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The impact of gaze-based assistive technology on daily activities in children with severe physical impairments
Linköpings universitet, Institutionen för samhälls- och välfärdsstudier, Hälsa, Aktivitet, Vård (HAV). Linköpings universitet, Medicinska fakulteten.
2016 (Engelska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
Abstract [en]

Aim: The aim of the thesis was to investigate the impact of gaze-based assistive technology on daily activities in children with severe physical impairments and without speech. The objectives were to develop and pilot a gaze-based assistive technology intervention (GAT intervention) at home and in school for these children and to understand its impact on daily activities as experienced by their parents.

Methods: Study I was a pilot study in which the basic components that were developed for the intervention were evaluated for students with physical impairments. The study aimed at improving the use of computers as assistive technology (AT) in school. Based on the findings in Study I, the GAT intervention was developed. The GAT intervention aimed at implementing gaze-based AT in daily activities. It consisted of two parts; having access to gaze-based AT and having access to services from a multi professional communication team during nine to ten months. Studies II-IV concerned gazebased AT for children with severe physical impairments without speech who participated in the GAT intervention. The participants were ten children (ages 1-15) (Studies II, III), and their parents (Study IV). Studies II and III had longitudinal designs and children were followed during 15-20 months with repeated measurements before, after and at follow-up. In Study II children’s repertoire of computer activities, extent of use, and goal attainment with gaze-based AT was evaluated, as well as parents’ satisfaction with the AT and with services. In Study III children’s eye gaze performance when using gaze-based AT was examined. In Study IV, parents were interviewed twice with the aim of  exploring their experiences of children’s gaze-based AT use in daily life. In Study IV a hermeneutical approach was used.

Results: The findings of Study I showed that the basic components of intervention improved the use of computers in school. Study II showed an increased repertoire of computer activities with the gazebased AT, maintained use in daily activities for all at follow up, and that all children attained goals for gaze-based AT use in daily activities. Parents were satisfied with the gaze-based AT, and with the services in the GAT intervention. In study III, nine children improved in eye gaze performance over time when using the gaze-based AT in daily activities. Study IV revealed that children’s gaze-based AT usage in daily activities made a difference to parents since the children demonstrated agency, and showed their personality and competencies by using gaze-based AT, and for the parents this opened up infinite possibilities for the child to do and learn things. Overall, children’s gaze-based AT usage provided parents with hope of a future in which their children could develop and have influence in life.

Conclusions: This thesis shows that these children with severe physical impairments and without speech acquired sufficient gaze control skills to use gaze-based AT for daily activities in the home and at school. The gaze-based AT had a positive impact on performing activities, for example, play activities and communication- and interaction-related activities. For the parents, children’s gaze-based AT usage made a difference since it shaped a hope of a better future for their children, where they can develop and gain influence in their future life. Furthermore, the children continued to perform daily activities with gaze-based AT over time. This finding suggests that key persons were provided with sufficient knowledge and skills to support children in maintained use of gaze-based AT after withdrawal of the services provided in the GAT intervention.

Ort, förlag, år, upplaga, sidor
Linköping: Linköping University Electronic Press, 2016. , s. 93
Serie
Linköping University Medical Dissertations, ISSN 0345-0082 ; 1490
Nyckelord [en]
Cerebral palsy, computer activities, daily activities, eye gaze control, self-help devices
Nationell ämneskategori
Sjukgymnastik Arbetsmedicin och miljömedicin
Identifikatorer
URN: urn:nbn:se:liu:diva-123303DOI: 10.3384/diss.diva-123303ISBN: 978-91-7685-913-1 (tryckt)OAI: oai:DiVA.org:liu-123303DiVA, id: diva2:881273
Disputation
2016-01-15, K1, Kåkenhus, Campus Norrköping, Norrköping, 13:00 (Svenska)
Opponent
Handledare
Tillgänglig från: 2015-12-10 Skapad: 2015-12-10 Senast uppdaterad: 2018-01-10Bibliografiskt granskad
Delarbeten
1. Improving computer usage for students with physical disabilities through a collaborative approach: A pilot study
Öppna denna publikation i ny flik eller fönster >>Improving computer usage for students with physical disabilities through a collaborative approach: A pilot study
2013 (Engelska)Ingår i: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 20, nr 6, s. 463-470Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Objective: The aim of this study was to evaluate the effect of an assistive technology (AT) intervention to improve the use of available computers as assistive technology in educational tasks for students with physical disabilities during an ongoing school year. Methods: Fifteen students (aged 12-18) with physical disabilities, included in mainstream classrooms in Sweden, and their teachers took part in the intervention. Pre-, post-, and follow-up data were collected with Goal Attainment Scaling (GAS), a computer usage diary, and with the Psychosocial Impact of Assistive Devices Scale (PIADS). Teachers opinions of goal setting were collected at follow-up. Results: The intervention improved the goal-related computer usage in educational tasks and teachers reported they would use goal setting again when appropriate. At baseline, students reported a positive impact from computer usage with no differences over time regarding the PIADS subscales independence, adaptability, or self-esteem. Discussion: The AT intervention showed a positive effect on computer usage as AT in mainstream schools. Some additional support to teachers is recommended as not all students improved in all goal-related computer usage. A clinical implication is that students computer usage can be improved and collaboratively established computer-based strategies can be carried out by teachers in mainstream schools.

Ort, förlag, år, upplaga, sidor
Informa Healthcare, 2013
Nyckelord
Assistive technology, children with disabilities, goal setting, intervention, self-help devices
Nationell ämneskategori
Medicin och hälsovetenskap
Identifikatorer
urn:nbn:se:liu:diva-102984 (URN)10.3109/11038128.2013.837506 (DOI)000328280300008 ()
Anmärkning

Funding Agencies|Swedish Research Council||Swedish Institute of Assistive Technology||Norrbacka-Eugeniastiftelsen||

Tillgänglig från: 2014-01-09 Skapad: 2014-01-09 Senast uppdaterad: 2017-12-06
2. Gaze-based assistive technology in daily activities in children with severe physical impairments: an intervention study
Öppna denna publikation i ny flik eller fönster >>Gaze-based assistive technology in daily activities in children with severe physical impairments: an intervention study
Visa övriga...
2017 (Engelska)Ingår i: Developmental Neurorehabilitation, ISSN 1751-8423, E-ISSN 1751-8431, Vol. 20, nr 3, s. 129-141Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Objective: To establish the impact of a gaze-based assistive technology (AT) intervention on activity repertoire, autonomous use, and goal attainment in children with severe physical impairments, and to examine parents’ satisfaction with the gaze-based AT and with services related to the gaze-based AT intervention.

Methods: Non-experimental multiple case study with before, after, and follow-up design. Ten children with severe physical impairments without speaking ability (aged 1–15 years) participated in gaze-based AT intervention for 9–10 months, during which period the gaze-based AT was implemented in daily activities.

Results: Repertoire of computer activities increased for seven children. All children had sustained usage of gaze-based AT in daily activities at follow-up, all had attained goals, and parents’ satisfaction with the AT and with services was high.

Discussion: The gaze-based AT intervention was effective in guiding parents and teachers to continue supporting the children to perform activities with the AT after the intervention program.

Ort, förlag, år, upplaga, sidor
Taylor & Francis, 2017
Nyckelord
Cerebral palsy, computer activities, eye-tracking technology, goal achievement, self-help devices
Nationell ämneskategori
Arbetsmedicin och miljömedicin Arbetsterapi
Identifikatorer
urn:nbn:se:liu:diva-123300 (URN)10.3109/17518423.2015.1132281 (DOI)000399489800003 ()26930111 (PubMedID)
Anmärkning

Funding agencies|Swedish Research Council; Jimmy Dahlstens Fond; Stiftelsen Sunnerdahls Handikappfond

At the time for thesis presentation publication was in status: Manuscript.

Tillgänglig från: 2015-12-10 Skapad: 2015-12-10 Senast uppdaterad: 2018-01-10Bibliografiskt granskad
3. Eye gaze performance for children with severe physical impairments using gaze-based assistive technology: a longitudinal study
Öppna denna publikation i ny flik eller fönster >>Eye gaze performance for children with severe physical impairments using gaze-based assistive technology: a longitudinal study
Visa övriga...
2016 (Engelska)Ingår i: Assistive technology, ISSN 1040-0435, E-ISSN 1949-3614, Vol. 28, nr 2, s. 93-102Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Gaze-based assistive technology (gaze-based AT) has the potential to provide children affected by severe physical impairments with opportunities for communication and activities. This study aimed to examine changes in eye gaze performance over time (time on task and accuracy) in children with severe physical impairments, without speaking ability, using gaze-based AT. A longitudinal study with an AB design was conducted on ten children (aged 1–15 years) with severe physical impairments, who were beginners to gaze-based AT at baseline. Thereafter, all children used the gaze-based AT in daily activities over the course of the study. Compass computer software was used to measure time on task and accuracy with eye selection of targets on screen, and tests were performed with the children at baseline, after 5 months, 9–11 months, and after 15–20 months. Findings showed that the children improved in time on task after 5 months and became more accurate in selecting targets after 15–20 months. This study indicates that these children with severe physical impairments, who were unable to speak, could improve in eye gaze performance. However, the children needed time to practice on a long-term basis to acquire skills needed to develop fast and accurate eye gaze performance.

Nyckelord
assistive devices, computer access, physical disability
Nationell ämneskategori
Pediatrik Psykologi (exklusive tillämpad psykologi)
Identifikatorer
urn:nbn:se:liu:diva-123301 (URN)10.1080/10400435.2015.1092182 (DOI)000376031400004 ()26496529 (PubMedID)
Anmärkning

Funding agencies: Swedish Research Council; Stiftelsen Sunnerdahls Handikappfond; Jimmy Dahlstens Fond

Tillgänglig från: 2015-12-10 Skapad: 2015-12-10 Senast uppdaterad: 2018-03-17Bibliografiskt granskad
4. Gaze-based assistive technology used in daily life by children with severe physical impairments: parents’ experiences
Öppna denna publikation i ny flik eller fönster >>Gaze-based assistive technology used in daily life by children with severe physical impairments: parents’ experiences
2017 (Engelska)Ingår i: Developmental Neurorehabilitation, ISSN 1751-8423, E-ISSN 1751-8431, Vol. 20, nr 5, s. 301-308Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

This study aims to describe and explore parents’ experiences when their children with severe physical impairments receive gaze-based assistive technology (gaze-based AT) for use in daily life. Semi-structured interviews were conducted twice, with one year in between, with parents of eight children with cerebral palsy that used gaze-based AT in their daily activities. To understand the parents’ experiences, hermeneutical interpretations were used during data analysis. The results demonstrate that for parents, children’s gaze-based AT usage meant that children demonstrated agency, provided them with opportunities to show  personality and competencies, and gave children possibilities to develop. Overall, children’s gaze-based AT provides hope to parents for a better future for their children with severe physical impairments; a future in which the children can develop and gain influence in life. In conclusion, gaze-based AT provides children with new opportunities to perform activities and take initiatives to communicate, giving parents hope about the children’s future.

Ort, förlag, år, upplaga, sidor
Taylor & Francis, 2017
Nyckelord
Activities in daily life, cerebral palsy, eye tracking controlled system, self-help devices, parental hope, qualitative
Nationell ämneskategori
Arbetsmedicin och miljömedicin Arbetsterapi
Identifikatorer
urn:nbn:se:liu:diva-123302 (URN)10.1080/17518423.2016.1211769 (DOI)000406527400008 ()
Anmärkning

Funding agencies: Swedish Research Council; Jimmy Dahlstens Fond; Stiftelsen Sunnerdahls Handikappfond

Tillgänglig från: 2015-12-10 Skapad: 2015-12-10 Senast uppdaterad: 2019-06-28Bibliografiskt granskad

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