Technology assisted therapy for an adult with visual and intellectual impairments and separation anxiety : a single case study
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Separation anxiety is highly prevalent among intellectually and visually impaired individuals, yet little research has been done into its treatment in this population. Due to delayed cognitive skills, these individuals struggle to develop the abstract concept of person permanence, which is necessary to diminish separation anxiety. The first aim of this study was to investigate whether using technology alone or including caregivers was the most beneficial approach to developing person permanence using technology-assisted therapy. The caregivers received training in advance in an attachment-based protocol about securing attachment relationships with the participant. It was hypothesised that the inclusion of attachment figures in technology-assisted therapy would enhance the acquisition of the person permanence concept. The second aim of this study was to determine whether technology-assisted therapy in tandem with the participation of caregivers consequently decreased separation anxiety and challenging behaviour in an adult with intellectual and visual impairment. It was hypothesised that the subject’s anxiety and challenging behaviour levels would significantly decrease due to the intervention. The final aim was to determine how the caregivers and the participant experienced this intervention. It was hypothesised that they would regard it as a positive experience. This single-subject design used a pre-experimental quantitative approach. It was based on the familiar ABAB design and comprised six phases. Phase A served as baseline, giving the participants time to become acquainted with the technology. Phase B consisted of automated responses to the participant’s messages. In phase C caregivers directed the active reply. The daily messages were discussed when the participant and caregiver reunited, incorporating the attachment-based protocol. Phase B and C were repeated. Phase D followed after the devices were handed in. The technology was a specially adapted touch iPhone with an application comprising coloured emoticons. When the participant was physically separated from the caregiver, he could send happy, sad, angry or scared emoticons, or request help. The caregiver, who had a similar device, responded by sending a pre-determined response such as acknowledging the participant’s “I am angry” message with a “You are angry” message. Due to the association between anxiety and challenging behaviour in this population, standardised instruments were used to measure changes in these behaviours. Repeated measure ANOVA and a non-parametric Friedman test were used to analyse the data, specifically comparing phase B and C. Overall, the results showed that behaviour did significantly change over the course of the intervention. The frequency of the various iPhone messages sent by the participant was recorded daily. ANOVA contracts results demonstrated significantly fewer anxious and angry messages sent during the C phases compared with the B phases. The professional caregivers recorded the frequency and intensity of anxiety and challenging behaviours. The ANOVA contrast results showed a significantly lower frequency and intensity of these behaviours in the C phases compared with the B phases. A questionnaire was developed to evaluate the social validity of the intervention. The independent samples t-test demonstrated a significant difference between the mean scores rated by the caregivers at the beginning and the end of the invention. The participant and caregivers were positive about the intervention. Although the results cannot be generalised, it can be concluded that the inclusion of caregivers in technology-assisted therapy can serve as an invaluable aid to developing the person permanence concept. The findings also indicate that the anxiety and challenging behaviour levels shown by the adult with ID and visual impairment decreased due to technology-assisted therapy applied by caregivers, while responses to the social validity of the intervention were positive.
- Humanities