Digital Support for Persons with Cognitive Impairment.

Cognitive impairment may cause difficulties in planning and initiating daily activities, as well as remembering to do what is scheduled. This study investigates the effectiveness of an interactive web-based mobile reminder calendar that sends text messages to the users mobile phone as support in everyday life, for persons with cognitive impairment due to neurological injury/diagnoses. The study has a randomised controlled trail design with data collection at baseline and at follow-up sessions after two and four months. Data collection started in August 2016 and continues until December 2017. The interactive web-based mobile reminder calendar may give the needed support to remind the person and thus increase the ability to perform activities and to be independence in everyday life. Preliminary results will be presented regarding what effect the interactive web-based mobile reminder calendar have for the participants performance of everyday life activities as well as perceived quality of life.

E-inclusion: Digital equality - young people with disabilities.

UNLABELLED: The United Nations' position is that digital access is a matter involving equality between groups of people, the securing of democratic rights, and equal opportunities for all citizens. This study investigates digital equality in school and leisure between young people with and without disabilities. A cross-sectional design with group comparisons was applied. Participants were young people (10-18 years of age) with disabilities (n=389) and a reference group in about the same ages. Data were collected by a survey focusing on access to and engagement in ICT activities in school and during leisure time. The results demonstrated young people with disabilities had restricted participation in computer use in educational activities, in comparison to young people in general. During leisure time young people with disabilities had a leading position compared to the reference group with respect to internet use in a variety of activities. Beneficial environmental conditions at home (and the reverse in schools) are discussed as parts of the explanation for the differing engagement levels at home and in school, and among young people with disabilities and young people in general. CONCLUSION: Schools need to prioritise use of ICT by young people with disabilities.

Usability of RemindMe - An Interactive Web-Based Mobile Reminder Calendar: A Professional's Perspective.

AIM: The aim of the study was to examine the usability of an interactive web-based mobile reminder calendar (RemindMe) developed for supporting individuals in organizing, planning and executing activities in everyday life, from the perspectives of professionals. METHODS AND MATERIAL: Eleven professionals working in community services evaluated the usability of RemindMe in their clinical practice. Data were collected using semi-structured interviews and analysed with inductive qualitative analysis. RESULTS: The professionals perceived that RemindMe was useful, easy to use, and intuitive. There was a need among professionals for a web-based reminder calendar that requires the active acknowledgement of reminders. RemindMe's feedback system offering self-monitored information based on the user's interaction with the system supported the professionals in discussions, evaluation, and follow-up based on the needs of the persons with cognitive impairments. CONCLUSION: The results indicate that RemindMe may be potentially useful to professionals who provide support to individuals with cognitive impairments. However, further research is needed to evaluate experience of using RemindMe from the perspective of individuals with cognitive impairments.

Parents of children with physical disabilities - perceived health in parents related to the child's sleep problems and need for attention at night.

BACKGROUND: Approximately half of all children with moderate to severe physical disabilities have persistent sleep problems and many of these children need parental attention at night. AIM: To study whether sleep problems and need for night-time attention among children with physical disabilities are associated with perceived parental health, headache, psychological exhaustion, pain due to heavy lifting, night-time wakefulness and disrupted sleep. METHODS: We asked parents of 377 children with physical disabilities aged 1-16 years to complete a questionnaire about their own health. The children all lived at home with both parents. RESULTS: Both parents reported poor health, psychological exhaustion, more night-time wakefulness and disrupted sleep when the child had sleep problems (P < 0.05). Mothers also reported more headache when the child had sleep problems (P = 0.001). Both parents reported more night-time wakefulness and disrupted sleep when the child needed night-time attention (P < 0.01). In general, mothers reported significantly poorer health, more night-time wakefulness, disrupted sleep, headache and psychological exhaustion than fathers (P < 0.001). CONCLUSIONS: Sleep problems need to be acknowledged within the paediatric setting in order to prevent psychological exhaustion and poor health in mothers and fathers of children with physical disabilities.

The influence of ICT on the activity patterns of children with physical disabilities outside school.

AIM: To investigate the outside school activity patterns of children with physical disabilities, and specifically their information and communication technology (ICT) usage compared with that of non-disabled children. In addition, the aim was to investigate the children's opinions on computer use and the associations between their use of the Internet and their interaction with peers. METHODS: Questionnaire on activities outside school, answered by 215 children and youths with physical disabilities, mean age 12 years 10 months, attending mainstream schools. For group comparisons with non-disabled children, data from the survey 'Kids and Media' were used. RESULTS: In the analysis, two sets of activity patterns were identified, depending on whether the child was disabled or not and on the gender of the child. A higher proportion of children with physical disabilities were engaged in ICT activities, while non-disabled children tended to be engaged in a broader range of activities outside school. The activity pattern was more uniform for boys and girls with disabilities than for their non-disabled peers. Use of the Internet was positively associated with peer interaction. CONCLUSION: Outside school, the activity patterns of children and youths with physical disabilities seem to be characterized by a focus on ICT activities, which enable children to compensate for their impairment because it suits all. In addition, digital skills developed outside school engage children with physical disabilities, giving them increased access to society and for educational purposes.

Support in everyday activities with a home-based electronic memory aid for persons with memory impairments.

PURPOSE: The purposes of this study was to examine the possibilities of a home-based electronic memory aid with sensors for persons with memory impairments, as support to carry out everyday activities in their own home environments. METHOD: The method involved a single-subject study with a multiple baseline AB design. Five participants identified three activities each that they usually forget to carry out. An electronic memory aid with individually spoken reminders was installed in the participant's home. There were automatic computer registrations of completed activities during the study phase of 12 weeks. Assessments of functioning and quality of life (QoL) were conducted before and after the intervention and at follow-up after 2 months. RESULTS: Four participants improved in completing most of the self-chosen activities when the electronic memory aid was used. Performance and satisfaction with performance and QoL improved, but there was no memory function improvement. There were technical problems with the aid, which had a negative effect for users. CONCLUSIONS: Electronic memory aids have a large potential for supporting persons with cognitive impairments. It is important to conduct follow-up afterwards, because the use of an aid and the need of support change over time and put high demands on technical reliability of the electronic memory aid.

Sleep problems and the need for parental night-time attention in children with physical disabilities.

BACKGROUND: The aim of the study was to investigate the frequency and predictors of sleep problems and the need for parental night-time attention in children with physical disabilities. METHODS: A questionnaire on sleep problems and need for parental night-time attention was completed by 505 parents of children with physical disabilities aged 1-16 years (mean 9 years 3 months) with moderate to severe motor disabilities. General characteristics of the children were analysed by frequencies and cross-tabulations. Logistic regression analysis was used to identify factors associated with sleep problems and the need for parental night-time attention. RESULTS: The results showed a high prevalence of sleep problems, which in general were chronic. Currently 48% of the children had sleep problems, of which 23% estimated the problems to be serious. About one-third (37%) needed parental night-time attention every night, and 10% needed help five times or more. No significant differences were found between younger children and school-aged children regarding sleep problems and the need for parental night-time attention. Having pain [odds ratio (OR) = 3.4] was associated with sleep problems, as was having problems eating and drinking (OR = 3) and the diagnosis of cerebral palsy (OR = 2.5) (P < 0.05). Children with muscular dystrophy (OR = 68.5), cerebral palsy (OR = 26.7) and 'other diagnosis' (OR = 18.5) were more likely to need support at night than were children with spina bifida, P < 0.001. Pain (OR = 7.6) was also associated with need for support at night, P < 0.001. CONCLUSIONS: The prevalence of sleep problems and need for parental night-time attention is high among children with physical disabilities. This in turn affects the whole family, and paediatric caregivers must keep this in mind. Besides certain diagnoses, the results suggest that children who have pain should be prioritized.

Using electronic aids to daily living after acquired brain injury: a study of the learning process and the usability.

PURPOSE: The purpose was to study the ability of persons with memory impairments after acquired brain injury to learn how to and use electronic aids to daily living (EADL) and to describe changes in function and quality of life. METHOD: Eight participants stayed in two apartments equipped with a set of basic and advanced EADL for either 4 or 6 months during an intervention time of 2 years. The teaching and learning method was influenced by certain principles of errorless learning. Ability to learn to use EADL was measured by structured observations. Function and quality of life were assessed with self-rating questionnaires. RESULTS: Results indicate that the participants learned to use EADL in their everyday activities. They perceived that EADL were very useful and easy to learn. Occupational performance and satisfaction with occupational performance and quality of life was improved. CONCLUSION: The results indicate that EADL may play an important role in facilitating everyday activities and improve satisfaction with occupational performance and quality of life for people with memory impairments. The study indicates the importance of adjusting technology to the user's needs and calls for more consideration for human-technology interaction factors.

Cognitive training in home environment.

PRIMARY OBJECTIVE: To examine the efficacy of cognitive rehabilitation in the patient's home or vocational environment. RESEARCH DESIGN: Pre-post-follow-up design. METHODS AND PROCEDURES: Ten outpatients with acquired attention and memory problems received cognitive training three times weekly, for 3 weeks. They received individual attention training with Attention Process Training, training for generalization for everyday activities and education in compensatory strategies for self-selected cognitive problems. Treatment effects were evaluated with neuropsychological and occupational therapy instruments before and after the training and after 3 months on impairment, activity and participation levels. MAIN OUTCOMES AND RESULTS: The results indicated a positive effect on some measures on impairment level, but no differences on activity or participation levels at follow-up. CONCLUSIONS: The study indicates that home-based cognitive training improves some attentional and memory functions and facilitates learning of strategies. Future controlled studies are needed to confirm the results and analyse the efficacy of different aspects of home-based training.

Environmental barriers in mainstream schools.

Research on students with disabilities in mainstream schools often focuses on the students' personal abilities rather than on the establishment itself. To promote inclusive education, the environmental prerequisite for participation has to be explored also. The aim of this study was to identify the barriers to participation in Swedish mainstream schools, from the personal perspective of students with physical disabilities. The study also investigated how gender, diagnosis, level of mobility, academic years and availability of an assistant were related to student-environment fit. A total of 34 students with physical disabilities, aged between 10 and 19 years, participated in the study. The students were assessed by 'The school-setting interview'. Results show that two-thirds of the students experienced barriers to participation in both the physical and the social environment. A majority of the barriers originated from the way in which school activities were organized and carried out in schools. Failure to provide adequate environmental adjustments resulted in restricted participation or exclusion from some of the activities in class. Older students experienced significantly more barriers than younger ones because the school organization was less favourable. The results suggest that the way in which activities are organized in school is the area in need of most improvements to promote participation of students with physical disabilities.

Accommodation needs and student-environment fit in upper secondary schools for students with severe physical disabilities.

The purpose of this study was to identify, from the personal perspective of students with disability, their needs for physical and social accommodations in upper secondary schools specially adapted for students with severe physical disabilities. The study also aimed to identify those areas of student-environment fit which were most often achieved. Forty-eight students in four schools in Sweden were assessed by occupational therapists using the School Setting Interview. Forty-seven students reported needs for accommodations in the school setting. The study indicates that schools generally were able to meet the students' accommodation needs in the physical environment. The schools also met students' accommodation needs for field trips, sport activities and assistance. Student-environment fit in occupations requiring reading, remembering and speaking was unsatisfactory. Accommodations on a general, group and individual level are highlighted and discussed. The study recommends that occupational therapists become more involved and offer society their expertise in barrier removal to a greater extent.