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• Communicative Interaction with and without Eye-Gaze Technology between Children and Youths with Complex Needs and Their Communication Partners

  2021. Yu-Hsin Hsieh (et al.). International Journal of Environmental Research and Public Health 18 (10)

  Artikel

  Use of eye-gaze assistive technology (EGAT) provides children/youths with severe motor and speech impairments communication opportunities by using eyes to control a communication interface on a computer. However, knowledge about how using EGAT contributes to communication and influences dyadic interaction remains limited. Aim: By video-coding dyadic interaction sequences, this study investigates the impacts of employing EGAT, compared to the Non-EGAT condition on the dyadic communicative interaction. Method: Participants were six dyads with children/youths aged 4-19 years having severe physical disabilities and complex communication needs. A total of 12 film clips of dyadic communication activities with and without EGAT in natural contexts were included. Based on a systematic coding scheme, dyadic communication behaviors were coded to determine the interactional structure and communicative functions. Data were analyzed using a three-tiered method combining group and individual analysis. Results: When using EGAT, children/youths increased initiations in communicative interactions and tended to provide more information, while communication partners made fewer communicative turns, initiations, and requests compared to the Non-EGAT condition. Communication activities, eye-control skills, and communication abilities could influence dyadic interaction. Conclusion: Use of EGAT shows potential to support communicative interaction by increasing children's initiations and intelligibility, and facilitating symmetrical communication between dyads.

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• Applying Eye-Gaze Assistive Technology in Daily Life in Children and Youth with Severe Physical Disabilities and Complex Communication Needs- A study protocol

  2019. Yu-Hsin Hsieh (et al.).

  Konferens

  Background: Children and youth with severe physical disabilities and complex communication needs might have decreased participation in school and community life. Recent studies have shown that using eye-gaze assistive technology (AT) with support from social environments, engagement of main caregivers and team collaboration could help their voices been heard based on ICF framework. However, the research evidences are insufficient.

  Purpose: This paper describes the study protocol that aims to investigate the feasibility of eye-gaze AT for participation and communication/social interaction in daily living in children and youth with severe physical disabilities and complex communication needs in Taiwan.

  Methods: A nonconcurrent multiple probe design with mixed methods will be conducted from September 2019 to August 2020. The eye gaze AT intervention will be implemented in daily activities with support from the multi-professional team to explore the acceptability and implementation in Taiwan’s contexts. The research data will be collected at baseline, at 3 months, 6 months, and at 7 months since provision of the eye-gaze AT, encompassing quantitative outcomes on children’s daily participation and social communication and qualitative interviews with parents and service providers.

  Expected results: This study expects to provide a preliminary evidence of eye-gaze AT implementation in Taiwan and bring new knowledge in both a national and international perspective.

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• Collaborative Home-Visit Program for Young Children With Motor Delays in Rural Taiwan

  2020. Yu-Hsin Hsieh (et al.). Physical Therapy 100 (6), 979-994

  Artikel

  Background. Caregiver engagement and collaborative team early childhood intervention (ECI) services are international trends; however, relevant evidence of collaborative home-visiting ECI in rural areas is as yet undetermined.

  Objective. The study aimed to investigate the effectiveness of a collaborative ECI program in a rural area of Taiwan.

  Design. The study was a pilot randomized control led trial.

  Methods. Children aged 6 to 33 months experiencing motor delays and their caregivers were enrolled in Taitung, Taiwan. Using stratified randomization, 24 participants were allocated to either experimental or control groups, and both received 5 home visits within 3 months. The experimental group received ECI services based on the International Classification of Functioning, Disability and Health framework and family-centered approaches. The control group received regular home visits by local social workers. Child outcomes included Pediatric Evaluation of Disability Inventory Chinese Version and Peabody Developmental Motor Scale, 2nd edition. Family outcomes included the Disability-Adapted Infant–Toddler version of Home Observation for Measurement, and Chinese versions of the Knowledge of Infant Development Inventory and Parental Stress Index-Short Form. A tester blinded to the study conducted assessments at baseline, postintervention, and 3-month follow-up. Two-way mixed analysis of variance was used with α = .05 (2-tailed).

  Results. The experimental group improved scores on the Disability-Adapted Infant–Toddler version of Home Observation for Measurement significantly more than the control group with an effect size of 0.64 at follow-up. In other outcomes, both groups showed no significant differences. The follow-up rate was 69%, and adherence to the ECI program was acceptable.

  Limitations. A limitation of the study was the heterogeneity of the sample.

  Conclusions. This pilot study revealed possible effectiveness in implementing collaborative ECI programs based on family-centered approaches and the International Classification of Functioning, Disability and Health in rural areas. Larger field studies are needed to confirm our findings.

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