Assistive Communication Devices Research Articles

Assistive Communication Devices in Rett Syndrome: A Case Report and Narrative Review

Assistive Communication Devices in Rett Syndrome: A Case Report and Narrative Review

Dismantling barriers: assistive communication devices

Dismantling barriers: assistive communication devices

Perceptual prioritization of self-associated voices.

Information associated with the self is prioritized relative to information associated with others and is therefore processed more quickly and accurately. Across three experiments, we examined whether a new externally-generated voice could become associated with the self and thus be prioritized in perception. In the first experiment, participants learned associations between three unfamiliar voices and three identities (self, friend, stranger). Participants then made speeded judgements of whether voice-identity pairs were correctly matched, or not. A clear self-prioritization effect was found, with participants showing quicker and more accurate responses to the newly self-associated voice relative to either the friend- or stranger- voice. In two further experiments, we tested whether this prioritization effect increased if the self-voice was gender-matched to the identity of the participant (Experiment 2) or if the self-voice was chosen by the participant (Experiment 3). Gender-matching did not significantly influence prioritization; the self-voice was similarly prioritized when it matched the gender identity of the listener as when it did not. However, we observed that choosing the self-voice did interact with prioritization (Experiment 3); the self-voice became more prominent, via lesser prioritization of the other identities, when the self-voice was chosen relative to when it was not. Our findings have implications for the design and selection of individuated synthetic voices used for assistive communication devices, suggesting that agency in choosing a new vocal identity may modulate the distinctiveness of that voice relative to others.

Test-Retest Reliability of Time-Domain EEG Features to Assess Cognitive Load Using a Wireless Dry-Electrode System.

Human Machine Interfaces (HMIs) can provide critical support and improve daily task functionality for prosthesis users or social interaction for patients with locked-in syndrome using an assistive communication device. One goal in the development of sophisticated HMIs is to reduce the cognitive load (CL) they place on the user to promote the use of the technology. Electroencephalogram (EEG)-derived measures collected with wired wet-electrode systems have been used to assess CL in laboratory environments and have demonstrated acceptable test-retest reliability. Assessment of CL during real-world unconstrained HMI operation, however, requires the use of a wireless dry-electrode EEG system which provides easier electrode application and untethered movement. However, the test-retest reliability of wireless dry-electrode systems to quantify CL has not been explored. Ensuring the consistent capture of CL-related signals across multiple sessions is critical if these devices are to be used to assess how improvements in HMIs affect CL. Therefore, the current study used a wireless dry-electrode EEG system to compare Evoked Response Potential (ERP) features of a simple auditory oddball task to measure CL during two separate testing sessions a week apart. ERPs of 11 subjects were recorded while participants performed a virtual task at two difficulty levels. A significant correlation was found between the P300 component of the ERPs and subjective ratings of CL during both testing sessions. Furthermore, there was a statistically significant test-retest reliability for this same ERP feature and similar signal-to-noise ratios (SNRs) across sessions.Clinical Relevance- This is an initial step in validating wireless dry-electrode EEG systems to assess cognitive load across multiple sessions. The evidence presented is critical if dry-wireless EEG systems are to be used to identify aspects of HMIs that reduce CL in clinical and real-life environments. Assessing CL in unconstrained environments can better inform clinicians and technology developers in their design of future HMIs.

청각장애 정보통신 보조기기 지원 실태 및 개선 방안

본 연구는 청각장애인들의 정보 접근을 위한 정보통신 보조기기에 대한 우리나라의 관련 법률과 보조기기 계획 및 지원에 대한 실태를 파악하여 개선해야 할 방안을 알아보고자 하였다. 그 결과, 청각장애인의 정보통신 보조기기와 관련한 우리나라의 법률은 「국가기본법」을 바탕으로 「장애인 등에 대한 특수교육법」, 「장애인복지법」, 「장애인차별금지 및 권리구제 등에 관한 법률」, 「장애인·노인 등을 위한 보조기기 지원 및 활용촉진에 관한 법률」 에서 법적인 근거를 제시하고 있었다. 청각장애인의 정보통신 보조기기 계획 및 지원에 대하여 특수교육과 관련 정부 부처의 보조기기 지원 및 보급사업 실태를 살펴보았다. 특수교육에서는 전국의 시도교육청에서 특수교육운영계획에 보조공학기기 및 학습보조기기 지원에 대한 내용을 수립하였고, 정부 부처에서는 장애인 실태조사를 통하여 청각장애의 보조기기에 대한 내용을 파악하고 정보통신 보조기기 보급사업을 통하여 필요한 보조기기를 보급 및 지원하고 있었다. 그러나 아직 청각장애 정보통신 보조기기는 부족한 실정이며 지원시스템 구축, 정부의 예산 확보와 정책적인 지원방안 마련이 필요한 것으로 나타났다.

Brain reading tech: Lets users control devices through thought alone

The first winner of IETs award for technology innovation is set to help the treatment and rehabilitation of people with severe brain injuries.NeuroCONCISE is commercialising a wearable, non-invasive system enabled by artificial intelligence that allows people to communicate and interact with computers without moving, using only their minds. It's predicted to have applications in rehabilitation, diagnostics, augmentative and assistive communication devices and entertainment. The technology is built around a brain-computer interface that translates changes associated with imagination of movement.

Assistive communication devices for patients with hearing loss: a cross-sectional survey of availability and staff awareness in outpatient clinics in England

Purpose: Fair and equal access to health care for all is a fundamental principle of the National Health Service (NHS) in England. However, findings from a previous national survey examining the experiences of hearing-impaired patients when accessing services within the primary care setting have revealed that significant barriers continue to exist. The aim of this study was to examine the availability of assistive communication devices for patients with hearing loss at reception desks and in patient waiting areas in hospital outpatient settings.Methods: We conducted a cross-sectional telephone survey involving Audiology and Ear, Nose and Throat (ENT) clinics in NHS hospitals in England. Questionnaires were administered to members of staff at clinic reception desks.Results: All NHS hospital trusts in England providing Audiology and ENT services were included in the survey. Information was obtained from a total of 208 individual clinic reception desks. Assistive communication devices were reported to be available at 64 per cent of Audiology (49/76), 42 per cent of ENT (32/76) and 71 per cent of shared Audiology and ENT reception areas (40/56). The most common type of device was an induction loop system. A substantial proportion of survey respondents were not aware of existing facilities.Conclusions: There is a shortage of assistive communication devices in Audiology and ENT clinic reception areas in England. The range of technology currently in place is insufficient. We have identified a significant lack of “deaf awareness” among frontline staff.Implications for rehabilitationProviders of health care services must recognize their legal obligation to ensure that their services are made more accessible to patients with hearing loss.The use of multimodal assistive technology ensures that more patients can benefit.Staff awareness and training is essential in improving the quality of service provision.

Use of a User-Friendly Tablet Application to Communicate with Pediatric Patients on Mechanical Ventilators

Objetivos: examinar cómo el uso de una aplicación para tableta como ayuda en la comunicación con pacientes pediátricos con respirador artificial afecta el nivel de satisfacción con la comunicación por parte del personal de enfermería y en las díadas cuidador–paciente. Materiales y método: se utilizó el diseño pretest-postest de un solo grupo para analizar el nivel de satisfacción del personal de enfermería con la comunicación y se utilizó un diseño de grupo de control pretest-postest no equivalente para los cuidadores. La muestra estaba conformada por 44 miembros del personal de enfermería y 18 díadas de cuidadores y pacientes pediátricos con ventilación de dos hospitales en Tailandia. Se utilizó una prueba de T pareada para comparar al personal de enfermería, la prueba U de Mann-Whitney para comparar los cuidadores y una estadística descriptiva para describir la satisfacción de los niños. Resultados: el personal de enfermería se sintió más satisfecho con la comunicación al usar la aplicación de la tableta que los métodos de comunicación regulares (t = -9,13, df = 43, p < ,001). Los cuidadores que usaron la aplicación para tableta también reportaron una mayor satisfacción con la comunicación respecto a aquellos que usaron los métodos de comunicación regulares (U = -3,41, p < ,001). Casi el 90 % de los pacientes pediátricos reportaron sentirse completamente satisfechos con el uso de la aplicación. Conclusiones: la aplicación para tableta diseñada para facilitar la comunicación con pacientes pediátricos con respirador artificial mejoró los niveles de satisfacción con la comunicación y debe promoverse como uno de los dispositivos de comunicación de asistencia para uso amplio.

A pilot study assessing the spiritual, emotional, physical/environmental, and physiological needs of mechanically ventilated surgical intensive care unit patients via eye tracking devices, head nodding, and communication boards

BackgroundMechanically ventilated patients in the intensive care unit (ICU) are unable to communicate verbally. We sought to evaluate their needs via a communication board (CB) and a novel eye tracking...

A Model to Estimate the Optimal Layout for Assistive Communication Touchscreen Devices in Children With Dyskinetic Cerebral Palsy.

Excess involuntary movements and slowness of movement in children with dyskinetic cerebral palsy often result in the inability to properly interact with augmentative and alternative communication (AAC) devices. This significantly limits communication. It is, therefore, essential to know how to adjust the device layout in order to maximize each child's rate of communication. The aim of this paper was to develop a mathematical model to estimate the information rate in children with dyskinetic cerebral palsy and to determine the optimal AAC layout for a touchscreen tablet that results in enhanced speed of communication. The model predicts information rate based on button size, number, spacing between buttons, and the probability of making an error or missing target buttons. Estimation of the information rate confirmed our hypothesis of lower channel capacity in children with dyskinetic cerebral palsy compared with age-matched healthy children. Information rate increased when the AAC layout was customized based on the optimal parameters predicted by the model. In conclusion, this paper quantifies the effect of motor impairments on communication with assistive communication devices and shows that communication performance can be improved by optimally matching the parameters of the AAC touchscreen device to the abilities of the child.

Quality of life in amyotrophic lateral sclerosis patients and caregivers: Impact of assistive communication from early stages.

In this study we performed a longitudinal investigation to assess the impact of early introduction of assistive communication devices (ACDs) on quality of life (QoL) in amyotrophic lateral sclerosis (ALS) patients and their caregivers. Patients were followed for 7-10 months (3 evaluation periods). Bulbar-onset ALS patients (N = 27) and paired caregivers (N = 17) were included. Fifteen randomly selected patients received early support in ACD use. Patients were assessed using the ALS Functional Rating Scale-revised (ALSFRS-R), the McGill QoL (MQoL), the Communication Effectiveness Index (CETI), and performance in writing; and caregivers were assessed with the MQoL and World Health Organization Quality of Life questionnaire (WHOQOL-BREF). Patients with early support had higher MQoL Psychological and MQoL Existential well-being domains; caregivers had higher MQoL Support domain and their MQoL Psychological domain positively associated with patient CETI. Most patients could communicate using a touchscreen keyboard to write, even when handwriting and speech were not possible. Early intervention with an ACD seems to have a positive impact on QoL and gives patients the opportunity to improve skills for communication in later disease stages.

Markers for upper limb dysfunction in Amyotrophic Lateral Sclerosis using analysis of typing activity

ObjectiveAssistive devices based on keyboard access support communication and control tools for patients with Amyotrophic Lateral Sclerosis (ALS). The aim of this work was to explore movement activity in the use of keyboards and identify markers for upper limb (UL) dysfunction. MethodsWe present a longitudinal study including 19 ALS patients, followed for 2–20months. Typing activity was recorded with an accelerometer placed on the posterior part of patients’ index finger. Participants performed the same 10-word typing task (2–6 assessments). Time and acceleration during keystroke were the main outcomes of this study. Patients were compared with 20 healthy subjects and 6 patients with other neuromuscular disorders. ResultsDuring disease progression, mean time in holding down a key increased and was longer than in control subjects. Acceleration at key press and key release decreased with progression of UL dysfunction. Delay between tapping and pressing down each key increased with UL dysfunction. ConclusionsDelay in pressing and releasing keys are markers of UL dysfunction in ALS. The decrease in the acceleration of movements related to keystroke can contribute to monitor disease progression. SignificanceTyping activity can be explored to access remotely and continuously to ALS progression by patients who use assistive communication devices.

Severely affected ALS patients have broad and high expectations for brain-machine interfaces

Brain-machine interfaces (BMIs) may provide new communication channels and motor function to individuals with severe neurodegenerative diseases, but little is known about their interests in such devices. We investigated the interests of severely affected ALS patients in BMIs, and examined factors that might influence these interests. We conducted an anonymous, mail-back questionnaire survey of severely disabled ALS patients diagnosed using the revised El Escorial criteria. Thirty-seven patients responded to the questionnaire. Twenty-nine (78.4%) had undergone tracheostomy positive pressure ventilation. More than 80% of the patients were interested in communication support. Thirty-three (89.2%) felt stressed during communication. Among those using assistive communication devices (17 patients), 15 (88.2%) were not satisfied with them. More than 50% of the patients expressed an interest in BMIs. Their expectations of BMIs ranged widely from emergency alarm to postural change. The frequent use of personal computers tended to be correlated with an interest in invasive BMIs (p = 0.07). In conclusion, this was the first questionnaire survey demonstrating that severely affected ALS patients have broad and high expectations for BMIs. Communication was the most desired support from BMIs for such patients. We need to meet their widely ranging expectations of BMIs.

Speed-Accuracy Testing on the Apple iPad® Provides a Quantitative Test of Upper Extremity Motor Performance in Children with Dystonia

The currently available scales for quantitative measurement of the severity of childhood dystonia require human observer ratings and provide poor granularity in the scores for individual limbs. We evaluated the use of new-generation high-quality touchscreens (an iPad) according with the Fitts law, which is a mathematical model that takes into account the relation between movement time and the task accuracy. We compared the abilities of healthy subjects and children with dystonia. The linear relation described by Fitts law held for all the groups. The movement time and the information transmitted were age and severity related. Our results provide evidence for the usability and validity of using Fitts law as a quantitative diagnostic tool in children with dystonia. Furthermore, testing on touchscreen tablets may help to guide the design of user interfaces to maximize the communication rate for children who depend upon assistive communication devices.

Pelizaeus-Merzbacher Disease, Pelizaeus-Merzbacher-Like Disease 1, and Related Hypomyelinating Disorders

The purpose of this article is to present contemporary information on the clinical and molecular diagnosis and the treatment of Pelizaeus-Merzbacher's disease (PMD) and related leukodystrophies. Various types of mutations of the X-linked proteolipid protein 1 gene (PLP1) that include copy number changes, point mutations, and insertions or deletions of a few bases lead to a clinical spectrum from the most severe connatal PMD, to the least severe spastic paraplegia 2 (SPG2). Signs of PMD include nystagmus, hypotonia, tremors, titubation, ataxia, spasticity, athetotic movements and cognitive impairment; the major findings in SPG2 are leg weakness and spasticity. A diffuse pattern of hypomyelination is seen on magnetic resonance imaging (MRI) of PMD/SPG2 patients. A similar constellation of signs and pattern of hypomyelination lead to the autosomal recessive disease called Pelizaeus-Merzbacher-like disease 1 (PMLD1) and the less-severe spastic paraplegia 44 (SPG44), caused by mutations of the gap junction protein, gamma-2 gene (GJC2), formerly known as the gap junction protein, α-12 gene (GJA12). Magnetic resonance spectroscopy (MRS) and brainstem auditory evoked potentials (BAEP) may assist with differential clinical diagnosis of PMD and PMLD1. Supportive therapy for patients with PMD/SPG2 and PMLD1/SPG44 includes medications for seizures and spasticity; physical therapy, exercise, and orthotics for spasticity management; surgery for contractures and scoliosis; gastrostomy for severe dysphagia; proper wheelchair seating, physical therapy, and orthotics to prevent or ameliorate the effects of scoliosis; special education; and assistive communication devices.

Apps: An Emerging Tool for SLPs

Apps: An Emerging Tool for SLPs

Introduction to the Special Issue: Evaluating Assistive Technology in the Education of Persons with Severe Disabilities

This special issue of the Journal of Behavioral Education was prepared to highlight the use of a range of assistive technologies for promoting improved learning and adaptive behavior functioning among individuals with severe disabilities. The range of technologies evaluated in this special issue includes microswitches, assistive communication devices, iPods, and computer-based technologies. Collectively, these papers illustrate how the use of assistive technology can be taught and evaluated to ascertain its effects on learning and adaptive functioning among person with severe disabilities.

Predictors of unmet needs for communication and mobility assistive devices among youth with a disability: the role of socio-cultural factors

Purpose. Despite the importance of ensuring access to assistive technology, high rates of underutilization remain. Relatively little is known about the characteristics of young people reporting unmet needs for assistive devices, so our study examined this further.Method. Data were analyzed using the 2006 Participation and Activity Limitation Survey. Youth aged 15–24 were selected to explore the characteristics associated with those currently using or reporting unmet needs for communication or mobility devices (n = 15,817).Results. Family structure and language spoken influenced the likelihood of using a communication device for two age subgroups. Meanwhile, language spoken influenced the likelihood of reporting unmet needs for communication assistive devices. The following factors influenced the likelihood of using a mobility device: age, gender, language spoken, income, family structure, and severity of impairment. Gender, geographic location, language spoken, family structure, duration and severity of impairment and presence of other impairments influenced the likelihood of reporting unmet needs for mobility devices.Conclusions. Clinicians need to pay particular attention to the socio-cultural factors of young clients transitioning to adult care.

Harvesters with Disabilities

A sermon written and delivered by William Rush, about his spiritual journey and his experiences as a person with cerebral palsy who uses a wheelchair and assistive communication devices, at The First Baptist Church of Lincoln, Nebraska. The sermon is also on the church's Website: www.fbclincoln.org

A Study of Human Interface for People in Japan Including the Disabled

Over a period of 28 years, the author has developed a basic research approach for assistive technology. As reviewed in this paper, he and his co-researchers have designed several aid devices as well as obtained many basic findings concerning human information processing. Some of the devices have been manufactured in Japan. Moreover, the technologies as well as the basic findings have been applied to construct human-centered computer interfaces. Consequently, it can be said that these newly developed computer interface technologies have led to improvements in the design of models for developing assistive communication devices.