Band 16, Heft 3

Recent neurological research indicates that the impaired motor skills of post-stroke patients can be enhanced and possibly restored through task-oriented repetitive training. This is due to neuroplasticity – the ability of the brain to change through adulthood. Various rehabilitation processes have been developed to take advantage of neuroplasticity to retrain neural pathways and restore or improve motor skills lost as a result of stroke or spinal cord injuries (SCI). Research in this area over the last few decades has resulted in a better understanding of the dynamics of rehabilitation in post-stroke patients and development of auxiliary devices and tools to induce repeated targeted body movements. With the growing number of stroke rehabilitation therapies, the application of robotics within the rehabilitation process has received much attention. As such, numerous mechanical and robot-assisted upper limb and hand function training devices have been proposed. A systematic review of robotic-assisted upper extremity (UE) motion rehabilitation therapies was carried out in this study. The strengths and limitations of each method and its effectiveness in arm and hand function recovery were evaluated. The study provides a comparative analysis of the latest developments and trends in this field, and assists in identifying research gaps and potential future work.

Background: The involvement of informal caregivers (CGs) in the provision of care for stroke survivors always ensures the success of stroke rehabilitation. Aims: The aim of this review was to find the determinants of caregiving burden and quality of life (QOL) of CGs of African stroke survivors. Methods: The literature was searched in Google Scholar and PUBMED, AJOL and Cochrane Databases using selected search strategies without date restriction. Results: A total of eight African studies met the inclusion criteria. There were more female stroke CGs (55.6%) than their male counterparts. The determinants of CG QOL were duration and burden of caregiving, the CG’s age and functional status of the stroke survivors. The determinants of caregiving burden were functional status of stroke survivors and having intimate relationship with them. Conclusion: Impairment of physical function in African stroke survivors was the consistent determinant of increased caregiving burden and deterioration of CG QOL. CG education and training is needed in order to enhance their ability to cope effectively with the burden of providing care to stroke survivors who have impairment of physical function and this may help to improve CG QOL.

Background: Persons with acquired neurological damage and multiple disabilities can be largely dependent on their caregivers, unless technology-aided programs are available to support them. Objective: This study extended the assessment of a technology-aided program recently developed to help these persons achieve independent occupations and communicate effectively. Subjects: Seven participants were involved in the study. Method: The program relied on: (a) a computer for presenting the occupation and communication options (e.g. songs, television, and text messaging); and (b) microswitches for helping the participants access those options with small responses. The program was diversified (in terms of options available and responses/microswitches used) according to the participants’ characteristics and interests, and thus multiple program versions were set up and assessed. Results: The participants successfully used the individualized versions of the program and, accordingly, managed independent occupation and communication (i.e. remaining engaged for means of about 60%–90% of the session times). Conclusion: A technology-aided program can be adapted to persons with acquired neurological damage and multiple disabilities to support their independent occupations and communication engagements.

Background: People with cerebral palsy (CP) experience limitations in motor control, strength, and range of motion (ROM). Abnormal movements caused by motor impairments commonly occur in people with CP. Activities of daily living (ADLs) can be seriously affected by insufficient ROM among others. To increase ROM, this study assessed the possibility of training three adolescents with CP using a Kinect-based system in a public school setting. Methods: We gamified the movement training by leveraging the Scratch language and the Kinect2Scratch tool that allowed the therapists to perform individual customization with less technical support. This experiment was carried out according to an ABAB reversal replication design in which A represented the baseline and B represented the intervention phases. Three adolescents in a public special-education school participated in the experiment. Results: Data showed that the three participants significantly increased their shoulder ROM and motivation of engaging in rehabilitation as well, thus improving exercise performance during the intervention phases. Conclusion: Despite that, the game is a promising and highly accepted training tool for school use, currently, it is still error-prone, and the requested support exceeds the support that can be provided by clinical therapists. A technically more robust system, combined with additional attractive games, likely results in higher patient motivation and better compliance. This would reduce the need for parents to motivate their children extrinsically and allow for clinical trials to investigate the effectiveness of the system.

Objective: To investigate the effectiveness of the strengths and difficulties questionnaire (SDQ) in the screening for autism spectrum disorders (ASD) and to find optimal scoring methods. Methods: The SDQ were given to parents of 4–12-year-old children with ASD (n=67), internalizing (n=49), externalizing disorders (n=87), and to a community sample (n=114). The total difficulties score and five subscales scores were compared between the four groups. Two additional scoring methods were calculated: prosocial behavior score minus peer relation problems score and sum of prosocial behavior score and emotional symptoms score. Receiving operating characteristics (ROC) analysis was used to find an effective way of screening for ASD. Results: All five subscales of the SDQ differed significantly between the ASD and the community samples. Only prosocial behavior and emotional symptoms subscales scores in the ASD group differed significantly from both internalizing and externalizing disorders groups (p<0.001). The total difficulties score reliably differentiated the ASD group from the community sample, but not from children with psychiatric disorders. Additional scoring methods’ problems showed the best area under the curve (AUC) in ROC analysis. Conclusion: The SDQ discriminates those with ASD well from other children with and without psychiatric disorders. Applying of additional algorithms is more effective rather than using the total difficulties or subscales scores alone.

The present study was undertaken to create job opportunities for hearing-impaired individuals in garment-manufacturing and sequin-finishing units. Employment is not only a statistical and practical issue but also a human rights and entitlement issue. The differently abled are no exception to this basic right. Disability is no longer a welfare or charity issue. However, unlike non-disabled people, people with disabilities, more often than not, face difficulties in getting educated and in accessing vocational training and higher education. Working with people with disabilities can be challenging, but by providing them with work and recognition, it can be the beginning of another way of life rather than the end of life for them. It is important to identify their capabilities and accordingly find suitable jobs, wherein with proper training along with encouragement, compassion, and constant motivation, they can effectively adapt to and settle in specific job operations. This study identifies various operations in different sections of these units and explores the training possibilities there, in an attempt to make the hearing impaired employable. Because of their limited abilities, it requires additional efforts for them to compete in the open labor market. Thus, this is an attempt to prove that hearing-impaired individuals can be gainfully employed in open employment situations.

Parents and service providers are the key care providers for children with disabilities (CWD) and understand their living circumstances best. These children are often invisible and face many challenges to full participation within their own communities. A qualitative phenomenological action research was carried out in three districts of Sri Lanka to explore the perspectives of parents and the service providers on the needs of CWD and how those were met by the present services. This qualitative study included interviews with families, and focus group discussions with service providers. Data was analyzed using a manual thematic analysis. The parents and service providers identified the needs under three main themes. The need for activity and participation, education and rehabilitation. The parents related the needs to the practical daily experiences of families while service providers identified these based on their experiences and knowledge about the medical conditions. Parents identified the public health midwife as the best first contact primary health care worker to coordinate services. The families from Sri Lanka defined initiatives to accomplish a service delivery model which would enable better inclusion of the children in community life.

Generally, people with disabilities (PWDs) experience barriers of different kinds than the people without disabilities, e.g. lower access to healthcare, education, employment, or economic participation, which are barriers to form an inclusive society. Access to information and communication technologies (ICTs) has paramount significance to remove these barriers. This study statistically investigates the factors that are significant in the acceptance process of ICT by the disabled and the positive change in the quality of their daily lives. We used exploratory factor analysis (EFA), a broadly used technique, to identify the factors responsible in the development process. This is mainly a sample-based study where the participants complete a well-defined questionnaire and assess the outcomes of ICT acceptance by PWDs, considering the change in the quality of their lives. A structural equation modeling is conducted to justify the total relationship based on the variables mainly involved. The findings show that the acceptance of ICT by PWDs was at moderate level, and there is a positive correlation between acceptance of ICT and quality improvement in the lives of PWDs. These results will help to improve individual lives of PWDs, social as well as national development, and to provide positive psychological intervention to promote the acceptance of ICT by PWDs.

This study documents the development and validation of the children’s version of the Family Needs Assessment (FNA) instrument for Colombia. The FNA is a scale that evaluates the needs of families with children with disabilities who are below the age of 18 years. To validate this scale, the research team identified the theoretical background regarding family members’ needs and performed a linguistic adaptation of the scale, which was reviewed to guarantee its validity through cognitive interviews and a pilot study. Results from the exploratory factor analysis (EFA) showed 72 items distributed in a 4-factor solution. Cronbach’s alpha coefficients for each factor and for the overall FNA scale were also estimated. Specifically, alpha computed from the correlation among the 72 items was 0.97 and ranged from 0.85 to 0.95 for the four factors. Findings from this study provided evidence to support the validity of the FNA for families with children with intellectual disability in Colombia. The findings also indicated that the FNA has the potential of contributing to a better understanding of inputs (e.g. needs of families with individuals with disability) with the aim of informing system decisions, enhancing policies, improving services and strengthening family-professional partnerships.

The utility of Rapid Automatized Naming (RAN) as a clinical tool to predict later reading abilities was addressed by researchers as early as the 1970s. Over the years, several variants of the task came into existence such as inclusion of a variety of stimuli, varying picture size, etc. but very few have addressed the response modality. The study aimed to compare rapid processing skills in typical children in verbal and non-verbal modalities using picture arrays of nouns and verbs. Twenty typically developing children in the age range of 5–7 years participated in the study. Picture arrays of five common nouns and verbs each served as the stimuli. The task comprised picture naming and picture pointing. The results revealed that nouns were processed faster than verbs in both verbal and non-verbal modalities. It was also found that there was no difference in the processing of nouns between the two modalities unlike verbs. Overall, the results point to the potential use of a non-verbal task to assess the rapid processing skills in children with limited verbal abilities.

A disability is a set of physical or mental disorders that personally or socially prohibit a person from having a normal and independent life. This study aimed to determine the prevalence of visual and hearing impairment in adults with intellectual disabilities in southwestern Iran. This cross-sectional study was conducted on people with disabilities in all rehabilitation centers of the Khuzestan state welfare organization in southwestern Iran from 1st January 2015 to 20th March 2016. The questionnaire was designed using the International Classification of Diseases-10 based criteria of intellectual disabilities diagnosis, in which it is referred to as a significantly sub-average intellectual functioning, slow development during the developmental period and a deficit in adaptive behavior. The questionnaire was field tested and validated before use. Visual and hearing impairment was defined based on the International Association for the Study of Intellectual and Developmental Disabilities (IASSID) international consensus statement. Two hundred cases were diagnosed to have either intellectual disabilities or visual and hearing impairment. Diagnoses of intellectual disabilities, visual and hearing impairment had been confirmed in the present screening in 79 (39.5%), 38 (19%) and 83 (41.5%) subjects, respectively. Considering the overall population of people with disabilities that refer to all rehabilitation centers of the Khuzestan state welfare organization (n=22483), the prevalence of intellectual disabilities, visual and hearing impairment in the present screening was 0.35, 0.27, and 0.37, respectively. Consanguineous marriage and history of consanguinity were the leading causes of intellectual disabilities, visual and hearing impairments in the southwestern region of Iran, most of which are avoidable. Design for the prevention of these disabilities is most recommended to decrease the proportion of avoidable disorders.

The education system has served as a key component of adolescent development, whether through traditional learning, peer-tutoring programs, or objective-specific programs. The production of scientific publications of students at Crescent School offered a unique experiential learning opportunity, where students not only learned about study design, data collection, statistical analyses and manuscript writing but also valuable lessons of work ethic, organizational skills, and interpersonal skills. The students have cited the experience as a memorable experience during their adolescent development.