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Piekema L, Ten Brug A, Waninge A, van der Putten A. From assistive to inclusive? A systematic review of the uses and effects of technology to support people with pervasive support needs. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2024; 37:e13181. [PMID: 38369310 DOI: 10.1111/jar.13181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 10/27/2023] [Accepted: 11/15/2023] [Indexed: 02/20/2024]
Abstract
BACKGROUND Although particular technologies can enhance the quality of life (QoL) of people with profound intellectual and multiple disabilities (we use the term pervasive support needs), their objectives and outcomes are understudied. A systematic literature review was therefore conducted to explore this topic. METHOD A search of four databases yielded 64 studies. Data were extracted on their general characteristics, methods and sample characteristics as well as the technology types, QoL domains and application within ecological systems. A narrative synthesis was subsequently developed. RESULTS Most of the studies applied assistive technology (AT) and focused on personal development and self-determination on an individual level. CONCLUSIONS Technology can enhance the QoL of people with pervasive support needs. There are indications that although MT and UD-based technology are used in practice, few studies have examined these technologies. Therefore, there is a knowledge gap regarding the kinds of technology that are used in practice.
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Affiliation(s)
- Lotte Piekema
- Department of Inclusive and Special Needs Education, University of Groningen, Groningen, The Netherlands
| | - Annet Ten Brug
- Department of Inclusive and Special Needs Education, University of Groningen, Groningen, The Netherlands
| | - Aly Waninge
- Hanze University of Applied Sciences Groningen, Research Group Healthy Ageing, Allied Health Care and Nursing, Groningen, The Netherlands
- Health Psychology Research, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Annette van der Putten
- Department of Inclusive and Special Needs Education, University of Groningen, Groningen, The Netherlands
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Moore TR, Lee S, Freeman R, Mahmoundi M, Dimian A, Riegelman A, Simacek JJ. A Meta-Analysis of Treatment for Self-Injurious Behavior in Children and Adolescents With Intellectual and Developmental Disabilities. Behav Modif 2024; 48:216-256. [PMID: 38197303 DOI: 10.1177/01454455231218742] [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] [Indexed: 01/11/2024]
Abstract
Self-injurious behavior (SIB) among children and youth with developmental disabilities has not diminished in prevalence despite the availability of effective interventions, and the impact on quality of life for people and their families is devastating. The current meta-analysis reviews SIB intervention research between 2011 and 2021 using single-case experimental designs with children and youth up to 21 years old and provides a quantitative synthesis of data from high-quality studies including moderator analyses to determine effects of participant and study characteristics on intervention outcomes. Encouraging findings include a high level of effectiveness across studies in the decrease of SIB (Tau-U = -0.90) and increase of positive behavior (Tau-U = 0.73), as well as an increase in studies (relative to prior reviews) reporting intervention fidelity, generalization, maintenance, and social validity. However, our findings shed limited light on potential moderating variables in the development of interventions for children and youth who exhibit SIB. Of the potential moderators of intervention effects, only implementer (researcher/therapist vs. parent/caregiver) and setting (clinic vs. home) were significantly associated with improved outcomes. We discuss the need for more robust involvement of natural communities of implementers in SIB intervention research to better equip them to effectively and sustainably meet the needs of people they care for. We also discuss the importance of creating systems enabling broad access for children with SIB to effective interventions in service of reducing burden for people, families, and society over time.
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Affiliation(s)
- Timothy R Moore
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, USA
| | - Seunghee Lee
- Institute on Community Integration, University of Minnesota, Minneapolis, USA
| | - Rachel Freeman
- Institute on Community Integration, University of Minnesota, Minneapolis, USA
| | - Maryam Mahmoundi
- Institute on Community Integration, University of Minnesota, Minneapolis, USA
| | - Adele Dimian
- Institute on Community Integration, University of Minnesota, Minneapolis, USA
| | - Amy Riegelman
- Social Sciences Libraries, University of Minnesota, Minneapolis, USA
| | - Jessica J Simacek
- Institute on Community Integration, University of Minnesota, Minneapolis, USA
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Stasolla F, Passaro A, Di Gioia M, Curcio E, Zullo A. Combined extended reality and reinforcement learning to promote healthcare and reduce social anxiety in fragile X syndrome: a new assessment tool and a rehabilitative strategy. Front Psychol 2023; 14:1273117. [PMID: 38179497 PMCID: PMC10765535 DOI: 10.3389/fpsyg.2023.1273117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 11/30/2023] [Indexed: 01/06/2024] Open
Affiliation(s)
| | - Anna Passaro
- University “Giustino Fortunato” of Benevento, Benevento, Italy
| | | | - Enza Curcio
- University “Giustino Fortunato” of Benevento, Benevento, Italy
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Stasolla F, Caffò AO, Bottiroli S, Ciarmoli D. An assistive technology program for enabling five adolescents emerging from a minimally conscious state to engage in communication, occupation, and leisure opportunities. Dev Neurorehabil 2022; 25:193-204. [PMID: 34895026 DOI: 10.1080/17518423.2021.2011457] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Post-coma patients emerging from a minimally conscious state may have extensive motor disabilities and pose serious challenges to medical centers and home settings. OBJECTIVES To promote academic performance and communication skills of post-coma individuals with traumatic brain injuries emerging from a minimally conscious state through an Assistive Technology setup. To evaluate its effects on the participants' positive participation. To generalize the learning process. To assess the intervention's clinical and social validity. METHOD Study I included five adolescents exposed to an Assistive Technology setup enabling them with targeted adaptive behaviors. Study II involved fifty external raters in a social validation assessment. RESULTS Data evidenced an improved performance of all the participants during the intervention, assessed through a concurrent multiple baseline design across participants. Social raters favorably scored the use of the technology. CONCLUSION An Assistive Technology setup may be helpful to enhance the performance and positive participation of adolescents with traumatic brain injuries emerging from a minimally conscious state.
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Affiliation(s)
| | - Alessandro O Caffò
- Department of Educational Sciences, Psychology, Communication, University "Aldo Moro", Bari, Italy
| | - Sara Bottiroli
- "Giustino Fortunato" University of Benevento, Benevento, Italy.,IRCCS Mondino Foundation, Pavia, Italy
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Stasolla F. Virtual Reality and Wearable Technologies to Support Adaptive Responding of Children and Adolescents With Neurodevelopmental Disorders: A Critical Comment and New Perspectives. Front Psychol 2021; 12:720626. [PMID: 34322073 PMCID: PMC8311117 DOI: 10.3389/fpsyg.2021.720626] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 06/18/2021] [Indexed: 12/16/2022] Open
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Oudshoorn CEM, Frielink N, Nijs SLP, Embregts PJCM. Psychological eHealth interventions for people with intellectual disabilities: A scoping review. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2021; 34:950-972. [PMID: 33704872 PMCID: PMC8359285 DOI: 10.1111/jar.12877] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Revised: 01/19/2021] [Accepted: 01/29/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND The use of eHealth, which has accelerated in the wake of the COVID-19 pandemic, could contribute to the access to tailor-made psychological interventions for people with intellectual disabilities. METHOD A scoping review was conducted on peer-reviewed studies between 1996-2019. RESULTS Thirty-three studies reported on the use of psychological eHealth interventions focused on mental health problems and/or challenging behaviour. The vast majority of these studies reported on interventions that were delivered at the individual level. The context in which these interventions were delivered varied, primarily ranging from the home setting to residential settings, as well as day or activity centres and schools. The studies described various types of interventions: telehealth interventions, computerized cognitive behavioural therapy, and interventions focused on (social) learning principles targeting challenging behaviour. CONCLUSIONS eHealth provides new opportunities for both therapists and lay-therapists to deliver psychological interventions. Future studies should focus on the effectiveness of psychological eHealth interventions.
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Affiliation(s)
- Cathelijn E. M. Oudshoorn
- TranzoTilburg School of Social and Behavioral SciencesTilburg UniversityTilburgThe Netherlands
- ASVZSliedrechtThe Netherlands
| | - Noud Frielink
- TranzoTilburg School of Social and Behavioral SciencesTilburg UniversityTilburgThe Netherlands
| | - Sara L. P. Nijs
- TranzoTilburg School of Social and Behavioral SciencesTilburg UniversityTilburgThe Netherlands
| | - Petri J. C. M. Embregts
- TranzoTilburg School of Social and Behavioral SciencesTilburg UniversityTilburgThe Netherlands
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Stasolla F, Caffò AO, Perilli V, Albano V. Experimental Examination and Social Validation of a Microswitch Intervention to Improve Choice-Making and Activity Engagement for Six Girls with Rett Syndrome. Dev Neurorehabil 2019; 22:527-541. [PMID: 31169045 DOI: 10.1080/17518423.2019.1624655] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Background: The use of assistive technology, specifically microswitches, with children with RTT has been shown to effectively moderate the impact of their disability on their quality of life- by facilitating access to meaningful leisure and other activities. Objectives: This study aimed to evaluate the effectiveness of a microswitch intervention on increased choice making, engagement in a targeted sorting activity, and indices of happiness, and decreased stereotypic behaviors for six girls with Rett syndrome. Targeted dependent variables were also assessed at six months post-intervention. Following the intervention study, 90 external raters completed a social validation procedure. Method: An ABABAB experimental sequence was implemented for each participant with a cross-over effect. A social validation assessment involving 90 external raters was carried out. Results: Data emphasized an improved performance for each participants involved (i.e., adaptive responses). Five participants showed a capacity of independent choice. One participant seemed to be closely linked to the position of the container. Social raters favorably endorsed the use of the program since they positively evaluated the use of the technology on all the dimensions investigated. Conclusion: A microswitch intervention may improve choice making and activity engagement for children with Rett syndrome. Further research is needed on the development of more sophisticated forms of individualized technological options to improve opportunities for enhanced engagement and choice-making for individuals with RTT.
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Affiliation(s)
| | | | | | - Vincenza Albano
- Department of Educational Sciences, Psychology, Communication, University of Bari , Italy
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Raspa M, Fitzgerald T, Furberg RD, Wylie A, Moultrie R, DeRamus M, Wheeler AC, McCormack L. Mobile technology use and skills among individuals with fragile X syndrome: implications for healthcare decision making. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2018; 62:821-832. [PMID: 30105880 PMCID: PMC6340143 DOI: 10.1111/jir.12537] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Revised: 06/27/2018] [Accepted: 07/19/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Little is known about how individuals with fragile X syndrome (FXS) and their families use technology in daily life and what skills individuals with FXS can perform when using mobile technologies. METHODS Using a mixed-methods design, including an online survey of parents (n = 198) and a skills assessment of individuals with FXS (n = 6), we examined the experiences and abilities of individuals with FXS for engaging with mobile technology. RESULTS Parents reported that individuals with FXS often used technology in their daily lives, with variations based on age of child, sex, autism status, depression, and overall ability. Parents frequently sought and shared FXS-related information online. Assessment data revealed that individuals with FXS demonstrated proficiency in interacting with technology. CONCLUSIONS Mobile technology is a tool that can be used in FXS to build skills and increase independence rather than simply for recreational purposes. Implications for using mobile technology to enhance healthcare decision making are discussed.
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Affiliation(s)
- Melissa Raspa
- RTI International, 3040 East Cornwallis Road, Research Triangle Park, NC 27709
| | - Tania Fitzgerald
- RTI International, 3040 East Cornwallis Road, Research Triangle Park, NC 27709
| | - Robert D. Furberg
- RTI International, 3040 East Cornwallis Road, Research Triangle Park, NC 27709
| | - Amanda Wylie
- RTI International, 3040 East Cornwallis Road, Research Triangle Park, NC 27709
| | - Rebecca Moultrie
- RTI International, 3040 East Cornwallis Road, Research Triangle Park, NC 27709
| | - Margaret DeRamus
- University of North Carolina at Chapel Hill, Carolina Institute for Developmental Disabilities, CB #7255, Chapel Hill, NC 27599-7255
| | - Anne C. Wheeler
- RTI International, 3040 East Cornwallis Road, Research Triangle Park, NC 27709
| | - Lauren McCormack
- RTI International, 3040 East Cornwallis Road, Research Triangle Park, NC 27709
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Stasolla F, Caffò AO, Perilli V, Boccasini A, Damiani R, D'Amico F. Assistive technology for promoting adaptive skills of children with cerebral palsy: ten cases evaluation. Disabil Rehabil Assist Technol 2018; 14:489-502. [DOI: 10.1080/17483107.2018.1467972] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Affiliation(s)
| | - Alessandro O. Caffò
- Department of Educational Sciences, Psychology, Communication, University of Bari, Bari, Italy
| | - Viviana Perilli
- Department of Neurosciences, University of Bari, Bari, Italy
| | - Adele Boccasini
- Department of Neurosciences, University of Bari, Bari, Italy
| | - Rita Damiani
- Department of Neurosciences, University of Bari, Bari, Italy
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Characterization, treatment patterns, and patient-related outcomes of patients with Fragile X syndrome in Germany: final results of the observational EXPLAIN-FXS study. BMC Psychiatry 2016; 16:318. [PMID: 27612457 PMCID: PMC5018176 DOI: 10.1186/s12888-016-1020-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Accepted: 08/29/2016] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND As data on the phenotype, characteristics and management of patients with Fragile X Syndrome (FXS) are limited, we aimed to collect such data in Germany in experienced centres involved in the treatment of such patients. METHODS EXPLAIN-FXS is a prospective observational (non-interventional) study (registry) performed between April 2013 and January 2016 at 18 sites in Germany. Requirements for patient participation included confirmed diagnosis of FXS by genetic testing (>200 CGG repeats) and written informed consent. Patients were followed for up to 2 years. RESULTS Seventy-five patients (84.0 % males, mean age 16.7 ± 14.5 years, ranging from 2 - 82 years) were analysed. The mean 6-item score, determined according to Giangreco (J Pediatr 129:611-614, 1996), was 6.9 ± 2.5 points. At least one neurological finding each was noted in 53 patients (69.7 %). Specifically, ataxia was noted in 5 patients (6.6 %), lack of fine motor skills in 40 patients, (52.6 %), muscle tonus disorder in 4 patients (5.3 %), and other neurological disorders in 39 patients (51.3 %). Spasticity was not noted in any patient. Seizures were reported in 6 patients (8.1 %), anxiety disorders in 22 patients (30.1 %), depression in 7 patients (9.6 %), ADHD/ADD in 36 patients (49.3 %), impairment of social behavior in 39 patients (53.4 %), and other comorbidities in 23 patients (31.5 %). The mean Aberrant Behaviour Checklist Community Edition (ABC-C) score on behavioral symptoms, obtained in 71 patients at first documentation, was 48.4 ± 27.8 (median 45.0, range 5-115). The mean visual analogue scale (VAS) score, obtained in 59 patients at first documentation, was 84.9 ± 14.6 points (median 90; range 50 - 100). CONCLUSIONS This report describes the largest cohort of patients with FXS in Europe. The reported observations indicate a substantial burden of disease for patients and their caregivers. Based on these observations, an early expert psychiatric diagnosis is recommended for suspected FXS patients. Further recommendations include multimodal and multi-professional management that is tailored to the individual patient's needs. TRIAL REGISTRATION The ClinTrials.gov identifier is NCT01711606 . Registered on 18 October 2012.
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