Brian Leung, Jessica A Brian, Tom Chau
Institute of Biomaterials and Biomedical Engineering, University of Toronto, ON, Canada.
Disabil Rehabil Assist Technol. 2013 Sep;8(5):426-33. doi: 10.3109/17483107.2012.754955. Epub 2013 Jan 22.
The present descriptive case study documents the behaviours of a child single-switch user in the community setting and draws attention to learning and mastery behaviours as risk factors to single-switch abandonment. Our observations were interpreted in the context of a longer term school-based evaluation of an advanced single-switch access technology with a nine year-old user with severe spastic quadriplegic cerebral palsy.
The child completed 25 experiment sessions averaging a rate of three sessions every two weeks. During each session he worked on several blocks of single-switch computer activity using his vocal cord vibration switch.
Despite high levels of single-switch sensitivity and specificity that suggested a good fit between the participant and the technology, the participant perceived a lower proficiency level of his own abilities, demonstrated impatience and intolerance to interaction errors, and was apprehensive of making mistakes when using his switch in public.
The benefit of gaining some degree of independent physical access might not necessarily enhance resilience to interaction errors or bouts of poor task performance. On the other hand, the participant's behaviours were consistent with those of a typically developing child learning or mastering any new skill or task. Implications for Rehabilitation The attitude and behaviour of a paediatric switch user towards skill development can be risk factors to abandonment of an access technology, despite successful clinical trial with the device. Children with severe disabilities can be associated with the same types of skill development behaviour patterns and achievement motivation as their typically developing peers. Empirical observations of the case participant's switch use behaviours suggest that user training could be adaptive in order to account for individual differences in skill development and achievement motivation.
本描述性案例研究记录了一名社区环境中使用单开关的儿童的行为，并提请注意学习和掌握行为是导致放弃单开关的风险因素。我们的观察结果是在对一名患有严重痉挛性四肢瘫脑瘫的9岁用户使用先进单开关接入技术进行的长期校内评估背景下进行解读的。
该儿童完成了25次实验课程，平均每两周进行三次课程。在每次课程中，他使用声带振动开关进行了几个单开关计算机活动模块。
尽管单开关具有较高的敏感性和特异性，表明参与者与该技术匹配良好，但参与者认为自己的能力熟练程度较低，表现出不耐烦和对交互错误的不耐受，并且在公共场合使用开关时担心犯错。
获得一定程度的独立身体接入的好处不一定能增强对交互错误或任务表现不佳情况的适应能力。另一方面，参与者的行为与典型发育儿童学习或掌握任何新技能或任务时的行为一致。对康复的启示 尽管该设备在临床试验中取得成功，但儿科开关用户对技能发展的态度和行为可能是放弃接入技术的风险因素。严重残疾儿童可能与典型发育的同龄人具有相同类型的技能发展行为模式和成就动机。对案例参与者开关使用行为的实证观察表明，用户培训可以进行调整，以考虑技能发展和成就动机方面的个体差异。
