The Silent Informer, February 1988

A newsletter published for Deaf Catholics in Tucson, A

Aplicación dos produtos de apoio de alta tecnoloxía no desempeño ocupacional das persoas con discapacidade visual: scoping review

[Resumo] Introdución: As persoas con discapacidade visual poden experimentar dificultades na realización de diferentes ocupacións cotiás. A tecnoloxía de apoio (TA) debe actuar coma un facilitador na participación desta poboación en actividades desexadas. Obxectivo: Coñecer se os produtos de apoio de alta tecnoloxía dan resposta ás dificultades no desempeño ocupacional coas que se atopan máis frecuentemente as persoas con discapacidade visual no seu día a día. Metodoloxía: Seguiuse unha metodoloxía de revisión de alcance. A busca bibliográfica foi levada a cabo nas bases de datos CINAHL, PubMed, Scopus e Web of Science. As variables temáticas establecéronse seguindo os compoñentes propostos polo Modelo da Actividade Humana e da Tecnoloxía de Apoio. Para a súa análise empregouse un enfoque mixto. Resultados: Na mostra incluíronse un total de 44 estudos. En moitos casos, non se especificou certa información relativa ás persoas participantes. A TA analizada centrouse principalmente na detección e na evitación de obstáculos, facilitando a mobilidade funcional. Os dispositivos reciben a información mediante sistemas de cámaras para transmitirlla á persoa por son. A TA está deseñada para contextos tanto interiores coma exteriores da vida diaria, e foi testada maiormente en ambientes reais. Conclusión: Os produtos de apoio de alta tecnoloxía están dirixidos principalmente a facilitar a mobilidade funcional, a participación social, e a lectura das persoas con discapacidade visual. En menor medida, abordaron a educación, o deporte e as tarefas do fogar. Así, non se centraron noutras actividades relevantes como a condución ou o emprego.[Resumen] Introducción: Las personas con discapacidad visual pueden experimentan dificultades en la realización de diferentes ocupaciones cotidianas. La tecnología de apoyo (TA) debe actuar como un facilitador en la participación de esta población en actividades deseadas. Objetivo: Conocer si los productos de apoyo de alta tecnología dan respuesta a las dificultades en el desempeño ocupacional con las que se encuentran más frecuentemente las personas con discapacidad visual en su día a día. Metodología: Se siguió una metodología de revisión de alcance. La búsqueda bibliográfica se llevó a cabo en las bases de datos CINAHL, PubMed, Scopus y Web of Science. Las variables temáticas se establecieron siguiendo los componentes propuestos por el Modelo de la Actividad Humana y la Tecnología de Apoyo. Para su análisis se empleó un enfoque mixto. Resultados: En la muestra se incluyeron un total de 44 estudios. En muchos casos, no se especificó cierta información relativa a las personas participantes. La TA analizada se centró principalmente en la detección y evitación de obstáculos, facilitando la movilidad funcional. Los dispositivos reciben la información mediante sistemas de cámaras para transmitírsela a la persona por audio. La TA está diseñada para contextos tanto interiores como exteriores de la vida diaria, y fue testada mayormente en ambientes reales. Conclusión: Los productos de apoyo de alta tecnología están dirigidos principalmente a facilitar la movilidad funcional, la participación social, y la lectura de las personas con discapacidad visual. En menor medida, abordaron la educación, el deporte, o las tareas del hogar. Así, no se centraron en otras actividades relevantes como la conducción o el empleo.[Abstract] Background: People with visual impairment can have difficulties in performing different daily occupations. Assistive technology (AT) should be an enabler in the participation of these population’s desired activities. Aim: To know if high-tech assistive devices respond to difficulties in the occupational performance that people with visual impairment most frequently experiment in their day-to-day lives. Methodology: A methodology of Scoping Review was used. The bibliographic search was carried out in the databases CINAHL, PubMed, Scopus y Web of Science. Thematic variables were established following the components proposed by the Human Activity Assistive Technology Model. For their analyses, a mixed methods approach was used. Results: A total of 44 studies were included in the sample. In many cases, certain information regarding the participants was not specified. The analyzed AT focused mainly on the detection and avoidance of obstacles, facilitating functional mobility. The devices receive the information through camera systems to transmit it to the person by audio. The AT is designed for indoor and outdoor contexts of everyday life, and it was mostly tested in real-world environments. Conclusion: The high-tech assistive devices are primarily aimed at facilitating the functional mobility, social participation, and reading of people with visual impairment. To a lesser extent, they addressed education, sports, or housework. However, they did not focus on other relevant activities such as driving or working.Traballo fin de mestrado (UDC.FCS). Asistencia e investigación sanitaria. Especialidade en Reeducación Funcional, Autonomía Persoal e Calidade de Vida. Curso 2020-202

Technology and Disability Identity: "Now You See Me, Now You Don't"

This qualitative study examines how students’ identities are constructed when technology and disability intersect. Understanding how technology constructs the identities of students with invisible special needs such as learning disabilities is critical to determining why students are resistant to, or accepting of, assistive technology pedagogy. The primary source of data for the study was in-depth, phenomenologically based interviewing using structured, open-ended dialogue. Three Ontario secondary schools provided the setting for the study. Participants included five students with learning disabilities who are users of assistive technology, two parents, two teachers, and two assistive technology coaches. A grounded theory methodology was used to permit theoretical categories to emerge from the data. The purpose of the research was to investigate: (a) Is the promise of technology compromised by the visibility of technology support, and how do students who access technology through the Special Equipment Amount (SEA) negotiate any related social dynamic? (b) What does the diagnosis of a learning disability mean to students and their parents? (c) What are the particular experiences and contexts within which students that access technology through SEA are trained? and (d) How do teachers, parents, and trainers see their role in the technology assistance program? The research findings indicated a strong positive association between the variables of awareness, understanding, and acceptance. Participants’ responses revealed: (a) a direct relationship between students’ lack of awareness of having a disability and lack of knowledge regarding why they have a SEA laptop with access to Assistive Technology (AT), (b) a strong connection between students’ awareness and understanding of the diagnosis of LD and their willingness to “own” or accept a disabled identity in order to access necessary supports such as AT, and (c) overall, that awareness, understanding, and acceptance of a LD appeared to significantly impact students’ willingness to happily engage with AT. Beliefs expressed by participants about responses to AT revealed tensions between the promised empowerment of AT and the negative self-perception related to AT use. Students appeared to be unwittingly trapped in a cost-versus-benefit dynamic, such as independence and improved abilities versus inferior status and social labelling. Consistent with the literature on stigma related to invisible disabilities, students in some instances appeared to shoulder the burden associated with the social cost of being perceived as academically inferior. Participants perceived several reasons for lack of engagement and abandonment of SEA equipment, including stigmatized identities, compromised self-esteem, and indifference. Although these reasons prove to be barriers to successful integration and engagement with SEA equipment, in this study, stigma appeared to be the most powerful recurring explanation for AT abandonment.

Technology and Disability Identity: Now You See Me, Now You Don\u27t

This qualitative study examines how students’ identities are constructed when technology and disability intersect. Understanding how technology constructs the identities of students with invisible special needs such as learning disabilities is critical to determining why students are resistant to, or accepting of, assistive technology pedagogy. The primary source of data for the study was in-depth, phenomenologically based interviewing using structured, open-ended dialogue. Three Ontario secondary schools provided the setting for the study. Participants included five students with learning disabilities who are users of assistive technology, two parents, two teachers, and two assistive technology coaches. A grounded theory methodology was used to permit theoretical categories to emerge from the data. The purpose of the research was to investigate: (a) Is the promise of technology compromised by the visibility of technology support, and how do students who access technology through the Special Equipment Amount (SEA) negotiate any related social dynamic? (b) What does the diagnosis of a learning disability mean to students and their parents? (c) What are the particular experiences and contexts within which students that access technology through SEA are trained? and (d) How do teachers, parents, and trainers see their role in the technology assistance program? The research findings indicated a strong positive association between the variables of awareness, understanding, and acceptance. Participants’ responses revealed: (a) a direct relationship between students’ lack of awareness of having a disability and lack of knowledge regarding why they have a SEA laptop with access to Assistive Technology (AT), (b) a strong connection between students’ awareness and understanding of the diagnosis of LD and their willingness to “own” or accept a disabled identity in order to access necessary supports such as AT, and (c) overall, that awareness, understanding, and acceptance of a LD appeared to significantly impact students’ willingness to happily engage with AT. Beliefs expressed by participants about responses to AT revealed tensions between the promised empowerment of AT and the negative self-perception related to AT use. Students appeared to be unwittingly trapped in a cost-versus-benefit dynamic, such as independence and improved abilities versus inferior status and social labelling. Consistent with the literature on stigma related to invisible disabilities, students in some instances appeared to shoulder the burden associated with the social cost of being perceived as academically inferior. Participants perceived several reasons for lack of engagement and abandonment of SEA equipment, including stigmatized identities, compromised self-esteem, and indifference. Although these reasons prove to be barriers to successful integration and engagement with SEA equipment, in this study, stigma appeared to be the most powerful recurring explanation for AT abandonment

EXPLORING THE ACCESSIBILITY OF HOME-BASED, VOICE-CONTROLLED INTELLIGENT PERSONAL ASSISTANTS

From an accessibility perspective, home-based, voice-controlled intelligent personal assistants (IPAs) have the potential to greatly expand speech interaction beyond dictation and screenreader output. This research examines the accessibility of off-the-shelf IPAs (e.g., Amazon Echo) by conducting two exploratory studies. To explore the use of IPAs by people with disabilities, we analyzed 346 Amazon Echo reviews mentioning users with disabilities, followed by interviews with 16 visually impaired IPA users. Although some accessibility challenges exist, individuals with a range of disabilities are using IPAs, including unexpected uses such as speech therapy and memory aids. The second study involved a three-week deployment of Echo Dot, a popular IPA, with five older adults who use technology infrequently. Findings indicate preferences for using IPAs over traditional computing devices. We identify design implications to improve IPAs for this population. Both studies highlight issues of discoverability and the need for feature-rich voice-based applications. The findings of this research can inform future work on accessible voice-based IPAs

Engaging older adults and people with dementia in the design of digital technologies

PhD ThesisImprovements in healthcare and nutrition have led to increased life expectancies for people around the world, and a growing need to support the larger numbers of older people living with chronic and age-related health conditions. Although the use of digital technologies is increasingly proposed for health and social care solutions, in practice the designers of these technologies are ill equipped to actively engage older people and in particular people with syndromes such as dementia. An examination of previous work on design for older people, and people with dementia, suggests that poor design arises from a gulf in knowledge and experience between the designers and their subjects. To address this divide the KITE participatory design method for engaging people with dementia in design is proposed. KITE facilitates engagement by structuring and scaffolding an empathic relationship between designers and their participants. The approach is elaborated and evaluated through an exercise to design a digital technology to help people with dementia have safe walking experiences. The analysis of this process leads to the formulation of the OASIS design method which is intended to apply to older people more generally. OASIS is evaluated and refined through a number of design studies for technologies to support healthy eating, day-to-day travelling needs and living safely within the community. Reflection on the application of the OASIS method highlights a number of key strategies that can be used to establish and maintain respectful, empathic, and productive participatory design relationships with older adults and people with dementia

DESIGN AND EVALUATION OF A NONVERBAL COMMUNICATION PLATFORM BETWEEN ASSISTIVE ROBOTS AND THEIR USERS

Assistive robotics will become integral to the everyday lives of a human population that is increasingly mobile, older, urban-centric and networked. The overwhelming demands on healthcare delivery alone will compel the adoption of assistive robotics. How will we communicate with such robots, and how will they communicate with us? This research makes the case for a relatively \u27artificial\u27 mode of nonverbal human-robot communication that is non-disruptive, non-competitive, and non-invasive human-robot communication that we envision will be willingly invited into our private and working lives over time. This research proposes a non-verbal communication (NVC) platform be conveyed by familiar lights and sounds, and elaborated here are experiments with our NVC platform in a rehabilitation hospital. This NVC is embedded into the Assistive Robotic Table (ART), developed within our lab, that supports the well-being of an expanding population of older adults and those with limited mobility. The broader aim of this research is to afford people robot-assistants that exist and interact with them in the recesses, rather than in the foreground, of their intimate and social lives. With support from our larger research team, I designed and evaluated several alternative modes of nonverbal robot communication with the objective of establishing a nonverbal, human-robot communication loop that evolves with users and can be modified by users. The study was conducted with 10-13 clinicians -- doctors and occupational, physical, and speech therapists -- at a local rehabilitation hospital through three iterative design and evaluation phases and a final usability study session. For our test case at a rehabilitation hospital, medical staff iteratively refined our NVC platform, stated a willingness to use our platform, and declared NVC as a desirable research path. In addition, these clinicians provided the requirements for human-robot interaction (HRI) in clinical settings, suggesting great promise for our mode of human-robot communication for this and other applications and environments involving intimate HRI

Understanding Education for the Visually Impaired

The contribution that this book makes to scholarship is regarded as ground-breaking, as it is based on recent research conducted with teachers on the ground-level, as well as on research and experiences of practitioners, gained over many years. In this volume, Understanding education for the visually impaired, the focus falls on understanding visual impairment within the South African context, more specifically on what the education of these learners entails. In addition to the contribution to existing literature in the fields of inclusive education and visual impairment, the publication has practical application value for teachers and practitioners who work with and support such learners

Training Needs and Development of Online AT Training for Healthcare Professionals in UK and France

Background: Assistive Technology (AT) solutions for people with disabilities has become part of mainstream care provision. Despite advantages of AT on offer, abandonment and non-compliance are challenges for healthcare professionals (HCPs), introducing this technology to clients. Studies of abandonment reveal that 1/3 of all devices provided to service users end up stored unused. Key need is training to make informed decisions about AT tailored to individual needs and circumstances. In an online survey undertaken by the ADAPT project, HPCs identified AT training needs and barriers. Currently, a programme is being developed aimed at introducing AT concepts and enhancing practices to a wide range of HCPs. Method: Survey questions explored gaps, availability, qualifications and barriers to AT training in England and France. A series of consultation meetings with ADAPT partners took place. An advisory group consisting of longstanding AT users and their formal/informal carers and HCPs (occupational therapist, speech and language therapist, psychologist and biomedical engineer) contributed to the discussions on survey findings, development and evaluation of AT training for HCPs, key content areas and means of delivery. Key results: HCPs had no AT specific qualifications (UK 94.6%; FR 81.3%) nor in-service AT training (UK 65.1%; FR 66.4%). They either did not know of AT courses (UK 63.3%) or knew that none existed (FR 72.5%). Barriers to AT training were mainly local training (UK 62.7%, FR 50%) and funding (UK 62.7%, FR 55.7%). Some training priorities were clearer for French HCPs – overall knowledge of AT devices (82.1%, UK 45.8%), customization of AT (65.3%, UK 30.1%), assessing patient holistically (53.4%, UK 25.3%), educating patient/carers (56.5%, UK 28.3%) (p < 0.001). Variances may be due to differing country-specific HCP education approach. A third of both groups highlighted also abandonment, client follow-up, powered wheelchair training and prescribing AT. To bridge gaps in knowledge and identified training needs of HCPs, the online interactive training programme starts by introducing foundations of AT, including definitions, types/uses of AT, legislation/policies and AT in practice. More specialist units build and expand on specific areas, e.g. AT for mobility, communication, assessment and evidence-based practice. The biopsychosocial model of Health and World Health Organisation’s (WHO) International Classification of Functioning, Disability and Health (ICF) framework underpin development of content. ICF shifts focus from disability to health and functioning, in line with a social model of rehabilitation. E-learning comprises existing videos, AT textbook material and bespoke animated presentations. Selfassessment and evaluation of training are embedded and learners receive certificate of completion. Training was piloted to a group of HCPs trainees and postregistration HCPs who commented on relevance of AT content, clarity, accessibility of presentation, and usefulness. Users found training very useful, especially legislation/policies and AT literature. Conclusion: Overall, survey results suggest that both UK and French HCPs’ training on AT solutions is limited and highly variable. There is need for crosschannel AT professional competencies, availability of work-based training and funding support. Development of online, interactive training aims to increase professional confidence and competence in this area as well as the evidence base for AT

A Survey of Assistive Technology (AT) Knowledge and Experiences of Healthcare Professionals in the UK and France: Challenges and Opportunities for Workforce Development

Background: Assistive Technologies (AT) in healthcare can increase independence and quality of life for users. Concurrently, new AT devices offer opportunities for individualised care solutions. Nonetheless, AT remains under-utilised and is poorly integrated in practice by healthcare professionals (HCPs). Although occupational therapists (OTs), physiotherapists and speech and language therapists (SLTs) consider that AT solutions can offer problem-solving approaches to personalised care, they have a lesser understanding of application of AT in their practice. In this paper, we report findings of a survey on AT knowledge and experiences of HCPs in UK and France. Training needs also explored in the survey are presented in a separate paper on development of online training for the ADAPT project. Method: A survey of 37 closed/open questions was developed in English and French by a team of healthcare researchers. Content was informed by published surveys and studies. Email invitations were circulated to contacts in Health Trusts in UK and France ADAPT regions and the survey was hosted on an online platform. Knowledge questions addressed AT understanding and views of impact on user’s lives. Experience questions focussed on current practices, prescription, follow-up, abandonment and practice standards. 429 HCPs completed the survey (UK = 167; FR = 262) between June and November 2018. Key results: Participants were mainly female (UK 89.2%; FR 82.8%) and qualified 10+ years (UK 66.5%; FR 62.2%). A key group in both countries were OTs (UK 34.1%; FR 46.6%), with more physiotherapists and SLTs in UK (16.8%, 16.8%; vs. FR 6.5%, 2.3%), and more nurses in France (22.1% Vs. UK 10.8%). More HCPs were qualified to degree level in France (75.2%; UK 48.5%, p < 0.001). In terms of knowledge, all HCPs agreed that AT helps people complete otherwise difficult or impossible tasks (UK 86.2%; FR 94.3%) and that successful AT adoption always depends on support from carers, family and professionals (UK 52.7%; FR 66.2%). There were some notable differences between countries that require further exploration. For example, more French HCPs thought that AT is provided by trial and error (84.7%, UK 45.5%, p < 0.001), while more UK HCPs believed that AT promotes autonomous living (93.4%; FR 42.8%, p < 0.001). Also, more French HCPs considered that AT refers exclusively to technologically advanced electronic devices (71.8%, UK 28.8%, p <0.001). In both countries, top AT prescribers were OTs, physiotherapists and SLTs. Respondents had little/no knowledge in comparing/choosing AT (UK 86.8%; FR 76.7%) and stated they would benefit from interdisciplinary clinical standards (UK 80.8%; FR 77.1%). A third of HCPs did not know if AT users had access to adequate resources/support (UK 34.1%; FR 27.5%) and rated themselves as capable to monitor continued effective use of AT (UK 38.9%; FR 34.8%). Conclusion: Knowledge and application of AT was varied between the two countries due to differences in health care provision and support mechanisms. Survey findings suggest that HCPs recognised the value of AT for users’ improved care, but had low confidence in their ability to choose appropriate AT solutions and monitor continued use, and would welcome AT interdisciplinary clinical standards