Technology-aided Interventions Research Articles

Improving Administrative Data at Scale: Experimental Evidence on Digital Testing in Indian Schools

AbstractLarge-scale student assessments are a cornerstone of proposed educational reforms to improve student achievement from very low levels in low- and middle-income countries. Yet, this promise relies on their presumed reliability. I use direct audit evidence from a large Indian state (Andhra Pradesh) to show that, as currently administered, official learning assessments substantially overstate proficiency and understate the ‘learning crisis’ of low student achievement. In an experiment covering over 2,400 schools, I evaluate whether digital tablet-based testing could reduce distortion. Although paper-based assessments proctored by teachers severely exaggerate achievement, tablet-based assessments closely match independent test data and are much less likely to be flagged for cheating. Furthermore, I use the direct audit-based retest to directly validate existing (indirect) statistical procedures for detecting cheating at scale and establish that it would be feasible to monitor data integrity cheaply and at scale with such methods. Overall, these results suggest that well-designed technology-aided interventions may improve data integrity at scale, without which these learning assessments are unlikely to serve as a catalyst for policy action.

Revisiting Vaccine Hesitancy in Residential Care Homes for the Elderly for Pandemic Preparedness: A Lesson from COVID-19.

Residents in residential care homes for the elderly (RCHEs) are at high risk of severe illnesses and mortality, while staff have high exposure to intimate care activities. Addressing vaccine hesitancy is crucial to safeguard vaccine uptake in this vulnerable setting, especially amid a pandemic. In response to this, we conducted a cross-sectional survey to measure the level of vaccine hesitancy and to examine its associated factors among residents and staff in RCHEs in Hong Kong. We recruited residents and staff from 31 RCHEs in July-November 2022. Of 204 residents, 9.8% had a higher level of vaccine hesitancy (scored ≥ 4 out of 7, mean = 2.44). Around 7% of the staff (n = 168) showed higher vaccine hesitancy (mean = 2.45). From multi-level regression analyses, higher social loneliness, higher anxiety, poorer cognitive ability, being vaccinated with fewer doses, and lower institutional vaccination rates predicted residents' vaccine hesitancy. Similarly, higher emotional loneliness, higher anxiety, being vaccinated with fewer doses, and working in larger RCHEs predicted staff's vaccine hesitancy. Although the reliance on self-report data and convenience sampling may hamper the generalizability of the results, this study highlighted the importance of addressing the loneliness of residents and staff in RCHEs to combat vaccine hesitancy. Innovative and technology-aided interventions are needed to build social support and ensure social interactions among the residents and staff, especially amid outbreaks.

Matching Assistive Technology, Telerehabilitation, and Virtual Reality to Promote Cognitive Rehabilitation and Communication Skills in Neurological Populations: A Perspective Proposal

Neurological populations (NP) commonly experience several impairments. Beside motor and sensorial delays, communication and intellectual disabilities are included. The COVID-19 pandemic has suddenly exacerbated their clinical conditions due to lockdown, quarantine, and social distancing preventive measures. Healthcare services unavailability has negatively impacted NP clinical conditions, partially mitigated by vaccine diffusion. One way to overcome this issue is the use of technology-aided interventions for both assessment and rehabilitative purposes. Assistive technology-based interventions, telerehabilitation, and virtual reality setups have been widely adopted to help individuals with neurological damages or injuries. Nevertheless, to the best of our knowledge, their matching (i.e., combination or integration) has rarely been investigated. The main objectives of the current position paper were (a) to provide the reader with a perspective proposal on the matching of the three aforementioned technological solutions, (b) to outline a concise background on the use of technology-aided solutions, (c) to argue on the effectiveness and the suitability of technology-mediated programs, and (d) to postulate an integrative proposal to support cognitive rehabilitation including assistive technology, telerehabilitation, and virtual reality. Practical implications for both research and practice are critically discussed.

Inclusive Education for Young Children with Autism Spectrum Disorder: Use of Humanoid Robots and Virtual Agents to Alleviate Symptoms and Improve Skills, and A Pilot Study

Individuals with Autism Spectrum Disorder often struggle to establish and keep positive relationships with peers and adults because of communication and social difficulties. It has been shown that humanoid robots and virtual agents can enable interventionists to maximize engagement during instruction and program for generalization. Humanoid robots have also been employed as a mediator and therapeutic support tool for children with Autistic Spectrum Disorder so that inclusive education for young children with Autism Spectrum Disorder can be achieved. Similarly, the findings obtained in many research studies carried out recently support the use of technology-aided interventions and instruction with interactive virtual agents on children with Autism Spectrum Disorder. Therefore, in this study, the use of humanoid robots and virtual agents for inclusive education is reviewed and a pilot study is presented. In addition, challenges, opportunities and future research directions in this domain are provided.

Exploration of a Sleep Hygiene, Mindfulness, and Sensory Pillow Program to Address Sleep Quality and Stress Among Higher Education Students

Abstract Date Presented 04/02/2022 Sleep disturbances may negatively influence an individual’s mental and psychosocial functioning, with higher education students of particular concern while managing daily stress. This exploratory study examined technology-aided interventions for sleep routine establishment, sleep hygiene, a mindfulness app, and a sensory pillow. Findings suggest improvements in sleep quality and sleep hygiene knowledge, no change in perceived stress, and various changes in objective sleep tracking data. Primary Author and Speaker: Sara Benham Additional Authors and Speakers: Karlie Brogan, Lauren Brown, Caitlin Gladwell, Christine Neu Contributing Authors: Nabila Enam

Technology-Aided Spatial Cues, Instructions, and Preferred Stimulation for Supporting People With Intellectual and Visual Disabilities in Their Occupational Engagement and Mobility: Usability Study.

BackgroundPersons with severe or profound intellectual disability and visual impairment tend to be passive and sedentary, and technology-aided intervention may be required to improve their condition without excessive demands on staff time.ObjectiveThis study aims to extend the assessment of technology-aided interventions for supporting functional occupational engagement and mobility in 7 people with intellectual disability and visual impairment and to use a technology system that is simpler and less expensive than those previously used.MethodsThe technology system involved a Samsung Galaxy A10, 4 Philips Hue indoor motion sensors, and 4 mini speakers. Within each session, the participants were to collect 18 objects (ie, one at a time) from 3 different areas (stations) located within a large room, bring each of the objects to a central desk, and put away each of those objects there. For each object, the participants received verbal (spatial) cues for guiding them to the area where the object was to be collected, a verbal instruction (ie, request) to take an object, verbal (spatial) cues for guiding them to the central desk, a verbal instruction to put away the object collected, and praise and preferred stimulation.ResultsDuring baseline, the frequency of responses completed correctly (objects collected and put away independently) was 0 or near 0. During the intervention phase (ie, with the support of the technology setup), the frequency increased for all participants, reaching a mean of almost 18 (out of 18 response opportunities) for 6 participants and about 13 for the remaining participant. The mean session duration ranged from 12 to 30 minutes.ConclusionsA program, such as the one used in this study, can be useful in promoting occupational engagement and mobility in persons with intellectual disability and visual impairment.

Improving preservice teachers’ noticing skills through technology-aided interventions in mathematics pedagogy courses

This study investigated effects of employing the Three-point framework (Key Point, Difficult Point, Critical Point) and three technology-aided interventions (online discussions, clinical interviews, and graphic lesson plan construction) on developing preservice teachers’ noticing skills in elementary mathematics pedagogy courses. Pre- and post-intervention assessments revealed significant improvement in the treatment group’s scores, and two case studies illustrated how the interventions can help preservice teachers develop noticing skills. These findings suggest that combining the framework with technology support provides an accessible model for guiding preservice teachers to use evidence from task-based interactions with learners to support instructional decisions.

Step-Instruction Technology to Help People with Intellectual and Other Disabilities Perform Multistep Tasks: a Literature Review

One of the main objectives for people with intellectual disability (with or without other disabilities) is the ability to perform multistep activities (e.g. preparing a sandwich) without external help from a caregiver. This paper provides a review of studies that evaluated technology systems to teach or support people with intellectual and other disabilities to carry out multistep functional activities through the presentation of single-step instructions. A literature search was performed for English language articles indexed in PubMed, PsycINFO and Web of Science. A narrative synthesis of the articles selected was provided together with a quantitative estimate of the effectiveness of their technology-aided interventions. The latter was carried out via the Percent of Nonoverlapping Data (PND) method. Twenty-six articles met inclusion criteria, with most studies following a single-subject research design (n = 25). The technologies identified were grouped into three categories (self-operated, automatic, and intelligent). Overall, the results are encouraging in that most of the technology solutions reviewed led to positive outcomes in terms of increasing independence of people with intellectual disability in performing relevant multistep activities (average PND score = 96.3%). This review highlights that technology systems designed to present single-step instructions can be effective in teaching or supporting the independent performance of multistep activities by people with intellectual disability with or without other disabilities. Only minimal research exists on development and use of intelligent systems.

Effectiveness of avatar-delivered instruction on social initiations by children with Autism Spectrum Disorder

BackgroundIndividuals with autism often struggle to establish and maintain positive relationships with peers and adults due to communication and social difficulties. Reviews of the research literature on social skills curricula suggest these approaches may be less than effective and often fail to promote generalization of acquired skills. Advances in the availability and adaptability of live animation and digital avatars could provide interventionists a tool to maximize engagement during instruction and program for generalization. The purpose of this study was to examine the effects of an avatar-based social skills intervention on participants’ social initiations in a clinical setting and with same-age peers. MethodThe research team used a nonconcurrent multiple baseline design to evaluate the effects of instruction from an avatar on students' social skills. Systematic direct observation and the Social Skills Improvement System were used to evaluate the effects of an avatar delivered social skills lesson. Social validity was measured from the perspective of both participants and their parents. ResultsFollowing instruction from an avatar, participants’ percentage of independent steps completed in the skill “starting a conversation” increased to consistently above 80 %, or above typical mastery levels. Participants’ conversation skills generalized to interactions with same-age peers. Finally, parents reported small positive gains in social skills, and participants indicated the intervention was socially valid. ConclusionsThe findings from this study support the use of technology-aided interventions and instruction, specifically the use of live animation avatars. Future studies could extend use of this technology beyond the relatively simple, yet effective, application described here.

Technology-Aided Interventions for Individuals With Autism: Implications for Policy and Practice

Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by pervasive difficulties in reciprocal social-communication skills and restricted, repetitive interests and behaviors. Advances in assistive technology can potentially improve the functional capabilities of individuals with ASD. This article reviews current legislation and professional standards related to educating students with ASD with an emphasis on technology and evidence-based practices. In particular, the article summarizes technology-aided interventions (e.g., speech-generating devices, computer-assisted instruction, video-based instruction, virtual reality, and robot-mediated interventions) that focused on social-communication skills among individuals with ASD. Implications and future directions of technology-aided interventions are discussed.

Neurotechnology-aided interventions for upper limb motor rehabilitation in severe chronic stroke.

Upper limb motor deficits in severe stroke survivors often remain unresolved over extended time periods. Novel neurotechnologies have the potential to significantly support upper limb motor restoration in severely impaired stroke individuals. Here, we review recent controlled clinical studies and reviews focusing on the mechanisms of action and effectiveness of single and combined technology-aided interventions for upper limb motor rehabilitation after stroke, including robotics, muscular electrical stimulation, brain stimulation and brain computer/machine interfaces. We aim at identifying possible guidance for the optimal use of these new technologies to enhance upper limb motor recovery especially in severe chronic stroke patients. We found that the current literature does not provide enough evidence to support strict guidelines, because of the variability of the procedures for each intervention and of the heterogeneity of the stroke population. The present results confirm that neurotechnology-aided upper limb rehabilitation is promising for severe chronic stroke patients, but the combination of interventions often lacks understanding of single intervention mechanisms of action, which may not reflect the summation of single intervention's effectiveness. Stroke rehabilitation is a long and complex process, and one single intervention administrated in a short time interval cannot have a large impact for motor recovery, especially in severely impaired patients. To design personalized interventions combining or proposing different interventions in sequence, it is necessary to have an excellent understanding of the mechanisms determining the effectiveness of a single treatment in this heterogeneous population of stroke patients. We encourage the identification of objective biomarkers for stroke recovery for patients' stratification and to tailor treatments. Furthermore, the advantage of longitudinal personalized trial designs compared to classical double-blind placebo-controlled clinical trials as the basis for precise personalized stroke rehabilitation medicine is discussed. Finally, we also promote the necessary conceptual change from 'one-suits-all' treatments within in-patient clinical rehabilitation set-ups towards personalized home-based treatment strategies, by adopting novel technologies merging rehabilitation and motor assistance, including implantable ones.

Influence of Personality and Differences in Stress Processing Among Finnish Students on Interest to Use a Mobile Stress Management App: Survey Study.

BackgroundExcessive stress has a negative impact on many aspects of life for both individuals and societies, from studying and working to health and well-being. Each individual has their unique level of stress-proneness, and positive or negative outcomes of stress may be affected by it. Technology-aided interventions have potential efficacy in the self-management of stress. However, current Web-based or mobile stress management solutions may not reach the individuals that would need them the most, that is, stress-sensitive people.ObjectiveThe aim of this study was to examine how personality is associated with stress among Finnish university students and their interest to use apps that help in managing stress.MethodsWe used 2 structured online questionnaires (combined, n=1001) that were advertised in the University of Helsinki’s mailing lists. The first questionnaire (n=635) was used to investigate intercorrelations between the Big Five personality variables (neuroticism, extraversion, openness, agreeableness, and conscientiousness) and other stress-related background variables. The second questionnaire (n=366) was used to study intercorrelations between the above-mentioned study variables and interest in using stress management apps.ResultsThe quantitative findings of the first questionnaire showed that higher levels of extraversion, agreeableness, and conscientiousness were associated with lower self-reported stress. Neuroticism, in turn, was found to be strongly associated with rumination, anxiety, and depression. The findings of the second questionnaire indicated that individuals characterized by the Big Five personality traits of neuroticism and agreeableness were particularly interested to use stress management apps (r=.27, P<.001 and r=.11, P=.032, respectively). Moreover, the binary logistic regression analysis revealed that when a person’s neuroticism is one SD above average (ie, it is higher than among 84% of people), the person has roughly 2 times higher odds of being interested in using a stress management app. Respectively, when a person’s agreeableness is one SD above average, the person has almost 1.4 times higher odds of being interested in using a stress management app.ConclusionsOur results indicated that personality traits may have an influence on the adoption interest of stress management apps. Individuals with high neuroticism are, according to our results, adaptive in the sense that they are interested in using stress management apps that may benefit them. On the contrary, low agreeableness may lead to lower interest to use the mobile stress management apps. The practical implication is that future mobile stress interventions should meaningfully be adjusted to improve user engagement and support health even among less-motivated users, for instance, to successfully engage individuals with low agreeableness.

Case series of technology-aided interventions to support leisure and communication in extensive disabilities

Objectives: This study assessed a new technology-aided program to support independent leisure and communication engagement with people with intellectual and motor or sensory-motor disabilities.Methods: Six adults participated. The program relied on the use of a Samsung Galaxy Tab S2 LTE tablet with Android 6.0 Operating System, a NANO SIM card, and the WhatsApp Messenger and MacroDroid applications. The participants were presented with leisure and communication (i.e. text messaging) alternatives, and, based on their choices, with series of steps allowing them to access leisure events or send messages.Results: During baseline, the participants were unable to access leisure events or send messages. During intervention and post-intervention phases, they used the program successfully and spent large percentages of the session time independently engaged in leisure and messaging.Conclusions: A program based on readily available technology may be functional to support leisure and communication in people like the participants of this study.

Electronic Screen Media Use in Youth With Autism Spectrum Disorder.

Electronic and social media play a prominent role in the lives of children and teenagers. Evidence suggests youth with autism spectrum disorder (ASD) use media differently than typically developing peers, and some of these differences place them at greater risk for negative health outcomes related to unhealthy and improper use of media. Such outcomes include physiologic, cognitive, social, emotional, and legal/safety problems. However, several technology-aided interventions have emerged to help youth with ASD across multiple domains. Parents of youth with ASD may benefit from several recommendations and resources from the American Academy of Pediatrics and the American Academy of Child and Adolescent Psychiatry.

Technology-Aided Interventions for Employment Skills in Adults with Autism Spectrum Disorder: A Systematic Review

There is a growing body of research investigating the effects of technology on remediating the employment challenges experienced by individuals with autism spectrum disorder (ASD). The current study provides a focused systematic review of 18 studies identified within the literature to employ technology to teach employment skills to adults with ASD. The review included 13 single-subject research and 5 group designs. Reichow’s (2011) criteria were employed to assess the interventions as evidence-based practice (EBP). Results showed that the use of technology-aided interventions to be effective on increasing employment outcomes for adults with ASD. Furthermore, the current study presented the ranges of employment skills targeted, as well as the focus of intervention towards those with higher functioning ASD. The review also highlights avenues for further research.

Case Studies of Technology-aided Interventions to Promote Hand Reaching and Standing or Basic Ambulation in Persons with Multiple Disabilities.

Motor impairments such as lack of standing and/or independent ambulation are common among persons with multiple disabilities. These two studies assessed technology-aided programs for persons with those impairments. Specifically, Study I assessed a program to teach two non-ambulatory adults to hand reach a stimulation-linked object by standing up. Study II assessed a program to teach a child and a man to ambulate while holding a rail or following a corridor wall. Standing increased from below 15% to about or over 80% of the session duration in Study I. The participants of Study II managed to complete brief ambulation trials independent of guidance. These performance achievements were discussed in relation to the technology-aided programs employed in the studies and the programs' applicability in daily contexts.

Technology-Aided Interventions and Instruction for Adolescents with Autism Spectrum Disorder.

The use of technology in intervention and instruction for adolescents with autism spectrum disorder (ASD) is increasing at a striking rate. The purpose of this paper is to examine the research literature underlying the use of technology in interventions and instruction for high school students with ASD. In this paper, authors propose a theoretical and conceptual framework for examining the use of technology by and for adolescents with ASD in school, home, and community settings. This framework is then used to describe the research literature on efficacy of intervention and instruction that utilizes technology. A review of the literature from 1990 to the end of 2013 identified 30 studies that documented efficacy of different forms of technology and their impact on academics, adaptive behavior, challenging behavior, communication, independence, social competence, and vocational skills.