Perceived importance of AAC messages to support communication in rehabilitation settings

Attitudes toward the use of low-tech AAC in acute settings: a systematized review

The purpose of this systematized review was to investigate how attitudes toward low-tech AAC might be impacting its use in acute care settings. A comprehensive and systematic search of databases identified 23 articles for inclusion. Thematic analysis using the World Health Organization International Classification of Functioning, Disability and Health (ICF) framework facilitated a narrative synthesis of findings. Results suggest that in acute care settings (a) adult patients, families, nursing staff, medical team, and allied health professionals all have opportunities to use but do not regularly engage with AAC; (b) individuals reject low-tech AAC devices for a variety of reasons, including that they are not useful, necessary, suitable, or appropriate in settings such as intensive care units; (c) negative attitudes toward AAC are linked to a lack of initial training and ongoing support, perceived impersonal content, limited functionality, and a lack of consistent availability; and (d) positive attitudes toward low-tech AAC are more prevalent when training and support are offered, low-tech AAC effectiveness is demonstrated, and organizational, financial, and procedural commitments are provided. Limitations of the research are highlighted and future research opportunities are identified.

Ability-Based Methods for Personalized Keyboard Generation

This study introduces an ability-based method for personalized keyboard generation, wherein an individual’s own movement and human–computer interaction data are used to automatically compute a personalized virtual keyboard layout. Our approach integrates a multidirectional point-select task to characterize cursor control over time, distance, and direction. The characterization is automatically employed to develop a computationally efficient keyboard layout that prioritizes each user’s movement abilities through capturing directional constraints and preferences. We evaluated our approach in a study involving 16 participants using inertial sensing and facial electromyography as an access method, resulting in significantly increased communication rates using the personalized keyboard (52.0 bits/min) when compared to a generically optimized keyboard (47.9 bits/min). Our results demonstrate the ability to effectively characterize an individual’s movement abilities to design a personalized keyboard for improved communication. This work underscores the importance of integrating a user’s motor abilities when designing virtual interfaces.

Personalization of Patient-Provider Communication Across the Lifespan

People with disabilities are more likely to be hospitalized and use healthcare services relative to people without disabilities. They also report experiencing negative experiences interacting with health care providers during these encounters placing them at risk for preventable adverse medical events, poor quality of life, and dependence on others. Fortunately, providers and people with communication disabilities can take steps to improve these interactions by personalizing and implementing communication supports to empower people with communication disabilities to actively participate in these interactions and improve outcomes. The purpose of this article is to describe strategies that health care providers can use to develop and implement personalized communication supports for children and adults with communication disorders during health care interactions. Additional strategies are provided to guide people with disabilities as well as their community/school providers and families to prepare for health care interactions. Case examples are provided to illustrate use of these strategies in acute care, inpatient rehabilitation, and outpatient settings. The use of emerging training tools (e.g., video visual scene displays) and AAC partner training formats (e.g., just-in-time training) are also presented as future directions to expedite learning and implementation of communication supports in fast-paced and time-limited health care interactions.

Rehabilitation in a rare case of coffin-siris syndrome with major cognitive and behavioural disorders

BACKGROUND

Coffin-Siris syndrome is a rare genetic disease with heterozygous variants in the ARID1A, ARID1B, ARID2, DPF2, SMARCA4, SMARCB1, SMARCE1 or SOX11 genes. It may manifest with somatic anomalies, deafness, urogenital malformations, recurrent infections, mental retardation, speech deficit, agenesis of the corpus callosum, convulsions, hypotonia, developmental delay, and scoliosis.

CASE REPORT

A 14-year-old boy with Coffin-Siris syndrome due to variants in the ARID1A gene was referred to the clinic. His rehabilitation over a 9-year period was described. The problem of assessment and the approach to rehabilitation was discussed, enabling a progressive remodelling of the cognitive-behavioural disorders that most hindered the possibility of his acquiring new skills and achieving social and family integration.

CLINICAL REHABILITATION

A protracted, customised, multiprofessional rehabilitation approach, centred on realistic functional objectives, implemented with the direct involvement of the family and school, was the only way to achieve the maximum independence and social and family integration permitted by his residual disability.