From the Stacks
There are literally thousands of journals published around the world that relate to the disability community. It is virtually impossible to capture even a fraction of them. HELEN receives "stacks" of journals and selectively earmarks what we feel are "must read" articles of interest for our readers. It's a HELEN perk.
Disability Researchers Turn To Families For Advice
Jeremy Olson
Disability Scoop ⎸ 6/23/2026
Gillette Children’s in St. Paul is trying to boost public confidence in medical research by doing something long considered taboo in U.S. healthcare: paying patients and their families to get involved.
The hospital for children and adults with disabilities is one of the first in the U.S. to hire “lived experience” partners who help researchers decide what to study when it comes to experimental treatments and how to evaluate their success or failure. The approach gained national attention this month when it was featured in Pediatrics, an influential scientific journal, as an example for others to follow.
In the past, researchers haven’t paid patients to sign up for clinical trials of new therapies or drugs, beyond travel reimbursements or token gift cards, because they worried that payment might give them a financial incentive to lie or take risks with their own health. But paying patients to give advice based on their own life experiences on how to conduct research can avoid other ethical pitfalls, including the professional incentives that motivate researchers, said Rhonda Cady, leader of Gillette’s health services research.
“The bias of academic research is, ‘What is going to get me funded? What is going to get me tenure?’ Not, ‘What is going to improve the health and quality-of-life outcomes of the person living with this condition?'” she said.
Program leaders said embracing the insights of patients and families could help restore public trust in research that declined following the COVID-19 pandemic and disagreements over everything from vaccines to masks to stay-at-home orders.
The share of Americans with little or no confidence in scientists rose from 12% in 2020 to 27% in 2023, according to polling by Pew Research Center. That trend has started to reverse, but more people still doubt scientists than they did before the pandemic.
Adenike Chon of St. Paul said her experience raising a 17-year-old son with a disability helped her guide Gillette on multiple studies. Her feedback helped broaden a study of a new wheelchair design, for example, to consider the needs of children at different ages and developmental stages. Patient and family input on research should result in better studies with more reliable results, she said, which should in turn boost public confidence.
“You know what happens when you don’t do that? Research programs fail. Devices fail. You have to do research over when you find out you did it wrong, which ends up costing more,” Chon said.
Forty-two patients or relatives have signed up so far to consult on research at Gillette, and 20 are involved in ongoing studies. The hospital considers them contractors who bill at hourly rates of $35 or more.
Payment not only compensates participants for their time, but it gives them a status level in studies that researchers take seriously, said Haley Brunelle, Gillette’s coordinator for family engagement in research. Each study at Gillette needs three lived experience partners to ensure a variety of perspectives.
“I like to think of that old disability mantra, ‘Nothing about us without us,'” Brunelle said. “It’s kind of democratizing the research process.”
Kari Pederson, a Gillette patient for more than 50 years, was diagnosed at age 3 with cerebral palsy, a neurological disorder that severely disrupts muscle tone, movement and posture. She became so closely involved with researchers at Gillette that she ended up as the lead author of an abstract on fall risks that was featured at a recent national conference.
The paper offered a unique perspective on what people with cerebral palsy want and don’t want to keep them safe from injuries, she said.
“I think it’s really affected the culture of Gillette’s research,” she said of the lived experience program, “because they really care about the voice of the patient, but there wasn’t a vehicle for that voice to be shared.”
Clinical Social Work and Healthcare Integration: Interdisciplinary Collaboration and Thematic Evolution over Two Decades
Hafize Nurgul Durmus Senyapar
Springer ⎸ 5/28/26
Abstract
This study presents a comprehensive bibliometric and thematic evolution analysis of scholarship at the intersection of clinical social work and healthcare from 2006 to late 2025. Based on 15,885 publications indexed in the Web of Science and Scopus databases, the analysis employs Bibliometrix and VOSviewer to examine publication trends, keyword co-occurrence patterns, collaboration networks, and thematic trajectories using bibliographic metadata (titles, keywords, and abstracts). The results indicate sustained growth in research output over two decades, reflecting the increasing integration of clinical social work into healthcare research and practice. Core thematic clusters—including social work, healthcare, mental health, palliative care, and patient care—underscore the profession’s combined focus on psychosocial intervention and systemic service delivery. Thematic evolution analysis indicates a shift from earlier emphases on allied health and occupational therapy toward more recent priorities, including mental health crises, interprofessional education, health equity, and digital health. COVID-19 emerges as a major thematic inflection point, highlighting its substantial impact on healthcare systems and social work practice, while the appearance of artificial intelligence and ChatGPT signals growing scholarly engagement with technological, ethical, and policy challenges. Conceptual structure mapping further identifies education, communication, and social support as cross-cutting dimensions linking micro-level practice to macro-level healthcare reform. The findings provide an integrated overview of the field’s intellectual development and offer analytically grounded insights relevant to research, education, and policy discussions on integrated and equitable healthcare systems.
Introduction
The temporal evolution of knowledge at the intersection of clinical social work and healthcare warrants close examination, given the rapidly changing dynamics of both disciplines and their shared role in addressing complex patient needs. Grounded in this longstanding role, clinical social work encompasses a broad professional scope that extends beyond individual therapeutic encounters to include micro-, mezzo-, and macro-level engagement within healthcare systems. Clinical social work has long supported individuals, families, and communities in coping with illness, navigating health systems, and promoting psychosocial well-being. Meanwhile, healthcare is increasingly embracing integrated care models that recognize psychosocial support as central to outcomes (Davis et al., 2019; Juvonen et al., 2022). Analyzing the trajectory of scholarly production at this nexus reveals emerging priorities and persistent gaps, shaping practice, education, and policy in ways that enhance the system’s responsiveness.
The relevance of this field lies in its influence on clinical quality, patient safety, and equity. Positioned at the front line, clinical social workers bridge medical interventions and psychosocial support and advocacy (Petruzzi et al., 2024). Evidence suggests that their contributions enhance adherence, decrease readmissions, and improve patient satisfaction (Abusaq et al., 2024). They also address social determinants—poverty, housing insecurity, and systemic discrimination—that underpin health inequities. Tracking how academic discourse engages with these systemic issues highlights whether innovations in care models translate into measurable safety and quality gains (Rashah et al., 2024; Derrick, 2018). At the systemic level, clinical social work increasingly intersects with health informatics, management, and policy, supporting integrated pathways, preventive strategies, and interprofessional collaboration (Miller, 2019; Coppersmith et al., 2019). This alignment embeds social work within healthcare’s quality and safety agendas, reducing fragmentation in service delivery, a persistent barrier to equitable care (Evans & Owolabi, 2018).
Beyond practice, the co-evolution of these fields carries academic and pedagogical significance. Curriculum design and professional training can draw on these insights to equip future practitioners for multidisciplinary contexts (Padykula et al., 2020; Reed et al., 2022), while policy stakeholders may use them to guide workforce development and regulatory frameworks that sustain integrated, patient-centered care (Putney et al., 2017; Barraclough et al., 2023). Thematic evolution analysis provides a rigorous means of tracing how priorities shift in response to healthcare needs, policy contexts, and practice innovations (Martínez et al., 2015; Yahiaoui et al., 2024). With its dual focus on psychosocial care and systemic advocacy, clinical social work adapts alongside transformations in clinical practice, safety, and equity (Chen et al., 2019), offering a valuable lens for mapping the trajectory of knowledge and informing the future of integrated health systems (Borisso 2024).
In this study, clinical social work is not conceptualized solely as an individual-level therapeutic intervention. Rather, it is understood as a multidimensional practice framework within healthcare settings that integrates micro-level clinical practice, mezzo-level interprofessional collaboration and care coordination, and macro-level roles such as policy advocacy, service development, and organizational practice. This broader conceptualization reflects the established scope of clinical social work in healthcare and avoids portraying it as a newly emerging or narrowly defined discipline. At the same time, this study recognizes that clinical social work practice is deeply shaped by structural factors, including race- and gender-related health disparities, which are considered in interpreting the findings.
The purpose of this study is to provide a comprehensive thematic analysis of research at the intersection of clinical social work and healthcare from 2006 up to November 2025, with a particular focus on its contributions to healthcare quality, equity, and integration. Previous bibliometric studies in related domains have provided valuable insights but were often constrained by limited time frames, narrow thematic scope, or insufficient focus on healthcare-specific outcomes (Shuang & Wang, 2022; Xie et al., 2025; Zhang et al., 2025; Rad et al., 2025). Unlike prior narrative or practice-oriented reviews, this study adopts a bibliometric approach to systematically map the evolution of research in this field, providing a data-driven perspective on the positioning of clinical social work within healthcare scholarship over time. Bibliometric patterns are treated as indicators of practice-relevant knowledge structures, and the analysis is interpreted through a clinical social work perspective to show how changing research trends reflect shifts in clinical priorities, intervention areas, and professional roles within healthcare systems.
The study is guided by three interrelated research questions: (1) What are the dominant and emerging themes within clinical social work and healthcare literature over the past two decades? (2) How have these themes evolved in response to shifts in healthcare delivery systems, technological innovations, and global crises? (3) What do the observed thematic trajectories reveal about collaboration networks, geographic patterns of research, and the alignment of clinical social work with healthcare policy priorities? These guiding questions ensure that the analysis speaks not only to theoretical advancement but also to practical and policy relevance. In particular, they are designed to make explicit how bibliometric patterns translate into clinically meaningful insights for social workers operating within complex healthcare environments.
By applying advanced co-word analysis and thematic evolution techniques, this study is expected to provide a structured overview of the development of scholarship at the intersection of clinical social work and healthcare over time. The analysis aims to clarify areas of continuity and change within the literature, with particular attention to recurring themes—such as patient-centered care, interdisciplinary collaboration, and health equity—as well as the gradual emergence of new domains, including digital health, tele-social work, healthcare informatics, and value-based care. Through a longitudinal mapping of keyword patterns across multiple time slices, the study seeks to illuminate how external forces, including major global health events such as the COVID-19 pandemic, may have influenced shifts in research priorities. Understanding these shifts is particularly relevant for clinical social workers engaged in healthcare settings, as it provides insight into evolving practice priorities, interdisciplinary roles, and emerging areas of intervention within integrated care systems. In this way, the findings are intended to support a more nuanced understanding of the evolving role of clinical social work within healthcare systems and to inform future research, education, and policy discussions concerned with quality, safety, and equitable access to care. The study is intended to provide a clinically relevant knowledge map that informs the practice, priorities, and positioning of clinical social work within healthcare systems. The findings should be interpreted as a macro-level reflection of evolving clinical priorities, with direct implications for assessment, intervention, professional training, and the future scope of clinical social work practice.
Boundary work in the implementation of an assistive exercise product to facilitate physical activity for children with cerebral palsy
Robert Holmberg
Katarina Lauruschkus
Åsa B Tornberg 2
Disability and Rehabilitation: Assistive Technology ⎸ 6/19/26
Abstract
Purpose: Children gain increased health and well-being by participating in physical activity (PA) and exercise. Globally, only 19% of children meet the World Health Organisation recommendations on PA and the rates are even lower among children with disabilities. Children with disabilities are often dependent on assistive exercise products (AEP) to be able to perform PA and exercise. The aim was to identify facilitating and hindering factors for PA of children with cerebral palsy, and additionally to identify conditions for implementation of an AEP for PA in this group.
Materials and methods: Interviews were conducted with healthcare professionals, decision-makers and researchers (N = 11 about experiences of implementing an AEP to support PA for children with cerebral palsy who are non-ambulant), until saturation was sustained. Interviews were transcribed verbatim and analysed through directed content analysis.
Results: Factors that influenced PA in this population were related to the child and the child's immediate environment, characteristics of the AEP itself and the assistive technology system. Findings indicate that severe disabilities contribute to increased complexity affecting implementation. Implementation in this assistive technology system was made more difficult due to boundaries between a development coalition focusing on hope and innovation and a professional bureaucracy coalition, focusing on professional accountability.
Conclusion: Communication across boundaries between stakeholders cannot rely only on transfer of information (dissemination) but depend on skilful management and transformation of boundaries concerning more fundamental differences involving interests.
Plain language summary
This study adds to the current state of knowledge where we have shown that the children’s dependency on their social and physical environment not only affects the child and their caregivers but has profound implications for the development and implementation of assistive technology systems and assistive exercise products. In this paper, we have shown that a focus on boundaries and the role of the implementation object and related resources that act as facilitators or inhibitors for boundary work can allow for a more dynamic and action-oriented understanding of implementation processes in complex healthcare organisations. Within the research setting, the assistive exercise product was part of a scientific community and regulated and used according to a study protocol. Implementation would mean that it transforms into an assistive exercise product that is regulated in ways that conform to laws, policies, guidelines and professional standards relevant to the service. This transformation involves boundary work between different communities of stakeholders that relate to the same physical object: the assistive exercise product. It follows from this that there is no “Archimedean point” in intervention research or implementation studies. Researchers and change agents do not have a privileged, neutral perspective. They also make up a community with its own epistemic culture, and this has to be dealt with, made explicit and taken into account in order to navigate boundaries. In this study, it was possible to identify the contours of two coalitions. We suggest that different coalitions with different orientations dynamically interact to decide the trajectory from idea/research object to a functioning assistive exercise product. Consequently, successful implementation relies on setting up structures and processes that address the interests and assumptions that inform different coalitions. This is a way to understand why early involvement of stakeholders, participatory approaches and participatory design have been shown to be successful. We therefore suggest that not only objects or innovations in themselves, but also research products like reports, presentations and participatory research that structures boundary work can be explored as boundary objects.
Genetic Screening of Newborn Babies
Alasdair Munro
Sensible Medicine ⎸ 6/18/26
Universal newborn screening with whole genome sequencing (WGS) is coming to the UK - at least on paper. There are conditions for which this would seem to clearly make sense, many for which it would be a disaster, and a vast area of grey in between. The government has ambitious plans to roll out WGS for all newborn infants by 2035, but the practical and ethical implications of this are not 10 years away.
Friends of mine are expecting their third baby, and they recently agreed to take part in a research study called Generation Study. This research involves performing genetic screening at birth for a selected set of 200 genetic conditions, and is being undertaken to better understand the implications of the UK government’s ambitious WGS plans.
We discussed their thought process behind consenting, and then they asked me, “Would you have entered your children into this study?”
I paused. Probably for longer than I should have.
Part of it is almost certainly my own philosophical biases about healthcare in childhood. But part of it is due to my apprehension about combining two topics that have great validity and simplicity at face value, but in reality are fraught with practical and ethical complexity.
Genetics
Genetics is of increasing importance within my own specialty (I am a combined paediatric immunology and infectious disease specialist), but it’s become clear it is far more complicated than we previously thought. Two siblings with identical genetic mutations can have vastly differing disease phenotypes - something I witness in my clinical practice. The idea then that we can simply identify any problem with any gene and immediately predict the outcome for the patient has been proven false. Finding variants of uncertain significance (VUS) or uncommon types of mutation make interpreting many genetic results very challenging.
Despite this, it has undoubtedly brought important progress. We have children with conditions that we have understood from the ground up; finding a genetic VUS has prompted more targeted functional testing of the immune pathways involved to clinch a diagnosis. These findings are not academic but have changed the targets of our treatment.
Screening
Despite its many issues in other settings, screening also undoubtedly has huge benefits in paediatrics. In the UK we currently screen for 10 conditions using the newborn blood spot test. One of the best examples is Cystic Fibrosis, the most common life-limiting genetic condition in the UK. We now have drugs which may completely re-establish normal life expectancy for children with CF (CFTR modulators), and the earlier treatment can be started, the better the long-term outcomes.
The criteria for adding to the UK screening list are so strict that no additional conditions were added between 2015 and 2022. This makes it even more challenging to contemplate universal WGS in the next decade.
Why not combine the two?
Testing children with a specific disease phenotype for a targeted set of genes that could be implicated is uncontroversial. Performing genetics tests on a well child prior to symptom onset is a different story.
There are two ends of the spectrum. Take Spinal Muscular Atrophy as a positive example. Because the condition has a clean genotype with bilateral loss of the SMN1 gene, testing will generate few false positives. The intervention window is also extremely narrow, with the new and relatively effective therapies needing to be commenced within the first few months of life to make a big difference to outcomes.
Then there are diagnoses that almost everyone would agree we should not screen for. Huntington’s disease is completely incurable, and the child’s family being aware from birth of this eventually and unavoidably lethal diagnosis is agreed by most to be unethical.
Between these two ends of the spectrum is where things get murky. There are inborn errors of immunity included within the Generation Study which result in immune dysregulation and autoinflammation, which do not usually present with symptoms until later in childhood. Symptoms are then managed responsively, with monitoring for pre-symptomatic inflammation in the interval periods. Should we be screening for these disorders? What do we do with a newborn baby who has not yet developed any symptoms of their disorder, and who would otherwise be living a normal life? Do we monitor them prior to symptom onset? Is there a role for pre-emptive anti-inflammatory treatment? These are not rhetorical but actual clinical questions; questions we have had to ask as children diagnosed as part of this study have come to our service.
Whilst being aware of my particular philosophical stance, I sometimes can’t help but feel that we have stolen something from the infant’s childhood by unearthing their diagnosis before its manifestation. Years spent as a family without doctors’ visits, without health anxiety, and without labels. The sense of normality. These things are precious, and for children with genetic conditions, will not be recovered once lost. Where we can be certain that taking this from a family earlier in life will improve the child’s health and longevity, it seems a worthwhile cost to bear. In some instances, things are not so clear.
What is the future?
Wherever you live, genetic screening at birth seems inevitable once costs have fallen sufficiently, and they are falling rapidly. The Human Genome Project cost more than $2.5 billion by its completion over 20 years ago - we are now approaching sequencing an entire genome for $100.
There are many important questions that need to be answered about the particulars of this testing. Should we be sequencing every child’s entire genome, and if so, what do we do with the data after screening? What rights should the child have to this once they are an adult? Should we test only for specific conditions, and if so, which ones?
I feel that equally stringent criteria should be applied to these conditions as are currently applied to the UK’s existing screening program. There are significant harms in causing confusion and uncertainty with findings that are non-definitive. The aims when designing the program should be to maximise test specificity and to focus only on conditions where we have clear evidence that early diagnosis improves longevity and quality of life. Where this is unknown, screening should only be implemented in a limited research setting.
So, would I have enrolled my children in the study if I’d had the chance? I honestly still don’t know. Would the risks of getting a diagnosis that is uncertain, or unclear if truly actionable, outweigh the potential benefits of getting a life-saving diagnosis in the first weeks of life?
I guess that’s what they call equipoise.
Dr Alasdair Munro is a paediatric specialist in both infectious diseases and immunology, and a clinical trialist working in the UK. He runs vaccine and antibiotic trials. He is on Substack at The Munro Report.
With 2 New Sports, Special Olympics To Get Underway
Michelle Diament, Disability Scoop ⎸ 06/16/26
For the first time in years, thousands of athletes with disabilities are preparing to come together from across the country for a week of competition and much of it will be broadcast.
The Special Olympics USA Games kick off Saturday in Minneapolis.
The event will feature more than 3,000 athletes ranging in age from 14 to 78 from all 50 states who will participate in Olympic-style competition in 16 different sports.
In addition to staples like basketball, bowling, gymnastics, swimming and powerlifting, this year’s games will for the first time include pickleball and cornhole. Some events will involve only athletes with intellectual disabilities while others will be unified meaning that individuals with and without disabilities will compete on the same team together.
ESPN will live stream much of the competition on ESPN+ complete with commentary, analysis and play-by-play reporting. Coverage will begin with the opening ceremony Saturday at 7:30 p.m. featuring performances by Grammy winner Jon Batiste and musician and actor Demi Lovato.
ABC will air a special preview of the games June 21 at noon ET as well as a review show with highlights from the competition July 25 at noon ET.
The USA games, which occur every four years, were last held in Orlando, Fla. in 2022. The next iteration of the national event is expected to be held in Cleveland in 2030.
Study reveals brain circuit that keeps memories from getting mixed up
UCLA Health ⎸ 5/28/26
When a person has a new experience, their brain faces a subtle but critical decision: should this experience be categorized with other stored memories, or should it be filed away as its own new memory? Getting it right allows the brain to help people navigate the world. But getting it wrong can cause false associations to form, which is a feature of several psychiatric conditions such as bipolar disorder and schizophrenia.
In a study published in the journal Nature Neuroscience, UCLA Health researchers have now identified the specific brain circuit that may be responsible for making that call.
Researchers at the UCLA Integrative Center for Learning and Memory found that a region of the brain’s prefrontal cortex, which is associated with decision-making and long-term memory, plays an active role in controlling how memories are organized in the brain’s hippocampus, which is the primary memory storage center. Using mice, they were able to trace the specific pathway through which this memory integration happens.
“We've known for a long time that the prefrontal cortex and hippocampus work together in memory, but how the prefrontal cortex actually controls which memories get linked has been a mystery,” said the study’s first author André de Sousa, a postdoctoral researcher at UCLA Health. “This study identifies a specific circuit that can bidirectionally regulate that process.”
Two key factors determine whether the brain will link two memories together: how similar the experiences are and how far apart in time that they occur. Experiences that happened close together in time, such as within a few hours, tended to be merged in the hippocampus automatically. When experiences were separated by several days, a more deliberate process appeared to take over.
Using mice, the research team found that a brain region called the ventromedial prefrontal cortex, or vmPFC, becomes significantly more active when an animal encounters a new environment several days after a previous one, especially when the two environments are clearly different. That surge in activity, the researchers found, is the brain's way of keeping those memories apart.
The researchers found the vmPFC acts like a quality control checkpoint. After several days, the prefrontal cortex has had enough time to consolidate an earlier memory. When a new experience comes along, it will compare the new experience to that earlier memory. If they are meaningfully different, the vmPFC signals the hippocampus to use a fresh set of neurons to record the new experience, which keeps the memories distinct. When the two experiences are similar, the vmPFC disengages, allowing the hippocampus to encode both memories in many of the same neurons and link them together. If the vmPFC is prevented from doing its job, the hippocampus loses this discriminatory ability and begins to incorrectly merge unrelated memories.
To demonstrate this, the UCLA researchers exposed mice to two distinct environments one week apart. When the mice visited the second environment, the researchers switched off the vmPFC in the mice and the mice behaved as if the two environments were the same. When the mice were given a mild foot shock in the second environment, they showed fear responses when placed in the first environment again despite nothing alarming having happened there.
However, when researchers silenced the vmPFC when mice were exposed to two different environments just five hours apart, nothing changed. The memories were linked regardless. De Sousa said this suggests the vmPFC’s role is specifically about managing memory organization across longer time spans, after it has had adequate time to consolidate what came before.
The study also traced the precise pathway the vmPFC uses to exert its influence using a combination of advanced techniques including miniature microscopes mounted on the heads of mice to watch individual neurons fire in real time and switching specific neurons on or off using drugs or light.
They found the signal traveled from the vmPFC to a relay region called the medial entorhinal cortex, which in turn communicates with the hippocampus. When this vmPFC-to-entorhinal pathway is blocked, memories that should stay separate get incorrectly merged. When it was artificially activated, memories that would normally be linked were pushed apart even when the experiences occurred close together in time.
At the end of this pathway, a specific type of inhibitory neuron in the hippocampus called a neurogliaform cell appears to act as the final gatekeeper, regulating which neurons get recruited to store a new memory and which do not.
“What's striking is that this circuit can work in both directions,” said de Sousa. “We can make memories merge that shouldn't, or keep separate memories that would otherwise be linked, just by manipulating this one pathway. That tells us this is a fundamental control mechanism.”
De Sousa said the findings provide a potential framework for understanding what goes wrong in conditions where memory organization is disrupted. Disorders including schizophrenia, bipolar disorder and certain anxiety disorders are associated with the formation of inappropriate associations and with impaired communication between the prefrontal cortex and hippocampus.
The findings may also have relevance to aging. Memory organization difficulties are a well-documented feature of cognitive decline, and prefrontal-hippocampal communication is known to deteriorate with age.
Further studies are needed to continue investigating how the prefrontal cortex works with the hippocampus to guide appropriate behavior.
“The prefrontal cortex supports several important cognitive functions, including working memory, long-term memory storage, and decision making. We are interested in understanding how it combines these processes with prior knowledge to influence hippocampal activity during memory formation and retrieval,” de Sousa said. “This work could help reveal how the brain integrates different cognitive functions to support adaptive behavior, and how these interactions may become disrupted in aging or disease.”
Children and young people's experiences of extended reality in rehabilitation: Engagement, equity, and ethics
Petra Karlsson
Developmental Medicine & Child Neurology ⎸ 06/06/26
Extended reality (XR), including virtual, augmented, and mixed reality, draws on established psychological principles about how the brain responds to immersive, multisensory environments.1 XR is now used across many domains of pediatric rehabilitation. By overlaying digital elements onto the physical environment, it can prompt purposeful movements such as reaching, grasping, or walking in children and young people with motor impairments. Traditional rehabilitation depends on high volumes of repeated movements, yet achieving this dose in pediatric settings is difficult. XR can turn these repetitions into engaging, game-like tasks that sustain participation. XR-based games also support cognitive rehabilitation, targeting memory, attention, and problem-solving for children and young people with developmental delays or neurological conditions.2 As these immersive environments become more sophisticated, they offer increasing potential for context-rich, interactive tasks aligned with functional goals. XR does not simply present an activity on a screen, it reshapes perception so young people feel as though they are inside the experience. This sense of presence heightens engagement, emotional investment, and motivation, making XR a powerful medium for participation in pediatric rehabilitation.
Hervo et al.3 provide important insights because children and young people's own perspectives on XR are rarely captured despite XR's rapid uptake in clinical settings. Grounded in real-world rehabilitation rather than controlled laboratory environments, the work highlights how XR can enhance autonomy, engagement, and participation. It also identifies implementation considerations clinicians often overlook, such as emotional safety, the relational role of therapists, and the need for adaptable interfaces, offering a more nuanced understanding of ethical and effective XR integration.
XR raises further issues in pediatric rehabilitation. A major gap concerns the developmental impact of repeated or prolonged XR exposure. While short-term effects such as cybersickness, visual strain, and fatigue are documented, no longitudinal research examines how immersive XR influences the developing brain. Most studies are small and focused on immediate therapeutic or experiential outcomes rather than neurodevelopment. This uncertainty has prompted caution, as XR-specific screen time cannot be equated with traditional media use, given its heightened sensory load, perceptual immersion, and collection of biometric data.4
Equity and access also remain major concerns, as XR technologies are costly, unevenly distributed, and often inaccessible to children and young people with disabilities or families with limited resources. This reflects broader UNICEF warnings about children's rights, digital safety, and the risk that emerging technologies may deepen inequities.5 XR reshapes the clinician's role, shifting practice from hands-on, toward technology-mediated interventions. This shift requires new competencies and careful attention to preserving the relational aspects of therapy that children value. Data privacy and child protection pose further ethical challenges. XR systems routinely collect biometric, behavioural, and gaze-tracking data, yet regulatory frameworks lag behind technological capability.
Consistent with broader pediatric XR research, Hervo et al.'s study3 reinforces the importance of family-centred practice with shared decision-making, as interventions aligned with children's preferences and emotional needs are more acceptable, motivating, and safe. Together, these considerations show that XR can enhance motivation, autonomy, and participation when implemented thoughtfully, while also pointing to the need for continued research on safety, clinician training, and the intervention value of commercial XR platforms across diverse contexts.
These findings underscore the need for robust ethical and regulatory frameworks to guide XR's safe integration in pediatric rehabilitation, including child-specific data governance, consent models, and standards for managing biometric and behavioural data. Clinically, XR should remain an adjunct to pediatric rehabilitation, with clinicians central in goal-setting, monitoring, and tailoring experiences to each child and young person's developmental and sensory profile. Ensuring accessibility and inclusion is essential, requiring adaptations for motor, cognitive, or sensory impairments and careful attention to avoid widening inequities in service access.
Acknowledgements
Open access publishing facilitated by The University of Sydney, as part of the Wiley - The University of Sydney agreement via the Council of Australasian University Librarians.
Exceptional Children's Foundation Marks 80 Years of Inclusive Communities and Lifespan Services at Los Angeles Gala
Samantha Maez
The National Law Review ⎸ 5/28/26
Exceptional Children’s Foundation, one of California’s most comprehensive nonprofit providers of lifespan services for children and adults with developmental disabilities and other special needs, will celebrate its 80th Anniversary Gala on Wednesday, June 17, 2026, at the Skirball Cultural Center in Los Angeles.
June 17 event at Skirball Cultural Center honors Jenni Kayne and Richard Ehrlich and supports ECF programs serving nearly 4,000 people annually.
"This anniversary is not only a celebration of what ECF has built, but a call to protect and expand the services that allow people with special needs to learn...”
— Veronica Arteaga, President and CEO of Exceptional Children’s Foundation
Fall-Related Emergency Department Visits Among Adults With and Without Intellectual and Developmental Disabilities or Cerebral Palsy
Natalia Cantet, Teal W. Benevides, Michelle A. Meade, Deborah A. Jehu, Michael M. McKee and Haylie L. Miller
Annals of Family Medicine ⎸ May 2026
Abstract
Although older adults (>65 years of age) are considered the highest-risk population for fall-related injuries, adults with intellectual and/or developmental disability (IDD) or cerebral palsy (CP) are also at increased fall risk. We aimed to compare the incidence of fall-related emergency department (ED) visits with injury and age-related trends among adults aged 18-80 years with IDD or CP and a non-IDD/CP comparison group using the 2019 Healthcare Cost and Utilization Project State Emergency Department Databases. Fall-related ED visits with injury represented a greater proportion of ED visits among adults with IDD or CP compared with adults without. Among adults aged 62-65 years with no IDD/CP, 7.3% of ED visits were for falls with injury. Similar incidences of fall with injury were found at earlier ages among adults with IDD (aged 42-45 years) or CP (aged 34-41 years). Clinicians should consider screening for fall risk at younger ages among patients with IDD or CP.
Advances in music therapy for neurological rehabilitation
Miao Yu, Yuxuan Song, Haochong Song, Haoyang Duan and Guodong Zhang 4
Frontiers in Neurology ⎸ 04.21.26
Abstract
This review systematically examines the advances, mechanisms, and clinical applications of music therapy in neurorehabilitation. The article first delineates the conceptual origins of music therapy and the developmental trajectory of neurologic music therapy, introducing the major technical classifications including receptive methods, active methods, improvisational approaches, and vibroacoustic music therapy. The core section elaborates on the multidimensional mechanisms underlying music therapy in neurorehabilitation, encompassing neuroanatomical networks, neurotrans Melodic Intonation Therapy and endocrine systems, neuroplasticity, and psychobehavioral dimensions, elucidating the functional recovery pathways through auditory-motor integration, neural network reorganization, and neuroplasticity enhancement. Regarding clinical applications, the article comprehensively discusses the specific implementations and evidence-based efficacy of music therapy in the rehabilitation of stroke, Parkinson's disease, and cerebral palsy, including improvements in motor, speech, and cognitive impairments. Finally, the article summarizes current challenges and outlines future directions, aiming to provide theoretical foundations and practical references for the standardized and precision application of music therapy in neurorehabilitation.