Assistive technologies : short overview and trends

This paper gives a brief overview of currently existing assistive technologies for different kinds of disabilities. An elaborate discussion of all types of assistive technologies is beyond the scope of this paper. Assistive technologies have evolved dramatically in recent years and will continue to be further developed thanks to major progress in artificial intelligence, machine learning, robotics, and other areas. Previously, assistive technologies were highly specialized and were often difficult or expensive to acquire. Today, however, many assistive technologies are included in mainstream products and services. An introduction and state of the art of assistive technologies are presented first. These are followed by an overview of technological trends in assistive technologies and a conclusion

What matters to older people with assisted living needs? A phenomenological analysis of the use and non-use of telehealth and telecare

Telehealth and telecare research has been dominated by efficacy trials. The field lacks a sophisticated theorisation of [a] what matters to older people with assisted living needs; [b] how illness affects people's capacity to use technologies; and [c] the materiality of assistive technologies. We sought to develop a phenomenologically and socio-materially informed theoretical model of assistive technology use. Forty people aged 60–98 (recruited via NHS, social care and third sector) were visited at home several times in 2011–13. Using ethnographic methods, we built a detailed picture of participants' lives, illness experiences and use (or non-use) of technologies. Data were analysed phenomenologically, drawing on the work of Heidegger, and contextualised using a structuration approach with reference to Bourdieu's notions of habitus and field. We found that participants' needs were diverse and unique. Each had multiple, mutually reinforcing impairments (e.g. tremor and visual loss and stiff hands) that were steadily worsening, culturally framed and bound up with the prospect of decline and death. They managed these conditions subjectively and experientially, appropriating or adapting technologies so as to enhance their capacity to sense and act on their world. Installed assistive technologies met few participants' needs; some devices had been abandoned and a few deliberately disabled. Successful technology arrangements were often characterised by ‘bricolage’ (pragmatic customisation, combining new with legacy devices) by the participant or someone who knew and cared about them. With few exceptions, the current generation of so-called ‘assisted living technologies’ does not assist people to live with illness. To overcome this irony, technology providers need to move beyond the goal of representing technology users informationally (e.g. as biometric data) to providing flexible components from which individuals and their carers can ‘think with things’ to improve the situated, lived experience of multi-morbidity. A radical revision of assistive technology design policy may be needed

Design for (every)one: co-creation as a bridge between universal design and rehabilitation engineering

In this paper the authors describe a general framework for co-designing assistive devices in a horizontal user innovation network [1] by and for disabled users. This framework attempts to identify, share and use “hidden solutions” in rehabilitation contexts and translate them into disruptive assistive devices build with local resources. Within healthcare contexts local solutions are frequently more effective, as they reflect the physical, emotional and cognitive needs of specific patients and engage all the stakeholders in a specific local context. By using an open horizontal innovation network, where assistive devices can be easily shared and physically hacked by other paramedics, general patterns can be detected and translated into standard universal design objects. This generative design thinking approach [2] is more than feasible with digital trends like crowd sourcing, user-generated content and peer production [3]. Cheap and powerful prototyping tools have become easier to use by non-engineers; it turns them into users as well as self manufactures [4]. We discuss the different aspects of this open innovation process within a ‘design for disability’ context and suggest the first steps of an iterative co-design methodology bringing together professional designers, occupational therapists and patients. In this paper the authors sketch the holistic framework which starts with the innovation development and the co-creation process between these disciplines

Towards solutions for assistive technology

Introduction What is assistive technology? The agreed World Health Organisation definition is "Assistive technology can be defined as “any piece of equipment, or product, whether it is acquired commercially, modified, or customized, that is used to increase, maintain, or improve the functional capabilities of individuals with disabilities” (WHO, 2011) The array of possible assistive technology products and solutions reflects the diversity of the needs of people with disabilities – ranging from digital technologies that can support social engagement, communication, employment, learning, memory, planning and safe guarding services through to products and devices that support mobility and personal care requirements. Typically as the complexities of assistive technology solutions increase, so do the costs and potential risks (if not appropriately set up or maintained). This document is primarily focused on the Assistive Technology solutions derived from aids and equipment. Home and vehicle modifications and prosthetics have not yet been explored in the same level of detail and will be subject of further work. Proposed approach The proposed assistive technology service approach has been developed in line with the strategic goals of the NDIA. It is one aspect of a broader strategic approach the NDIA has to using technologies to enhance its engagement and management of relationships, services and supports with suppliers, providers, participants and the Australian community. The NDIA’s goal is to use technology in its various forms to ensure that services, supports, and communications between all stakeholders are as streamlined as possible and services are timely and effective. This document outlines the elements of a proposed service delivery approach for individuals to access assistive technology solutions and is based on the three key objectives outlined above

Control of virtual environments for young people with learning difficulties

Purpose: The objective of this research is to identify the requirements for the selection or development of usable virtual environment (VE) interface devices for young people with learning disabilities. Method: a user-centred design methodology was employed, to produce a design specification for usable VE interface devices. Details of the users' cognitive, physical and perceptual abilities were obtained through observation and normative assessment tests. Conclusions : A review of computer interface technology, including virtual reality and assistive devices, was conducted. As there were no devices identified that met all the requirements of the design specification, it was concluded that there is a need for the design and development of new concepts. Future research will involve concept and prototype development and user-based evaluation of the prototypes

Inclusion of Persons with Disabilities in the Health Financing System in Tanzania

This report assesses the potential barriers and obstacles that people with disabilities might face when accessing health care services. It is the overall objective of this study to provide evidence on obstacles and financial barriers that people with disabilities might face when accessing health care services in Tanzania. The study presents data of a household surveys with a total amount of 1,480 participants as well as evidence from in-depth interviews and Focus Group Discussions (FGDs) which have been conducted in two selected regions in Tanzania: Tanga and Lindi. The report summarizes these findings and provides evidence on the financing gap in terms of both direct and indirect costs. In order to overcome the many barriers that this report identifies, recommendations on how the gap can be addressed. The relationship between disability and ill-health is complex and need not necessarily result in negative health outcomes for persons with disabilities. This section provides some information on how to define disability. The World Report on Disability (WRD), which was jointly published by the World Bank and the World Health Organization (WHO), notes that disability is associated with a diverse range of primary health conditions of which may result in poor health and high health care needs. Furthermore, the reciprocal relationship ill-health, poverty and vulnerability is emphasized in this chapter.The cross-sectional study at hand employs both quantitative and qualitative research methods. As for the quantitative household survey, 1,480 participants, who were divided into treatment group (households with people with disabilities) and control group (households without people with disabilities), were interviewed in two regions: Tanga and Lindi. The differentiation in these two groups allows to statistically compare whether people with disabilities experience significantly higher barriers to access health care services compared to people without disabilities (instead of just having occurred by chance). Both areas were selected in order to obtain a broader picture in both, rural and urban areas. Furthermore, ethnographic approaches such as in-depth interviews and Focus Group Discussions (FGDs) were used in triangulation, incorporating the advantages of each research approach. The findings of the report suggest that persons with disabilities experience worse socio-economic outcomes and are more prone to poverty than persons without disabilities. Since people with disabilities have lower educational achievements, participate less in the economy and have higher rates of poverty than people without disabilities, they also have a higher risk of poorer health outcomes. Furthermore, the findings of this report show that people with disabilities seldom access health care facilities for either routine or specialised health care services. Only 21 % of the respondents went for routine care within the past three months. The majority of those who went to seek medical assistance went to public health facilities at primary level. Health care seekers reported being overall satisfied with the services and the waiting time. Also, the respondents reported that health service providers tried to establish a trustworthy environment where they treated them in privacy. Those people with disabilities who accessed health services mainly paid the services out of their pocket or through their insurance scheme. Only few people paid the services with other means of informal payment. Additionally, the findings of the report with regards to costs are presented. Costs for medical care can be broken down into three broader categories: (1) Direct Medical Care Costs, (2) Direct Non-Medical Care Costs, (3) Indirect Costs. Overall, 97.4% of the respondents reported to have incurred direct medical costs in both districts. There were more respondents who incurred medical costs for specialised health care in Nachingwea 63.1% as compared to Tanga municipality 47.3%. In terms of indirect costs, 67% of respondents reported that they had to pay for transportation and almost 40 % indicated their consumable costs. In terms of indirect costs, participants reported that they encounter losses of productivity due to the necessity to access health care services (10 days on overage per three months, mean average income lost in Nachingwea and Tanga were Tshs.45,580 (29US$) and Tshs.20,178 (13US$) respectively). Notably, people with disabilities seem to have lower costs for outpatient services than others. This might be due to the fact that many people with disabilities are exempted at dispensary and health center level, though there were complains about the intransparency and malfunctioning of the exemption/waiver-policy in general. In addition, costs for inpatient services (provided at health center and hospital level) for people living with disabilities are almost double the average costs of the control group. (Tshs.77,438 vs Tshs. 41,938). In terms of access to social health protection, few people reported actually using health insurance schemes. Only 12.8 % of the respondents reported to have access to social security related to specialized health care services. Many participants reported that there is not enough information for people with disabilities on insurance schemes and that waiving policies for exempting poor and vulnerable people are inconclusive. More, lack of money seems to be the decisive factor of why people with disabilities are not able to access health care services (72 % reported missing routine health care services and 62 % for specialised health services due to constraint financial resources). Social and communal network are considered particularly important in supporting people with disabilities in accessing health care services. Last but not least, people with disabilities reported a number of unmet needs, including the lack of various services like rehabilitation, counselling services and vocational trainings to improve their productivity. The discussion part of the study contextualises the findings. It reiterates the reciprocal link of poverty and disability and tries to find answers of why people with disabilities hardly access health care services. It further outlines the importance of making health care services available to all, in order to ensure the well-being of people with disabilities. In order to promote the utilization of health care services for people with disability, it further suggests to consider the health care user‟s own perceptions [1]. Despite efforts made by the Ministry of Heath to deliver health care services to the people, most of health care services are still inaccessible to the majority of people with disability. Hence, this study provides a number of recommends with regards to Policy and Legislation, Financing and Affordability, Accessibility and Communit

“Can you hear me now?”: Insurance Coverage for Hearing Benefits in the United States

Public and private insurance coverage for hearing benefits underscores the gaps in coverage for treating hearing loss in the U.S. The commodification of the hearing benefits sector of healthcare in this country has detrimental consequences for personal health. Using three personal anecdotes to frame the issue, my paper explores the complex worlds of both public and private insurance as well as the implications of each type of insurance for both adults and children. Current regulations and laws for hearing benefits leave many people to suffer financially, physically, and emotionally. After reviewing the current regulations I propose changes to rectify some of the problems within this sector of health care

Housing and Support Options for People with Intellectual and Developmental Disabilities

This document presents resources and next-steps for finding housing options by ideal situation and level of support for people suffering with intellectual and/or developmental disabilities