Computer Usage by Children with Down Syndrome

Eliminating the gap between the use of assistive technologies and the inclusion of people with intellectual disabilities in leisure activities

Information and Communication Technology (ICT) tools and Assistive Technologies (AT) can support people with Down Syndrome (PDS) and Intellectual Disabilities (PID) in increasing their self-confidence and independence, enhancing skills, and competences, participating in leisure activities. For families of PDS/PID, professionals, non-formal caregivers and volunteers, the challenge is to appreciate the benefits of ICT Tools in promoting inclusion. The aim of this study is to present the interdisciplinary and multidimensional scope of the DS Leisure project aiming at promoting the inclusion of PDS/PID through innovative ICT tools and their participation in inclusive leisure activities. Particularly, 24 individuals were asked to assess the global satisfaction and performance of PDS/PID, as well as the exploitation of ICT tools. Findings suggested that PDS/PID specific social, decision-making, and communication skills were significantly improved after their participation in the Experiential Activity and the e-Training platform was positively rated and considered a constructive learning experience.

Technology-enhanced and game based learning for children with special needs: a systematic mapping study

Technology-based education of children with special needs has become the focus of many research works in recent years. The wide range of different disabilities that are encompassed by the term "special needs", together with the educational requirements of the children affected, represent an enormous multidisciplinary challenge for the research community. In this article, we present a systematic literature review of technology-enhanced and game-based learning systems and methods applied on children with special needs. The article analyzes the state-of-the-art of the research in this field by selecting a group of primary studies and answering a set of research questions. Although there are some previous systematic reviews, it is still not clear what the best tools, games or academic subjects (with technology-enhanced, game-based learning) are, out of those that have obtained good results with children with special needs. The 18 articles selected (carefully filtered out of 614 contributions) have been used to reveal the most frequent disabilities, the different technologies used in the prototypes, the number of learning subjects, and the kind of learning games used. The article also summarizes research opportunities identified in the primary studies.

The Home Learning Environment of Primary School Children with Down Syndrome and those with Williams Syndrome

Background and aims: Research on typically developing (TD) populations has shown that the home learning environment plays a significant role in cognitive development and learning, but very little is known about the home learning environment of children with Down syndrome (DS) or children with Williams syndrome (WS). The present study examined and compared, for the first time, the home learning environment of children diagnosed with DS and children diagnosed with WS to investigate whether different cognitive profiles were reflected in their home literacy and number experiences. Methods and procedures: Quantitative and qualitative data were collected through a web-based survey from 58 parents and one foster parent of primary school children with DS (n = 35) and WS (n = 24) mostly based in the UK. The survey targeted the children’s general level of functioning and academic skills; type, format, and frequency of home learning activities; parents’ expectations for their child’s academic outcomes; parents’ attitudes towards literacy and mathematics; children’s interest towards mathematics; and the use of technology to support home learning activities. Outcomes and results: Our results showed that, overall, the home learning environment of children with DS and children with WS were similar but changed based on the child’s cognitive profile. Comparative analyses showed that parents of children with DS engaged more often in activities supporting counting than parents of children with WS, despite both groups reporting difficulties with this skill. Moreover, our results indicated that literacy-based activities occurred more often than mathematics-based activities and that the home numeracy environment was characterized by activities supporting different mathematical skills such as counting, arithmetic, and numeracy. Parents in both groups engaged with their child in both formal and informal literacy and mathematics-based activities, but informal activities occurred more often when supporting counting and number recognition skills. Conclusions and implications: The current study provides evidence that the home learning environment of children with DS and children with WS include different literacy- and mathematics-based activities and that the home learning environment changes on the basis of the child’s strengths and weaknesses. The findings are discussed in relation to previous studies and the impact on parental interventions.

Analysing Touchscreen Gestures: A Study Based on Individuals with Down Syndrome Centred on Design for All

There has been a conscious shift towards developing increasingly inclusive applications. However, despite this fact, most research has focused on supporting those with visual or hearing impairments and less attention has been paid to cognitive impairments. The purpose of this study is to analyse touch gestures used for touchscreens and identify which gestures are suitable for individuals living with Down syndrome (DS) or other forms of physical or cognitive impairments. With this information, app developers can satisfy Design for All (DfA) requirements by selecting adequate gestures from existing lists of gesture sets. Twenty touch gestures were defined for this study and a sample group containing eighteen individuals with Down syndrome was used. A tool was developed to measure the performance of touch gestures and participants were asked to perform simple tasks that involved the repeated use of these twenty gestures. Three variables are analysed to establish whether they influence the success rates or completion times of gestures, as they could have a collateral effect on the skill with which gestures are performed. These variables are Gender, Type of Down syndrome, and Socioeconomic Status. Analysis reveals that significant difference is present when a pairwise comparison is performed, meaning individuals with DS cannot perform all gestures with the same ease. The variables Gender and Socioeconomic Status do not influence success rates or completion times, but Type of DS does.

Challenges of Developing a Mobile Game for Children with Down Syndrome to Test Gestural Interface

After a literature review published by Nascimento et. al. (2017), the research team noticed the lack of studies focused on game controllers’ accessibility during use by children with Down syndrome. In view of that, this research describes a mobile game development and its usability analyses, which were created to evaluate the accessibility of touchscreen gestural interfaces. The methodology was organized into three steps: bibliographic research and the definition of the project guidelines, the game development, and its evaluation. The guidelines used were based on a study made by Nascimento et. al. (2019) of the impairments that children can have, their game preferences found on Prena’s article (2014), games accessibility guidelines for people with intellectual deficiency from the Includification Book (2012), a manual of touchscreen gestural interfaces from Android and iOS and a game development framework from Schuytema (2008). Then, for the usability analyses, the team decided to first submit the game to a group of experts in order to make some improvements before submitting it to the audience. In this way, two evaluations were done, a heuristic test with usability specialists and a cognitive walkthrough with health professionals. The list of heuristics used on the tests was created by a mash up of the Breyer evaluation (2008) and the recommendations of the Able Games Association (2012) and the cognitive one followed the Preece, Sharp and Rogers (2007) recommendations. The results found reveal some challenges in the field and adjustments, mainly in the narrative, game goals and interface feedback, that should be addressed as soon as possible.

Comparing Traditional and Tablet-Based Intervention for Children With Speech Sound Disorders: A Randomized Controlled Trial

Purpose This article reports on the effectiveness of a novel tablet-based approach to phonological intervention and compares it to a traditional tabletop approach, targeting children with phonologically based speech sound disorders (SSD). Method Twenty-two Portuguese children with phonologically based SSD were randomly assigned to 1 of 2 interventions, tabletop or tablet (11 children in each group), and received intervention based on the same activities, with the only difference being the delivery. All children were treated by the same speech-language pathologist over 2 blocks of 6 weekly sessions, for 12 sessions of intervention. Participants were assessed at 3 time points: baseline; pre-intervention, after a 3-month waiting period; and post-intervention. Outcome measures included percentage of consonants correct, percentage of vowels correct, and percentage of phonemes correct. A generalization of target sounds was also explored. Results Both tabletop and tablet-based interventions were effective in improving percentage of consonants correct and percentage of phonemes correct scores, with an intervention effect only evident for percentage of vowels correct in the tablet group. Change scores across both interventions were significantly greater after the intervention, compared to baseline, indicating that the change was due to the intervention. High levels of generalization (60% and above for the majority of participants) were obtained across both tabletop and tablet groups. Conclusions The software proved to be as effective as a traditional tabletop approach in treating children with phonologically based SSD. These findings provide new evidence regarding the use of digital materials in improving speech in children with SSD. Supplemental Material https://doi.org/10.23641/asha.9989816.

Hand Gestures in Virtual and Augmented 3D Environments for Down Syndrome Users

Studies have revealed that applications using virtual and augmented reality provide immersion, motivation, fun and engagement. However, to date, few studies have researched how users with Down syndrome interact with these technologies. This research has identified the most commonly used interactive 3D gestures according to the literature and tested eight of these using Oculus, Atheer and Leap Motion technologies. By applying MANOVAs to measurements of the time taken to complete each gesture and the success rate of each gesture when performed by participants with Down syndrome versus neurotypical participants, it was determined that significant difference was not shown for age or gender between these two sample groups. From the results, a difference was only demonstrated for the independent variable Down syndrome when analysed as a group. By using ANOVAs, it was determined that both groups found it easier to perform the gestures Stop, Point, Pan and Grab; thus, it is argued that these gestures should be used when programming software to create more inclusive AR and VR environments. The hardest gestures were Take, Pinch, Tap and Swipe; thus, these should be used to confirm critical actions, such as deleting data or cancelling actions. Lastly, the authors gather and make recommendations on how to develop inclusive 3D interfaces for individuals with Down syndrome.

Web Page Design Recommendations for People with Down Syndrome Based on Users' Experiences

At present, there is a high number of people with Down syndrome interested and trained to be an active part of society. According to the data extracted by our surveys we know that only 6% of the population with Down syndrome feels isolated in daily activities. However, when the activity requires the use of a computer, the percentage of people who feel isolated increases to 18%. This means that there are obvious website accessibility barriers that make it difficult for users with Down syndrome. To solve this problem, it is considered necessary to make an exhaustive study about Down syndrome. We know that the trisomy of chromosome 21 causes a series of symptoms that directly affect ones Internet browsing capabilities. For example, speech disturbances make communication and speed difficult. This guide is based on a neurological study of Down syndrome. Alterations in listening make understanding audio, retention of audio concepts and speed difficult. The alterations in the physiognomy of movement make it difficult for them to act quickly. Many of these alterations are caused by cognitive disability. After assessing the needs, the benefits of Web Content Accessibility Guidelines 2.0 (WCAG 2.0), and the existing usability guidelines are analyzed and those that may be useful for this profile are extracted. User tests are carried out through two websites developed specifically for this study with the aim of demonstrating the level of effectiveness of each of the planned guidelines. Considering the neurological characteristics of this intellectual disability, research is developed that seeks to extract a list of useful accessibility and usability guidelines for web developers.

Parental perspectives on video game genre preferences and motivations of children with Down syndrome

Purpose

Video games have the potential to improve brain plasticity in people with Down syndrome. However, little has been done to understand video game preferences in this population. The purpose of this paper is to describe a brief exploration of video game preferences in children with Down syndrome.

Design/methodology/approach

An online survey was used to collect information from parents of children with Down syndrome about their child’s favorite video games and why they like video games.

Findings

Children with Down syndrome, as reported by their parents, most frequently play action/adventure games, and have several motivating factors for game play including overcoming challenges to gain reward and having fun engaging in the game world.

Research limitations/implications

The current study only recruited from a small sample of the Down syndrome population and therefore may lack generalizability.

Practical implications

Gaining a better understanding of which aspects of video games appeal to children with Down syndrome. Knowing what they prefer will enable us to design games that are engaging and cognitively beneficial.

Originality/value

This paper proposes the importance of video game play to promote development in children with Down syndrome.

The effectiveness of the computerized visual perceptual training program on individuals with Down syndrome: An fMRI study

This study investigated the effectiveness of the Computerized Visual Perception Training (CVPT) program on individuals with Down syndrome (DS, mean age=13.17±4.35years, age range: 6.54-20.75 years). All participants have mild intellectual disability classified by the standard IQ measures (mean=61.2, ranges from 55 to 68). Both the Test of Visual Perceptual Skill- Third Edition (TVPS-3) and functional magnetic resonance imaging (fMRI) were used to evaluate the training outcomes. Results of TVPS-3 and fMRI showed that DS group had visual perceptual deficits and abnormal neural networks related to visual organization. The results showed that DS intervention group had significant improvements on TVPS-3 after intervention. The fMRI results indicated more activation in superior and inferior parietal lobes (spatial manipulation), as well as precentral gyrus and dorsal premotor cortex (motor imagery) in DS intervention group. The CVPT program was effective in improving visual perceptual functions and enhancing associated cortical activations in DS.

Design Features in Games for Health: Disciplinary and Interdisciplinary Expert Perspectives

Games for health (G4H) aim to improve health outcomes and encourage behavior change. While existing theoretical frameworks describe features of both games and health interventions, there has been limited systematic investigation into how disciplinary and interdisciplinary stakeholders understand design features in G4H. We recruited 18 experts from the fields of game design, behavioral health, and games for health, and prompted them with 16 sample games. Applying methods including open card sorting and triading, we elicited themes and features (e.g., real-world interaction, game mechanics) around G4H. We found evidence of conceptual differences suggesting that a G4H perspective is not simply the sum of game and health perspectives. At the same time, we found evidence of convergence in stakeholder views, including areas where game experts provided insights about health and vice versa. We discuss how this work can be applied to provide conceptual tools, improve the G4H design process, and guide approaches to encoding G4H-related data for large-scale empirical analysis.

Self-tracking for Mental Wellness: Understanding Expert Perspectives and Student Experiences

Previous research suggests an important role for self-tracking in promoting mental wellness. Recent studies with college student populations have examined the feasibility of collecting everyday mood, activity, and social data. However, these studies do not account for students' experiences and challenges adopting self-tracking technologies to support mental wellness goals. We present two studies conducted to better understand self-tracking for stress management and mental wellness in student populations. First, focus groups and card sorting activities with 14 student health professionals reveal expert perspectives on the usefulness of tracking for three scenarios. Second, an online survey of 297 students examines personal experiences with self-tracking and attitudes toward sharing self-tracked data with others. We draw on findings from these studies to characterize students' motivations, challenges, and preferences in collecting and viewing self-tracked data related to mental wellness, and we compare findings between students with diagnosed mental illnesses and those without. We conclude with a discussion of challenges and opportunities in leveraging self-tracking for mental wellness, highlighting several design considerations.

Iterative Design and Field Trial of an Aphasia-Friendly Email Tool

In this article, we describe the iterative design and field trial of Amail, an email client specifically designed for people with aphasia who have problems expressing themselves verbally. We conducted a 3-month study with eight persons with aphasia to better understand how people with aphasia could integrate Amail in their daily life. Subjective data (questionnaires, interviews, and diaries) and objective data (usage logs) were collected to gain understanding of the usage patterns. All persons with aphasia in our study were able to use Amail independently, and four participants continued using Amail after the study period. The usage patterns, especially the frequency and length of the composed email messages, indicated that, over time, persons with aphasia were able to improve their email communication. Email partners also had the impression that their email partners with aphasia were improving gradually. Last but not least, the use of Amail positively influenced the number and quality of social contacts for the persons with aphasia. We also report some of the challenges encountered while conducting the field trial.

Investigating User Behavior for Authentication Methods

A wide variety of authentication mechanisms have been designed to ensure information security. Individuals with cognitive disabilities depend on computers and the Internet for a variety of tasks and, therefore, use authentication applications on an everyday basis. However, although there have been numerous studies investigating password usage by neurotypical users, there have been no research studies conducted to examine the use of authentication methods by individuals with cognitive disabilities. In this article, we systematically investigate how individuals with cognitive disabilities, specifically Down syndrome (DS), interact with various user authentication mechanisms. This research provides the first benchmark data on the performance of individuals with DS when using multiple authentication methods. It confirms that individuals with DS are capable of using the traditional alphanumeric passwords with reasonable efficiency. The passwords created by individuals with DS are of similar strength to those created by neurotypical people. Graphic passwords are not as effective as traditional alphanumeric and mnemonic passwords regarding efficiency, and are less preferred by the participants. Based on the findings of the study, we propose design guidelines that aim to assist both practitioners and researchers in designing and developing effective authentication applications that fit the specific needs of individuals with DS.