Trends in Communicative Access Solutions for Children With Cerebral Palsy

Abstract

Access solutions may facilitate communication in children with limited functional speech and motor control. This study reviews current trends in access solution development for children with cerebral palsy, with particular emphasis on the access technology that harnesses a control signal from the user (eg, movement or physiological change) and the output device (eg, augmentative and alternative communication system) whose behavior is modulated by the user's control signal. Access technologies have advanced from simple mechanical switches to machine vision (eg, eye-gaze trackers), inertial sensing, and emerging physiological interfaces that require minimal physical effort. Similarly, output devices have evolved from bulky, dedicated hardware with limited configurability, to platform-agnostic, highly personalized mobile applications. Emerging case studies encourage the consideration of access technology for all nonverbal children with cerebral palsy with at least nascent contingency awareness. However, establishing robust evidence of the effectiveness of the aforementioned advances will require more expansive studies.

The impact of gaze-based assistive technology on daily activities in children with severe physical impairments

“…The communication partner also needs to pay close attention to the child's eye gaze, facial expressions and body movements, by looking for changes in any movement to interpret the child's communication attempt. In addition, the partner needs to have some prior knowledge of the child's personal preferences to interpret the child's communication, which implies familiarity with the child (Myrden et al, 2014). Thus, interacting partners are limited and parents or other family members usually need to act as interpreters for their child (Hewitt-Taylor, 2008;Myrden et al, 2014).…”

Brain-Computer Interfaces for Children With Complex Communication Needs and Limited Mobility: A Systematic Review

“…Among these pediatric-specific challenges included the absence of guidelines for processing brain signals from children, heightened neural plasticity including evolving cortical organization and frequency content of signals, and child engagement considerations such as fear, comfort, and positioning (Mikołajewska and Mikołajewski, 2014). Notwithstanding these concerns, the need for pediatric BCI research remains high given the lack of viable access technologies for children and youth with severe and multiple disabilities (Myrden et al, 2014).…”

Stakeholder consensus for decision making in eye-gaze control technology for children, adolescents and adults with cerebral palsy service provision: findings from a Delphi study

“…Eye-gaze control technology provides an effective and direct access method to computers and speech generating devices for people with significant physical disabilities, such as cerebral palsy [4,5], who are able to use purposeful looking behaviours including gaze fixations and gaze transfers [6][7][8][9][10]. This technology holds the potential to unlock people's capacity to participate in leisure and productivity pursuits, play games, listen to music, use social media, and for environmental control.…”