| 1. |
- Kolkowska, Ella
(författare)
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A method for analyzing value-based compliance in systems security
- 2013
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Aim: The aim of this thesis is to design a method that supports analysis of different values that come into play in compliance and non compliance situations within information systems security (ISS). The thesis addresses the problem of lack of ISS compliance methods that support systematic analysis of compliant and non-compliant behaviours as well as the reasons for these behaviours. The problem is addressed by designing a method that supports analysis of different values that come into play in compliance and non compliance situations in ISS. The method is called Value Based Compliance method (VBC method).Research questions: The main research question of the thesis is: How should a method for analysis of different values that come in play in compliance and non-compliance situations within ISS be designed? This research question is answered by answering three sub-questions: 1) What values and goals (perspective) should the VBC method realize? 2) What underpinning design principles should the VBC method build on? 3) How should the VBC method be constructed to realize the VBC perspective and to incorporate the design principles?Research method: Design Science Research (DSR) was chosen as a research approach in this thesis. DSR prescribe how to carry on a design process of an artefact with preserved rigor and relevance. The approach is both useful in order to solve real life problems and theoretically ground suchproblems. The VBC method is informed by a number of kernel theories and based on current knowledge in ISS compliance literature. The method is also empirically tested in three different contexts, during six DSR cycles.Contributions: The three main contributions from the thesis are: the VBC perspective, the design principles and the VBC method. The VBC perspective is in line with a social view on ISS’s role in organisation. This perspective is realized in the VBC method by analysing values and value conflicts that come in play in compliance and non-compliance situations. Thus this study contributes to the field of ISS by designing a method that realizes the social view on ISS’s role in an organisation. The five design principles for a VBC method is the second contribution. The design theory with the five empirically tested design principles may be the point of departure for development of other compliance methods focusing on analysis of values and value conflicts that come into play in relation to ISS compliance. The design principles contribute also to the ISS compliance field by 1) extending compliance analysis with consideration of the different rationalities (values and goals) 2) acknowledging the difference between rational and non-rational ISS actions and 3) emphasizing the importance of finding articulated as well as unarticulated ISS actions. Finally, the VBC method itself contributes to the ISS compliance research and practice by offering a formalized, theoretically and empirically grounded method for systematic analysis of compliance and non-compliance situations as well as rationalities that come into play in these situations.
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| 2. |
- Ask, Andreas, 1977-
(författare)
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The Role of Enterprise Architecture in Local eGovernment Adoption
- 2012
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- eFörvaltning ses som ett medel för att göra kommunalt förvaltningsarbete mer effektivt och interoperabelt. Dock begränsas kommuner av oförmåga att uppnå det vilket försvårar genomförandet av deras uppdrag. En orsak till varför införandet av eFörvaltning inte ger de systematiska fördelar som efterfrågas beror på att införandet av informations och kommunikations teknologier (IKT) inte är tillräckligt. Förändringen som krävs kan inte ske över en natt utan är en gradvis förändring över tid som även kräver nya sätt att arbeta på. Kommuner behöver hantera sin eFörvaltningsutveckling på ett mer strukturerat sätt för att öka möjligheterna att förverkliga de fördelarna som sägs kunna erhållas. Enterprise Architecture (EA) har på senare tid kommit att ses som en möjlig lösning för att komma tillrätta med denna problematik. Genom att arbeta mot en EA skapas möjligheten att brygga IKT system med affärsprocesser och därigenom leda till effektivitet och interoperabilitet. Dock är EA inom offentlig sektor ifrågasatt. Forskare menar att EA saknar tydlig definierad omfattning och begreppsvärld, vilket gör användningen av EA inom förvaltningsarbete svår. De omfattande logiska EA ramverk som finns idag saknar innehåll som är specifikt relaterade till offentlig sektor. Vari det blir problematiskt att arbeta mot en EA inom offentlig sektor.Denna licentiatavhandling lägger följande forskningsfråga: ”Vilken roll har EA för införandet av eFörvaltning inom Svenska kommuner?” Samt följande underfrågor ”Vilka förutsättningar finns för att använda EA vid eFörvaltningsutveckling?” ”Vad har Örebro kommun uppnått genom att arbete mot en EA i deras eFörvaltningsutveckling?” Och ”Vilka problem har Örebro kommun upplevt av att arbeta mot en EA vid eFörvaltningsutvecklingen?”. En longitudinell fallstudie av ett eFörvaltningsutvecklingsprojekt i Örebrokommun genomfördes mellan 2007 och 2009 med syfte att utröna dessa frågor och för att skapa insikt om EAs roll för eFörvaltningsutveckling. Förutsättningar, resultat och upplevda problem vid eFörvaltningsutvecklingen studerades. I anslutning till detta empiriska arbete genomfördes även en jämförandestudie av eFörvaltningsmål såsom de anges i officiella statliga dokument inom så väl Sverige som i EU gentemot förmodade fördelarna med EA som diskuteras i samtida EA-litteratur.Studien visar att EA som fenomen ses som en förutsättning för att lyckas med eFörvaltning. 7 viktiga aspekter gällande förutsättningen för att lyckas med kommuners eFörvaltningsutveckling identifierades: Skillnaden mellan administrativa och politiska ansvaret, Politiskt mandat, Politisk timing, Resursfördelning, Samordning under NPM, Leverantörsberoende, Val av standard och bäst praxis. För att förbättra möjligheten att röna framgång i eFörvaltningsutveckling behöver dessa aspekter aktualiseras och hanteras. New Public Management (NPM) som styrmodell utgör ett strukturellt hinder för eFörvaltningsutveckling som förhindrar en mer explicit användning av EA-ramverk, vilket påverkar möjligheten att uppnå uppsatta mål negativt. Trots den strukturella problematik som föreligger, kan stöd erhållas genom att arbeta utifrån ett ”EA-tänk”. Ett ”EAtänk” kan här ses som ett medel för att påbörja förändringen mot en EA utan att för den delen explicit använda sig av ett EA-ramverk, eller -metod. Dock är det viktigt skapa en förståelse för att ”EA-tänk” som fenomen i sin tur ger upphov till strukturer och således kan leda till problem som även de måste hanteras för att eFörvaltningsutveckling skall lyckas. eFörvaltning, NPM och ett ”EA-tänk” skapar en strukturell triad där olika strukturella egenskaper i vissa fall sammanfaller med varandra vari de kan stödja kommuner i dess arbete och således bidra till positiv utveckling. Medan det i andra fall leder till negativ utveckling där administrationen upplever problem att ta till sig av de rekommendationer eFörvaltningsprojektet kan tänkas ge till organisationen som helhet. Paradoxalt nog skapar denna strukturella triad en situation där kommuner måste arbete runt sig själv för att komma framåt. Normer och befintliga strukturer i kommuner förhindrar effektiv samarbete både internt mellan olika förvaltningar och externt gentemot andra kommuner och landsting vilket leder till fragmentariska framsteg mot projektmålen och i slutänden även kommunens övergripande mål gällande eFörvaltningsutveckling. Givet de i många fall motstridiga strukturella egenskaper som finns mellan NPM och eFörvaltning innebär att det initiala arbetet mot EA i eFörvaltningsutveckling är ett ytterst komplext fenomen. För att öka möjligheten att eFörvaltningsutvecklingen blir lyckad krävs det att kommuner känner till och hantera den negativa inverkan NPM har på eFörvaltningsutveckling. Samtidigt behöver de känna till och hanterar problematiken som uppstår av att arbeta mot en EA genom ett ”EA-tänk”, Samt att som studien visat, EA ger inget stöd för mer politiseras mål, vari kommuner behöver annat sätt och andra strategier för sådant arbete. Detta är viktigt att beakta, speciellt med tanke på att mer politiserade mål i mångt och mycket är de mål som kommer premieras av politiker. Av just den enkla orsaken att politiker inte blir omvalda på grund av “effektiva IKT integrerade interna processer” utan blir omvalda utifrån förbättringar som är synliga och som gagnar medborgare positivt.Avhandlingen bidrar till forsknings genom att öka förståelse för och behovet av att hantera både positiva och negativa faktorer som påverkar möjligheten att lyckas med eFörvaltningsutveckling inom kommunalt arbete. Vilket inkluderar de 7 identifierade kritiska faktorer måste aktualiseras och hanteras för att öka möjligheten att lyckas. Den negativa effekt NPM har på eFörvaltningsutveckling och hur ett ”EA-tänk” kan leda till positiv utveckling, även om det som denna studie visat inte kan bidra till mer politiserade mål. Vad gäller denna licentiatavhandlings bidrag till praktiken så bidrar den med att belysa den problematiska situation som föreligger av att institutionaliserade strukturer i många fall verkar som ett hinder mot förändring. Studien möjliggör även till att kommuner kan skapa en förståelse för sin egna eFörvaltningsutveckling och möjligtvis kan verka för att inte uppleva samma problematik som identifierats i Örebros eFörvaltningsutveckling samt visa på hur en kommun kan arbeta för att hantera den problematik som inte kan förhindras alternativ som uppstår trots denna kunskap.
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| 3. |
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| 4. |
- Larsson, Hannu, 1985-
(författare)
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Sustainable eGovernance
- 2014
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis focuses on eGovernance – the use of ICT as a means to improve public sector practice. Previous research has shown that there is a lack of long-term discussion on the purposes and directions of eGovernance development, often outlining it as unequivocally positive, while missing to consider the complexities and conflicts involved in this process. In order to understand the complexities of eGovernance a future-oriented perspective is needed. In other words a perspective that not only focuses on using ICT to be responsive to present needs but also making it possible to discuss which goals public sector ICT initiatives should strive for and how these correspond to goals and means in the public sector as a whole. In order to do this I employ a sustainability perspective.The aim of this thesis is to understand how eGovernance can be sustainable in such a complex organizational environment. This is approached in four papers; based on two case studies, situated in the public sector of Sweden, and a structured literature review of the use of the sustainability concept in eGovernance research.The findings of this thesis include a framework of sustainable eGovernance, including an outline of the different dimensions of sustainability: social, economic, environmental and technical. These dimensions are seen as carriers of different values and goals which are in a process of continuous dialogue and conflict. Cutting across these four dimensions are two themes: decision making and information infrastructure, which make up the backbone of how ICT can be used in order to improve public practice. The theoretical lens of sustainability widens our understanding and helps in the questioning of motivations, directions and implications of eGovernance initiatives. This thesis thus contributes with a theoretically and empirically founded framework, which is suitable as a foundation for sustainable eGovernance development and further research into that area.
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| 5. |
- Andersson, Annika, 1968-
(författare)
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Learning to learn in e-Learning : constructive practices for development
- 2010
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- This thesis concerns technology use in distance educations and learning practices related to this use. The research was carried out over the period 2005 to 2009 in Bangladesh and Sri Lanka and has been reported in 6 published papers. The research is situated within the field of Information and Communication Technologies for Development (ICT4D) and within this field e-learning. Education is important for development and for many students in developing countries distance education is often the only option to get educated. The research question is if the use of Information and Communication Technology (ICT) in distance education can contribute to development, and if so, how?This question is explored through two case studies in Sri Lanka and Bangladesh. A variety of data collection methods have been used: interviews, questionnaires, participant observations and document review. The research approach is interpretative and findings are analyzed using Structuration Theory.Initial findings showed that a major challenge for students was the change of learning practices that distance education required. Findings also showed that new constructive learning practices emerged through the use of ICT. For development to take place the learning practices of students are important. Students used to learning practices based on uncritical memorization of facts will not easily take initiatives for change, whereas students used to constructive learning practices will. Notwithstanding the fact that most students found this transition challenging, it was found that by introducing technology into long-established transmission structures, changes towards constructive learning practices occurred.A major contribution of this thesis is to increase the understanding of how ICT in distance education can facilitate constructive learning practices. By arguing that constructive learning practices are conducive to societal change this finding also has implications for development. The thesis also makes a theoretical contribution by extending Structuration Theory’s applicability in demonstrating its explanatory power in settings where researcher and informants are geographically and socially distant.
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| 6. |
- Havstorm, Tanja Elina, 1991-
(författare)
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Cargo Cult in Agile Software Development
- 2023
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Software development (SD) projects are complex endeavors, and organizations employ software development methods (SDMs) both to add structure and to propel their projects. Nowadays, agile SDMs are the most used methods. Still, inefficient and ineffective use of SDMs is a challenge, and existing research shows cases of SD teams failing in their use of SDMs due to deviations made. Of course, methods should not be used in rigorous and textbook-like ways. Among practitioners, some of these deviations are referred to as cargo cult behavior; without, however, providing much of theoretical depth or any analytical tools to identify and characterize such behaviors. Although existing research has investigated SDM deviations, they have not been investigated as cargo cult behavior.Against this backdrop, the aim of this thesis is to understand the challenges in succeeding with SDM use by developing a theory called SDM cargo cult theory (SDMCCT), to identify, analyze, and describe the cargo cult phenomenon in agile SDM use. The journey of this thesis takes its starting point in practitioners’ use of the buzzwords “cargo cult” when referring to flawed SDM use. By returning to the field of social anthropology and its studies of cargo cult, a definition of SDM cargo cult and an analytical framework are iteratively crafted through a longitudinal ethnographic study to constitute the SDMCCT. The research approach has been abductive and the SDMCCT builds on social action theory and work motivation theory.The ethnographical study took place at an international industrial manufacturing company in Sweden that is using agile SDMs. This study includes three years of data collection, which includes observations, interviews, and gathering of business documents. The ethnographic study focused on three SD teams and their daily work using agile SDMs. The analysis using the analytical framework includes four agile SDM practices: daily scrum meeting, sprint demo, continuous integration, and visualization. In total, the analysis uncovered 36 deviations in the SD teams’ use of these practices, structured into 30 SDM cargo cult categories. In addition, this study shows that the framework is applicable to analyze and characterize effective SDM use as well, although it is not its main focus. The framework can be used by researchers to make similar analysis of cargo cult situations in other organizations, and the catalogue of cargo cult situations can serve as background knowledge for other organizations to study and improve their SD teams’ use of agile SDM practices.
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| 7. |
- Larsson, Hannu, 1985-
(författare)
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On the road to interoperability : Complexities of public sector enterprise thinking
- 2011
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Increasingly, eGovernment (the use of ICTs in order to achieve better government) is moving its focus from web presence and electronic service provision to striving for an interoperable public sector. Interoperability refers to the ability for information exchange across organizational borders, concerning technology as well as business aspects. Policy for such change has been formulated and implementation is currently taking place in many government sectors. In such programs there is a strong need for coordination with regard to the way in which interoperability is to be implemented. Interoperability work requires coordination, as it is a complex endeavour because of the interrelatedness of information systems, public services, departments and organizations, as well as policies, constraints and regulations. In order to achieve interoperability, architectural approaches are increasingly used in the public sector to try to coordinate interoperability work. One such approach, Enterprise Architecture (EA), is becoming increasingly influential. EA has been defined as an overview of the complete business processes and business systems, both in terms of how they overlap and their interrelatedness. However, previous research show that state-of-the-art EA is seldom fully applied in practice. Previous research has also proposed that information infrastructures and architectures should be seen as evolving dynamically during the implementation process through changing relationships between actors. The implementation of IS architecture for interoperability is thus seen as an evolving process of social production. As the research field is still immature further research on the evolution of public information infrastructures and architectures is needed, as well as how the strategic alignment of handling of goals, and ambiguities in implementation is done. This thesis hence addresses the challenges of implementing national public sector interoperability as an evolving process by addressing the research question: How is interoperability interpreted and enacted by different actors in public sector implementation? In order to approach the research question, an interpretive case study is performed. The case studied in this thesis is from the implementation of the Strategy for eHealth in Sweden, where healthcare is mainly publicly funded, and catered for by 20 county councils (who mainly focus on healthcare, and 290 municipalities (who also cater for a great deal of other public services). The case is an example of how interoperability is implemented, from the early stages of outlining a general picture of goals and requirements, to the formulation of a strategy and an architecture. This case is also an example of how EA influences an interoperability program through enterprise thinking. The research uses an interpretive case study approach influenced by Actor-Network Theory (ANT). ANT is used as a toolbox for telling stories about technology in practice, as emergent in socio-material relations. A number of complementary qualitative methods are used. These include semi-structured interviews, observations and document analysis, with the foremost part of the empirical material being first-hand. In order to understand interoperability implementation in the public sector I examine the background to eGovernment implementation, by contrasting conceptualizations of eGovernment evolution to contemporary theories of public policy implementation. It is shown that, during the last decade, stage models have been used as tools for describing, predicting and directing the evolution of eGovernment. The stage model approach has been criticized for presenting a linear development which has little empirical support and delimits the understanding of eGovernment development as a dynamic process. Newer stage models have started to take this criticism into consideration and alternative models on eGovernment have also been developed. Consequently, eGovernment implementation is in this thesis perceived as a process in which technologies, policies and organizations are in a process of mutual shaping, where policymaking and policy implementation are intermingled. Implementing interoperability is hence not a matter of disseminating a policy that is to be implemented in every setting exactly as stated on paper, but a process in which the goals and means of interoperability are constantly being negotiated. Also, EA has been proposed as an approach to treat technology and business in the public sector as interrelated. However, since previous research show that state-of-the-art EA is seldom fully applied in public sector practice, the concept of enterprise thinking is developed in this thesis. Enterprise thinking is intended to be a concept that describes EA as a contemporary zeitgeist which in practice is adopted in varying ways. The results of the thesis show how interoperability in eHealth was roughly outlined before implementation although still containing conflicts and ambiguities. Central to this thesis is the controversy of defining “the enterprise”, as the health care sector was delimited as one enterprise, which became increasingly problematic during implementation. This to a large extent concerned municipalities, whose business area stretched much wider than just the health care sector, and hence the definition of the enterprise became problematic. Another central aspect was legal obstacles to cooperation, as there was a clash between the values of efficiency and patient privacy as a result of a new law that had been implemented in order to allow for information sharing. The legal grounds for sharing information proved to be problematic, which lead to that several involved actors perceived that a large portion of the patients in health care could not benefit from interoperability as their information could not be shared despite this law. The legal challenges also dampened the enthusiasm for the eHealth program as a whole. The program had also outlined a technology architecture before implementation. This architecture was however treated in conflicting ways, both as a blueprint (something to be implemented) and a tool for communication (as a way of discussing what was to be implemented). For instance, several municipalities perceived that the planned infrastructure was unsuitable to their business needs (as it did not meet the requirements of other actors in eGovernment), and thus questioned it, using it as a tool for communication rather than a blueprint. Meanwhile, other actors argued that the blueprint had already been decided, and thus needed to be implemented. The case also shed light on the use of informal networks, outside traditional bureaucracy, as a means to deal with interoperability. Such networks were used in order to align actions and perceptions of a large number of autonomous municipalities. This revealed issues concerning local decision as knowledge of, and resources for, ICT and architectural work was lacking in several municipalities. Also, as the networks lacked formal power no decisions could be taken jointly, but in the end had to be negotiated locally. This made coordinated decision making hard as the processes were lengthy and often lacked clear incentives. Furthermore, ambiguous feedback from national authorities, as well as an overall lack of understanding among local actors, concerning what was legal to do in terms of procurement and information sharing, complicated the situation further. These findings are summarized in four main conclusions; The process of defining which organizations are to be made interoperable, or what is to be considered as “the enterprise”, is a political process which might be brought into question and require re-negotiations throughout implementation, as the drawing of boundaries of “the enterprise” can be filled with conflict. Different perspectives on an enterprise, from different architectural viewpoints, are often described as complementary, and it has previously been shown that different architectural metaphors can be used by different actors during implementation. However, in practice, different use of metaphors for architectures can open up for discussion and conflict. These may not only be different, but may also contradict other actors’ use of metaphors, since different metaphors might clash. Interoperability work can be a novel task for some local governments. Therefore, there is a need for negotiation and to establish forms of formal decision making and informal dissemination because such structures might be lacking. It should be anticipated that implementation might be slow because of a lack of understanding about interoperability programs (particularly in terms of something other than ICT). In addition, there may be few forums for coordinated decision making, or there may be obstructions in the form of prior formal and legal arrangements. Enterprise thinking is interconnected with Enterprise Architecture as a zeitgeist for interoperability work. It draws upon EA as an ideal, whilst acknowledging that public organizations are influenced by this zeitgeist, although practical conditions might not allow for adoption of an EA approach. Enterprise thinking thus refers to the notion of EA as an ideal, not as a specific way of applying EA. Enterprise thinking has a process focus on interoperability. ICT, business goals, and work practices are perceived as interconnected, and hence need to be treated from a holistic perspective. How this is approached is, however, dependent upon the context in which it is implemented. Further research efforts could approach how enterprise thinking affects interoperability work in the long run with a longitudinal approach. Also, as this thesis has shown how the use of different architectural metaphors can clash, further research could focus on the positive and negative effects of negotiations being in
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| 8. |
- Rexhepi, Hanife, 1984-
(författare)
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Improving healthcare information systems : A key to evidence based medicine
- 2015
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Licentiatavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Delivering good quality care is a complex endeavor that is highly dependent on patient information and medical knowledge. When decisions about the care of a patient are made, they must, as far as possible, be based on research-derived evidence rather than on clinical skills and experience alone. Evidence based medicine (EBM) is the conscientious and judicious use of current best evidence in conjunction with clinical expertise as well as patient values and preferences to guide healthcare decisions. Following the principles of EBM, healthcare practitioners are required to formulate questions based on patients’ current clinical status, medical history, values and preferences, search the literature for answers, evaluate the evidence for its validity and usefulness, and finally apply the information to the patient. Information systems play a crucial role in the practice of evidence based medicine, by allowing healthcare practitioners to access clinical evidence and information about the patients’ health as they formulate their patient-care strategies. However, current information systems solutions are far from this perspective for various reasons. One of these reasons is that existing information systems do not support a seamless flow of patient information along the patient process. Due to interoperability issues, healthcare practitioners cannot easily exchange patient information from one information system to another and from one healthcare practitioner to another. Consequently, vital information that is stored in separate information systems and which could present a clear and complete picture of the patient cannot be easily accessed. All too often, units have to operate without knowledge of the problems addressed by other healthcare practitioners from other units, the services provided, medications prescribed, or preferences expressed in those previous situations. The practice of EBM is further complicated by current information systems that do not support practitioners in their search and evaluation of current evidence in everyday clinical care.Based on a qualitative approach, this work aims to find solutions for how future healthcare information systems can support the practice of EBM. By combining existing research on process orientation, knowledge management and evidence based medicine with empirical data, a number of recommendations have been initiated. These recommendations aim to support healthcare managers, IT–managers and system developers in the development of future healthcare information systems, from a process-oriented and knowledge management perspective. By following these recommendations, it is possible to develop information systems that facilitate the practice of evidence based medicine, and improve patient engagement.
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| 9. |
- Tsertsidis, Antonios, 1990-
(författare)
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Towards a Consumer-Directed Service Delivery of Digital Technologies for Ageing in Place to People with Dementia
- 2021
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- One of the major societal challenges occuring within our time is that of the increased elderly population and subsequently elderly people suffering from dementia. However, the existing workforce for taking care of this population is rapidly diminishing, thus alternatives or aids are needed. Digital technologies for ageing in place are offered by Swedish municipalities as part of their welfare services. Their aim, to maintain the independency and prolong the time staying at home or also known as “ageing in place”. However, it is important that people with dementia have a say in the delivery of such services by maintaining a consumer-directed role.This thesis address the question: What are the consumer-directed challenges for service delivery of digital technologies for ageing in place to elderly with dementia?The thesis adopts a consumer-directed perspective, meaning that it perceives people with dementia as able to control and direct the delivery of digital technologies for ageing in place. The thesis uses a qualitative case study methodology and a literature review approach. Three case studies are conducted. The first case studied the challenges occuring in the delivery of digital technologies for ageing in place in a Swedish municipality. The second case was conducted at a dementia care residence with the purpose of identifying various needs (from staff, relatives and people with dementia) for suggesting possible digital technologies. The third case investigated the level of Consumer Direction people with dementia have over the delivery process of a mobile security alarm as part of the welfare services. This thesis identifies a number of challenges in the delivery process to people with dementia, and gives an overview of the problematic areas within such process. Lastly the thesis provides insights on the factors that influence the acceptance of digital technologiesf or ageing in place, as a step towards the actual use of the technologies that takes place under the delivery process.
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| 10. |
- Wandin, Helena, 1971-
(författare)
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Symbol-based communication intervention for individuals with Rett syndrome : Current practices, assessment of visual attention, and communication partner strategies
- 2020
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Individuals with Rett syndrome need extensive support to actively participate in social interaction and to develop their communication. The overall aim of this thesis was to investigate communication intervention for individuals with Rett syndrome, especially aided symbol-based communication and partner strategies.Study I was a cross-sectional survey exploring services provided by speech language pathologists (SLPs) in Sweden. Communication aids were often used in the intervention and were found to be useful. Few SLPs used systematic tools for assessment and evaluation and communication partners were often instructed through informal conversations.In study II, a tool (AVAI) for assessing visual attention in interaction was developed and its psychometric properties were explored. AVAI was also used as an outcome measure in study III. In both studies, the tool was found to be reliable, able to detect change and acceptable to the participants.In study III, a single case experimental design was applied to evaluate an intervention consisting of aided language modelling whilst using responsive partner strategies and a gaze-controlled device. The adult participants with Rett syndrome (n=3) increased their expressive communication following individual learning patterns. The intervention was appreciated by the participants’ social network.Study IV was a case study exploring and describing a communication partner’s use of responsive and scaffolding partner strategies in interaction with individuals with Rett syndrome (n=3). The use of these strategies varied in interaction with different individuals with Rett syndrome. The communication partner responded more frequently to communication through a gaze-controlled device than unaided communication.In conclusion, gaze-controlled devices should be considered in communication intervention with individuals with Rett syndrome. Systematic tools and procedures should be applied in interventions, which is not the case in current clinical practice. Adults with Rett syndrome are able to develop their communication which highlights the need for communication support throughout their lifetime.
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