Enhancing Interaction: The Crucial Role of Eye-Tracking Technology in Assessing Children with Profound Intellectual and Multiple Disabilities in Poland

Keywords: profound intellectual multiple disabilities (PIMD), eye-gaze assistive technology (EGAT), non-eye-gaze assistive technology (NEGAT), eyeLearn software, Look to Learn software, functional assessment

Abstract

The Objective of the Research: This research focuses on the pivotal role of utilizing eye-gaze assistive technology (EGAT) in diagnosing individuals with profound intellectual and multiple disabilities (PIMD). The study included six children aged 5–12 with PIMD who do not use speech. The primary aim was twofold: first, to assess and validate diagnoses (certificates) issued by Psychological and Pedagogical Counselling Centres in Poland, which traditionally do not use eye-gaze assistive technology (NEGAT); second, to identify specific exercises from the Look to Learn and eyeLearn software that facilitate the examination of various cognitive abilities. These abilities include visual-spatial skills (e.g., perception ability, visual-auditory coordination, and precision of vision), language skills (both comprehension and expression), and logical thinking (ranging from cause-effect actions to making choices among multiple elements).

Research Method:

 The study employed an action research approach with methodological triangulation, including:

  • Analysis of medical and therapeutic documents (certificates from Psychological and Pedagogical Counselling Centres)
  • Participant observation (both open and structured), and
  • The multiple (collective) case study method.

Sessions using EGAT were developed, and exercises that could be used to verify specific skills were selected. The PCEye Mini Track & Learn tool—featuring Gaze Point & Gaze Viewer—was used in the research.

Structure of the Article: The article is organized into eight sections: introduction; a brief overview of the current diagnostic procedures in Poland; objectives; methods; results; discussion on improving access to EGAT; and conclusions.

Research Findings and their impact on the Development of Educational Sciences: The findings indicate that diagnoses provided by Psychological and Pedagogical Counselling Centres in Poland may require reconsideration. By incorporating eye-gaze assistive technology (EGAT) and re-diagnosing six children previously identified as having profound intellectual disabilities, we identified previously unrecognized abilities in speech comprehension, logical reasoning, visual-spatial skills, and learning pace. The research brings attention to the necessity for standardized tests using eye-tracking technology to assess the intellectual functioning of children with disabilities.

Conclusions and Recommendations:  It is recommended that Psychological and Pedagogical Counselling Centres be equipped with EGAT to ensure more accurate diagnoses of children suspected of having profound intellectual disabilities. The study advocates discontinuing the issuance of certificates indicating profound intellectual disability and instead implementing functional assessments using EGAT.

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: American Psychiatric Press.

Andreassen, M., Borgestig, M., & Hemmingsson, H. (2024). The psychosocial impact of eye-gaze assistive technology on everyday life of children and adults. Annals of Medicine, 56(1). https://doi.org/10.1080/07853890.2024.2318397

AssisTech. (2023, December 6). https://assistech.eu/pl/eyelearn/

Błeszyński, J. J., Lubińska-Kościółek, E., & Zielińska, J. (2019). Zastosowanie techniki eye trackingu w diagnozie dzieci ze spektrum autyzmu [The use of eye-tracking technique in the diagnosis of children with autism spectrum disorder]. Wydawnictwo Naukowe Uniwersytetu Pedagogicznego.Brunyé, T. T., Drew, T., Weaver, D. L., & Elmore, J. G. (2019). A review of eye tracking for understanding and improving diagnostic interpretation. Cognitive Research: Principles and Implications, 4(7). https://doi.org/10.1186/s41235-019-0159-2

Cavadini, T., Courbois, Y., & Gentaz, E. (2022). Eye-tracking-based experimental paradigm to assess social-emotional abilities in young individuals with profound intellectual and multiple disabilities. PLoS ONE, 17(4), e0266176. https://doi.org/10.1371/journal.pone.0266176

Central Economic Information Center. (2023, October 16). Lista wykaz poradni psychologiczno-pedagogicznych. [List of psychological and pedagogical counseling centres]. https://www.coig.com.pl/lista_wykaz_poradni-psychologiczno-pedagogicznych.php

de Haas, C., Grace, J., Hope, J., & Nind, M. (2022). Doing research inclusively: Understanding what it means to do research with and alongside people with profound intellectual disabilities. Social Sciences, 11(4), 159. https://doi.org/10.3390/socsci11040159

Donmez, M. (2023). A systematic literature review for the use of eye-tracking in special education. Education and Information Technologies, 28, 6515–6540. https://doi.org/10.1007/s10639-022-11456-z

Erhard, P., & Falcomata, T. S. (2023). Generalization. In J. L. Matson (Ed.), Handbook of applied behavior analysis. Autism and child psychopathology series (pp. 1–15). Springer. https://doi.org/10.1007/978-3-031-19964-6_15

European Commission, Directorate-General for Employment, Social Affairs and Inclusion. (2021). Union of equality: Strategy for the rights of persons with disabilities 2021–2030. Publications Office. https://data.europa.eu/doi/10.2767/31633

Gjermestad, A., Skarsaune, S. N., & Bartlett, R. L. (2023). Advancing inclusive research with people with profound and multiple learning disabilities through a sensory-dialogical approach. Journal of Intellectual Disabilities, 27(1), 40–53. https://doi.org/10.1177/17446295211062390

Guillén-Gámez, F. D., Colomo-Magaña, E., Ruiz-Palmero, J., & Tomczyk, Ł. (2023). Teaching digital competence in the use of YouTube and its incidental factors: Development of an instrument based on the UTAUT model from a higher order PLS-SEM approach. British Journal of Educational Technology, 55(1), 1–23. https://doi.org/10.1111/bjet.13365

Hemmingsson, H., & Borgestig, M. (2020). Usability of eye-gaze controlled computers in Sweden: A total population survey. International Journal of Environmental Research and Public Health, 17(5), 1–13. https://doi.org/10.3390/ijerph17051639

Hoogerwerf, E.-J., Desideri, L., Koth, A., Mavrou, K., Meletiou-Mavrotheris, M., Miesenberger, K., Scherer, M. J., Solander-Gross, A., & Weston, S. (2016). Digital inclusion: A white paper. ENTELIS Consortium.

Hsieh, Y.-H., Borgestig, M., Gopalaro, D., McGowan, J., Granlund, M., & Hemmingsson, H. (2021). Communicative interaction with and without eye-gaze technology between children and youths with complex needs and their communication partners. International Journal of Environmental Research and Public Health, 18(10), 5134. https://doi.org/10.3390/ijerph18105134

Hsieh, Y.-H., Granlund, M., Hwang, A.-W., & Hemmingsson, H. (2023). Feasibility of an eye-gaze technology intervention for students with severe motor and communication difficulties in Taiwan. Augmentative and Alternative Communication, 40(3), 196–207. https://doi.org/10.1080/07434618.2023.2288837

Hsieh, Y.-H., Granlund, M., Odom, S. L., Hwang, A.-W., & Hemmingsson, H. (2022). Increasing participation in computer activities using eye-gaze assistive technology for children with complex needs. Disability and Rehabilitation: Assistive Technology, 19(2), 492–505. https://doi.org/10.1080/17483107.2022.2099988

Jenner, L. A., Farran, E. K., Welham, A., Jones, C., & Moss, J. (2023). The use of eye-tracking technology as a tool to evaluate social cognition in people with an intellectual disability: A systematic review and meta-analysis. Journal of Neurodevelopmental Disorders, 15(42). https://doi.org/10.1186/s11689-023-09506-9

Kochanowicz, A. M. (2019). Eye-tracking in the diagnosis, therapy, and education of children with multiple disabilities: An outline of issues. Edukacja Elementarna w Teorii i Praktyce, 14(4[54]), 109–119. https://doi.org/10.35765/eetp.2019.1454.08

Kochanowicz, A. M. (2021). Using eye-tracking technology as an art medium and a tool of clinical intervention in art therapy of a child with multiple disabilities. Studia Paedagogica Ignatiana, 24(4), 131–149. https://doi.org/10.12775/SPI.2021.4.007

Kochanowicz, A. M. (2023a). Znaczenie przekładu specjalistycznych terminów anglojęzycznych dla rozwoju edukacji włączającej w Polsce [The importance of translating specialist English terms for the development of inclusive education in Poland]. Przegląd Socjologii Jakościowej, 19(3), 178–201. https://doi.org/10.18778/1733-8069.19.3.10

Kochanowicz, A. M. (2023b). The effectiveness of using eye-gaze assistive technology in the verification of diagnosis of children with profound intellectual disabilities in Poland - a case study. In G. Kouroupetroglou & D. Archambault (Ed.), Book of Abstracts. 17th International Conference of the Association for the Advancement of Assistive Technology in Europe, AAATE 2023 Paris, August 30-September 1, 2023, 19, 130-133.

Kopeć, D. (2020). Pozór w edukacji osób z głęboką intelektualną i wieloraką niepełnosprawnością [The pretence in the education of people with profound intellectual and multiple disabilities]. Kultura – Społeczeństwo – Edukacja, 2(18), 83–98. https://doi.org/10.14746/kse.2020.18.4.1

Kopeć, D. (2021). Koncepcja kształcenia z ForMatem w procesie edukacji ucznia z głęboką niepełnosprawnością intelektualną [The concept of education with ForMat in the education process of a student with profound intellectual disability]. Niepełnosprawność. Dyskursy Pedagogiki Specjalnej, (41), 34–45.

Kruithof, K., Willems, D., van Etten-Jamaludin, F., & Olsman, E. (2020). Parents' knowledge of their child with profound intellectual and multiple disabilities: An interpretative synthesis. Journal of Applied Research in Intellectual Disabilities, 33(6), 1141–1150. https://doi.org/10.1111/jar.12740

Maes, B., Nijs, S., Vandesande, S., Van Keer, I., Arthur-Kelly, M., Dind, J., Goldbard, J., Petitpierre, G., & Van der Putten, A. A. J. (2021). Looking back, looking forward: Methodological challenges and future directions in research on persons with profound intellectual and multiple disabilities. Journal of Applied Research in Intellectual Disabilities, 34(1), 250–262. https://doi.org/10.1111/jar.12803

Molina, A. I., Arroyo, Y., Lacave, C., Redondo, M. A., Bravo, C., & Ortega, M. (2024). Eye-tracking-based evaluation of accessible and usable interactive systems: Toolset of guidelines and methodological issues. Universal Access in the Information Society. https://doi.org/10.1007/s10209-023-01083-x

Nakken, H., & Vlaskamp, C. A. (2007). Need for a taxonomy for profound intellectual and multiple disabilities. Journal of Policy and Practice in Intellectual Disabilities, 4(2), 83–87. https://doi.org/10.1111/j.1741-1130.2007.00104.x

Patel, D. R., Cabral, M. D., Ho, A., & Merrick, J. (2020). A clinical primer on intellectual disability. Translational Pediatrics, 9(Suppl1). https://doi.org/10.21037/tp.2020.02.02

Poland’s Data Portal. (2023, March 2). Number of children with a certificate of need for rehabilitation and educational classes in the 2022/2023 school year by voivodeship and type of institution organizing the classes. https://dane.gov.pl/pl/dataset/510/resource/45541

Regulation of the Minister of National Education of April 23, 2013, on the conditions and method of organizing rehabilitation and educational classes for children and adolescents with profound mental retardation. (2013). https://isap.sejm.gov.pl/isap.nsf/DocDetails.xsp?id=wdu20130000529

Regulation of the Minister of National Education of January 30, 1997, on the principles of organizing rehabilitation and educational classes for children and adolescents with profound mental disabilities. (1997). https://isap.sejm.gov.pl/isap.nsf/DocDetails.xsp?id=WDU19970140076

Skarsaune, S. N. (2023). Self-determination of people with profound intellectual and multiple disabilities. Developmental Medicine & Child Neurology, 65(1), 16–23. https://doi.org/10.1111/dmcn.15363

Smartbox. (2023, December 6). Look to Learn. https://thinksmartbox.com/product/look-to-learn/

Vlaskamp, C. (2005). Interdisciplinary assessment of people with profound intellectual and multiple disabilities. In J. Hogg & A. Langa (Eds.), Assessing adults with intellectual disabilities: A service providers’ guide (pp. 39–51). Blackwell Publishers.

Wessels, M. D., Van der Putten, A. A. J., & Paap, M. C. S. (2021). Inventory of assessment practices in people with profound intellectual and multiple disabilities in three European countries. Journal of Applied Research in Intellectual Disabilities, 34(6), 1521–1537. https://doi.org/10.1111/jar.12896

World Health Organization (WHO) & United Nations Children’s Fund (UNICEF). (2022). Global report on assistive technology. Geneva: WHO and UNICEF.

Zaorska, M. (2023). Dziecko/uczeń z głębokim stopniem niepełnosprawności intelektualnej w polskim systemie edukacji (ze szczególnym uwzględnieniem edukacji włączającej) [A child/student with a severe intellectual disability in the Polish education system (with particular emphasis on inclusive education)]. Szkoła Specjalna, LXXXIV(3), 171–182. https://doi.org/10.5604/01.3001.0053.8977

Published
2024-12-30
How to Cite
Kochanowicz, A. M., & Pawłowski, L. (2024). Enhancing Interaction: The Crucial Role of Eye-Tracking Technology in Assessing Children with Profound Intellectual and Multiple Disabilities in Poland. Multidisciplinary Journal of School Education, 13(2 (26), 229-250. https://doi.org/10.35765/mjse.2024.1326/11