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. 2025 May;20(4):1128-1139.
doi: 10.1080/17483107.2024.2437142. Epub 2024 Dec 8.

Eyes on communication: strategies to facilitate uptake of clinical practice guidelines for implementation of eye-gaze control technology by people with cerebral palsy. A mixed methods study

Breyana Stevens-Hofer  1 , Margaret Wallen  1 , Michelle McInerney  2 , Petra Karlsson  3
Affiliations

Eyes on communication: strategies to facilitate uptake of clinical practice guidelines for implementation of eye-gaze control technology by people with cerebral palsy. A mixed methods study

Breyana Stevens-Hofer et al. Disabil Rehabil Assist Technol. 2025 May.

Abstract

Guidelines for implementation of eye-gaze control technology by people with cerebral palsy were published in 2021. The purpose of this study was to identify barriers and facilitators clinicians perceive exist relating to use of these guidelines for eye-gaze control technology, and to explore potential resources that may be developed to support their implementation. A two-phased mixed methods explanatory sequential design was adopted. In phase 1, an online survey containing quantitative and open-ended questions was completed by 97 health professionals and in phase 2 two online focus groups of five clinicians were conducted. The guidelines for eye-gaze control technology were considered helpful for clinicians new to eye-gaze control technology, useful to provide insight into processes for implementing eye-gaze control technology, were flexible, supported clinical reasoning and professional credibility, and were easy to use. However, time to read the guidelines for eye-gaze control technology, and insufficient funding for time to implement the technology were prominent barriers identified in this study. Through the qualitative findings four themes emerged: (1) Complexity of learning to use and implement the guidelines for eye-gaze control technology; (2) Time and resources in short supply; (3) Takes a dedicated team working together; and (4) guidelines for eye-gaze control technology informing practice. Participants in both study phases identified: case studies and video examples; education and training; and practice in implementing eye-gaze control technology, as facilitators to aligning their practice with the guidelines for eye-gaze control technology recommendations and to optimise outcomes.

Keywords: Eye-tracking; assistive technology; augmentative and alternative communication; cerebral palsy; clinical guidelines.

Plain language summary

Navigating the implementation of eye-gaze control technology (EGCT) is a complex process that requires time, funding, and other resources.Barriers to implementation of existing EGCT include inadequate time and funding.Use of existing EGCT Guidelines would be supported by clinically oriented education, resources to enhance efficiency of using guidelines, organisational support and enabling more effective access to the guidelines.Outcomes of EGCT may be enhanced by more realistic provision of funding and ensuring a strong support network for the user of the technology.Free access to the EGCT clinical guidelines is available here: https://www.ausacpdm.org.au/resources/eye-gaze-control-clinical-guidelines/.

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