This study aims to determine the interrater reliability and the clinical utility of the NSASA. It also aims to develop a training package that can be used for future sharing of the NSASA with clinicians internationally.
The aims of this study are to:
- determine the inter-rater reliability of the Novita Switch Access Solutions Assessment (NSASA)
- develop a training package that can be used for future training of clinicians in the use of the NSASA
- assess the clinical utility of the NSASA based on the data from the Occupational Therapist (OT) assessors’ feedback survey for each video scored using the Clinician Confidence in Scoring the Novita Switch Access Solution Assessment.
This latter activity will permit final adjustments to the training protocol and scoring to optimize ease of use of the NSASA.
Children with severe and multiple disabilities may require assistance to fully participate and engage with the world around them. Access to assistive technology enables children to learn, play, and communicate within their home, school or community. Some children need switches to use assistive devices. For access to be successful the prescribed switch must fit the child’s individual needs and abilities. The complexity of switch access presents many challenges for clinicians involved in the assessment and planning for the use of assistive technology by children with severe and multiple disabilities.
The Novita Switch Access Solutions Assessment (NSASA) was developed at Novita Children’s Services (Novita) by OTs with assistive technology expertise to address the current lack of standardised, valid and reliable evaluation and outcome measures for use of switch access technologies.
A total of 24 Novita clients will be recruited for the study.
- Ages 12 months to 18 years
- Any neurological/neuromuscular/musculoskeletal condition
- MACS Levels III to V or equivalent level of function if there is no diagnosis of Cerebral Palsy
- Some active movement head/trunk/extremity to enable switch activation.
- MACS level I to II or equivalent level of function if there is no diagnosis of Cerebral Palsy
- Ability to direct access and use mainstream assistive technology such as touch screen, keyboard, mouse.
The study involves:
- Further development of the Novita Switch Access Solutions Assessment and Training materials.
Four children who are current switch users will be involved in the training video series. The training video creation process will consist of the child attending a single NSASA session, whereby the child will be asked to do one or more switching activities they are familiar with for 20 – 30 minutes.
- OT Assessor Training
Two OT assessors will be trained on how to score the NSASA using the training videos to reach a minimum 80% (competence level) test score.
- Reliability Evaluation
To establish inter-rater reliability of the NSASA, another 20 study videos will be independently scored by the two OT assessors.
Potential outcomes and implications?
For children and families
Successful switch prescription and use of related assistive technology enables children with severe and multiple disabilities to learn, communicate and play. It is anticipated that the better suited the switch set-up is to the child’s abilities and needs, the more likely they are to adopt it and continue its use. The use of a valid and reliable outcome measure will also reduce the likelihood of prolonged, less than optimal trials or repeat trials of previously unsuccessful switch access methods.
The ability of clinicians to accurately record a child’s switching ability and monitor this over time will ensure that children are provided with the most appropriate switching technology across the developmental continuum, and training can be tailored to specific areas of skill acquisition. The use of the NSASA as an outcome measure would provide the much-needed opportunity for empirically determining the comparative impact of different switch training programs and also allow comparison of the impact of different switches on a child’s switching abilities/access.
Annabelle Tilbrook, Senior Occupational Therapist, Assistive Technology Service, Novita Children’s Services
Dr Toan Nguyen, Senior Rehabilitation Engineer, Knowledge & Innovation, Novita Children’s Services
A/Prof Virginia Wright, Senior Scientist, Holland Bloorview Kids Rehabilitation Hospital, Bloorview Research Institute
(08) 8349 2023