Hee-Tae Jung

Purpose: Discourse production tasks are widely used to assess language across clinical and research contexts. Virtual reality (VR) offers an alternative discourse elicitation modality by providing immersive 3-D environments that may influence language production differently from traditional picture-based tasks. This study examined whether immersive VR affects discourse production compared with traditional picture description tasks as well as how younger and older adults perceive the usability and acceptability of and relative preference for each modality. Method: Forty-five younger and 33 older neurotypical adults described two widely studied images (Cookie Theft and Cat Rescue), presented either as colored 2-D images or as immersive 3-D VR environments. Participants completed both modalities in a counterbalanced order and completed a posttask VR usability survey. Discourse samples were analyzed for total utterances, total words, mean length of utterance (MLU), proportion of open- and closed-class words, moving-average type–token ratio (MATTR), and embedded clauses. Results: Significant main effects of group and modality emerged for total utterances and total words, such that older adults produced more language overall and participants produced more language in VR than in the 2-D condition. A significant interaction between group and modality emerged for MLU, such that modality effects were observed only in older adults. Older adults also produced relatively more open-class and fewer closed-class words in VR, whereas younger adults showed no modality effects. Embedded clause production and MATTR did not vary by group or modality. Survey responses indicated positive engagement in both groups, although older adults reported greater difficulty with VR. Conclusions: VR increases language production across age groups but differentially affects aspects of language production in older adults. These findings highlight both the potential and the practical constraints of using immersive VR for language assessment and discourse elicitation. Supplemental Material: https://doi.org/10.23641/asha.33345684

Serious games are an effective means to help children with ADHD improve their attention and impulse control. As prior works primarily focused on clinical benefits, the relationship among serious games, children, and their caregivers remains underexplored. To bridge this knowledge gap, we conducted a two-stage study: (1) with nine educators specialized in ADHD in clinical settings and (2) with seven dyads of children and their caregivers in home settings. To facilitate the study, we developed and deployed NeuroWorld DTx v1.0 , a suite of five games that train children to improve their attention capacity. Our analysis found that children demonstrated self-efficacy, engagement, and adherence despite NeuroWorld being less fun than entertainment games. Additionally, most caregivers emphasized the importance of educational aspects over entertainment aspects. Collectively, our findings provide novel insights into how serious games could be developed and deployed for at-home use among children with ADHD.

This paper examines the complex dynamics of shift assignment in agency-based home care settings, emphasizing the essential but overlooked role of care coordinators. Drawing on 18 qualitative interviews with home care aides and coordinators from three U.S. agencies, our findings reveal the work coordinators do to enable the aide-client relationships at the heart of home care. Coordinators act as both logisticians and matchmakers, trying to meet the needs of their clients with a limited and ever-changing pool of aides, all of whom have their own unique identities and needs. To do so, they draw on their own relationships with aides and other coordinators. Home care management software assists coordinators, but it cannot function without the social infrastructure they help to maintain. This study challenges the current focus of both technology designers and researchers, advocating for a perspective that recognizes the importance of relationships in home care and the interdependence of aides, clients, and coordinators.

Purpose: The study highlights the significance of continuous support and services in communication, socialization, and literacy skills for adults with developmental disabilities (DDs). The aim of the study was to gather in-depth information on the individualized needs, lived experiences, and expectations of adults with DD by interviewing their parents. Method: A total of 14 parents of adults with DD participated in one-on-one semistructured interviews. During the interviews, parents were asked to describe (a) their children's current communication, socialization, reading and writing skills; (b) the types of communication, socialization, and literacy support their children were receiving; and (c) the types of support that their children needed. Interviews were video- and audio-recorded, transcribed, and analyzed qualitatively using thematic analysis. Results: Thematic analysis revealed three main themes and eight subthemes: (1) insufficient support and services for adults with DD (i.e., lack of competent professionals and lack of literacy support), (2) approaches that the parents attempted for their children with DD (i.e., parents' responsibilities, technologies, and pseudoscience), and (3) recommendations for ongoing support and services (i.e., novel technologies, social media, and motivation). Conclusions: The study highlights crucial gaps between the participating parents' desire for individualized, consistent, and innovative support and services for their adult children with DD and scarcity of resources in communication, socialization, and literacy. The dearth of evidence-based support and resources leads to easy access to pseudoscience. Future research is warranted to develop innovative, customized, and highly motivating programs in communication, socialization, and literacy for adults with DD. Supplemental Material: https://doi.org/10.23641/asha.27214407

Dog guides are favored by blind and low-vision (BLV) individuals for their ability to enhance independence and confidence by reducing safety concerns and increasing navigation efficiency compared to traditional mobility aids. However, only a relatively small proportion of BLV individuals work with dog guides due to their limited availability and associated maintenance responsibilities. There is considerable recent interest in addressing this challenge by developing legged guide dog robots. This study was designed to determine critical aspects of the handler-guide dog interaction and better understand handler needs to inform guide dog robot development. We conducted semi-structured interviews and observation sessions with 23 dog guide handlers and 5 trainers. Thematic analysis revealed critical limitations in guide dog work, desired personalization in handler-guide dog interaction, and important perspectives on future guide dog robots. Grounded on these findings, we discuss pivotal design insights for guide dog robots aimed for adoption within the BLV community.

Background: The key for successful stroke upper-limb rehabilitation includes the personalization of therapeutic interventions based on patients’ functional ability and performance level. However, therapists often encounter challenges in supporting personalized rehabilitation due to the lack of information about how stroke survivors use their stroke-affected arm outside the clinic. Wearable technologies have been considered as an effective, objective solution to monitor patients’ arm use patterns in their naturalistic environments. However, these technologies have remained a proof of concept and have not been adopted as mainstream therapeutic products, and we lack understanding of how key stakeholders perceive the use of wearable technologies in their practice.Objective: We aim to understand how stroke survivors and therapists perceive and envision the use of wearable sensors and arm activity data in practical settings and how we could design a wearable-based performance monitoring system to better support the needs of the stakeholders.Methods: We conducted semi-structured interviews with four stroke survivors and 15 occupational therapists (OTs) based on real-world arm use data that we collected for contextualization. To situate our participants, we leveraged a pair of finger-worn accelerometers to collect stroke survivors’ arm use data in real-world settings, which we used to create study probes for stroke survivors and OTs, respectively. The interview data was analyzed using the thematic approach.Results: Our study unveiled a detailed account of (1) the receptiveness of stroke survivors and OTs for using wearable sensors in clinical practice, (2) OTs’ envisioned strategies to utilize patient-generated sensor data in the light of providing patients with personalized therapy programs, and (3) practical challenges and design considerations to address for the accelerated integration of wearable systems into their practice.Conclusions: These findings offer promising directions for the design of a wearable solution that supports OTs to develop individually-tailored therapy programs for stroke survivors to improve their affected arm use.

Despite the harmful effect on health, e-cigarette and hookah smoking in youth in the U.S. has increased. Developing tailored e-cigarette and hookah cessation programs for youth is imperative. The aim of this study was to identify predictor variables such as social, mental, and environmental determinants that cause nicotine addiction in youth e-cigarette or hookah users and build nicotine addiction prediction models using machine learning algorithms. A total of 6511 participants were identified as ever having used e-cigarettes or hookah from the National Youth Tobacco Survey (2019) datasets. Prediction models were built by Random Forest with ReliefF and Least Absolute Shrinkage and Selection Operator (LASSO). ReliefF identified important predictor variables, and the Davies–Bouldin clustering evaluation index selected the optimal number of predictors for Random Forest. A total of 193 predictor variables were included in the final analysis. Performance of prediction models was measured by Root Mean Square Error (RMSE) and Confusion Matrix. The results suggested high performance of prediction. Identified predictor variables were aligned with previous research. The noble predictors found, such as ‘witnessed e-cigarette use in their household’ and ‘perception of their tobacco use’, could be used in public awareness or targeted e-cigarette and hookah youth education and for policymakers.

Upper-limb impairments due to stroke can severely affect the quality of life in patients. Scientific evidence supports that repetitive rehabilitation exercises can improve motor ability in stroke patients. Rehabilitation games gained tremendous interest among researchers and clinicians because of their potential to make the seemingly mundane, enduring rehabilitation therapies more engaging. However, routine and longitudinal use of rehabilitation games in real-world clinical settings has not been investigated in depth. Particularly, we know little about current practices, challenges, and their potential impacts on therapeutic outcomes. To address this gap, we established a partnership with a rehabilitation hospital where game-assisted rehabilitation was routinely employed over a 2-year period. We then conducted an observational study, in which we observed 11 game-assisted therapy sessions and interviewed 15 therapists who moderated the therapy. Significant findings include (1) different engagement patterns of stroke patients in game-assisted therapy, (2) imperative roles of therapists in moderating games and challenges that therapists face during game-assisted therapy, and (3) lack of support for therapists in delivering patient-centered, personalized therapy to individual stroke patients. Furthermore, we discuss design implications for more effective rehabilitation game therapies that take into consideration both patients and therapists and their specific needs.