Evaluating the rehabilitative potential of tactile number expressions for multisensory vision and hearing loss using wearable haptics

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PROJECT SUMMARY: Congenitally blind children with co-morbid hearing loss (DeafBlind children) often experience severe language delays due to their multisensory losses. These delays often lead to misidentification of these children as Developmentally Delayed and subsequently negatively impact intervention, rehabilitation, and educational efforts. Providing early, accessible language may address this issue by scaffolding early cognitive development. However, current rehabilitation approaches have extremely limited success. Existing interventions rely on establishing associations between an object the child touches (e.g., shoes), and a specific functional activity (e.g., going outside). This approach lacks the linguistic structures needed for early cognitive development. Only in later childhood do interventions begin to use visual sign language and/or spoken language. This approach poses two major problems: First, neither of these languages is fully accessible for DeafBlind children. Second, by the time language is introduced, many children are past the age at which language can be effectively acquired (i.e., the critical period for language). Consequently, only a small number of DeafBlind children acquire effective communication and achieve age- appropriate cognitive, and daily life milestones. Until recently, no fully accessible language for DeafBlind children existed. Protactile is a fully tactile language that has recently developed among DeafBlind adults. This research endeavor focuses on measuring how well protactile can serve as an early language for DeafBlind children. Adult Protactile Experts who are DeafBlind will play with DeafBlind children using protactile multiple times per week in a longitudinal study. We will use number language to index the efficacy of the intervention. Number language serves as an excellent index because it provides a targeted set of vocabulary items to measure, is directly linked to cognitive development, and has non-linguistic perception-based abilities that have been found in typically developing infants. The specific aims of this study are: (1) Intervention: Identify which tactile number expressions produced by DeafBlind adults are learned by DeafBlind children, (2) Prototype Development: Develop a haptic device to be worn by DeafBlind children that delivers taps and squeezes and also measures heart rate patterns, and (3) Non-linguistic Assessment: Using the wearable device and heart rate patterns, we will demonstrate whether DeafBlind children perceive differences between different numbers of taps or squeezes produced by the device. We expect that DeafBlind children will express protactile number language, and that our haptic measure will reveal non-linguistic abilities similar to typically developing children. This project will generate evidence regarding the use of protactile in early intervention, supporting the achievement of early developmental milestones in DeafBlind children and contributing to their long-term quality of life. Further, successful completion will contribute to the development of nonlinguistic measures of cognition in DeafBlind children and other children with whom visual measures are not suitable.