Movement-to-music computer technology: a developmental play experience for children with severe physical disabilities

Children with severe physical disabilities often lack the physical skills to explore their environment independently, and to play with toys or musical instruments. The movement-to-music (MTM) system is an affordable computer system that allows children with limited movements to play and create music. The present study explored parents' experiences of using the MTM system with their children. A qualitative methodology employing in-depth interview techniques was used with six mothers and their children. The themes extracted from the data were organized under two main concepts of the International Classification of Functioning, Disability, and Health (ICF) (WHO, 2001) framework. The results showed that the MTM expanded horizons for the child along the ICF health dimensions and the MTM had a positive impact on ICF environmental determinants of health. The small sample size should be noted as a limitation of this study. Further research should be carried out with a larger sample of children with restricted mobility to obtain a better understanding of the impact of MTM technology on children's psychosocial development.     

The Turkish version of the Family Impact of Assistive Technology Scale: A validity and reliability study

Abstract

Objective: The purpose of the current study is to estimate the preliminary measurement properties of the Turkish version of Family Impact of Assistive Technology Scale (FIATS-tr). Method: The validity and reliability of the scale was performed in two phases. Phase I focused on construction of the Turkish version of the instrument and pilot testing. The scale was translated using the back-translation technique. The comprehensiveness and clarity of the scale was assessed with 20 participants. Phase II included psychometric assessment of the scale using a classical test theory approach. The final version of the scale was pretested with Turkish-speaking parents (46 mothers, four fathers and five caregivers) of 55 chronically disabled children. Results: Test–retest reliability was found to be ICC = 0.931 (95% CI 0.881–0.960) for FIATS-tr total. Cronbach's alpha for the overall FIATS-tr was 0.858. Individual alpha values for FIATS-tr subscales ranged from 0.199 to 0.838. The FIATS-tr total was moderately correlated with the Functional Independence Measure for Children (WeeFIM) total (r = 0.688, p < 0.001). Conclusions: This study showed that overall FIATS-tr appears to have acceptable levels of validity and reliability when used to measure the functional impact of assistive devices. Further study of the constructs and homogeneity of its total and subscales may further improve the internal consistency, validity, and other measurement properties of the FIATS-tr.     

A pilot study on attitudes toward making reasonable accommodations for occupational therapists with disabilities

The Americans with Disabilities Act (ADA) ensures that persons with disabilities in the United States are entitled to reasonable accommodations in five areas including employment. This pilot study (1) tested the reliability and validity of a questionnaire, which (2) explored how much training American occupational therapists had in the ADA and (3) investigated the attitudes of occupational therapist supervisors toward occupational therapist employees with disabilities. A questionnaire consisting of 20 statements was designed by the researcher. The questionnaire was mailed to 18 occupational therapy administrators. Ten participants who completed the mailed questionnaire were included in the results. Participants with ADA training had a more positive attitude towards making reasonable accommodations than those without training. Only participants working in psychosocial settings claimed to have occupational therapy employees with disabilities. Six of the administrators made reasonable accommodations for employees who had disabilities. Further study of a larger sample of occupational therapy administrators is recommended to determine the attitude towards reasonable accommodations for employees with disabilities. Copyright © 1996 Whurr Publishers Ltd.     

The health of caregivers for children with disabilities: caregiver perspectives

BACKGROUND: There are an estimated 5.9 million children with severe disabilities in the USA, and most of them are cared for at home by their parents and families. Indirect evidence suggests that poor caregiver health may contribute to recurrent hospitalizations and out-of-home placements for children with chronic conditions and disabilities. Greater knowledge of caregiver health-related needs would allow for the improvement of existing services and the development of new strategies to sustain caregivers in their vital roles. This study explores caregiver perspectives of the health implications of long-term informal caregiving for children with disabilities. METHODS: Forty parents/caregivers of children with disabilities residing in urban, suburban and rural regions of Utah completed questionnaires and participated in focus groups that explored their feelings regarding their current physical and emotional health and the factors that they viewed as either impairing or promoting their health. The sessions were audiotaped and transcribed. Summary statistics were generated for the questionnaire responses. Focus group content was analysed according to emerging themes and patterns in clusters of information. RESULTS: The caregiving experience was captured by five themes: (i) stress of caregiving; (ii) negative impact on caregiver health; (iii) sharing the burden; (iv) worry about the future; and (v) caregiver coping strategies. Forty-one per cent of the caregivers reported that their health had worsened over the past year, and attributed these changes to a lack of time, a lack of control and decreased psychosocial energy. CONCLUSIONS: Caregivers of children with disabilities describe negative physical, emotional and functional health consequences of long-term, informal caregiving. They have important insights regarding those aspects of caregiving that have positive and negative influences on their health. Interventions that address these issues may have the potential to positively impact caregiver health.     

Barriers to the use of assistive technology for children with multiple disabilities

Assistive technology has aided children with multiple disabilities to improve access and participation in their school and home environments. Effective educational outcomes from assistive technology use are dependent upon a coordinated assessment and implementation process. The literature on assistive technology with children was reviewed in order to identify current barriers to its effective integration within schools. These barriers were found to include lack of appropriate staff training and support, negative staff attitudes, inadequate assessment and planning processes, insufficient funding, difficulties procuring and managing equipment, and time constraints. A team model for assistive technology assessment and planning is proposed to optimize the educational goal achievement of children with multiple disabilities. Such a model can help target the allocation of occupational therapy resources in schools to best promote educational and broader functional outcomes from assistive technology use.     

Improving the health and health behaviors of women aging with physical disabilities: A peer-led health promotion program

OBJECTIVE: To examine the efficacy of a health promotion program for women aging with physical disabilities. METHOD: A sample of 137 middle-aged and older women with physical disabilities was randomly assigned to either an 8-week health promotion program or to a wait-list control group. Both groups completed questionnaires before, immediately after, and 3 months after the intervention. RESULTS: Relative to women in the control group, women in the health-promotion program demonstrated improvements in health behaviors, most of which were maintained at follow-up. The intervention group showed some improvements on measures of physical health, but there was little evidence of improvement in psychological health outcomes. Testing our theoretical model, self-efficacy was supported as a mediator of the effect of the intervention on health behaviors, and health behaviors combined with self-efficacy were supported as mediators of the effect of the intervention on physical health outcomes. Contrary to our hypotheses, our measures of social support and social connectedness were not affected by the intervention. CONCLUSIONS: A brief, peer-led, group health promotion program resulted in improved scores on measures of self-efficacy, increased health behavior, and physical health. Self-efficacy, which was supported as a mediator in the effect of the intervention on behaviors and health outcomes, should remain an important focus of future interventions with this population.     

Policy and provision of WASH in schools for children with disabilities: A case study in Malawi and Uganda

There is a growing body of evidence on the correlation between improving access to water, sanitation and hygiene (WASH) in schools and positive health and educational outcomes for students. Similar evidence on the impact of school WASH facilities on health, enrolment and absence for children with disabilities is not available. The limited data have revealed that children with disabilities are burdened by poor WASH in schools access, and even prevented from attending school due to inaccessible WASH facilities. We conducted two case studies of policy and provision of school WASH services for children with disabilities in Uganda and Malawi. We found a robust policy environment in Uganda and Malawi with policies and guidelines in place for WASH in schools for children with disabilities. However, provision of services and facilities are low and focused primarily on sanitation.     

Reliability of assessing the sensory perception of children with profound intellectual and multiple disabilities: a case study

BACKGROUND: This study describes preliminary stages of developing a checklist to enable practitioners to determine the behavioural responses of children with profound intellectual and multiple disabilities to sensory stimuli. Reliability of currently used checklists is low, with a focus on the child's sensory integration instead of perception. METHODS: The inter-rater reliability of a checklist was determined, and adjustments were made to improve reliability. RESULTS: Strikingly, the reliability decreased for all components after adjustment. The effect of a smaller item pool was ruled out. The effect of familiarity of teachers as raters was examined. CONCLUSIONS: Results show that teachers who know a child well could interpret that child's behaviour more accurately than persons who were unfamiliar with the child. However, reliability of the checklist remains a problem.     

Beyond behavioural observations: a deeper view through the sensory reactions of children with profound intellectual and multiple disabilities

Background The present study was aimed at assessing the behavioural and physiological responsiveness of three children with profound intellectual and multiple disabilities to a set of sensory stimuli. Methods Eighteen items, ‘believed’ by clinicians to be appropriate for routine interventions, were presented to the participants and responsiveness was assessed in terms of: (i) consistent behavioural and electrodermal reactions and (ii) biphasic changes in heart rate. Results Results were twofold. First, all participants showed frequent consistent physiological reactions but rare consistent behavioural ones. Second, all participants showed biphasic changes in heart rate, pointing to the possibility of different appraisals (novelty and pleasantness) of most of the presented items. Conclusions Data here presented may have implications for the development and the emotional well‐being of individuals with profound intellectual and multiple disabilities in that it suggests that reactions to, and potential appraisals of, sensory stimuli may occur despite the lack of consistent observable behaviours.     

Contraceptive knowledge and use among women with intellectual,physical, or sensory disabilities: A systematic review

Background

Women spend most of their reproductive years avoiding pregnancy. However, we know little about contraceptive knowledge and use among women with disabilities, or about strategies to improve contraceptive knowledge and decision-making in this population.

Right-to-know training of workers with IQ less than 70: A pilot study

Chemical emergencies occur frequently in the workplace. Laws and regulations have been enacted to reduce the risk of injuries to workers, including workers with an IQ less than 70. These regulations require employers to educate their workers about the nature and hazards of toxic substances in the workplace, about methods to reduce exposure, and about appropriate responses in case of an accident or an emergency. From May to August 1996, a project examined the responses of 58 Goodwill Industries employees before and after their attendance at a mandatory “Right-to-Know” training program. Responses to five questions relating to the safe use of chemicals were analyzed. A combination of quantitative and qualitative evaluations determined that for the 28 subjects with IQ < 70, the program did not achieve its goals. However, the program did provide fuller information for the 30 subjects with IQ > 70. The findings of this pilot study show the need to develop training programs tailored to meet the needs and conditions of workers with IQ < 70. Am. J. Ind. Med. 32:417–420, 1997. © 1997 Wiley-Liss, Inc.     

Patient-provider communication quality for persons with disabilities: A cross-sectional analysis of the Health Information National Trends Survey

BackgroundIt is unclear how perceived patient-provider communication quality (PPPCQ) varies according to disability status. Lack of adequate patient-provider communication may prevent providers from considering healthcare issues that are relevant and important to persons with disabilities (PWD), potentially contributing to poorer health outcomes.Objective/Hypothesis: To examine PPPCQ by disability status using current U.S. Department of Health and Human Services standards for surveillance of functional disabilities.MethodsThis cross-sectional study used nationally-representative data from the 2012–2013 Health Information National Trends Survey (HINTS). Participants were categorized as having any disability (hearing, vision, mobility, cognitive, self-care, and/or independent living limitations). PPPCQ was assessed using seven HINTS questions about communication with healthcare professionals. Linear regression was used to estimate mean differences in composite PPPCQ scores, and logistic regression was used to estimate odds ratios (OR) for a provider “always or usually” performing PPPCQ.ResultsThe study population comprised 5301 participants, representing 180,442,731 U.S. adults. Overall, 22.1% (weighted) reported any disability. Adjusted mean PPPCQ scores were significantly lower for PWD (72.8, 95% CI: 68.2–77.4) than persons without disability (78.3, 95% CI: 76.5–80.2), p = 0.021. More specifically, PWD were significantly less likely to be given attention needed to address feelings and emotions (OR = 0.6, 95% CI: 0.4, 0.9, p = 0.017), to have next steps understood (OR = 0.4, 95% CI: 0.2, 0.8, p = 0.019), and to receive a clear explanation (OR = 0.3, 95% CI: 0.1, 0.8, p = 0.018).ConclusionsPWD are less likely to report key elements of effective patient-provider communication. Implementing patient-centered care may improve patient-provider communication for this vulnerable population.     

Ready for recess: a pilot study to increase physical activity in elementary school children

BACKGROUND: Creating an optimal environment at recess may be necessary to maximize physical activity (PA) participation in youth. The purpose of this study was to determine the initial effectiveness of an elementary school recess intervention on the amount of moderate PA (MPA) and vigorous PA (VPA) during recess and the school day. METHODS: This school‐based intervention included staff training, activity zones, and playground equipment. The PA levels of third, fourth, and fifth grade students (n = 93) at two schools were measured at baseline and post‐intervention using ActiGraph accelerometers. Paired t tests were used to compare percentage of time spent during recess in MPA and VPA. Multiple regressions were utilized to model the effect of intervention, age, sex, race, body mass index, and school on minutes spent in MPA and VPA. RESULTS: The multiple regression results demonstrated increases of 2.5 minutes of MPA (p < .001) and 2.2 minutes of VPA (p < .001) at recess and an increase of 18.7 minutes of MPA (p < .001) and 4.7 minutes of VPA (p < .001) during the school day. These represent respective increases of 51.2% and 112.2% in the adjusted means of MPA and VPA during recess and respective increases of 92.2% and 71.6% in the adjusted mean of MPA and VPA during school day. CONCLUSION: Staff training, recreational equipment, and playground markings are inexpensive, simple ways to increase PA during recess so that children can accumulate minutes of PA to meet the recommended guidelines of 60 minutes per day.