BACKGROUND:

Establishment in productive occupations i.e. work and further studies, is challenging for students who experience special educational needs (SEN).

OBJECTIVE:

The study aim was to investigate productive occupations and perceived work ability one year after upper secondary education among former students with SEN who had received a student-centred information and communication technology (ICT) intervention.

METHODS:

Questionnaire data on productive occupations (n = 81) were complemented with the semi-structured Worker Role Interview (WRI) concerning perceived work ability (n = 20), in an embedded mixed methods design. Group comparisons between participants who were and were not established in productive occupations were performed. Written notes from the WRI were analysed with a deductive content analysis.

RESULTS:

Findings demonstrated that almost two-thirds (63% n = 51) of the former students with SEN were established in productive occupations. The established group had to a higher extent obtained pass grades and had to a lesser extent received time-assisting ICT. Managing daily routines in combination with a productive role in a satisfactory manner was perceived as most challenging for the participants in relation to their work ability.

CONCLUSION:

The results indicate that students with SEN need person-centred support to handle difficulties both in and outside upper secondary school to promote the transition from school to establishment in productive occupations.

PurposeInformation and communication technology (ICT) has been proposed to enable an inclusive learning environment and increased participation for students with special educational needs. The aim of this study was to investigate the perceived need for ICT before and after an individualized ICT intervention among high school students with neurodevelopmental disorders and describe how the ICT was used to improve participation in school activities.Materials and methodsThis mixed-method study, with a one-group pre- and post-test design, included 99 high school students with neurodevelopmental disorders. Data from questionnaires and assessments using the School Setting Interview (SSI) were analyzed using descriptive statistics and the Wilcoxon signed-rank test. Deductive content analysis was performed on written notes in the SSI assessment.ResultsThe results showed that students median number of perceived needs for ICT in school activities had decreased from six needs at baseline to one need at follow-up (t16.5 df(98), p<.001). There were five SSI items for which over 50% of the students perceived a need for ICT, with most students (95%) needing support in the item Remember things. Students received a laptop, tablet or smartphone (95%), software for planning or structure (84%) and ICT for writing and reading (66%). The ICT facilitated participation in multiple school activities, providing reminders and structure, facilitating notetaking and improving spelling. After the ICT intervention, students (61%) experienced improved study results and improved ability to manage difficult school situations (68%).ConclusionTo conclude, an individualized ICT intervention as support to increase school participation is promising among high school students with neurodevelopmental disorders.

Background Evidence-based information and communication technology (ICT) interventions to enhance school participation among students with special educational needs (SEN) are required. Aim To evaluate the impact of an ICT intervention on school participation among upper secondary school students with special educational needs. Materials and methods Data on 300 students assessments with the School Setting Interview (SSI), grades and school attendance were used in this quasi-experimental study, with a one-group pretest-posttest design. Descriptive and inferential statistics and effect size were used, as well as Rasch analysis to generate interval data on the students ordinal SSI ratings. Results In the ICT intervention (median time eight hours), 54% of the students received a tablet, and software concerned with planning and structure was received by 85%. After the ICT intervention, a significant decrease in perceived need for adjustments in school activities was found on a group level and 30% of the students improved their school attendance. Students who benefitted the most from the ICT intervention had few adjustment needs in school activities and no special educational support at baseline. Conclusion An ICT intervention is promising for improving school participation among upper secondary school students with SEN.

Students in vocational programs have lower qualifications and more difficulties with successful entry into the labor market if they graduate without a diploma. The aim of this study was to describe the student - environment fit for high school students who are struggling with their studies in vocational programs, in terms of their perceived adjustment needs, and to describe planned interventions based on the students needs. The aim was also to investigate whether there was a relationship between students perceived adjustment needs and students self-reported mental health. The study included 25 students in six vocational programs at three different high schools in Sweden. The School Setting Interview was used to identify adjustment needs, and mental health problems were identified using the Strengths and Difficulties Questionnaire. Results showed that students identified adjustment needs to increase their participation in several school activities, and that academic school activities had the most identified needs. Interventions related to planning and organizing were most common. Results also showed a correlation between self-perceived adjustment needs and mental health. By identifying students adjustment needs, the chances of succeeding with student-centered interventions are increased, which in turn can support educational achievement.

Context-based collaboration between teachers and occupational therapists has shown promise as a strategy to enhance teachers capacity to enable the participation of children in elementary schools. In this study, we applied the Canadian Partnering for Change (P4C) model as a collaborative, coaching- and context-based approach in the Netherlands and Sweden. The aim was to gain insight into teachers and occupational therapists experiences of their collaboration applying P4C within their specific European elementary school context. To this end, we held semi-structured interviews with 4 teachers and 4 occupational therapists and performed a conventional, inductive content analysis of the ensuing interview transcripts. We found that participants collaboration in the classroom context was a continuous, multi-stage process that we defined as a unique mastery journey toward collaborative learning and trustful partnership. Participants indicated that they needed time to become familiar with the new collaboration, how they learned from each other, and that they enhanced childrens inclusion by applying strategies collaboratively. The results carry implications for the embedment of collaboration in schools and offer relevant strategies that serve the inclusion of all children. We propose that future studies evaluate the effects of P4C and seek to obtain a holistic picture of collaboratively applied actions.

The aim of this study was to investigate student-environment fit and perceived need of adjustments for students in the regular upper secondary school, with and without a diagnosis. The students (n = 419) were interviewed with the assessment School Setting Interview. The results showed that for seven of the 16 items, 60% or more of the students experienced that the demands of the school environment were not consistent with their abilities. Girls had a greater need of adjustments in eight of nine SSI school activities. The findings put an emphasis on the importance of recognizing the students individuals need of adjustments, and on offering flexible support in order to enhance the student-environment-fit and well-being of students in need of special educational support.

Background:Little is known about the everyday life of individuals with Rett syndrome. Aim/Objective:To describe ten participants (teenagers/young adults) activities during a period of seven days, the time-use, where and with whom the activities were performed and the participants responses in the form of visible/audible reactions during activities. Material and method:A time-geographic self-administered diary was filled in by 63 informants (parents/support staff) and analysed using the software, DAILY LIFE 2011. Results/Findings:The most frequently reported activities were hygiene/toilet, moving around indoors, eating and getting dressed. Most time was spent in sleeping, daily care, medical health care and travel/transportation. Little time remained for receptive activities, daytime rest, physical, social/creative, communication, school/daily work and domestic chore activities, especially for the young adults. Most time was spent with staff, thereafter with families and the least time was spent with friends. The most reported response was "interested", and "opposed" was the least reported. Conclusions:Daily and medical health care activities were time consuming. Improved communication between all parties may increase participation and well-being and provide solutions for handling unpleasant activities and sedentary time. Significance:A more varied range of activities may improve the everyday life for individuals with Rett syndrome.

The aim was to compare the presence of environmental barriers to participation and facilitators for assistive technology (AT) use and study the relation between barriers and AT use in three different AT devices. A cross-sectional survey was conducted. Inclusion criteria were ≥one year of experience as a user of myoelectric prosthesis (MEP), powered mobility device (PMD), or assistive technology for cognition (ATC) and age 20-90 years. Overall, 156 participants answered the Swedish version of the Craig Hospital Inventory of Environmental Factors and a study-specific questionnaire on facilitating factors. Non-parametric tests were used for comparisons. Barriers to participation were lowest in MEP users (md=0.12; p>0.001), and highest in ATC users (md=1.56; p>0.001) with the least support for AT use (p>0.001 - p=0.048). A positive correlation between fewer barriers and higher use of MEP was seen (r=0.30, p=0.038). The greatest barriers to participation were Natural environment, Surroundings and Information, and the most support came from relatives and professionals. Support, training and education are vital in the use of AT. These factors may lead to a more sustained and prolonged use of AT and may enable increased participation. Future research should focus on interventions that meet the needs of people with cognitive disabilities.

The service delivery process (SDP) of assistive technology devices (ATDs) is attracting interest, as theprovision of ATDs is critical for the independence and participation in society of individuals withdisabilities. The purpose of the current study was to investigate what impact the SDP has on satisfactionwith ATDs in individuals with disabilities in relation to everyday activities. A systematic literature reviewwas conducted, which resulted in 53 articles included. The results showed that there are factors inalmost all the different steps of the SDP that affect the satisfaction with of the devices, which can lead tounderutilization and abandonment of ATDs. Only a few studies have been conducted with a designrobust enough to generalize the results; therefore, more research is needed. Therefore, the conclusion isthe SDP as a whole contributes to the satisfaction with and usability of ATDs in individuals with disabilityin relation to achieving the desired goals of participation in everyday activities, for the articles includedmust be deemed as moderate. A client-centred approach in the process is advocated, and was found tobe an important factor for an effective SDP and satisfied users.

The aim of this study was twofold: (1) to identify factors associated with a high level of accommodation needs in school activities among students with special educational needs (SEN) in regular upper secondary education; and (2) to investigate the extent to which schools have met students’ perceived accommodation needs. Accommodation needs and their provision in school activities were assessed with the School Setting Interview for 484 students with SEN. Students’ mean age was 17.3 years and 50% did not have a diagnosis. A logistic regression analysis revealed that a high level of school absence, studying a vocational programme, and a neuropsychiatric disorder were associated with a high level of accommodation needs. In the majority of school activities, about 50% of students had not received any accommodation despite an experienced need for support. About 30% of students perceived a need for support even though they had been provided with accommodations, and around 25% stated they were satisfied with received accommodations. Regular upper secondary school students with SEN are insufficiently provided with accommodations to satisfactorily participate in education. Specific student characteristics, e.g. high level of school absence, should receive special attention when investigating and accommodating students’ needs for support in school activities.

Background: Participation in education is a vital component of adolescents everyday life and a determinant of health and future opportunities in adult life. The School Setting Interview (SSI) is an instrument which assesses student-environment fit and reflects the potential needs for adjustments to enhance students participation in school activities. The aim of the study was to investigate the psychometric properties of the SSI for students with special educational needs in regular high school. Methods: A sample of 509 students with special educational needs was assessed with the SSI. The polytomous unrestricted Rasch model was used to analyze the psychometric properties of the SSI regarding targeting, model fit, differential item functioning (DIF), response category functioning and unidimensionality. Results: The SSI generally confirmed fit to assumptions of the Rasch model. Reliability was acceptable (0.73) and the SSI scale was able to separate students into three different levels of student-environment fit. DIF among gender was detected in item "Remember things" and in item "Homework" DIF was detected among students with or without diagnosis. All items had disordered thresholds. The SSI demonstrated unidimensionality and no response dependence was present among items. Conclusion: The results suggest that the SSI is valid for use among students with special educational needs in order to provide and evaluate environmental adjustments. However, the items with the detected DIF and the SSI rating scale with its disordered thresholds needs to be further scrutinized.

Background Guidance during Meals is a two-week inpatient intervention undertaken at the Folke Bernadotte Regional Habilitation Centre, Sweden, to help parents deal with children's eating problems. Parents are given advice about medical and/or behavioural reasons for food selectivity and possible treatment strategies. Aims To identify the way parents handle mealtimes and associated difficulties and investigate parents' opinion on children's progress using Guidance during Meals. Method A questionnaire, consisting of 30 statements and answered by 41 parents, was used to investigate parents' opinions regarding the success of the intervention in altering their child's eating habits at home. Findings Most parents thought that the intervention had helped them and their child, by teaching them how to guide their child during mealtimes, what made it easier for their child to eat, and how to communicate with their child in an encouraging way. Most children retained their increased interest in eating once back at home. These results were not dependent on time of onset of eating problems, number of intervention periods, length of time since the intervention, or gastrostomy. Conclusion The Guidance during Meals intervention helps parents develop knowledge about factors that hinder or facilitate eating in their child and tools that can help their child finish meals, and gives them a sense of hope that positive change can occur.

AimThis study compared daily activity energy expenditure (AEE) in children with cerebral palsy with a control group and investigated whether the children achieved healthy levels of physical activity. MethodsWe enrolled eight children with bilateral cerebral palsy, from eight to 10years of age, and a group of controls matched for age and gender. For three days, physical activity was simultaneously measured by accelerometers and self-reports using a diary. The daily AEE results were compared between groups and methods. The number of children that achieved healthy physical activity levels in each group was explored. ResultsChildren with cerebral palsy had significantly lower daily AEE, as measured by accelerometers, than the controls, and they did not achieve the healthy moderate to heavy physical activity level defined in the Nordic Nutrition Recommendations. Self-reports using the diaries resulted in an overestimation of physical activity compared with the ankle accelerometer measurements in both groups. ConclusionOur investigation of physical activity in children with cerebral palsy and controls using accelerometers and a diary found low levels of daily AEE and physical activity, and these results were most prominent in the group with cerebral palsy. The diaries overestimated physical activity in both groups.

The United Nations' position is that digital access is a matter involving equality between groups of people, the securing of democratic rights, and equal opportunities for all citizens. This study investigates digital equality in school and leisure between young people with and without disabilities. A cross-sectional design with group comparisons was applied. Participants were young people (10–18 years of age) with disabilities (n=389) and a reference group in about the same ages. Data were collected by a survey focusing on access to and engagement in ICT activities in school and during leisure time. The results demonstrated young people with disabilities had restricted participation in computer use in educational activities, in comparison to young people in general. During leisure time young people with disabilities had a leading position compared to the reference group with respect to internet use in a variety of activities. Beneficial environmental conditions at home (and the reverse in schools) are discussed as parts of the explanation for the differing engagement levels at home and in school, and among young people with disabilities and young people in general.

Conclusion: Schools need to prioritise use of ICT by young people with disabilities.

INTRODUCTION: Young adults with spina bifida often have cognitive difficulties. As a result, young adults with disabilities are facing challenges with respect to housing, education, relationships and vocation which increases risk of unemployment.

AIM: The aim is to describe a method to develop a smartphone application together with young adults with spina bifida as an assistive technology for cognition.

METHOD: In a Participatory Action Research approach, young adults (n = 5) with spina bifida were individually interviewed with Canadian Occupational Performance Measure (COPM). The participants' restrictions in everyday life activities, identified by COPM, were discussed in a focus group formed by the young adults and the result was analyzed using qualitative content analysis. Developing the application the principles of Human-Centered-Design and Universal Design was followed.

RESULT: An application made for iOS with a focus on usability and worthiness, done by creating a clear and intuitive interface, with a calendar function useful for example to initiate and plan social activities was developed.

CONCLUSION: The method seems useful when the outcome from the project, a beta version of an application for iOS Smartphone, was achieved in agreement with the participants. The study highlight the importance of involving individuals with disabilities when developing smartphone applications.

Bedömning av anpassningar i skolmiljön (BAS) är ett bedömningsinstrument som utvecklats i Sverige för att användas inom skola. Det är avsett för barn från ungefär 7 år och äldre. Användare av instrumentet är arbetsterapeuter, speciallärare, specialpedagoger och andra professioner som fokuserar på elevens aktivitet och delaktighet i skolan.Instrumentet fokuserar på hur faktorer i omgivningen inverkar på elevens aktivitet och delaktighet i skolan. Instrumentet innehåller 16 frågeområden om vardagliga aktiviteter i skolan, där varje frågeområde bedöms utifrån en fyrgradig skala.

De 16 frågeområdena är: 1. Skriva2. Läsa3. Tala4. Komma ihåg saker5. Räkna6. Göra läxor7. Göra prov8. Delta i sportaktiviteter9. Delta i praktiska/estetiska ämnen10. Delta i klassrummet11. Umgås/leka på rasten12. Delta i praktiska rastaktiviteter13. Åka på studiebesök14. Få assistans15. Ha tillgång till skolans lokaler16. Samarbeta med skolans personal

Följande frågor ställs för varje frågeområde:

• Hur ofta gör du/fungerar det när du ska ...........?
• Har du några anpassningar? Vilka?
• Är du nöjd med hur det fungerar nu?
• Om inte, vad skulle kunna underlätta för dig?Efter diskussion med eleven avslutas varje frågeområde med skattning huruvida eleven
• behöver nya anpassningar,
• har vissa anpassningar men behöver kompletterande anpassningar,
• har tillfredställande anpassningar, eller• inte behöver några anpassningar.

Denna nya version av BAS har uppdaterats i de teoretiska avsnitten och kompletteras med en mappning av frågeområdena till ICF. Instrumentet innehåller nu även exempel på barn och ungdomar med neuropsykiatriska funktionsnedsättningar (såsom ADHD och Aspergers syndrom) och sociala begränsningar. Instrumentet har dessutom en ny grafisk form och är mer användarvänlig.

OBJECTIVE:

Information and communication technology (ICT) has the potential to enhance participation in educational activities for students with physical disabilities. Even though incorporating ICTs into teaching and learning in education has become an important issue, it is unclear what evidence research has provided. The aim of this study was to investigate types of ICT items and how ICT is being used by students with physical disabilities, and describe the benefits of ICT use in school activities.

METHODS:

A systematic literature search, covering the period 2000-May 2012, was performed in the databases AMED, CINAHL, Eric, OTseeker, Psych Info, PubMed, and Scopus. Data analysis entailed extracting, editing, grouping, and abstracting findings.

RESULTS:

A total of 32 articles were included, 16 of which were intervention studies. More than half of the studies concerned students with motor impairments. Type of ICT used differed among impairment groups, and ICT seemed to be especially beneficial for writing, spelling, and communication.

CONCLUSIONS:

Even though the review found heterogeneity across the studies students seemed to benefit from ICT use regardless of the type. For future research it is important to highlight intervention studies, especially for students with visual, hearing, and communication impairments.

Objective: The aim of this article is to report, compare and reflect on two studies as investigated ICT usage in children with physical disabilities compared with that of non-disabled children, and discuss the results in relation to occupational therapy. Method: A cross-sectional survey about ICT- activities in school and outside school among students with physical disabilities (n=287). Group comparisons were made with students from the general population. Results: Students with a physical disability used computers for less varied educational activities than students without disabilities. The environments; in school and outside school, provide different opportunities for developing and using the digital skills of children with physical disabilities. Conclusion: Digital skills developed outside school captivate children with physical disabilities, providing them with increased access to society and benefiting them educationally. The implications are that, in order to increase children's participation in computer activities in school, changes such as having access to their own

Introduction: One type of support in school that holds promise for students with attention deficit hyperactivity disorder (ADHD) is the use of information and communication technology (ICT) such as computers and Internet. Computer use in educational activities may be one promising tool to support academic performance of students with ADHD experiencing difficulties in school. However, students with ADHD may be overlooked regarding available support compared with students with physical disabilities.Objectives: The aim of this study was to investigate computer use in educational activities by students with attention deficit hyperactivity disorder (ADHD) in comparison with that of students with physical disabilities and students from the general population.Methods: The design of the study was cross-sectional with group comparison. Students with a primary diagnosis of ADHD and related disorders were recruited from habilitation centres (HCs). Students with ADHD (n=102) were pairmatched in terms of age and sex with students with physical disabilities and students from the general population (n = 940) were used as a reference group.Results: Students with ADHD reported significantly less frequent use of computers for almost all educational activities compared with students with physical disabilities and students from the general population. Students with ADHD reported low satisfaction with computer use in school. In addition, students with ADHD reported a desire to use computers more often and for more activities in school compared with students with physical disabilities. Conclusion: From an equality perspective, it is essential to enable students with ADHD to use computers in educational activities. Contribution to the practice/evidence base of occupational therapy: Focusing on promoting computer use in educational activities in school for students with physical disabilities as well as students with ADHD is an emerging field in occupational therapy.

The SSI is a student-centred interview assessment intended for examing the level of student-environment fit of students from approx. 7 years of age and older. The assessment focus on how environmental factors influence students’ activity and participation in school. SSI includes 16 items, which are scored by using a four-step rating scale.

The 16 items are:1. Write2. Read3. Speak4. Remember things5. Do mathematics6. Do homework7. Take exams8. Participate in sports activities9. Participate in practical subjects10. Participate in the classroom11. Participate in social activities during breaks12. Participate in practical activities during breaks13. Go on field trips14. Get assistance15. Access to school16. Interact with staffFor each item, the following questions are asked:

• How do you act/manage in your class when you .......... (e.g. 1. Write)?
• Do you have any supports or adjustments? If so, what type?
• Are you satisfied with the present situation?
• If not, what kind of change would help you the most?

The theoretical foundation of SSI is MOHO (Kielhofner, 2008) and client-centred practice (Law, 1998).

This new version now also includes examples of children with neuropsychiatric impairments and social limitations. It has been updated in the theoretical sections and supplemented with a linking/mapping of the SSI items to ICF concepts.

Aim: The aim of this study was to investigate computer use in educational activities by students with attention deficit hyperactivity disorder (ADHD) in comparison with that of students with physical disabilities and students from the general population.

Methods: The design of the study was cross-sectional with group comparison. Students with ADHD (n = 102) were pair-matched in terms of age and sex with students with physical disabilities and students from the general population (n = 940) were used as a reference group.

Results: The study showed that less than half of the students with ADHD had access to a computer in the classroom. Students with ADHD reported significantly less frequent use of computers for almost all educational activities compared with students with physical disabilities and students from the general population. Students with ADHD reported low satisfaction with computer use in school. In addition, students with ADHD reported a desire to use computers more often and for more activities in school compared with students with physical disabilities.

Conclusions: These results indicate that occupational therapists should place more emphasize on how to enable students with ADHD to use computers in educational activities in school.

Objective: To investigate the prevalence of children with physical disabilities who used a computer-based ATD, and to examine characteristics differences in children and youths who do or do not use computer-based ATDs, as well as, investigate differences that might influence the satisfaction of those two groups of children and youths when computers are being used for in-school and outside school activities.Method: A cross-sectional survey about computer-based activities in and outside school (n = 287) and group comparisons.Results: The prevalence of using computer-based ATDs was about 44 % (n = 127) of the children in this sample. These children were less satisfied with their computer use in education and outside school activities than the children who did not use an ATD.Conclusion: Improved coordination of the usage of computer-based ATDs in school and in the home, including service and support, could increase the opportunities for children with physical disabilities who use computer-based ATDs to perform the computer activities they want, need and are expected to do in school and outside school. [Box: see text].

Aim To investigate the outside school activity patterns of children with physical disabilities, and specifically their information and communication technology (ICT) usage compared with that of non-disabled children. In addition, the aim was to investigate the childrens opinions on computer use and the associations between their use of the Internet and their interaction with peers. Methods Questionnaire on activities outside school, answered by 215 children and youths with physical disabilities, mean age 12 years 10 months, attending mainstream schools. For group comparisons with non-disabled children, data from the survey Kids and Media were used. Results In the analysis, two sets of activity patterns were identified, depending on whether the child was disabled or not and on the gender of the child. A higher proportion of children with physical disabilities were engaged in ICT activities, while non-disabled children tended to be engaged in a broader range of activities outside school. The activity pattern was more uniform for boys and girls with disabilities than for their non-disabled peers. Use of the Internet was positively associated with peer interaction. Conclusion Outside school, the activity patterns of children and youths with physical disabilities seem to be characterized by a focus on ICT activities, which enable children to compensate for their impairment because it suits all. In addition, digital skills developed outside school engage children with physical disabilities, giving them increased access to society and for educational purposes.

The aim of this study was to determine the information and communication technologies use in school activities of two groups of students with physical disabilities, comprised of those who did and those who did not use a computer-based assistive technology device (ATD) and to make a comparison with students from the general population. In addition, positive factors associated with in-school computer use are identified for students with physical disabilities. The method adopted was a cross-sectional survey about computer-based activities in school among students with physical disabilities (n = 287); including those who used (n = 127) and those who did not use (n  = 160) a computer-based ATD in school (mean age 13 years 6 months). Group comparisons were made with students from the general population (n  = 940). The results showed that the most frequent computer users were students with physical disabilities, who used a computer-based ATD daily. However, when considered as a group, students with physical disabilities used the computer for less varied educational activities than the reference group. Four factors had a positive association to ‘participation in computer activities in school’ for students with physical disabilities: attending a mainstream school, the students’ age (notably, being 16–18 years old), using a computer often in school, and the teachers using a computer frequently in teaching. The present study concludes that, regardless of whether they use a computer-based ATD or not, students with a physical disability have restricted participation in some computer-based educational activities in comparison to students from the general population. An individual plan could be beneficial for each student to: focus on the aim of the computer use; examine the students’ needs in terms of computer-based ATDs and their inclusion in education; and ensure that the students’ digital skills are fully utilised.

OBJECTIVE. The use and nonuse of assistive technology devices in school by students with physical disabilities was investigated, and the students’ experiences in using these devices is described.

METHOD. We used a mixed-methods approach with predominantly qualitative methods to collect and analyze data, which included observations of and interviews with 20 students with physical disabilities and the number and type of assistive technology devices provided.

RESULTS. It is vital that devices be integrated into educational practice and that students experience immediate benefits for their function in everyday school activities without detrimental effects on their social participation. The latter was often more important than being able to perform activities independently.

CONCLUSION. The students adopted both a functional and a psychosocial perspective of their devices, and providers should neglect neither. Children and youth need both verbal information and practical experience using devices to be able to make informed decisions.