User-Centered Design of a Proactive RF-Based Wearable Bladder Monitor for Toilet Training of Children with ASD/IDD

摘要 尿失禁(UI)和如厕训练的困难是面临的重大和常见的挑战 患有自闭症谱系障碍(ASD)和/或智力和发育障碍的儿童和年轻人 残疾(IDD)。对于这些人来说，厕所问题可能会导致进展缓慢，总体成功率降低 与神经典型的同龄同龄人相比，接受如厕训练的比率，而且经常出现显著的负面影响 影响他们的独立性和参与教育和社区环境的能力。不幸的是 许多人，这些大小便失禁的困难会持续到成年，造成身体和心理上的质量 生活障碍，如身体不适、社会孤立、不适当的卫生和自信心下降，以及 独立。为受过如厕训练的儿童提供的支持工具并未取得进展 在几十年内意义重大，迫切需要各种方法来帮助这些人实现长期 洗手间很成功。在这项工作中，提出了一种技术支持工具，它将为以下方面提供主动解决方案 帮助进行如厕训练。通过在事故发生前主动发出警报，预计用户将能够 学会识别和注意触发警报的感觉。此外，积极主动的反应将减少 事故风险，将事故相关的尴尬降至最低，并降低发生 厌恶如厕的行为。该项目采取了多学科的方法，结合了电气公司的专业知识 工程学和特殊教育，以实现两个关键目标。第一个目标是识别高度 一组依赖人口的需求和约束，通过与 主要利益相关者(包括ASD/IDD儿童的父母或照顾者，以及照顾者、教育工作者和 临床专业人员)，通过焦点小组和基于调查的问卷。第二个目标是设计， 实施并试行测试以用户为中心的膀胱监测器，旨在提供独特的支持工具 主动警惕膀胱充盈，支持儿童和年轻人的尊严和独立 患有ASD/IDD，以及其他患有尿崩症的人。基于射频(RF)技术建造的 膀胱监护仪将是非侵入性的，能够实时、安全和连续地测量和监测 通过灵活、谨慎和无线的传感器阵列检测膀胱状态。生成的监视器将满足 这一人群的多样化需求，将成为有史以来第一个主动提供膀胱警报的工具 已经接近满员，以支持厕所培训并避免事故。将进行初步验证测试 通过电磁计算模拟和实验演示，然后进行试点测试 与建立现实世界的可行性和社会有效性，与扩展的个人行为研究 ASD/IDD有厕所困难的人，计划随后进行培训。从长远来看，这一设备被设想为 支持来自不同背景的患有自闭症/缺碘的儿童和年轻人向独立过渡， 为他们实现更高的生活质量，并更多地参与教育和社区环境。

Abstract Urinary incontinence (UI) and difficulties with toilet training are significant and common challenges faced by children and young adults with autism spectrum disorder (ASD) and/or intellectual and developmental disabilities (IDD). For these individuals, toileting problems can result in slower progress and lower overall success rates with toilet training compared to their neurotypical same-aged peers, and often having substantial negative impact their independence and ability to participate in educational and community settings. Unfortunately for many, these difficulties with incontinence can continue into adulthood, creating physical and psychological quality of life barriers, such as physical discomfort, social isolation, improper hygiene, and lowered self-confidence and independence. The available support tools for children struggling with toilet training have not advanced significantly in decades, and there is an urgent need for approaches to help these individuals achieve long-term successful toileting. In this work, a technological support tool is proposed that will provide a proactive solution to help with toilet training. By proactively alerting before an accident occurs, it is expected that the user will be able to learn to recognize and attend to the sensation that triggers the alert. Further, a proactive response will reduce accident risk, minimize associated embarrassment from accidents, and decrease the likelihood of developing toileting averse behaviors. The project takes a multi-disciplinary approach, combining expertise from Electrical Engineering and Special Education, in order to tackle two key aims. The first aim is to identify the highly population-dependent set of needs and constraints for an ideal toileting support tool through engagement with key stakeholders (including parents or caregivers of children with ASD/IDD, and care providers, educators, and clinical professionals), through focus groups and survey-based questionnaires. The second aim is to design, implement, and pilot test a user-centered bladder monitor that aims to uniquely provide a support tool to proactively alert of bladder fullness and support dignity and independence for children and young adults with ASD/IDD, and others suffering from UI. Built based on radio-frequency (RF)-based technology, the bladder monitor will be non-invasive and enable real-time, safe, and continuous measurement and monitoring of the bladder state through a sensor array that is flexible, discreet, and wireless. The resulting monitor will meet the diverse needs of this population, and will be the first tool ever to provide a proactive alert when the bladder is approaching full, to support toilet training and to avoid accidents. Initial validation testing will be conducted through electromagnetic computational simulations and experimental demonstrations, followed by pilot testing with to establish real-world feasibility and social validity, with expanded behavioral studies in individuals with ASD/IDD who have difficulties with toilet training planned subsequently. Long-term, this device is envisioned to support the transition to independence for children and young adults with ASD/IDD from diverse backgrounds, for them to achieve a higher quality of life, and greater participation in educational and community settings.