Smart speaker devices can improve speech intelligibility in adults with intellectual disability

Extending patient-centred communication to non-speaking intellectually disabled persons

Patient-centred communication is widely regarded as a best practice in contemporary medical care, both in terms of maximising health outcomes and respecting persons. However, not all patients communicate in ways that are easily understood by clinicians and other healthcare professionals. This is especially so for patients with non-speaking intellectual disabilities. We argue that assumptions about intellectual disability-including those in diagnostic criteria, providers' implicit attitudes and master narratives of disability-negatively affect communicative approaches towards intellectually disabled patients. Non-speaking intellectually disabled patients may also be taken to lack decision-making capacity and resultingly, may be given very little role in determining their care. But, given evidence of the heterogeneous communicative practices available to non-speaking patients, efforts should be made to extend patient-centred communication to them. We offer four suggestions for doing so: (1) treating those with non-speaking intellectual disabilities as potential communicators; (2) lengthening appointment times to develop relationships necessary for communication; (3) disentangling capacity from communication in concept and in practice; and (4) recognising the bidirectional connection between supported decision-making and patient-centred communication.

Hey Google! Intelligent personal assistants and well-being in the context of disability during COVID-19

BACKGROUND

Amidst the greatest technological advancement that societies have seen, the (health)care and quality of life of all, and especially of vulnerable individuals, see unprecedented improvements. Intelligent personal assistants (IPAs), such as Google Home (GH), can easily be implemented in their daily lives to facilitate routines. Technology can offer significant benefits for individuals with impairments and/or limitations in achieving greater autonomy and well-being. However, this opportunity still needs to be fully exploited, especially in long-term care facilities. Furthermore, such potential may be particularly needed during social isolation due to health concerns, such as the COVID-19 lockdowns and restrictions. We investigated the validity of implementing GH in residential care for individuals with visual impairments (VIs) and intellectual disabilities (IDs) and assessed the effects of a 10-week intervention on self-reported well-being.

METHODS

We used a mixed-methods multiple case studies approach (N = 7) and performed intensive assessments (20 weeks), including self-report well-being questionnaires and observations focusing on well-being, autonomy, social participation and GH experiences. Nonoverlap of all pairs analyses were performed for quantitative data indexing performance differences between intervention phases. Thematic analysis was performed for the qualitative data.

RESULTS

We found meaningful improvements in well-being in five clients, while all rated the experience of using GH positively.

CONCLUSIONS

Our findings from the quantitative and qualitative analyses document that individuals with VI and/or ID benefit from IPAs in fostering better autonomy by facilitating access to information and entertainment. Further implications and possible barriers to large-scale implementation of IPAs in residential care are discussed.

Understanding the possibilities and limitations of assistive technology in health and welfare services for people with intellectual disabilities, staff perspectives

PURPOSE

Little is known regarding what assistive technology (AT) exists and how it is used in welfare services for people with intellectual disabilities (ID). This study aimed to explore healthcare staff's perspectives and insights regarding AT in daily support and welfare services for people with ID. We also sought to explore the associations between the use of AT and workplace-related factors and background characteristics (e.g., gender, age, and experience).

MATERIALS AND METHODS

Three focus group discussions were conducted with 11 informants (8 women, 3 men) working in home-based and day services. Also, 176 healthcare staff (43 men, 133 women) who worked in municipal home-based services and day services completed a questionnaire comprised of background questions and 14 items with a five-point answer scale.

RESULTS

Number of years using AT was positively associated with a positive attitude and use of AT among the staff. Staff were mainly positive towards AT and believed that it could represent various possibilities in the everyday lives of people with ID and their own service delivery. However, the staff expressed uncertainties and ethical concerns regarding AT, and they experienced a lack of knowledge, focus, and awareness about technology in services for this group. The quantitative results mainly showed positive associations between believing in AT's usefulness and using it in services for people with ID.

CONCLUSIONS

The findings indicate that providing equipment and resources, personal interests, and staff attitudes are essential factors in successfully implementing AT for people with ID.Implications for rehabilitationHealthcare staff have a positive attitude towards using AT for people with intellectual disabilities, but they also perceive uncertainty and ethical concerns.The staff believe that there is a broad range of AT devices and systems available that can support the independence and participation of people with intellectual disabilities.The staff need to receive more training and technical supports from their workplace and AT-related experience is associated positively with the use of assistive technology by the staff.

Technologies to support the diagnosis and/or treatment of neurodevelopmental disorders: A systematic review

In recent years, there has been a great interest in utilizing technology in mental health research. The rapid technological development has encouraged researchers to apply technology as a part of a diagnostic process or treatment of Neurodevelopmental Disorders (NDDs). With the large number of studies being published comes an urgent need to inform clinicians and researchers about the latest advances in this field. Here, we methodically explore and summarize findings from studies published between August 2019 and February 2022. A search strategy led to the identification of 4108 records from PubMed and APA PsycInfo databases. 221 quantitative studies were included, covering a wide range of technologies used for diagnosis and/or treatment of NDDs, with the biggest focus on Autism Spectrum Disorder (ASD). The most popular technologies included machine learning, functional magnetic resonance imaging, electroencephalogram, magnetic resonance imaging, and neurofeedback. The results of the review indicate that technology-based diagnosis and intervention for NDD population is promising. However, given a high risk of bias of many studies, more high-quality research is needed.

Voice-Based Screening for SARS-CoV-2 Exposure in Cardiovascular Clinics (VOICE-COVID-19-II): Protocol for a Randomized Controlled Trial

BACKGROUND

The COVID-19 pandemic has disrupted the health care system, limiting health care resources such as the availability of health care professionals, patient monitoring, contact tracing, and continuous surveillance. As a result of this significant burden, digital tools have become an important asset in increasing the efficiency of patient care delivery. Digital tools can help support health care institutions by tracking transmission of the virus, aiding in the screening process, and providing telemedicine support. However, digital health tools face challenges associated with barriers to accessibility, efficiency, and privacy-related ethical issues.

OBJECTIVE

This paper describes the study design of an open-label, noninterventional, crossover, randomized controlled trial aimed at assessing whether interactive voice response systems can screen for SARS-CoV-2 in patients as accurately as standard screening done by people. The study aims to assess the concordance and interrater reliability of symptom screening done by Amazon Alexa compared to manual screening done by research coordinators. The perceived level of comfort of patients when interacting with voice response systems and their personal experience will also be evaluated.

METHODS

A total of 52 patients visiting the heart failure clinic at the Royal Victoria Hospital of the McGill University Health Center, in Montreal, Quebec, will be recruited. Patients will be randomly assigned to first be screened for symptoms of SARS-CoV-2 either digitally, by Amazon Alexa, or manually, by the research coordinator. Participants will subsequently be crossed over and screened either digitally or manually. The clinical setup includes an Amazon Echo Show, a tablet, and an uninterrupted power supply mounted on a mobile cart. The primary end point will be the interrater reliability on the accuracy of randomized screening data performed by Amazon Alexa versus research coordinators. The secondary end point will be the perceived level of comfort and app engagement of patients as assessed using 5-point Likert scales and binary mode responses.

RESULTS

Data collection started in May 2021 and is expected to be completed in fall 2022. Data analysis is expected to be completed in early 2023.

CONCLUSIONS

The use of voice-based assistants could improve the provision of health services and reduce the burden on health care personnel. Demonstrating a high interrater reliability between Amazon Alexa and health care coordinators may serve future digital tools to streamline the screening and delivery of care in the context of other conditions and clinical settings. The COVID-19 pandemic occurs during the first digital era using digital tools such as Amazon Alexa for disease screening, and it represents an opportunity to implement such technology in health care institutions in the long term.

TRIAL REGISTRATION

ClinicalTrials.gov NCT04508972; https://clinicaltrials.gov/ct2/show/NCT04508972.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

DERR1-10.2196/41209.

Chinese adult segmentation according to health skills and analysis of their use for smart home: a cross-sectional national survey

Background

Digital health has become a heated topic today and smart homes have received much attention as an important area of digital health. Smart home is a device that enables automation and remote control in a home environment via the internet. However, most of the existing studies have focused on discussing the impact of smart home on people. Only few studies have focused on relationship between health skills and use of smart home.

Aims

To analyze the health skills of Chinese adults and segment them to compare and analyze the use of smart home for each group.

Methods

We used data from 11,031 participants aged 18 and above. The population was clustered based on five health skills factors: perceived social support, family health, health literacy, media use, and chronic diseases self-behavioral management. A total of 23 smart homes were categorized into three sub-categories based on their functions: entertainment smart home, functional smart home, and health smart home. We analyzed demographic characteristics and utilization rate of smart home across different cluster. Each groups’ features and the differences in their needs for smart home functions were compared and analyzed.

Results

As a result of the survey on health skills, three groups with different characteristics were clustered: good health skills, middle health skills, and poor health skills. The utilization rate of smart home was the highest was good health skills group (total smart home: 92.7%; entertainment smart home: 61.1%, functional smart home: 77.4%, and health smart home: 75.3%; P < 0.001). For entertainment smart home, smart TV had the highest utilization rate (good health skills: 45.7%; middle health skills: 43.5%, poor health skills: 33.4%, P < 0.001). For functional smart home, smart washing machine (good health skills: 37.7%, middle health skills: 35.11%, poor health skills: 26.5%; P < 0.001) and smart air conditioner (good health skills: 36.0%, middle health skills: 29.1%, poor health skills: 24.6%) were higher than other of this category. For health smart home, sports bracelet has the highest utilization rate (good health skills: 37.3%, middle health skills: 24.5%, poor health skills: 22.8%).

Conclusion

People can be divided into different categories based on health skill profiles, those with good health skills had a better utilization rate of smart home. The government and smart home companies need to focus on people with poor smart home use in various ways to promote their use of smart homes for personal health management.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12913-022-08126-8.

Social Adventure

Social environments can be challenging for people with intellectual disability. These challenges impact a person’s social inclusion and participation in their communities. Social skills development requires training and practice, but training is often time-limited, costly, and hard to access. However, games on smart speakers provide interesting opportunities to improve training access, motivate self-directed learning, and focus on speech. The authors developed an interactive narrative-based social skills training game for smart-speakers. The game facilitates exploration of the social consequences of making various choices in different social situations and uses natural language inputs. Having tested the game with ten adults with intellectual disability, the authors offer designers insights into participant engagement and the game’s audio-only, natural language interface usability. The authors also propose four design considerations to help designers design applications that help people with intellectual disability participate in social activities.

Voice-Activated Virtual Home Assistant Use and Social Isolation and Loneliness Among Older Adults: Mini Review

A lack of social connectedness is common among older adults due to living alone, loss of loved ones, reduced mobility, and, more recently, social distancing created by the global Covid-19 pandemic. Older adults are vulnerable to social isolation and loneliness, which pose significant health risks comparable to those of smoking, obesity, physical inactivity, and high blood pressure. A lack of social connectedness is also correlated with higher mortality rates even when controlling for other factors such as age and comorbid conditions. The purpose of this mini review was to explore the emerging concepts of older adults' use of commercially available artificial intelligent virtual home assistants (VHAs; e.g., Amazon Echo, Google Nest), and its relationship to social isolation and loneliness. A secondary purpose was to identify potential areas for further research. Results suggest that VHAs are perceived by many older adult users as “companions” and improve social connectedness and reduce loneliness. Available studies are exploratory and descriptive and have limited generalizability due to small sample sizes, however, similar results were reported across several studies conducted in differing countries. Privacy concerns and other ethical issues and costs associated with VHA use were identified as potential risks to older adults' VHA adoption and use. Older adults who were using VHAs expressed the need and desire for more structured training on device use. Future research with stronger methods, including prospective, longitudinal, and randomized study designs are needed. Public education, industry standards, and regulatory oversight is required to mitigate potential risks associated with VHA use.