Disability design and innovation in computing research in low resource settings

80% of people with disabilities worldwide live in low resourced settings, rural areas, informal settlements and in multidimensional poverty. ICT4D leverages technological innovations to deliver programs for international development. But very few do so with a focus on and involving people with disabilities in low resource settings. Also, most studies largely focus on publishing the results of the research with a focus on the positive stories and not the learnings and recommendations regarding research processes. In short, researchers rarely examine what was challenging in the process of collaboration. We present reflections from the field across four studies. Our contributions are: (1) an overview of past work in computing with a focus on disability in low resource settings and (2) learnings and recommendations from four collaborative projects in Uganda, Jordan and Kenya over the last two years, that are relevant for future HCI studies in low resource settings with communities with disabilities. We do this through a lens of Disability Interaction and ICT4D

THE CROSS CULTURAL EXAMINATION OF A BRIEF AUTISM DIAGNOSTIC INTERVIEW (ADI-R) IN KOREA AND THE UNITED STATES

Autism is the fastest growing developmental disability in the United States; as many as 1 in 88 individuals have been identified with an Autism Spectrum Disorder (ASD) (Centers for Disease Control and Prevention [CDC], 2010). Although scientists are working on understanding how many people in the population have autism, there is a limited amount of focus on the identification of any cultural factors that may influence people’s understanding about autism, attitudes about autism, and reporting of symptoms. The accepted methods for diagnosing autism are the Autism Diagnostic Observation Schedule (ADOS) and the Autism Diagnostic Interview-Revised (ADI-R). This study seeks to develop a brief version of the ADI-R using Item Response Theory with a Korean sample of school aged children divided into two groups based on age and language ability. The specific items from the Brief Korean Autism Diagnostic Interview (KBADI) are compared to the Korean translated ADI-R scoring algorithms, which were originally derived in the United States, in order to give some insight into any cultural differences. This study aims to identify any Korean cultural influences that may play a role in the parent or caregiver’s reporting of autism symptom

Autism and Communication: A Phenomenology of Parents’ Perspectives

Autism spectrum disorders (ASD) are characterized by language impairments and are often treated with a variety of communication interventions. In addition to these interventions, the parents of autistic children have to learn how to care for and communicate with their children on a daily basis, especially when their children do not speak. This study made use of phenomenological investigation techniques to explore (1) what parents understand about communication with their nonspeaking autistic children and (2) what particular strategies they find to be effective. Six mothers of autistic children were interviewed, and resulting themes were divided according to parents’ understandings and the formal and informal strategies they use. Implications for practice and future research are given

Effects of an Electronic Visual Activity Schedule on Independence for a Student with Severe Disability

This study investigated the effects of an electronic visual activity schedule (eVAS; i.e., FIRST THEN Visual Schedule application) paired with the system of least prompts on the latency period and level of independence that a fifth-grade student with Intellectual Disability needed to transition throughout the day. Also investigated were the value that the teacher and student placed on the use of an eVAS to teach daily life and school routines instead of typical instruction (e.g., traditional visual schedule) and the student’s ability to generalize the use of the eVAS across instructors and materials (display). An ABAB single case design was used to investigate the effects of the eVAS app. Study research results indicated a functional relation between the use of the eVAS paired with the system of least prompts and the students correct responding and decreased latency. Limitations of the study and the suggestions for future research are discussed

Enabling self-directed computer use for individuals with cerebral palsy: a systematic review of available assistive devices and technologies

Aim  The purpose of this study was to systematically review published evidence on the development, use, and effectiveness of devices and technologies that enable or enhance self-directed computer access by individuals with cerebral palsy (CP). Methods  Nine electronic databases were searched using keywords ‘computer’, ‘software’, ‘spastic’, ‘athetoid’, and ‘cerebral palsy’; the reference lists of articles thus identified were also searched. Thirty articles were selected for review, with 23 reports of development and usability testing of devices and seven evaluations of algorithms to increase computer recognition of input and cursor movements. Results  Twenty-four studies had fewer than 10 participants with CP, with a wide age range of 5 to 77 years. Computer task performance was usually tested, but only three groups sought participant feedback on ease and comfort of use. International standards exist to evaluate effectiveness of non-keyboard devices, but only one group undertook this testing. None of the study designs were higher than American Academy for Cerebral Palsy and Developmental Medicine level IV. Interpretation  Access solutions for individuals with CP are in the early stages of development. Future work should include assessment of end-user comfort, effort, and performance as well as design features. Engaging users and therapists when designing and evaluating technologies to enhance computer access may increase acceptance and improve performance

Caregiver perceptions of children who have complex communication needs following a home-based intervention using augmentative and alternative communication in rural Kenya: an intervention note:Home-based intervention using AAC in rural Kenya

A high level of unmet communication need exists amongst children with developmental disabilities in sub-Saharan Africa. This study investigated preliminary evidence of the impact associated with a home-based, caregiver-implemented intervention employing AAC methods, with nine children in rural Kenya who have complex communication needs. The intervention used mainly locally-sourced low-tech materials, and was designed to make use of the child's strengths and the caregiver's natural expertise. A pretest-posttest design was used in the study. Data were gathered using an adapted version of the Communication Profile, which was based on the International Classification of Functioning, Disability, and Health (ICF) framework. The non-parametric Wilcoxon signed-rank test was applied to data from the first two sections of the Communication Profile-Adapted. Qualitative analysis was conducted on the final section. The data provided evidence of statistically significant positive changes in caregiver perceptions of communication at the levels of Body Structure and Function, and Activities for Communication. Also, analysis of the Participation for Communication section revealed some expansion to the children's social activities. The potential impact of the home-based intervention would benefit from investigation on a larger scale. Limitations of the study are discussed

How a Diverse Research Ecosystem Has Generated New Rehabilitation Technologies: Review of NIDILRR’s Rehabilitation Engineering Research Centers

Over 50 million United States citizens (1 in 6 people in the US) have a developmental, acquired, or degenerative disability. The average US citizen can expect to live 20% of his or her life with a disability. Rehabilitation technologies play a major role in improving the quality of life for people with a disability, yet widespread and highly challenging needs remain. Within the US, a major effort aimed at the creation and evaluation of rehabilitation technology has been the Rehabilitation Engineering Research Centers (RERCs) sponsored by the National Institute on Disability, Independent Living, and Rehabilitation Research. As envisioned at their conception by a panel of the National Academy of Science in 1970, these centers were intended to take a “total approach to rehabilitation”, combining medicine, engineering, and related science, to improve the quality of life of individuals with a disability. Here, we review the scope, achievements, and ongoing projects of an unbiased sample of 19 currently active or recently terminated RERCs. Specifically, for each center, we briefly explain the needs it targets, summarize key historical advances, identify emerging innovations, and consider future directions. Our assessment from this review is that the RERC program indeed involves a multidisciplinary approach, with 36 professional fields involved, although 70% of research and development staff are in engineering fields, 23% in clinical fields, and only 7% in basic science fields; significantly, 11% of the professional staff have a disability related to their research. We observe that the RERC program has substantially diversified the scope of its work since the 1970’s, addressing more types of disabilities using more technologies, and, in particular, often now focusing on information technologies. RERC work also now often views users as integrated into an interdependent society through technologies that both people with and without disabilities co-use (such as the internet, wireless communication, and architecture). In addition, RERC research has evolved to view users as able at improving outcomes through learning, exercise, and plasticity (rather than being static), which can be optimally timed. We provide examples of rehabilitation technology innovation produced by the RERCs that illustrate this increasingly diversifying scope and evolving perspective. We conclude by discussing growth opportunities and possible future directions of the RERC program