1
|
Andreassen M, Borgestig M, Hemmingsson H. The psychosocial impact of eye-gaze assistive technology on everyday life of children and adults. Ann Med 2024; 56:2318397. [PMID: 38442288 PMCID: PMC10916903 DOI: 10.1080/07853890.2024.2318397] [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] [Received: 12/07/2023] [Accepted: 02/08/2024] [Indexed: 03/07/2024] Open
Abstract
PURPOSE This study investigates the psychosocial impact of eye-gaze assistive technology (EGAT) in both children and adults with long-term experience using eye-gaze assistive technology in everyday life, as well as the psychosocial impact as related to duration of use. METHODS In this descriptive comparative study, 34 adult and 27 child EGAT users participated in a structured individual interview using the Psychosocial Impact of Assistive Devices Scale (PIADS). RESULTS The participants' age ranged from 5-74 years, 50% were female and 52% had been diagnosed with cerebral palsy. The EGAT had a positive psychosocial impact on competence, adaptability, and self-esteem among adult and child users. Competence was the only subscale with a higher value for adults (p = 0.038), compared to children. The items with the highest impact for the psychosocial aspects were quality of life, ability to participate, and self-esteem. The adults had longer duration of use than children, but for high-, medium-, and low-duration users, the device showed a positive psychosocial impact. CONCLUSIONS Participants considered EGAT to have high positive impacts for participation and quality of life. The study adds new knowledge in that high positive psychosocial impact may be found even among low-duration users of EGAT, which is important to consider for service providers.
Collapse
Affiliation(s)
- Maria Andreassen
- Department of Health, Medicine and Caring Sciences, Linköping University, Norrköping, Sweden
| | - Maria Borgestig
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Helena Hemmingsson
- Department of Special Education, Stockholm University, Stockholm, Sweden
| |
Collapse
|
2
|
Piekema L, Ten Brug A, Waninge A, van der Putten A. From assistive to inclusive? A systematic review of the uses and effects of technology to support people with pervasive support needs. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2024; 37:e13181. [PMID: 38369310 DOI: 10.1111/jar.13181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 10/27/2023] [Accepted: 11/15/2023] [Indexed: 02/20/2024]
Abstract
BACKGROUND Although particular technologies can enhance the quality of life (QoL) of people with profound intellectual and multiple disabilities (we use the term pervasive support needs), their objectives and outcomes are understudied. A systematic literature review was therefore conducted to explore this topic. METHOD A search of four databases yielded 64 studies. Data were extracted on their general characteristics, methods and sample characteristics as well as the technology types, QoL domains and application within ecological systems. A narrative synthesis was subsequently developed. RESULTS Most of the studies applied assistive technology (AT) and focused on personal development and self-determination on an individual level. CONCLUSIONS Technology can enhance the QoL of people with pervasive support needs. There are indications that although MT and UD-based technology are used in practice, few studies have examined these technologies. Therefore, there is a knowledge gap regarding the kinds of technology that are used in practice.
Collapse
Affiliation(s)
- Lotte Piekema
- Department of Inclusive and Special Needs Education, University of Groningen, Groningen, The Netherlands
| | - Annet Ten Brug
- Department of Inclusive and Special Needs Education, University of Groningen, Groningen, The Netherlands
| | - Aly Waninge
- Hanze University of Applied Sciences Groningen, Research Group Healthy Ageing, Allied Health Care and Nursing, Groningen, The Netherlands
- Health Psychology Research, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Annette van der Putten
- Department of Inclusive and Special Needs Education, University of Groningen, Groningen, The Netherlands
| |
Collapse
|
3
|
Neul JL, Percy AK, Benke TA, Berry-Kravis EM, Glaze DG, Peters SU, Marsh ED, An D, Bishop KM, Youakim JM. Trofinetide Treatment Demonstrates a Benefit Over Placebo for the Ability to Communicate in Rett Syndrome. Pediatr Neurol 2024; 152:63-72. [PMID: 38232652 DOI: 10.1016/j.pediatrneurol.2023.11.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 10/27/2023] [Accepted: 11/18/2023] [Indexed: 01/19/2024]
Abstract
BACKGROUND Trofinetide was approved by the US Food and Drug Administration for the treatment of Rett syndrome (RTT) in March 2023. Benefiting the ability to communicate in RTT is often identified as the most important caregiver goal for new therapies. This analysis reports the communication-related end points from the phase 3 LAVENDER study of trofinetide in RTT. METHODS Females with RTT, aged five to 20 years, were randomized 1:1 to trofinetide or placebo for 12 weeks. Secondary efficacy end points related to communication were based on change from baseline to week 12 and included the caregiver-rated Communication and Symbolic Behavior Scales Developmental Profile™ Infant-Toddler Checklist (CSBS-DP-IT) Social Composite score (key secondary end point; scores ranged from 0 to 26 [higher scores indicated better communication]) and novel clinician rating scales (0 [normal] to 7 [severe impairment]) measuring the ability to communicate choices nonverbally (RTT-COMC) and verbally (RTT-VCOM). RESULTS Trofinetide demonstrated a statistically significant difference versus placebo for the CSBS-DP-IT Social Composite score (least squares mean [LSM] difference = 1.0; 95% confidence interval [CI], 0.3 to 1.7; P = 0.0064; Cohen's d effect size = 0.43) and a nominally significant difference for the RTT-COMC (LSM difference: -0.3; 95% CI, -0.6 to -0.0; P = 0.0257; Cohen's d effect size = 0.36). As expected, there was no difference for the RTT-VCOM. CONCLUSIONS Significant treatment benefit for trofinetide versus placebo was observed in scales measuring the ability to communicate. These scales may be appropriate for future clinical studies in RTT and other neurodevelopmental disorders.
Collapse
Affiliation(s)
- Jeffrey L Neul
- Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Alan K Percy
- University of Alabama at Birmingham, Birmingham, Alabama
| | - Timothy A Benke
- Children's Hospital of Colorado, University of Colorado School of Medicine, Aurora, Colorado
| | | | - Daniel G Glaze
- Texas Children's Hospital, Baylor College of Medicine, Houston, Texas
| | - Sarika U Peters
- Vanderbilt Kennedy Center, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Eric D Marsh
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Di An
- Acadia Pharmaceuticals Inc, San Diego, California
| | | | | |
Collapse
|
4
|
Hsieh YH, Granlund M, Odom SL, Hwang AW, Hemmingsson H. Increasing participation in computer activities using eye-gaze assistive technology for children with complex needs. Disabil Rehabil Assist Technol 2024; 19:492-505. [PMID: 35861506 DOI: 10.1080/17483107.2022.2099988] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Accepted: 07/05/2022] [Indexed: 10/17/2022]
Abstract
PURPOSE Eye-gaze assistive technology offers children with severe motor and communication difficulties the opportunity to access and control a computer through eye movements. The aim of this study was to examine the impact of eye-gaze assistive technology intervention on participation in computer activities and technology usability among children with complex needs in Taiwan. MATERIALS AND METHODS This study involved a multiple baseline design across individuals. The participants were four children aged three to six years with severe motor and communication difficulties and low eye-control skills. The six-month intervention consisted of two collaborative team meetings and 12 individual supports to facilitate the use of eye-gaze assistive technology at home or in educational environments. Participation in computer activities (diversity, frequency, and duration) was repeatedly measured through a computer use diary. Other outcomes included assessments of goal achievements and parents/teachers' ratings on children's performance in computer activities. RESULTS The young children increased the diversity of their computer activities and their frequency and duration of computer use from baseline to the intervention phase. The children attained six of eight predefined goals related to play, communication, and school learning. Parents and teachers perceived the children's changes in performance as meaningful. CONCLUSION This study strengthens the evidence that eye-gaze assistive technology is useful in everyday contexts for children with complex needs in Taiwan. The findings add knowledge that children with weak eye-control skills increased participation in computer activities as a result of the eye-gaze assistive technology. Implications for RehabilitationEye-gaze assistive technology (EGAT) as an access method to control a computer can provide opportunities for children with severe motor and communication difficulties to participate in computer activities.Children with severe motor and communication difficulties and low eye-control skills with sufficient practice can learn to use EGAT for communication and learning, with support from stakeholders and collaborative service.EGAT could be introduced for children with complex needs at early ages as a means of using computers for play, communication, and school learning, which could be helpful for later education and learning.Stakeholders in educational environments could include EGAT in educational computer systems so that pupils with severe motor and communication difficulties could interact with a computer, thereby enhancing their engagement and learning.
Collapse
Affiliation(s)
- Yu-Hsin Hsieh
- Department of Special Education, Stockholm University, Stockholm, Sweden
| | - Mats Granlund
- CHILD, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Samuel L Odom
- Frank Porter Graham Child Development Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Ai-Wen Hwang
- Graduate Institute of Early Intervention, College of Medicine, Chang-Gung University, Tao-Yuan City, Taiwan
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Linkou, Tao-Yuan City, Taiwan
| | - Helena Hemmingsson
- Department of Special Education, Stockholm University, Stockholm, Sweden
| |
Collapse
|
5
|
Kolb RL, McComas JJ, Girtler SN, Simacek J, Dimian AF, Unholz-Bowden EK, Shipchandler AH. Teaching Requesting to Individuals with Rett Syndrome Using Alternative Augmentative Communication (AAC) Through Caregiver Coaching via Telehealth. JOURNAL OF DEVELOPMENTAL AND PHYSICAL DISABILITIES 2023; 35:1063-1090. [PMID: 38053943 PMCID: PMC10697698 DOI: 10.1007/s10882-023-09894-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/25/2023] [Indexed: 12/07/2023]
Abstract
Rett syndrome is a severe neurodevelopmental disorder that results in both motor and language skill regression with a wide range of severity in symptom presentation. Communication intervention may be particularly challenging for this population due to the decline in speech, motor skills, and motor planning difficulties that characterize the disorder (Townend et al., 2020), often resulting in the need for augmentative and alternative communication (AAC) technology. Very limited research has evaluated communication interventions for individuals with Rett syndrome and even fewer have targeted expressive communication, an important skill required for improved autonomy and quality of life (Sigafoos et al., 2009; Townend et al., 2020). The current study sought to systematically replicate the Simacek et al. (2017) mand training procedures to teach three girls with Rett Syndrome to use AAC to make requests through caregiver coaching by researchers via telehealth. Results suggest that mand training was successful in increasing AAC use for all three participants. Barriers to intervention for this population and implications of results for future research and clinical practice are discussed.
Collapse
Affiliation(s)
- Rebecca L. Kolb
- Department of Educational Psychology, The University of Minnesota, 56 River Rd E., Minneapolis, MN 55414, USA
| | - Jennifer J. McComas
- Department of Educational Psychology, The University of Minnesota, 56 River Rd E., Minneapolis, MN 55414, USA
| | - Shawn N. Girtler
- Department of Educational Psychology, The University of Minnesota, 56 River Rd E., Minneapolis, MN 55414, USA
| | - Jessica Simacek
- Institute on Community Integration, University of Minnesota, 2025 E River Pkwy, Minneapolis, MN 55414, USA
| | - Adele F. Dimian
- Institute on Community Integration, University of Minnesota, 2025 E River Pkwy, Minneapolis, MN 55414, USA
| | - Emily K. Unholz-Bowden
- Department of Educational Psychology, The University of Minnesota, 56 River Rd E., Minneapolis, MN 55414, USA
| | - Alefyah H. Shipchandler
- Department of Educational Psychology, The University of Minnesota, 56 River Rd E., Minneapolis, MN 55414, USA
| |
Collapse
|
6
|
Sigafoos J, Roche L, O'Reilly MF, Lancioni GE, Marschik PB. Updated systematic-narrative review on communication intervention in Rett Syndrome: 2010-2022. Augment Altern Commun 2023; 39:241-255. [PMID: 37526342 DOI: 10.1080/07434618.2023.2215864] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 04/27/2023] [Accepted: 05/08/2023] [Indexed: 08/02/2023] Open
Abstract
Due to loss of spoken language and resulting complex communication needs, people with Rett syndrome are obvious candidates for communication intervention. To advance evidence-based practice and guide future research efforts, we identified and summarized 16 communication intervention studies published since a previous 2009 review on this topic. Studies were summarized in terms of (a) participants, (b) dependent variables related to communication, (c) intervention characteristics, (d) outcomes, and (e) certainty of evidence. Across the 16 studies, intervention was provided to a total of 100 participants from 3 to 47 years of age. Half of the studies used systematic instruction to teach aided AAC. Other interventions and associated technologies included music therapy, eye tracking technology, and transcranial stimulation. Positive outcomes (e.g., using AAC devices to make requests and/or initiate social-communication interactions) were reported in 13 of the studies. These 16 new studies provide additional guidance on how to enhance the communicative functioning of people with Rett syndrome. Future research directions are highlighted.
Collapse
Affiliation(s)
- Jeff Sigafoos
- School of Education, Victoria University of Wellington, Wellington, New Zealand
| | - Laura Roche
- School of Education, The University of Newcastle, Callaghan, Australia
| | - Mark F O'Reilly
- Department of Special Education, The University of Texas at Austin, Austin, TX, USA
| | - Giulio E Lancioni
- Department of Neuroscience and Sense Organs, University of Bari, Bari, Italy
| | - Peter B Marschik
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen and Leibniz Science Campus Primate Cognition, Gottingen, Germany
- Division of Phoniatrics, 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
| |
Collapse
|
7
|
A Scoping Review of Eye Tracking Technology for Communication: Current Progress and Next Steps. CURRENT DEVELOPMENTAL DISORDERS REPORTS 2023. [DOI: 10.1007/s40474-023-00271-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
|
8
|
Wandin H, Lindberg P, Sonnander K. A trained communication partner’s use of responsive strategies in aided communication with three adults with Rett syndrome: A case report. Front Psychol 2022; 13:989319. [PMID: 36248576 PMCID: PMC9559184 DOI: 10.3389/fpsyg.2022.989319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 09/09/2022] [Indexed: 11/13/2022] Open
Abstract
PurposeTo explore and describe a trained communication partner’s use of responsive strategies in dyadic interaction with adults with Rett syndrome.IntroductionResponsive partner strategies facilitate social, communicative, and linguistic development. The common feature is that the communication partner responds contingently to the other’s focus of attention and interprets their acts as communicative. Research on responsive partner strategies that involves individuals with significant communication and motor disabilities remains sparse. The same applies to if, and how, the use of communication aids impacts on the partner’s use of responsive strategies.Materials and methodsA therapist, trained in responsive partner strategies and aided communication interacted during 14 sessions with each of three participants. The participants were adults with Rett syndrome. A gaze-controlled device and responsive strategies were used during all sessions. The Responsive Augmentative and Alternative Communication Style scale (RAACS) was used to assess the partner’s responsiveness. RAACS consists of 11 items including ratings of to what extent the partner is being attentive to, confirms, and expands the individual’s communication. During eight of the 14 sessions, aided AAC Modelling was also used, i.e., the communication partner pointed at symbols on the gaze-controlled device while interacting. In addition to RAACS, each time the communication partner confirmed or expanded on communication when (a) the participants used the gaze-controlled device and (b) the participants did not use the gaze-controlled device was counted. Descriptive statistics were used to present the results. Non-parametric tests were used to compare means between the two conditions and between participants.ResultsInter-rater agreement for the different RAACS items ranged from 0.73 to 0.96 and was thus found to be fair to excellent. The communication partner’s use of responsive strategies varied when communicating with different participants and the scores were higher when aided AAC modeling was used. The communication partner’s number of responses and use of responsive strategies were higher when the participants communicated through a gaze-controlled device.ConclusionThe communication partner’s use of responsive and scaffolding strategies is not a fixed construct but varies in interactions with different non-speaking persons. The same is true whether the non-speaking person uses a gaze-controlled device with digitized speech or not.
Collapse
Affiliation(s)
- Helena Wandin
- Disability and Habilitation, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
- National Center for Rett Syndrome and Related Disorders, Frösön, Sweden
- *Correspondence: Helena Wandin,
| | - Per Lindberg
- Clinical Psychology, Department of Psychology, Uppsala University, Uppsala, Sweden
| | - Karin Sonnander
- Disability and Habilitation, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| |
Collapse
|