An Integrated Approach to Detecting Communicative Intent Amid Hyperkinetic Movements in Children

Abstract

Children with hyperkinetic movement (HKM) often have limited access to traditional augmentative and alternative communication technologies (e.g., mechanical switches). To seek a communication solution for these children, this study explored the possibility that discernable biomechanical patterns, related to preference, exist amid HKM. We deployed a unified approach to analyse a child's movements, fusing caregiver and clinician observations with quantitative data (accelerations of the upper extremities). Two case studies were examined. In both, the accelerometer data identified preference at adjusted accuracies statistically above chance using a linear discriminant classifier. Visually, communicative movement patterns were identified in the first child (κ=0.25-0.27) but not in the second child (κ=0.03-0.11). Implications of this study include possible enhancement in communication and independence for these children.

E-textiles in Clinical Rehabilitation: A Scoping Review

“…For example, such quantification can reveal changes in movement performance due to development, injury, recovery, therapy or assistive technology. The measurement of movement can also be used to decode communicative intent in non-verbal individuals [71] and to predict adverse events, such as falls or loss of balance [72]. Long-term compliance to therapy, particularly in the community, may benefit from remote monitoring through wearable systems that sense movement.…”

Trends in Communicative Access Solutions for Children With Cerebral Palsy

“…12 For those with some controlled movement, standard (eg, trackballs, joysticks, mice, and keyboards) or adapted (eg, mechanical switches) input devices can facilitate access to communication via specialized augmentative and alternative communication hardware (Table 1) or augmentative and alternative communication software applications (Table 2) on generic computing platforms. For those capable of deictic gestures (eg, pointing), capacitive and resistive touch screen technologies offer direct access to communication devices and applications (eg, Noren et al 9 ). Likewise, individuals who can control intraoral air pressure (eg, via buccinator muscles and diaphragm) may be able to operate a ''sip and puff'' switch.…”

“…[53][54][55] Accelerometry has also been exploited for the automatic decoding of preferences of nonverbal children with hyperkinetic movements. 56 Although the above-cited studies present some promising early case evidence, the general effectiveness of these passive access modalities remains to be proven. A fundamental challenge in establishing effectiveness is the absence of ground truth; that is, these children and youth cannot confirm the verity of the inferred state or response, and often a subjective proxy validation (eg, parent or familiar caregiver) is all that is available.…”

“…These forms of communication require some degree of motor control on the part of the child. On the other hand, interpretation of such communicative attempts requires that the communication partner possess a high degree of familiarity with the child, including his or her behavioral idiosyncrasies, movement patterns, 9 personal preferences, 10 and daily routine. Successful communication also necessitates close attention to subtle physical cues, such as changes in the child’s body posture, eye gaze, facial expressions, vocalizations, and muscle tone.…”