The use of technology-assisted intervention in vocabulary learning for children with autism spectrum disorder: a systematic review.

Introduction: Children with autism spectrum disorder may show delays in vocabulary development. Technology-based interventions could facilitate the teaching of different vocabulary skills; however, it is still not clear whether technology represents an added value. Methods: The current review preregistered in PROSPERO evaluates the efficacy of technology-based interventions in vocabulary learning for children with autism spectrum disorder. We selected articles published in the period 2006-2022 from five databases. Results: The results identified two group studies, one within subject design, nine single-case studies and one randomized controlled design in participants aged 0-16 years who had used technological devices to learn vocabulary. Overall, five of the 13 studies showed positive results of using technology-assisted intervention, six described mixed results, one described negative result, and one described no differences in technology-assisted intervention. The studies are divided into the categories of efficacy of technology and comparison between technology and non-technology. Discussion: In summary, technology, such as tablets and computers, might be useful tools to improve vocabulary skills in certain children with ASD. However, the various degrees of impact found in the studies we reviewed indicate that personalized assessments, acknowledgment of previous experiences, and awareness of the context of usage are essential. The contrast with nontechnological approaches highlights the necessity for more detailed studies to pinpoint the precise conditions under which technology-based interventions can offer the most advantages. Systematic review registration: [https://clinicaltrials.gov/], identifier [CRD42021238758].

A Systematic Review and Meta-Analysis of Vocabulary Interventions for Deaf/Hard of Hearing Children and Adolescents.

PURPOSE: The development of vocabulary size in deaf/hard of hearing (DHH) children and adolescents can be delayed compared to their peers due to lack of access to early language input. Complementary vocabulary interventions are reported in the literature. Our aim is to evaluate the effectiveness of intervention methods for their vocabulary improvement. METHOD: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, we searched five databases for peer-reviewed journal articles in English, published between 2000 and 2022 (inclusive), reporting vocabulary interventions for 2- to 18-year-old DHH children and adolescents without comorbidities. We conducted separate meta-analyses using a random-effects model on receptive oral vocabulary, expressive oral vocabulary, and signed vocabulary. We assessed the methodological quality of each paper. This review is preregistered in PROSPERO (International Prospective Register of Systematic Reviews) with ID CRD42021243479. RESULTS: We included 25 group studies in this review out of 1,724 identified records. The quality assessment of the studies revealed risk of bias ranging from some concerns to high risk. Experimental vocabulary instruction produced improvement in receptive oral vocabulary (Hedges's g = 1.08, 95% CI [0.25, 1.90], I2 = 93.46, p = .01), expressive oral vocabulary (Hedges's g = 1.00, 95% CI [0.18, 1.83], I2 = 96.37, p = .02), and signed vocabulary (Hedges's g = 1.88, 95% CI [1.09, 2.66], I2 = 96.01, p < .001) in the experimental groups. Written vocabulary and general vocabulary skills are also reported as a synthesis of results. CONCLUSIONS: Multisensory and multimodal explicit vocabulary instruction for DHH children and adolescents is helpful in improving vocabulary acquisition with respect to baseline levels. However, its effectiveness must be carefully interpreted due to the lack of proper control groups and details on treatment as usual reported in the studies. SUPPLEMENTAL MATERIAL: https://doi.org/10.23641/asha.23646357.

Linear and Non-linear Analyses of EEG in a Group of ASD Children During Resting State Condition.

This study analyses the spontaneous electroencephalogram (EEG) brain activity of 14 children diagnosed with Autism Spectrum Disorder (ASD) compared to 18 children with normal development, aged 5-11 years. (i) Power Spectral Density (PSD), (ii) variability across trials (coefficient of variation: CV), and (iii) complexity (multiscale entropy: MSE) of the brain signal analysis were computed on the resting state EEG. PSD (0.5-45 Hz) and CV were averaged over different frequency bands (low-delta, delta, theta, alpha, low-beta, high-beta and gamma). MSE were calculated with a coarse-grained procedure on 67 time scales and divided into fine, medium and coarse scales. In addition, significant neurophysiological variables were correlated with behavioral performance data (Kaufman Brief Intelligence Test (KBIT) and Autism Spectrum Quotient (AQ)). Results show increased PSD fast frequency bands (high-beta and gamma), higher variability (CV) and lower complexity (MSE) in children with ASD when compared to typically developed children. These results suggest a more variable, less complex and, probably, less adaptive neural networks with less capacity to generate optimal responses in ASD children.

Neuropsychological profile associated to PKAN in its initial phase: a case series report.

Pantothenase kinase-associated neurodegeneration (PKAN) is characterized by an abnormal accumulation of iron in basal ganglia and progressing varied extrapyramidal clinical symptoms. There are few studies on the cognitive symptoms and their development. The aim of this study is to explore the neuropsychological profile of PKAN patients in the initial stages of the disorder, when there are relatively fewer motor limitations. we present a full neuropsychological examination of three female cases (two early and one late onset). perception and spatial cognition were within normal range. Performance on other tasks were mixed, except for primary impairments in inhibition, flexibility, and cognitive fluency, which were consistent across cases. unlike most previous studies which report adults with major motor impairment, we present cases of young participants with minor motor difficulties. The results of the neuropsychological assessment - potentially less confounded by poor motor functioning during examination - are compatible with impairments in the fronto-subcortical circuits in the early phases of the disease. This could explain frequent misdiagnoses (e.g., with attention deficit hyperactivity disorder) in initial referrals.

Socioeconomic Status, Culture, and Reading Comprehension in Immigrant Students.

Research on reading comprehension in immigrant students is heterogeneous and conflicting. Differences in socioeconomic status and cultural origins are very likely confounds in determining whether differences to native pupils can be attributed to immigrant status. We collected data on 312 Spanish students of Native, of Hispanic origin-therefore with the same family language as native students- and Non-Hispanic origin, while controlling for socioeconomic status, non-verbal reasoning and school membership. We measured reading comprehension, knowledge of syntax, sentence comprehension monitoring, and vocabulary. Differences among groups appeared only in vocabulary and syntax (with poorer performance in the non-Hispanic group), with no differences in reading comprehension. However, regression analyses showed that most of the variability in reading comprehension was predicted by age, socioeconomic status, non-verbal reasoning, and comprehension monitoring. Group membership did not significantly contribute to explain reading comprehension variability. The present study supports the idea that socioeconomically disadvantaged students, both native and immigrants from diverse cultural backgrounds, irrespective of the language of origin, are probably equally at risk of poor reading comprehension.

Virtual Reality for the Treatment of Anxiety Disorders: A Scoping Review.

IMPORTANCE: Virtual reality in head-mounted displays (HMD-VR) may be a valuable tool in occupational therapy to address anxiety. Findings from the virtual reality exposure therapy (VRET) literature may facilitate translation of HMD-VR to occupational therapy psychosocial practice. OBJECTIVE: To explore how HMD-VR has been used to treat anxiety through VRET and could be translated to occupational therapy. DATA SOURCES: We searched seven electronic databases for articles published between 2000 and 2020: CINAHL, Cochrane Library, Embase, ERIC, Ovid MEDLINE, PsycINFO, and Web of Science. Search terms included HMD-VR constructs, products, and therapy concepts. Study Selection and Data Collection: We used Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to report studies implementing VRET to treat anxiety. At least two reviewers assessed each citation, and a third resolved disagreements. Articles were included if they were in English, reported experimental data, and used HMD-VR. Letters, commentaries, book chapters, technical descriptions, theoretical papers, conference proceedings (≤4 pages), and reviews were excluded. FINDINGS: Twenty-eight studies used HMD-VR to treat posttraumatic stress disorder (n = 3), specific phobias (n = 19), and performance-based social anxiety (n = 6); protocols and levels of evidence varied (randomized controlled trials, n = 11; controlled trials without randomization, n = 6; case-control or cohort studies, n = 11). Qualitative examination indicates HMD-VR is an effective treatment tool. CONCLUSIONS AND RELEVANCE: HMD-VR can be a valuable tool for occupational therapy to simulate environments where clients with anxiety disorders participate. Eliciting presence through multisensory features and body representation may enhance outcomes. What This Article Adds: Drawing from the VRET literature, this scoping review suggests that HMD-VR can be used by occupational therapy practitioners to simulate ecologically valid environments, evaluate client responses to fearful stimuli, and remediate anxiety though immersion in virtual tasks when participation in natural contexts is unfeasible. Having ecologically valid environments is particularly important for people with anxiety disorders because they need support to cope when they encounter triggers in everyday life environments.

[Empirically Supported Psychological Treatments for Children and Adolescents: State of the Art].

Empirically Supported Psychological Treatments for Children and Adolescents: State of the Art. BACKGROUND: The empirical evidence accumulated on the efficacy, effectiveness, and efficiency of psychotherapeutic treatments in children and adolescents calls for an update. The main goal of this paper objective was to carry out a selective review of empirically supported psychological treatments for a variety of common psychological disorders and problems in childhood and adolescence. METHOD: A review was carried out of the psychological treatments for different psychological disorders and problems in social-emotional or behavioral adjustment in the child-adolescent population according to the Spanish National Health System (Clinical Practice Guidelines) levels of evidence and degrees of recommendation. RESULTS: The findings suggest that psychological treatments have empirical support for addressing a wide range of psychological problems in these developmental stages. The degree of empirical support ranges from low to high depending on the phenomenon analyzed. The review suggests unequal progress in the different fields of intervention. CONCLUSIONS: From this update, psychologists will be able to make informed decisions when implementing those empirically supported treatments to address the problems that occur in childhood and adolescence.

The Impact of Intervention Dose Form on Oral Language Outcomes for Children With Developmental Language Disorder.

Purpose The aim of this study was to extract key learning from intervention studies in which qualitative aspects of dosage, dose form, have been examined for children with developmental language disorder (DLD)-in vocabulary, morphosyntax, and phonology domains. This research paper emerged from a pair of systematic reviews, aiming to synthesize available evidence regarding qualitative and quantitative aspects of dosage. While quantitative aspects had been experimentally manipulated, the available evidence for dose form (tasks or activities within which teaching episodes are delivered) was less definitive. Despite this, the review uncovered insights of value to DLD research. Method A preregistered systematic review (PROSPERO ID: CRD42017076663) adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was completed. Included papers were quasi-experimental, randomized controlled trial, or cohort analytic studies, published in any language between January 2006 and May 2019; oral language interventions with vocabulary, morphosyntax, or phonology outcomes; and participants with DLD (M = 3-18 years). The intention was to include papers in which dose form was experimentally manipulated or statistically analyzed, while quantitative dosage aspects were controlled, such that definitive conclusions about optimal dose form could be drawn and gaps in the evidence identified. Results Two hundred and twenty-four papers met the above inclusion criteria; 27 focused on dose form. No study controlled for all quantitative aspects of dosage such that we could effectively address our original research questions. Despite this, key points of learning emerged with implications for future research. Conclusions There is tentative evidence of advantages for explicit over implicit instruction and of the benefits of variability in input, elicited production, and gestural and other visual supports. With careful design of dose form, there is potential to design more efficient interventions. Speech-language pathology research would benefit from an agreed taxonomy of dose form components and standardized reporting of intervention studies, to enable cross-study comparisons and a systematic accrual of knowledge to identify optimal dose form for clinical application.

An experimental eye-tracking study of text adaptation for readers with dyslexia: effects of visual support and word frequency.

Easy-to-read guidelines recommend visual support and lexical simplification to facilitate text processing, but few empirical studies confirm a positive effect from these recommendations in individuals with dyslexia. This study examined the influence of the visual support and lexical simplification on sentence processing through eye movements at both the text- and word-level, and the differences between readers with and without dyslexia. Furthermore, we explored the influence of reading experience and vocabulary, as control variables. We tested 20 young adults with dyslexia and 20 chronological age-matched controls. Participants read 60 sentences in total. Half the sentences contained an image and the other half did not, and half contained a low-frequency word and half a high-frequency word. Results showed that visual support and lexical simplification facilitated sentence processing, potentially by jointly facilitating lexical semantic access. We also found that participants with lower print exposure and lower vocabulary benefited more from word-level lexical simplification. We conclude that both adaptations could benefit readers with low print exposure and smaller vocabularies, and therefore, to many dyslexic readers who show these characteristics.

The Influence of Quantitative Intervention Dosage on Oral Language Outcomes for Children With Developmental Language Disorder: A Systematic Review and Narrative Synthesis.

Purpose The aim of this study was to examine the degree to which quantitative aspects of dosage (dose, dose frequency, and total intervention duration) have been examined in intervention studies for children with developmental language disorder (DLD). Additionally, to establish the optimal quantitative dosage characteristics for phonology, vocabulary, and morphosyntax outcomes. Method This registered review (PROSPERO ID CRD42017076663) adhered to PRISMA guidelines. Search terms were included in seven electronic databases. We included peer-reviewed quasi-experimental, randomized controlled trial or cohort analytical studies, published in any language between January 2006 and May 2020. Included articles reported on participants with DLD (M = 3-18 years); oral language interventions with phonology, vocabulary, or morphosyntax outcomes; and experimental manipulation or statistical analysis of any quantitative aspect of dosage. Studies were appraised using the Cochrane risk-of-bias tool. Results Two hundred forty-four articles reported on oral language interventions with children with DLD in the domains of interest; 13 focused on experimentally/statistically manipulating quantitative aspects of dosage. No article reported phonological outcomes, three reported vocabulary, and eight reported morphosyntax. Dose frequency was the most common characteristic manipulated. Conclusions Research is in its infancy, and significant further research is required to inform speech-language pathologists in practice. Dosage characteristics are rarely adequately controlled for their individual effects to be identified. Findings to date suggest that there is a point in vocabulary and morphosyntax interventions after which there are diminishing returns from additional dosage. If dose is high (number of learning opportunities within a session), then the literature suggests that session frequency can be reduced. Frequent, short sessions (2/3 × per week, approximately 2 min) and less frequent, long sessions (1 × per week, approximately 20 min) have yielded the best outcomes when composite language measures have been used; however, replication and further research are required before clinicians can confidently integrate these findings into clinical practice. Supplemental Material https://doi.org/10.23641/asha.13570934.

Reading Goals and Executive Function in Autism: An Eye-Tracking Study.

The sources of reading comprehension difficulties in people with autism spectrum disorder (ASD) are still open to discussion. We explored their ability to adapt reading strategies to different reading goals using eye-tracking technology. A group of participants with ASD, and intelligence-, receptive oral language- and reading skills-matched control peers, read three stories under three different reading goals conditions: read for entertainment; read for study; and read fast and search information for a previously presented question. Each text required participants to answer comprehension questions. The ASD group was less accurate in question answering. The control group was faster in reading questions, displayed more fixations on the text, and reported to be more confident in question answering during reading for study compared to reading for entertainment. These differences between reading goals were not observed in the ASD group. The control group adopted and was aware of using different reading strategies according to different reading goals. In contrast, the ASD group did not change their reading behavior and strategies between entertainment and study reading goal condition, showing less of a tendency to adopt deep-level processing strategies when necessary. Planning, as measured by Tower of Hanoi, was the only executive task that predicted individual differences in text reading time across conditions. Participants with better planning ability were also able to adapt their reading behavior to different reading instructions. Difficulties in adjusting the reading behavior according to the task, evaluating own performance and planning may be partly involved in reading comprehension problems in ASD. LAY ABSTRACT: The control group read questions faster, reported to be more confident in question answering during reading for study compared to reading for entertainment, and were aware of using different reading strategies according to different reading goals. In contrast, the autistic group did not change their reading behavior and strategies according to the reading goal. Difficulties in adjusting the reading behavior according to the task, in evaluating own performance and in planning may be partly involved in reading comprehension problems in autism. Autism Res 2021, 14: 1007-1024. © 2020 International Society for Autism Research, Wiley Periodicals, LLC.

Comprehending reflexive and clitic constructions in children with autism spectrum disorder and developmental language disorder.

BACKGROUND: It has been established that people with autism spectrum disorder (ASD) often have difficulties understanding spoken language. Understanding reflexive and clitic pronouns is vital to establishing reference-based inference, but it is as yet unclear whether such constructions pose specific difficulties for those with ASD. Pronoun interpretation seems be connected to the development of pragmatic abilities, and can therefore be considered a plausible marker in the differential diagnosis between ASD and developmental language disorder (DLD). AIMS: To establish whether or not there are differences between ASD and DLD in relation to their understanding of pronoun constructions (both reflexive and clitic). The working hypothesis was that although no differences were expected between groups in relation to automatic (online) pronoun processing, the comprehension of reflexive pronouns would constitute a diagnostic marker between the group with ASD and language disorder and the DLD group. METHODS & PROCEDURES: The study carried out two experiments with three clinical groups (two with ASD and different levels of language proficiency and one with DLD) and two control groups with typically developing people (with equivalent language levels), analysing their on- and offline processing in pronoun resolution tasks. The first experiment uses an online method (eye-tracking) to record pronoun processing in real time. The second uses an offline method to analyse comprehension accuracy. OUTCOMES & RESULTS: The results of the two experiments indicated no differences in the way in which the clinical and control groups resolved the tasks, but a shorter reaction time was observed only in the age-matched control group in comparison with the ASD group without language disorder in the first experiment, perhaps due to the fact that processing pronouns involves a greater cognitive load among the latter group. CONCLUSIONS & IMPLICATIONS: The comprehension of reflexive pronouns cannot be considered a diagnostic marker for distinguishing ASD from DLD. What this paper adds What is already known on the subject Previous studies have found that the performance of children with ASD in the comprehension of personal pronouns is equivalent to youngest control groups, but poorer regarding the interpretation of reflective pronouns. However, children with DLD do not usually have problems with the use of pronouns, which suggests that their pronoun processing is not affected. As pronoun interpretation seems be connected to the development of pragmatic abilities, it could be considered a plausible marker in the differential diagnosis between ASD and DLD. What this paper adds to existing knowledge This paper presents the results of two experiments involving pronoun processing by those with ASD (both with and without language disorder) and those with DLD. The design enables us to analyse the reflexive and clitic pronoun processing in people with ASD and DLD, regardless of their language proficiency. One experiment uses an eye-tracking methodology that allows us to obtain data about how the pronouns are processed in real time. It represents an attempt to identify language markers that may help distinguish between the two groups and adapt the interventions to the specific problems experienced by each one. What are the potential or actual clinical implications of this work? The results indicate that it is not possible to identify any specific impairment in pronoun processing among the clinical groups (ASD and DLD).

Applications of Head-Mounted Displays for Virtual Reality in Adult Physical Rehabilitation: A Scoping Review.

IMPORTANCE: Head-mounted displays for virtual reality (HMD-VR) may be used as a therapeutic medium in physical rehabilitation because of their ability to immerse patients in safe, controlled, and engaging virtual worlds. OBJECTIVE: To explore how HMD-VR has been used in adult physical rehabilitation. DATA SOURCES: A systematic search of MEDLINE, Embase, Cochrane Library, CINAHL, Web of Science, PsycINFO, and ERIC produced 11,453 abstracts, of which 777 underwent full-text review. STUDY SELECTION AND DATA COLLECTION: This scoping review includes 21 experimental studies that reported an assessment or intervention using HMD-VR in a physical rehabilitation context and within the scope of occupational therapy practice. FINDINGS: HMD-VR was used for assessment and intervention for patients with a range of disorders, including stroke, multiple sclerosis, spinal cord injury, and Parkinson's disease. CONCLUSIONS AND RELEVANCE: HMD-VR is an emerging technology with many uses in adult physical rehabilitation. Higher quality clinical implementation studies are needed to examine effects on patient outcomes. WHAT THIS ARTICLE ADDS: We review existing research on how immersive virtual reality (e.g., using head-mounted displays) has been used for different clinical populations in adult physical rehabilitation and highlight emerging opportunities in this field for occupational therapists.

The Impact of Family Environment on Language Development of Children With Cochlear Implants: A Systematic Review and Meta-Analysis.

OBJECTIVES: The authors conducted a systematic review of the literature and meta-analyses to assess the influence of family environment on language development in children with cochlear implants. DESIGN: The Pubmed, excerpta medica dataBASE (EMBASE), Education Research Information Center, cumulative index to nursing and allied health literature (CINAHL), Healthcare Literature Information Network, PubPsych, and Social SciSearch databases were searched. The search strategy included terms describing family environment, child characteristics, and language development. Studies were included that (a) assessed distal family variables (such as parental income level, parental education, family size, and parental stress) with child language outcomes, and/or more proximal correlates that directly affect the child (such as family engagement and participation in intervention, parenting style, and more specifically, the quantity and quality of parental linguistic input) on child language; (b) included children implanted before the age of 5 years; (c) measured child language before the age of 21 years with standardized instruments; (d) were published between 1995 and February 2018; and (e) were published as peer-reviewed articles. The methodological quality was assessed with an adaptation of a previously validated checklist. Meta-analyses were conducted assuming a random-effects model. RESULTS: A total of 22 study populations reported in 27 publications were included. Methodological quality was highly variable. Ten studies had a longitudinal design. Three meta-analyses on the correlations between family variables and child language development could be performed. A strong effect of the quality and quantity of parental linguistic input in the first 4½ years postimplantation on the child's language was found, r = 0.564, p ≤ 0.001, 95% confidence interval (CI) = 0.449 to 0.660, accounting for 31.7% of the variance in child language outcomes. Results demonstrated high homogeneity, Q(3) = 1.823, p = 0.61, I = 0. Higher-level facilitative language techniques, such as parental expansions of the child's utterances or the use of open-ended questions, predicted child language skills. Risk of publication bias was not detected. The results on the impact of family involvement/participation in intervention on child language development were more heterogeneous. The meta-analysis included mainly cross-sectional studies and identified low to moderate benefits, r = 0.380, p ≤ 0.052, 95% CI = -0.004 to 0.667, that almost attained significance level. Socioeconomic status, mainly operationalized by parental level of education, showed a positive correlation with child language development in most studies. The meta-analysis confirmed an overall low and nonsignificant average correlation coefficient, r = 0.117, p = 0.262, 95% CI = -0.087 to 0.312. A limitation of the study was the lack of some potentially relevant variables, such as multilingualism or family screen time. CONCLUSIONS: These data support the hypothesis that parental linguistic input during the first years after cochlear implantation strongly predicts later child language outcomes. Effects of parental involvement in intervention and parental education are comparatively weaker and more heterogeneous. These findings underscore the need for early-intervention programs for children with cochlear implants focusing on providing support to parents for them to increase their children's exposure to high-quality conversation.

A Spanish Sign Language (LSE) Adaptation of the Communicative Development Inventories.

This article presents the adaptation of the MacArthur Communicative Development Inventory (CDI; Fenson et al., 1993, Guide and technical manual for the MacArthur Communicative Development Inventories. San Diego, CA: Singular Press; Fenson et al. 1994, Variability in early communicative development. Monographs of the Society for Research in Child Development, 59, 1-173) to Spanish Sign Language (LSE). Data were collected from 55 participants (32 boys and 23 girls; 17 deaf signers, 38 hearing signers) who, evaluated by their caregivers every 4 months, presented a total of 170 records. The parents reported the signs that the children could understand or produce between 8 and 36 months. Results suggested that the CDI adapted to LSE is a valid and reliable instrument. Signing children could understand more signs than they produced at this early developmental stage. There were no significant differences between boys and girls, or between deaf and hearing children. The development of LSE is similar to other sign languages, although with a lower production of signs in the early stages, perhaps due to the bilingualism of most of the children of our study.

Impaired P1 Habituation and Mismatch Negativity in Children with Autism Spectrum Disorder.

Passive testing of auditory function is an important objective in individuals with ASD due to known difficulties in understanding and/or following task instructions. In present study the habituation to standard tones following deviants and the auditory discriminative processes were examined in two conditions: electronic and human sounds, in a sample of 16 ASD children. ASD children presented a reduced habituation in the P1 component and a decrease in the amplitude of the mismatch negativity indicating a lower auditory discrimination with respect to controls. MMN amplitude was related to sensory sensitivity. Results suggest an increased activation to repeatedly auditory stimulus and a poor auditory discrimination, for both: electronic and human sounds with consequences on the impaired sensory behavior of ASD subjects.

Do Individuals with Autism Change Their Reading Behavior to Adapt to Errors in the Text?

Reading monitoring is poorly explored, but it may have an impact on well-documented reading comprehension difficulties in autism. This study explores reading monitoring through the impact of instructions and different error types on reading behavior. Individuals with autism and matched controls read correct sentences and sentences containing orthographic and semantic errors. Prior to the task, participants were given instructions either to focus on semantic or orthographic errors. Analysis of eye-movements showed that the group with autism, differently from controls, were less influenced by the error's type in the regression-out to-error measure, showing less change in eye-movements behavior between error types. Individuals with autism might find it more difficult to adapt their reading strategies to various reading materials and task demands.

Effects of a Brain-Computer Interface With Virtual Reality (VR) Neurofeedback: A Pilot Study in Chronic Stroke Patients.

Rehabilitation for stroke patients with severe motor impairments (e.g., inability to perform wrist or finger extension on the affected side) is burdensome and difficult because most current rehabilitation options require some volitional movement to retrain the affected side. However, although these patients participate in therapy requiring volitional movement, previous research has shown that they may receive modest benefits from action observation, virtual reality (VR), and brain-computer interfaces (BCIs). These approaches have shown some success in strengthening key motor pathways thought to support motor recovery after stroke, in the absence of volitional movement. The purpose of this study was to combine the principles of VR and BCI in a platform called REINVENT and assess its effects on four chronic stroke patients across different levels of motor impairment. REINVENT acquires post-stroke EEG signals that indicate an attempt to move and drives the movement of a virtual avatar arm, allowing patient-driven action observation neurofeedback in VR. In addition, synchronous electromyography (EMG) data were also captured to monitor overt muscle activity. Here we tested four chronic stroke survivors and show that this EEG-based BCI can be safely used over repeated sessions by stroke survivors across a wide range of motor disabilities. Finally, individual results suggest that patients with more severe motor impairments may benefit the most from EEG-based neurofeedback, while patients with more mild impairments may benefit more from EMG-based feedback, harnessing existing sensorimotor pathways. We note that although this work is promising, due to the small sample size, these results are preliminary. Future research is needed to confirm these findings in a larger and more diverse population.

Mindfulness Meditation Effects on Poststroke Spasticity: A Feasibility Study.

This study examined the feasibility of an adapted 2-week mindfulness meditation protocol for chronic stroke survivors. In addition, preliminary effects of this adapted intervention on spasticity and quality of life in individuals after stroke were explored. Ten chronic stroke survivors with spasticity listened to 2 weeks of short mindfulness meditation recordings, adapted from Jon Kabat-Zinn's Mindfulness-Based Stress Reduction course, in a pre/post repeated measures design. Measures of spasticity, quality of life, mindfulness, and anxiety, along with qualitative data from participants' daily journals, were assessed. On average, participants reported meditating 12.5 days of the full 15 days (mean 12.5 days, SD 0.94, range 8-15 days). Seven of the 10 participants wrote comments in their journals. In addition, there were no adverse effects due to the intervention. Exploratory preliminary analyses also showed statistically significant improvements in spasticity in both the elbow (P = .032) and wrist (P = .023) after 2 weeks of meditation, along with improvements in quality of life measures for Energy (P = .013), Personality (P = .026), and Work/Productivity (P = .032). This feasibility study suggests that individuals with spasticity following stroke are able to adhere to a 2-week home-based mindfulness meditation program. In addition, preliminary results also suggest that this adapted, short mindfulness meditation program might be a promising approach for individuals with spasticity following stroke. Future research should expand on these preliminary findings with a larger sample size and control group.