Sensorimotor challenges in developmental disabilities: implications for assistive technology and augmentative alternative communication
Year: 2024
Type: dissertation
Abstract: The provision of physical support through touch is a frequent and often spontaneous component of daily practice among professionals in special education, rehabilitation, and Assistive Technology (AT). Over the past 30 years, however, the use of touch assistance in relation to developmental disabilities (DD) has often been linked with controversial approaches such as Facilitated Communication (FC), rapid prompting (RPM), or spelling2communicate (S2C). This thesis starts (Chapter 1) with a consideration of these methods, particularly facilitated communication, in the context of AT and Augmentative Alternative Communication (AAC), showing how research has mainly focused on evaluating the authorship of the textual outputs produced via such techniques, neglecting in large part the dynamic that leads to the generation of such outputs. Chapter 1’s conclusion is a call for approaches to Facilitated Communication and similar techniques that investigate all the possible levels of user and facilitator contribution and address the mechanisms underlining the facilitation process. Accordingly, the thesis pursues two research interests: evaluating the value of existing touch-based assistive approaches (Chapter 2 and 3) and exploring the mechanism by which touch-based support can benefit users with developmental disabilities in (Chapter 4 and 5). Chapter 2 applies quantitative linguistics to the analysis of authorship style to corpora of FC text written over a 20-year period by multiple users working with multiple facilitators. This analysis shows that both users’ and facilitators’ stylistic fingerprints are detectable in text written with FC, and therefore an assistive method like it is best understood as a co-creative process. Chapter 3 presents an empirical investigation of the pointing gestures at the keyboard exhibited during FC. Using movement and eye-tracking analysis, this study shows that users’ movement behaviour cannot be explained exclusively in terms of facilitator influence or cueing, and that they should be acknowledged of some degree of literacy skills. It also becomes clear that participating in FC is not always associated with linguistic participation in text generation for at least some users. Chapter 4 presents a neurocognitive hypothesis of the pathway by why touch may assist users with DD by reducing the cognitive load of motor-postural control, freeing up capacity for higher order cognitive tasks such as text generation. Chapter 5 begins the empirical evaluation of this hypothesis using fNIRS to track the effect of touch on frontal brain activation. The results suggest that frontal brain activation can be modulated by the provision of touch support especially when the postural context of the task becomes more challenging, and that the effect of touch may have a different direction and magnitude in individuals with and without cognitive capacity limitation. The concluding Chapter 6 focuses on integrating the various lines of research addressed in the thesis. First, FC and FC-like techniques are presented in a renewed perspective, whereby the user’s participation and literacy development, and not the prospects of autonomous communication, are considered the primary goals. Second, the facilitating role of touch support deserves further consideration in the context of DD, not only in relation to existing touch-based assistive techniques, but more importantly in relation to the development of new assistive and rehabilitation programs.
Author: Nicoli, G
Language: English
Subfield: Occupational Therapy
Field: Health Professions
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7024434725