, China
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Gaze Fixation and Visual Searching Behaviors during an Immersive Virtual Reality Social Skills Training Experience for Children and Youth with Autism Spectrum Disorder: A Pilot Study. Brain Sci 2022; 12:brainsci12111568. [DOI: 10.3390/brainsci12111568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 11/04/2022] [Accepted: 11/16/2022] [Indexed: 11/19/2022] Open
Abstract
Children and youth with Autism Spectrum Disorder (ASD) display difficulties recognizing and interacting with behavioral expressions of emotion, a deficit that makes social interaction problematic. Social skills training is foundational to the treatment of ASD, yet this intervention is costly, time-consuming, lacks objectivity, and is difficult to deliver in real-world settings. This pilot project investigated the use of an immersive virtual reality (IVR) headset to simulate real-world social interactions for children/youth with ASD. The primary objective was to describe gaze fixation and visual search behaviors during the simulated activity. Ten participants were enrolled and completed one social-skills training session in the IVR. The results demonstrate differential patterns between participants with mild, moderate, and severe ASD in the location and duration of gaze fixation as well as the patterns of visual searching. Although the results are preliminary, these differences may shed light on phenotypes within the continuum of ASD. Additionally, there may be value in quantifying gaze and visual search behaviors as an objective metric of interventional effectiveness for social-skills training therapy.
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6G to Take the Digital Divide by Storm: Key Technologies and Trends to Bridge the Gap. FUTURE INTERNET 2022. [DOI: 10.3390/fi14060189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/10/2022] Open
Abstract
The pandemic caused by COVID-19 has shed light on the urgency of bridging the digital divide to guarantee equity in the fruition of different services by all citizens. The inability to access the digital world may be due to a lack of network infrastructure, which we refer to as service-delivery divide, or to the physical conditions, handicaps, age, or digital illiteracy of the citizens, that is mentioned as service-fruition divide. In this paper, we discuss the way how future sixth-generation (6G) systems can remedy actual limitations in the realization of a truly digital world. Hence, we introduce the key technologies for bridging the digital gap and show how they can work in two use cases of particular importance, namely eHealth and education, where digital inequalities have been dramatically augmented by the pandemic. Finally, considerations about the socio-economical impacts of future 6G solutions are drawn.
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