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Hsieh, Y.-H., Granlund, M., Odom, S. L., Hwang, A.-W. & Hemmingsson, H. (2024). Increasing participation in computer activities using eye-gaze assistive technology for children with complex needs. Disability and Rehabilitation: Assistive Technology, 19(2), 492-505
Open this publication in new window or tab >>Increasing participation in computer activities using eye-gaze assistive technology for children with complex needs
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2024 (English)In: Disability and Rehabilitation: Assistive Technology, ISSN 1748-3107, E-ISSN 1748-3115, Vol. 19, no 2, p. 492-505Article in journal (Refereed) Published
Abstract [en]

PURPOSE: Eye-gaze assistive technology offers children with severe motor and communication difficulties the opportunity to access and control a computer through eye movements. The aim of this study was to examine the impact of eye-gaze assistive technology intervention on participation in computer activities and technology usability among children with complex needs in Taiwan.

MATERIALS AND METHODS: This study involved a multiple baseline design across individuals. The participants were four children aged three to six years with severe motor and communication difficulties and low eye-control skills. The six-month intervention consisted of two collaborative team meetings and 12 individual supports to facilitate the use of eye-gaze assistive technology at home or in educational environments. Participation in computer activities (diversity, frequency, and duration) was repeatedly measured through a computer use diary. Other outcomes included assessments of goal achievements and parents/teachers' ratings on children's performance in computer activities.

RESULTS: The young children increased the diversity of their computer activities and their frequency and duration of computer use from baseline to the intervention phase. The children attained six of eight predefined goals related to play, communication, and school learning. Parents and teachers perceived the children's changes in performance as meaningful.

CONCLUSION: This study strengthens the evidence that eye-gaze assistive technology is useful in everyday contexts for children with complex needs in Taiwan. The findings add knowledge that children with weak eye-control skills increased participation in computer activities as a result of the eye-gaze assistive technology.

Implications for Rehabilitation

  • Eye-gaze assistive technology (EGAT) as an access method to control a computer can provide opportunities for children with severe motor and communication difficulties to participate in computer activities.
  • Children with severe motor and communication difficulties and low eye-control skills with sufficient practice can learn to use EGAT for communication and learning, with support from stakeholders and collaborative service.
  • EGAT could be introduced for children with complex needs at early ages as a means of using computers for play, communication, and school learning, which could be helpful for later education and learning.
  • Stakeholders in educational environments could include EGAT in educational computer systems so that pupils with severe motor and communication difficulties could interact with a computer, thereby enhancing their engagement and learning.
Place, publisher, year, edition, pages
Taylor & Francis, 2024
Keywords
Communication, computer usage, eye-gaze controlled computer, learning, participation, play, severe motor and speech impairments
National Category
Pediatrics
Identifiers
urn:nbn:se:hj:diva-58038 (URN)10.1080/17483107.2022.2099988 (DOI)000828584600001 ()35861506 (PubMedID)2-s2.0-85134621223 (Scopus ID)HOA;intsam;822870 (Local ID)HOA;intsam;822870 (Archive number)HOA;intsam;822870 (OAI)
Funder
Clas Groschinski Memorial FoundationKempe-Carlgrenska FoundationStiftelsen Folke Bernadottes minnesfondHelge Ax:son Johnsons stiftelse
Available from: 2022-07-25 Created: 2022-07-25 Last updated: 2024-02-22Bibliographically approved
Ritoša, A., Almqvist, L., Danielsson, H. & Granlund, M. (2024). Profiles of State and Trait Engagement of Preschool Children. Early Education and Development
Open this publication in new window or tab >>Profiles of State and Trait Engagement of Preschool Children
2024 (English)In: Early Education and Development, ISSN 1040-9289, E-ISSN 1556-6935Article in journal (Refereed) Epub ahead of print
Abstract [en]

Research Findings: This study examined the engagement of 494 preschool children in Sweden (M = 53.44 months, SD = 10.64) using both teacher questionnaires to measure global engagement (trait) and observations to measure momentary engagement (state). Using a person-oriented approach with cluster analysis, we identified five distinct profiles of global and momentary engagement, with four of them showing discrepancies between global and observed engagement levels. We found that age, hyperactivity, and second language learner (SLL) status were related to a specific engagement profile. Specifically, children high in hyperactivity tended to be in clusters with higher momentary engagement than global engagement, whereas second language learners were overrepresented in clusters with lower momentary engagement. Practice or Policy: The findings suggest that global and observed measures of engagement capture different aspects of children's engagement and should not be used interchangeably. Children with low engagement ratings on both measures of engagement are more likely to have an extreme score on the global engagement measure, indicating that difficulties they experience will be more noticeable in their global engagement. On the other hand, displays of high levels of momentary engagement could signal children's inherent potential, prompting tailored encouragement and support within Early Childhood Education and Care (ECEC) settings and promoting their overall engagement levels.

Place, publisher, year, edition, pages
Taylor & Francis, 2024
National Category
Learning Pedagogical Work
Identifiers
urn:nbn:se:hj:diva-63338 (URN)10.1080/10409289.2023.2297656 (DOI)001129330900001 ()2-s2.0-85180260240 (Scopus ID)HOA;;926932 (Local ID)HOA;;926932 (Archive number)HOA;;926932 (OAI)
Available from: 2024-01-12 Created: 2024-01-12 Last updated: 2024-01-12
Antoniadou, M., Granlund, M. & Andersson, A. K. (2024). Strategies used by professionals in pediatric rehabilitation to engage the child in the intervention process: A scoping review. Physical & Occupational Therapy in Pediatrics
Open this publication in new window or tab >>Strategies used by professionals in pediatric rehabilitation to engage the child in the intervention process: A scoping review
2024 (English)In: Physical & Occupational Therapy in Pediatrics, ISSN 0194-2638, E-ISSN 1541-3144Article, review/survey (Refereed) Epub ahead of print
Abstract [en]

AIM: To investigate strategies used by professionals in pediatric rehabilitation to engage children in every step of the intervention process, including assessment, goal setting, planning and implementation of the intervention, and results evaluation.

METHODS: A scoping literature review was conducted, and seven databases were searched, including CINAHL and MEDLINE, ProQuest Central, PsycINFO, Social Science Premium Collection, PubMed, and Web of Science. A citation search of included articles was completed. Predetermined criteria, quality standards, and PIO framework guided the selection process. Results were presented in relation to Self-Determination Theory (SDT) and the contextual model of therapeutic change.

RESULTS: In total, 20 studies were included in the review. Pediatric professionals reported that therapeutic use of self and their own engagement in the intervention facilitated the establishment of a supportive relationship. Providing clear explanations about their role and therapy rationale developed positive expectations. By making the child feel successful within-session and outside-session activities, professionals enhanced child mastery. Professionals' strategies were abstractly described.

CONCLUSIONS: Further research is needed to investigate strategies that are effective in the different steps of the intervention. More observational, longitudinal studies are required to capture fluctuations in in-session engagement.

Place, publisher, year, edition, pages
Taylor & Francis, 2024
Keywords
Child engagement, children with disabilities, intervention process, pediatric rehabilitation
National Category
Pediatrics Nursing
Identifiers
urn:nbn:se:hj:diva-63364 (URN)10.1080/01942638.2023.2290038 (DOI)001141950800001 ()38213190 (PubMedID)2-s2.0-85182158613 (Scopus ID)HOA;;928242 (Local ID)HOA;;928242 (Archive number)HOA;;928242 (OAI)
Available from: 2024-01-16 Created: 2024-01-16 Last updated: 2024-01-29
Danielsson, H., Imms, C., Ivarsson, M., Almqvist, L., Lundqvist, L.-O., King, G., . . . Granlund, M. (2023). A systematic review of longitudinal trajectories of mental health problems in children with neurodevelopmental disabilities. Journal of Developmental and Physical Disabilities
Open this publication in new window or tab >>A systematic review of longitudinal trajectories of mental health problems in children with neurodevelopmental disabilities
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2023 (English)In: Journal of Developmental and Physical Disabilities, ISSN 1056-263X, E-ISSN 1573-3580Article, review/survey (Refereed) Epub ahead of print
Abstract [en]

To review the longitudinal trajectories – and the factors influencing their development – of mental health problems in children with neurodevelopmental disabilities. Systematic review methods were employed. Searches of six databases used keywords and MeSH terms related to children with neurodevelopmental disabilities, mental health problems, and longitudinal research. After the removal of duplicates, reviewers independently screened records for inclusion, extracted data (outcomes and influencing factors), and evaluated the risk of bias. Findings were tabulated and synthesized using graphs and a narrative. Searches identified 94,662 unique records, from which 49 publications were included. The median publication year was 2015. Children with attention deficit hyperactivity disorder were the most commonly included population in retrieved studies. In almost 50% of studies, trajectories of mental health problems changed by < 10% between the first and last time point. Despite multiple studies reporting longitudinal trajectories of mental health problems, greater conceptual clarity and consideration of the measures included in research is needed, along with the inclusion of a more diverse range of populations of children with neurodevelopmental disabilities.

Place, publisher, year, edition, pages
Springer, 2023
Keywords
Adolescents, Children, Disability, Longitudinal, Mental health, Trajectories
National Category
Pediatrics Psychology
Identifiers
urn:nbn:se:hj:diva-60425 (URN)10.1007/s10882-023-09914-8 (DOI)000989885900001 ()2-s2.0-85159692027 (Scopus ID)HOA;intsam;881199 (Local ID)HOA;intsam;881199 (Archive number)HOA;intsam;881199 (OAI)
Funder
Swedish Research Council, 2018-05824
Available from: 2023-05-24 Created: 2023-05-24 Last updated: 2023-06-01
Zheng, H., Bornman, J., Granlund, M., Zhao, Y. & Huus, K. (2023). Agreement between children with long-term health conditions and their primary caregivers on reports of perceived participation. Frontiers in Rehabilitation Sciences, 4, Article ID 1123651.
Open this publication in new window or tab >>Agreement between children with long-term health conditions and their primary caregivers on reports of perceived participation
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2023 (English)In: Frontiers in Rehabilitation Sciences, E-ISSN 2673-6861, Vol. 4, article id 1123651Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: There is limited knowledge regarding the perceived participation of children with long-term health conditions in everyday activities. Children may have perceptions that differ from those of their primary caregivers. It is unclear whether children and caregivers rate their participation in everyday situations in the same way.

OBJECTIVES: We aimed to explore the level of agreement pertaining to perceived participation (attendance and involvement) and examine whether differences exist in the rank order of activities selected as the three most important between reports from children with long-term health conditions and their primary caregivers.

METHODS: The simplified Chinese version of the Picture My Participation (PMP-C; Simplified) was used in an interview with children with long-term health conditions; meanwhile, their primary caregivers finished the questionnaire independently. Data were analyzed using Wilcoxon tests, weighted kappa values, and Spearman's rank order correlation.

RESULTS: Children with long-term health conditions reported significantly lower attendance scores for six activity items (p < 0.05) and higher involvement scores for two activity items (p < 0.05) than their primary caregivers did. An overall slight to fair agreement in perceived participation was found at the child-caregiver dyad level, though differences in dyads were observed. A strong correlation was identified between the rank order of the most important activities for both groups (r = 0.81).

CONCLUSIONS: Differences may exist between the perceived participation of children with long-term health conditions, as reported by primary caregivers and the children themselves. The findings highlight that children with long-term health conditions exhibit unique views with respect to their perceived participation and have to be asked regarding their perceptions themselves.

Place, publisher, year, edition, pages
Frontiers Media S.A., 2023
Keywords
agreement, child reports, long-term health conditions, participation, proxy reports
National Category
Pediatrics
Identifiers
urn:nbn:se:hj:diva-61663 (URN)10.3389/fresc.2023.1123651 (DOI)001061649300001 ()37350849 (PubMedID)2-s2.0-85174905805 (Scopus ID)GOA;intsam;888158 (Local ID)GOA;intsam;888158 (Archive number)GOA;intsam;888158 (OAI)
Available from: 2023-06-27 Created: 2023-06-27 Last updated: 2023-11-06Bibliographically approved
Shi, L., Granlund, M., Wang, L. & Huus, K. (2023). Barriers and facilitators to participation in everyday activities for children with intellectual disabilities in China.. Child Care Health and Development, 49(2), 346-356
Open this publication in new window or tab >>Barriers and facilitators to participation in everyday activities for children with intellectual disabilities in China.
2023 (English)In: Child Care Health and Development, ISSN 0305-1862, E-ISSN 1365-2214, Vol. 49, no 2, p. 346-356Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Children with intellectual disabilities (IDs) are vulnerable and participate less in everyday activities compared to their peers with typical development. This study aimed to identify barriers and facilitators related to the participation in everyday activities of children with IDs in China.

METHODS: Twenty semi-structured interviews were conducted with primary caregivers of children with IDs from special schools in Tianjin, China. The data was transcribed and analysed using inductive qualitative content analysis.

RESULTS: Four categories of barriers to participation in everyday activities for children with IDs were identified: Insufficient knowledge, attitudes and skills in primary caregivers; ID-related characteristics of children; Stigma and Chinese culture; and Lack of support from society. Four categories describing facilitators of participation in everyday activities for children with IDs were also identified: The optimistic attitude of the primary caregiver; Adequate family support; Active environment in school and policy; and Attractive characteristics of children with IDs.

CONCLUSIONS: The findings in this study add knowledge on important barriers and facilitators affecting the participation of children with IDs in everyday activities in China. The primary caregivers' voices need to be heard by government and society. Appropriate and effective changes in family-oriented services and the legal, social, political and economic context of the child welfare management system for the scale-up of improving participation should be implemented for children with IDs.

Place, publisher, year, edition, pages
John Wiley & Sons, 2023
Keywords
China, barrier, children, facilitator, intellectual disability, participation
National Category
Psychiatry Nursing
Identifiers
urn:nbn:se:hj:diva-58389 (URN)10.1111/cch.13052 (DOI)000847821100001 ()36001483 (PubMedID)2-s2.0-85137222544 (Scopus ID)HOA;intsam;1691778 (Local ID)HOA;intsam;1691778 (Archive number)HOA;intsam;1691778 (OAI)
Available from: 2022-08-31 Created: 2022-08-31 Last updated: 2023-09-25Bibliographically approved
Kang, L.-J., Lin, P.-Y., Granlund, M., Chen, C.-L., Sung, W.-H. & Chiu, Y.-L. (2023). Development and usability of an app-based instrument of participation in children with disabilities. Scandinavian Journal of Occupational Therapy, 30(3), 322-333
Open this publication in new window or tab >>Development and usability of an app-based instrument of participation in children with disabilities
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2023 (English)In: Scandinavian Journal of Occupational Therapy, ISSN 1103-8128, E-ISSN 1651-2014, Vol. 30, no 3, p. 322-333Article in journal (Refereed) Published
Abstract [en]

Background: Picture My Participation (PmP) is a picture-supported child-report instrument of participation of children with disabilities.

Aims: This study described the development of a mobile application of the PmP Traditional Chinese version (PmP-C) and evaluated its usability.

Methods: The PmP-C App includes features that allow the input of a child’s demographics, identification of frequency and involvement of 22 culturally appropriate activities, selection of the three most important activities and the specification of the environmental facilitators and barriers. The usability test was conducted with 10 healthcare workers, who interviewed 10 children with disabilities aged 6–12 years. The healthcare workers completed a usability questionnaire and were asked to provide feedback on the ease of use, learning, satisfaction and perceived usefulness.

Results: The mean score for the usability questionnaire ranged from 2.7 to 4.6 out of 5.0. The feedback indicated that the interface was simple to operate by the healthcare workers and was attractive and motivating to children. Improvements of layout design, operation instructions and technical problems were recommended, which contributed to the app program optimization.

Conclusions: The PmP-C App provides a practical tool with initial support for usability to enable active engagement and communication of children with disabilities with healthcare providers.

Place, publisher, year, edition, pages
Taylor & Francis, 2023
Keywords
Children with disabilities, design, environment, mobile application, participation, usability, article, child, clinical article, demographics, female, handicapped child, health care personnel, human, human experiment, learning, male, preschool child, questionnaire, satisfaction, usability testing
National Category
Nursing
Identifiers
urn:nbn:se:hj:diva-57470 (URN)10.1080/11038128.2022.2083014 (DOI)000811139400001 ()35701083 (PubMedID)2-s2.0-85131819219 (Scopus ID);intsam;1673785 (Local ID);intsam;1673785 (Archive number);intsam;1673785 (OAI)
Available from: 2022-06-21 Created: 2022-06-21 Last updated: 2023-05-04Bibliographically approved
Hsieh, Y.-H., Granlund, M., Hwang, A.-W. & Hemmingsson, H. (2023). Feasibility of an eye-gaze technology intervention for students with severe motor and communication difficulties in Taiwan. Augmentative and Alternative Communication: AAC
Open this publication in new window or tab >>Feasibility of an eye-gaze technology intervention for students with severe motor and communication difficulties in Taiwan
2023 (English)In: Augmentative and Alternative Communication: AAC, ISSN 0743-4618, E-ISSN 1477-3848Article in journal (Refereed) Epub ahead of print
Abstract [en]

Eye-gaze technology provides access to a computer through the control of eye movements, thus allowing students with severe motor and communication difficulties to communicate and participate in curriculum activities and leisure; however, few studies have investigated whether any challenges exist to its implementation. This study examines the feasibility for teachers, parents, and therapists of applying an eye-gaze technology intervention for students with severe motor and communication difficulties in everyday settings. A mixed-method design was applied, focusing on the acceptability, demands, implementation, and practicality of the technology applications. Data was collected from 16 participants who assisted five students using eye-gaze technology in a previous 6-month intervention. The intervention comprised (a) use of eye-gaze devices with individualized content; and (b) services including training in use, team meetings, and bi-monthly support on implementation problems. The results showed that the participants perceived the technology as appropriate to enhance interaction and understanding of the students' learning and communication messages. Portable and easy-to-adjust systems were crucial to apply eye-gaze technology in different contexts. Improving eye-gaze services was required to afford in-service education, follow-up services, and loaning programs for sustainable implementation. The facilitators and barriers could guide researchers and practitioners to enhance the implementation of eye-gaze technology.

Place, publisher, year, edition, pages
Taylor & Francis, 2023
Keywords
Acceptability, gaze-controlled computer, implementation, participation, students with severe disabilities
National Category
Human Computer Interaction Occupational Therapy
Identifiers
urn:nbn:se:hj:diva-63269 (URN)10.1080/07434618.2023.2288837 (DOI)001123540400001 ()38085526 (PubMedID)2-s2.0-85179656221 (Scopus ID)HOA;intsam;926111 (Local ID)HOA;intsam;926111 (Archive number)HOA;intsam;926111 (OAI)
Funder
Clas Groschinski Memorial Foundation
Available from: 2024-01-10 Created: 2024-01-10 Last updated: 2024-01-10
Björklund, A.-C., Darcy, L., Santacroce, S. J., Granlund, M. & Björk, M. (2023). Individual patterns of problems with participation, activity, body function and environment in everyday life for children who completed brain tumor treatment. Disability and Rehabilitation, 45(23), 3841-3851
Open this publication in new window or tab >>Individual patterns of problems with participation, activity, body function and environment in everyday life for children who completed brain tumor treatment
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2023 (English)In: Disability and Rehabilitation, ISSN 0963-8288, E-ISSN 1464-5165, Vol. 45, no 23, p. 3841-3851Article in journal (Refereed) Published
Abstract [en]

PURPOSE: The study purpose was to, with the help of ICF and the CPS model, describe and explain patterns of co-occurring problems with participation in everyday life activities, body functioning and environment for children who completed brain tumor treatment.

MATERIALS AND METHODS: Hospital, habilitation and school records for nine children (5-11 yrs.) diagnosed with brain tumor, were retrospectively reviewed for everyday problems after treatment completion. These problems were linked to ICF codes. Median code distribution within ICF constructs participation, body function, body structure, activity, and environment were calculated to generate typical (close to median) and atypical (distant from median) patterns of problems on individual and group levels. Two children were in-depth analyzed with collaborative problem-solving (CPS) model to identify participation problems and plausible explanations.

RESULTS: In total, 4543 ICF linked codes revealed similarities and differences between individuals. The selected child-cases displayed educational challenges and peer-relational problems. The ICF codes related to activity, body function and environment revealed plausible explanations for the children's documented problems with participation in everyday life.

CONCLUSIONS: The combination of ICF and CPS can provide a comprehensive view of the child's problems and guide development of participation in everyday life-focused interventions for children treated for brain tumors.Implications for rehabilitationCare should be guided by interventions and support directed at individual children and their everyday life.The International Classification of Functioning, Disability and Health (ICF) framework can support identification of the individual child's patterns of problems and how these affects the child's everyday life.It is recommended to start by identifying participation problems when using ICF to identify and describe problems in children's natural settings.The collaborative problem-solving model can guide healthcare, habilitation and school services when identifying and acting on typical and atypical problem patterns experienced by these children.

Place, publisher, year, edition, pages
Taylor & Francis, 2023
Keywords
Brain tumor, ICF, child, document analysis, everyday life, patterns of problems, treatment completion
National Category
Nursing Pediatrics
Identifiers
urn:nbn:se:hj:diva-58856 (URN)10.1080/09638288.2022.2140845 (DOI)000879730300001 ()36341684 (PubMedID)2-s2.0-85141553431 (Scopus ID)HOA;intsam;58856 (Local ID)HOA;intsam;58856 (Archive number)HOA;intsam;58856 (OAI)
Funder
Swedish Childhood Cancer Foundation
Available from: 2022-11-10 Created: 2022-11-10 Last updated: 2023-10-31Bibliographically approved
Dada, S., Bastable, K., Samuels, A., Granlund, M., Schlebusch, L. & Huus, K. (2023). PARTICIPATION OF CHILDREN WITH DISABILITIES AND THEIR PEERS IN LOW- AND MIDDLE-INCOME COUNTRIES: Comparison of Children with and without Disabilities. In: The Routledge Handbook of Inclusive Education for Teacher Educators: Issues, Considerations, and Strategies (pp. 157-190). Taylor & Francis
Open this publication in new window or tab >>PARTICIPATION OF CHILDREN WITH DISABILITIES AND THEIR PEERS IN LOW- AND MIDDLE-INCOME COUNTRIES: Comparison of Children with and without Disabilities
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2023 (English)In: The Routledge Handbook of Inclusive Education for Teacher Educators: Issues, Considerations, and Strategies, Taylor & Francis, 2023, p. 157-190Chapter in book (Other academic)
Abstract [en]

Participation in all aspects of life is a right of children. However, in high-income countries, children with developmental disabilities (DD) are not afforded the same participation as their peers with typical development (TD). This can affect their life experiences and academic success. For children with DD, most of whom live in low- and middle–income countries (LMIC), understanding of how patterns of participation differ from their peers with TD is limited, which impacts how they are included in the classroom. This study described research on the participation of children with DD and their peers with TD in LMIC. A scoping review was conducted for studies on the participation of children with DD and their peers with TD from LMIC, using established assessments. Sixteen studies from eight middle-income countries were identified. These studies suggested that decreased participation for children with DD in comparison to their peers with TD was prevalent. Overall, the participation of children with DD and their peers with TD followed a similar pattern in the LMIC countries to that in high-income countries, with children with DD having lower participation in physical, social and skill-based activities, suggesting that the participation of children may follow universal patterns.

Place, publisher, year, edition, pages
Taylor & Francis, 2023
National Category
Educational Sciences
Identifiers
urn:nbn:se:hj:diva-60350 (URN)10.4324/9781003266068-13 (DOI)2-s2.0-85156212400 (Scopus ID)9781000843415 (ISBN)9781032129877 (ISBN)
Available from: 2023-05-15 Created: 2023-05-15 Last updated: 2023-05-15Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0001-9597-039X

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