第22屆 眼控科技輔具介入對重度肢體及語言障礙兒童參與電腦活動之初探

眼控科技輔具介入對重度肢體及語言障礙兒童參與電腦活動之初探

Preliminary Evidence of An Eye-Gaze Technology Intervention on Participation in Computer Activities for Children with Severe Motor and Speech Impairments

謝伃鑫^1,* 黃靄雯^2,3 Mats Granlund⁴ Helena Hemmingsson¹

Yu-Hsin Hsieh^1,* Ai-Wen Hwang^2,3 Mats Granlund⁴ Helena Hemmingsson¹

¹ 瑞典斯德哥爾摩大學特殊教育學系、²長庚大學醫學院早期療育研究所、³林口長庚紀念醫院復健醫學部、⁴瑞典延雪平大學健康福祉學院CHILD研究中心

¹ Department of Special Education, Stockholm University, Stockholm, Sweden, ²      Graduate Institute of Early Intervention, College of Medicine, Chang-Gung University, Tao-Yuan, Taiwan, ³ Department of Physical Medicine and Rehabilitation, Chang Gung Memorial Hospital, Linkou, Tao-Yuan, Taiwan, ⁴ CHILD, Swedish Institute of Disability Research, School of Health and Welfare, Jönköping University, Jönköping, Sweden.

Background and Purpose: Eye-gaze assistive technology (EGAT) provides alternative access for children with severe motor and speech impairments to control a computer through eye movements, thereby participating in activities and communication. Research supporting the use of EGAT in children’s everyday life is sparse in Taiwan. This study investigates the impacts of an EGAT intervention on participation in computer activities and technology usability in children of Taiwan.

Methods: A multiple baseline design across individuals was applied. Four children (three females, one male) aged 3 to 6 years (mean=5.1 years (SD=1.1)), with severe cerebral palsy or neurometabolic disorder participated in a six-month EGAT intervention. All had cognitive impairments, and two had visual impairments. The EGAT intervention, encompassing eye-gaze technology devices and collaborative team service delivery, was systematically manipulated. Parents and teachers participated in two EGAT team meetings and received twelve individual support services delivered by the collaborative team (therapists and research group) to facilitate children’s use of EGAT at home or in school contexts. Changes in participation in computer activities (frequency, duration, and number of types of activities by computer use diary) were repeatedly measured. Other outcomes included assessments of goal achievements (Goal Attainment Scaling), children’s performance on computer activities, and stakeholders’ satisfaction with children’s performance (Performance and Satisfaction scales of Canadian Occupational Performance Measure). Visual inspection and restricted maximum likelihood estimation (REML) were performed to analyze the changes in computer use duration. Descriptive analysis was conducted to report other outcomes.

Results: Participants increased frequency of computer use from baseline to intervention phase (0.3-2 to 2.2-3.2 days/week). Three of four participants improved the duration of participation in computer activities across phases (less than 20 minutes to mean=22.8-30.8 minutes per user day) despite large variability. REML estimation showed a moderate effect (ES=0.76) in the computer use duration. There was an increasing number of types of activities from baseline to intervention phase (n=1-2 to 3-6) in four participants consistently, with playing games and communication as joint activities. Six of eight goals (engagement in play, early communication, and learning) achieved an expected level. Stakeholders’ ratings on children’s performance and their satisfaction with children’s performance reached clinical significance (score change above 2 points) except for one child.

Conclusions: The EGAT intervention showed preliminary effects on participation in computer activities for children with severe disabilities. Findings supported the use of EGAT to increase children’s participation in play and choice-making. Further research is needed to investigate the prerequisites for effective use of EGAT in daily contexts in Taiwan.

Keywords: Eye-gaze controlled computer, participation, complex needs, single-case research design