| Summary: | This thesis investigated the use of technology, the benefits this can offer, and the experience of using technology, for individuals with a range of difficulties that impact on their learning. It also explored the benefits of technology for facilitating children to communicate. Paper 1 is a meta-synthesis of qualitative studies exploring the experience of using different types of technology for children, young people and adults with learning difficulties and disabilities. A systematic literature search of nine databases, specific journals and Google Scholar identified 1221 studies, of which ten met inclusion criteria. Noblit and Hare's (1988) meta-ethnographic approach and Britten et al.'s (2002) second- and third-order interpretations were used to synthesise the studies, resulting in three themes and nine sub-themes, and third-order interpretations to inform further research. A model of overarching themes and those unique to people with learning disabilities was developed and clinical implications were discussed. Paper 2 is an empirical paper exploring the comparability of an iPad application (app) assessment tool called This Much! as a response modality for a paper-based health-related quality of life measure. It explored the use of different statistical methods to test agreement between response modalities, including correlation, paired samples t-test, and a recommended approach which is the Bland and Altman method (1986). Finally it explored the acceptability of the iPad app for children. Seventy children aged 5 to 9 years completed the paper and iPad app response modalities in a counter-balanced design and indicated their preference. All children could use the iPad app and the majority understood the questionnaire across both modalities. The two modalities did not show acceptable agreement in total scores, and only the recommended approach to measuring agreement between methods identified this. Fifty seven children (82.6%) reported preferring the iPad format. Paper 3 is an empirical paper that builds on Paper 2, exploring the feasibility of the iPad app response modality with children with special educational needs (SEN). It included 15 children aged 5 to 10 years in mainstream primary schools with a range of SEN. It examined their understanding of the questionnaire, their use of and engagement with the iPad app, their response times to the different subscales, and their views on the iPad app. All children were able to use the iPad app regardless of their level of understanding. It discussed the potential for the iPad app to facilitate assessment with children with SEN in an engaging and accessible way, and some of the difficulties children experienced with this. Paper 4 is a critical reflection on the research process as a whole and on the individual papers described above, in terms of methodology, clinical and research implications, and personal reflections.
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