Technology-Aided Spatial Cues, Instructions, and Preferred Stimulation for Supporting People With Intellectual and Visual Disabilities in Their Occupational Engagement and Mobility: Usability Study

Background Persons with severe or profound intellectual disability and visual impairment tend to be passive and sedentary, and technology-aided intervention may be required to improve their condition without excessive demands on staff time. Objective This study aims to extend the assessment of technology-aided interventions for supporting functional occupational engagement and mobility in 7 people with intellectual disability and visual impairment and to use a technology system that is simpler and less expensive than those previously used. Methods The technology system involved a Samsung Galaxy A10, 4 Philips Hue indoor motion sensors, and 4 mini speakers. Within each session, the participants were to collect 18 objects (ie, one at a time) from 3 different areas (stations) located within a large room, bring each of the objects to a central desk, and put away each of those objects there. For each object, the participants received verbal (spatial) cues for guiding them to the area where the object was to be collected, a verbal instruction (ie, request) to take an object, verbal (spatial) cues for guiding them to the central desk, a verbal instruction to put away the object collected, and praise and preferred stimulation. Results During baseline, the frequency of responses completed correctly (objects collected and put away independently) was 0 or near 0. During the intervention phase (ie, with the support of the technology setup), the frequency increased for all participants, reaching a mean of almost 18 (out of 18 response opportunities) for 6 participants and about 13 for the remaining participant. The mean session duration ranged from 12 to 30 minutes. Conclusions A program, such as the one used in this study, can be useful in promoting occupational engagement and mobility in persons with intellectual disability and visual impairment.

Effects of verbal instruction vs. modelling on imitation and overimitation

Human culture is the result of a unique cumulative evolutionary process. Despite the importance of culture for our species the social transmission mechanisms underlying this process are still not fully understood. In particular, the role of language—another unique human behaviour—in social transmission is under-explored. In this first direct, systematic comparison of demonstration vs. language-based social learning, we ran transmission chains of participants (6- to 8-year-old children and adults from Cyprus) who attempted to extract a reward from a puzzle box after either watching a model demonstrate an action sequence or after listening to verbal instructions describing the action sequence. The initial seeded sequences included causally relevant and irrelevant actions allowing us to measure transmission fidelity and the accumulation of beneficial modifications through the lens of a subtractive ratchet effect. Overall, we found that, compared to demonstration, verbal instruction specifically enhanced the faithful transmission of causally irrelevant actions (overimitation) in children, but not in adults. Cumulative cultural evolution requires the faithful transmission of sophisticated, complex behaviour whose function may not be obvious. This indicates that, by supporting the retention of actions that appear to lack a causal function specifically by children, language may play a supportive role in cumulative cultural evolution.

Koulunkäynninohjaaja perusopetukseen valmistavan opetuksen luokassa: koskettaminen ohjaamisen tukena

The article presents a microethnographic study on touch episodes between teaching assistants and pupils in the context of immigrant students' preparatory classroom. The data consist of 16 classroom lessons, 45 minutes each, with 7–12-year-old participants, 4–7 pupils at a time. We calculated all touches, categorizing them by touch initiators, and classified various physical types of touch. In three vignettes, we outline how the teaching assistant implemented teacher's verbal instruction in verbal-tactile mode, made discreet tactile interventions to disturbing or passive students, and thus enabled the classroom dialogue to continue. The institutional roles of the teacher and the assistant are evident in their different ways of touching, rather than in their frequency: the teaching assistant's touch episodes were often long-lasting, or series of different touches, even with two hands, while the typical way for a teacher to touch was a light one-hand-touch on a pupil's shoulder.

Finalising the administration of co-SSPedi, a dyad approach to symptom screening for paediatric patients receiving cancer treatments

ObjectivesSymptom Screening in Pediatrics Tool (SSPedi) is a validated self-report symptom screening tool for patients with cancer 8–18 years of age. Co-SSPedi is a novel dyad approach in which both child and parent complete SSPedi together. The objective was to finalise the approach to co-SSPedi administration with instruction that is easy to understand, resulting in dyads completing co-SSPedi correctly.MethodWe enrolled child and parent dyads, who understood English and where children (4–18 years) had cancer or were hematopoietic stem cell transplantation recipients. We provided each dyad with instruction on how to complete co-SSPedi together. Mixed methods were used to determine how easy or hard the instruction was to understand. Two raters adjudicated if co-SSPedi was completed correctly. Dyads were enrolled in cohorts of 12 evenly divided by age (4–7, 8–10, 11–14 and 15–18 years).ResultsWe enrolled 5 cohorts of 12 dyads, resulting in 60 dyads. Following verbal instruction provided in the first cohort, we identified the need for written instruction emphasising children should wait for parent response prior to entering scores. The instruction was iteratively refined based on qualitative feedback until the fifth cohort, where all 12 dyads found the instruction easy to understand and completed co-SSPedi correctly.ConclusionsWe developed a standard approach to dyad symptom screening named co-SSPedi with instruction that is easy to understand, resulting in correct co-SSPedi completion. Future efforts should focus on co-SSPedi validation and understanding how co-SSPedi scores compare to self- or proxy-reported symptom reporting.

Technology-Aided Spatial Cues, Instructions, and Preferred Stimulation for Supporting People With Intellectual and Visual Disabilities in Their Occupational Engagement and Mobility: Usability Study (Preprint)

BACKGROUND Persons with severe or profound intellectual disability and visual impairment tend to be passive and sedentary, and technology-aided intervention may be required to improve their condition without excessive demands on staff time. OBJECTIVE This study aims to extend the assessment of technology-aided interventions for supporting functional occupational engagement and mobility in 7 people with intellectual disability and visual impairment and to use a technology system that is simpler and less expensive than those previously used. METHODS The technology system involved a Samsung Galaxy A10, 4 Philips Hue indoor motion sensors, and 4 mini speakers. Within each session, the participants were to collect 18 objects (ie, one at a time) from 3 different areas (stations) located within a large room, bring each of the objects to a central desk, and put away each of those objects there. For each object, the participants received verbal (spatial) cues for guiding them to the area where the object was to be collected, a verbal instruction (ie, request) to take an object, verbal (spatial) cues for guiding them to the central desk, a verbal instruction to put away the object collected, and praise and preferred stimulation. RESULTS During baseline, the frequency of responses completed correctly (objects collected and put away independently) was 0 or near 0. During the intervention phase (ie, with the support of the technology setup), the frequency increased for all participants, reaching a mean of almost 18 (out of 18 response opportunities) for 6 participants and about 13 for the remaining participant. The mean session duration ranged from 12 to 30 minutes. CONCLUSIONS A program, such as the one used in this study, can be useful in promoting occupational engagement and mobility in persons with intellectual disability and visual impairment. CLINICALTRIAL

Enculturation of Caring Behaviors in Clinical Simulation: An Integrative Review

There exists the evidence that clinical simulation can cultivate caring behaviors among nursing students. Despite this, there is an inadequate educational approach used in cultivating caring behaviors. This paper presents the enculturation practices use in cultivating caring in clinical simulation. An integrative review was conducted using primary research articles published between 2010 and 2020 from electronic databases and the web. In the context of simulation, enculturation is defined as an outcome of learning where the nursing student is immersed in a structured environment. Vehicles for cultivating caring behaviors are delivered intentionally or unintentionally through role modeling, didactics, verbal instruction, interactions, and socialization.

Implementing and Evaluating a Standardized New Diagnosis Education Checklist: A Report From the Children's Oncology Group

When a child is newly diagnosed with cancer, parents report feeling overwhelmed with the amount of information that they must process in order to safely care for their child at home. The Children’s Oncology Group (COG) Nursing Discipline has focused on examining current practices for educating families of children newly diagnosed with cancer, and developing tools to enhance the process of patient/family education at the time of diagnosis, including development of a COG Standardized Education Checklist, which classifies education into primary, secondary, and tertiary topics. The COG Nursing Discipline awarded nursing fellowships to two doctorally prepared nurses practicing at two distinct COG institutions to evaluate the checklist implementation. This project addressed the primary topics on the checklist essential to safely care for the child at home following the first hospital discharge. Checklist feasibility was determined by the proportion of checklists completed. Checklist fidelity was determined by review of documentation on the checklist regarding educational topics covered, learner preferences, and methods used. Checklist acceptability was assessed through parent/caregiver and nurse feedback. Project implementation occurred over a 5-month period and involved 69 newly diagnosed families. Implementation of the checklist was feasible (81%), with moderate fidelity to checklist topics taught across the two sites. Verbal instruction and written documentation were the most prevalent form of education. The return rate for the parent/caregiver and nurse acceptability questionnaires was moderate to low (68% and 12%, respectively), parent/caregiver feedback was positive and acceptability among responding nurses was high, with 92% of nurses identifying the primary checklist as useful.

Incentive-based, instructed, and social observational extinction of avoidance: Fear-opposite actions and their influence on fear extinction

Avoidance is a transdiagnostic symptom of clinical anxiety and its reduction a major focus of cognitive-behavioral treatments. This study examined the instrumental extinction of goal-directed avoidance by means of incentives, verbal instruction, and social observation and their influence on fear extinction.Participants acquired conditioned fear and instrumental avoidance responses (N = 160). In four randomized groups, the reduction of avoidance by incentives for non-avoidance, instructions to refrain from avoidance, and social observation of non-avoidance was compared to no intervention before removing the aversive outcome. Conditioned fear when avoidance became unavailable was tested.Incentives, instruction, and observation all reduced avoidance better than no intervention, however, with different degrees and influence on conditioned fear. Incentives and instructions strongly reduced avoidance despite high levels of fear (i.e., fear-opposite actions). This initiated fear extinction, thereby reducing conditioned fear when avoidance became unavailable. Social observation directly reduced conditioned fear, presumably because it conveyed additional information about the absence of the aversive outcome. However, observation only moderately reduced avoidance and resulted in higher fear when avoidance became unavailable.The effects of social observation may depend on the nuances of the demonstrator’s behavior. The clear effects of incentive and instructions provide support for clinical interventions to reduce avoidance during exposure therapy and can serve as experimental models for their controlled investigation.