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Foetal alcohol spectrum disorder: The development of guidelines to inform policyAdebiyi, Babatope Oluwadamilare January 2019 (has links)
Philosophiae Doctor - PhD / Introduction: Maternal alcohol consumption during pregnancy can result to birth defects, which may be developmental, intellectual and physical. Fetal alcohol spectrum disorder (FASD) is a term used to describe an array of disorders related to alcohol consumption during pregnancy. FASD is a severe public health problem globally, with South Africa having the highest prevalence (29 to 290 per 1000 live births). What makes the FASD problem severe in the country is rife of maternal risk factors and widespread binge drinking during pregnancy. There is no policy specifically addressing FASD despite being pervasive in South Africa. Government programmes to prevent and manage FASD remain limited and fragmental across relevant departments. Herein, we aimed to conduct a multi-method study with a modified Delphi approach to developing a guideline to inform the development of a comprehensive and multi-sectoral policy for the prevention and management of FASD.
Method and analysis: We used a modified version of the World Health Organization’s approach to guideline development in three phases. In phase 1, we conducted four different studies to design the initial guideline prototype. The studies include an in-depth interview with policymakers and a focus group with relevant service providers on policy requirements for FASD, a document review of policies on FASD and a scoping review of various interventions employed for the prevention and management of FASD. The second phase involved using the initially developed guideline prototype to engage with the local and international experts on FASD for improvement on the content. In the third phase, we refined the prototype using a modified Delphi approach. Framework method and content analysis were used to analyse the qualitative data while the Statistical Package for Social Science (SPSS) software was used to analyse the quantitative data.
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Using gaze aware regions in eye tracking calibration for users with low-attention span / Användning av regioner medvetna om blicken inom kalibrering av ögonstyrning för personer med låg fokuseringsförmågaLarsson, Joakim January 2017 (has links)
Eye trackers have enabled users to interact with computers for a long time. Yet, there are still many challenges left to be solved to make the interaction easy for users with development disabilities. Especially, when it comes to setup eye tracking where calibration of the eye tracker is important to get accurate estimation of where users are looking. This paper presents a study in which three modified versions of a calibration interface for eye trackers has been designed and evaluated by nine participants with development disabilities. These calibration interfaces used regions that were aware of when a user gazed at them, gaze-aware regions, and varied in the speed of which a stimulus moved during the calibration and how quickly the regions around the stimulus grew. Data was collected for each interface about interaction with the gaze-aware regions, time to complete a calibration, how many calibration points that were completed and gaze offset from the stimulus. No statistically significance was found between the modified interfaces for its efficiency, effectiveness and accuracy. However, a stimulus moving quicker and a gaze-aware region growing faster indicated a more effective and efficient calibration method without loss in accuracy. Also, if only screen engagement is involved using smooth-pursuit calibration could improve the calibration process. / Ögonstyrning har under en längre tid möjliggjort interaktion för användare. Dock är det fortfarande många utmaningar för att göra interaktionen lätt för användare med intellektuella funktionsnedsättningar. Framförallt när det kommer till inställningar för ögonstyrning, där kalibrering har visat sig vara viktigt för att ge en noggrann uppskattning vart användarna fokuserar. Denna rapport presenterar en studie där tre modifierade versioner av ett kalibreringsgränsnitt för ögonstyrning har blivit designat och utvärderat av nio deltagare med låg fokuseringsförmåga. Dessa gränssnitt använde regioner som var medvetna när en användare tittade inom dom, så kallade blickmedvetna regioner, och varierade i vilken hastighet ett stimuli rörde sig och hur snabbt regionerna runt ett stimuli växte. Data samlades in för varje gränssnitt om interaktionen med de blickmedvetna regionerna, tiden för att genomföra kalibreringen, antal avklarade kalibreringspunkter och avståndet mellan användarnas blick och stimuli. Ingen statistisk signifikans hittades mellan de modifierade gränssnitten mellan tidseffektivitet, effektivitet och noggrannhet. Däremot indikerades en mer tidseffektiv och effektiv kalibreringsmetod, utan minskad noggrannhet, genom användningen av ett stimuli som rör sig snabbare med blickmedvetna regioner som växer. Dessutom skulle kalibreringsprocessen kunna förbättras om enbart engagemang med skärmen används genom smooth-pursuit kalibrering
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Användning av Alternativ och Kompletterande Kommunikation i grundsärskolan : Elever på tidig utvecklingsnivå / The use of Augmentative and Alternative Communication in special school : Students with development disabilities in early stagesÅgren, Christine January 2016 (has links)
The purpose of this study has been to examine the use of augmentative and alternative communication in special school The study examine which methods and various purpose AAC used by and with the students and what it is that determines what form to use according to educators. The research shows how important communication is for a child's cognitive development and that it is largely a question of competence on how AAC is used in special school. It is a qualitative study based on observations at three different special schools and three interviews with five educators who all work with students having development disabilities in early stages and use AAC in their daily activities. The empirical data has been analyzed from a socio-cultural perspective, focusing on the concepts of artifacts and mediation. The results show that they use both aided and unaided AAC. AAC are used to structure the day visually in schematically pictures, to enhance their speech, to help to show their intention and to help their memory. The result also shows that, according to educators, students' abilities and previous experience is crucial to which form of AAC that they will use. It is also clear that many cases the teachers themselves is the one who analyze the abilities that students have and then choose an AAC method to work with. Another factor that also influences is the financial resources allocated to special school and the teachers 'and assistants' lack of expertise in the field. The result also reveal that a very small portion of AAC use is about how students communicate with AAC, to make their opinions and voices heard in a more independent way. The conclusion is that there are many different forms of AAC in special school. The purpose of the AAC is usually about structuring and make the world more understandable to students. It is generally the student's abilities that determine what form of AAC used, but there are other factors that also affect. Financial resources and lack of expertise are some of these factors. In other words, the special teacher have in their profession an important role in which type of AKK that are used and in which knowledge those who working in special school have of AAC. / Syftet med studien är att undersöka användningen av alternativ och kompletterande kommunikation (AKK) i grundsärskolan. I studien undersöks vilka olika former och i vilka olika syften AKK används av och med eleverna, samt vad det är som avgör vilken form man använder enligt pedagogerna. Forskningen visar hur viktig kommunikationen är för ett barns kognitiva utveckling och att det till stor del handlar om kompetens på hur AKK-användningen ser ut. Studien är en kvalitativ undersökning som bygger på tre observationer i grundsärskolan samt tre intervjuer med fem pedagoger som alla arbetar med elever på tidig utvecklingsnivå och använder AKK i den dagliga verksamheten. Empirin har analyserats ur ett sociokulturellt perspektiv med fokus på begreppen artefakter och mediering. Resultatet visar på att det både används hjälpmedelsberoende och hjälpmedelsoberoende AKK. AKK används i syfte att strukturera vardagen visuellt i form av schemabilder, förstärka det talade språket, att förmedla sin vilja och som minneshjälp. Resultatet visar även på att det enligt pedagogerna är elevernas förmågor och tidigare erfarenheter som är avgörande för vilken form av AKK som används, det framgår också att det många fall är pedagogerna själva som analyserar vilka förmågor som eleverna har och därefter tar fram en AKK-metod som man arbetar med. En annan faktor som också påverkar är vilka ekonomiska resurser som tilldelats grundsärskolan samt pedagogers och assistenters brist på kompetens inom området. Resultatet visar även på att en väldigt liten del av AKK användandet handlar om hur eleverna kommunicerar med AKK för att göra sin röst hörd eller sina egna åsikter på ett mer självständigt sätt. Slutsatsen är att det finns många olika former av AKK i grundsärskolan. Syftet med AKK handlar oftast om att strukturera och göra omvärlden mer begriplig för eleverna. Det är i huvudsak elevens förmågor som avgör vilken form av AKK som används, men det finns andra faktorer som också spelar in. Ekonomiska resurser och brister i kompetens är några av dessa faktorer. Med andra ord så har specialläraren i sin profession en viktig roll i vilken typ av AKK som används och i hur kompetensen hos de som arbetar i grundsärskolan ser ut.
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Avalia??o da intelig?ncia para crian?as deficientes visuais: Constru??o de subtestes e investiga??o de suas qualidades psicom?tricas / Intelligence assessment for visually impaired children: subtest construction and investigation of psychometric properties / Evaluaci?n de la inteligencia de ni?os con discapacidad visual: construcci?n de pruebas e investigaci?n de sus cualidades psicom?tricasCampos, Carolina Rosa 13 February 2017 (has links)
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Previous issue date: 2017-02-13 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior - CAPES / Considering the importance of the inclusion of the visually impaired regarding issues investigated by Psychology, this research had the objective of continuing a process of building a battery to assess cognitive abilities of visually impaired children. The instrument, consisting of four subtests (verbal reasoning, logical, numerical and memory) which belong to the Intelligence Assessment Battery for Visually Impaired Children (PAIC-DV) and the scale of Teacher?s Perception of Visually Impaired Children?s Intelligence (EPIC-DV), was the target of a series of studies aiming for the investigation of its psychometric qualities. Different samples were used to achieve these goals: 195 children, with 30 visually impaired (type: acquired n = 8; congenital n = 12; degree: low vision n = 23; blindness n = 7) aged between seven and 12 years (M = 9.76; DP = 1.81) and 165 normal vision children, aged between seven and 12 years (M = 11.57; DP = 0.41); 15 teachers, with 10 specialized in service to the visually impaired and 5 regular education teachers, which responded to scale evaluating each of the 195 children. The results of the PAIC-DV pointed to psychometric suitability of the instrument?s factorial structure, inside a model with second-order factor (General Intelligence) and three specific factors related to the subtests Verbal Reasoning, Logical and Numeric (the Memory subtest was not inserted in the analysis). Significant differences were also found related to total scores of each subtest within the group, and normal vision children showed better results in all subtests when compared to children with visual impairment. Significant positive correlations were found in moderate magnitude and weak for most of the results in the comparison between PAIC-DV and BPR-5, as well as between the PAIC-DV and school grades and levels of internal consistency amongst 0.85 and 0.88 for each factor, indicating good precision of the instrument. EPIC-DV results showed content evidence validity through the analysis of judges and construct validity evidence by means of a model with second-order factor (General Intelligence) and four specific factors related to the subtests Verbal Reasoning, Logical, Numerical and Memory. Significant differences were found regarding the performance subtests at all, with the exception of numerical reasoning. The evaluations carried out by the teachers showed better performance of children with visual impairment in all factors (with the exception of numerical reasoning), compared to the evaluations carried out for normal vision children. Regarding the type of disability, a significant difference was found only for verbal reasoning, with better performance of children with congenital deficiency and, in relation to the degree, no significant differences were found for any factor. Considering school grades, few correlations and low magnitude have been found. The reliability, by means of internal consistency ranged from 0.94 to 0.97 for each factor, indicating good accuracy of the instrument. Supplementary analysis made through the investigation of convergent validity evidence, used the BPR-5 that indicated significant negative correlations and weak magnitude from the PAIC-DV with Logical Reasoning and Numerical Reasoning, as well as of the total score of the EPIC-DV with Numerical Reasoning test. Finally, congruence analysis was applied concerning the instruments that structure the battery, whose results indicated significant correlations as moderate positive and weak among the instruments, indicating the possibility that both are used as complements when assessing cognitive aspects of children with visual impairment. We conclude that the studies developed with the instruments brought relevant data about the importance of a specific intelligence assessment instrument for children with visual impairment, and studies with larger samples can enrich and contribute to the expansion in use of the built instrument. / Teniendo en cuenta la importancia de la inclusi?n de la discapacidad visual en las cuestiones investigadas por la psicolog?a, esta investigaci?n tuvo como objetivo continuar con el proceso de construcci?n de una bater?a de pruebas para evaluar las capacidades cognitivas de los ni?os con discapacidad visual. El instrumento consta de cuatro pruebas de rendimiento (razonamiento verbal, l?gico, num?rico y memoria) que pertenece a la Bater?a de Evaluaci?n de Inteligencia para ni?os con discapacidad visual (PAIC-DV) y la Escala de Percepci?n de Maestros acerca de la inteligencia de ni?os con discapacidad visual (EPIC -DV), que fue objeto de una serie de estudios para investigar sus cualidades psicom?tricas. Diferentes muestras se utilizaron para alcanzar estas metas: 195 ni?os, 30 discapacitados visuales (tipo: Adquirida n = 8; cong?nita n = 12; grado: baja visi?n n = 23; ceguera n = 7) con edades comprendidas entre siete y 12 a?os ( M = 9.76, SD = 1.81) y 165 ni?os videntes, con edades comprendidas entre siete y 12 a?os (M = 11,57, SD = 0,41); 15 profesores, 10 especializados en el servicio a personas con discapacidad visual y 5 maestros de escuelas regulares, que respondieron a la escala de evaluaci?n de cada uno de los 195 ni?os. Los resultados de la PAIC-DV se?alaron adecuaci?n psicom?trica de la estructura factorial del instrumento dentro de un modelo con un factor de segundo orden (inteligencia general) y tres factores espec?ficos relacionados con las pruebas de razonamiento verbal, l?gico y num?rico (prueba memoria no fue insertado en el an?lisis). Tambi?n se encontraron diferencias significativas en relaci?n al total de cada prueba en relaci?n con el grupo. Los ni?os con visi?n han obtenido mejores resultados en todas las pruebas en comparaci?n con los ni?os con discapacidad visual. En cuanto al tipo de discapacidad, no se encontraron diferencias significativas, y s?lo la prueba de la memoria mostr? diferencias significativas a favor de los ni?os con baja visi?n. Se encontraron correlaciones significativas positivas de magnitud moderada y baja para la mayor?a de los resultados en comparaci?n entre PAIC-DV y BPR-5, as? como entre PAIC-DV y los a?os escolares. Los ?ndices de consistencia interna estuvieron entre 0,85 y 0,88 para cada factor, lo que indica buen instrumento de precisi?n. Los resultados de EPIC-DV mostraron evidencia de la validez de contenido, a trav?s del an?lisis de los jueces y validez de contenido de pruebas por medio de un modelo con un factor de segundo orden (inteligencia general) y cuatro factores espec?ficos relacionados con las pruebas razonamiento verbal, l?gico, num?rico y la memoria. No se encontraron diferencias significativas con respecto al rendimiento en todas las pruebas, excepto por el razonamiento num?rico. La evaluaci?n hecha por los profesores indicaron un mejor rendimiento de los ni?os con discapacidad visual en todos los factores (excepto para el razonamiento num?rico), en comparaci?n con las evaluaciones para los ni?os videntes. En cuanto al tipo de discapacidad, no se encontraron diferencias significativas, s?lo para el razonamiento verbal, con un mejor rendimiento de los ni?os con discapacidad cong?nita y en relaci?n al grado, no hubo diferencias significativas para cualquier factor. En cuanto a los a?os escolares, se encontraron pocas correlaciones y baja magnitud. La precisi?n a trav?s de la consistencia interna vari? de 0,94 a la 0,97 para cada factor, lo que indica buen instrumento de precisi?n. Posterior an?lisis de investigaci?n de validez convergente con la BPR-5 ha indicado correlaciones significativas negativas y de baja magnitud de PAIC-DV con el Razonamiento L?gico y el factor de Razonamiento Num?rico, as? como el total de la EPIC -DV con la prueba de Razonamiento Num?rico. Por ?ltimo, se realiz? un an?lisis de congruencia entre los instrumentos que componen la bater?a y la escala. Los resultados mostraron correlaciones significativas moderadas y d?biles positivas entre los instrumentos de forma que indique la posibilidad de que ambos se utilizan de manera complementaria en la evaluaci?n cognitiva de los ni?os con discapacidades visual. Se concluye que los estudios llevados a cabo con el instrumento trajeron datos relevantes sobre la importancia de un instrumento espec?fico para evaluar la inteligencia de los ni?os con discapacidad visual y que los estudios con muestras m?s grandes pueden enriquecer y contribuir a la expansi?n del uso del instrumento construido. / Considerando a necessidade da inclus?o do deficiente visual nas quest?es investigadas pela Psicologia, bem como a garantia de igualdade nas avalia??es psicol?gicas realizadas, essa pesquisa teve como objetivo a continua??o do processo de constru??o de uma bateria de testes para avalia??o das habilidades cognitivas de crian?as deficientes visuais. O instrumento, composto por quatro subtestes de execu??o (racioc?nio verbal, l?gico, num?rico e mem?ria) pertencentes ? Provas de Avalia??o da Intelig?ncia para Crian?as Deficientes Visuais (PAIC- DV) e pela Escala de Percep??o de Professores da Intelig?ncia de Crian?as deficientes visuais (EPIC-DV), foi alvo de uma s?rie de estudos visando a investiga??o das suas qualidades psicom?tricas. Diferentes amostras foram utilizadas para alcan?ar esses objetivos: 195 crian?as, sendo 30 deficientes visuais (tipo: adquirida n= 8; cong?nita n=12; grau: baixa vis?o n= 23; cegueira n= 7) com idades entre sete e 12 anos (M= 9,76; DP= 1,81) e 165 crian?as normovisuais, com idades entre sete e 12 anos (M= 11,57; DP= 0,41); 15 professores, sendo 10 especializados no atendimento a deficientes visuais e 5 professores de ensino regular, os quais responderam a escala avaliando cada uma das 195 crian?as, assim como um grupo de ju?zes especialistas na ?rea de avalia??o psicol?gica. Os resultados do conjunto PAIC-DV apontaram adequa??o psicom?trica da estrutura fatorial do instrumento, dentro de um modelo com fator de segunda ordem (intelig?ncia geral) e tr?s fatores espec?ficos relacionados aos subtestes Racioc?nio Verbal, L?gico e Num?rico. Foram encontradas diferen?as significativas em rela??o ao total de acertos de cada subteste em rela??o a grupo (crian?as normovisuais apresentaram melhores resultados em todos os subtestes em compara??o com as crian?as com defici?ncia visual), o mesmo n?o ocorrendo em rela??o ao tipo de defici?ncia (somente o subteste de Mem?ria apresentou diferen?as significativas a favor das crian?as com baixa vis?o). Foram encontradas correla??es significativas positivas de magnitude moderada e fraca para a maioria dos resultados na compara??o entre PAIC-DV e BPR-5, bem como entre o conjunto PAIC-DV e as notas escolares, tomados como crit?rio externo. ?ndices de consist?ncia interna entre 0,85 e 0,88 foram encontrados para cada fator, indicando boa precis?o do instrumento. Os resultados da EPIC-DV, por sua vez, apresentaram evid?ncias de validade de conte?do, por meio da an?lise de ju?zes e evid?ncias de validade de construto por meio de um modelo com fator de segunda ordem (intelig?ncia geral) e quatro fatores espec?ficos relacionados aos subtestes Racioc?nio Verbal, L?gico, Num?rico e Mem?ria. Diferen?as significativas em rela??o ao desempenho em todos os subtestes, com exce??o do racioc?nio num?rico, a favor das crian?as com defici?ncia visual em todos os fatores (com exce??o do racioc?nio num?rico). Em rela??o ao tipo de defici?ncia, diferen?a significativa foi encontrada apenas para o racioc?nio verbal, com melhor desempenho das crian?as com defici?ncia cong?nita e, em rela??o ao grau, n?o foram encontradas diferen?as significativas para nenhum fator. Em rela??o ?s notas escolares, poucas correla??es e de baixa magnitude foram encontradas. A precis?o, por meio da consist?ncia interna variou entre 0,94 e 0,97 para cada fator, indicando boa precis?o do instrumento. An?lise complementar, por meio da investiga??o de evid?ncias de validade convergente, usando-se a Bateria de Provas de Racioc?nio 5 indicou correla??es significativas negativas e de magnitude fraca da PAIC-DV com o fator Racioc?nio L?gico e Racioc?nio Num?rico, bem como do Total da EPIC-DV com a prova de Racioc?nio Num?rico. Por fim, foi realizada an?lise de congru?ncia entre os instrumentos que comp?em a bateria, cujos resultados indicaram correla??es significativas positivas moderadas e fracas entre os instrumentos, de modo a indicar a possibilidade de que ambos sejam usados de forma complementar na avalia??o cognitiva de crian?as com defici?ncia visual. Conclui-se que os estudos desenvolvidos com o instrumental trouxeram dados relevantes quanto ? import?ncia de um instrumento espec?fico de avalia??o da intelig?ncia para crian?as com defici?ncia visual e que, estudos com amostras maiores podem enriquecer e contribuir para a expans?o do uso do instrumento constru?do.
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