Hope and Technology: Other-Oriented Hope Related to Eye Gaze Technology for Children with Severe Disabilities

Intervention with hand orthosis: experience from boys with Duchenne muscular dystrophy and their parents

PURPOSE

To identify and describe possible ways of experiencing an intervention with hand orthoses in a study group including boys with Duchenne muscular dystrophy (DMD) and their parents. To capture the experiences of the persons directly involved as well as their family members.

MATERIAL AND METHODS

Eight boys with DMD (aged 8-21; median age 17.7) and five of their parents were interviewed immediately post-intervention. Additionally, follow-up interviews were later performed with five boys and three parents.

RESULTS

Ten categories of intervention experiences emerged and were allocated to three aspects: "Prerequisites in the treatment situation", "The intervention makes a difference" and "Instilling hope for the future". The requirements for intervention success include co-operation with parents and hand orthoses with a good fit. Maintained or increased joint mobility, reduced pain and improved occupational performance were experienced.

CONCLUSION

The boys and parents perceived that the intervention with hand orthoses could counteract the deterioration of the boys' hands. This instilled hope of preserving occupational performance throughout life. They also considered that a good hand-orthosis fit, appropriate adjustments to daily routines and good co-operation with the people around them were important for the intervention to be and remain successful.

Parents' Perceptions of Eye-Gaze Technology Use by Children With Complex Communication Needs

PURPOSE

Some preschool students with complex communication needs explore eye-gaze computer technology (EGCT) and adopt computer-based augmentative and alternative communication (AAC). The objective of this study was to follow preschool explorers of EGCT who are now school aged to describe the children's use of technology and parents' perceptions of its utility for communication, participation, or leisure.

METHOD

Ten parents completed survey questions by Internet and phone and reported their perceptions of nine children's effectiveness in the use and acceptance of AAC and the support they received in implementing technology. The results are reported as a descriptive study.

RESULTS

All children in this research continue to use AAC technology in school and most at home. Many children who tried and obtained EGCT while in preschool continue to use that technology. Most parents agreed that the children understood how to use the devices, which enhanced the children's communication, and that the parents received sufficient support. Most children were limited in their use of the devices for leisure and control of their environments.

CONCLUSIONS

Computer-based AAC for school-aged children who trialed it when they were in preschool appears to be a powerful means for them to communicate and participate. However, the technology appears not to be used to its full capabilities to support the children's agency to control environments and to pursue leisure. Teams may want to consider how to support children in using their AAC devices to meet multiple needs. The study was limited by its small sample size and its descriptive nature. Additional research on this subject is needed.

The Impact of Eye-gaze Controlled Computer on Communication and Functional Independence in Children and Young People with Complex Needs - A Multicenter Intervention Study

INTRODUCTION

Children and young people with complex needs (severe motor impairments and without speech) have few opportunities to use alternative devices for communication. Eye-gaze controlled computers (EGCCs) might provide individuals with complex needs increased opportunities for communication and participation in society.

OBJECTIVE

To investigate the impact of EGCCs on communication, functional independence and participation in activities in children and young people with complex needs.

METHODS

A multicenter intervention study during seven months, measuring outcomes with or without EGCC at four time points, was conducted in Sweden, Dubai, and in USA. Seventeen participants (aged 3-26 years, diagnosis e.g. cerebral palsy, Rett syndrome) were provided with EGCC and services from an Assistive Technology center to implement EGCC in school and/or at home.

RESULTS

Participants significantly increased their expressive communication skills and functional independence with EGCC compared to baseline. All but one (16 of 17) increased their activity repertoire and computer use with EGCC. With EGCC, participation in computer activities averaged 4.1 performed activities (e.g. communication, play), with a duration of 70 minutes/day and a frequency of 76% of days.

DISCUSSION

The study strengthened the research evidence that EGCC can be an effective intervention in daily life for children and young people with complex needs. Communication and independence, common goals of intervention, were shown to be relevant EGCC outcomes.