“That is how I speak nowadays” – experiences of remote communication among persons with communicative and cognitive disabilities

When you are not here, I cannot do what I want on the tablet - The use of ICT to promote social participation of young people with intellectual disabilities

Most youths use Information and Communication Technology (ICT) for socialising, but there is a discussion about whether using ICT promotes social participation for youths with intellectual disabilities (IDs). Employing the concepts of social participation and self-determination together with the youths' perspectives, as conveyed by staff, we examine how social participation might be promoted for youths with intellectual disabilities in institutional settings in Sweden. The findings revealed three overarching themes. The first theme, Developing skills, self-determination and becoming less reliant, illustrates the basic use of ICT. The second theme, Sharing events, socialising and participating with others, draws attention to how youths take technology a step further to interact with others. The third theme, Resources and attitudes, concerns the youths' need and desires for adequate support and equipment and the mindset of surrounding communities concerning ICT. Our conclusion is that ICT has the potential to promote social participation if the youths have access to personalised equipment and supportive staff.

Qualitative health research in the fields of developmental medicine and child neurology

This invited review introduces the principles of qualitative health research (QHR) to the fields of developmental medicine and child neurology to facilitate the conduct of applied qualitative research. It provides practical guidance on how to write a study purpose statement aligned with the foci of QHR and then articulate an overarching research question using the Emphasis-Purposeful sample-Phenomenon of interest-Context framework. Guidance for health researchers on how to select a study design that aligns with the practice, education, or policy goals of applied QHR is provided. This is followed by strategies to guide decision-making with respect to purposeful sampling, selecting data collection methods, and identifying the most appropriate analytic approach to code and synthesize the data. Findings from QHR studies can be used conceptually or instrumentally to provide new insights or inform decisions within the discipline of developmental medicine and child neurology. While qualitive findings are increasingly valued in the field, designing studies that demonstrate methodological congruence is one strategy to improve the overall quality and trustworthiness of discipline specific QHR.

Enhanced participation or just another activity? The social shaping of iPad use for youths with intellectual disabilities

The use of smartphones and tablet devices in activities is believed to have great potential for enhancing the participation of people with intellectual disabilities. However, these technologies, in themselves, do not contribute to participation. What matters is how they are used. Employing the concept of domestication and insights gained from interviews with staff, this article examines conditions for the enhanced participation of youths with intellectual disability and how tablet devices are being integrated into social care settings, in particular.The findings reveal two approaches to tablet integration. In one approach, tablet use is an organized practice focused on technology acquisition, skills improvement and entertainment. In the other, it is integrated into existing practices as an aid to interpersonal communication. The organized digital activities create conditions for the youths to participate like non-disabled peers. The greatest potential for enabling participation with each other is when the youths themselves initiate the use of tablets.

"It's Our Gang" - Promoting Social Inclusion for People with Dementia by Using Digital Communication Support in a Group Activity

OBJECTIVES

In the present paper we aim to contribute to the understanding of how people with dementia experience using a web-based communication support application on a tablet computer in a group activity. The specific focus of the present paper is on perception of social inclusion among people with dementia in a group activity using digital communication support.

METHODS

The study is based on interviews with participants in a communication group for people with dementia where the application CIRCA, specifically designed to support interaction involving people with dementia, was used. Five individuals with dementia were recruited from a residential care home where they lived in different wards. Seven group interviews with the participating persons with dementia following directly after each session were carried out.

RESULTS

The views of the participants were generally very positive, regarding many aspects of the activity. In the present study, the group activity seemed more important and beneficial for the participants, than the specific use of the application in itself.

CONCLUSIONS

Taking part in a group activity targeting communication made participants with dementia feel that they were part of a social group, that they had learnt things, and that they had been able to contribute with their expertise to others.

CLINICAL IMPLICATIONS

Group activities targeting communication give people with dementia the opportunity to exercise their social inclusion practices. Group activities may render a feeling of social community and a sense of belonging to the participants. The use of digital communication support may enhance such activities.

Children's Perspectives on Mealtimes When Living with a Gastrostomy Tube: A Qualitative Study

PURPOSE

To explore children's experiences of mealtimes when living with a gastrostomy tube.

DESIGN AND METHODS

The study used a qualitative descriptive design framed within ecocultural theory. Seven children, three girls and four boys, aged 6-12 years with long-term health conditions and a gastrostomy tube participated in individual interviews. The interviews were qualitatively analysed by means of systematic text condensation.

RESULTS

Four main categories comprised the findings of the children's mealtimes experiences: "Stable in form, open to variation," "An individual, and a shared activity," "An object that needs to be dealt with" and "A part of me." A complex picture emerged, where the children experienced nutrition, whether through the gastrostomy tube or orally, as necessary for a healthy body, although this did not suffice to make the mealtime experience positive.

CONCLUSIONS

Regardless of the children's amount of oral intake, everyday mealtimes were valued as opportunities for social interaction and experienced as a predictable, routine activity no different from the mealtimes of other families. The accounts illustrated that in many situations the children knew precisely what they needed and did not need, what they liked and disliked and why.

PRACTICE IMPLICATIONS

Healthcare professionals should take children's knowledge into consideration to a greater extent when planning follow-up and intervention. The study illuminates that children can take an active part in their healthcare when offered flexible and carefully designed communication material, even in the presence of communicative and/or intellectual disability.

People with intellectual and visual disabilities access basic leisure and communication using a smartphone's Google Assistant and voice recording devices

PURPOSE

This study assessed a new technology system to help six participants with intellectual and visual disabilities manage leisure engagement and communication with distant partners in an independent manner.

METHODS

A nonconcurrent multiple baseline design across participants was used to assess the effects of the new technology system. This included a Samsung Galaxy J4 Plus smartphone with Android 9.0 operating system, mini voice recording devices, and a Bluetooth speaker. The smartphone was provided with a Google account and Internet connection. The participants could activate the smartphone's Google Assistant and thus access leisure events, start telephone calls or send messages by triggering mini voice recording devices. Each device, when triggered, uttered a specific verbal request (i.e., a request for a leisure option or for a communication partner to call or to reach by messages). Messages received from those partners were read automatically by the smartphone.

RESULTS

During baseline (when the voice recording devices were not available), the participants did not manage to activate the smartphone's Google Assistant and thus did not access leisure events and did not make telephone calls or send messages independently. During the post-intervention phase (when the voice recording devices were available), all participants accessed leisure events and made telephone calls or sent and received messages independently, remaining positively engaged throughout the 10-min sessions. Staff rated the new technology system positively.

CONCLUSION

The new technology system may be a useful resource to help people like the participants of this study access basic leisure and communication independently.Implications for rehabilitationA technology system relying on commercial devices may be practical and acceptable in daily programs for persons with intellectual and other disabilities.Such system may be used for supporting the persons' independent leisure engagement and communication with distant partners.A system may be accessible to persons with significant disabilities if the responses needed to operate it are simple.Simple hand-pressure responses may be sufficient to operate a system that relies on the input of mini voice recording devices.

Challenges and opportunities caring for neurology outpatients across language differences

BACKGROUND

With over 66 million Americans who speak over 350 languages other than English at home, we sought to examine attitudes and behaviors of neurology clinicians and staff when communicating across language differences.

METHODS

We conducted an electronic-enabled cross-sectional survey of clinicians and patient services coordinators working at an academic neurology outpatient clinic. Questions focused on professional medical interpreter (PMI) services usage, satisfaction, and perceived barriers to utilization.

RESULTS

A total of 82/235 (35%) neurology clinicians and 24/52 (46%) coordinators met the study eligibility criteria. Most clinicians (96%) reported seeing at least 1 non-English-speaking patient and using PMI services (85%) in the last month. Most commonly self-reported interpretation modalities were face-to-face PMI services (39%) and patients' family members or friends (28%). Perceived barriers to using PMI included time constraints (60%) and lack of available face-to-face PMI (51%). Among patient services coordinators, 33% reported consistently asking patients their preferred language and 50% if they needed a PMI for appointments. Most respondents (77% clinicians and 71% coordinators) were satisfied with PMI services. Recommendations included having more available face-to-face PMI, greater coordinated efforts to preschedule PMI, and more education on the effective use of PMI.

CONCLUSIONS

More than 70% of outpatient neurology clinicians and patient services coordinators were satisfied with PMI. However, their perceived barriers and reported practices suggest a need for updated policies and education to improve the use of PMI services.

Children's Perceptions of Pictures Intended to Measure Anxiety During Hospitalization

Many children experience anxiety during a hospital stay, which can have an adverse impact on their recovery and response to future hospital care. To facilitate assessment of anxiety in young children and children with communicative disabilities, the short S-STAI (short version of the State scale of the State-Trait Anxiety Inventory), has previously been adapted to a visual format. The aims of the present study were (a) to validate the pictures used to represent emotions and the steps of a quantitative scale ('a lot' - 'some' - 'a little'), including to determine whether any of them should be replaced, and (b) to assess different pictures to be used for a qualitative scale ('good/like' - 'in between/so-so' -'bad/dislike') in the same instrument. A total of 103 children aged 5-8 years were asked to choose verbal labels for pictures of facial expressions intended to represent emotions, match those pictures with the emotional categories used in the short S-STAI (Tense/Nervous, Worried/Afraid, Calm/Relaxed, and Happy/Content) and indicate their preferences for pictures intended to represent the steps of a quantitative scale and a qualitative one. The children understood both scales and the differences between positive and negative emotions in the short S-STAI. The older children (aged 7 and 8) significantly more often chose a picture for each step of the scales that was intended to represent that particular step. The article discusses implications for the choice of pictures representing emotional states in the short S-STAI and presents recommended pictures.

An Upgraded Smartphone-Based Program for Leisure and Communication of People With Intellectual and Other Disabilities

Background: People with intellectual disability and sensory or sensory-motor impairments may display serious problems in managing functional daily activities as well as leisure activities and communication with distant partners. Aim: The study assessed an upgraded smartphone-based program to foster independent leisure and communication activity of eight participants with mild to moderate intellectual disability, sensory or sensory-motor impairments, and limited speech skills. Method: The upgraded program was based on the use of (a) a Samsung Galaxy A3 smartphone with Android 6.0 Operating System, near-field communication, music and video player functions, and Macrodroid application, and (b) special radio frequency-code labels. Participants requested leisure and communication activities by placing mini objects or pictures representing those activities and containing frequency-code labels on the smartphone. The smartphone, via the Macrodroid application, read the labels (i.e., discriminated the participants' requests) and provided the participants with the activities requested. Results: During the baseline (i.e., in the absence of the program), the participants failed to request/access leisure and communication activities independently. During the post-intervention phase of the study (i.e., using the program), they succeeded in requesting/accessing those activities independently and spent about 70-90% of their session time busy with those activities. Conclusion: The upgraded smartphone-based program may be highly functional for people like the participants of this study.