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Rensfeld Flink A, Thunberg G, Nyman A, Broberg M, Åsberg Johnels J. Augmentative and alternative communication with children with severe/profound intellectual and multiple disabilities: speech language pathologists' clinical practices and reasoning. Disabil Rehabil Assist Technol 2024; 19:962-974. [PMID: 36327995 DOI: 10.1080/17483107.2022.2137252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 10/07/2022] [Accepted: 10/12/2022] [Indexed: 11/06/2022]
Abstract
PURPOSE Augmentative and alternative communication (AAC) is recommended to be included in communication interventions directed at children/youth with severe/profound intellectual and multiple disabilities (S/PIMD). Even so, the evidence base for AAC practices with children with S/PIMD is limited. Also, little is known about how frequently AAC is implemented with this target group, which AAC tools and methods are applied, and the related clinical reasoning of speech-language pathologists (SLPs). This study aimed to explore SLPs' beliefs, clinical reasoning and practices in relation to AAC implementation with children/youth with S/PIMD. MATERIALS AND METHODS In this sequential, mixed-methods study, 90 SLPs working with children with disabilities within habilitation services in Sweden participated in an online survey. The survey answers were statistically analysed. Subsequently, focus group data were collected from seven SLPs and analysed using thematic analysis. RESULTS AND CONCLUSIONS Despite AAC being highly prioritized, SLPs found it challenging and complex to implement with this target group. A wide variety of AAC methods and tools were considered and implemented. Clinical decision-making was a balancing act between competing considerations and was mainly guided by the SLPs' individual, clinical experiences. The resources, engagement and wishes of the social network surrounding the child were considered crucial for clinical decision-making on AAC. Implications for research and practice are discussed.Implications for rehabilitationSpeech-language pathologists (SLPs) seemingly find a wide variety of Augmentative and Alternative Communication (AAC), ranging from unaided methods to assistive technology of various complexity, to be potentially suitable for children/youth with severe/profound intellectual and multiple disabilities (S/PIMD).The motivation and preferences of the social network surrounding the child with S/PIMD seem to influence SLPs' clinical decision-making on AAC to a high degree. Sometimes this may be considered an even more important factor than the abilities of the child.SLPs' clinical decision-making on AAC for children/youth is guided by their individual, clinical experience to a high degree.An increase in family oriented AAC intervention research targeting individuals with S/PIMD could potentially strengthen the association between research and the current, experience-based clinical practice.
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Affiliation(s)
- Anna Rensfeld Flink
- Speech and Language Pathology Unit, Department of Health and Rehabilitation, University of Gothenburg, Gothenburg, Sweden
- Habilitation & Health, Region Västra Götaland, Vänersborg, Sweden
| | - Gunilla Thunberg
- Speech and Language Pathology Unit, Department of Health and Rehabilitation, University of Gothenburg, Gothenburg, Sweden
- DART Centre for AAC and AT, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Anna Nyman
- Division of Speech and Language Pathology, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- Habilitation & Health, Stockholm, Sweden
| | - Malin Broberg
- Department of Psychology, University of Gothenburg, Gothenburg, Sweden
| | - Jakob Åsberg Johnels
- Speech and Language Pathology Unit, Department of Health and Rehabilitation, University of Gothenburg, Gothenburg, Sweden
- Gillberg Neuropsychiatry Centre, University of Gothenburg, Gothenburg, Sweden
- Child Neuropsychiatric Clinic, Sahlgrenska University Hospital, Gothenburg, Sweden
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Ware J, Buell S, Chadwick DD, Bradshaw J, Goldbart J. A systematic review of research on staff training as an intervention to develop communication in children and adults with profound intellectual and multiple disabilities. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2024; 37:e13201. [PMID: 38332474 DOI: 10.1111/jar.13201] [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: 12/20/2022] [Revised: 12/15/2023] [Accepted: 12/19/2023] [Indexed: 02/10/2024]
Abstract
INTRODUCTION This paper aims to identify to what extent staff training interventions are successful in enhancing the development of communication skills in people with profound intellectual and multiple disabilities. METHODS A systematic review was undertaken, conforming to PRISMA guidelines. English language, peer reviewed, empirical studies of staff training interventions to enhance the communication of people with profound intellectual and multiple disabilities were included. Databases Scopus, Web of Science, Proquest, Linguistics and Language Behaviour Abstracts (LLBA) and Medline were searched in July 2015 and updated in December 2022. Quality appraisal was conducted on 13 studies using Crowe's Critical Appraisal Tool (CCAT). RESULTS Few good quality evaluations of interventions were found. Challenges to research rigour included the diversity of people with profound intellectual and multiple disabilities, small sample sizes, intervention intensity and the management of fidelity. CONCLUSIONS Manualised and bespoke interventions showed promise in improving staff communication and responsiveness.
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Affiliation(s)
- Jean Ware
- School of Educational Sciences, Bangor University, Bangor, Wales
| | - Susan Buell
- School of Health Sciences, University of Dundee, Dundee, Scotland
| | - Darren D Chadwick
- School of Psychology, Liverpool John Moores University, Liverpool, England
| | - Jill Bradshaw
- Tizard Centre, University of Kent, Canterbury, England
| | - Juliet Goldbart
- Department of Psychology, Manchester Metropolitan University, Manchester, England
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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.
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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
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Bos GF, van Wingerden E, Sterkenburg PS. The effectiveness of the use of a technology toolkit on activities and mother-child interactions: children with complex care needs. Disabil Rehabil Assist Technol 2023:1-12. [PMID: 38112320 DOI: 10.1080/17483107.2023.2293870] [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: 06/28/2023] [Accepted: 12/06/2023] [Indexed: 12/21/2023]
Abstract
PURPOSE Meaningful interactions with significant others are crucial for children's well-being, including those with severe to profound intellectual and multiple disabilities. This study aimed to gain more insight into the potential of an ICT-Toolkit in enhancing or contributing to the interaction between parents and their children with complex care needs. METHODS A multiple case study with an AB experimental design was conducted. Four mother-child dyads were observed during eight two-and-a-half-hour home visits. Children between 6 and 16 years with severe to profound intellectual and multiple disabilities were included. A participatory research observation approach was used. RESULTS Using the ICT-Toolkit compared to the baseline phase stimulated a decrease in the repetitive activities of two of the four dyads. Overall, the activity repertoire of the children and the length of time being engaged in individual activities increased, and the activities together increased in three of the dyads. There were more turn-taking interactions; the children took more initiative to engage their mother in their activity, and the children exhibited more affection when engaging with the ICT-Toolkit items. Three mothers followed their children more in their play, and all mothers were more verbally and physically active in instructing and/or motivating their children. DISCUSSION All mothers noticed their child's "new" behaviour when interacting with an ICT-Toolkit item. The mothers followed the child's lead when engaged with the ICT-Toolkit. The ICT-Toolkit's added effect may be due to the predictability, uncomplicated and highly perceivable stimuli it provides with minimal effort and maximum effect.
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Affiliation(s)
- G F Bos
- Department of Care Ethics, University of Humanistic Studies, Utrecht, Netherlands
| | - E van Wingerden
- Clinical Child and Family Studies and Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, Netherlands
- Department of Assessment and Treatment, Bartiméus, Netherlands
| | - P S Sterkenburg
- Clinical Child and Family Studies and Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, Netherlands
- Department of Assessment and Treatment, Bartiméus, Netherlands
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Hsieh YH, Granlund M, Hwang AW, Hemmingsson H. Feasibility of an eye-gaze technology intervention for students with severe motor and communication difficulties in Taiwan. Augment Altern Commun 2023:1-12. [PMID: 38085526 DOI: 10.1080/07434618.2023.2288837] [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: 02/24/2023] [Accepted: 10/24/2023] [Indexed: 12/19/2023] Open
Abstract
Eye-gaze technology provides access to a computer through the control of eye movements, thus allowing students with severe motor and communication difficulties to communicate and participate in curriculum activities and leisure; however, few studies have investigated whether any challenges exist to its implementation. This study examines the feasibility for teachers, parents, and therapists of applying an eye-gaze technology intervention for students with severe motor and communication difficulties in everyday settings. A mixed-method design was applied, focusing on the acceptability, demands, implementation, and practicality of the technology applications. Data was collected from 16 participants who assisted five students using eye-gaze technology in a previous 6-month intervention. The intervention comprised (a) use of eye-gaze devices with individualized content; and (b) services including training in use, team meetings, and bi-monthly support on implementation problems. The results showed that the participants perceived the technology as appropriate to enhance interaction and understanding of the students' learning and communication messages. Portable and easy-to-adjust systems were crucial to apply eye-gaze technology in different contexts. Improving eye-gaze services was required to afford in-service education, follow-up services, and loaning programs for sustainable implementation. The facilitators and barriers could guide researchers and practitioners to enhance the implementation of eye-gaze technology.
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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
| | - 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, Kwei-Shan, Tao-Yuan City, Taiwan
| | - Helena Hemmingsson
- Department of Special Education, Stockholm University, Stockholm, Sweden
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Vandesande S, Bosmans G, Sterkenburg P, Schuengel C, Maes B. Piloting attachment psychoeducation provided to parents of children with severe disabilities: Testing the feasibility of a digital micro-intervention. JOURNAL OF INTELLECTUAL DISABILITIES : JOID 2023; 27:433-450. [PMID: 35465752 DOI: 10.1177/17446295221087564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
BackgroundA digital micro-intervention offering attachment psychoeducational videos was explored regarding its feasibility in parents of children with severe disabilities. Method: A mixed-methods study (including daily diaries and one-time questionnaires) with 16 parents (75.0% female) of children with severe disabilities (up to 10 years of age) was done during a three-week intervention. Results: Parents were positive about the video series and almost no drop-out occurred. The videos stimulated their learning and thinking and offered parents some personal meaning. Preliminary efficacy tests showed no major changes in parents' parenting self-efficacy (PSE) or perceptions of statements on parent-child attachment. Conclusions: The study showed promising results regarding the micro-interventions' acceptability and implementation. The limited efficacy testing did not show major changes in parents' PSE. Further research is needed to investigate the differential relevance of the micro-intervention, based on parents' needs, as well as its optimal embeddedness in a broader intervention trajectory.
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Affiliation(s)
- Sien Vandesande
- Department of Special Education and Parenting, KU Leuven, Belgium
| | - Guy Bosmans
- Department of Clinical Psychology, KU Leuven, Belgium
| | - Paula Sterkenburg
- Department of Clinical Child and Family Studies, Vrije Universiteit Amsterdam, The Netherlands
| | - Carlo Schuengel
- Department of Clinical Child and Family Studies, Vrije Universiteit Amsterdam, The Netherlands
| | - Bea Maes
- Department of Special Education and Parenting, KU Leuven, Belgium
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Goldbart J. Communication as a human right for children with profound intellectual disabilities. Dev Med Child Neurol 2023; 65:725-726. [PMID: 37157223 DOI: 10.1111/dmcn.15564] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 02/15/2023] [Indexed: 05/10/2023]
Affiliation(s)
- Juliet Goldbart
- Paul Polani Annual Lecturer 2023, British Academy of Childhood Disability (BACD)
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Dhondt A, Van Keer I, van der Putten A, Maes B. Changes in the early communicative behaviors of young children with significant cognitive and motor developmental delays in a two-year span. JOURNAL OF COMMUNICATION DISORDERS 2023; 104:106337. [PMID: 37253298 DOI: 10.1016/j.jcomdis.2023.106337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 05/09/2023] [Accepted: 05/09/2023] [Indexed: 06/01/2023]
Abstract
INTRODUCTION This study examines longitudinal changes in communicative behavior of young children with significant cognitive and motor developmental delays (SDD) and determines their individual communicative trajectories. A second focus of this study is the relation of changes in communicative behavior with motor skills. METHODS Data consists of codes resulting from a self-developed coding scheme used on observations of 23 children in three different settings and responses on a questionnaire. First, group trends were determined to find out whether communication-related variables tend to significantly change over the course of two years. Furthermore, these findings were contrasted with the individual trajectories of the children. Next, the association of initial communicative skills and (the acquisition of) specific motor skills with the change in their communicative functioning was studied. Wilcoxon Signed Ranks and correlational analyses were used to answer the research questions. RESULTS Out of sixteen different variables related to communicative behavior, ten changed significantly over the course of two years. Children with more focus on prompt on the first datapoint showed a significantly larger increase of signs of functionality. Still, all children showed highly individual trajectories. Children with better motor skills on the first datapoint showed a significantly larger increase in communication rate. CONCLUSIONS Results show that if a myriad of detailed variables are taken into account children with significant cognitive and motor developmental disabilities do change regarding their communicative functioning, but that they tend to all show unique developmental trajectories. Children with stronger skills in some aspects of communication and motor functioning, can be considered advantaged regarding their communicative development.
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Affiliation(s)
- Ann Dhondt
- Faculty of Psychological and Educational Sciences, Parenting and Special Education Research Unit, Catholic University of Leuven, Belgium.
| | - Ines Van Keer
- Faculty of Psychological and Educational Sciences, Parenting and Special Education Research Unit, Catholic University of Leuven, Belgium
| | | | - Bea Maes
- Faculty of Psychological and Educational Sciences, Parenting and Special Education Research Unit, Catholic University of Leuven, Belgium
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Dhondt A, Van keer I, Ceulemans E, van der Putten A, Maes B. Describing the communicative profiles of young children with a significant cognitive and motor developmental delay. Augment Altern Commun 2022:1-12. [DOI: 10.1080/07434618.2022.2138780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Affiliation(s)
- Ann Dhondt
- Faculty of Psychological and Educational Sciences, Catholic University of Leuven, Leuven, Belgium
| | - Ines Van keer
- Faculty of Psychological and Educational Sciences, Catholic University of Leuven, Leuven, Belgium
| | - Eva Ceulemans
- Faculty of Psychological and Educational Sciences, Catholic University of Leuven, Leuven, Belgium
| | - Annette van der Putten
- Faculty of Behavioral and Social Sciences, University of Groningen, Groningen, The Netherlands
| | - Bea Maes
- Faculty of Psychological and Educational Sciences, Catholic University of Leuven, Leuven, Belgium
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Penninga W, Nijs SLP, van Bakel HJA, Embregts PJCM. Meaningful moments of interaction with people with profound intellectual disabilities: Reflections from direct support staff. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2022; 35:1307-1316. [PMID: 35726014 PMCID: PMC9796127 DOI: 10.1111/jar.13019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 04/28/2022] [Accepted: 05/29/2022] [Indexed: 01/01/2023]
Abstract
BACKGROUND High-quality, affective relationships are built on meaningful moments of interaction, which are challenging for support staff to establish with people with profound intellectual disabilities. Therefore, we explored what makes a moment of interaction meaningful to support staff and what circumstances facilitate meaningful moments of interaction taking place. METHOD Five direct support staff took part in unstructured, in-depth interviews. The interviews were analysed using interpretative phenomenological analysis (IPA). Member checks were also conducted. RESULTS Support staff experienced moments of interaction as meaningful because they felt a connection with a person with profound intellectual disabilities and/or they had the feeling of being meaningful for this person. Staff-related and contextual circumstances facilitating meaningful moments of interaction to take place were described. CONCLUSIONS Meaningful moments of interaction are highly valued by support staff, who believe these moments are valued by persons with profound intellectual disabilities as well. Implications for daily practice are described.
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Affiliation(s)
- Wieneke Penninga
- Tranzo, Tilburg School of Social and Behavioral SciencesTilburg UniversityTilburgThe Netherlands,AmerpoortBaarnThe Netherlands
| | - Sara L. P. Nijs
- Tranzo, Tilburg School of Social and Behavioral SciencesTilburg UniversityTilburgThe Netherlands
| | - Hedwig J. A. van Bakel
- Tranzo, Tilburg School of Social and Behavioral SciencesTilburg UniversityTilburgThe Netherlands
| | - Petri J. C. M. Embregts
- Tranzo, Tilburg School of Social and Behavioral SciencesTilburg UniversityTilburgThe Netherlands
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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.
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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
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Suttora C, Guarini A, Zuccarini M, Aceti A, Corvaglia L, Sansavini A. Integrating Gestures and Words to Communicate in Full-Term and Low-Risk Preterm Late Talkers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19073918. [PMID: 35409598 PMCID: PMC8997750 DOI: 10.3390/ijerph19073918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 03/10/2022] [Accepted: 03/10/2022] [Indexed: 01/27/2023]
Abstract
Young children use gestures to practice communicative functions that foster their receptive and expressive linguistic skills. Studies investigating the use of gestures by late talkers are limited. This study aimed to investigate the use of gestures and gesture–word combinations and their associations with word comprehension and word and sentence production in late talkers. A further purpose was to examine whether a set of individual and environmental factors accounted for interindividual differences in late talkers’ gesture and gesture–word production. Sixty-one late talkers, including 35 full-term and 26 low-risk preterm children, participated in the study. Parents filled out the Italian short forms of the MacArthur–Bates Communicative Development Inventories (MB–CDI), “Gesture and Words” and “Words and Sentences” when their children were 30-months-old, and they were then invited to participate in a book-sharing session with their child. Children’s gestures and words produced during the book-sharing session were transcribed and coded into CHAT of CHILDES and analyzed with CLAN. Types of spontaneous gestures (pointing and representational gestures) and gesture–word combinations (complementary, equivalent, and supplementary) were coded. Measures of word tokens and MLU were also computed. Correlational analyses documented that children’s use of gesture–word combinations, particularly complementary and supplementary forms, in the book-sharing session was positively associated with linguistic skills both observed during the session (word tokens and MLU) and reported by parents (word comprehension, word production, and sentence production at the MB–CDI). Concerning individual factors, male gender was negatively associated with gesture and gesture–word use, as well as with MB–CDI action/gesture production. In contrast, having a low-risk preterm condition and being later-born were positively associated with the use of gestures and pointing gestures, and having a family history of language and/or learning disorders was positively associated with the use of representational gestures. Furthermore, a low-risk preterm status and a higher cognitive score were positively associated with gesture–word combinations, particularly complementary and supplementary types. With regard to environmental factors, older parental age was negatively associated with late talkers’ use of gestures and pointing gestures. Interindividual differences in late talkers’ gesture and gesture–word production were thus related to several intertwined individual and environmental factors. Among late talkers, use of gestures and gesture–word combinations represents a point of strength promoting receptive and expressive language acquisition.
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Affiliation(s)
- Chiara Suttora
- Department of Psychology "Renzo Canestrari", University of Bologna, 40126 Bologna, Italy
| | - Annalisa Guarini
- Department of Psychology "Renzo Canestrari", University of Bologna, 40126 Bologna, Italy
| | - Mariagrazia Zuccarini
- Department of Educational Sciences, University of Bologna, Via Filippo Re 6, 40126 Bologna, Italy
| | - Arianna Aceti
- Neonatal Intensive Care Unit, IRCCS Azienda Ospedaliero-Universitaria Bologna, Via Massarenti 9, 40138 Bologna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Via Massarenti 9, 40138 Bologna, Italy
| | - Luigi Corvaglia
- Neonatal Intensive Care Unit, IRCCS Azienda Ospedaliero-Universitaria Bologna, Via Massarenti 9, 40138 Bologna, Italy
- Department of Medical and Surgical Sciences, University of Bologna, Via Massarenti 9, 40138 Bologna, Italy
| | - Alessandra Sansavini
- Department of Psychology "Renzo Canestrari", University of Bologna, 40126 Bologna, Italy
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Flink AR, Broberg M, Strid K, Thunberg G, Johnels JÅ. Following children with severe or profound intellectual and multiple disabilities and their mothers through a communication intervention: single-case mixed-methods findings. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2022; 69:869-887. [PMID: 37885841 PMCID: PMC10599180 DOI: 10.1080/20473869.2022.2031778] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 01/13/2022] [Indexed: 10/28/2023]
Abstract
There is limited research targeting communication interventions for children with severe/profound intellectual and multiple disabilities. This study addressed outcomes from a communication course for parents of children with severe/profound intellectual and multiple disabilities and follows up on a previous publication by Rensfeldt Flink et al. (2020). Potential observable changes in the children's and parents' communicative behavior were studied as well as the parents' experiences of the intervention process and the effect of the course on parent-child communication. A mixed-methods design with a case-study framework was used. Two mother-child dyads participated. Data were collected before, during, and after the course. Video-recorded repeated play interactions by the dyads were coded and analyzed for the mothers' responsivity and use of augmentative and alternative communication and the children's interactive engagement. Longitudinal interview data from the mothers were analyzed thematically. No clear signs of behavioral change were observed in the coded video data. However, thematic analyses showed that the mothers experienced changes to communicative behaviors. Moreover, the course affected both mothers' reasoning about communication with their child and their child's communicative needs. The mothers' narratives contributed insights into how reflective processes might guide action in parent-mediated communication interventions. The implications for research and clinical practice are discussed.
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Affiliation(s)
- Anna Rensfeldt Flink
- Speech Pathology Unit, Department of Health and Rehabilitation, University of Gothenburg
- Habilitation and Health, Region Västra Götaland, Vanersborg, Sweden
| | | | - Karin Strid
- Department of Psychology, University of Gothenburg
| | - Gunilla Thunberg
- Speech Pathology Unit, Department of Health and Rehabilitation, University of Gothenburg
- DART – Centre for AAC and Assistive Technology, Sahlgrenska University Hospital
| | - Jakob Åsberg Johnels
- Speech Pathology Unit, Department of Health and Rehabilitation, University of Gothenburg
- Gillberg Neuropsychiatry Centre, University of Gothenburg
- Child Neuropsychiatric Clinic, Sahlgrenska University Hospital, Gothenburg, Sweden
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14
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Variation in differential reactions to comfort by parents versus strangers in children with severe or profound intellectual disabilities: the role of parental sensitivity and motor competence. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-021-02501-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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15
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Van Keer I, Dhondt A, Van der Putten A, Maes B. Lessons learned: A critical reflection on child- and contextual variables related to the development of children with a significant cognitive and motor developmental delay. RESEARCH IN DEVELOPMENTAL DISABILITIES 2022; 120:104142. [PMID: 34875547 DOI: 10.1016/j.ridd.2021.104142] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 11/26/2021] [Accepted: 11/30/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND The scientific study of young children with a significant cognitive and motor developmental delay is challenging due to the children's complex disabilities and high demands on family life and professional support. We aim to critically reflect on the measurement and analysis of child- and contextual variables within an ongoing research project on these children's developmental trajectories. METHOD The OJKO-project tracked the development of a sample of children (n = 45) between the age of 6 months and 4 years with a significant cognitive and motor developmental delay, in Belgium and the Netherlands. RESULTS The complexity of the children's disabilities and daily life context, and subsequent challenges in measurement and analysis of variables, were confirmed and reflected upon. CONCLUSIONS Due to the uniqueness and complexity of this target group, research should be characterized by creativity, perseverance and substantial modesty in the immediate generalization of results.
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Affiliation(s)
- Ines Van Keer
- University of Leuven, Faculty of Psychology and Educational Sciences, Research Unit Parenting and Special Education, Leopold Vanderkelenstraat 32, box 3765, 3000 Leuven, Belgium.
| | - Ann Dhondt
- University of Leuven, Faculty of Psychology and Educational Sciences, Research Unit Parenting and Special Education, Leopold Vanderkelenstraat 32, box 3765, 3000 Leuven, Belgium
| | - Annette Van der Putten
- University of Groningen, Faculty of Behavioural and Social Sciences, Grote Rozenstraat 38, 9712 TJ Groningen, The Netherlands
| | - Bea Maes
- University of Leuven, Faculty of Psychology and Educational Sciences, Research Unit Parenting and Special Education, Leopold Vanderkelenstraat 32, box 3765, 3000 Leuven, Belgium
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Borgestig M, Al Khatib I, Masayko S, Hemmingsson H. The Impact of Eye-gaze Controlled Computer on Communication and Functional Independence in Children and Young People with Complex Needs - A Multicenter Intervention Study. Dev Neurorehabil 2021; 24:511-524. [PMID: 33872136 DOI: 10.1080/17518423.2021.1903603] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Children and young people with complex needs (severe motor impairments and without speech) have few opportunities to use alternative devices for communication. Eye-gaze controlled computers (EGCCs) might provide individuals with complex needs increased opportunities for communication and participation in society. OBJECTIVE To investigate the impact of EGCCs on communication, functional independence and participation in activities in children and young people with complex needs. METHODS A multicenter intervention study during seven months, measuring outcomes with or without EGCC at four time points, was conducted in Sweden, Dubai, and in USA. Seventeen participants (aged 3-26 years, diagnosis e.g. cerebral palsy, Rett syndrome) were provided with EGCC and services from an Assistive Technology center to implement EGCC in school and/or at home. RESULTS Participants significantly increased their expressive communication skills and functional independence with EGCC compared to baseline. All but one (16 of 17) increased their activity repertoire and computer use with EGCC. With EGCC, participation in computer activities averaged 4.1 performed activities (e.g. communication, play), with a duration of 70 minutes/day and a frequency of 76% of days. DISCUSSION The study strengthened the research evidence that EGCC can be an effective intervention in daily life for children and young people with complex needs. Communication and independence, common goals of intervention, were shown to be relevant EGCC outcomes.
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Affiliation(s)
- Maria Borgestig
- Department of Neuroscience, Uppsala University, Uppsala, Sweden
| | - Isphana Al Khatib
- Al Noor Training Centre for Persons with Disabilities, Dubai, United Arab Emirates
| | - Sandra Masayko
- Assistive Technology Department, Easterseals Southeastern Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Helena Hemmingsson
- Department of Special Education, Stockholm University, Stockholm, Sweden.,Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
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Dhondt A, Van Keer I, Nijs S, van der Putten A, Maes B. In search of a novel way to analyze early communicative behavior. Augment Altern Commun 2021; 37:87-101. [PMID: 34096819 DOI: 10.1080/07434618.2021.1928283] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
The aim of this study was to develop a coding scheme that enables researchers and practitioners to conduct a detailed analysis of the communicative behavior of young children with significant cognitive and motor developmental delays. Currently, there is a paucity of methods to do conduct such an analysis. For the study, video observations of three different scenarios from 38 children with significant cognitive and motor developmental delays aged between 12 and 54 months, were used. Findings from the video observations served as the primary means for development of the coding scheme, which comprises three main categories - context, partner behavior, and individual behavior - and several subcategories. The coding scheme was used to document the early expressive communicative behavior of persons with significant cognitive and motor developmental delays in a detailed manner. This fine-grained information is necessary to differentiate children based on their communicative abilities, to monitor their communicative development longitudinally, and to inform person-centered communicative interventions.
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Affiliation(s)
- Ann Dhondt
- Faculty of Psychological and Educational Sciences, Parenting and Special Education Research Unit, Catholic University of Leuven, Leuven, Belgium
| | - Ines Van Keer
- Faculty of Psychological and Educational Sciences, Parenting and Special Education Research Unit, Catholic University of Leuven, Leuven, Belgium
| | - Sara Nijs
- Faculty of Psychological and Educational Sciences, Parenting and Special Education Research Unit, Catholic University of Leuven, Leuven, Belgium
| | - Annette van der Putten
- Faculty of Behavioral and Social Sciences, University of Groningen, Groningen, Netherlands
| | - Bea Maes
- Faculty of Psychological and Educational Sciences, Parenting and Special Education Research Unit, Catholic University of Leuven, Leuven, Belgium
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Hsieh YH, Borgestig M, Gopalarao D, McGowan J, Granlund M, Hwang AW, Hemmingsson H. Communicative Interaction with and without Eye-Gaze Technology between Children and Youths with Complex Needs and Their Communication Partners. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18105134. [PMID: 34066169 PMCID: PMC8151590 DOI: 10.3390/ijerph18105134] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 05/04/2021] [Accepted: 05/05/2021] [Indexed: 11/23/2022]
Abstract
Use of eye-gaze assistive technology (EGAT) provides children/youths with severe motor and speech impairments communication opportunities by using eyes to control a communication interface on a computer. However, knowledge about how using EGAT contributes to communication and influences dyadic interaction remains limited. Aim: By video-coding dyadic interaction sequences, this study investigates the impacts of employing EGAT, compared to the Non-EGAT condition on the dyadic communicative interaction. Method: Participants were six dyads with children/youths aged 4–19 years having severe physical disabilities and complex communication needs. A total of 12 film clips of dyadic communication activities with and without EGAT in natural contexts were included. Based on a systematic coding scheme, dyadic communication behaviors were coded to determine the interactional structure and communicative functions. Data were analyzed using a three-tiered method combining group and individual analysis. Results: When using EGAT, children/youths increased initiations in communicative interactions and tended to provide more information, while communication partners made fewer communicative turns, initiations, and requests compared to the Non-EGAT condition. Communication activities, eye-control skills, and communication abilities could influence dyadic interaction. Conclusion: Use of EGAT shows potential to support communicative interaction by increasing children’s initiations and intelligibility, and facilitating symmetrical communication between dyads.
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Affiliation(s)
- Yu-Hsin Hsieh
- Department of Special Education, Stockholm University, Se-106 91 Stockholm, Sweden;
- Correspondence:
| | - Maria Borgestig
- Department of Neuroscience, Uppsala University, 751 24 Uppsala, Sweden;
| | - Deepika Gopalarao
- Al Noor Training Centre for Persons with Disabilities, Building No. 01, Street No. 21 Al Barsha 1, Dubai PO 8397, United Arab Emirates;
| | - Joy McGowan
- Easterseals of Southeastern Pennsylvania, 3975 Conshohocken Ave., Philadelphia, PA 19131, USA;
| | - Mats Granlund
- CHILD, Swedish Institute of Disability Research, School of Health and Welfare, Jönköping University, 553 18 Jönköping, Sweden;
| | - Ai-Wen Hwang
- Graduate Institute of Early Intervention, College of Medicine, Chang-Gung University, Tao-Yuan City 33301, Taiwan;
- Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Linkou, 5 Fu-Xing St., Kwei-Shan, Tao-Yuan City 33301, Taiwan
| | - Helena Hemmingsson
- Department of Special Education, Stockholm University, Se-106 91 Stockholm, Sweden;
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Maes B, Nijs S, Vandesande S, Van Keer I, Arthur-Kelly M, Dind J, Goldbart J, Petitpierre G, Van der Putten A. Looking back, looking forward: Methodological challenges and future directions in research on persons with profound intellectual and multiple disabilities. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2020; 34:250-262. [PMID: 33073444 DOI: 10.1111/jar.12803] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 06/29/2020] [Accepted: 07/29/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND Within the context of the Special Interest Research Group (SIRG) on Persons with Profound Intellectual and Multiple Disabilities (PIMD), researchers often discuss the methodological problems and challenges they are confronted with. The aim of the current article was to give an overview of these challenges. METHODS The challenges are centred on six topics. These reflect the main components of a study's design: (a) participant demarcation, (b) participant recruitment, (c) data collection and instruments, (d) data analysis, (e) ethics/including the "voice" of persons with PIMD and (f) theoretical models. RESULTS Next, to describing the specific challenges, possible solutions and pathways to address them are discussed. These are illustrated by recent studies by the authors and other researchers in the field. CONCLUSIONS The current contribution wants to stimulate further discussion and exchange of ideas, and the development of creative research techniques.
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Affiliation(s)
- Bea Maes
- Faculty of Psychology and Educational Sciences, Research Unit Parenting and Special Education, Catholic University of Leuven, Leuven, Belgium
| | - Sara Nijs
- Faculty of Psychology and Educational Sciences, Research Unit Parenting and Special Education, Catholic University of Leuven, Leuven, Belgium
| | - Sien Vandesande
- Faculty of Psychology and Educational Sciences, Research Unit Parenting and Special Education, Catholic University of Leuven, Leuven, Belgium
| | - Ines Van Keer
- Faculty of Psychology and Educational Sciences, Research Unit Parenting and Special Education, Catholic University of Leuven, Leuven, Belgium
| | | | - Juliane Dind
- Département de Pédagogie spécialisée, Université de Fribourg, Fribourg, Switzerland
| | - Juliet Goldbart
- Faculty of Health, Psychology & Social Care, Manchester Metropolitan University, Manchester, UK
| | | | - Annette Van der Putten
- Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, The Netherlands
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