Search

It is estimated that approximately 97 million people in the world have complex communication needs and may benefit from alternative and augmentative communication (AAC). Although AAC is considered an evidenced-based intervention, device abandonment remains common, and researchers have attempted to analyze the causes of people abandoning devices. These devices have been prescribed following extensive assessment and often a protracted period of negotiation with a funding body. In this paper, we present the process of AAC prescription using a new model called the Communication Capability Approach by adding the Capability Approach from Amartya Sen to the widely used Participation Model. This allows clinicians to see individual daily decision-making as a valid choice of the individual. We propose reframing the concept of device abandonment as the person and their family making a choice to use a full range of multimodal communication to meet their own needs. This changes the tone of the narrative to viewing the person using AAC as competent and able to exercise self-determination and agency in this decision rather than as abandoning the device. AAC choices can be made on a day-to-day basis, according to the context of use so that people do not abandon devices but rather use whichever mode of communication is appropriate to the context.

Disability and ableism exist within a societal context that does not ignore the many facets of a person's identity, however often our disability research does not recognize how experiences vary based on the intersecting identities individuals hold. This article utilizes Intersectionality, Dis/ability Critical Race Studies (DisCrit), and Disability Justice to identify ways for rehabilitation researchers to adapt their research practices for maximum inclusivity and representation. Using these three frameworks, we have developed a call to action including recommendations for rehabilitation researchers to consider as they design and implement research projects. Incorporating these frameworks provides an opportunity to reimagine current research practices An accessible approach can help researchers better understand and report on the nuances of intersecting identities on the lives of disabled people. Disability identity and ableism must be viewed intersectionally, and disability related research must attend to the many facets of a person's identity. Intersectionality, DisCrit, and Disability Justice provide useful frameworks through which we can conduct more inclusive and accessible disability research. We present a call-to-action including seven general considerations that researchers can implement to guide the development of intersectional and inclusive disability research. [ABSTRACT FROM AUTHOR]

BackgroundImplementing exercises in the form of video games, otherwise known as exergaming, has gained recent attention as a way to combat health issues resulting from sedentary lifestyles. However, these exergaming apps have not been developed for exercises that can be performed in wheelchairs, and they tend to rely on whole-body movements. ObjectiveThis study aims to develop a mobile phone app that implements electromyography (EMG)-driven exergaming, to test the feasibility of using this app to enable people in wheelchairs to perform exergames independently and flexibly in their own home, and to assess the perceived usefulness and usability of this mobile health system. MethodsWe developed an Android mobile phone app (Workout on Wheels, WOW-Mobile) that senses upper limb muscle activity (EMG) from wireless body-worn sensors to drive 3 different video games that implement upper limb exercises designed for people in wheelchairs. Cloud server recordings of EMG enabled long-term monitoring and feedback as well as multiplayer gaming. Bench testing of data transmission and power consumption were tested. Pilot testing was conducted on 4 individuals with spinal cord injury. Each had a WOW-Mobile system at home for 8 weeks. We measured the minutes for which the app was used and the exergames were played, and we integrated EMG as a measure of energy expended. We also conducted a perceived usefulness and usability questionnaire. ResultsBench test results revealed that the app meets performance specifications to enable real-time gaming, cloud storage of data, and live cloud server transmission for multiplayer gaming. The EMG sampling rate of 64 samples per second, in combination with zero-loss data communication with the cloud server within a 10-m range, provided seamless control over the app exergames and allowed for offline data analysis. Each participant successfully used the WOW-Mobile system at home for 8 weeks, using the app for an average of 146 (range 89-267) minutes per week with the system, actively exergaming for an average of 53% of that time (39%-59%). Energy expenditure, as measured by integrated EMG, was found to be directly proportional to the time spent on the app (Pearson correlation coefficient, r=0.57-0.86, depending on the game). Of the 4 participants, 2 did not exercise regularly before the study; these 2 participants increased from reportedly exercising close to 0 minutes per week to exergaming 58 and 158 minutes on average using the WOW-Mobile fitness system. The perceived usefulness of WOW-Mobile in motivating participants to exercise averaged 4.5 on a 5-point Likert scale and averaged 5 for the 3 participants with thoracic level injuries. The mean overall ease of use score was 4.25 out of 5. ConclusionsMobile app exergames driven by EMG have promising potential for encouraging and facilitating fitness for individuals in wheelchairs who have maintained arm and hand mobility.

Purpose: To explore the perspectives and practices of speech-language pathologists on dosage of swallowing exercises in stroke rehabilitation. Method: Online focus groups involved 20 speech-language pathologists working in various settings across Australia. Focus group data were recorded, deidentified, and analysed using inductive thematic analysis guided by an interpretivist phenomenological approach. Result: Analysis resulted in four main themes: (1) "Getting the most bang for your buck": Importance of dosage in swallowing, (2) "No patient is identical": Personalising swallowing exercise dosage to the patient, (3) "You've got what you should do, and then what you can do": Gap between recommendations and practical application, and (4) "Not much guidance out there about dosage": More research needed to guide dosage. Speech-language pathologists agreed that dosage was theoretically important for swallowing exercises, but practical application of dosage was impacted by patient factors, limited access to resources, and lack of research-based guidelines. Conclusion: Speech-language pathologists reported trying to provide optimal care despite multiple barriers to prescribing dosages of swallowing exercises in practice. Personalising exercise dosage to the patient, creative clinician strategies, improved and equitable access to resources, and research-based guidelines on swallowing exercise dosages are needed to address these barriers. [ABSTRACT FROM AUTHOR]

Research has shown that using telehealth for rehabilitation assessment can be an effective approach. The COVID-19 pandemic and subsequent lockdowns led to many rehabilitation counselors pivoting to telehealth assessment with their clients. This study explores rehabilitation counselors' use of rehabilitation assessments and telehealth since the beginning of the COVID-19 pandemic. Using a mixed-methods approach, the researchers analyzed data from 41 rehabilitation counselors across Australia. Participants were asked which measures they used prior to the pandemic, how their use of the measures changed during telehealth, and how their work changed due to the COVID-19 pandemic. The Depression Anxiety Stress Scales and the Occupational Search Inventory were the most commonly used tests. Theoretical analysis demonstrated that participants utilized tests based on their usefulness in comprehensive assessment and rehabilitation planning, for engaging the client in the assessment process, out of necessity (mandated tests), and due to attributes of the test the counselor valued. Participants described the impact of COVID-19 on assessment practice, demonstrating that despite challenges to telehealth, there were also benefits and that assessment measures could be altered for use in telehealth. Although telehealth had an impact on how rehabilitation counselors provided assessments, many found ways to make it work at a distance. [ABSTRACT FROM AUTHOR]

This study examined the effect of rehabilitation counseling students' age, sex, disability status, geographic location, marital status, religion, sexual orientation, and level of sexuality training on knowledge, comfort, approach, and attitudes toward the sexuality of people with disabilities. Participants were 312 rehabilitation counseling master's students in Council on Rehabilitation Education (CORE) accredited programs all over the United States. Multivariate analysis of variance (MANOVA) analyses demonstrated that Knowledge scores were affected by intensity of training. Other subscale scores indicated that rehabilitation counseling students had generally negative attitudes toward sex and disability and low levels of comfort with approaches from clients. Results demonstrate the importance of rehabilitation counselor educators incorporating the topic of sex and disability in training programs so that graduating students have the knowledge and comfort necessary to discus sex with their clients with disabilities.

Given the importance of supervision in the counseling fields for facilitating trainee growth, the frequency, type, and delivery of supervision varies widely and can be limited or nonexistent (Pearson, 2004). Thus, a supervisor in any counseling profession must have strong supervisory skills that match the needs of the trainee, even if their professional skills and background differ (Davies et al., 2004). This study examined the effectiveness of a professional development training for school counseling, rehabilitation counseling and school psychology site supervisors. Results demonstrated significant improvements in participant confidence in Managing Supervision as well as general improvements in self-reported self-efficacy. Future directions for supporting the ongoing professional development of supervisors is discussed. [ABSTRACT FROM AUTHOR]

This article reviews basic conceptions of death and dying in the context of people who have disabilities and chronicmedical conditions. The authors take a developmental approach in discussing issues pertinent to the Rehabilitation Counseling profession and the role of the Counselor in providing services to clients on this subject. The second part of this article describes cultural views on death, dying and disability from the viewpoint of five cultures. [ABSTRACT FROM AUTHOR]

Pregnancy in multiple sclerosis (MS) is considered safe for both the woman and the child. Nevertheless, pregnancy issues in MS are complex both from a patient's and a provider's perspective. In an anonymous survey, 28 healthcare providers in the United States reported on the management of multiple sclerosis (MS) during pregnancy. Participants were asked about their recommendations to patients about the use of disease modifying therapies during pregnancy and breastfeeding and general recommendations about MS and pregnancy. Healthcare providers were also asked about sources from which they receive information about the management of patients with MS. Results suggested that healthcare providers do not discourage pregnancy for women with MS, recommend that women not use disease modifying therapies while pregnant, and have a positive view of breastfeeding for women with MS. Results also indicated the need for guidelines on patient management for pregnant women with MS. [ABSTRACT FROM AUTHOR]

Sexuality is an important topic in rehabilitation counseling. Nonetheless, little is known about the state of training on sexuality for rehabilitation counseling students. This study surveyed rehabilitation counseling students on how much training they received on sexuality during their education. Less than half of the sample reported receiving graduate-level training on sexuality. Implications for research, training, and practice are discussed. [ABSTRACT FROM PUBLISHER]