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

Some problems of designing for augmentative and alternative communication users: an enquiry through practical design activity

The submission is concerned with, and addresses, problems of designing for people with disabilities, with specific reference to people who are illiterate and cannot speak. People with such disabilities often depend on electronic AAC (Augmentative and Alternative Communication) devices for interpersonal communication. A central theme of the thesis, however, is that such products, and products intended for people with disabilities more generally, have characteristics that inadequately attend to users' needs. Through a combination of practical product development and literature reviews, the thesis demonstrates how improvements to AAC devices 'can be made through user-participatory, usercentred and more sensitive and perceptive design. Literature reviews in the following subjects are reported: AAC; the operational knowledge base for design and disability; user participatory design; and wearable computing. At the core of the thesis is the presentation and discussion of an empirical case study, carried out by the researcher, to design and develop the Portland Communication Aid (PCA). The PCA was conceived as an AAC product that would attempt to redress the inadequacies of predecessor devices. The design activity for the PCA is traced in the thesis, from initial concepts and development models through to a working prototype. Key ideas and essential principles of the design are illustrated. Throughout the work on the PCA, many problems associated with designing for people with severe communication disabilities were encountered. These problems, as with their resolutions, comprised matters of both designing (as an activity) and design (as product specification). The thesis contains comprehensive exposure and analysis of these problems and resolutions. In particular, the value of shaping meaning, metaphor, and other product semantics into devices intended for use by people with disabilities is explored. The study provides two substantive conclusions. First, that both the activity and the outcomes of Industrial Design have a valuable role in the empowerment and rehabilitation of AAC users. And second, that key principles have been identified that will enable designers to better identify, articulate and respond to the needs of people with communication disabilities (and the needs of people with disabilities more generally

Usability in assistive technology: a case study of an alternative communication system for children with autism

A pesquisa relatada neste artigo contemplou avaliações de usabilidade sobre um sistema de Comunicação Alternativa (CA) voltado para as necessidades de crianças com a Síndrome do Autismo. O processo de construção do Sistema de Comunicação Alternativa para o Letramento de pessoas com Autismo (SCALA) desdobrou-se em diferentes etapas, abrangendo desde a sua idealização até a sua avaliação efetivada com potenciais usuários da ferramenta. Neste artigo, primeiramente são apresentados os requisitos do sistema, sua modelagem e suas propostas de interface. Após, relata-se como se deu a verificação sobre a usabilidade do sistema, seguindo as heurísticas definidas por Nielsen e adaptadas por Rauber, a partir dos métodos de avaliação Inspeção e Teste de usabilidade. No método de inspeção uma das autoras realizou um conjunto de dez tarefas, previamente estabelecidas, a serem realizadas com o sistema. Nos testes de usabilidade, as mesmas tarefas foram realizadas por quatro educadoras especiais atuantes em salas de recursos, com crianças com déficits de oralidade. Os resultados das avaliações realizadas com potenciais usuários da ferramenta apontaram para um conjunto de melhorias a serem realizadas para a implementação da próxima versão do sistema. No momento, a versão 2.0 do SCALA já está em fase de finalização e logo deverá ser disponibilizada gratuitamente no site do projeto.The research reported in this paper included usability evaluations on a system of Alternative Communication (CA) focused on the needs of children with Autism Syndrome. The process of building system Alternative Communication Literacy for people with Autism (SCALA) was divided into different stages, ranging from its idealization to evaluation carried out with potential users of the tool. In this article, we present the first resquisitos system, its modeling and its proposed interface. After it is reported how was checking on the usability of the system, following the heuristics defined by Nielsen and adapted by Rauber, from assessment methods Inspection and Testing of usability. Inspection method in one of the authors conducted a set of ten tasks, previously established, to be performed with the system. In usability testing, the same tasks were performed by four special educators working in resource rooms, children with oral language deficits. The results of the evaluations with potential users of the tool pointed to a series of improvements are made to the implementation of the next version of the system. At the time, the 2.0 version of SCALA is already being finalized and will soon be available for free on the project site

The integration of children with Autism in the Egyptian society by the use of ICT tools

Autism has been discussed through the fields of medicine, sociology or psychology all over the past decades. Today, however it is being discussed through a different lens: „Communication‟. Being privileged by so many virtues, the Mass communication field not only spreads information, news and discusses views but also bonds people together. In that sense, Children with Autism should be part of this dynamic sphere, with the use of Information and Communication Technologies (ICT) tools, integrating those suffering from autism within the Egyptian society. A Descriptive Survey research clarifies the actual use of children with autism to ICT tools through the perspectives of their parents and their caregivers. A comparison between both views interweaving with various demographic criteria clarifies a larger outlook of the issue. The topic was explored through the Uses & Gratification and Digital Divide theories and further added the Laswell Model to elucidate possible clarifications to realize the integration of children with autism in the Egyptian society through the use of ICT tools. „Who, says what to whom‟ principle is scrutinized to identify the best mode to address the information to the children with Autism and make it reach them, based on research and experience. Although the innate limitations of children with Autism can impede integration willingness, the role of ICT can be shaped to serve the parents and caregivers with valid ideas, information and handling mechanisms with the aim of supporting the children with Autism to develop improved behavioral patterns. These techniques will help people affected with autism to be more accepted within the society‟s social code of conduct, and consequently more integrated. High importance is given to early intervention that avoids the hassle of unlearning negative traits. iii The research proved that neither the standard of education nor the financial capabilities of the parents, directly affects the child with Autism‟s acquisition of ICT tools thus the integration within the society. Computer tablets in particular and various ICT tools in general are provided, but the main issue is the awareness and training of the parents and caregivers to know that the child‟s use should be accompanied and tutored for best outcomes. A further step in the research focuses on the correct choice and use of the applications installed on the computer tablets and assistive ICT tools to be tailored to help each child‟s personalized need

A concept-environment for computer-based augmentative and alternative communication founded on a systematic review

Introduction: locked-In Syndrome is admittedly the worst case of motor and speech impairment, it seriously damages the ability of oral and gestural communication of patients. In recent years, alternative and augmentative communication technology has provided resources to restore these patients' ability to communicate. Methods: in order to relate and classify the main methods with that purpose, this work conducted a systematic review on several journal databases. Results: we found 203 related papers and 55 of them were selected to compose the study. After that, we classified them into three major groups and we identified the main difficulties when using each approach. Conclusion: in order to overcome these difficulties, we propose a new system concept to develop an adaptive, robust and low cost communication environment. The proposed system is composed of five modules: data entry, communication, aid to the caregiver and external interaction

The Design of Voice Output Communication Aids

Communication aids are an aided AAC medium that can improve communication for those who otherwise experience difficulties with speaking. Voice output communication aids (VOCAs) provide speech output based on the user’s input and typically use speech synthesis technology. VOCAs present a challenging design brief. Using technology to support face to face communication is a unique challenge that is further compounded by the fact that those accessing VOCAs may require alternative methods of control and/or representation of language. VOCAs are consequently often perceived as slow and ineffectual by those who use them. Design thus offers a considerable potential role in improving the outcomes of VOCA use. This thesis collates a body of work related to the design of VOCAs. The work described investigated different aspects of VOCA design and this commentary explores how these aspects of design impact on the usability of VOCAs. Five publications by the author and a commentary are presented with the aim of demonstrating that the body of work is substantial, coherent, and impactful. The included publications were derived from a number of projects investigating and developing VOCAs and assistive technologies in which the author was involved

Using multimedia technology to enhance self-advocacy of people with intellectual disabilities: Introducing a theoretical framework for ‘Multimedia Advocacy’

Background: Multimedia Advocacy is the use of digital technology for people with intellectual disabilities as means of developing identities, being heard, connecting to family and care networks and, advocating for change. Methods: We explore principles and theories that underpin Multimedia Advocacy, mapping disciplinary approaches that have influenced the concept and praxis. Results: We describe relevant theories from cultural and media studies, personal therapeutic practices, communication, universal design, and systemic adoption of technology. We discuss new ways of achieving person-centred working with digital technology. We aim to develop a stronger theory/practice dialogue between these disciplines. Conclusions: The theories described highlight the importance of embedding access and use of digital technology within everyday settings. Long-term implementation plans and buy-in from all organisational levels are required for Multimedia Advocacy tools to be embraced by health and social care systems so the voice of an individual is included and genuine person-centred practice is achieved