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Savolainen K, Kujala S. Testing Two Online Symptom Checkers With Vulnerable Groups: Usability Study to Improve Cognitive Accessibility of eHealth Services. JMIR Hum Factors 2024; 11:e45275. [PMID: 38457214 PMCID: PMC10960212 DOI: 10.2196/45275] [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: 12/22/2022] [Revised: 03/08/2023] [Accepted: 02/03/2024] [Indexed: 03/09/2024] Open
Abstract
BACKGROUND The popularity of eHealth services has surged significantly, underscoring the importance of ensuring their usability and accessibility for users with diverse needs, characteristics, and capabilities. These services can pose cognitive demands, especially for individuals who are unwell, fatigued, or experiencing distress. Additionally, numerous potentially vulnerable groups, including older adults, are susceptible to digital exclusion and may encounter cognitive limitations related to perception, attention, memory, and language comprehension. Regrettably, many studies overlook the preferences and needs of user groups likely to encounter challenges associated with these cognitive aspects. OBJECTIVE This study primarily aims to gain a deeper understanding of cognitive accessibility in the practical context of eHealth services. Additionally, we aimed to identify the specific challenges that vulnerable groups encounter when using eHealth services and determine key considerations for testing these services with such groups. METHODS As a case study of eHealth services, we conducted qualitative usability testing on 2 online symptom checkers used in Finnish public primary care. A total of 13 participants from 3 distinct groups participated in the study: older adults, individuals with mild intellectual disabilities, and nonnative Finnish speakers. The primary research methods used were the thinking-aloud method, questionnaires, and semistructured interviews. RESULTS We found that potentially vulnerable groups encountered numerous issues with the tested services, with similar problems observed across all 3 groups. Specifically, clarity and the use of terminology posed significant challenges. The services overwhelmed users with excessive information and choices, while the terminology consisted of numerous complex medical terms that were difficult to understand. When conducting tests with vulnerable groups, it is crucial to carefully plan the sessions to avoid being overly lengthy, as these users often require more time to complete tasks. Additionally, testing with vulnerable groups proved to be quite efficient, with results likely to benefit a wider audience as well. CONCLUSIONS Based on the findings of this study, it is evident that older adults, individuals with mild intellectual disability, and nonnative speakers may encounter cognitive challenges when using eHealth services, which can impede or slow down their use and make the services more difficult to navigate. In the worst-case scenario, these challenges may lead to errors in using the services. We recommend expanding the scope of testing to include a broader range of eHealth services with vulnerable groups, incorporating users with diverse characteristics and capabilities who are likely to encounter difficulties in cognitive accessibility.
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Affiliation(s)
- Kaisa Savolainen
- Department of Computer Science, Aalto University School of Science, Espoo, Finland
| | - Sari Kujala
- Department of Computer Science, Aalto University School of Science, Espoo, Finland
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Michalsen H, Henriksen A, Pettersen G, Hartvigsen G, Wangberg S, Thrane G, Jahnsen R, Anke A. Using mobile health to encourage physical activity in individuals with intellectual disability: a pilot mixed methods feasibility study. FRONTIERS IN REHABILITATION SCIENCES 2023; 4:1225641. [PMID: 37691911 PMCID: PMC10483399 DOI: 10.3389/fresc.2023.1225641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 08/04/2023] [Indexed: 09/12/2023]
Abstract
Background Many individuals with intellectual disability (ID) have a sedentary lifestyle. Few interventions aimed at increasing their level of physical activity (PA) have shown lasting effects. Aim To assess the feasibility and acceptability of a pilot intervention study using innovative mobile health (mHealth) support systems to encourage PA in individuals with ID. Methods Nine individuals with ID and a low level of PA, aged 16-36 years, were included in the present convergent triangulation mixed method design. Two mHealth support systems (apps) were developed and tested. PA was measured with a Fitbit smartwatch, accelerometer, the International Physical Activity Questionnaire-Short Form (IPAQ-S), and Goal attainment scaling. Data were collected through online pre-, mid- (4 weeks), and post-intervention (12 weeks) questionnaires and activity trackers. Semi-structured qualitative interviews with participants and/or a family or staff member were held after the 12-week follow-up. Data were analyzed using conventional nonparametric statistics and thematic analyses. Results The response rate and retention to the trial were 16% and 100%, respectively. Data quality was high, except for missing data from Fitbit activity trackers of approximately 30% from the 4- and 12-week follow-up stages. The feasibility challenges with activity trackers include rashes, size, non-acceptance, and loss of motivation. Participants and family members/staff reported interest in the study theme and were pleased with the data collection method. All but one participant achieved their PA goals. Most participants reported being satisfied with the apps as they were enjoyable or provided a reminder for performing physical and other activities. Social support for PA among family members also increased. However, app support from staff and family members was needed, and apps were not used regularly. Two of nine participants (22%) had increased their PA measured as steps per day with Fitbit at the 12-week follow-up. Conclusions The acceptability and feasibility of using tailored mobile applications in natural settings to increase PA among adults with ID are promising. This study aligns with previous studies in showing the challenges to increasing PA, which requires the inclusion of family members, staff, and stakeholders. The intervention requires modifications before a randomized controlled trial can be conducted.
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Affiliation(s)
- Henriette Michalsen
- Department of Rehabilitation, University Hospital of North Norway, Tromsø, Norway
- Faculty of Health Sciences, Department of Clinical Medicine, UiT—The Artic University of Norway, Tromsø, Norway
| | - André Henriksen
- Faculty of Science and Technology, Department of Computer Science, UiT—The Artic University of Norway, Tromsø, Norway
| | - Gunn Pettersen
- Faculty of Health Sciences, Department of Health and Care Sciences, UiT—The Arctic University of Norway, Tromsø, Norway
| | - Gunnar Hartvigsen
- Faculty of Science and Technology, Department of Computer Science, UiT—The Artic University of Norway, Tromsø, Norway
| | - Silje Wangberg
- Faculty of Health Sciences, Department of Health and Care Sciences, UiT—The Arctic University of Norway, Narvik, Norway
| | - Gyrd Thrane
- Faculty of Health Sciences, Department of Health and Care Sciences, UiT—The Arctic University of Norway, Tromsø, Norway
| | - Reidun Jahnsen
- Institute of Health and Society, Research Centre for Habilitation and Rehabilitation Models and Services (CHARM), Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Audny Anke
- Department of Rehabilitation, University Hospital of North Norway, Tromsø, Norway
- Faculty of Health Sciences, Department of Clinical Medicine, UiT—The Artic University of Norway, Tromsø, Norway
- Institute of Health and Society, Research Centre for Habilitation and Rehabilitation Models and Services (CHARM), Faculty of Medicine, University of Oslo, Oslo, Norway
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Michalsen H, Wangberg SC, Hartvigsen G, Henriksen A, Pettersen G, Jaccheri L, Jahnsen RB, Thrane G, Arntzen C, Anke A. Mobile health support to stimulate physical activity in individuals with intellectual disability: Protocol for mixed methods pilot study (Preprint). JMIR Res Protoc 2022; 11:e37849. [PMID: 36107473 PMCID: PMC9523523 DOI: 10.2196/37849] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 06/21/2022] [Accepted: 06/27/2022] [Indexed: 11/24/2022] Open
Abstract
Background Several studies have shown that individuals with intellectual disabilities (IDs) have low levels of physical activity (PA), and intervention studies on PA suggest inconsistent evidence. The use of technology as a means of motivation for PA has yet to be extensively explored and needs to be further investigated. Objective We aim to assess the feasibility and acceptability of procedures for an intervention arm in a future trial on mobile health (mHealth) to support PA for individuals with IDs. In addition, we aim to examine how the use of technology can influence motivation for PA among participants, their caregivers, and staff members. Methods A mixed methods pilot study of an intervention arm will be carried out in a planned randomized controlled trial (RCT). Ten participants with ID and their caregivers or a staff member will be included. Information will always be provided by a caregiver or a staff member, or participants with ID if possible. Assessments will be carried out at baseline, follow-up after 4 weeks, and 12 weeks, and include questionnaires on PA, social support, self-efficacy, and challenging behavior. PA will be measured with 2 different activity trackers (Fitbit and Axivity) for 1 week at all assessments. Feasibility will be assessed as recruitment and adherence rate, missing data, usability of the motivational mHealth tool, and estimates of effectiveness. Acceptability of study procedures, activity measures, and motivation for participation in PA will be additionally assessed with qualitative methods at the end of the intervention. Results Enrollment commenced in May 2021. Data collection was completed in March 2022. Conclusions This pilot study will evaluate the feasibility and acceptability of study procedures of the intervention arm of a planned RCT to address feasibility issues, improve study procedures, and estimate effectiveness of the study measures. How the use of technology can influence motivation for PA will also be examined, which can help guide and improve future PA interventions involving the use of technology. Trial Registration ClinicalTrials.gov NCT04929106; https://clinicaltrials.gov/ct2/show/NCT04929106 International Registered Report Identifier (IRRID) DERR1-10.2196/37849
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Affiliation(s)
- Henriette Michalsen
- Department of Rehabilitation, University Hospital of North Norway, Tromsø, Norway
| | - Silje C Wangberg
- Department of Health and Care Sciences, Faculty of Health Sciences, UiT - The Arctic University of Norway, Narvik, Norway
| | - Gunnar Hartvigsen
- Department of Computer Science, Faculty of Science and Technology, UiT - The Artic University of Norway, Tromsø, Norway
| | - André Henriksen
- Department of Computer Science, Faculty of Science and Technology, UiT - The Artic University of Norway, Tromsø, Norway
| | - Gunn Pettersen
- Department of Health and Care Sciences, Faculty of Health Sciences, UiT - The Arctic University of Norway, Tromsø, Norway
| | - Letizia Jaccheri
- Department of Computer Science, Faculty of Information Technology and Electrical Engineering, NTNU, Trondheim, Norway
| | - Reidun Birgitta Jahnsen
- Institute of Health and Society, Research Centre for Habilitation and Rehabilitation Models and Services (CHARM), Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Gyrd Thrane
- Department of Health and Care Sciences, Faculty of Health Sciences, UiT - The Arctic University of Norway, Tromsø, Norway
| | - Cathrine Arntzen
- Department of Health and Care Sciences, Faculty of Health Sciences, UiT - The Arctic University of Norway, Tromsø, Norway
| | - Audny Anke
- Department of Rehabilitation, University Hospital of North Norway, Tromsø, Norway
- Institute of Health and Society, Research Centre for Habilitation and Rehabilitation Models and Services (CHARM), Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Clinical Medicine, Faculty of Health Sciences, UIT - The Arctic University of Norway, Tromsø, Norway
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Glencross S, Mason J, Katsikitis M, Greenwood KM. Internet Use by People with Intellectual Disability: Exploring Digital Inequality-A Systematic Review. CYBERPSYCHOLOGY, BEHAVIOR AND SOCIAL NETWORKING 2021; 24:503-520. [PMID: 33761269 DOI: 10.1089/cyber.2020.0499] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Many people with intellectual disability experience digital inequality due to a lack of Internet access; this is known as the digital divide. Digital inequality is also apparent when people with intellectual disability have Internet access, but only use it for a small number of applications (e.g., watching videos and playing games). Recently, it has been suggested that digital inequality also occurs in situations where some Internet users are less likely than others to translate their online activities to offline resources, including educational outcomes and social capital. The extent to which people with intellectual disability are translating their online activities to offline resources has not been examined. We conducted a systematic and critical review using PRISMA guidelines. The search strategy terms "intellectual disability" and "Internet use" were used to search the databases: Scopus; Wiley Online Library; Psychiatry Online; Web of Science; CINAHL; and PubMed. Twenty-four studies were found, which described 53 types of Internet use, 48 risks of Internet use, and 28 benefits of Internet use. The data were identified thematically and categorized to facilitate comparisons. The most frequently reported types of Internet use were in the category of social media/social networking (23%), the most common Internet risks were in the category of emotional distress (24%), and the most often reported benefits were in the category of friendships and social connection (33%). The findings indicate that the benefits of Internet use for people with intellectual disability have received much less attention than the risks.
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Affiliation(s)
- Sarah Glencross
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Maroochydore, Australia
| | - Jonathan Mason
- School of Health and Behavioural Sciences, University of the Sunshine Coast, Maroochydore, Australia
| | - Mary Katsikitis
- College of Education, Psychology, and Social Work, Flinders University, Adelaide, Australia
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Torra Moreno M, Canals Sans J, Colomina Fosch MT. Behavioral and Cognitive Interventions With Digital Devices in Subjects With Intellectual Disability: A Systematic Review. Front Psychiatry 2021; 12:647399. [PMID: 33927655 PMCID: PMC8076520 DOI: 10.3389/fpsyt.2021.647399] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 03/17/2021] [Indexed: 01/01/2023] Open
Abstract
In recent years, digital devices have been progressively introduced in rehabilitation programs and have affected skills training methods used with children and adolescents with intellectual disabilities (ID). The objective of this review is to assess the effects of the use of digital devices on the cognitive functions and behavioral skills in this population, and to acknowledge their potential as a therapeutic tool. Electronic databases were analyzed until February 2020 using search formulas with free terms related to ID and the use of digital systems with children or adolescents. The risk of bias in randomized controlled trials was assessed by means of the modified Cochrane Collaboration tool and the quality level of the non-randomized studies was assessed using the Newcastle-Ottawa Scale. Forty-four studies were analyzed, most of which were categorized as low quality. Of the executive function studies analyzed, 60% reported significant improvements, most commonly related to working memory. Within the cognitive skills, 47% of the studies analyzed reported significant improvements, 30% of them in language. Significant improvements in the social (50%) and behavioral domains (30%) were also reported. These results suggest that digital interventions are effective in improving working memory and academic skills, and positively affect both the social and behavioral domains. Little information has been published regarding the duration of the effects, which could be limited in time. Further research is necessary to assess long-term effectiveness, the influence of comorbidities, and the effects on subjects with severe ID. The inclusion of smartphones and special education centers is also necessary.
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Affiliation(s)
- Marta Torra Moreno
- Jeroni de Moragas Private Fundation, Tarragona, Spain
- Jeroni de Moragas Association, Tarragona, Spain
| | - Josefa Canals Sans
- Department of Psychology, Research Center for Behavioral Assessment (CRAMC), Rovira i Virgili University, Tarragona, Spain
| | - Maria Teresa Colomina Fosch
- Department of Psychology, Research Center for Behavioral Assessment (CRAMC), Rovira i Virgili University, Tarragona, Spain
- Research Group in Neurobehavior and Health (NEUROLAB), Tarragona, Spain
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Lancioni GE, Singh NN, O'Reilly MF, Sigafoos J, Alberti G, Chiariello V, Carrella L. Everyday Technology to Support Leisure and Daily Activities in People with Intellectual and Other Disabilities. Dev Neurorehabil 2020; 23:431-438. [PMID: 32118503 DOI: 10.1080/17518423.2020.1737590] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Objective: The study evaluated a smartphone-aided program to support independent access to leisure events and performance of daily activities in seven participants with moderate intellectual disability, four of whom also had severe hearing loss. Method: The program relied on the use of a Samsung Galaxy J4 Plus smartphone with Android 9.0 operating system. The smartphone's functioning was automated via the MacroDroid application. The program was to allow the participants to alternate access to leisure events (delivered via the smartphone) with performance of vocational activities (guided through smartphone-delivered pictorial or pictorial and verbal instructions) over sessions of about 30 min. Results: During the baseline, the participants failed to access leisure events and perform scheduled activities independently. When the program was used, however, all participants succeeded in both accessing leisure events and performing activities independently. Conclusions: The smartphone-aided program can be a useful tool for people like the participants of this study.
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Affiliation(s)
| | | | | | - Jeff Sigafoos
- Victoria University of Wellington , Wellington, New Zealand
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Oudshoorn CEM, Frielink N, Nijs SLP, Embregts PJCM. eHealth in the support of people with mild intellectual disability in daily life: A systematic review. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2020; 33:1166-1187. [PMID: 32578361 PMCID: PMC7687216 DOI: 10.1111/jar.12758] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 03/27/2020] [Accepted: 05/03/2020] [Indexed: 01/19/2023]
Abstract
BACKGROUND eHealth has recently made rapid progress in care, support and treatment. However, studies on the use of eHealth to support people with a mild intellectual disability in daily life are limited. A systematic review was conducted to provide an overview of this use of eHealth. METHODS Seven databases were searched for relevant studies and assessed according to the PRISMA guidelines. Descriptive analyses were deployed using the Matching Person to Technology model to evaluate the key areas contributing to successful eHealth use. RESULTS Most of the 46 studies included were small-scale case studies and focused on using eHealth to acquire daily living skills and vocational skills. In addition, several studies focused on eHealth use for self-support in daily living, and three studies focused on remote professional support. CONCLUSIONS eHealth offers opportunities to support people with mild intellectual disability in various different contexts of daily life. Scientific research on this topic is in its early stage, and further high-quality research is needed.
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Affiliation(s)
- Cathelijn E M Oudshoorn
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands.,ASVZ, Sliedrecht, The Netherlands
| | - Noud Frielink
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | - Sara L P Nijs
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
| | - Petri J C M Embregts
- Tranzo, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, The Netherlands
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Patrick PA, Obermeyer I, Xenakis J, Crocitto D, O'Hara DM. Technology and social media use by adult patients with intellectual and/or developmental disabilities. Disabil Health J 2019; 13:100840. [PMID: 31582357 DOI: 10.1016/j.dhjo.2019.100840] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 08/19/2019] [Accepted: 08/28/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND Technology and social media offer individuals with intellectual and/or developmental disabilities (I/DD) unique and innovative ways to facilitate active participation in their own healthcare process. What remains unclear is the extent to which devices are currently used by this growing patient population. OBJECTIVE To explore the prevalence of technology and social media use, as well as the possible barriers, among adult patients with I/DD. METHODS A cross-sectional study utilizing an anonymous, accessible survey was used to obtain data from all adult patients (18 + years of age) with I/DD presenting for primary care services at a healthcare facility in New York between September and December of 2016. RESULTS A total of 370 individuals completed the survey (529 approached, 69.9% response rate). Less than half (44.6%) of respondents used devices such as a tablet, smartphone or desktop; most (86.8%) did not use social media. Only 21.6% of respondents indicated that they use some type of assistive technology. While some respondents (46.0%) were identified by their caregivers as having a disability that would prevent them from learning/using technology, other respondents reported having no challenges (18.0%), needing training and/or ongoing support (7.4%), or being uncertain as to whether they would experience any challenges (15.5%). CONCLUSIONS Many adult patients with I/DD do not use technology and social media that could promote self-determination and participation in their healthcare. Continued efforts must be made to promote technology use among adults with I/DD and to ensure that appropriate training is available for both the individual and his/her caregivers to achieve adoption and utilization.
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Affiliation(s)
- Patricia A Patrick
- Westchester Institute for Human Development, Valhalla, NY, USA; School of Health Sciences & Practices, New York Medical College, Valhalla, NY, USA; Department of Pediatrics, New York Medical College, Valhalla, NY, USA.
| | - Izel Obermeyer
- Westchester Institute for Human Development, Valhalla, NY, USA; School of Health Sciences & Practices, New York Medical College, Valhalla, NY, USA
| | - Jason Xenakis
- Westchester Institute for Human Development, Valhalla, NY, USA; School of Health Sciences & Practices, New York Medical College, Valhalla, NY, USA
| | - Doug Crocitto
- Westchester Institute for Human Development, Valhalla, NY, USA
| | - David M O'Hara
- Westchester Institute for Human Development, Valhalla, NY, USA; School of Health Sciences & Practices, New York Medical College, Valhalla, NY, USA
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Lancioni GE, Olivetti Belardinelli M, Singh NN, O'Reilly MF, Sigafoos J, Alberti G. Recent Technology-Aided Programs to Support Adaptive Responses, Functional Activities, and Leisure and Communication in People With Significant Disabilities. Front Neurol 2019; 10:643. [PMID: 31312169 PMCID: PMC6614206 DOI: 10.3389/fneur.2019.00643] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 05/31/2019] [Indexed: 12/17/2022] Open
Abstract
This paper presents an overview of recent technology-aided programs (i. e., technology-aided support tools) designed to help people with significant disabilities (a) engage in adaptive responses, functional activities, and leisure and communication, and thus (b) interact with their physical and social environment and improve their performance/achievement. In order to illustrate the support tools, the paper provides an overview of recent studies aimed at developing and assessing those tools. The paper also examines the tools' accessibility and usability, and comments on possible ways of modifying and advancing them to improve their impact. The tools taken into consideration concern, among others, (a) microswitches linked to computer systems, and aimed at promoting (i.e., through positive stimulation) minimal responses or functional body movements in individuals with intellectual disabilities and motor impairments; (b) computer systems, tablets, or smartphones aimed at supporting functional activity engagement of individuals with intellectual disabilities or Alzheimer's disease; and (c) microswitches with computer-aided systems, elaborate communication devices, and specifically arranged smartphones or tablets, directed at promoting leisure, communication, or both.
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Affiliation(s)
- Giulio E. Lancioni
- Department of Neuroscience and Sense Organs, University of Bari, Bari, Italy
| | - Marta Olivetti Belardinelli
- Interuniversity Center for Research on Cognitive Processing in Natural and Artificial Systems (ECONA), Sapienza University of Rome, Rome, Italy
| | - Nirbhay N. Singh
- Medical College of Georgia, Augusta University, Augusta, GA, United States
| | - Mark F. O'Reilly
- Department of Special Education, University of Texas at Austin, Austin, TX, United States
| | - Jeff Sigafoos
- School of Education, Victoria University of Wellington, Wellington, New Zealand
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Weber JD, Smith E, Berry-Kravis E, Cadavid D, Hessl D, Erickson C. Voice of People with Fragile X Syndrome and Their Families: Reports from a Survey on Treatment Priorities. Brain Sci 2019; 9:brainsci9020018. [PMID: 30678024 PMCID: PMC6406416 DOI: 10.3390/brainsci9020018] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 01/16/2019] [Accepted: 01/16/2019] [Indexed: 01/29/2023] Open
Abstract
To date, there has been limited research on the primary concerns and treatment priorities for individuals with fragile X syndrome (FXS) and their families. The National Fragile X Foundation in collaboration with clinical investigators from industry and academia constructed a survey to investigate the main symptoms, daily living challenges, family impact, and treatment priorities for individuals with FXS and their families, which was then distributed to a large mailing list. The survey included both structured questions focused on ranking difficulties as well as qualitative analysis of open-ended questions. It was completed by 467 participants, including 439 family members or caretakers (family members/caretakers) of someone with FXS, 20 professionals who work with a person with FXS, and 8 individuals with FXS. Respondents indicated three main general areas of concern: Anxiety, behavioral problems, and learning difficulties. Important differences were noted, based on the sex and age of the individual with FXS. The results highlight the top priorities for treatment development for family members/caretakers, as well as a small group of professionals, and an even smaller group of individuals with FXS, while demonstrating challenges with "voice of the patient" research in FXS.
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Affiliation(s)
| | - Elizabeth Smith
- Cincinnati Children's Hospital Medical Center Division of Child & Adolescent Psychiatry, Cincinnati, OH 45229, USA.
| | - Elizabeth Berry-Kravis
- Departments of Pediatrics, Neurological Sciences, Biochemistry, Rush University Medical Center, Chicago, IL 60612, USA.
| | | | - David Hessl
- MIND Institute and Department of Psychiatry and Behavioral Sciences, University of California Davis School of Medicine, Sacramento, CA 95817, USA.
| | - Craig Erickson
- Cincinnati Children's Hospital Medical Center, Division of Child & Adolescent Psychiatry and the University of Cincinnati College of Medicine Department of Psychiatry and Behavioral Neuroscience, Cincinnati, OH 45229, USA.
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