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Andreassen M, Borgestig M, Hemmingsson H. The psychosocial impact of eye-gaze assistive technology on everyday life of children and adults. Ann Med 2024; 56:2318397. [PMID: 38442288 PMCID: PMC10916903 DOI: 10.1080/07853890.2024.2318397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 02/08/2024] [Indexed: 03/07/2024] Open
Abstract
PURPOSE This study investigates the psychosocial impact of eye-gaze assistive technology (EGAT) in both children and adults with long-term experience using eye-gaze assistive technology in everyday life, as well as the psychosocial impact as related to duration of use. METHODS In this descriptive comparative study, 34 adult and 27 child EGAT users participated in a structured individual interview using the Psychosocial Impact of Assistive Devices Scale (PIADS). RESULTS The participants' age ranged from 5-74 years, 50% were female and 52% had been diagnosed with cerebral palsy. The EGAT had a positive psychosocial impact on competence, adaptability, and self-esteem among adult and child users. Competence was the only subscale with a higher value for adults (p = 0.038), compared to children. The items with the highest impact for the psychosocial aspects were quality of life, ability to participate, and self-esteem. The adults had longer duration of use than children, but for high-, medium-, and low-duration users, the device showed a positive psychosocial impact. CONCLUSIONS Participants considered EGAT to have high positive impacts for participation and quality of life. The study adds new knowledge in that high positive psychosocial impact may be found even among low-duration users of EGAT, which is important to consider for service providers.
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Affiliation(s)
- Maria Andreassen
- Department of Health, Medicine and Caring Sciences, Linköping University, Norrköping, Sweden
| | - Maria Borgestig
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Helena Hemmingsson
- Department of Special Education, Stockholm University, Stockholm, Sweden
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Griffiths T, Judge S, Souto D. Use of eye-gaze technology feedback by assistive technology professionals: findings from a thematic analysis. Disabil Rehabil Assist Technol 2024:1-18. [PMID: 38592954 DOI: 10.1080/17483107.2024.2338125] [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: 09/15/2023] [Accepted: 03/27/2024] [Indexed: 04/11/2024]
Abstract
Purpose: Eye-gaze technology offers professionals a range of feedback tools, but it is not well understood how these are used to support decision-making or how professionals understand their purpose and function. This paper explores how professionals use a variety of feedback tools and provides commentary on their current use and ideas for future tool development.Methods and Materials: The study adopted a focus group methodology with two groups of professional participants: those involved in the assessment and provision of eye-gaze technology (n = 6) and those who interact with individuals using eye-gaze technology on an ongoing basis (n = 5). Template analysis was used to provide qualitative insight into the research questions.Results: Professionals highlighted several issues with existing tools and gave suggestions on how these could be made better. It is generally felt that existing tools highlight the existence of problems but offer little in the way of solutions or suggestions. Some differences of opinion related to professional perspective were highlighted. Questions about automating certain processes were raised by both groups.Conclusions: Discussion highlighted the need for different levels of feedback for users and professionals. Professionals agreed that current tools are useful to identify problems but do not offer insight into potential solutions. Some tools are being used to draw inferences about vision and cognition which are not supported by existing literature. New tools may be needed to better meet the needs of professionals and an increased understanding of how existing tools function may support such development.
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Affiliation(s)
- Tom Griffiths
- School of Computing, University of Dundee, Dundee, UK
| | - Simon Judge
- Barnsley Assistive Technology Team, Barnsley Hospital NHS Foundation Trust, Barnsley, UK
| | - David Souto
- School of Psychology and Vision Sciences, University of Leicester, Leicester, UK
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McKenzie G, Willis C, Yao A, Munzel F, Kennedy R, Shields N. Identifying and prioritising strategies to optimise community gym participation for young adults with cerebral palsy: an e-Delphi study. Disabil Rehabil 2024; 46:1309-1317. [PMID: 37021370 DOI: 10.1080/09638288.2023.2193431] [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: 10/19/2022] [Accepted: 03/16/2023] [Indexed: 04/07/2023]
Abstract
PURPOSE Identify and prioritise strategies to optimise physical activity participation in the community gym setting for young adults with cerebral palsy. METHODS An e-Delphi method was implemented over three rounds with four stakeholder groups (young adults with cerebral palsy, their families, gym staff or exercise professionals, and health professionals). Strategies for change were identified by the stakeholders in round 1. In rounds 2 and 3, strategies for change were rated on the importance for implementation using a 7-point Likert scale (1 being lowest importance, 7 being highest). The consensus was achieved if ≥70% of participants identified a strategy as high importance. RESULTS Seventy participants (20 young adults 10 family members, 21 health professionals, and 19 exercise professionals) identified 83 strategies for improving gym participation. Of these, 44 strategies met the consensus criteria. The highest priority strategies related to changing the physical environment, addressing cost barriers, gym staff training, and developing partnerships between sectors. CONCLUSIONS Addressing physical accessibility, cost of attendance and the skills of gym staff were agreed upon by the stakeholder groups as priority areas for future resource allocation and research translation. Clinicians and community leisure facilities must work with consumers to implement strategies in their local contexts.
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Affiliation(s)
- Georgia McKenzie
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, VIC, Australia
- CP-Achieve, NHMRC Centre of Research Excellence, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Claire Willis
- School of Allied Health, Human Services and Sport, La Trobe University, VIC, Australia
| | - Alexa Yao
- CP-Achieve, NHMRC Centre of Research Excellence, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Freya Munzel
- CP-Achieve, NHMRC Centre of Research Excellence, Murdoch Children's Research Institute, Parkville, VIC, Australia
| | - Rachel Kennedy
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, VIC, Australia
| | - Nora Shields
- Olga Tennison Autism Research Centre, School of Psychology and Public Health, La Trobe University, VIC, Australia
- CP-Achieve, NHMRC Centre of Research Excellence, Murdoch Children's Research Institute, Parkville, VIC, Australia
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Sowers DJ, Wilkinson KM. Speech-Language Pathologists' Approach to Alternative Access for Augmentative and Alternative Communication for Children With Motor Impairments. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024; 33:774-790. [PMID: 38085653 DOI: 10.1044/2023_ajslp-23-00129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/08/2024]
Abstract
PURPOSE This study examined the processes that speech-language pathologists (SLPs) use during an augmentative and alternative communication (AAC) assessment with children with motor impairments to determine alternative access solutions. These children often are the most vulnerable to a poor fit of their AAC system, which alternative access is an integral part. Although there is an abundance of information as to what types of considerations should be made during these assessments, there is no guidance as to how the assessment is completed. The goal of this study is to build evidence about the process. METHOD A collective case design was used to gain detailed insights into the decision-making process. Interviews and vignette responses were two components of the data collection. Each of the five SLPs, or cases, who participated in the study transcripts was analyzed in isolation as part of a within-case analysis. Once each SLP's process was understood, a cross-case comparison was completed to ascertain similarities or differences across the five. RESULTS The cross-case assertions are presented in this article. Although the SLPs individually reported a lack of defined process, a clear systemization became evident when considered collectively. The SLPs all focused on the child, isolated motor access skills, and used a process of experimentation over time to build their final recommendations. CONCLUSIONS These results have implications for SLPs working with children with motor impairments who may benefit from AAC intervention. The shared framework can serve as a roadmap to other SLPs, especially those with less experience with these types of complex cases. The varying teaming approaches to support these cases are also discussed.
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Affiliation(s)
- Dawn J Sowers
- Department of Communication Sciences and Disorders, The Pennsylvania State University, University Park
| | - Krista M Wilkinson
- Department of Communication Sciences and Disorders, The Pennsylvania State University, University Park
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Vieira BS, Airoldi MJ, Chalfun D, Bonfim RGAS, Teplicky R, Rosenbaum P, Mancini MC, Brandão MB. "From All, To All": Implementing a collaborative online conference to reflect on the daily living of individuals with cerebral palsy. Child Care Health Dev 2024; 50:e13254. [PMID: 38517156 DOI: 10.1111/cch.13254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 10/26/2023] [Accepted: 02/25/2024] [Indexed: 03/23/2024]
Abstract
BACKGROUND Translating knowledge to improve paediatric rehabilitation has become a research area of interest. This study describes the development and evaluation of an online conference that brought together perspectives of individuals with cerebral palsy (CP), families, health care professionals, and researchers to discuss the daily living of individuals with CP. METHODS We anchored the development and implementation of the online conference in the action cycle of the Knowledge to Action Framework. To develop the meeting, we included representatives from each stakeholder group in the programme committee. The conference programme was designed having the lifespan perspective of individuals with CP, from birth to adulthood, as its central core, with themes related to daily living (e.g., self-care, mobility, and continuing education). Participants' satisfaction with the conference was assessed using an anonymized online survey sent to all participants. RESULTS The conference had 1656 attendees, of whom 675 answered the online satisfaction survey. Most participants rated the structure of the conference (i.e., quality of the technical support, audio and video, and online platform) and discussed topics (i.e., relevance, content, discussion, speakers, and available time) positively. CONCLUSION Collaborative conferences that include stakeholders throughout the planning and implementation are a viable, effective knowledge translation strategy that allows for sharing experiences and disseminating knowledge among families and individuals with CP, health care professionals, and researchers.
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Affiliation(s)
| | - Marina J Airoldi
- Instituto Nossa Casa, Campinas, Brazil
- Graduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | | | - Rachel Teplicky
- CanChild Centre for Childhood Disability, McMaster University, Hamilton, Ontario, Canada
| | - Peter Rosenbaum
- CanChild Centre for Childhood Disability, McMaster University, Hamilton, Ontario, Canada
| | - Marisa C Mancini
- Graduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Marina B Brandão
- Graduate Program in Rehabilitation Sciences, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
- Department of Occupational Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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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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Griffiths T, Clarke MT, Swettenham J. The ability of typically developing 2-3 year olds to infer the control mechanism for eye-gaze technology and the impact of causal language instruction. Disabil Rehabil Assist Technol 2023:1-8. [PMID: 38112177 DOI: 10.1080/17483107.2023.2293874] [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: 05/17/2023] [Accepted: 12/06/2023] [Indexed: 12/21/2023]
Abstract
PURPOSE Little is known about how children learn to control eye-gaze technology, and clinicians lack information to guide decision-making. This paper examines whether typically developing 2-3 year olds can infer for themselves the causal mechanisms by which eye-gaze technology is controlled, whether a teaching intervention based on causal language improves performance and how their performance compares to the same task accessed via a touchscreen.Methods and materials: Typically developing children's (n = 9, Mean Age 28.7 months) performance on a cause and effect game presented on eye-gaze and touchscreen devices was compared. The game was presented first with no specific instruction on how to control the devices. This was followed by a subsequent presentation with explicit instruction about how the access methods worked, using a causal language approach. A final presentation examined whether children had retained any learning. RESULTS Performance in the eye-gaze condition without instruction (42.5% successful trials) was significantly below performance in the corresponding touchscreen condition (75%). However, when causal language instruction was added, performance with both access methods rose to comparable levels (90.7% eye-gaze and 94.6% touchscreen success). Performance gains were not retained post-intervention. CONCLUSIONS Although 2-3 years in the study could make use of eye-gaze technology with support, this study found no evidence that these children could infer the causal mechanisms of control independently or intuitively. The lack of spatial contiguity and the comparative lack of feedback from eye-gaze devices are discussed as possible contributory factors.
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Affiliation(s)
- Tom Griffiths
- School of Computing, University of Dundee, Dundee, UK
| | - Michael T Clarke
- Department of Speech, Language and Hearing Sciences, San Francisco State University, San Francisco, CA, USA
| | - John Swettenham
- Division of Psychology and Language Sciences, University College London (UCL), London, UK
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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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A Scoping Review of Eye Tracking Technology for Communication: Current Progress and Next Steps. CURRENT DEVELOPMENTAL DISORDERS REPORTS 2023. [DOI: 10.1007/s40474-023-00271-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
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Murphy A, Bailey B, Arciuli J. Exploring the Effects of Literacy Instruction for Children With Cerebral Palsy: A Systematic Review. Lang Speech Hear Serv Sch 2023; 54:299-321. [PMID: 36306504 DOI: 10.1044/2022_lshss-22-00014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
PURPOSE Some children with cerebral palsy (CP) have difficulty acquiring conventional reading and writing skills. This systematic review explores the different types of literacy instruction and their effects on the reading and writing skills of children with CP. METHOD Relevant studies published between 2000 and 2020 were identified using electronic databases and terms related to CP and literacy. Data on participant characteristics, instruction characteristics, and instruction outcomes were extracted. A standardized measure of effect size was used to quantify reported treatment effects. RESULTS The systematic search identified 2,970 potentially relevant studies, of which 24 met inclusion criteria. These studies included 66 children with CP aged 5-18 years. One of the included studies utilized a group research design, whereas the remaining used single-subject designs. Studies investigated literacy instruction methods designed to teach phonics, sight-word recognition, reading fluency, reading comprehension, spelling, or written expression skills, or multicomponent instruction (instruction methods encompassing three or more of these skills). Most instruction methods were associated with gains in reading and writing skills with medium to large effects; however, our analysis of methodological rigor suggests that these findings need to be interpreted with caution. CONCLUSIONS We propose that literacy instruction utilizing evidence-based principles can be effective for children with CP, provided instruction is accessible and allows children to demonstrate and receive feedback on their skills; however, further research is greatly needed. Clinical implications and priorities for future research are discussed. SUPPLEMENTAL MATERIAL https://doi.org/10.23641/asha.21357558.
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Affiliation(s)
- Annemarie Murphy
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Benjamin Bailey
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
| | - Joanne Arciuli
- Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, South Australia, Australia
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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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Eek MN, Blomkvist A, Olsson K, Lindh K, Himmelmann K. Objective measurement of sitting - Application in children with cerebral palsy. Gait Posture 2022; 96:210-215. [PMID: 35700638 DOI: 10.1016/j.gaitpost.2022.05.039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 04/27/2022] [Accepted: 05/31/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Children with cerebral palsy (CP) and a severe motor impairment, have limited ability to perform volitional movements due to spasticity, involuntary postures and movements and reduced ability to maintain antigravity head and trunk control. A stable sitting position is a prerequisite for participation in daily life, but there is a lack of objective measurement methods for this population. RESEARCH QUESTION Is it feasible to measure a stable sitting position with pressure mapping and 2D motion analysis, and can it detect differences to a) a reference group, b) between subgroups of CP and c) before and after treatment with intrathecal baclofen (ITB)? METHODS Pressure mapping, and a 2D motion analysis system, were used to capture movements of centre of pressure (CoP), and movements of head, hand and leg, sitting on a bench for 90 s. Twenty-two children with dyskinetic or bilateral spastic CP, GMFCS III-V, mean age 9.0, and 30 children with typical development (TD) mean age 10.7, were recruited between 2010 and 2019. Seventeen children were treated with ITB. Parents were interviewed regarding aspect of sitting. Non-parametric methods were used for statistical analysis. RESULTS Differences in CoP and kinematics were detected with more movements in children with CP compared to children with TD (p < 0.001). There were more movements in children with dyskinetic CP compared to children with bilateral spastic CP as captured with the pressure mapping system (CoP distance p = .005 and Anterio-Posterior sway p = .014). After treatment with ITB, involuntary movements had decreased (CoP p = 0.006-0.035, kinematics p = 0.002-0.020). Parents reported improvement in sitting. The two measurement systems showed consistent results (rho 0.500-0.771, p = <0.001-0.049). SIGNIFICANCE It was feasible to objectively measure sitting position in children with a moderate-to-severe motor impairment with differences to a reference group and after an intervention. CoP and head movements were the variables that were easiest to capture.
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Affiliation(s)
- Meta N Eek
- Department of Health and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Sweden.
| | - Annika Blomkvist
- Regional Rehabilitation Centre, Sahlgrenska University Hospital, Box 21062, 418 04 Gothenburg, Sweden
| | - Kristina Olsson
- Regional Rehabilitation Centre, Sahlgrenska University Hospital, Box 21062, 418 04 Gothenburg, Sweden
| | - Karin Lindh
- Regional Rehabilitation Centre, Sahlgrenska University Hospital, Box 21062, 418 04 Gothenburg, Sweden
| | - Kate Himmelmann
- Regional Rehabilitation Centre, Sahlgrenska University Hospital, Box 21062, 418 04 Gothenburg, Sweden; Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden
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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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