Learning and mastery behaviours as risk factors to abandonment in a paediatric user of advanced single-switch access technology.

PURPOSE: The present descriptive case study documents the behaviours of a child single-switch user in the community setting and draws attention to learning and mastery behaviours as risk factors to single-switch abandonment. Our observations were interpreted in the context of a longer term school-based evaluation of an advanced single-switch access technology with a nine year-old user with severe spastic quadriplegic cerebral palsy.

METHOD: The child completed 25 experiment sessions averaging a rate of three sessions every two weeks. During each session he worked on several blocks of single-switch computer activity using his vocal cord vibration switch.

RESULTS

Despite high levels of single-switch sensitivity and specificity that suggested a good fit between the participant and the technology, the participant perceived a lower proficiency level of his own abilities, demonstrated impatience and intolerance to interaction errors, and was apprehensive of making mistakes when using his switch in public.

CONCLUSIONS

The benefit of gaining some degree of independent physical access might not necessarily enhance resilience to interaction errors or bouts of poor task performance. On the other hand, the participant's behaviours were consistent with those of a typically developing child learning or mastering any new skill or task. Implications for Rehabilitation The attitude and behaviour of a paediatric switch user towards skill development can be risk factors to abandonment of an access technology, despite successful clinical trial with the device. Children with severe disabilities can be associated with the same types of skill development behaviour patterns and achievement motivation as their typically developing peers. Empirical observations of the case participant's switch use behaviours suggest that user training could be adaptive in order to account for individual differences in skill development and achievement motivation.