Assistive Technology Solutions for Enabling People with Intellectual and Motor or Sensory-Motor Disabilities to Access Communication Events

Lancioni G., Alberti G., Pezzuoli F., Bruciati J., Singh N., O'Reilly M., Sigafoos J.

PurposeThis study assessed two technology systems aimed at enabling a man with intellectual disability, blindness, deafness and motor and tactile discrimination problems to make verbal requests through simple one-hand signs.Design/methodology/approachThe study was conducted according to an ABAB design. During the B (intervention) phases, the man used the two systems, which included (1) nine mini recording devices fixed on the man’s clothes or wheelchair (i.e. in positions the man touched with his sign movements) and (2) nine tags with radio frequency identification codes (fixed at approximately the same positions as the mini recording devices) and a dedicated tag reader, respectively. Making a sign (i.e. touching a recording device or reaching a tag) led to the verbalization of the request related to that sign.FindingsDuring baseline, the mean frequency of signs/requests made was below 2 per session, and only some of those requests were identified/satisfied. During the intervention, the mean frequency of requests made and satisfied was about 10 per session with each of the systems.Originality/valueThe results, which are to be taken with caution given the preliminary nature of the study, seem to suggest that the systems can help translate simple signs into verbal requests.

Lancioni G.E., Singh N.N., O’Reilly M.F., Sigafoos J.

Lancioni G.E., Singh N.N., O’Reilly M.F., Sigafoos J., Alberti G., Troccoli O., Orlando I., Ricci C.

ObjectiveThis study aimed to help six participants with intellectual disability combined with sensory and motor impairments to make verbal requests through the use of a technology system involving cardboard chips and a smartphone.MethodThe participants were divided into two groups of three based on whether they did or did not have visual skills. Each group was exposed to the intervention with the technology system according to a non-concurrent multiple baseline across participants design. During the 20 min intervention sessions, the participants were provided with a smartphone and nine cardboard chips each of which had a picture or object (i.e., a mini object replica or raised object contour) and several radio frequency identification tags attached to it. To make a request, the participants were to bring a cardboard chip in contact with the smartphone. This read the tags attached to the cardboard and verbalized the request related to that cardboard.ResultsDuring the baseline (without cardboard chips and smartphone), the participants’ mean frequency of independent requests (all non-verbal requests) varied between zero and near 1.5 per session. During the intervention (with cardboard chips and smartphone), the participants’ mean frequency of independent requests (all verbal requests) varied between over 4.5 and about 10 per session.ConclusionThe results suggest that the system might be useful to help participants like the ones included in this study to make verbal requests with simple responses.

Danker J., Dreyfus S., Strnadová I., Pilkinton M.

AbstractBackgroundAdults with severe/profound intellectual disability typically face poor communication outcomes as they are often nonverbal and need their supporters to provide for their communication needs. This review aimed to identify studies focused on the communication resources people with severe/profound intellectual disability use for functional communication, and the enablers and barriers to functional communication.MethodsNine databases were systematically reviewed with keywords pertaining to the functional communication of adults with severe/profound intellectual disability. Out of 3427 identified articles, 12 met the inclusion criteria. Hand searches and ancestral searches identified another 4 articles. Out of the 16 articles, two did not meet the quality assessment criteria and were excluded. Thus, 14 articles were included in this review.ResultsThe findings revealed that picture exchange communication systems is the most common communication system used to support the development of functional communication. The most common functions enabled by the communication systems were choice‐making and making requests. Several barriers (e.g., individual factors related to adults with severe/profound intellectual disability, others' attitudes, behaviour and knowledge) to and enablers (e.g., accessibility and availability of the communication system, training for those supporting adults with severe/profound intellectual disability) of functional communication were identified.ConclusionsRemoving the barriers and enabling functional communication is essential to developing the functional communication of adults with severe/profound intellectual disability.

Lancioni G.E., Singh N.N., O'Reilly M.F., Sigafoos J., Alberti G., Chiariello V., Desideri L.

ObjectivesThis study assessed whether a simple technology-aided program (i.e., a program involving the use of microswitches linked to a smartphone) could be set up to enable people with motor, sensory and intellectual disabilities to control preferred environmental stimulation through two different response movements.MethodsTen participants were involved in the study. Each of them was exposed to an ABAB design, in which A represented baseline phases without the program and B intervention phases with the use of the program. The study assessed whether the participants (a) had significant increases of each of the two response movements available and/or showed response variability across sessions and over time and (b) had signs of satisfaction/happiness during the study sessions, in connection with their stimulation access and control.ResultsThe program was effective in increasing the participants' responding and consequently their self-regulated stimulation input. Half of the participants showed a significant increase of both responses available from the first intervention phase. Other participants seemed to focus more on one of the two responses. Even so, they tended to have occasionally high performance frequencies also with regard to their non-dominant (not significantly increased) response. Finally, all participants showed clear signs of satisfaction/happiness during the intervention sessions.ConclusionsThe program represents a potentially useful approach for enabling people with extensive multiple disabilities to self-regulate their access to preferred environmental stimulation and improve their mood.

Burns J., Carter A., Draper S., Foad A.

Lancioni G.E., Singh N.N., O’Reilly M.F., Sigafoos J., Alberti G., Fiore A.

People with mild to moderate intellectual or multiple disabilities may have serious difficulties in accessing leisure events, managing communication exchanges with distant partners, and performing functional daily activities. Recently, efforts were made to develop and assess technology-aided programs aimed at supporting people in all three areas (i.e., leisure, communication, and daily activities). This study assessed a new technology-aided program aimed at helping four participants with intellectual and multiple disabilities in the aforementioned areas. The program, which was implemented following a non-concurrent multiple baseline across participants design, relied on the use of a smartphone or tablet connected via Bluetooth to a two-switch device. This device served to select leisure and communication events and to control the smartphone or tablet’s delivery of step instructions for the activities scheduled. Data showed that during the baseline phase (with only the smartphone or tablet available), three participants failed in each of the areas (i.e., leisure, communication and functional activities) while one participant managed to access a few leisure events. During the intervention phase (with the support of the technology-aided program), all participants managed to independently access leisure events, make telephone calls, and carry out activities. These results suggest that the program might be a useful tool for helping people with intellectual and multiple disabilities improve their condition in basic areas of daily life.

Mishra S., Laplante-Lévesque A., Barbareschi G., Witte L.D., Abdi S., Spann A., Khasnabis C., Allen M.

Rushton R., Kossyvaki L., Terlektsi E.

Music is motivational, accessible and engaging for individuals with learning disabilities. Several systematic reviews have addressed the effects of music activity on people with learning disabilities; however, none has specifically reviewed the use of musical activity with people with profound and multiple learning disabilities. This review aimed to: 1. identify peer-reviewed studies and describe the characteristics of evidence-based musical activity used with people with profound and multiple learning disabilities and 2. evaluate and analyse the effectiveness of these music-based interventions and identify gaps within current research. A systematic search was conducted in April 2021 identifying seven peer-reviewed studies which included music-based interventions with at least one person with profound and multiple learning disabilities. Findings reveal the interventions varied in their frequency, duration and content. The outcome of most (n=6) interventions documented the development of the participants’ social skillset. Interventions were predominantly (n=6) implemented by facilitators with musical expertise. The diverse and novel nature of the reviewed studies highlights a need to expand and enhance research with this population.

Lancioni G.E., Singh N.N., O’Reilly M.F., Sigafoos J., Alberti G., Campodonico F., Desideri L.

The study assessed a new smartphone-based program to enable five adults with moderate intellectual disabilities and visual or visual-motor impairments to independently access leisure events, communication with distant partners, and functional activities. The program was evaluated through a non-concurrent multiple baseline design across participants. During the intervention and post-intervention sessions, the participants used a Samsung Galaxy A10 smartphone and eight mini voice-recording devices. The smartphone was provided with a SIM card, Internet connection, and Google account, and fitted with MacroDroid. Four of the mini recording devices contained recorded requests for singers/bands’ songs (leisure). The other four contained recorded requests for telephone calls with preferred communication partners. During those sessions, periods in which the participants could engage in leisure and communication alternated with periods in which the smartphone invited them to carry out functional activities and presented verbal instructions for the activity steps. Data showed that during the baseline phase the participants’ performance was unsuccessful or only partially successful. During the post-intervention phase, on the other hand, all participants succeeded in independently accessing leisure events, making telephone calls, starting the activities, and performing those activities with high accuracy. These findings suggest that the aforementioned smartphone-based program might be quite helpful for people like those included in this study.

Botelho F.H.

The potential of digital technology to assist persons with disabilities has always been known. The capabilities of digital devices have been improving so impressively for so long, that the assumption that in parallel the same is happening with accessibility is common. Unfortunately, accessibility for persons with disabilities is neither certain nor constant, and in fact, a conscious and systemic effort is required to ensure that the potential of digital technologies for inclusion is realized.Digital accessibility is best understood as a chain of dependencies where training, hardware, software, content, and standards must work together harmoniously, and each of these elements must be understood as a dynamic process. For example, smartphones can be incompatible with hearing aids required by the deaf, touch screens too sensitive for those with motor impairments, and web pages often lack the text labels needed by screen reading software used by the blind. Even if each of these examples is fixed, the accessibility may be short lived if the production process behind that hardware or software was not corrected, as the digital world is constantly being updated. Training, hardware design, software development, content production, and standards definition processes, must be pursued taking accessibility and affordability into account.

Abdi S., Kitsara I., Hawley M.S., de Witte L.P.

Limited access to assistive technology (AT) is a well-recognized global challenge. Emerging technologies have potential to develop new assistive products and bridge some of the gaps in access to AT. However, limited analyses exist on the potential of these technologies in the AT field. This paper describes a study that aimed to provide an overview of emerging technological developments and their potential for the AT field. It involved conducting a gray literature review and patent analysis to create an overview of the emerging enabling technologies that may foster the development of new AT products and services and identify emerging AT applications. The analysis identified seven enabling technologies that are relevant to the AT field. These are artificial intelligence, emerging human-computer interfaces, sensor technology, robotics, advances in connectivity and computing, additive manufacturing and new materials. Whilst there are over 3.7 million patents related to these enabling technologies, only a fraction of them - 11,000 patents were identified in the analysis specifically related to AT (0.3%). The paper presents some of the promising examples. Overall, the results indicate that there is an enormous potential for new AT solutions that capitalize on emerging technological advances.

Horton S.

Halvorsrud L., Holthe T., Karterud D., Thorstensen E., Lund A.

Smith E., Sumner P., Hedge C., Powell G.

Background Successful communication is vital to quality of life. One group commonly facing speech and communication difficulties is individuals with intellectual disability (ID). A novel route to encourage clear speech is offered by mainstream smart speakers (e.g., Amazon Alexa and Google Home). Smart speakers offer four factors important for learning: reward immediacy, spaced practice, autonomy/intrinsic motivation and reduced social barriers. Yet the potential of smart speakers to improve speech intelligibility has not been explored before. Aims To determine whether providing individuals with intellectual disabilities with smart speaker devices improved ratings of speech intelligibility for (1) phrases related to device use and (2) unrelated words via a semi-randomized controlled trial. Methods & Procedures In a semi-randomized controlled trial, an intervention group of adults with ID (N = 21) received smart speakers, while a control group (N = 22) did not. Before and after about 12 weeks, participants were recorded saying smart speaker-related phrases and unrelated words. Naïve participants then rated the intelligibility of the speech recordings. Outcomes & Results The group that received smart speakers made significantly larger intelligibility gains than the control group. Although the effect size was modest, this difference was found for both smart speaker-related phrases and unrelated words. Conclusions & Implications While the mechanism of action remains to be determined, the presence of smart speakers in the home had a demonstrable impact on ratings of speech intelligibility, and could provide cost-effective inclusive support for speech and communication improvement, improving the quality of life of vulnerable populations. What this paper adds What is already known on the subject Speech intelligibility is a key obstacle for social relationships and quality of life across several vulnerable populations (children with speech difficulties, older adults with dementia, individuals with ID). Anecdotal reports suggest mainstream smart speakers (e.g., Amazon Alexa, Google Home), could improve speech intelligibility. What this paper adds to existing knowledge We used a semi-randomized controlled trial to show that using a smart speaker for about 12 weeks could improve ratings of speech intelligibility in adults with ID for both smart speaker-related phrases and unrelated words. What are the potential or actual clinical implications of this work? These initial findings suggest that smart speaker technology could be a novel, and inclusive, route to improving speech intelligibility in vulnerable populations.