Persons with multiple disabilities engage in stimulus choice and postural control with the support of a technology-aided program

Transition to adulthood of adolescents with profound intellectual and multiple disabilities: Content validation of the SGU-PIMD to support families

BACKGROUND

For families with adolescent children, the transition to adulthood is usually challenging. This period may be extra demanding for families with a child with profound intellectual and multiple disabilities due to the child's strong and persistent support needs. To support these families during this phase and to facilitate the transition process of these adolescents, we adapted the Canadian skills for growing up (SGU) into the skills for growing up-profound intellectual and multiple disabilities (SGU-PIMD). The aim of this study is to determine its content validity.

METHOD

A Delphi study with family members and healthcare professionals was conducted.

RESULTS

Results showed good content validity. However, the Delphi panel suggested minor adjustments to improve relevance, comprehensibility and comprehensiveness.

CONCLUSIONS

The current SGU-PIMD can be used in practice for supporting adolescents with profound intellectual and multiple disabilities. However, there are also recommendations for research into the feasibility and acceptability of the instrument.

Programs Using Stimulation-Regulating Technologies to Promote Physical Activity in People With Intellectual and Multiple Disabilities: Scoping Review

BACKGROUND

People with intellectual and multiple disabilities tend to engage in very low levels of physical activity.

OBJECTIVE

This review paper aims to provide a comprehensive picture of intervention programs using stimulation-regulating technologies to promote forms of physical activity in people with intellectual and multiple disabilities.

METHODS

Following the PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews) checklist, a scoping review was conducted to identify and provide a synthesis of eligible studies published in English between 2010 and 2021. Studies were identified by searching PubMed, Web of Science, PsycINFO, ERIC, and CINAHL as well as by using Google Scholar and manual searches. Studies were included if they involved individuals with intellectual or multiple disabilities, used stimulation-regulating technology systems to help participants engage in physical activity, and reported data on the impact of the intervention.

RESULTS

A total of 42 studies met the inclusion criteria. These studies were divided into 2 groups based on whether they pursued the increase in physical activity through technology-aided delivery of brief periods of preferred stimulation contingent on specific responses or the use of video games (exergames) and related auditory and visual stimulation. Subsequently, a narrative synthesis of the studies was provided.

CONCLUSIONS

The evidence reported by the 2 groups of studies is encouraging. However, further research is needed to compare the overall applicability and impact of the intervention strategies proposed by these groups of studies.

Everyday Technology to Help People with Intellectual and Other Disabilities Access Stimulation via Functional Motor Responses and Improved Body Posture

PURPOSE

This study assessed everyday technology to help eight participants with intellectual and sensory-motor disabilities access stimulation via functional arm/hand responses and improved body posture.

METHODS

An ABABB¹BB¹ design was used for each participant, with A representing baseline phases, B intervention phases in which arm/hand responses led to a 12-s stimulation, and B¹ intervention phases in which the stimulation for arm/hand responses was conditional on an improved/correct torso and head posture. The technology involved a Samsung Galaxy A10 smartphone fitted with Google Assistant and MacroDroid, a mini voice-recording device, and a portable mini voice amplifier.

RESULTS

All participants had a large increase in arm/hand responses from the baseline periods to the B and B¹ phases. They also had a large increase in correct posture from the B phases to the B¹ phases.

CONCLUSION

This technology-aided approach may be a helpful resource for people similar to the participants of this study.

Assistive technology for people with PIMD in challenging scenarios

Purpose

The purpose of this study is to examine in what type of scenarios of daily life assistive technology such as the INSENSION system would provide considerable benefit for people with profound intellectual and multiple disabilities (PIMD).

Design/methodology/approach

A series of focus group workshops were held with relatives of people with PIMD and direct support professionals (DSPs), as well as experts in information and communications technology (ICT). They were oriented towards the design thinking approach and moderated as per the Disney method.

Findings

The participants identified transitions from known to unknown caregivers, provision of care during the night and the impact of external factors on a person’s mood as challenging situations within the PIMD context.

Practical implications

Solving these problems would lead to considerable benefits to the affected people. Based on the ideas gathered in workshops, three technological applications for the INSENSION system were derived, i.e. communication application, multimedia player and smart room devices, all of which will provide remedies in specific usage scenarios.

Originality/value

Methods drawing on the participant’s creativity in combination with the workshops’ multi-perspectivity facilitated a direct reference to the daily life of the target group. In this manner, the innovative ICT system INSENSION can be oriented towards the requirements of this vulnerable group.

New technologies and future trends

Numerous technologies have been introduced for the diagnosis, treatment, and management of patients with neurologic disorders, offering the promise of early diagnosis, tailored and individualized interventions, improvement in quality of life, and restoration of neurologic function. Many of these technologies have become available commercially without having been evaluated by rigorous clinical trials and regulatory reviews, or at the least by peer review of results submitted for publication. A subset is intended to assess, assist, and monitor cognitive functions, motor skills, and autonomic functions and as such may be applicable to persons with developmental disabilities. Barriers that have previously limited the use of technologies by persons with neurodevelopmental disabilities are disappearing as new technologies that have the potential to substantially augment diagnosis and interventions to enhance the daily lives of persons with these disorders are emerging. While recent and future advances in technology have the potential to transform their lives, cautious and thoughtful evaluation is needed to ensure the technologies provide maximal value. As such, further work is needed to demonstrate feasibility, efficacy, and cost-effectiveness, and technologies should be designed to be optimized for individual use.

Postural care for people with intellectual disabilities and severely impaired motor function: A scoping review

BACKGROUND

Poor postural care can have severe and life-threatening complications. This scoping review aims to map and summarize existing evidence regarding postural care for people with intellectual disabilities and severely impaired motor function.

METHOD

Studies were identified via electronic database searches (MEDLINE, CINAHL, PsycINFO and Web of Science) covering January 1990 to March 2016, and email requests to researcher networks. Results were collated via descriptive numerical summary of studies and thematic analysis.

RESULTS

Twenty-three studies were identified and summarized narratively in relation to three themes: characteristics and prevalence, interventions and service related issues. The evidence base is small with significant gaps. Lack of evidence for night-time positioning equipment and 24-hr postural care needs to be addressed urgently.

CONCLUSION

Future research should be clearly directed towards ascertaining how best postural care interventions can be employed to help improve the health and quality of life of people with intellectual disabilities.