The impact of Snoezelen in pediatric complex continuing care: A pilot study

Perceptions of a virtual reality sensory room for adults with neurodevelopmental disabilities

PURPOSE

Mental ill health and sensory processing difficulties often limit participation in everyday life for adults with neurodevelopmental disabilities. Interventions using technology such as virtual reality (VR) are increasingly accessible and may mitigate these difficulties. Understanding what contributes to the successful implementation of novel interventions is important for future use and evaluation. This study aimed to explore the feasibility of implementing a VR sensory room for adults with neurodevelopmental disabilities, their carers and support staff and to explore future iterations of the product and process.

MATERIALS AND METHODS

Thirteen stakeholders who participated in a pilot trial of a VR sensory room were interviewed. Interviews were recorded and transcribed verbatim for thematic analysis.

RESULTS

Eleven themes were identified which indicated that adults with neurodevelopmental disabilities found the VR sensory room to be mostly acceptable and enjoyable with usage largely consistent. Individual variation and support requirements were highlighted for each user. Future use may require modifications to the headset, in-built customisation options as well as buy-in and training for support staff.

CONCLUSIONS

The VR Sensory room is a promising tool to support adults with neurodevelopmental disabilities and results warrant further scaled research into the impact of this tool on outcomes for adults with disabilities.Implications for RehabilitationWhilst adults with neurodevelopmental disabilities may experience sensory processing difficulties which impact their everyday life, there is a paucity of interventions to address these difficulties.Implementation studies offer the opportunity to explore how evidence-based interventions may be implemented to facilitate the best outcomes.A Virtual Reality Sensory Room may offer an innovative alternative to a traditional sensory room for adults with neurodevelopmental disabilities where implementation is well supported.

Effectiveness of sensory adaptive dental environments to reduce psychophysiology responses of dental anxiety and support positive behaviours in children and young adults with intellectual and developmental disabilities: a systematic review and meta-analyses

BACKGROUND

People with Intellectual and developmental disabilities (IDDs) experience oral health inequality due to myriad of risk factors and complex needs. Sensory processing difficulties, maladaptive behaviours and dental anxiety contribute to difficulties in receiving preventive and routine dental treatments. This study aimed to systematically review the evidence on the effectiveness of sensory adaptive dental environments (SADE) for children and young adults (up to the ages 24 years) with IDD to address cooperation and dental anxiety.

METHODS

This review was reported according to The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. MEDLINE (Ovid), The Cochrane Library, Embase, Google Scholar, Web of Science and OT Seeker were searched using appropriate terms to identify Randomised Control Trails (RCTs) that matched inclusion criteria. Screening was conducted by two reviewers after de-duplication based on titles and abstracts followed by full text retrieval. Quality of the included studies was assessed using Cochrane Risk of Bias (ROB)-2 for crossover trials and data extracted by two reviewers. The details of the interventions and effectiveness were compared and discussed narratively, and comparable outcomes were included to meta-analyses using R software.

RESULTS

A total of 622 articles were identified and five articles met eligibility for inclusion. Three studies used multi-sensory adaptations and one used single sensory adaptation of music. Narrative synthesis showed some evidence of SADE reducing magnitude and duration, although, questionable for reducing the number of maladaptive behaviours. Two studies demonstrated conflicting evidence of the effect of SADE on cooperation. Three studies demonstrated significant positive impact of SADE on psychophysiological outcomes. Despite an overall tendency to favour SADE, no statistically significant difference of maladaptive behaviours was found between SADE and regular dental environment (RDE) (Standardised mean change (SMC) = 0.51; 95% Confidence Interval (CI) -0.20 to 1.22; p = 0.161). SADE was superior to RDE (SMC -0.66; 95% CI -1.01 to -0.30; p =  < 0.001) in reducing psychophysiological responses of dental anxiety.

CONCLUSION

Current evidence suggests that adapting visual, tactile, and auditory aspects of the dental environment in a single or multi-sensory approach demonstrates small positive effects on psychophysiological responses and maladaptive behaviours of dental anxiety for people with IDD.

TRIAL REGISTRATION

The title of this review was registered with PROSPERO (CRD42022322083).

Evaluating a virtual reality sensory room for adults with disabilities

Sensory processing difficulties can negatively impact wellbeing in adults with disabilities. A range of interventions to address sensory difficulties have been explored and virtual reality (VR) technology may offer a promising avenue for the provision of sensory interventions. In this study, preliminary evidence about the impact of Evenness, an immersive VR sensory room experience, for people with disabilities was investigated via a single intervention pre-post mixed methods design. Quantitative methodology included single intervention pre-post design (five month timeframe) with 31 adults with various developmental disabilities to determine the impact of use of aVR sensory room using a head mounted display (HMD) in relation to anxiety, depression, sensory processing, personal wellbeing and adaptive behaviour. Qualitative semi-structured interviews were also conducted with thirteen purposefully selected stakeholders following Evenness use. Results indicated significant improvements in anxiety, depression and sensory processing following Evenness use. Qualitative analysis corroborated the anxiety findings. No significant changes were observed in personal wellbeing or adaptive behaviour. Results are promising and indicate that a VR sensory room may have a positive impact on anxiety, depression and sensory processing for adults with disabilities. A longer study timeframe and a more rigorous experimental methodology is needed to confirm these findings.

Clinical Utility of Multisensory Environments for People With Intellectual and Developmental Disabilities: A Scoping Review

IMPORTANCE

Adults with intellectual and developmental disabilities (IDD) are twice as likely as their peers without disabilities to have had a physical exam in the past year; however, as a result of challenging behavior during office visits, they are significantly less likely to have received recommended health screenings. Challenging behaviors in clinical settings have been identified as a barrier to providing adequate care for this population.

OBJECTIVE

This scoping review examined the within-session effects of multisensory environments (MSEs) on people with IDD to determine the clinical utility of MSEs for this population.

DATA SOURCES

Studies published between January 1, 2000, and August 1, 2018, were identified using Summon and Google Scholar.

STUDY SELECTION

Studies were included in the review if they systematically collected and reported data on within-session effects of an MSE intervention on people with IDD.

FINDINGS

Thirteen studies met criteria for this review: 4 with Level I evidence, 2 with Level II evidence, 3 with Level III evidence, and 4 with Level IV evidence. Studies examined the effects of MSEs on maladaptive behaviors, positive behaviors, distress and discomfort, activity and alertness states, and cost of care for people with IDD.

CONCLUSION AND RELEVANCE

Preliminary support was found for the use of MSEs in clinical settings to reduce anxiety and challenging behaviors in patients with IDD during clinical care. Further research is needed to determine the efficacy of MSEs for producing the effects described in this review.

WHAT THIS ARTICLE ADDS

The findings support the potential of MSEs as a tool that occupational therapy practitioners can use to support their clients with IDD who have sensory sensitivities in clinical settings. This article also highlights a multidisciplinary approach whereby medical providers and occupational therapy practitioners could work together in nontraditional ways to support this population.

The design of electronic medical records for patients of continuous care

In order to meet the ever-increasing needs of health care, as well as helping patients who need continuous care after being discharged from the hospital and making modern medical technology better serve humans, the design of electronic medical records for continuous care patients, especially those with malignant tumors, is investigated. In the research process, the idea of Browser/Server (B/S) framework is adopted, and the corresponding electronic medical record system is designed based on the targets and the overall structure of the system; afterward, the black-box testing and white-box testing are carried out to test the functions, reliability, and stability of the designed electronic medical record system; in addition, combined with other research results, the feasibility of the design is proved. It can be seen that the electronic medical record system designed for patients who need continuous care in the study is absolutely feasible, which can be further researched and improved with the development of electronic medical records; therefore, it would make greater contributions to both patients and hospitals in the future.