Purpose: This study explores limitations in communication in daily life of children with developmental language disorder (DLD) from their parents' perspective as well as communicative abilities and social functioning in the classroom from their teacher's perspective. Furthermore, differences between children with mixed receptive–expressive disorder and children with expressive-only disorder in communication in daily life and social functioning are studied. Method: Data were collected through questionnaires completed by parents and teachers of children (5–6 years old) who attended schools for special education for DLD. Language test scores were retrieved from school records. Parents of 60 children answered open-ended questions about situations and circumstances in which their child was most troubled by language difficulties. Teachers of 83 children rated communicative abilities, social competence, and student–teacher relationship. Results: Parents reported communication with strangers as most troublesome and mentioned the influence of the mental state of their child. Parents considered limitations in expressing oneself and being understood and not being intelligible as core difficulties. Teachers rated the children's communicative abilities in the school context as inadequate, but their scores concerning social competence and the quality of teacher–child relationships fell within the normal range. Children with receptive–expressive disorder experienced limitations in communication in almost all situations, whereas those with expressive disorder faced limitations in specific situations. Children with receptive–expressive disorder were also significantly more limited in their communicative abilities and social competence at school than children with expressive disorder. No differences were found between the two groups in the quality of the teacher–child relationship. Conclusions: The results confirm that children with DLD face significant challenges in a variety of communicative situations. We found indications that children with receptive–expressive disorder experience more severe limitations than children with expressive disorder. The involvement of parents and teachers in evaluating a child's communicative ability provides valuable and clinically relevant information.
Objective: This exploratory study investigated to what extent gait characteristics and clinical physical therapy assessments predict falls in chronic stroke survivors. Design: Prospective study. Subjects: Chronic fall-prone and non-fall-prone stroke survivors. Methods: Steady-state gait characteristics were collected from 40 participants while walking on a treadmill with motion capture of spatio-temporal, variability, and stability measures. An accelerometer was used to collect daily-life gait characteristics during 7 days. Six physical and psychological assessments were administered. Fall events were determined using a “fall calendar” and monthly phone calls over a 6-month period. After data reduction through principal component analysis, the predictive capacity of each method was determined by logistic regression. Results: Thirty-eight percent of the participants were classified as fallers. Laboratory-based and daily-life gait characteristics predicted falls acceptably well, with an area under the curve of, 0.73 and 0.72, respectively, while fall predictions from clinical assessments were limited (0.64). Conclusion: Independent of the type of gait assessment, qualitative gait characteristics are better fall predictors than clinical assessments. Clinicians should therefore consider gait analyses as an alternative for identifying fall-prone stroke survivors.
Purpose: The purposes of this study were, first, to (re)design the user-interface of the activity tracker known as the MOX with the help of input from elderly individuals living independently and, second, to assess the use of and experiences with the adapted Measure It Super Simple (MISS) activity tracker in daily life. Methods: The double diamond method, which was used to (re)design the user-interface, consists of four phases: discover, define, develop, and deliver. As a departure point, this study used a list of general design requirements that facilitate the development of technology for the elderly. Usage and experiences were assessed through interviews after elderly individuals had used the activity tracker for 2 weeks. Results: In co-creation with thirty-five elderly individuals (65 to 89-years-old) the design, feedback system, and application were further developed into a user-friendly interface: the Measure It Super Simple (MISS) activity. Twenty-eight elderly individuals (65 to 78-years-old) reported that they found the MISS activity easy to use, needed limited help when setting the tracker up, and required limited assistance when using it during their daily lives. Conclusions: This study offers a generic structured methodology and a list of design requirements to adapt the interface of an existing activity tracker consistent with the skills and needs of the elderly. The MISS activity seemed to be successfully (re)designed, like the elderly who participated in this pilot study reported that anyone should be able to use it.
Alcohol use disorder (AUD) is a pattern of alcohol use that involves having trouble controlling drinking behaviour, even when it causes health issues (addiction) or problems functioning in daily (social and professional) life. Moreover, festivals are a common place where large crowds of festival-goers experience challenges refusing or controlling alcohol and substance use. Studies have shown that interventions at festivals are still very problematic. ARise is the first project that wants to help prevent AUD at festivals using Augmented Reality (AR) as a tool to help people, particular festival visitors, to say no to alcohol (and other substances). ARise is based on the on the first Augmented Reality Exposure Therapy (ARET) in the world that we developed for clinical treatment of AUD. It is an AR smartphone driven application in which (potential) visitors are confronted with virtual humans that will try to seduce the user to accept an alcoholic beverage. These virtual humans are projected in the real physical context (of a festival), using innovative AR glasses. Using intuitive phone, voice and gesture interactions, it allows users to personalize the safe experience by choosing different drinks and virtual humans with different looks and levels of realism. ARET has been successfully developed and tested on (former) AUD patients within a clinical setting. Research with patients and healthcare specialists revealed the wish to further develop ARET as a prevention tool to reach people before being diagnosed with AUD and to extend the application for other substances (smoking and pills). In this project, festival visitors will experience ARise and provide feedback on the following topics: (a) experience, (b) awareness and confidence to refuse alcohol drinks, (c) intention to use ARise, (d) usability & efficiency (the level of realism needed), and (e) ideas on how to extend ARise with new substances.
Everyone has the right to participate in society to the best of their ability. This right also applies to people with a visual impairment, in combination with a severe or profound intellectual and possibly motor disability (VISPIMD). However, due to their limitations, for their participation these people are often highly dependent on those around them, such as family members andhealthcare professionals. They determine how people with VISPIMD participate and to what extent. To optimize this support, they must have a good understanding of what people with disabilities can still do with their remaining vision.It is currently difficult to gain insight into the visual abilities of people with disabilities, especially those with VISPIMD. As a professional said, "Everything we can think of or develop to assess the functional vision of this vulnerable group will help improve our understanding and thus our ability to support them. Now, we are more or less guessing about what they can see.Moreover, what little we know about their vision is hard to communicate to other professionals”. Therefore, there is a need for methods that can provide insight into the functional vision of people with VISPIMD, in order to predict their options in daily life situations. This is crucial knowledge to ensure that these people can participate in society to their fullest extent.What makes it so difficult to get this insight at the moment? Visual impairments can be caused by a range of eye or brain disorders and can manifest in various ways. While we understand fairly well how low vision affects a person's abilities on relatively simple visual tasks, it is much more difficult to predict this in more complex dynamic everyday situations such asfinding your way or moving around during daily activities. This is because, among other things, conventional ophthalmic tests provide little information about what people can do with their remaining vision in everyday life (i.e., their functional vision).An additional problem in assessing vision in people with intellectual disabilities is that many conventional tests are difficult to perform or are too fatiguing, resulting in either no or the wrong information. In addition to their visual impairment, there is also a very serious intellectual disability (possibly combined with a motor impairment), which makes it even more complex to assesstheir functional vision. Due to the interplay between their visual, intellectual, and motor disabilities, it is almost impossible to determine whether persons are unable to perform an activity because they do not see it, do not notice it, do not understand it, cannot communicate about it, or are not able to move their head towards the stimulus due to motor disabilities.Although an expert professional can make a reasonable estimate of the functional possibilities through long-term and careful observation, the time and correct measurement data are usually lacking to find out the required information. So far, it is insufficiently clear what people with VZEVMB provoke to see and what they see exactly.Our goal with this project is to improve the understanding of the visual capabilities of people with VISPIMD. This then makes it possible to also improve the support for participation of the target group. We want to achieve this goal by developing and, in pilot form, testing a new combination of measurement and analysis methods - primarily based on eye movement registration -to determine the functional vision of people with VISPIMD. Our goal is to systematically determine what someone is responding to (“what”), where it may be (“where”), and how much time that response will take (“when”). When developing methods, we take the possibilities and preferences of the person in question as a starting point in relation to the technological possibilities.Because existing technological methods were originally developed for a different purpose, this partly requires adaptation to the possibilities of the target group.The concrete end product of our pilot will be a manual with an overview of available technological methods (as well as the methods themselves) for assessing functional vision, linked to the specific characteristics of the target group in the cognitive, motor area: 'Given that a client has this (estimated) combination of limitations (cognitive, motor and attention, time in whichsomeone can concentrate), the order of assessments is as follows:' followed by a description of the methods. We will also report on our findings in a workshop for professionals, a Dutch-language article and at least two scientific articles. This project is executed in the line: “I am seen; with all my strengths and limitations”. During the project, we closely collaborate with relevant stakeholders, i.e. the professionals with specific expertise working with the target group, family members of the persons with VISPIMD, and persons experiencing a visual impairment (‘experience experts’).
Building Blocks for Liveable Neighbourhoods. Four suburbs in the province of Noord-Brabant are case-studies for a new method of urban development. Participation and scenario's are the starting point. The tools for local stakeholders to (literally) shape their own future environment are the end result.Societal issue: Gap between the plannend world and the daily life in city neighbourhoods. People are eager to take responsibility for their living environment but have no tools or knowledge to do it.Benefit to society: The method developed in this design research project enables the different stakeholders to connect, align and be effective in shaping their common future living environment.
