Department of Public Health and Caring Sciences, Research in Disability and Habilitation, Uppsala University, Uppsala, Sweden.
Swedish National Center for Rett Syndrome and Related Disorders, Region Jämtland Härjedalen, Frösön, Sweden.
Disabil Rehabil Assist Technol. 2023 Oct;18(7):1011-1025. doi: 10.1080/17483107.2021.1967469. Epub 2021 Aug 28.
To examine the effect of a communication intervention package on expressive communication and visual attention in individuals with Rett syndrome.
A modified withdrawal (A-B1-A1-B2-A2) single case experimental design with a direct inter-subject replication across three participants was applied. Three women with Rett syndrome participated. The study took place over a six-week period and comprised 32 sessions with each participant. All sessions were video recorded. During the intervention the communication partner used aided language modelling on a gaze-controlled device in combination with using responsive partner strategies. Expressive communication was assessed as synthesised words per minute and unique synthesised words per minute. Visual attention was assessed as rate of focused gazes (1 s or longer) in interaction.
An intervention effect was found on the rate of unique words for all participants. The rate of words increased for two participants when the intervention was introduced but no withdrawal effect could be seen. An intervention effect on visual attention could be seen for one participant. The intervention appeared to have social validity as reported by caregivers.
Aided language modelling (ALM), while using responsive partner strategies and a gaze-controlled device may be used with adult individuals with Rett syndrome to increase their rate of expressive communication. Detailed observational measures revealed individual learning patterns, which may provide clinically valuable insights.Implications for RehabilitationAdults with Rett syndrome may benefit from access to gaze-controlled devices in combination with responsive partner strategies.Responsive partner communication may be effective for some individuals with Rett syndrome to increase their rate of synthesised utterances.Rate of focused gazes may be considered as an outcome measure for individuals with oculomotor difficulties when introducing aided language modelling.
研究沟通干预方案对雷特综合征患者表达性沟通和视觉注意力的影响。
采用改良撤出（A-B1-A1-B2-A2）单案例实验设计，在 3 名参与者之间进行直接的交叉复制。3 名雷特综合征女性参与了研究。研究持续 6 周，每个参与者有 32 个会话。所有会话均进行了录像。在干预期间，沟通伙伴在注视控制设备上使用辅助语言模型，并结合使用反应性伙伴策略。表达性沟通通过每分钟综合单词数和每分钟独特综合单词数进行评估。视觉注意力通过互动中注视时间的注视率（1 秒或更长时间）进行评估。
所有参与者的独特单词率都显示出干预效果。当引入干预时，两名参与者的单词率增加，但没有观察到撤回效应。一名参与者的视觉注意力出现干预效果。护理人员报告称，干预具有社会有效性。
辅助语言模型（ALM），同时使用反应性伙伴策略和注视控制设备，可用于增加成年雷特综合征患者的表达性沟通率。详细的观察测量揭示了个体的学习模式，这可能提供有临床价值的见解。
雷特综合征患者可能受益于获得注视控制设备，同时结合反应性伙伴策略。反应性伙伴沟通可能对一些雷特综合征患者有效，以增加他们的综合话语率。在引入辅助语言模型时，注视时间的注视率可被视为有眼球运动障碍的个体的一种结果测量指标。
