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Reeve BB, Lucas N, Chen D, McFatrich M, Jones HN, Gordon KL, Leiva LZ, Lin L, Coenraads M, von Hehn J, Carpenter RL, Marsh ED, Zigler CK. Validation of the Observer-Reported Communication Ability (ORCA) measure for individuals with Rett syndrome. Eur J Paediatr Neurol 2023; 46:74-81. [PMID: 37536121 DOI: 10.1016/j.ejpn.2023.07.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 07/24/2023] [Accepted: 07/27/2023] [Indexed: 08/05/2023]
Abstract
PURPOSE The study goal was to validate the Observer-Reported Communication Ability (ORCA) measure for use with females with Rett Syndrome (RTT). METHODS Qualitative interviews, including concept elicitation and cognitive interviewing methods, were conducted with 19 caregivers of individuals with RTT ages 2 and older. A quantitative study was then conducted in 279 caregivers to evaluate construct validity and reliability. RESULTS After minor modifications were made, the modified ORCA measure was well understood and captured key communication concepts. Quantitative data showed evidence for reliable scores (α = 0.90, test-retest intraclass correlation = 0.88), minimal floor and no ceiling effects, and strong correlation with the Communication and Symbolic Behaviors Scale (r = 0.73). CONCLUSIONS This study provided initial support that the modified ORCA measure is an acceptable caregiver-reported measure of communication ability for females with RTT. Future work should include evaluation of longitudinal validity of the measure and its associations with clinician- and performance-based measures in diverse samples.
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Affiliation(s)
- Bryce B Reeve
- Center for Health Measurement, Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA; Department of Pediatrics, Duke University School of Medicine, Durham, NC, USA.
| | - Nicole Lucas
- Center for Health Measurement, Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Dandan Chen
- Center for Health Measurement, Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Molly McFatrich
- Center for Health Measurement, Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Harrison N Jones
- Department of Head and Neck Surgery & Communication Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Kelly L Gordon
- Department of Speech Pathology and Audiology, Duke University Health System, Durham, NC, USA
| | - Leslie Zapata Leiva
- Center for Health Measurement, Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Li Lin
- Center for Health Measurement, Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
| | | | | | | | - Eric D Marsh
- Division of Child Neurology, Department of Pediatrics, Children's Hospital of Philadelphia and Department of Neurology, University of Pennsylvania Perelman School of Medicine Philadelphia, PA, USA
| | - Christina K Zigler
- Center for Health Measurement, Department of Population Health Sciences, Duke University School of Medicine, Durham, NC, USA
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Gómez Taibo ML, Paramos Alonso S. Documentación de habilidades comunicativas y de lenguaje receptivo en un caso de Síndrome de Rett. REVISTA DE INVESTIGACIÓN EN LOGOPEDIA 2022. [DOI: 10.5209/rlog.77431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Las dificultades de las personas con síndrome de Rett (SR) para hablar y producir respuestas motoras hace de la valoración un proceso difícil, resultando necesario combinar métodos informales y adaptaciones en los instrumentos formales para obtener información sobre los niveles de competencia. El objetivo de este estudio es documentar el proceso de valoración de las habilidades comunicativo-lingüísticas seguido con una niña con SR combinando métodos de evaluación y realizando adaptaciones en los tests estandarizados. Se llevaron a cabo observaciones informales en entornos naturales, los compañeros de comunicación cubrieron la Matriz de Comunicación, y se realizaron adaptaciones en los tests Vocabulario en Imágenes Peabody y TSA de desarrollo de la morfosintaxis, y en el Test of Aided Communication Performance, consistentes en reducir el número de alternativas, presentarlas en una disposición accesible a la señalización con la mirada, y en dar tiempo de espera para la respuesta de la participante con SR. Los resultados obtenidos mediante las adaptaciones utilizando la mirada como método de acceso mostraron niveles de dominio de comunicación preintencional y de comunicación no convencional, junto con destrezas emergentes en comunicación convencional y simbólica para funciones de petición e interacción social y una comprensión de estructuras gramaticales sencillas. La conclusión que se desprende es que es imperativo que las evaluaciones se adapten a las limitaciones físicas y orales de las personas con SR, de modo que puedan descubrirse capacidades ocultas, se establezcan objetivos para la intervención basados en sus niveles reales de competencia para apoyar al máximo la comunicación.
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Ward C, Chiat S, Townend GS. A comparison of formal and informal methods for assessing language and cognition in children with Rett syndrome. RESEARCH IN DEVELOPMENTAL DISABILITIES 2021; 114:103961. [PMID: 33915382 DOI: 10.1016/j.ridd.2021.103961] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 03/25/2021] [Accepted: 04/20/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Opinions about the cognitive and receptive language skills of people with Rett syndrome (RTT) range from severe intellectual impairment to near-normal development. Assessment is challenging because most are non-verbal, with no purposeful hand use. Clarkson et al. (2017) adapted the Mullen Scales of Early Learning for use with eye gaze technology (MSEL-A/ET) for people with RTT. AIMS To investigate and compare the performance of children with RTT on formal and newly-designed informal assessments of language and cognition using eye gaze/tracking technology. METHODS AND PROCEDURES Ten children with RTT aged 4:0-6:8 were assessed on the MSEL-A/ET for Visual Reception (VR) and Receptive Language (RL), and standard MSEL for Expressive Language (EL). Informal assessments of the same skills were embedded in activities such as reading and cake-decorating. OUTCOMES AND RESULTS Standard scores on MSEL-A/ET VR and RL subtests ranged from 'very low' to 'above average'. All children scored 'very low' on standard EL assessment. Informal assessments added information about EL, with children producing 1-3 word utterances and a range of communicative functions through an eye gaze device. CONCLUSIONS AND IMPLICATIONS Combining low-tech augmentative and alternative communication, eye gaze technology, informal activities and formal assessment, yields greater insight into children's abilities. This is important in informing suitable support and education for the individual.
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Affiliation(s)
- Callie Ward
- School of Health Sciences, Language and Communication Science, City, University of London, Northampton Square, London, EC1V 0HB, UK; Rett UK, Victory House, Chobham Street, Luton, LU1 3BS, UK
| | - Shula Chiat
- School of Health Sciences, Language and Communication Science, City, University of London, Northampton Square, London, EC1V 0HB, UK
| | - Gillian S Townend
- Rett UK, Victory House, Chobham Street, Luton, LU1 3BS, UK; Rett Expertise Centre Netherlands-GKC, Maastricht University, PO Box 616, 6200MD, Maastricht, The Netherlands.
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4
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Semmel ES, Fox ME, Na SD, Kautiainen R, Latzman RD, King TZ. Caregiver- and Clinician-Reported Adaptive Functioning in Rett Syndrome: a Systematic Review and Evaluation of Measurement Strategies. Neuropsychol Rev 2019; 29:465-483. [PMID: 31748842 DOI: 10.1007/s11065-019-09420-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 11/06/2019] [Indexed: 01/03/2023]
Abstract
Rett syndrome is the second most common cause of intellectual disability in females worldwide. The severity of many individuals' impairment limits the effectiveness of traditional assessment. However, clinician and parent reports of adaptive functioning may provide insight into these patients' abilities. This review aims to synthesize the current literature assessing adaptive functioning in Rett syndrome and evaluate existing measurement tools in this population. A search was conducted on PubMed using the search term "Rett syndrome." Studies that quantitatively assessed adaptive functioning outcomes in Rett syndrome with published and normed questionnaire measures were included. Twenty-three studies met inclusion criteria. Overall results indicate that the population of people with Rett syndrome is highly impaired, both in overall adaptive functioning as well as in specific subdomains (e.g., mobility, activities of daily living). Atypical Rett syndrome groups performed better on measures of adaptive functioning relative to patients with classic Rett syndrome. Our findings identified measurement weaknesses, as many of the studies found floor effects and therefore were unable to capture meaningful variability in outcomes. Individuals with Rett syndrome are highly reliant on caregivers due to disrupted adaptive functioning abilities. Optimizing measurement of adaptive skills in Rett syndrome will facilitate the quantification of meaningful change in skills and the identification of efficacious interventions aimed at improving outcomes and quality of life.
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Affiliation(s)
- Eric S Semmel
- Department of Psychology and Neuroscience Institute, Georgia State University, P.O. Box 5010, Atlanta, GA, 30302-5010, USA
| | - Michelle E Fox
- Department of Psychology and Neuroscience Institute, Georgia State University, P.O. Box 5010, Atlanta, GA, 30302-5010, USA
| | - Sabrina D Na
- Department of Psychology and Neuroscience Institute, Georgia State University, P.O. Box 5010, Atlanta, GA, 30302-5010, USA
| | - Rella Kautiainen
- Department of Psychology and Neuroscience Institute, Georgia State University, P.O. Box 5010, Atlanta, GA, 30302-5010, USA
| | - Robert D Latzman
- Department of Psychology and Neuroscience Institute, Georgia State University, P.O. Box 5010, Atlanta, GA, 30302-5010, USA
| | - Tricia Z King
- Department of Psychology and Neuroscience Institute, Georgia State University, P.O. Box 5010, Atlanta, GA, 30302-5010, USA.
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Stasolla F, Caffò AO, Perilli V, Albano V. Experimental Examination and Social Validation of a Microswitch Intervention to Improve Choice-Making and Activity Engagement for Six Girls with Rett Syndrome. Dev Neurorehabil 2019; 22:527-541. [PMID: 31169045 DOI: 10.1080/17518423.2019.1624655] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Background: The use of assistive technology, specifically microswitches, with children with RTT has been shown to effectively moderate the impact of their disability on their quality of life- by facilitating access to meaningful leisure and other activities. Objectives: This study aimed to evaluate the effectiveness of a microswitch intervention on increased choice making, engagement in a targeted sorting activity, and indices of happiness, and decreased stereotypic behaviors for six girls with Rett syndrome. Targeted dependent variables were also assessed at six months post-intervention. Following the intervention study, 90 external raters completed a social validation procedure. Method: An ABABAB experimental sequence was implemented for each participant with a cross-over effect. A social validation assessment involving 90 external raters was carried out. Results: Data emphasized an improved performance for each participants involved (i.e., adaptive responses). Five participants showed a capacity of independent choice. One participant seemed to be closely linked to the position of the container. Social raters favorably endorsed the use of the program since they positively evaluated the use of the technology on all the dimensions investigated. Conclusion: A microswitch intervention may improve choice making and activity engagement for children with Rett syndrome. Further research is needed on the development of more sophisticated forms of individualized technological options to improve opportunities for enhanced engagement and choice-making for individuals with RTT.
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Affiliation(s)
| | | | | | - Vincenza Albano
- Department of Educational Sciences, Psychology, Communication, University of Bari , Italy
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6
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Abstract
Background: Stereotypical hand movements have been observed in most individuals diagnosed with Rett syndrome. Objectives: To investigate factors that increase or decrease hand stereotypies in individuals with Rett syndrome. Methods: A questionnaire regarding hand stereotypies or purposeful hand behaviours was sent to 1016 schools for special needs education and 204 facilities in Japan. Results: Information was acquired from 216 cases (3-53 years old) with Rett syndrome; 81.9% and 87.6% of individuals had factors that increased and decreased stereotypical hand movements, respectively. Stereotypies were mainly increased by displeasure (63.8%) or pleasure (48.5%), and decreased by somnolence (43.5%), pleasure (30.0%), or food (24.1%). Conclusion: Emotion was the main factor increasing stereotypical hand movements, whereas there were a large number of factors that decreased these movements. The factors that decrease stereotypies could be useful to prevent the skin problems or joint contracture observed in patients with Rett syndrome.
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Affiliation(s)
- Daisuke Hirano
- a International University of Health and Welfare Graduate School , Otawara , Japan.,b International University of Health and Welfare , Narita , Japan
| | - Takamichi Taniguchi
- a International University of Health and Welfare Graduate School , Otawara , Japan.,c International University of Health and Welfare , Otawara , Japan
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7
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Clarkson T, LeBlanc J, DeGregorio G, Vogel-Farley V, Barnes K, Kaufmann WE, Nelson CA. Adapting the Mullen Scales of Early Learning for a Standardized Measure of Development in Children With Rett Syndrome. INTELLECTUAL AND DEVELOPMENTAL DISABILITIES 2017; 55:419-431. [PMID: 29194024 DOI: 10.1352/1934-9556-55.6.419] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Rett Syndrome (RTT) is characterized by severe impairment in fine motor (FM) and expressive language (EL) function, making accurate evaluations of development difficult with standardized assessm ents. In this study, the administration and scoring of the Mullen Scales of Early Learning (MSEL) were adapted to eliminate the confounding effects of FM and EL impairments in assessing development. Forty-seven girls with RTT were assessed with the Adapted-MSEL (MSEL-A), a subset (n = 30) was also assessed using the Vineland Adaptive Behavior Scales-Second Edition (Vineland-II) and a further subset (n = 17) was assessed using an eye-tracking version of the MSEL (MSEL-ET). Participants performed better on the visual reception (VR) and receptive language (RL) domains compared to the FM and EL domains on the MSEL-A. Individual performance on each domain was independent of other domains. Corresponding MSEL-A and Vineland-II domains were significantly correlated. The MSEL-ET was as accurate as the MSEL-A in assessing VR and RL, yet took a 44% less time. Results suggested that the MSEL-A and the MSEL-ET could be viable measures for accurately assessing developmental domains in children with RTT.
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Affiliation(s)
- Tessa Clarkson
- Tessa Clarkson, Jocelyn LeBlanc, Geneva DeGregorio, Vanessa Vogel-Farley, and Katherine Barnes, Boston Children's Hospital, MA; Walter E. Kaufmann, Boston Children's Hospital, MA and Harvard Medical School, Boston, MA; and Charles A. Nelson, Boston Children's Hospital, Harvard Medical School, Boston, and Harvard Graduate School of Education, Boston, MA
| | - Jocelyn LeBlanc
- Tessa Clarkson, Jocelyn LeBlanc, Geneva DeGregorio, Vanessa Vogel-Farley, and Katherine Barnes, Boston Children's Hospital, MA; Walter E. Kaufmann, Boston Children's Hospital, MA and Harvard Medical School, Boston, MA; and Charles A. Nelson, Boston Children's Hospital, Harvard Medical School, Boston, and Harvard Graduate School of Education, Boston, MA
| | - Geneva DeGregorio
- Tessa Clarkson, Jocelyn LeBlanc, Geneva DeGregorio, Vanessa Vogel-Farley, and Katherine Barnes, Boston Children's Hospital, MA; Walter E. Kaufmann, Boston Children's Hospital, MA and Harvard Medical School, Boston, MA; and Charles A. Nelson, Boston Children's Hospital, Harvard Medical School, Boston, and Harvard Graduate School of Education, Boston, MA
| | - Vanessa Vogel-Farley
- Tessa Clarkson, Jocelyn LeBlanc, Geneva DeGregorio, Vanessa Vogel-Farley, and Katherine Barnes, Boston Children's Hospital, MA; Walter E. Kaufmann, Boston Children's Hospital, MA and Harvard Medical School, Boston, MA; and Charles A. Nelson, Boston Children's Hospital, Harvard Medical School, Boston, and Harvard Graduate School of Education, Boston, MA
| | - Katherine Barnes
- Tessa Clarkson, Jocelyn LeBlanc, Geneva DeGregorio, Vanessa Vogel-Farley, and Katherine Barnes, Boston Children's Hospital, MA; Walter E. Kaufmann, Boston Children's Hospital, MA and Harvard Medical School, Boston, MA; and Charles A. Nelson, Boston Children's Hospital, Harvard Medical School, Boston, and Harvard Graduate School of Education, Boston, MA
| | - Walter E Kaufmann
- Tessa Clarkson, Jocelyn LeBlanc, Geneva DeGregorio, Vanessa Vogel-Farley, and Katherine Barnes, Boston Children's Hospital, MA; Walter E. Kaufmann, Boston Children's Hospital, MA and Harvard Medical School, Boston, MA; and Charles A. Nelson, Boston Children's Hospital, Harvard Medical School, Boston, and Harvard Graduate School of Education, Boston, MA
| | - Charles A Nelson
- Tessa Clarkson, Jocelyn LeBlanc, Geneva DeGregorio, Vanessa Vogel-Farley, and Katherine Barnes, Boston Children's Hospital, MA; Walter E. Kaufmann, Boston Children's Hospital, MA and Harvard Medical School, Boston, MA; and Charles A. Nelson, Boston Children's Hospital, Harvard Medical School, Boston, and Harvard Graduate School of Education, Boston, MA
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8
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Chen Y, Yu J, Niu Y, Qin D, Liu H, Li G, Hu Y, Wang J, Lu Y, Kang Y, Jiang Y, Wu K, Li S, Wei J, He J, Wang J, Liu X, Luo Y, Si C, Bai R, Zhang K, Liu J, Huang S, Chen Z, Wang S, Chen X, Bao X, Zhang Q, Li F, Geng R, Liang A, Shen D, Jiang T, Hu X, Ma Y, Ji W, Sun YE. Modeling Rett Syndrome Using TALEN-Edited MECP2 Mutant Cynomolgus Monkeys. Cell 2017; 169:945-955.e10. [PMID: 28525759 DOI: 10.1016/j.cell.2017.04.035] [Citation(s) in RCA: 135] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2016] [Revised: 03/07/2017] [Accepted: 04/25/2017] [Indexed: 02/05/2023]
Abstract
Gene-editing technologies have made it feasible to create nonhuman primate models for human genetic disorders. Here, we report detailed genotypes and phenotypes of TALEN-edited MECP2 mutant cynomolgus monkeys serving as a model for a neurodevelopmental disorder, Rett syndrome (RTT), which is caused by loss-of-function mutations in the human MECP2 gene. Male mutant monkeys were embryonic lethal, reiterating that RTT is a disease of females. Through a battery of behavioral analyses, including primate-unique eye-tracking tests, in combination with brain imaging via MRI, we found a series of physiological, behavioral, and structural abnormalities resembling clinical manifestations of RTT. Moreover, blood transcriptome profiling revealed that mutant monkeys resembled RTT patients in immune gene dysregulation. Taken together, the stark similarity in phenotype and/or endophenotype between monkeys and patients suggested that gene-edited RTT founder monkeys would be of value for disease mechanistic studies as well as development of potential therapeutic interventions for RTT.
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Affiliation(s)
- Yongchang Chen
- Yunnan Key Laboratory of Primate Biomedicine Research, Institute of Primate Translational Medicine, Kunming University of Science and Technology, Kunming 650500, China; Yunnan Provincial Academy of Science and Technology, Kunming 650051, China; Kunming Enovate Institute of Bioscience, Kunming 650000, China.
| | - Juehua Yu
- Translational Stem Cell Research Center, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, China
| | - Yuyu Niu
- Yunnan Key Laboratory of Primate Biomedicine Research, Institute of Primate Translational Medicine, Kunming University of Science and Technology, Kunming 650500, China; Yunnan Provincial Academy of Science and Technology, Kunming 650051, China; Kunming Enovate Institute of Bioscience, Kunming 650000, China
| | - Dongdong Qin
- Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences & Yunnan Province, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming 650223, China
| | - Hailiang Liu
- Translational Stem Cell Research Center, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, China
| | - Gang Li
- Department of Radiology and BRIC, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Yingzhou Hu
- Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences & Yunnan Province, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming 650223, China
| | - Jiaojian Wang
- Key Laboratory for NeuroInformation of the Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 625014, China
| | - Yi Lu
- Department of Medical Imaging, the First Affiliated Hospital, Kunming Medical University, Kunming 650032, China
| | - Yu Kang
- Yunnan Key Laboratory of Primate Biomedicine Research, Institute of Primate Translational Medicine, Kunming University of Science and Technology, Kunming 650500, China; Yunnan Provincial Academy of Science and Technology, Kunming 650051, China; Kunming Enovate Institute of Bioscience, Kunming 650000, China
| | - Yong Jiang
- The First People's Hospital of Yunnan Province and The Affiliated Hospital of Kunming University of Science and Technology, Kunming 650032, China
| | - Kunhua Wu
- The First People's Hospital of Yunnan Province and The Affiliated Hospital of Kunming University of Science and Technology, Kunming 650032, China
| | - Siguang Li
- Translational Stem Cell Research Center, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, China
| | - Jingkuan Wei
- Yunnan Key Laboratory of Primate Biomedicine Research, Institute of Primate Translational Medicine, Kunming University of Science and Technology, Kunming 650500, China; Yunnan Provincial Academy of Science and Technology, Kunming 650051, China
| | - Jing He
- Yunnan Key Laboratory of Primate Biomedicine Research, Institute of Primate Translational Medicine, Kunming University of Science and Technology, Kunming 650500, China; Yunnan Provincial Academy of Science and Technology, Kunming 650051, China
| | - Junbang Wang
- Translational Stem Cell Research Center, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, China
| | - Xiaojing Liu
- Translational Stem Cell Research Center, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, China
| | - Yuping Luo
- Translational Stem Cell Research Center, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, China
| | - Chenyang Si
- Yunnan Key Laboratory of Primate Biomedicine Research, Institute of Primate Translational Medicine, Kunming University of Science and Technology, Kunming 650500, China; Yunnan Provincial Academy of Science and Technology, Kunming 650051, China; Kunming Enovate Institute of Bioscience, Kunming 650000, China
| | - Raoxian Bai
- Yunnan Key Laboratory of Primate Biomedicine Research, Institute of Primate Translational Medicine, Kunming University of Science and Technology, Kunming 650500, China; Yunnan Provincial Academy of Science and Technology, Kunming 650051, China
| | - Kunshan Zhang
- Translational Stem Cell Research Center, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, China
| | - Jie Liu
- Translational Stem Cell Research Center, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, China
| | - Shaoyong Huang
- Yunnan Key Laboratory of Primate Biomedicine Research, Institute of Primate Translational Medicine, Kunming University of Science and Technology, Kunming 650500, China; Yunnan Provincial Academy of Science and Technology, Kunming 650051, China
| | - Zhenzhen Chen
- Yunnan Key Laboratory of Primate Biomedicine Research, Institute of Primate Translational Medicine, Kunming University of Science and Technology, Kunming 650500, China; Yunnan Provincial Academy of Science and Technology, Kunming 650051, China
| | - Shuang Wang
- Yunnan Key Laboratory of Primate Biomedicine Research, Institute of Primate Translational Medicine, Kunming University of Science and Technology, Kunming 650500, China; Yunnan Provincial Academy of Science and Technology, Kunming 650051, China
| | - Xiaoying Chen
- Translational Stem Cell Research Center, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, China
| | - Xinhua Bao
- Department of Pediatrics, Peking University First Hospital, Beijing 100034, China
| | - Qingping Zhang
- Department of Pediatrics, Peking University First Hospital, Beijing 100034, China
| | - Fuxing Li
- Translational Stem Cell Research Center, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, China
| | - Rui Geng
- Translational Stem Cell Research Center, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, China
| | - Aibin Liang
- Translational Stem Cell Research Center, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, China
| | - Dinggang Shen
- Department of Radiology and BRIC, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Tianzi Jiang
- Key Laboratory for NeuroInformation of the Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 625014, China; National Laboratory of Pattern Recognition, Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China
| | - Xintian Hu
- Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences & Yunnan Province, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming 650223, China
| | - Yuanye Ma
- Yunnan Key Laboratory of Primate Biomedicine Research, Institute of Primate Translational Medicine, Kunming University of Science and Technology, Kunming 650500, China; Yunnan Provincial Academy of Science and Technology, Kunming 650051, China
| | - Weizhi Ji
- Yunnan Key Laboratory of Primate Biomedicine Research, Institute of Primate Translational Medicine, Kunming University of Science and Technology, Kunming 650500, China; Yunnan Provincial Academy of Science and Technology, Kunming 650051, China; Kunming Enovate Institute of Bioscience, Kunming 650000, China.
| | - Yi Eve Sun
- Translational Stem Cell Research Center, Tongji Hospital, Tongji University School of Medicine, Shanghai 200065, China; Department of Psychiatry and Biobehavioral Sciences, UCLA Medical School, Los Angeles, CA 90095, USA.
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Holmqvist E, Thunberg G, Peny Dahlstrand M. Gaze-controlled communication technology for children with severe multiple disabilities: Parents and professionals' perception of gains, obstacles, and prerequisites. Assist Technol 2017; 30:201-208. [PMID: 28471273 DOI: 10.1080/10400435.2017.1307882] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
The aim of this study was to explore parents' and professionals' thoughts of how a gaze-controlled computer can be beneficial to children with severe multiple disabilities. All systems were provided primarily for symbol-based communication, but were also used for other purposes such as play, leisure and school activities. A further aim was to investigate factors affecting usability, specifically for communication. The study used a qualitative approach, involving content analysis of semistructured interviews with the children's key persons (N = 11). The analysis yielded three categories and twelve subcategories. There were gains for the children in terms of empowerment, social interaction, learning opportunities and efficient computer use. Inaccessibility, liability issues and technical failure were seen as obstacles, while the prerequisites included time, collaboration, stimulating content, know-how and opportunities. To sum up, this study suggests that gaze-controlled technology can provide children who have multiple disabilities involving severe motor dysfunction and communicative and cognitive problems with new opportunities to communicate, interact and perform activities independently, as long as conditions are right.
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Affiliation(s)
- Eva Holmqvist
- a Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg , Gothenburg , Göteborg, Sweden.,b Dart Centre for AAC and AT , Sahlgrenska University Hospital , Gothenburg , Sweden
| | - Gunilla Thunberg
- b Dart Centre for AAC and AT , Sahlgrenska University Hospital , Gothenburg , Sweden
| | - Marie Peny Dahlstrand
- a Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg , Gothenburg , Göteborg, Sweden.,c Regional Habilitation Centre , Sahlgrenska University Hospital , Gothenburg , Sweden
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10
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Urbanowicz A, Ciccone N, Girdler S, Leonard H, Downs J. Choice making in Rett syndrome: a descriptive study using video data. Disabil Rehabil 2017; 40:813-819. [PMID: 28112551 DOI: 10.1080/09638288.2016.1277392] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
PURPOSE To describe the choice-making abilities of girls and women with Rett syndrome. METHOD Females with Rett syndrome registered with the Australian Rett Syndrome Database with a pathogenic MECP2 mutation were included in this study. Video clips showing choice making in 64 females at a median age of 11.6 years (range 2.3-35.6 years) were analysed. Video clips were coded for the location and nature of the choice-making interaction, and the actions of the communication partner and female with Rett syndrome. RESULTS The majority (82.8%, 53/64) of females made a choice, most using eye gaze. Just under half (24/53) used one modality to communicate their choice, 52.8% used two modalities and one used three modalities. Of those who made a choice, 50% did so within 8 s. The length of time to make a choice did not appear to vary with age. During choice making, 57.8% (37/64) of communication partners used language and gestures, 39.1% (25/64) used only language and two used language, gestures and symbols within the interaction. CONCLUSIONS The provision of adequate time allowing for a response and observation for the use of multiple modalities could promote effective choice making in females with Rett syndrome. Implications for Rehabilitation The provision of adequate time allowing for a response will promote effective choice making in girls and women with Rett syndrome. Although almost all girls and women with Rett syndrome used eye gaze to indicate their choice, communication partners also need to recognise and respond to other communication modalities that are sometimes used like body movements.
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Affiliation(s)
- Anna Urbanowicz
- a Telethon Kids Institute , The University of Western Australia , Subiaco , Australia.,b School of Medical and Health Sciences , Edith Cowan University , Joondalup , Australia.,c Queensland Centre for Intellectual & Developmental Disability , Mater Research Institute-UQ, The University of Queensland , Brisbane , Australia
| | - Natalie Ciccone
- b School of Medical and Health Sciences , Edith Cowan University , Joondalup , Australia
| | - Sonya Girdler
- d School of Occupational Therapy and Social Work , Curtin University , Perth , Australia
| | - Helen Leonard
- a Telethon Kids Institute , The University of Western Australia , Subiaco , Australia
| | - Jenny Downs
- a Telethon Kids Institute , The University of Western Australia , Subiaco , Australia.,e School of Physiotherapy and Exercise Science , Curtin University , Perth , Australia
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Townend GS, Marschik PB, Smeets E, van de Berg R, van den Berg M, Curfs LM. Eye Gaze Technology as a Form of Augmentative and Alternative Communication for Individuals with Rett Syndrome: Experiences of Families in The Netherlands. JOURNAL OF DEVELOPMENTAL AND PHYSICAL DISABILITIES 2015; 28:101-112. [PMID: 27069348 PMCID: PMC4785214 DOI: 10.1007/s10882-015-9455-z] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
This paper provides a brief report on families' experiences of eye gaze technology as one form of augmentative and alternative communication (AAC) for individuals with Rett syndrome (RTT), and the advice, training and support they receive in relation to this. An online survey exploring communication and AAC was circulated to 190 Dutch families; of the 67 questionnaires that were returned, 63 had answered questions relating to eye gaze technology. These 63 were analysed according to parameters including: experiences during trial periods and longer-term use; expert knowledge, advice and support; funding; communicative progress; and family satisfaction. 20 respondents were using or had previous experience of using an eye gaze system at the time of the survey, 28 of those with no prior experience wanted to try a system in the future. Following a trial period, 11 systems had been funded through health insurance for long-term use and two families had decided a system was not appropriate for them. Levels of support during trials and following long-term provision varied. Despite frustrations with the technology, satisfaction with the systems was higher than satisfaction with the support. The majority of families reported progress in their child's skills with longer term use. These findings suggest that although eye gaze technologies offer potential to individuals with RTT and their families, greater input from suppliers and knowledgeable AAC professionals is essential for individuals and families to benefit maximally. Higher levels of training and support should be part of the 'package' when an eye gaze system is provided.
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Affiliation(s)
- Gillian S. Townend
- />Rett Expertise Centre – Governor Kremers Centre, Maastricht University Medical Centre, PO Box 616, 6200 MD Maastricht, The Netherlands
| | - Peter B. Marschik
- />Institute of Physiology, Research Unit iDN – Interdisciplinary Developmental Neuroscience, Medical University of Graz, Graz, Austria
- />Center of Neurodevelopmental Disorders (KIND), Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
| | - Eric Smeets
- />Rett Expertise Centre – Governor Kremers Centre, Maastricht University Medical Centre, PO Box 616, 6200 MD Maastricht, The Netherlands
| | - Raymond van de Berg
- />Rett Expertise Centre – Governor Kremers Centre, Maastricht University Medical Centre, PO Box 616, 6200 MD Maastricht, The Netherlands
- />Division of Balance Disorders, Department of Otorhinolaryngology and Head and Neck Surgery, Faculty of Health Medicine and Life Sciences, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
- />Faculty of Physics, Tomsk State University, Tomsk, Russian Federation
| | - Mariёlle van den Berg
- />Nederlandse Rett Syndroom Vereniging, Dutch Rett Syndrome Parent Association, Utrecht, The Netherlands
| | - Leopold M.G. Curfs
- />Rett Expertise Centre – Governor Kremers Centre, Maastricht University Medical Centre, PO Box 616, 6200 MD Maastricht, The Netherlands
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12
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Townend GS, Bartl-Pokorny KD, Sigafoos J, Curfs LMG, Bölte S, Poustka L, Einspieler C, Marschik PB. Comparing social reciprocity in preserved speech variant and typical Rett syndrome during the early years of life. RESEARCH IN DEVELOPMENTAL DISABILITIES 2015; 43-44:80-6. [PMID: 26159884 PMCID: PMC5951281 DOI: 10.1016/j.ridd.2015.06.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Revised: 06/10/2015] [Accepted: 06/18/2015] [Indexed: 05/27/2023]
Abstract
This study compared early markers of social reciprocity in children with typical Rett syndrome (RTT) and in those with the preserved speech variant (PSV) of RTT. Retrospective video analysis of 10 toddlers with typical RTT and five with PSV investigated participants' orientation to their name being called between the ages of 5 and 24 months, prior to their diagnosis. From analysis of the recordings two distinct profiles were apparent. Although response rate was higher in girls with typical RTT than PSV at 5 to 8 months this noticeably reversed from 9 to 12 months onwards. By two years of age there was a markedly higher rate and range of responses from girls with PSV. This study contributes to the delineation of different profiles for the variants of RTT.
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Affiliation(s)
- Gillian S Townend
- Rett Expertise Centre-GKC, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Katrin D Bartl-Pokorny
- Institute of Physiology, Research Unit iDN - interdisciplinary Developmental Neuroscience, Center for Physiological Medicine, Medical University of Graz, Graz, Austria
| | - Jeff Sigafoos
- School of Education, Victoria University of Wellington, Wellington, New Zealand
| | - Leopold M G Curfs
- Rett Expertise Centre-GKC, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Sven Bölte
- Center of Neurodevelopmental Disorders (KIND), Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Luise Poustka
- Department of Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany; Department of Child and Adolescent Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Christa Einspieler
- Institute of Physiology, Research Unit iDN - interdisciplinary Developmental Neuroscience, Center for Physiological Medicine, Medical University of Graz, Graz, Austria
| | - Peter B Marschik
- Institute of Physiology, Research Unit iDN - interdisciplinary Developmental Neuroscience, Center for Physiological Medicine, Medical University of Graz, Graz, Austria; Center of Neurodevelopmental Disorders (KIND), Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden; BEE-PRI: Brain, Ears & Eyes-Pattern Recognition Initiative, BioTechMed-Graz, Graz, Austria.
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13
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Quest KM, Byiers BJ, Payen A, Symons FJ. Rett syndrome: a preliminary analysis of stereotypy, stress, and negative affect. RESEARCH IN DEVELOPMENTAL DISABILITIES 2014; 35:1191-1197. [PMID: 24582142 DOI: 10.1016/j.ridd.2014.01.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2013] [Revised: 01/07/2014] [Accepted: 01/09/2014] [Indexed: 06/03/2023]
Abstract
Rett syndrome (RTT) is a neurodevelopmental disorder primarily affecting females. It is characterized by apparently normative development of motor and communicative abilities followed by deterioration in these domains. Stereotypic hand movements are one of the core diagnostic criteria for RTT. There is some anecdotal but limited scientific evidence that changes in hand stereotypy may be a sign of increased anxiety or arousal (i.e., a 'stress response') in RTT. Understanding stress responsivity is difficult in RTT because almost all individuals are nonverbal or otherwise severely communicatively impaired. This study used direct behavioral observation to quantify and compare the frequency of hand stereotypy and signs of negative affect during presumed periods of high and low stress associated with functional analysis conditions (negative reinforcement ['escape'] and control ['free play'], respectively) for 5 females with RTT (mean age=17.8; range 4-47). Negative affect was more likely to occur during negative reinforcement ('stress') conditions for each participant whereas hand stereotypies did not differ across conditions for any of the participants. Although preliminary, the results suggest that hand stereotypy may not be a valid behavioral 'stress-response' indicator in females with RTT. Alternatively, the approach we used may have been limited and not sufficient to evoke a stress response. Either way, more work with direct relevance to improving our understanding of hand stereotypy and anxiety in RTT in relation to social context appears warranted.
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Affiliation(s)
- Kelsey M Quest
- Department of Educational Psychology, University of Minnesota, United States.
| | - Breanne J Byiers
- Department of Educational Psychology, University of Minnesota, United States
| | - Ameante Payen
- Department of Educational Psychology, University of Minnesota, United States
| | - Frank J Symons
- Department of Educational Psychology, University of Minnesota, United States
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Didden R, Korzilius H, Smeets E, Green VA, Lang R, Lancioni GE, Curfs LM. Communication in Individuals with Rett Syndrome: an Assessment of Forms and Functions. JOURNAL OF DEVELOPMENTAL AND PHYSICAL DISABILITIES 2010; 22:105-118. [PMID: 20339577 PMCID: PMC2837828 DOI: 10.1007/s10882-009-9168-2] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
In the present study we assessed the forms and functions of prelinguistic communicative behaviors for 120 children and adults with Rett syndrome using the Inventory of Potential Communicative Acts (IPCA) (Sigafoos et al. Communication Disorders Quarterly 21:77-86, 2000a). Informants completed the IPCA and the results were analysed to provide a systematic inventory and objective description of the communicative forms and functions present in each individual's repertoire. Results show that respondents reported a wide variety of communicative forms and functions. By far most girls used prelinguistic communicative behaviors of which eye contact/gazing was the most common form. The most often endorsed communicative functions were social convention, commenting, answering, requesting and choice-making. Problematic topographies (e.g., self-injury, screaming, non-compliance) were being used for communicative purposes in 10 to 41% of the sample. Exploratory analyses revealed that several communicative forms and functions were related to living environment, presence/absence of epilepsy, and age. That is, higher percentages of girls who showed some forms/functions were found in those who lived at home, who had no epilepsy and who were relatively young.
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Affiliation(s)
- Robert Didden
- Behavioural Science Institute, Radboud University Nijmegen, P.O. Box 9104, 6500 HE Nijmegen, The Netherlands
| | - Hubert Korzilius
- Institute for Management Research, Radboud University Nijmegen, Nijmegen, The Netherlands
| | - Eric Smeets
- University of Maastricht, Maastricht, The Netherlands
| | | | - Russell Lang
- The Eli and Edythe L. Broad Asperger Research Center, University of California, Santa Barbara, CA USA
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15
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Monteiro CBDM, Graciani Z, Torriani C, Kok F. Caracterização das habilidades funcionais na síndrome de Rett. FISIOTERAPIA E PESQUISA 2009. [DOI: 10.1590/s1809-29502009000400010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
O objetivo deste estudo foi identificar as áreas de maior comprometimento nas habilidades funcionais na síndrome de Rett (SR). Foram avaliadas 64 pacientes que preenchiam os critérios para a forma clássica da doença, com idade entre 2 e 26 anos. Foi aplicado o Inventário de avaliação pediátrica de incapacidade (PEDI) que contém 197 itens nas áreas de autocuidado, mobilidade e função social. Dentre as 73 atividades da área de autocuidado, 52 (71,2%) não foram realizadas por qualquer paciente; na mobilidade, dentre as 59 atividades propostas, 8 (13,5%); e na área de função social, dentre as 65 atividades, 50 (76,9%) não foram realizadas por paciente alguma. O desempenho médio ajustado em escala de 0 a 100 para a área de autocuidado foi de 8,9/100, variando de 0 a 19; na área de mobilidade, foi de 30,2/100, variando de 1 a 44; e na de função social, 5,2/100, com variação de 0 a 14. Foi possível verificar fortes correlações entre a área de autocuidado e as de mobilidade e função social; no entanto, entre as áreas de mobilidade e função social não foi detectada correlação significativa. Infelizmente, devido à gravidade da síndrome, o menor comprometimento da mobilidade, comparado ao das áreas de autocuidado e função social, não traz vantagens adaptativas ou maior independência às pacientes com SR.
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