Shira Yalon-Chamovitz

Improving physical fitness of individuals with intellectual and developmental disability through a Virtual Reality Intervention Program

Individuals with intellectual and developmental disabilities (IDD) are in need of effective physical fitness training programs. The aim was to test the effectiveness of a Virtual Reality (VR)-based exercise program in improving the physical fitness of adults with IDD. A research group (N=30; mean age=52.3+/-5.8 years; moderate IDD level) was matched for age, IDD level and functional abilities with a control group (N=30, mean age=54.3+/-5.4 years). A 5-6 week fitness program consisting of two 30 min sessions per week included game-like exercises provided by the Sony PlayStation II EyeToy VR system. Changes in physical fitness were monitored by the Energy Expenditure Index (EEI), the modified 12 min walk/run and the Total Heart Beat Index (THBI). Significant (p<0.05) improvements in physical fitness were demonstrated for the research group in comparison to the control group for the Modified Cooper test and the THBI but not for the EEI test. The EEI, Modified Cooper and THBI tests were found feasible to evaluate physical fitness levels and change of individuals with IDD under clinical conditions. VR technology intervention was suitable for adults with IDD and resulted in significant improvements in the physical fitness levels of the participants.

Virtual reality as means to improve physical fitness of individuals at a severe level of intellectual and developmental disability.

Individuals with intellectual and developmental disabilities (IDD) are in need of effective and motivating physical fitness training programs. The aim was to test the effectiveness of a virtual reality (VR)-based exercise program in improving the physical fitness of adults with severe IDD when implemented by on-site caregivers. A research group (N=20; mean age+/-standard deviation=47.9+/-8.6 years; severe IDD level) was matched for age, IDD level and functional abilities with a comparison group (N=24, mean age=46.2+/-9.3 years; severe IDD level). An 8-week fitness program consisting of 2-3 30-min sessions per week included game-like exercises provided by the IREX/GX video capture VR system. Changes in physical fitness were monitored by changes in heart rate at rest. A significant (P<0.005) reduction in heart rate was demonstrated for the research group. No change in heart rate was monitored in the comparison group. Despite statistically significant improvements in heart rate, the results are not strong enough functionally to claim that this program improved physical fitness of individuals with severe intellectual disability.

Deconstructing Hierarchies: A Pedagogical Model with Service User Co-Teachers

This article examines the contribution of partnering with service users to the training of health and welfare professionals in Israel. These professions, while professing a shift to the social model of disability, still practise according to a medical model, which functions to strengthen the legitimacy of the professional and sustain the dependency of their clients. In adopting the social model of disability, we present a new pedagogic model in which social work students engage throughout the course with a co-teacher service user to contest these traditional methods and deconstruct accepted hierarchies. This teaching method focuses on the development of a new therapeutic dialogue within the partnerships created in the classroom, which enables the students and co-teachers to participate in the challenging experience of integrating theoretical knowledge with lived knowledge, thereby contributing to the development of a more inclusive knowledge base.

Training Caregivers to Provide Virtual Reality Intervention for Adults with Severe Intellectual and Developmental Disability

Background. Individuals with intellectual and developmental disabilities (IDD) are in need of effective physical fitness training programs, leisure time opportunities, and strategies to improve their participation in daily life activities.1 Purpose. This study sought to present an educational program that enabled the implementation of a virtual reality (VR) program operated by in‐house caregivers for adults at a severe level of IDD. Methods. During the initial stages of this series of studies, 2 groups of participants underwent a video‐capture, VR‐based, game‐like, exercise program. The first study group (N = 33; mean age = 28.1 ± 5.3 years; moderate IDD) was trained by an experienced occupational therapist, and the second study group (N = 30; mean age = 52.3 ± 5.8 years; moderate IDD) was trained by occupational therapy students. Changes in physical fitness were monitored for all participants in comparison to matched control groups. A third study group (N = 20; mean age = 48.1 ± 8.6 years; severe IDD) was trained by in‐house caregiver staff. An educational program including gathering appropriate caregivers, presenting theoretical background for the program, as well as providing on going technical support was implemented. Results. The strategy used to enable the implementation of a VR program by in‐house caregivers was shown to be feasible. The VR intervention program promoted activity and was motivating to and enjoyable by all participants with mild to moderate IDD and to most individuals with severe IDD. Significant (P < .05) improvements in physical fitness were demonstrated for all research groups in comparison to the matched control groups, supporting the effectiveness of this educational program. Conclusion. VR technology was found as fully effective tool to engage adults with mild to moderate IDD, and some with severe levels of IDD, in a variety of activities by caregivers from different educational backgrounds and professions.

Lessons learned towards a best practices model of virtual reality intervention for individuals with intellectual and developmental disability

Individuals with intellectual and developmental disabilities (IDD) are in need of effective physical fitness training programs, leisure time opportunities and strategies to improve their participation. The overall objective was to gather “lessons learned” towards the formulation of a best practices model for the application of VR intervention for adults with IDD. During study 1 a group of 33 participants (mean age = 28.1 ± 5.3 years; moderate IDD level) underwent a 12 week program of 2–3 30 minute sessions per week consisting of game-like exercises provided by the GestureTeks IREX VR operated by an occupational therapist. During study 2 a research group (N=30; mean age = 52.3 ± 5.8 years; moderate IDD level) participated in a 6 week fitness program of three 30 minute sessions per week consisting of game-like exercises provided by the Sony PlayStation II EyeToy VR system. Changes in physical fitness were monitored by the Energy Expenditure Index (EEI), the modified 12 min walk\run and the Total Heart Beat Index (THBI). Results were compared to a control group (N=30, mean age = 54.3 ± 5.4 years). During study 3, 24 participants with severe levels of IDD (N=30; mean age = 52.3 ± 5.8 years; moderate IDD level) were matched for age, IDD level and functional abilities with a control group (N=30, mean age = 54.3 ± 5.4 years). The research group participated in an 8 week VR program (3 times per week) using GestureTeks IREX video capture technology operated by the local caregiver staff. The VR programs were found to attract full participation by the participants at moderate levels of IDD but some difficulties were found in fully engaging all individuals at severe levels of IDD. Different commercial VR systems were used and were found to be usable by health-profession students and local caregiver staff. Significant (P≪0.05) improvements in physical fitness were demonstrated for the research group in comparison to the control group. VR technology is an effective tool to engage individuals with IDD in a variety of activities by operators of different educational background and professions. VR technology could be successfully operated for adults at mild, moderate and severe levels of IDD and VR technology resulted in significant improvements in the physical fitness levels of the participants. Further research is needed to complete the construction of a “best practice” model.

Enhancing classroom participation of students with intellectual and developmental disabilities

Background. Students with intellectual and developmental disabilities (IDD) have been found to participate less in school-based activities. Purpose. This study aimed to examine the effectiveness of a combined in-service and collaborative consultation intervention model for enhancing classroom participation of students with IDD. Method. The Collaborative Consultation for Participation of Students With IDD (Co-PID) program involved a multidisciplinary team (an occupational therapist and 17 teachers) as well as 35 students and was compared to an in-service program (20 teachers and 34 students). Students were 8 to 20 years old. The programs aimed to enhance three classroom participation components: communicating, choosing, and initiating. Findings. The Co-PID was found to significantly improve students’ participation in all areas, whereas the participation of the students in the in-service group decreased. Implications. A school-based multidisciplinary intervention program for students with IDD, combining in-service and collaborative consultation (e.g., Co-PID), may assist in enhancing classroom participation among students with IDD.

Interpersonal social responsibility model of service learning: A longitudinal study

Abstract Background: Service-learning (SL) is commonly used in Occupational Therapy (OT) programs worldwide as a community placement educational strategy. However, most SL models are not clearly defined in terms of both methodology and learning outcomes. Objectives: This longitudinal study explores a structured model of Service-Learning (Interpersonal Social Responsibility-Service Learning: ISR-SL) aimed towards the development of professional identity among OT students. Based on OT students experiences from the end of the course through later stages as mature students and professionals. Material and methods: A qualitative research design was used to explore the perceptions and experiences of 150 first, second, and third-year OT students and graduates who have participated in ISR-SL during their first academic year. Results: Our findings suggest that the structured, long-term relationship with a person with a disability in the natural environment, which is the core of the ISR-SL, allowed students to develop a professional identity based on seeing the person as a whole and recognizing his/her centrality in the therapeutic relationship. Conclusions and significance: This study suggests ISR-SL as future direction or next step for implementing SL in OT and other healthcare disciplines programs.