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Assistive Technology Assessment Handbook

March 2012

March 2012

DOI:10.1201/b11821

Publisher: CRC Press
ISBN: 978-1-4398-3865-5

Authors:

Stefano Federici

University of Perugia. Italy

Marcia Scherer

Institute for Matching Person and Technology

The process of matching a person who has a disability with the most appropriate assistive technology requires a series of assessments, typically administered by multidisciplinary teams at specialized centers for technical aid. Assistive Technology Assessment Handbook fills the need for a reference that helps assistive technology experts perform assessments that more effectively connect the person and the technology. Emphasizing the well-being of the individual with a disability, the book proposes an ideal model of the assistive technology assessment process and outlines how this model can be applied in practice internationally. Organized into three parts, the handbook: Gives readers a toolkit for performing assessments Describes the roles of the assessment team members, among them the new profession of the psychotechnologist, who is skilled in understanding individuals and their psychosocial and technological needs and preferences Reviews cutting-edge technologies for rehabilitation and independent living, including brain–computer interfaces and microswitches The book synthesizes information scattered throughout the international literature, focusing on aspects that are particularly representative or innovative. It also addresses the challenges posed by the variety of health and social care systems and the different ways that individuals who need aid are defined—are they users, patients, clients, or consumers, and how does that affect the assessment?

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Assistive Technology

Assessment

Handbook

Rehabilitation Science in Practice Series

Series Edito

Published Titles

Assistive Technology Assessment Handbook,

edited by Stefano Federici and Marcia J. Scherer

Paediatric Rehabilitation Engineering: From Disability to Possibility,

edited by Tom Chau and Jillian Fairley

Forthcoming Titles

Ambient Assisted Living, edited by Nuno M. Garcia, Joel Jose P. C. Rodrigues,

Dirk Christian Elias, Miguel Sales Dias

Assistive Technology for the Visually Impaired/Blind,

Roberto Manduchi and Sri Kurniawan

Computer Systems Experiences of Users with and without Disabilities:

An Evaluation Guide for Professionals,

Simone Borsci, Masaaki Kurosu, Stefano Federici, Maria Laura Mele

Multiple Sclerosis Rehabilitation: From Impairment to Participation,

edited by Marcia Finlayson

Neuroprosthetics: Principles and Applications, Justin C. Sanchez

Rehabilitation Goal Setting: Theory, Practice and Evidence,

edited by Richard Siegert and William Levack

Quality of Life Technology, Richard Schultz

Marcia J. Scherer, Ph.D.

President

Institute for Matching Person and Technology

Professor

Orthopaedics and Rehabilitation

University of Rochester Medical Center

Dave Muller, Ph.D.

Executive

Suffolk New College

Editor-in-Chief

Disability and Rehabilitation

Founding Editor

Aphasiology

CRC Press is an imprint of the

Taylor & Francis Group, an informa business

Boca Raton London New York

Editedby

StefanoFedericiandMarciaJ.Scherer

Assistive Technology

Assessment

Handbook

CRC Press

Taylor & Francis Group

6000 Broken Sound Parkway NW, Suite 300

Boca Raton, FL 33487-2742

CRC Press is an imprint of Taylor & Francis Group, an Informa business

No claim to original U.S. Government works

Version Date: 20120227

International Standard Book Number-13: 978-1-4398-3866-2 (eBook - PDF)

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Visit the Taylor & Francis Web site at

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and the CRC Press Web site at

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CRC Press

Taylor & Francis Group

6000 Broken Sound Parkway NW, Suite 300

Boca Raton, FL 33487-2742

CRC Press is an imprint of Taylor & Francis Group, an Informa business

No claim to original U.S. Government works

Printed in the United States of America on acid-free paper

Version Date: 20120227

Internat ional Standard Book Number: 978-1-4398-38 65-5 (Hardback)

This book contains information obtained from authentic and highly regarded sources. Reasonable efforts have been made to

publish reliable data and information, but the author a nd publisher cannot assume responsibilit y for the validity of all materials

or the consequences of t heir use. The authors a nd publishers have attempted to trace the copy right holders of all materia l repro-

duced in this publication and apologize to copyright holders if permission to publish in this form has not been obtained. If any

Except as p ermitted under U. S. Copyright L aw, no part of t his book may be repr inted, reproduced, t ransmitte d, or utilized i n any

form by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying, microfilming,

and recording, or in any information storage or retrieval system, without written permission from the publishers.

For permission to photocopy or use material electronically from this work, please access www.copyright.com (http://ww w.copy-

right.com/) or contact the Copyright Clearance Center, Inc. (CCC), 222 Rosewood Drive, Danvers, MA 01923, 978-750-8400.

CCC is a not-for-profit orga nization that prov ides license s and registrat ion for a variet y of users. For organ izations that h ave been

granted a photocopy license by the CCC, a separate system of payment has been arranged.

Trademark Notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identifica-

tion and explanation without intent to infringe.

Librar y of Congress Cataloging‑in‑Publication Data

Assistive technology assessment handbook / editor[s], Stefano Federici, Marcia J. Scherer.

p. ; cm. -- (Rehabilitation science in practice series)

Includes bibliographical references and index.

ISBN 978-1-4398-3865-5 (hardback : alk. paper)

I. Federici, Stefano. II. Scherer, Marcia J. (Marcia Joslyn), 1948- III. Series: Rehabilitation science in

practice series.

[DNLM: 1. Self-Help Devices. 2. Technolog y Assessment, Biomedical. 3. Disabled

Persons--rehabilitation. WB 320]

617’.033--dc23 2012000644

Visit the Taylor & Francis Web site at

http://www.taylorandfrancis.com

and the CRC Press Web site at

http://www.crcpress.com

This book is dedicated to the psychotechnologists of today and the

future, regardless of the country in which they work.

vii

Contents

Foreword .........................................................................................................................................ix

Preface .............................................................................................................................................xv

Contributors ................................................................................................................................. xix

Section I The Assistive Technology Assessment Model and

Basic Definitions

S. Federici and M. J. Scherer

1. Assessing Individual Functioning and Disability ........................................................ 11

S. Federici, M. J. Scherer, F. Meloni, F. Corradi, M.Adya,D. Samant,

M.Morris,and A. Stella

2. Measuring Individual Functioning .................................................................................. 25

S. Federici, F. Meloni, and F. Corradi

3. Measuring the Assistive Technology Match................................................................... 49

F. Corradi, M. J. Scherer, and A. Lo Presti

4. The Assessment of the Environments of AT Use: Accessibility,

Sustainability, and Universal Design .............................................................................. 67

M. Mirza, A. Gossett Zakrajsek, and S. Borsci

5. Measuring the Impact of AT on Family Caregivers ....................................................... 83

L. Demers and B.W. Mortenson

Section II Assessment Professionals: Working on the

Multidisciplinary Team

M. J. Scherer and S. Federici

6. The Cognitive Therapist ................................................................................................... 107

M. Olivetti Belardinelli, B. Turella, and M. J. Scherer

7. The Special Educator ......................................................................................................... 131

S. Zapf and G. Craddock

8. The Psychologist ................................................................................................................. 149

F. Meloni, S. Federici, A. Stella, C. Mazzeschi, B. Cordella, F. Greco, and M. Grasso

9. The Psychotechnologist: A New Profession in the Assistive Technology

Assessment ...........................................................................................................................179

K. Miesenberger, F. Corradi, and M. L. Mele

viii Contents

10. The Opt ometr ist .................................................................................................................. 201

M. Orlandi and R. Amantis

11. The Occupational Therapist: Enabling Activities and Participation Using

Assistive Technology ......................................................................................................... 229

D. de Jonge, P. M. Wielandt, S. Zapf, and A. Eldridge

12. Pediatric Specialists in Assistive Solutions .................................................................. 245

L. W. Braga, I. L. de Camillis Gil, K. S. Pinto, and P. S. Siebra Beraldo

13. The Ger iatr ician .................................................................................................................. 269

M. Pigliautile, L. Tiberio, P. Mecocci, and S. Federici

14. Role of Speech–Language Pathologists in Assitive Technology Assessments...... 301

K. Hill and V. Corsi

Section III Assistive Technology Devices and Services

S. Federici and M. J. Scherer

15. Systemic User Experience ................................................................................................. 337

S. Borsci, M. Kurosu, M. L. Mele, and S. Federici

16. Web Solutions for Rehabilitation and Daily Life ........................................................ 361

G. Liotta, E. Di Giacomo, R. Magni, and F. Corradi

17. Brain–Computer Interfaces: The New Landscape in Assistive Technology .......... 379

E. Pasqualotto, S. Federici, M. Olivetti Belardinelli, and N. Birbaumer

18. New Rehabilitation Opportunities forPersonswith Multiple Disabilities

Through the Use of Microswitch Technology .............................................................. 399

G. E. Lancioni, N. N. Singh, M. F. O’Reilly, J. Sigafoos, D. Oliva, and G. Basili

19. Methods and Technologies for Leisure, Recreation, and an Accessible Sport ...... 421

C. M. Capio, G. Mascolo, and C. H. P. Sit

Index ............................................................................................................................................. 439

Foreword

Global Perspectives and Emerging Themes in

Assistive Technology Assessment

I am delighted and privileged to be asked by the eminent editors of this text, Stefano

Federici and Marcia J. Scherer, to write a foreword. These colleagues are at the forefront

of work within the eld of assistive technology and have pioneered much of the current

thinking resulting in both the delivery of services to individuals and transformational

research. The emergence and importance of this eld can be demonstrated through the

emergence of Disability and Rehabilitation: Assistive Technology as a standalone journal

afliated with Disability and Rehabilitation. This journal, which embraces the broad eld of

assistive technology, is edited by Marcia J. Scherer, ably assisted by Stefano Federici as an

editorial board member.

These two journals, like this book, are characterized by their international coverage,

multiprofessional publications, and interprofessional research of the highest quality.

This edited volume includes contributions from ve continents and reinforces the global

approach to responding to the needs of individuals and in some cases communities

requiring support and intervention.

This is no easy challenge, and the need remains to recognize both the integrity of those

contributing disciplines and individuals along with the emerging integrative approach to

rehabilitation.

What this text does is set a framework for future practice and research within the eld

of assistive technology assessment. It is clearly structured into three sections, the rst of

which sets the context, the second brings together perspectives from those professions

working in the eld, and the third focuses on assistive technology devices themselves

and the positive outcomes that can emerge. Each section of this book has a separate

introduction, and these contributions themselves are not only informative but reect the

vision of the editors for this eld of work.

Having been asked to write this introduction, it was with pleasure that I was able to read

the chapters prior to their publication, and rather than repeating or simply reiterating what

can readily be assimilated, I found myself reecting on some of the emerging cross-cutting

themes. Although not comprehensive, the four themes that stood out for me characterize

the need to develop innovative approaches within this eld while recognizing the

individuality of both the user and those professionals engaged.

In many ways the topic all of the authors are addressing and the eld of enquiry is

relatively straightforward. The advances in technology and the potential benets that can

accrue highlight the need to undertake purposeful and sophisticated forms of assessment

of individuals to understand their need and how they can benet from the wide range of

available devices. These individuals themselves in different ways are looking for better

outcomes in response to their disabilities and broadly through the rehabilitative process to

improve in some way or other their quality of life. Therefore, assessment is the rst stage of

xForeword

this process and facilitates an evaluation of the effectiveness of the intervention that must

be undertaken on a regular basis. What then emerges from my initial reading of these

outstanding chapters from individuals working in this eld?

Assistive Technology Is Increasingly Complex and Sophisticated,

Which Needs to Be Reflected in the Assessment Process

Although this actually states the obvious, it still provides one of the greatest challenges in

undertaking the assessment of individuals to determine how best to deploy technology.

Chapters 16, 17, and 18 highlight the sophistication emerging withi n the elds of technology

and the potential benets to individuals.

Nevertheless, the more complex both the assessment process and the technological aids

themselves become, there is a danger that they become less accessible, and a number of

authors throughout this text remind us through their work of “abandonment,” with one of

the greatest problems being that individuals stop using the devices. Furthermore, the more

complex the assessment process, the less motivated individuals can become given their

need and their understandable desire to have access to available facilities and support.

And not only is the complexity difcult for the user and those professionals undertaking

the assessments, but there remains the danger that they become more costly and hence

have lower impact.

Indeed, the process of assessment itself is costly given the number of professionals who

potentially need to be engaged, and there is an “opportunity cost” issue here in terms

of direct therapeutic intervention as compared with careful assessment and planning.

Therefore, one of our conundrums is that the more complex and greater technological

advances we make, there remains a potential threat of the extent to which these can be

applied in practice, which in turn affects the vulnerability of those with disabilities.

The Need for Inter- and Multidisciplinary Approaches to Assessment

For me, this is then the second major issue. It is clear from this text that the assessment

process is critical to future success, but that it involves a wide range of disciplines and in

some cases the emergence of new interdisciplinary approaches. For example, Chapter 9

introduces for the rst time to myself the role of the “psychotechnologist.” I am sure there a re

other integrated professional approaches yet to be brought together. As knowledge within

the professional elds involved with assistive technology becomes more sophisticated and

our knowledge simply grows exponentially, the capacity to introduce shared professional

education and training becomes increasingly difcult.

Furthermore, we do need to recognize and indeed value the different perspectives

offered by the vast range of individuals working within this eld through their initial

education, training, and postgraduate study. There are different paradigms ranging

from those working primarily in the eld from a medical perspective, through to those

in focused but relatively multidisciplinary professions, and on to those making such

enormous contributions through their technological rather than social skills.

xiForeword

No one person or profession can any longer cover this breadth, and we therefore need to

nd new ways of working together.

Fortunately, it is not the case that people cannot do this, but it is a time-consuming,

resource-intensive process, and the outputs as prioritized and measured need to

demonstrate the effectiveness of such an approach.

I know that myself and Marcia J. Scherer are proud to be editing journals that encourage

multidisciplinary approaches and perspectives on different aspects of rehabilitation and

work hard to include contributions from diverse cultures and backgrounds. In reecting

upon these issues, we should not forget the range of professionals not included in this text,

particularly those working in the eld of employment, advocacy, insurance, and related

business professions. There is nothing negative about recognizing the changing roles of

professionals, but the challenge remains to help all of us take different perspectives and to

give away some aspects of our own understanding to work better with others.

The Impact of the Environment and the Context

Individuals and indeed communities both embrace and are constrained by the context in

which they live. The assessment of an individual has to take this into account, and both

place and context are integral to this process. In relatively structured rehabilitation, there

are well-worked processes and procedures within which to undertake assessment and to

draw upon the services and opportunities presented by the environment within which

this is done. However, there are circumstances in which the assessment process is either

limited through the resources that are available or by the requirement to respond at a

pragmatic level. Community-based programs are often limited by personnel and resources

and rely much more upon those living and working within that particular environment.

Disasters such as those recently affecting Japan and Haiti require swift and emergency

response mechanisms in which the assessment process might be less important when

looking to provide assistive technologies to help support the vast numbers of individuals

clearly in need. These issues are not conned to the environment or the context but to the

interpersonal connections of the individual being assessed.

Chapter 5 highlights the impact on caregivers and the family, but we should add to this

the wide range of individual contacts, including friends, peers, and those in the workplace.

This al so affects the social context and in uences those outputs by which the effect iveness

of any intervention is judged, including economic well-being. Underpinning this in many

cases is a commitment to enhance the quality of life, often through participation in the

world of others with the view to retaining and playing a respected role within wider

soci ety.

What the User Wants and How Can It Be Measured?

The importance of participation and enhancing the quality of life as much as alleviating

some aspects of disability was referred to in the previous section. In many cases these

measures are more important to the individual and more greatly affect the way in which

xii Foreword

the success of having access to assistive technology is measured. Chapter 15 is an excellent

overview of the “user experience framework.” Any perceived improvement through the

use of assistive technology must be recognized and valued by the individual himself or

herself for the impact to be measured effectively.

Many studies are published that do show improvement on a range of variables, and

although these are important in demonstrating the efcacy of particular techniques

without recourse to simply measuring the impact on the individual from his or her

perspective, they do lack an element of validity.

This is not to say that publications of this kind should not be published; it just further

reinforces the complexity of working in the eld of rehabilitation. The more recent

emphasis on goal-setting both jointly with professionals and individually is a positive

way forward in terms of measuring impact. There is both a realism to goal-setting and the

opportunity to be aspirational and to go beyond that which perhaps others think possible.

The goal of employment is not unlikely to remain critical to many for reintegration into

the life experienced prior to the disability. This might not always be possible, but without

understanding the perspective of the user, the success or otherwise of intervention cannot

fully be understood.

At the heart of undertaking an assessment of an individual for the use of assisted

technology is where this person is starting from, where they want to go or believe they

can get, aspirational thinking to take them further, and the journey itself. I judge that this

book in the way it has brought together such a wide range of committed individuals has

as its underpinning philosophy a commitment to listening to and responding positively

to the voice of the individual participant. Resources are still given to rather than owned

by those requiring them, and as in other changing areas such as education and social care

there may yet be a further strengthening of the role of the user by providing resources

from which they can choose or even purchase.

I found this book stimulating, and I am proud to have had an opportunity to contribute

a few thoughts. Thank you to Marcia and Stefano for this opportunity to join you in

contributing to this debate.

Dave J. Muller

Editor-in-Chief, Disability and Rehabilitation

Suffolk New College, United Kingdom

The collaboration between Marcia J. Scherer and the Centre for Technological Aid and

Research Ausilioteca of the Leonarda Vaccari Institute in Rome was born when Marcia,

accompanied with Stefano Federici, visited our institute. On that day, a warm empathy

between me and Marcia was born. An interesting brainstorm about the various activities

took off: activities that we could carry out together because we realized that we share the

same visions. The activities of the Leonarda Vaccari Institute—with its multidisciplinary

team—reected the working methods for the Matching Person and Technology model

carried out by Professor Scherer.

Almost a year later, I went to Rochester University to see Marcia again, and it was there

that we managed to bring the drafting of the handbook to reality. The Ausilioteca di Roma

(Centre for Technological Aid of Rome) put itself at the authors’ disposal to verify the

xiiiForeword

assistive technology assessment process model and the new competencies that had to be

given to the new specic gure of the psycotechnologist.

The following are just a few words to understand what the Leonarda Vaccari Institute

does and, in particular, what the Ausilioteca di Roma stands for. The Leonarda Vaccari

Institute, the oldest nonprot educational institution in Italy, addresses the special needs of

children, adolescents, and adults with disabilities. Founded in 1936 by Professor Marchesa

Leonarda Vaccari to help children affected with polio, today the institute provides

comprehensive service to hundreds of individuals each year. The Leonarda Vaccari

Institute is acknowledged as the Moral Entity with Royal Charter No. 2032 and public

noncommercial initiative certied by the Region of Lazio; the institute functions under

the National Health Service. Established 75 years ago, today the institution is one of the

most experienced centers for the rehabilitation of people affected by severe mental and/

or physical disabilities between the developmental stages of childhood and adulthood.

On December 8, 2007, the President of Italy, Giorgio Napolitano, awarded the Leonarda

Vaccari Institute with the Gold Medal of Merit for Public Health Service. In the same

year, the center was included in the 2° “Eurispes survey” among the 100 Italian Centres

of Excellence. The Vaccari Institute is certied with the ISO 9001-200 IMQ/CSQ 9211.LVA

qual ity.

The intent to provide a comprehensive diagnosis and to help people with disabilities

with their special needs have been one of the initiative’s main concerns since its founda-

tion. In accordance with the institute’s 1936 Constitution, treatment extending to the vari-

ous aspects of disability can be synthesised in three procedures: medical care, education,

and integration into the labor market. Since then, the Leonarda Vaccari Institute has been

expanding its activities throughout comprehensive and individualized interventions,

bringing a multidisciplinary analysis to every single case. Each day, the Vaccari Institute

provides support to more than 300 people who require re-education and rehabilitation

care within the framework of full-time hospital care, day care, or outpatient services. The

institute provides a large number of therapies such as kinesitherapy and logotherapy,

alternative communication, psychosensory stimulation, respiratory exercises, drama, etc.,

all charged to the National Health Service. The diagnostic team is composed of experi-

enced clinical and school psychologists, psychotechnologists, psychiatrists, neuropsychia-

trists, neuropsychologists, pediatricians, orthopedists, rehabilitation therapists, and other

professionals working in specic relative elds.

In 1996, the Vaccari Institute founded the Ausilioteca di Roma, a center for

technological aid and research. The sector of technological devices is characterized by a

fast evolution, by the complexities of solutions that need to be found, and by the necessity

to personalize these solutions. This innovative vision leads to different procedures for

the various rehabilitation, welfare, and educational processes. To nd an international

model of assistive technology assessment, the institute has therefore initiated a fruitful

collaboration with Stefano Federici of the University of Perugia, Olivetti Belardinelli

of the Sapienza University of Rome, and Marcia J. Scherer of the Institute for Matching

Person and Technology of Webster, NY. The success of this assistive technology

assessment process lies primarily in the selection and implementation of technical aids

determined by

• The quality of the assignment’s processes,

• The quality of assistive proposals, and

• The taking into account of the specic context of use.

xiv Foreword

The development of this sector nds its cultural motivations and improvement in the

recent declaration of intents issued at the European level (e.g., Madrid 2002; European Year

for People with Disabilities 2003), at the national level (e.g., Guidelines for the Rehabilitation

released by the Ministry of Health in 1998), and at the international level [e.g., the

International Classication of Functioning, Disability, and Health (ICF), promoted by the

World Health Organization].

Digital devices are instruments of an extraordinary importance apt to satisfy the

needs of autonomy and quality of life of people with disabilities and their families. They

also guarantee a suitable proposal by adding value to the right solutions and giving a

permanent help to health service professionals and users. Moreover, a good assistive

technology match can also guarantee the efciency of the public expenses in this sector.

The Ausilioteca is a highly specialized service center that operates together with the

National Health Service, various public entities, and schools, sustaining different projects

and the use of advanced technologies aimed to the best inclusion of people with disabilities

in schools and other life environments.

The handbook, realized in collaboration with academic professionals from different

countries (United States, Europe, Australia, Brazil, and Japan), contains a scientic pattern

for the assignment of assistive technologies to people with disabilities founded under the

ICF model. The fulllment and achievement of the model described in the handbook—

together with the highlighted procedures—are one of the best practices carried out by the

highly specialized personnel of the Leonarda Vaccari Institute.

It is with satisfaction and gratitude that I thank the authors of the handbook and in

particular the editors, Marcia J. Scherer of the Institute for Matching Person and Technology

and Stefano Federici of the University of Perugia, for their useful and splendid work.

Saveria Dandini De Sylva

Executive President

Istituto Leonarda Vaccari

Preface

This book is the result of scientic collaboration and sincere friendship that was born in

2001 and has gradually strengthened over time.

The collaboration begins with the creation, at the Faculty of Psychology, Sapienza

University of Rome, of the rst course in psychotechnology that was held in Italy. This

course aimed to combine multiple topics, bringing together technological and ergonomic

arguments and issues concerning the psychology of rehabilitation to train competent

psychologists within assistive technology provision.

The course was designed by Stefano Federici and held at the Sapienza University

of Rome from 2001 to 2008. The term “psychotechnology,” with the meaning adopted

and introduced in the psychology of rehabilitation by Federici, initially sounded like a

neologism. In fact, the objective of the course was to integrate technology and ergonomic

aspects with those more specic of cognitive ergonomics, reread under the lens of the

biopsychosocial model of disability, to train psychologists with both psychological and

technological expertise and who were able to lead a user to meet their needs. Only in this

way would it have been possible for the user to search and nd a technological product

that not only was satisfactory to his or her own person, but was also able to support

him or her in the integration process within its milieu, by preventing, compensating,

monitoring, relieving, or neutralizing disability and social barriers. Therefore, the

psychotechnologist should possess those skills to be spent in centers for technical aid

that, at the end of the last millennium, have begun to be characterized as autonomous

centers of technology device assessment and assignment for an individual’s disability

and independent living.

The main theoretical difculty in designing the psychotechnology course was to

integrate technological-engineering models—not dissimilar in some way by certain

models of cognitive functioning that tend to generalize and idealize the individual—

with the biopsychosocial model of disability. The ergonomic approach to technology,

both of cognitive and engineering types, indeed often tends to neglect the emotional,

motivational, and social user experience so that it does not take into account those

factors that very often affect it with a higher rate of incidence in the successful outcome

in device use.

The discovery by Federici of the Matching Person and Technology model by MarciaJ.

Scherer was like the key to squaring the circle. It is a model that has combined people

with disabilities’ needs with assistive technologies in a user-centered context, without

neglecting the functional and ergonomic features of the device. The answer to that fateful

question was found, namely, that the psychotechnologist usually turned to him- or herself

to nd an effective integration of knowledge. As Federici was used to repeating in the

psychotechnology course at the Sapienza University of Rome: “This course could also be

called ‘Matching Person and Technology from the psychologist’s standpoint’.”

The collaboration between the Sapienza University of Rome and the Institute for Matching

Person and Technology has produced dozens of theses and several doctoral dissertations

concerning the adaptation and validation of the Matching Person and Technology model

and tools or related to the professional prole and role of the psychologist in the assistive

technology assessment and assignment processes. Some of those researchers and students

are now successful professionals in psychotechnology. Furthermore, many authors who

xvi Preface

took part in writing of the chapters of this book come from that experience of study and

research.

However, the collaboration and friendship between Marcia and Stefano has not only

led to the sharing of ideas and research projects, but they have also created a scientic

network among Italian, American, and other nations’ scholars who have formed the

scientic community that has allowed such a large participation of authors in the writing

of this work.

As the editors, let us now respond to the reasons for this book, which certainly was

not intended to be a history of this social network or a biography of its editors. This

book is a challenge for us: to develop an international ideal model of the assistive

technology assessment process that gathers the most recent scientic developments in

the assessment and provision of technical aids for an outcome that, if reached, would be

a real success—the well-being of the disabled person. Therefore, this model intends to

express in an idealized and essential form an assessment process performed in a center

for technical aid because it provides such tools for the assessment and the professional

proles that we might also dene as “psychotechnological.”

Of course, just because we speak of “challenge,” we reveal our awareness about the

problems and limitations of an “international” ideal model. For example, one of the

unsolved problems is the difculty, already met several times, in dening the features

of a center for technical aid. The modeling process of a center for technical aid is difcult

if one takes into account the extraordinary variety of systems of regional and national

health and social care, both public and private. This variety inuences in different ways

the specic characteristics that are required at a center. Furthermore, the different nature

of the center for technical aid makes problematic the denition itself of the individual

who addresses to it: user, patient, client, or consumer? The user (for convenience we use

this denition, a little more generic than the others) of a center for technical aid could

be a patient of a physician (physiatrist) who operates in a national system of health care

and sends him or her to a specialized facility, the center for technical aid indeed, for a

more thorough assessment of a particular device. This assessment can be provided free of

charge if the center is part of a national health system or by paying out money if the center

is part of a private health system. Furthermore, the product chosen by the user could

be sold or assigned directly from the center for technical aid or, alternatively, the device

provision may be made later by other providers, external and independent from the center

for technical aid.

These are just some of the issues to be discussed by the authors of this book. In fact,

other issues will be also addressed that are even more problematic from a scientic

viewpoint. We refer to those that are intrinsically linked to the design of an international

model. Because of the difculty in nding an adequate and effective synthesis of the

various models proposed by specic national systems of public health and welfare, the

scientic community faces a modeling of assistive technology system delivery that will

be increasingly individualized with respect to either the social and cultural diversity

of users or to the necessary adjustment of the center for technical aid’s functioning to

the local health system. However, it should be noted that this particularization of the

models clashes with some trends that are aimed at instead promoting their globalization

(for example, this occurs both in social and health policies of the European Community

and in those of the World Health Organization). The internationalization of a model is

indeed advantageous because it often emerges as a synthesis of experiences and know-

hows of regional models. Moreover, it offers the opportunity, by sharing the theoretical

xviiPreface

model and evaluation criteria, to share data essential to scientic research, planning,

and evaluation of national and international policies and verify the quality of public

services.

A goal that we set in the writing of this project was to narrow the topics, trying to

legitimate the choice made. In fact, our intention was not only to provide a theoretical

text that aims to develop an ideal model of assistive technology assessment processes,

but also to provide an operational tool that is able to outline both the specic space of

applicability of the model itself and the main characteristics of a center for technical

aid’s functioning, a tool-kit for a proper assessment, and proles of professionals acting

within the center. Moreover, it even seemed essential for us to compare our model with

some of the most advanced researches in technologies for rehabilitation and supports

for independent living. However, we were well aware that a detailed description of all

matters regarding the functioning of a center for technical aid (i.e. assessment tools,

professional proles, the latest technology devices for rehabilitation and independent

living) would have required an encyclopedia and not a manual such as this book.

Therefore, and this could be read both as a limit and as well an advantage of this book,

we have chosen, for each of the three areas mentioned—the tools of evaluation, the

experts of the evaluation in a center for technical aid and new technologies—the aspects

of the current state of the art that we judged as the most representative or innovative.

So, we not only identied for each topic the leading experts and invited them to write

about their topic, but also, where possible, we tried to ensure that each chapter was

written by more hands, concerted and promoting cross-cultural viewpoints. For this

reason, the reader should certainly not be surprised if he or she will not nd mention

some professions among those that could be treated in such a manual. We tried to

give more prominence to the denition, training, and professional role of the new

profession of psychotechnologist, as well as to highlighting the professional prole of

the speech language pathologist because of the relevance of dysfunctions in language

in today’s international health and social policies.

Finally, we would like to stress that this book does not intend to model the assistive

technology assessment process as a result of a mere academic mental exercise, but it

has even faced an applied research of the model. This is for two main reasons: The

theoretical view of the authors’ chapters and editors emerge from experimental research

applied to rehabilitation and assistive technologies. In addition, the international ideal

model of the assistive technology assessment process is already applied in centers for

technical aid. Thanks to scientic and clinical collaboration, economic and operational

support of the Centre for Technical Aid of Rome, Leonarda Vaccari Institute—which, in

turn, is part of the Italian Network of Centres Advice on Computer and Electronic Aids

and cooperates with the Institute for Matching Person and Technology and Columbia

University, with whom it shares the principles that underlie the assistive technology

assessment process—it was possible to dene the assessment model proposed in this

book because the model is already operative in the Centre for Technical Aid of Rome.

This center offers a noncommercial advisory and support on assistive technology and

computers for communication, learning, and autonomy. The service is free of charge for

users who access it through the Italian National Health Service. Several scientic projects

granted by the institute are in progress at the center to verify not only the advantages of

a systematic application of the Matching Person and Technology tools in the assessment

process, but also the application of the assistive technology assessment process model.

Some results will be presented and discussed in the chapters of this book.

xviii Preface

Sincere thanks go to the authors of the chapters who have welcomed with enthusiasm our

model, enriching in many parts the initial draft of this work and giving it a wide-ranging

speech that is updated and credible. Special thanks also go to the publisher, Taylor &

Francis, who accepted the project with competence, supporting the long process of drafting

and revising the work. Again, special thanks go to many peer-reviewers of the chapters,

who have played a generous and valuable role, such as guarantors for the scientic nature

and validity of each contribution as well as representatives of the international scientic

community in this area.

xix

Contributors

M. Adya

Burton Blatt Institute

Syracuse University

Syracuse, New York

R. Amantis

Leonarda Vaccari Institute for

Rehabilitation

Integration, and Inclusion of Persons with

Disabilities

Rome, Italy

G. Basili

Department of Pediatrics

Senigallia General Hospital

Senigallia, Italy

N. Birbaumer

Institute of Medical Psychology and

Behavioral Neurobiology

Eberhard-Karls University

Tübingen, Germany

and

IRCCS, San Camillo Scientic Hospital

Institute

Venezia Lido, Italy

S. Borsci

Department of Human Science and

Education

University of Perugia

Perugia, Italy

and

School of Information Systems, Computing

and Mathematics

Brunel University

Uxbridge, United Kingdom

and

Mathematics for Match Plus Project Brunel

University Uxbridge,

United Kingdom

L. W. Braga

Director, Neurosciences and

Neurorehabili tation Division

SARAH Network of Neurorehabilitation

Hospitals

Brasilia, Brazil

C. M. Capio

Institute of Human Performance

University of Hong Kong

Hong Kong, China

B. Cordella

Department of Dynamic and Clinical

Psychology

Sapienza University of Rome

Rome, Italy

F. Cor radi

Leonarda Vaccari Institute for

Rehabilitation Integration,

and Inclusion of Persons

with Disabilities

Rome, Italy

V. Cor si

F.A.R.E—Specialist Centre for Dyslexia

and Learning Difculties

Perugia, Italy

G. Craddock

Centre for Excellence in Universal Design

Dublin, Ireland

I. L. de Camillis Gil

Neurological Rehabilitation Division

SARAH Network of Neurorehabilitation

Hospitals

Brasilia, Brazil

xx Contributors

D. de Jonge

Division of Occupational Therapy

School of Health and Rehabilitation

Sciences

University of Queensland

Brisbane St. Lucia, Queensland, Australia

L. Demers

School of Rehabilitation

Université de Montréal

Montréal, Quebec, Canada

E. Di Giacomo

Department of Computer Engineering

University of Perugia

Perugia, Italy

A. Eldridge

Division of Occupational Therapy

School of Health and Rehabilitation

Sciences

University of Queensland

Brisbane St. Lucia, Queensland, Australia

S. Federici

Department of Human Science and

Education

University of Perugia

Perugia, Italy

and

CIRID - Interdisciplinary Centre for

Integrated

Research on Disability

Sapienza University of Rome

Rome, Italy

A. Gossett Zakrajsek

Occupational Therapy Program

School of Health Sciences

Eastern Michigan University

Ypsilanti, Michigan

M. Grasso

Department of Dynamic and Clinical

Psychology

Sapienza University of Rome

Rome, Italy

F. Greco

Department of Dynamic and Clinical

Psychology

Sapienza University of Rome

Rome, Italy

K. Hill

Performance and Testing Teaching

Laboratory

School of Health and Rehabilitation

Sciences

University of Pittsburgh

Pittsburgh, Pennsylvania

M. Kurosu

Center of ICT and Distance Education

Open University of Japan

Chiba City, Japan

G. E. Lancioni

Department of Psychology

University of Bari

Bari, Italy

G. Liotta

Department of Computer Engineering

University of Perugia

Perugia, Italy

A. Lo Presti

CIRID

Interdisciplinary Centre for Integrated

Research on Disability

Sapienza University of Rome

Rome, Italy

R. Magni

Pragma Engineering Sr1

Perugia, Italy

G. Mascolo

External collaborator at the Department of

Dynamic and Clinical Psychology

Sapienza University of Rome

Rome, Italy

xxiContributors

C. Mazzeschi

Department of Human Science and

Education

University of Perugia

Perugia, Italy

P. Mecocci

Institute of Gerontology and Geriatrics

University of Perugia

Perugia, Italy

M. L. Mele

ECoNA—Interuniversity Centre for

Research on Cognitive Processing in

Natural and Articial Systems

Sapienza University of Rome

Rome, Italy

F. Meloni

CIRID

Interdisciplinary Centre for Integrated

Research on Disability, and Department

of Psychology

Sapienza University of Rome

Rome, Italy

K. Miesenberger

Institute Integriert Studieren

University of Linz

Linz, Austria

M. Mirza

Institute for Healthcare Studies

Northwestern University

Chicago, Illinois

M. Morris

Burton Blatt Institute

Syracuse University

Syracuse, New York

B. W. Mortenson

School of Rehabilitation

Université de Montréal

Montréal, Quebec, Canada

M. Olivetti Belardinelli

Department of Psychology and CIRID

Interdisciplinary Centre for Integrated

Research on Disability

Sapienza University of Rome

Rome, Italy

and

ECoNA Interuniversity Center for

Research in Cognitive Processing in

Natural and Articial Systems, and

Department of Psychology

Sapienza University of Rome

Rome, Italy

D. Oliva

Lega F. D’Oro Research Center

Osimo, Italy

M. F. O’Reilly

Meadows Center for Preventing

Educational Risk

University of Texas at Austin

Austin, Texas

M. Orlandi

Vision Research Center of Rome

Rome, Italy

E. Pasqualotto

Institute of Medical Psychology and

Behavioral Neurobiology

Eberhard-Karls University

Tübingen, Germany

M. Pigliautile

Institute of Gerontology and Geriatrics

University of Perugia

Perugia, Italy

and

Department of Psychology

Sapienza University of Rome

Rome, Italy

xxii Contributors

K. S. Pinto

Pediatric Rehabilitation Divisison

SARAH Network of Neurorehabilitation

Hospitals

Brasilia, Brazil

D. Samant

Burton Blatt Institute

Syracuse University

Syracuse, New York

M. J. Scherer

Institute for Matching Person &

Technology, Inc.

Webster, New York

and

Burton Blatt Institute

Syracuse University

Syracuse, New York

P. S. Siebra Beraldo

Clinical Research Division

SARAH Network of Neurorehabilitation

Hospitals

Brasilia, Brazil

J. Sigafoos

School of Psychology and Pedagogy

Victoria University of Wellington

Wellington, New Zealand

N. N. Singh

American Health and Wellness Institute

Verona, Virginia

C. H. P. Sit

Institute of Human Performance

University of Hong Kong

Hong Kong, China

and

Department of Sports Science and Physical

Education

Chinese University of Hong Kong, China

A. Stella

Department of Comparative Cultures

University for Foreigners

Perugia, Italy

L. Tiberio

Institute for Cognitive Science and

Technologies

National Research Council of Italy

Rome, Italy

B. Tu r e lla

Department of Psychology

Sapienza University of Rome

Rome, Italy

P. M. Wielandt

Department of Occupational Therapy

School of Health & Human Services

Central Queensland University

Rockhampton, Australia

S. Zapf

Children’s Journey to Shine, Inc.

Houston, Texas

Section I

The Assistive Technology

Assessment Model and

Basic Denitions

S. Federici and M. J. Scherer

Introduction

As a part of the human condition, “Disability is complex, dynamic, multidimensional, and

contested” (WHO and World Bank 2011, p. 3). The concept of disability conveys a very wide

set of different and correlated issues: from disability models to individual functioning

and its measurement, from social barriers to the digital divide, from the objective quality

of life to subjective experience, to concepts of functioning, activity and participation,

human rights and poverty, health and well-being, morbidity, and quality of life (WHO

and World Bank 2011). Because of the multidimensionality of disability, the International

Classication of Functioning, Disability, and Health (ICF) would like to make clear that

disability (and its correlated term “functioning”) must be understood as an umbrella term,

“encompassing all body functions, activities and participation” (WHO 2001, p. 3).

Disability’s multidimensionality and complexity entails a kind of “denitional paradox”

(Madans and Altman 2006): On the one hand, any theoretical denition of disability

implies aporia, and on the other hand, operational meaning is determined by the purpose

of research. In fact, Mont explains:

[If] each domain represents a different area of measurement and each category or ele-

ment of classication within each domain represents a different area of operationaliza-

tion of the broader domain concept, [then] to generate a meaningful general prevalence

measure one must determine which component best reects the information needed to

address the purpose of the data collection. (2007, p. 4)

9Section I: The Assistive Technology Assessment Model and Basic Deﬁnitions

user/client and assistive solution. Because the assistive solution represents the outcome of

a user-driven process aimed toward the improvement of individual functioning, it can be

considered as a mediator of quality of life and well-being in a specic context of use. For

these reasons, it is important to underscore that the assistive solution does not coincide

with AT because the rst one is a complex system in which psycho-socio-environmental

factors and AT interact in a nonlinear way by reducing activity limitations a nd participation

restrictions by means of one or more technologies.

The denition of ATA represents the core denition of this handbook, summarizing the

properties of the ATA process. All of the chapters in the section rst refer to this denition

and follow a guiding reference model (see Figure I.1).

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Assessing Individual Functioning and Disability

S. Federici, M. J. Scherer, F. Meloni, F. Corradi,

M.Adya,D. Samant, M. Morris, and A. Stella

1.1 The Universal Model of Disability

The origins of the biopsychosocial model date back to the proposal put forward by psy-

chiatrist George Engel in 1977 to integrate within the medical model the dominant social

and psychological variables:

The dominant model of disease today is biomedical, and it leaves no room within its

framework for the social, psychological, and behavioural dimensions of illness. A bio-

psychosocial model is proposed that provides a blueprint for research, a framework for

teaching, and a design for action in the real world of health care. (1977, p. 130)

Engel made the leading theoretical contribution to building the biopsychosocial model,

identied in von Bertalanffy’s general systems theory (von Bertalanffy 1950). According

to this approach, the unifying principles in the scientic context are not a reduction of

but the organization that explains a scientic phenomenon. It is not sufcient to divide a

scientic phenomenon into a simpler unit of analysis and study such units one by one, but

it is necessary to study the interrelations among these units. We contrast the old scientic

method, which refuses all forms of teleology and is based on linear causality and relations

CONTENTS

1.1 The Universal Model of Disability .................................................................................... 11

1.2 Classication, Declaration, and International Denitions of Functioning and

Disability ............................................................................................................................... 13

1.3 Where Individual Functioning and Disability Are Assessed:Assistiveand

Rehabilitation Technology Service Delivery Models ..................................................... 16

1.3.1 Charity-Based Models ............................................................................................. 17

1.3.2 Community-Based Rehabilitation Models ........................................................... 17

1.3.3 Individual Empowerment Models ........................................................................ 17

1.3.4 Entrepreneurial Models .......................................................................................... 17

1.3.5 Globalization Model ................................................................................................ 18

1.3.6 Universal Design Models........................................................................................ 18

1.4 Assessing Individual Functioning Within a Rehabilitation Process ........................... 18

1.5 Assessing Individual Functioning and Disability in the ATA Process ....................... 20

1.6 Conclusions ........................................................................................................................... 23

Summary of the Chapter .............................................................................................................. 23

References .......................................................................................................................................23

23Assessing Individual Functioning and Disability

technical aid column, Figure 1.2) and subjective (the user’s actions column, Figure1.2),

or rather between the objective and subjective functioning measurements. The features

of this dynamic, within the assessment process, tie professionals of rehabilitation to

nding solutions that take into consideration the social and cultural context of an

individual.

1.6 Conclusions

An ATA model is needed and proposed in this chapter that is consistent with the ICF in that

it emphasizes the individual’s well-being and the best match between the user/client and

the assistive solution. This requires a user-driven process through which the selection of

one or more technological aids for an assistive solution is facilitated by the comprehensive

use of clinical measures, functional analysis, and psycho-socio-environmental evaluations.

Summary of the Chapter

This chapter discusses the biopsychosocial model as operationalized by the WHO’s

International Classication of Functioning, Disability, and Health, the Convention on the

Rights of Persons with Disabilities, the 2002 AAMR Denition, Classication, and System

of Supports, and most recently the World Report on Disability. A move from the medical to

social view of disability requires that assistive technology professionals view disability as

existing within a cultural, political, and economic milieu. International models of assistive

technology service delivery are reviewed and the need for enhanced assessment of the

person with a disability’s functioning is highlighted in order to achieve a good match of

person and technology.

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Measuring Individual Functioning

S. Federici, F. Meloni, and F. Corradi

2.1 What Individual Functioning Measures

2.1.1 The Best Measure: Is There an Elixir of Measurements

for Turning an Assessment into Gold?

In June 2001, the U.N. International Seminar on the Measurement of Disability brought

together a large number of experts in disability measurement from developed and devel-

oping countries to review the current status of methods used in population-based data

collection activities to measure disability in national statistical systems (UN 2001). The

seminar developed recommendations and priorities to advance work on the measurement

of disability. In particular, the seminar improved principles and standard forms for global

indicators of disability for use in censuses and helped to build a network of institutions

and experts given the broad consensus on the need for population-based measures of

disability for countrywide use and international comparisons. The U.N. international

seminar experts selected the International Classication of Functioning, Disability, and

CONTENTS

2.1 What Individual Functioning Measures .......................................................................... 25

2.1.1 The Best Measure: Is There an Elixir of Measurements for Turning an

Assessment into Gold? ............................................................................................25

2.1.1.1 Fitting Measure for the Purpose of the Assistive Technology

Assessment .................................................................................................28

2.1.1.2 From the Measures to the Purposes (Well-Being), from the

Purposes to the Measurers (Multidisciplinary Team) ......................... 29

2.1.1.3 What Is Measured Versus Who Measures: Balancing the Power

of the Assessment .....................................................................................30

2.2 How to Measure Individual Functioning ........................................................................ 31

2.2.1 Guidelines for Measurement and Assessment .................................................... 31

2.2.2 Measurement and Assessment in the ATA Process ...........................................32

2.2.3 Monitoring Individual Functioning in the Context of an AT Use: The

Outcome of the ATA Process..................................................................................34

2.3 Suggested Measurement Tools for an ATA Process .......................................................35

2.3.1 Outcome Analysis Tools .........................................................................................39

2.4 Conclusions ........................................................................................................................... 42

Summary of the Chapter .............................................................................................................. 43

References .......................................................................................................................................44

44 Assistive Technology Assessment Handbook

valid for every assessment. Additionally, the only guiding principle for a proper mea-

surement is the clarity of the purpose of the measurement. The second section focuses

on how to measure individual functioning by both pointing out some guiding principles

for choosing and applying a set of measures and by suggesting some tools that t these

principles. The third section suggests some measurement tools for an ATA process used in

a center for technical aid.

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Measuring the Assistive Technology Match

F. Corradi, M. J. Scherer, and A. Lo Presti

3.1 Introduction

The World Health Organization (WHO) Disability and Rehabilitation Action Plan 2006–

2011 (2006) reports that approximately 10% of the world’s population experiences some

form of temporary or permanent disability. This document highlights that assistive tech-

nology (AT) may be a helpful aid for people with disabilities “to increase their level of inde-

pendence in their daily living and to exercise their rights” (WHO 2006, p. 5). To achieve

this goal, it is necessary to further the development, production, distribution, and support

to use AT. In particular, the aims of the WHO are to

• Support member states to develop national policies on AT;

• Support member states to train personnel at various levels in the eld of AT,

especially in prosthetics and orthotics; and

• Promote research on assistive technology and facilitate transfer of technology.

WHO’s World Report on Disability (2011) afrms this commitment.

Different studies show an average rate of approximately 30% of abandonment of AT

within the rst year of use, realizing that rates vary depending on the type of AT (Philips

and Zhao 1993; Scherer 1998; Kittel et al. 2002; Scherer et al. 2004, 2005; Dijcks et al. 2006).

A recent study (Federici and Borsci 2011) found approximately 25% AT abandonment in a

CONTENTS

3.1 Introduction .......................................................................................................................... 49

3.2 Measuring the Assistive Technology Match .................................................................... 51

3.2.1 The ICF and Other Outcome Measures ................................................................ 51

3.2.2 The Matching Person and Technology Model ..................................................... 52

3.2.3 The MPT Process and Measures ............................................................................ 55

3.2.4 The MPT Model and the ICF .................................................................................. 58

3.2.5 Different Versions of Matching Person and Technology ................................... 58

3.3 The Assistive Technology Assessment Process ...............................................................58

3.3.1 The ATA Process in the Center for Technical Aid and in the

Rehabilitation Project .............................................................................................. 60

3.4 The MPT and the Assistive Technology Assessment Process ...................................... 61

3.5 Conclusions ...........................................................................................................................62

Summary of the Chapter ..............................................................................................................62

References ....................................................................................................................................... 63

63Measuring the Assistive Technology Match

and private centers for technical aid provision, allowing them to compare, evaluate, and

improve their own matching model. The actions required by the ATA model to centers for

technical aid can be divided into four fundamental steps: access to the structure and acti-

vation of the process, evaluation and activation of the aid/AT selection, delivery, and fol-

low-up. The ATA is a user-driven process through which the selection of one or more aids/

AT is facilitated by the utilization of comprehensive clinical measures, functional analysis,

and psycho-socio-environmental evaluations that address, in a specic context of use, the

personal well-being of the user through the best matching of user/client and assistive

solution (Scherer et al., Early Online). Because the ATA process and the MPT model and

accompanying measures share a user-driven working methodology and embrace the ICF

biopsychosocial model, they can be integrated within a path aiming for the best combina-

tion of AT to promote user/customer’s personal well-being.

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The Assessment of the Environments of

AT Use: Accessibility, Sustainability,

and Universal Design

M. Mirza, A. Gossett Zakrajsek, and S. Borsci

4.1 Introduction

The role of the environment in inhibiting or supporting full societal participation of people

with disabilities is increasingly being acknowledged. Theoretical frameworks of disability

such as the social model (Oliver 1990) and the International Classication of Functioning,

Disability, and Health (ICF; WHO 2001) recognize the role of the environment in “produc-

ing” disability, albeit to varying extents. Even the preamble of the United Nations (UN)

Convention on the Rights of Persons with Disabilities afrms that disability results from the

interaction between individuals with impairments and environmental barriers (UN 2006).

Furthermore, research studies have repeatedly underscored the dynamic relationship

between environmental factors and the community participation of people with disabili-

ties (Egilson and Traustadottir 2009; Verdonschot et al. 2009). In addition, there is a robust

body of literature demonstrating that conict between assistive technology (AT) and its

context of use is an important contributor to AT nonuse and abandonment (Philips and

Zhao 1993; Day et al. 2001; Kittel et al. 2002; Scherer 2002; Scherer et al. 2004, 2005; Dijcks

CONTENTS

4.1 Introduction .......................................................................................................................... 67

4.2 Accessibility, Sustainability, and Universal Design: An Overview ............................68

4.2.1 What Do We Mean by Accessibility, Sustainability, and

UniversalDesign? ........................................................................................... 68

4.2.2 Interaction between Accessibility, UniversalDesign, and

Sustainability .............................................................................................. 69

4.3 Environment Assessment in the ATA Process Based on the concepts of

Accessibility, Sustainability, and Universal Design ........................................................ 71

4.4 The Environmental Assessment Process: An Overview ............................................... 72

4.4.1 The EA Process: Step-by-Step Decision Making ................................................. 75

4.4.2 Case Evaluation: Considering Accessibility, Universal Design, and

Sustainability Within the EA Process ................................................................... 76

4.5 Conclusions ...........................................................................................................................79

Summary of the Chapter .............................................................................................................. 79

Acknowledgments ........................................................................................................................ 80

References ...................................................................................................................................... 80

80 Assistive Technology Assessment Handbook

achieve the “ideal” design solution which will enhance the match between the AT, the user,

and his/her environment. The second part of this chapter offers a step-by-step decision-

making process to guide the multidisciplinary team to effectively evaluate the environ-

ment as an on-going component of the ATA process. The overall aim of this environmental

assessment process is to help practitioners arrive at an assistive solution that will optimize

user participation and satisfaction in the context of use. The chapter concludes with a case

study exemplifying the environmental assessment process in practice.

Acknowledgments

We acknowledge the role of Ann Kathleen Barnds and Daisy Feidt in developing some of

the key concepts presented in this chapter. We also thank Joy Hammel and Barbara Knecht

for their valuable input and guidance in relation to the UD project that this chapter draws

upon. Finally, special thanks to Hsiang-Yi Tseng for her work during the UD project.

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Measuring the Impact of AT

on Family Caregivers

L. Demers and B.W. Mortenson

5.1 Introduction

It is generally understood that assistive technology (AT) has the potential to enhance

users’ functioning, and, in the process, allow them to be less dependent on the assistance

of others. However, for the vast preponderance of ATs, this secondary assumption is not

buttressed by systematic evidence (McWilliam et al. 2000; Henderson et al. 2008). To create

an enhanced understanding of the impact of AT on caregivers, we need (1) better empirical

evidence, (2) an improved conceptual understanding of the inter-relationship of outcomes

between assistance users and caregivers, and (3) more developed and rened measure-

ment tools. To address these needs this chapter has the following goals:

• To provide an overview of current literature that explores the impact of AT on

informal caregivers of children and adults,

• To offer theoretical contributions that explicate the relationship between AT inter-

ventions and outcomes for assistance users and their informal caregivers and

CONTENTS

5.1 Introduction .......................................................................................................................... 83

5.2 Overview of Current Literature ......................................................................................... 84

5.2.1 AT and Human Assistance ..................................................................................... 84

5.2.2 Caregivers of Assistance Users .............................................................................. 85

5.3 Conceptual Frameworks on the Impact of AT on Caregivers and Users .................... 87

5.3.1 Conceptual Framework 1 ........................................................................................87

5.3.2 Conceptual Framework 2 ........................................................................................89

5.3.3 Conceptual Framework 3 ........................................................................................ 90

5.4 Measurement Tools Adressing AT Impacts on Family Caregivers .............................. 91

5.4.1 Caregiver Assistive Technology Outcome Measure ...........................................91

5.4.2 Family Impact of Assistive Technology Scale......................................................92

5.4.3 Examples of Outcome Measurement With Vignettes Based on the

Assistance Users/Caregiver Dyad Assistive Technology Process Model ....... 93

5.4.3.1 Vignette 1 ....................................................................................................93

5.4.3.2 Vignette 2 .....................................................................................................95

5.5 Future Directions ................................................................................................................. 97

5.6 Conclusions ...........................................................................................................................97

Summary of the Chapter .............................................................................................................. 98

Acknowledgments ........................................................................................................................ 98

References .......................................................................................................................................98

98 Assistive Technology Assessment Handbook

test their psychometric properties. Given the stage of development of research in this area,

mixed methods research studies may provide invaluable data about the impact of AT on

informal caregivers from a variety of perspectives. By developing a thorough understanding

of the impact of AT on assistance users and their informal caregivers, interventions that are

more suitable can be offered and funding that is more appropriate can be sought.

Summary of the Chapter

In this chapter, we have provided an overview of research that has explored the impact of

AT on informal caregivers. We have offered informal caregiver-specic models that help

explicate how AT may impact informal caregivers, and we described two measures that

are intended to capture this effect. We have proposed that the process of AT provision

needs to explicitly acknowledge the role of the informal caregiver. With two vignettes, this

chapter provides examples of how these measures could be used to capture the impact

of AT on informal caregivers. We have provided suggestions for future work in this area.

Acknowledgments

Dr. Demers is supported by the Fonds de la Recherche en Sante du Quebec as a senior

research sc holar. Dr. Mortenson is supported via a postdoctoral fellowship for the Canadia n

Institutes of Health–Institute of Aging. Funding for the development of the CATOM was

provided by the National Institute on Disability and Rehabilitation Research through the

Consortium on Assistive Technology Outcomes Research (CATOR, http://www.outcomes.

org/). (Grant # H133A060062).

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Section II

Assessment Professionals:

Working on the

Multidisciplinary Team

M. J. Scherer and S. Federici

Introduction

How disability is diagnosed and treated differs according to age at onset and the type

of disability. Developmental disabilities, which occur in infancy and childhood, are

typically diagnosed after behavioral and maturational anomalies are observed and are

then conrmed medically. Acquired disability can occur at any time in the life span and

treatment is often initiated in a hospital emergency room. Disability associated with a

degenerative condition, typically associated with advanced age, is generally managed by

primary care physicians, neurologists, gerontologists, and family members.

Treating Developmental Disabilities

Developmental disabilities such as Down syndrome or cerebral palsy cannot be “cured.”

However, interventions applied as early as possible can make a great deal of difference

in current and future functioning. Orthopedic and neurological impairments can be

surgically corrected or medically managed. Often children with developmental disabilities

undergo many treatments during their initial development with the goal of strengthening

or extending the use of existing capabilities (Scherer 2005). Sensory disabilities can be

greatly helped with advances in technology and the means to communicate can be made

possible through alternative and augmented communication devices.

101

105Section II: Assessment Professionals

The Joint Committee states that

When cognitive, communication, emotional, and psychosocial domains are affected,

the team should include at least a clinical neuropsychologist or rehabilitation psycholo-

gist, and speech–language pathologist. Team membership will vary with the age of the

persons served, the type of impairment, the stage of recovery, and the special training

of team members (2007, p. 4).

Thus, there is considerable consistency in these two views of the rehabilitation team, the

rst from Singapore and the second from the United States.

The nine chapters presented in this section (Table II.1) focus on and describe the role of

many professions in the rehabilitation of persons with disabilities and their match with

appropriate assistive technologies.

Each chapters was written by an international expert in his or her area of specialty. What

unites these authors is not only their commitment to optimal rehabilitation outcomes, but

their perspective of the biopsychosocial approach to the assistive technology evaluation,

selection, and provision.

Conclusion

The best rehabilitation outcomes are achieved when individuals with shared perspectives,

but representing different areas of knowledge and skill, pool their expertise to derive

interventions that meet the person al, psychosocial as well as physical needs and preferences

of the individual with a disability. This teamwork also needs to be brought to bear on

the selection and provision of assistive solutions. Each of the contributors to this section

describes how this can be achieved from the viewpoint of their training and practice.

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TABLE II.1

Chapters of Section II

Chapter Topic

6 The Cognitive Therapist (Olivetti Belardinelli, Turella, and Scherer)

7 The Special Educator (Zapf and Craddock)

8 The Psychologist (Meloni, Federici, Stella, Mazzeschi, Cordella, Greco, and Grasso)

9 The Psychotechnologist (Miesenberger, Corradi, and Mele)

10 The Optometrist (Orlandi and Amantis)

11 The Occupational Therapist (de Jonge, Wielandt, Zapf, and Eldridge)

12 The Pediatric Specialist (Braga, de Camillis Gil, Pinto, and Siebra Beraldo)

13 The Geriatrician (Pigliautile, Tiberio, Mecocci, and Federici)

14 The Speech–Language Pathologist (Hill and Corsi)

106 Assistive Technology Assessment Handbook

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107

The Cognitive Therapist

M. Olivetti Belardinelli, B. Turella, and M. J. Scherer

6.1 Cognitive Therapy

The origins of cognitive therapy are generally grounded in behavioral therapies. This is

true when we consider the original modalities of the behavioral therapies. However, in the

frame of the cognitive therapy panorama, we nd that it is important now for therapists to

consider behavior within a psychodynamic frame.

Behavioral therapy started in the 1940s and 1950s using the conditioning techniques

envisaged by Pavlov for human behavior. On this basis, some authors explained human

behavior by means of mediators, dened as intervening variables of a biological basis

or cognitive type able to interact with antecedents through conditioning to particular

consequences. The paradigm of instrumental conditioning afforded the possibility of

modifying human behavior. In the rst years behavioral modications were obtained in

situations in which it was easy to manipulate the environmental variables, or with subjects

characterized with “cognitive simplicity,” such as children, psychotics, and “generically

disabled people.” Afterward, neuroses, emotional problems, and behaviors connected

with anxiety and depression were faced.

The name behavioral therapy was given by Lazarus to contrast it with the contemporary

psychodynamic therapies. Lazarus based his approach on learning experience and

conditioning principles.

CONTENTS

6.1 Cognitive Therapy ............................................................................................................. 107

6.2 The Cognitive Therapist ................................................................................................... 110

6.3 Cognitive Therapy With Individuals Having Cognitive Disability ........................... 114

6.4 Cognitive Rehabilitation ................................................................................................... 115

6.5 Assistive and Cognitive Support Technologies ............................................................. 116

6.6 Case Study .......................................................................................................................... 121

6.6.1 A Real-Life Example of a Vocational Rehabilitation Counselor’s

Solution-Seeking for James, Who Has Early Onset Alzheimer’s Disease .... 121

6.6.2 MPT Survey Results and Assessment Analysis ................................................ 122

6.6.3 Research, Implementation, and Recommendations .........................................123

6.7 Conclusions .........................................................................................................................125

Summary of the Chapter ............................................................................................................125

References .....................................................................................................................................126

126 Assistive Technology Assessment Handbook

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131

The Special Educator

S. Zapf and G. Craddock*

7.1 The Role of the Special Educator in Assistive Technology Assessment

The World Health Organization and the United Nations Global Disability report esti-

mates that individuals with disabilities account for 15% of the world population, and

there are approximately 150 million children with disabilities in the world (WHO 2010).

The denition of special education varies worldwide because many countries use a

social classication system similar to the International Classication System addressing

the child’s ability to participate across the educational domain, whereas other counties

focus on a medical model for education that is based on specic categories of impair-

ment or disabilities. Assistive technology (AT) has long been recognized as a tool for

enabling independence and access for individuals with disabilities (Bowe 1995; Østensjø

et al. 2005; Watson et al. 2010). Although changes in legislation have provided a positive

shift to include the consideration of AT in the student’s educational plan/setting, there

still remains a deciency in many developing countries for children with disabilities to

have access to needed AT to assist with meeting their educational plan and participation

in daily activities. The World Health Organization reports that only 5–15% of individuals

with disabilities have access to AT in many developing countries. The United Nations

Standard and World Health Organization Rule 4 (WHO 2010) promotes the training of

personnel at various levels in AT to improve access for technology. The special educator

can play a vital role in providing technology access and implementation of tools to be

used with students in the educational setting.

CONTENTS

7.1 The Role of the Special Educator in Assistive Technology Assessment .................... 131

7.2 Teaching Alternatives Using AT ......................................................................................134

7.3 Outcome Studies of Assistive Technology in the Educational Setting ...................... 136

7.4 Environmental Factors to Promote AT in the Classroom ............................................ 136

7.5 Going Forward: Universal Design for Learning (UDL) ............................................... 138

7.6 Case Evaluation .................................................................................................................. 139

7.6.1 First Case Study: Zoey ..........................................................................................139

7.6.2 Second Case Study: John ......................................................................................140

7.7 Conclusions ......................................................................................................................... 145

Summary of the Chapter ............................................................................................................ 146

References ..................................................................................................................................... 146

* The views expressed by Dr. Ger Craddock are his own and are not of his employer, the National Disability

Authorit y.

146 Assistive Technology Assessment Handbook

can determine use or nonuse of AT. Finally, as technology advances and AT is increasingly

supported within the mainstream market, the authors outline the next stage of technology

provision within the classroom—UDL. Ultimately, providing an educational environment

where classrooms are designed to cater for all types of students regardless of their disability

or special need is optimal. It is imperative for teachers to recognize that all students have

varying ability, and it is a measure of their ability, not disability, that should determine how

their education is supported. The classroom should provide a range of supports for any stu-

dent who may have issues in accessing the curriculum—from reading difculties to writing

to understanding. A special educator should have the knowledge, skills, and competence

backed up with the support of technologies to support all within the education environment.

Summary of the Chapter

This chapter describes the importance of assistive technology in education and the role

of the special educator in the process of integrating assistive technology for students with

disabilities into the educational system. The special educator is a crucial team member,

providing knowledge of the students’ educational capabilities and their daily interaction

in the use of assistive technology. Assistive technology can provide many children and

adolescents with disabilities the tools necessary to be more successful in school, at work,

and at achieving independence in daily living. Unfortunately, many special educators do

not receive training in the application of assistive technology nor do they have adequate

resources to effectively assess, implement, and follow-up on the use of assistive technology

in the classroom. This chapter will identify the special educator’s role in the assessment

and implementation of AT. Recommendations for future training needs for special educa-

tors will also be discussed.

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149

The Psychologist

F. Meloni, S. Federici, A. Stella, C. Mazzeschi, B. Cordella, F. Greco, and M. Grasso

8.1 The Languishing Psychologist’s Role

inAssistive Technology Assessment

Psychology itself is dead. Or, to put it another way, psychology is in a funny situation.

My college, Dartmouth, is constructing a magnicent new building for psychology. Yet

its four stories go like this: The basement is all neuroscience. The rst oor is devoted

to classrooms and administration. The second oor houses social psychology, the third

oor, cognitive science, and the fourth, cognitive neuroscience. Why is it called the psy-

chology building? (Gazzaniga 1998, pp. xi–xii)

CONTENTS

8.1 The Languishing Psychologist’s Role inAssistive Technology Assessment ............ 149

8.2 Nothing about “Psycho” without Psychologists: The ICF and the Need for Its

Revision ............................................................................................................................... 151

8.3 The Personal Factors of Functioning and Disability .................................................... 153

8.4 Personal Factors and Assistive Solutions ....................................................................... 154

8.5 The Psychologist in a Center for Technical Aid: The Specialist in Personal Factors ...155

8.6 Outlining the Psychologist’s Role in the ATA Process ................................................. 157

8.6.1 When the Psychologist Role in the ATA Process Is Required ......................... 158

8.6.2 How a Psychologist Facilitates the Awareness of the User/Client’s

Context and Multidisciplinary Team Perspectives ........................................... 160

8.6.2.1 Methodology ............................................................................................ 160

8.6.2.2 Goals ......................................................................................................... 163

8.6.2.3 What a Psychologist Should Do in Promoting a User/Client

Request ..................................................................................................... 164

8.7 Psychologist “Know Thyself”: Psychologist and Professional’s Representations

of the Disabled Users/Clients and Assistive Technologies ......................................... 164

8.7.1 Professionals’ Representation of Disability ....................................................... 165

8.7.2 New Approach in Psychological Practice ...........................................................168

8.7.3 Psychological Professional Practice Guidelines in the ATA Process..............168

8.7.3.1 The User.................................................................................................... 169

8.7.3.2 The Family ............................................................................................... 169

8.7.3.3 The Professionals’ Multidisciplinary Team ........................................ 170

8.8 Conclusions ......................................................................................................................... 170

Summary of the Chapter ............................................................................................................172

Acknowledgments ...................................................................................................................... 172

References .....................................................................................................................................172

172 Assistive Technology Assessment Handbook

Summary of the Chapter

This chapter deals with the role and the competencies of the psychologist in a center for

technical aid. The lapse of the psychologist’s role in ATA is probably due to the noncoding

of personal factors in the ICF. In viewing the psychologist as the “specialist” on personal

factors, the authors call for a revision of the ICF so that in the biopsychosocial model, the

“psycho” does not remain as just a prex. The psychologist in the center has the goals

to support the user’s request in the user-driven process as well as to act as a mediator

between users seeking solutions and the multidisciplinary team. He or she also acts to

build a team spirit and enhance the relationship between the client and his or her home

environment. Finally, an original study closes the chapter, focusing on psychologists and

professionals’ representations of disabled users/clients and ATs.

Acknowledgments

Fabio Meloni, Stefano Federici, and Aldo Stella contributed equally to this study, except for

Section 8.6, which was edited by Claudia Mazzeschi, and Section 8.7, which was edited by

Barbara Cordella, Francesca Greco, and Massimo Grasso.

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179

The Psychotechnologist: A New Profession

in the Assistive Technology Assessment

K. Miesenberger, F. Corradi, and M. L. Mele

CONTENTS

9.1 Introduction ........................................................................................................................ 180

9.2 The Psychotechnologist and the AT Assessment Process ........................................... 181

9.3 Case Example: Application of Models and Measurements ......................................... 184

9.3.1 Medical Case...........................................................................................................185

9.3.1.1 Motor Evaluation .....................................................................................185

9.3.1.2 Neuropsychological Test ........................................................................ 185

9.3.1.3 Communication Strategy ....................................................................... 186

9.3.1.4 Evaluation of Visual, Perceptive, and Motor Functions .................... 186

9.3.1.5 Aids and Assistance ............................................................................... 186

9.3.1.6 Request .....................................................................................................186

9.3.2 The ATA Process .................................................................................................... 186

9.3.2.1 Multidisciplinary Team Meeting .......................................................... 186

9.3.2.2 Setting Set-Up .......................................................................................... 187

9.3.2.3 Matching Process .................................................................................... 187

9.3.2.4 Assistive Solution Multidisciplinary Team Evaluation ..................... 187

9.3.2.5 User Support ............................................................................................ 188

9.3.2.6 Follow-Up ................................................................................................. 188

9.4 The AT Assignation Process in a Center for Technical Aid and the

Psychotechnologist ............................................................................................................ 188

9.5 Psychotechnology Education: An Example ...................................................................190

9.5.1 The Context of the Profession “Psychotechnologist” ....................................... 190

9.5.2 Psychotechnologist—The Need for Education .................................................. 191

9.5.3 The Assistec Program ........................................................................................... 192

9.5.4 The Curriculum ...................................................................................................... 193

9.5.5 eLearning System ................................................................................................... 194

9.5.6 Graduates—Psychotechnologists ........................................................................ 195

9.5.7 Impact ...................................................................................................................... 196

9.6 Conclusions .........................................................................................................................197

Summary of the Chapter ............................................................................................................ 197

References .....................................................................................................................................198

198 Assistive Technology Assessment Handbook

emulates, extends, amplies and modies sensory-motor, psychological or cognitive

functions of the mind” (Federici 2002), highlighting in this way the intrasystemic rela-

tion between the artifact and the user. Starting from these suggestions, the primary role

of psychotechnologist is to follow a systemic approach to allow users a better autonomy

(TeleMate 2011). This goal is only possible by taking into account the users’ needs, their

reached autonomy degree, and the environment in which they live. In this work, we have

explained in more detail two elds of application of this new professional gure: the AT

assignation process in a center for technical aid and the ICT-based systems and services,

i.e., eSystems and eServices.

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201

The Optometrist

M. Orlandi and R. Amantis

10.1 Introduction

The choice of the appropriate assistive technology is conditioned by the visual skills

of the subject. Visual perception is a complex process in which various subprocesses

participate and in which various anatomic structures are involved. It is therefore neces-

sary that the assessment protocol used permits having a clear picture of all of the visual

abilities and skills of the patient as well as his/her limits. A detailed analysis of the

visual skills permits the assistive technology assessment (ATA) team to plan specic test

settings to be used with the patient without having to make random attempts, which

usually prove themselves not only to be useless, but also to be frustrating for the patient

and the family.

CONTENTS

10.1 Introduction ...................................................................................................................... 201

10.2 Vision and the Role of the Optometrist in ATA .......................................................... 202

10.2.1 The Complexity of the Visual Process from Eye to Brain ............................ 202

10.2.2 The Visual Abilities in Behavioral Optometry .............................................. 208

10.2.2.1 Visual Acuity .....................................................................................208

10.2.2.2 Fixation ............................................................................................... 211

10.2.2.3 Slow Pursuit ......................................................................................212

10.2.2.4 Saccadic Movements......................................................................... 213

10.2.2.5 Binocular Vision................................................................................ 214

10.2.2.6 Convergence ...................................................................................... 214

10.2.2.7 Accommodation ................................................................................215

10.2.2.8 Refraction ........................................................................................... 216

10.2.2.9 The Field of Vision ............................................................................ 218

10.2.2.10 Superior Perceptive Abilities........................................................... 219

10.3 The Role of Optometrists in the ATA Process ............................................................. 220

10.4 Evaluation of Visual, Perceptive, and Motor Functions: Clinical Case 1 ................. 222

10.5 Evaluation of Visual, Perceptive, and Motor Functions: Clinical Case 2 ................. 224

10.6 Visual Training .................................................................................................................225

10.7 Conclusions ....................................................................................................................... 225

Summary of the Chapter ............................................................................................................ 226

Acknowledgments ...................................................................................................................... 226

References .....................................................................................................................................227

Suggested Reading ......................................................................................................................227

227The Optometrist

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229

The Occupational Therapist: Enabling Activities

and Participation Using Assistive Technology

D. de Jonge, P. M. Wielandt, S. Zapf, and A. Eldridge

11.1 Occupational Therapist’s Perspective

Occupational therapists use a holistic approach in which they recognize the transac-

tion among the person, the activities they need or want to engage in, and the environ-

ments in which these activities are undertaken. Occupation, or activity engagement and

participation, is seen as playing an essential role in human life and inuencing people’s

state of health (Kielhofner 2004). Disruption to occupation or activity engagement affects

people’s quality of life, restricts their development, reduces capacity, and leads to mal-

adaptive reactions (Kielhofner 2004). In contrast, removing barriers to participation allows

people to engage in necessary and desired occupations, which result in improved health

(Kielhofner 2004).

Each person is seen as simultaneously fullling various roles that require them to

perform a diversity of activities in a range of environments. Activities range from per-

sonal care and household activities to work, leisure, and social participation. People

have personal preferences, interests, and expectations that inuence their choice of

activities and the way they undertake activities. Activities are invariably performed in

CONTENTS

11.1 Occupational Therapist’s Perspective ........................................................................... 229

11.2 Overview of Interventions Used by Occupational Therapists and the

PlaceofAT Within These................................................................................................ 231

11.3 The Denition and Role of AT ....................................................................................... 232

11.4 Overview of the Process Involved in Selecting and Using AT ................................. 233

11.5 Overview of the Process Involved in Selecting and Using AT Case Studies ......... 236

11.5.1 Case Study Number 1: ZA ................................................................................236

11.5.1.1 Person ................................................................................................. 236

11.5.1.2 Current Status ................................................................................... 237

11.5.1.3 Environment ...................................................................................... 238

11.5.1.4 Occupation .........................................................................................238

11.5.2 Case Study Number 2: AB ................................................................................239

11.5.2.1 Person ................................................................................................. 239

11.5.2.2 Current Status ................................................................................... 240

11.6 Conclusions .......................................................................................................................242

Summary of the Chapter ............................................................................................................242

References .....................................................................................................................................243

243The Occupational Therapist

and the environments in which these activities are undertaken. In doing so, they can iden-

tify the specic requirements of the technology and ensure that it is able to meet the goals

and skills of the person as well as the demands of current and future activities and envi-

ronments. A detailed understanding of these requirements also enables the therapist to

customize the technology to ensure it can be used efciently and effectively. Occupational

therapists also work with the AT user to promote his or her understanding of the technol-

ogy and its application so that he or she can monitor its ongoing utility.

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245

Pediatric Specialists in Assistive Solutions

L. W. Braga, I. L. de Camillis Gil, K. S. Pinto, and P. S. Siebra Beraldo

12.1 Pediatric Specialists in the Process of

Development and Rehabilitation

The development or neurorehabilitation process of the child with impairments requires

an approach involving different areas of specialization because these children may

present difculties or challenges in various developmental domains (sensorial, motor,

neuropsychological, communication, and socialization, among others). This generates

the need for assessments and interventions by interprofessional teams of physicians

(pediatricians, orthopedic surgeons, neurologists, geneticists, psychiatrists, and other

specialists); nurses; physical, occupational, and speech therapists; psychologists; special

educators; technologists such as engineers; and prosthetics/orthotics technicians.

CONTENTS

12.1 Pediatric Specialists in the Process of Development and Rehabilitation ..................245

12.2 Pediatric Specialists in Assistive Solutions .................................................................... 248

12.3 Assistive Solutions and the Interdisciplinary Team Approach .................................. 248

12.4 AT Resources Applied to the Daily Life of the Child and Family ..............................250

12.5 AT and Learning ................................................................................................................ 251

12.6 Case Evaluation in an Interprofessional Team .............................................................. 253

12.6.1 Case 1—Michael (Cerebral Palsy) ........................................................................ 253

12.6.1.1 Case History ............................................................................................253

12.6.1.2 Motor Evaluation .....................................................................................253

12.6.1.3 Neuropsychological Evaluation ............................................................254

12.6.1.4 Communication Strategy .......................................................................254

12.6.1.5 Evaluation of Visual, Auditive, and Perceptive Functions ................254

12.6.1.6 Neurorehabilitation Team Approach ...................................................254

12.6.2 Case 2—John (Traumatic Brain Injury) ............................................................... 260

12.6.2.1 Case History ............................................................................................260

12.6.2.2 Motor Evaluation .....................................................................................260

12.6.2.3 Neuropsychological Evaluation ............................................................ 260

12.6.2.4 Communication Strategy ....................................................................... 261

12.6.2.5 Evaluation of Visual, Auditive, and Perceptive Functions ................ 261

12.6.2.6 Neurorehabilitation Team Approach ................................................... 261

12.7 Conclusions ......................................................................................................................... 264

Summary of the Chapter ............................................................................................................ 265

References .....................................................................................................................................265

265Pediatric Specialists in Assistive Solutions

Summary of the Chapter

This chapter describes the role of the pediatric specialist in the neurorehabilitation

process of the child that incorporates AT and its uses, applications, and indications. Two

case studies, a child with CP and one with TBI, illustrate how AT impacted the children’s

development, recovery, and progress and how the pediatric specialist played an essential

role in this process.

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FIGURE 12.11

(See color insert.) AT resources that facilitate social interaction.

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269

The Geriatrician

M. Pigliautile, L. Tiberio, P. Mecocci, and S. Federici

13.1 Introduction

The word “geriatrics” was coined by Ignatz Leo Nascher (1863–1944), a Viennese man who

worked as a physician in New York and who claimed that aging is not a disease but a

period of life with its own physiology, requiring the need to treat geriatric medicine as

a separate entity, as is done for pediatrics (Achenbaum 1995; Morley 2004). In the 1930s,

Marjory Warren developed the principles of modern geriatric medicine in the United

Kingdom by enhancing the environment, introducing active rehabilitation programs, and

emphasizing the importance of the older person’s motivation (Morley 2004).

Over time, geriatric medicine developed core values, a knowledge base, and clinical skills

to improve the health, functioning, and well-being of older people and to afford appropri-

ate palliative care, for which a marked expansion over the past three decades occurred

to meet the growing needs for care of the aging population (American Geriatrics Society

Core Writing Group of the Task Force on the Future of Geriatric Medicine 2005). In fact,

the U.S. Census Bureau data (Kinsella and He 2009) reports an extraordinary demographic

and epidemiological change that can be seen as a success story for public health policies

CONTENTS

13.1 Introduction ........................................................................................................................ 269

13.2 Analysis of the Older Patient: Diseases, Disability, and Frailty .................................. 270

13.2.1 Disease ..................................................................................................................... 270

13.2.2 Disability ................................................................................................................. 271

13.2.3 Frailty .......................................................................................................................272

13.3 Geriatric Assessment ......................................................................................................... 273

13.4 Geriatric Rehabilitation .....................................................................................................275

13.5 Assistive Solutions: A Challenge in Geriatric Rehabilitation ......................................277

13.5.1 Technological Devices for Elderly People With Cognitive Impairments ...... 278

13.5.2 Technological Devices for Elderly People With Motor Disability .................. 279

13.5.3 Socially Assistive Robotics Systems ....................................................................280

13.6 Acceptance, Rejection, or Abandonment of an AssistiveTechnology ....................... 281

13.7 The Role of the Geriatrician in the Assistive Technology Assessment Process ....... 282

13.8 Case Study and the ATA Process ....................................................................................287

13.8.1 The Role of the Geriatrician in the ATA Process for the User A.B. ................288

13.9 Conclusions .........................................................................................................................291

Summary of the Chapter ............................................................................................................292

References .....................................................................................................................................293

293The Geriatrician

dimensions. Rehabilitation is the goal of the geriatric assessment, and the introduction

of assistive solutions in geriatric rehabilitation makes possible a scenario in which

the functioning of elderly people with physical or cognitive limitations is improved.

This chapter provides an overview of the areas where technological systems may

offer support to the everyday life of the elderly and their caregivers. The contribution

of a geriatrician in a center for technical aid is described, linking the comprehensive

geriatric assessment with the ICF model. The lack of implementation of the ICF and

the requirement of training in assistive solutions for geriatricians and caregivers are

discussed.

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301

Role of Speech–Language Pathologists in

Assitive Technology Assessments

K. Hill and V. Corsi

14.1 Description of the Professional Profile

A speech–language pathologist (SLP) is a professional trained to evaluate and treat people

who have communication and swallowing disorders. A person must have the required aca-

demic training and clinical experience to be certied or licensed as an SLP. The SLP is then

able to diagnose and treat disorders across the life span pertaining to speech, language,

voice, or swallowing. The specic course requirements and extent of clinical training vary

internationally across curricula and awarded degrees. In some countries, professionals

may practice as speech therapists with a 2- or 4-year degree. However, the more accepted

standard for delivering clinical SLP services requires completion of a Master’s degree. In

North America, SLPs become independent practitioners after earning a Master’s degree

incommunication science and disorders, completing a clinical fellowship year, and receiv-

ing a Certicate of Clinical Competence from the American Speech–Language-Hearing

Association (ASHA). An advanced degree may be earned through a clinical doctorate

CONTENTS

14.1 Description of the Professional Prole ........................................................................... 301

14.1.1 Assistive Technology Teams and the SLP .......................................................... 303

14.1.2 Evidence-Based Practice and SLPs ......................................................................304

14.1.3 AT Assessments and the SLP ............................................................................... 307

14.1.4 Matching Persons With Technology and SLPs ..................................................308

14.1.5 Evaluation of the Effectiveness and Usefulness of the AT .............................. 311

14.1.6 Development and Implementation of AT Intervention Plans ......................... 313

14.1.7 The SLP’s Role in Advocacy ................................................................................. 313

14.1.8 Specic Learning Disabilities .............................................................................. 313

14.2 Case Evaluation in a Multidisciplinary Team or as a Professional Consultant ........ 320

14.2.1 Characterizing the Client ..................................................................................... 320

14.2.2 Step 1: Asking Meaningful EBP Questions ........................................................ 320

14.2.3 Step 2: Collecting Clinical and Personal Evidence ...........................................321

14.2.4 Step 3: Locating and Reviewing Research Evidence ........................................ 321

14.2.5 Step 4: Using the Evidence ....................................................................................321

14.3 Conclusions .........................................................................................................................322

Summary of the Chapter ............................................................................................................323

Acknowledgments ...................................................................................................................... 324

References .....................................................................................................................................324

324 Assistive Technology Assessment Handbook

and environments. Personal well-being and life experience are directly related to an indi-

vidual’s ability to communicate as effectively as possible.

Acknowledgments

Katya Hill contributed to the entire study except for Section 14.1.8, which was reviewed by

Corsi Valerio.

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Section III

Assistive Technology

Devices and Services

S. Federici and M. J. Scherer

Introduction

Today much information about assistive technologies (ATs) can be obtained from many

databases and web sites on the World Wide Web (WWW).* However, we can make a clear

distinction between databases and web sites: AT web sites mostly aim to present a cata-

logue of technologies for a specic kind of disability, such as the American Printing House

for the Blind (http://www.aph.org/), or for other specic groups of disabilities, such as

the Cambium Learning Technology Company web site (http://www.intellitools.com/).

Databases are more focused on the diffusion of technical information about equipment by

collecting a very extensive list of ATs.

The two largest and most complete databases of devices are†

• AbleData.com (http://www.abledata.com): Supported by the National Institute

on Disability and Rehabilitation Research in 1996, this database currently pro-

vides information on approximately 40,000 products classied into 20 areas. It also

offers information on noncommercial prototypes, customized and one-of-a-kind

products, and do-it-yourself designs.

• The European Assistive Technology Information Network (EASTIN, http://

www.eastin.info): In 2003, some of the best-known expert information providers

in Europe joined together to create a comprehensive information service on AT,

which currently offers information on 66,269 products.

* A complete list of AT databases and web sites can be found at http://www.a4access.org/atia.htm.

† The number of products on http://www.abledata.com and http://www.eastin.info was retrieved in May 2011.

329

335Section III: Assistive Technology Devices and Services

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337

Systemic User Experience

S. Borsci, M. Kurosu, M. L. Mele, and S. Federici

15.1 Introduction

The term User eXperience (UX), proposed in the 1990s by Donald A. Norman and col-

leagues (1995) is focused on pleasure, value, and on performance during a human-system

interaction. In the design process of the interaction, the usability of the system is a neces-

sary but not sufcient condition for obtaining (designing or evaluating) a good level of UX;

indeed, although usability is a dimension of the interaction, UX is a holistic perspective on

how a user feels about using a system. There are various denitions regarding UX, includ-

ing the one provided by Norman in explaining the UX term as “all aspects of the user’s

interactions with the product: how it is perceived, learned and used. It includes ease of use

and, most important of all, the needs that the product fulls” (1998, p. 47), and the deni-

tion provided by Garrett, “how the product behaves and is used in the real world” (2003,

p. 17). Recently, the International Organization for Standardization (ISO) 9241-210 (1999)

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use of a product, system or service.” The ISO also states that

User experience is a consequence of the presentation, functionality, system perfor-

mance, interactive behaviour, and assistive capabilities of an interactive system, both

hardware and software [...]. It is also a consequence of the user’s prior experiences, atti-

tudes, skills, habits and personality (ISO 1999).

CONTENTS

15.1 Introduction ...................................................................................................................... 337

15.2 From Accessibility and Usability of Systems to the Users’

ExperienceofSystems ................................................................................................ 340

15.2.1 The Relationship Between Accessibility and Usability ................................340

15.2.2 An Overview of the Usability Standards ....................................................... 341

15.3 Evaluation of Systems .....................................................................................................343

15.3.1 A Conceptual Framework: An Integrated Model of Interaction

Evaluation ...........................................................................................................343

15.4 Example of the UX Concept Application inDesign Systems for Rehabilitation .... 348

15.4.1 UX in the Assistive Technology Assessment Process ..................................348

15.4.2 Sonication of the System ................................................................................. 351

15.4.2.1 Application of a UX Framework for Designing aSonied

Visual Web Search Engine ..............................................................353

15.5 Conclusions ....................................................................................................................... 354

Summary of the Chapter ............................................................................................................ 355

References .....................................................................................................................................355

355Systemic User Experience

the redesign of a sonicated web search engine is presented as an example of the growing

need of the UX approach in the AT design.

Summary of the Chapter

This chapter discusses the relation and the role of the constructs of accessibility and

usability under the user experience theoretical approach. An integrated model of interac-

tion evaluation, a new evaluation perspective based on the user experience, is presented as

a framework not only to set up an evaluation of the users’ interaction with assistive tech-

nology, but also to organize and evaluate the Assistive Technology Assessment process.

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361

Web Solutions for Rehabilitation and Daily Life

G. Liotta, E. Di Giacomo, R. Magni, and F. Corradi

16.1 Introduction

This chapter presents two studies: the rst one discusses the design and the evaluation

process of a tool for extending the possibility for disabled users to search and access the

information on the Internet; the second discusses the development of a telemedicine

tool for rehabilitation. Both the tools are created by a User Centered Design perspective

(Norman, 1983) with a test–retest process:

• The rst tool, called WhatsOnWeb, is a sonied clustering web search engine

that makes use of visualization techniques to improve the effectiveness and ef-

ciency of web searching. The whole information is presented to the user simulta-

neously in an interactive and sonied visual map, simplifying the user’s ability

to access and nd information. This technology is very important in a world

in which more than two Exabytes of new information are created every year

(Lyman and Varian, 2003).

CONTENTS

16.1 Introduction ...................................................................................................................... 361

16.2 The Simplication of the World Wide Web for Disabled Users: The

WhatsOnWeb Search Engine ......................................................................................... 362

16.2.1 Introduction ........................................................................................................ 362

16.2.2 The Interaction Model .......................................................................................363

16.2.3 The Information Visualization Approach ......................................................365

16.2.3.1 The Application Information Visualization Approach: The

Web Accessibility for Disabled Users ............................................ 366

16.2.3.2 A Sonication Example ....................................................................367

16.2.3.3 A Usability Evaluation ..................................................................... 368

16.3 The Telemedicine: The Nu!Reha Desk .......................................................................... 369

16.3.1 Introduction to Telemedicine ........................................................................... 369

16.3.2 Telerehabilitation ............................................................................................... 370

16.3.3 The Nu!Reha Platform .......................................................................................370

16.3.4 Proposed Approach ........................................................................................... 371

16.3.5 Clinical Evaluation ............................................................................................372

16.3.5.1 Results and Discussion .................................................................... 373

16.3.6 Future Evolutions ............................................................................................... 374

16.4 Conclusions .......................................................................................................................375

Summary of the Chapter ........................................................................................................... 376

References .................................................................................................................................... 376

376 Assistive Technology Assessment Handbook

Summary of the Chapter

This chapter presents two studies: the rst one discusses the design and the evaluation

process of a tool for extending the possibility for disabled users to search and access the

information on the Internet (WhatsOnWeb); the second discusses the development of a

telemedicine tool for rehabilitation (Nu!Reha). WhatsOnWeb can widen the ability of web

users to search and access information through a semantic and spatial organization of

information. This tool, by its sonication algorithm, becomes an important tool for visu-

ally impaired users because it allows this kind of user to explore the spatial organization

of the retrieved information without performance differences to those of nonimpaired

users. Also, the use of the user-centered perspective allows the designer to set up the

WhatsOnWeb technology for brain–computer interface use with locked-in subjects to

spread the semantic web possibility of searching in the World Wide Web. The second tech-

nology, the Nu!Reha Desk, is a telemedicine system that can include in the rehabilitation

process disabled users without easy access to practitioners. The analysis of the user expe-

rience of this technology, and in particular the ease of learning perceived by the users, is

the core for the implementation of this tool to optimize access to the rehabilitation process.

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379

Brain–Computer Interfaces: The New

Landscape in Assistive Technology

E. Pasqualotto, S. Federici, M. Olivetti Belardinelli, and N. Birbaumer

17.1 What Is a Brain–Computer Interface?

A brain–computer interface (BCI) provides a direct connection between the brain and

an external device, such as a computer or any other system capable of receiving a signal.

In June 1999, the First International Meeting on Brain–Computer Interface Technology

took place at the Rensselaerville Institute (Albany, NY). The aims of this rst meeting,

which 50 researchers from 22 different research groups attended, were to review the

state of the art of BCI research and to dene a shared set of procedures, methods, and

denitions. During this meeting, it was established that “a brain–computer interface is a

communication system that does not depend on the brain’s normal output pathways of

peripheral nerves and muscles” (Wolpaw et al. 2000). In a BCI, neuromuscular activity

is not necessary for the production of the activity that is needed to convey the message

(Pasqualotto et al. 2011a).

CONTENTS

17.1 What Is a Brain–Computer Interface? ........................................................................... 379

17.2 Measuring Brain Activity ............................................................................................... 381

17.2.1 EEG ......................................................................................................................381

17.2.2 MEG ..................................................................................................................... 381

17.2.3 fMRI ..................................................................................................................... 381

17.2.4 fNIRS ................................................................................................................... 382

17.3 History of BCIs ................................................................................................................. 382

17.4 Communication ................................................................................................................384

17.4.1 Potential Users ....................................................................................................384

17.4.2 Development .......................................................................................................385

17.5 Motor Restoration ............................................................................................................ 387

17.5.1 Potential Users ....................................................................................................387

17.5.2 BCI in Movement Restoration ..........................................................................388

17.6 BCI and Behavioral Disorders .......................................................................................389

17.6.1 Epilepsy and ADHD ..........................................................................................389

17.6.2 Neurofeedback in Epilepsy and ADHD ......................................................... 389

17.7 Assistive Technologies and BCI ..................................................................................... 390

17.8 Conclusions .......................................................................................................................391

Summary of the Chapter ............................................................................................................392

References .....................................................................................................................................393

415New Rehabilitation Opportunities for Persons with Multiple Disabilities

to allow the person direct access to stimulation as well as the possibility to call for social

attention and interaction. The fourth section discusses (1) the results obtained with the dif-

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tion/rehabilitation contexts, and (2) the possibility of using combinations of microswitches

also for programs aimed at simultaneously targeting increases of adaptive responding

and reduction of problem behaviors or inadequate postures.

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421

Methods and Technologies for Leisure,

Recreation, and an Accessible Sport

C. M. Capio, G. Mascolo, and C. H. P. Sit

19.1 Introduction

19.1.1 Self-Efficacy Theory

A well-established area of sport psychology has built research on the role of self-efcacy

in successful sports participation. Initially proposed by Bandura (1997), self-efcacy refers

to the belief than an individual has in his or her the ability to execute a task to generate a

specic outcome. This belief of having some amount of control over one’s own function-

ing has been described to have a pervasive inuence in an individual’s task performance.

Studies of the self-efcacy construct in sport have included physical prociency and dif-

ferent aspects of game performance such as strategy selection, prediction of opponent’s

actions, and pressure management (Short and Ross-Stewart 2009).

Self-efcacy beliefs have been theorized to be products of an individual’s cognitive pro-

cessing of diverse sources of efcacy information (Feltz et al. 2008). The four principal

sources of efcacy information as proposed by Bandura (1997) are (1) past performance

accomplishments, (2) vicarious experiences, (3) verbal persuasion, and (4) psychological

and emotional states. Among individuals with disabilities, efcacy information may be

CONTENTS

19.1 Introduction ........................................................................................................................ 421

19.1.1 Self-Efcacy Theory ...............................................................................................421

19.1.2 Facilitating Psychological Recovery through Sport .......................................... 422

19.2 Adapted Physical Activity: When Physical Activity Is for Everyone.........................422

19.2.1 Adapted Physical Activity .................................................................................... 423

19.2.2 Types of APA Programs ........................................................................................ 423

19.3 Sport and Disability...........................................................................................................425

19.3.1 Historical Perspective ............................................................................................426

19.3.2 Classication Systems within Paralympic Sports ............................................. 427

19.3.3 Sports Participation among Persons With Disabilities .....................................428

19.4 Sport and Disability Techniques and Technologies for a “Sport for All” .................429

19.4.1 Power Wheelchair Sports .....................................................................................429

19.4.2 Prosthetic Technology ........................................................................................... 430

19.4.3 Technology for Developing Countries ................................................................ 431

19.5 Conclusions .........................................................................................................................432

Summary of the Chapter ............................................................................................................432

References .....................................................................................................................................432

432 Assistive Technology Assessment Handbook

essential strategy in wheelchair design in developing countries because it not only keeps

the costs low, but it also ensures that the chair will be locally maintained (Pfaelzer and

Krizack 2000). The corresponding local labor cost was also much lower relative to devel-

oped countries, and the combination with local materials resulted in a wheelchair design

that cost less than 20% of similar equipment in the United States. It has been advocated

that the cost of technology should not be a hindrance for individuals with disability to

take part in sports and physical activity (Sport and Development 2011). Essentially, projects

such as this one need to be pursued to enhance the participation of individuals with dis-

abilities from less developed nations, leading toward the ideal of “sport for all.”

19.5 Conclusions

Sport represents one form of physical activity, and among individuals with disabilities,

this has been facilitated by adaptation strategies. Disability sport continues to grow in

terms of both participation and competition. Such positive change appears to be dynamic,

as methods, strategies, and technologies continue to evolve from research ndings.

Summary of the Chapter

This chapter initiated the discussion on methods and technologies that facilitate acces-

sible sport through self-efcacy theories that provide the motivation for enabling sports

participation for all. The proposition that adapted physical activity (APA) programs sets

up the stage for making PA participation possible for everyone was developed. Diverse

forms of APA have been documented to have benecial effects among individuals with

disabilities, and sports activities appear to be an important form of PA. The wide extent of

sports participation among individuals with disabilities is evident in the Special Olympics

and Paralympics.

Such prestigious status of sports for individuals with disabilities has generated a corre-

sponding body of research that has started to move towards evidence-based practice. The

inherent competitive nature of sports has also been evident, consequently resulting in the

use of technology to address evolving demands of athletes with disabilities. While it appears

that PA is indeed for everyone, and is achieved through sports as supported by technology,

further research is desired to enhance different parameters of the current status.

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439

Index

Accessibility

denitions, 332–333, 340, 341, 343

usability and, 340–341

Accessibility, sustainability, and universal

design (UD), 68

continuum model of, 69–70

environmental assessment process and,

71–72, 76–79

environment assessment in ATA process

based on concepts of, 71–72

interaction between, 69–71

intersection model of, 69, 70

meaning of, 68–69

Accommodation (vision), 202, 203, 215–216

Action by Design Component (ADC)

framework, 368

Adapted physical activity (APA), 422–423

Adapted physical activity (APA) programs,

types of, 423–425

Adaptive behavior, dened, 20

Alzheimer’s disease, vocational rehabilitation

for, 121–125

American Speech-Language-Hearing

Association (ASHA), 301–302

conceptual framework of ASHA practice

documents, 302

Ametropias, 217–218

Amyotrophic lateral sclerosis (ALS), 385–386,

390, 392

Assistance Users/Caregiver Dyad Assistive

Technology Process Model, outcome

measurement with vignettes based

on,93–97

Assistec graduates, elds of expertise of, 196

Assistec program, 192–193, 196

curriculum, 193–194

impact, 196–197

Assistive technology (AT)

acceptance, rejection, or abandonment of an,

280–282, see also Assistive technology

(AT) abandonment

denition and role of, 232–233

is increasingly complex and sophisticated, x

process involved in selecting and using,

233–236

Assistive technology (AT) abandonment,

5–6; see also under Assistive

technology

Assistive technology assessment (ATA), global

perspectives and emerging themes in,

ix–xiv

Assistive technology assessment (ATA)

model, 2–5

Assistive technology assessment (ATA) process,

58, 60–61, 221

assessing individual functioning and

disability in, 20–23

outcome of, 34–35

Assistive technology assessment (ATA) process

ow chart, 22, 189

Assistive Technology Device Predisposition

Assessment (ATD-PA), 36–37, 56–61,

120, 123, 157

Assistive technology devices, databases of,

329–330

Assistive technology (AT) match, measuring

the, 51–58

outcome measures, 51–52

Assistive Technology Outcomes Measurement

System (ATOM), 41–42

Association of Intellectual and Developmental

Disabilities (AAIDD), 38–39

AT, see Assistive technology

ATA, see Assistive technology assessment

Attention decit hyperactivity disorder

(ADHD), 389

neurofeedback in, 389–390

Augmentative and alternative

communication (AAC), 136, 252,

309–310, 321–323

Ausilioteca di Roma (Centre for Technological

Aid of Rome), xii–xiii

Bathing chair, 257

Behavioral-cognitive therapy, see Cognitive-

behavioral therapy

Behavioral disorders and brain-computer

interfaces, 389–390

Binocular vision, 214

Biopsychosocial approach, 103, 114–116

440 Index

Biopsychosocial model, 3–5, 11–12, 21, 27

ICF, 3–5, 21, 60, 116–117, 152, 188

interaction system according to, 183

BlinkAndPitch model, 368

BlinkAndPitchSonication model, 368

Body functions, 156

Brain activity, measuring, 381–382

Brain-computer interaction (BCI), 363

Brain-computer interfaces (BCIs), 391–392

AT and, 390–391

behavioral disorders and, 389–390

for communication

development of, 385–387

potential users of, 384–385

comparison of technologies, 384

history, 382–383

for motor restoration, potential users of,

387–389

nature of, 379–380

Canadian Occupational Performance Measure

(COPM), 38, 51–52

Caregiver Assistive Technology Outcome

Measure (CATOM), 91–92, 95

domains, 92

scores over time, 95

Caregivers of assistive users, 83–87, 97–98

conceptual framework for understanding

outcomes experienced by, 89, 90

conceptual framework on the impact of AT

on users and, 87–91

future directions regarding, 97

measurement tools addressing AT impacts

on, 91–97

model for AT outcomes on user/caregiver

dyad, 88–90

Care-O-Bot, 280

Case studies, AT

process involved in selecting and using,

236–242

Center for technical aid, xvi–xvii, 4–5, 22, 32,

171, 221, 350

ATA process in, 60–61, 188–190

ow chart of, 159

environmental assessment process and, 73

psychologist in, 155–157

Cerebral palsy (CP), case studies of, 140,

144–145, 253–259, 264, 320–322

Chair to help child sit and use upper

limbs, 255

Charity/donation models, 16, 17

Children; see also Pediatric specialists

AT resources applied to daily life of,

250–251

Client-oriented model, see Service delivery

models

Cognitive-behavioral therapy (CBT), 108–111

Cognitive impairments, 276

technological devices for people with,

278–279

Cognitive Orthosis for Assessing aCtivities in

the Home (COACH) system, 279

Cognitive prostheses, 278

Cognitive rehabilitation, 115–116

Cognitive screening, 276

Cognitive support technology (CST), 116–119

Cognitive Support Technology Device

Predisposition Assessment (CST PA), 56

Cognitive therapists, 110–113

Cognitive therapy (CT), 107–111

case study, 121–125

with individuals having cognitive disability,

114–115

Communication, see Augmentative and

alternative communication; Brain-

computer interfaces; Voice output

communication aids

Community-based rehabilitation (CBR) models,

16, 17

Complete locked-in syndrome (CLIS), 384, 391, 392

Comprehensive geriatric assessment (CGA),

274–275, 292

Computers, see Brain-computer interfaces;

Human-computer interaction

Cone and rod cell, 204

Context, impact of, xi

Convention on the Rights of Persons with

Disabilities, 14

Convergence (vision), 203, 204

CoRT (Cognitive Research Trust) Thinking

Techniques, 137

Degenerative disabilities, treating, 102

Depression, 276–277

Design for All, 191; see also Universal design

Developmental disabilities, treating, 101–102

Disability(ies), 1–2

classication, declaration, and international

denitions of, 13–16, 26

measurement of, 25–28

441Index

objective vs. subjective dimensions of, 29–30

personal factors of, 153–154

persons with multiple, 399–400, see also

Microswitches

professionals’ representation of, 165–168

treating acquired, 102–103

Donation models, see Charity/donation

models

eAccessibility, 190–191

Ease of operation, 342; see also Accessibility;

Usability

Education, vocational eld of, 193

Educational setting

environmental factors to promote AT in

classrooms, 136–138

outcome studies of AT in, 136

Education Technology Device

Predisposition Assessment

(ET PA), 57, 121

Effectiveness, dened, 333

Efcacy, dened, 333

Efciency, dened, 333

eInclusion, 190–191

Elderly people, 162

eLearning system, 194–195

Electroencephalography (EEG), 381

Electronic travel aids (ETAs), 352

categories of, 352

Empowering USers Through Assistive

Technology (EUSTAT), 42

Encephalopathy, hypoxic-ischemic, 139–143,

236–239

Entrepreneurial models, 16, 17

Environment, impact of, xi

Environmental assessment (EA) process, 67–68,

72–75

case evaluation, 76–79

step-by-step decision making, 75–76

Epilepsy, 389

neurofeedback in, 389–390

Ergonomics, 182

eSystems, 181, 338

intrasystemic relation between users and,

339, 340

Evaluation methods/strategies, 230; see also

specic topics

Evidence-based practice (EBP), 304–307,

320–321

four-step model for, 304, 305

Eye, structure of, 203

Eye movements during reading text, 213

Family, 169–170; see also Caregivers of

assistive users

AT resources applied to daily life of child

and, 250–251

Family Impact of Assistive Technology Scale

(FIATS), 41, 92–93

scores over time, 93, 94

Frailty, dened, 272

Functional magnetic resonance imaging (fMRI),

381–382

Functional near-infrared spectroscopy

(fNIRS), 382

Functioning

classication, declaration, and international

denitions of, 13–16

how to measure, 31

guidelines for measurement and

assessment, 31–32

measurement and assessment in ATA

process, 32–33

measures of, 25–31

monitoring, in the context of ATA use, 34–35

objective vs. subjective dimensions of, 29–30

personal factors of, 153–154

suggested measurement tools for an ATA

process, 35–39

outcome analysis tools, 39–42

Geriatric assessment, 273–275

vs. assessment of young adults, 274

of a clinical case, 288–291

ICF codes and, 282–287

interaction dimensions of, 274

Geriatric Assessment in a Centre for Technical

Aids, 291

Geriatricians, 270, 291–293

role in ATA process, 282–287

case study, 288–291

Geriatric rehabilitation, 275–277

assistive solutions in, 277–281

objectives, 275

Geriatrics, 269–270

Globalization and large-scale manufacturing

model, 16 –18

Global position system (GPS), 279

442 Index

Goal Attainment Scale (GAS), 51, 52

Guido, 279

Health, dened, 20

Healthcare Technology Device Predisposition

Assessment (HCT PA), 57, 121

“Hellodoc” project, 372–373

Human assistance, AT and, 84–85

Human-centered design (HCD), 339

Human-computer interaction (HCI), 181, 340–342

hierarchical model for, 362

Hypermetropia, 237–239

I-Cat robot, 280

Inclusive Learning through Technology (ILT), 137

Individual empowerment model, 16, 17

Individual functioning, see Functioning

Individualized education plan (IEP), 132

Individual Prioritised Problem Assessment

(IPPA), 41, 51, 52

Information visualization approach (IVA),

365–369

Institute for Matching Person and

Technology, xv

Intellectual disability (ID), 15, 20

Intelligence, dened, 20

Interaction evaluation, integrated model of,

343–348

Interaction model (human-computer

interaction), 363–365

Interdisciplinary approaches to assessment,

need for, x–xi

Interdisciplinary team approach; see also

Multidisciplinary team; Pediatric case

evaluation in an interprofessional

team; Teamwork

assistive solutions and, 248–250

International Classication of Functioning,

Disability, and Health (ICF), 1, 3, 13, 14,

25–26

ATA process under the lens of ICF

biopsychosocial model, 3–5,

21, 60, 116–117, 152, 188, see also

Biopsychosocial model

ICF Checklist, 35

ICF codes and geriatric assessment,

282–287

ICF Core Set, 35

Matching Person & Technology Model and,

58, 59

and measuring the AT match, 51

need for revision, 151–153

overview, 151–152

International Classication of Impairments,

Disabilities, and Handicaps (ICIDH),

152, 153

Internet, see Web accessibility

iSonic system, 353

Language activity monitoring (LAM), 312

Leadership Energy and Environmental Design

(LEED), 74

Learning, AT and, 251–253

Learning disabilities, 313–320

Leonarda Vaccari Institute, xii–xiii

Locked-in syndrome (LIS), 384–387, 391, 392

Locomotion, device for independent, 256

Magnetoencephalography (MEG), 381

MANUS, 279–280

Matching Assistive Technology and Child

(MATCH), 58

Matching Older Adults with Dementia and

Technology (MOADT), 287–291

Matching Person & Technology (MPT)

Model, xv, 7, 36, 39, 51–55, 119,

133, 139

assessment process and forms, 56–57,

119–121, 292

ATA process and, 61–62

different versions of, 58

ICF and, 58, 59

process and measures, 55–58

Medical model, 2, 11, 27

Mental models, 182, 345–348, 354

“Mental prostheses,” 385–387

Mental retardation, see Intellectual disability

Microswitches

combinations of, 405–407

combinations of VOCAs and, 407–410

experimental, for small (nontypical)

responses, 402–405

Microswitch technology, studies using,

401–405

outcomes of, 410–411

practical perspectives and implications of,

411–413

443Index

Motor disability, technological devices for

elderly people with, 279–280

Motor functions, evaluation of, 222–223

Motor restoration, brain-computer interfaces

for, 387–389

Movement restoration, brain-computer

interface in, 388–389

MPT, see Matching Person & Technology (MPT)

Model

Multidisciplinary approaches to assessment,

need for, x–xi

Multidisciplinary team, 30, 170, 182; see also

Interdisciplinary team approach;

Tea mwork

assessment professionals on, 101–103

meeting with psychologist, 159

Multidisciplinary team evaluation, assistive

solution, 160, 187–188

Multidisciplinary team meetings, 159,

186–187

National Health and Aging Trends Study

(NHATS), 286

Near-infrared spectroscopy (NIRS), 382

Neurofeedback, 389–390

Nu!Reha Desk, 362, 369–371

clinical evaluation, 372–374

ow chart of experimental design for

clinical evaluation of, 374

proposed approach of, 371–372

Occupational therapists (OTs)

interventions used by, 231–232

perspective of, 229–230

Older patients

disability, 271–272

disease, 270–271

frailty, 272–273

Optic chiasm, 206, 208

Optic nerves and their pathway, 206, 208

Optometrists, role in ATA process, 220–222

vision and, 202–220

Optotype symbol examples, 209

PAM-AID (Personal Adaptive Mobility

Aid), 279

PanAndPitchBlinking model, 368

PanAndPitch model, 368

Paralympic Games, 425–426

classication systems within Paralympic

sports, 427–428

Pediatric case evaluation in an interprofessional

team, 253–264

Pediatric specialists

in assistive solutions, 248

in the process of development and

rehabilitation, 245–248

Perceptive abilities, superior, 219–220

Perceptive functions; see also Visual abilities in

behavioral optometry

evaluation of, 222–223

Personal factors

assistive solutions and, 154–155

of functioning and disability, 153–154

psychologist as specialist in, 155–157

Physical activity (PA), 422–423; see also Adapted

physical activity

PICO, 306

PitchAndVolume model, 368

POEM, 306

Power wheelchair sports, 429–430

Profession groups, 165, 166

Prosthetic technology, 430–431

P300 Speller, 385

Psychological practice, new approach

in, 168

Psychological professional practice guidelines

in ATA process, 168–170

Psychologist role in ATA process, 157–158

when it is required, 158–160

Psychologists

in a center for technical aid, 155–157

facilitating awareness of user/client’s

context and multidisciplinary team

perspectives, 160–164

and professional’s representations of

disabled users/clients and AT,

164 –170

role in ATA, 149–151, 170–171

what they should do in promoting user/

client request, 164

Psychosocial Impact of Assistive Devices Scale

(PIADS), 40 – 41

Psychotech nologists, 180–181, 184–186

and AT assignation process in center for

technical aid, 188–190

the context of their profession,

190–191

need for education, 191–192

role in ATA process, 181–183, 186–188

444 Index

Psychotechnology

denitions of, 180

rst course in, xv

Psychotechnology education, example of,

190–197

Quadriplegia, congenital, 236–239

Quebec User Evaluation of Satisfaction with

Assistive Technology 2.0 (QUEST),

39–40

Rational emotive behavioral therapy (REBT),

108 –109, 111

Rehab - CYCLE, 19

Rehabilitation; see also Geriatric rehabilitation;

User eXperience (UX) concept

application in design system for

rehabilitation

cognitive, 115 –116

community-based, 16, 17

pediatric, 245–248

Rehabilitation counseling, vocational,

121–125, 193

Rehabilitation Problem-Solving Form (RPS-

Form), 19

Rehabilitation process

assessing individual functioning within a,

18–20

Rehabilitation project, ATA process in the, 60–61

Rehabilitation technology service delivery

models, see Service delivery models

Retina

functional division, 204, 205

histological characteristics, 204, 206

projection of visual elds onto left and right,

206, 207

structure, 204, 205

RoboCare, 280

Sapienza University of Rome, xv

Satisfaction, dened, 333

Scope of Practice in Speech-Language Pathology

(ASHA), 302

Search engines, see WhatsOnWeb search engine

Self-efcacy theory, 421–422

Service delivery

dened, 5

Service delivery models, 5–7, 16–18, 27

Service delivery process of AT, stages in, 139

Service delivery system in different

countries, 5–7

Slow cortical potentials (SCPs), 386

Socially assistive robotics systems, 280–281

Social model, 27; see also Service delivery

models

Sonication, 351–353, 367–368

dened, 333

Special educator, role in ATA, 131–133,

145 –146

case studies, 139–145

teaching alternatives using AT, 134–135

Specic learning disabilities (SLDs),

313–320

Speech-language pathologists (SLPs),

322–323

AT assessments and, 307–308

case evaluation in multidisciplinary

team vs. as a professional

consultant, 320

asking meaningful EBP questions,

320–321

characterizing the client, 320

collecting clinical and personal

evidence, 321

locating and reviewing research

evidence, 321

using the evidence for MPT process,

321–322

description of professional prole,

301–303

development and implementation of AT

intervention plans, 313

evaluation of the effectiveness and

usefulness of AT, 311–313

evidence-based practice and, 304–307

matching persons with technology and,

308–311

overlapping domains of language and

literacy assessed by, 308

role in advocacy, 313

specic learning disabilities and,

313–320

AT teams and, 303–304

Sport, facilitating psychological recovery

through, 422

Sport and disability techniques and

technologies for a “sport for all,”

429–431

technology for developing countries,

431–432

445Index

Sports

disability and, 425–426

historical perspective, 426–427

included and Special Olympics and

Paralympics, 425, 426

Sports participation among persons with

disabilities, 428–429

STATEMENT project, 145

Stroke, ischemic, 239–242

Support Intensity Scale (SIS), 32, 38–39

Survey of Technology Use (SOTU), 56, 157

Sustainability, see Accessibility,

sustainability, and universal

design

Systems, evaluation of, 343–348

Tal ker

with keyboard, 263

that uses simple switches to scan letters for

forming words, 259

Tea mwork, 246 –247; see also Interdisciplinary

team approach; Multidisciplinary

team

Technology Acceptance Model (TAM), 280

Telemedici ne, 369 –374

future evolutions, 374–375

Thinking skills, 137

Toilet seat, customized, 257

Toy with adaptive switch, 256

Traumatic brain injury (TBI)

case of, 260–264

United Nations (UN)

International Seminar on the Measurement

of Disability, 25

Universal design (UD), 74, 75, 333; see also

Accessibility, sustainability, and

universal design; Design for All

principles of, 77

in public use infrastructure models, 17, 18

Universal design for learning (UDL),

138–139

Usability

dened, 340, 342

rights of access and, 340–341

Usability standards, 341–342

User-assistive technology, 181; see also specic

topics

User-centered design (UCD), 333, 339

User eXperience (UX), 337–338, 354–355

application of UX framework for designing

sonied visual Web search engine,

353–354

areas in which it goes beyond

usability, 338

in ATA process, 348–351

dened, 337

four phases of, 338, 339

User eXperience (UX) concept application

in design system for rehabilitation,

348–351

sonication of the system, 351–353

User eXperience (UX) evaluation

evaluator’s mental model for from the

perspective of, 347, 348

Vineland Adaptive Behaviour Scales (VABS),

35–36

Visual abilities in behavioral optometry, 208

accommodation, 202, 203, 215–216

binocular vision, 214

convergence, 214–215

eld of vision, 218–219

xation, 211–212

refraction, 216–218

saccadic movements, 213–214

slow pursuit, 212–213

superior perceptive abilities, 219–220

visual acuity, 208–211

Visual functions, evaluation of,222–223

Visual process from eye to brain, complexity of,

202–208

Visual training, 225

Visus font, 211

Vocal synthesis, 318

Vocational rehabilitation counseling, 121–125,

193

Voice output communication aids

(VOCAs), 400

combinations of microswitches and, 407–410

vOICe system, 352–353

Volatile organic compound (VOC)-free

manufacturing processes, 77–78

VolumeSonication model, 368

Web accessibility, 341; see also Information

visualization approach

Well-being, 29

446 Index

WhatsOnWeb search engine, 353–354, 361–363

sonication, 367–368

usability evaluation, 368–369

Wheelchair-mounted robotic arms

(WMRAs), 279

Wheelchair with anatomical seat and backrest,

257, 258

WHODAS II, 37

Workplace Technology Device Predisposition

Assessment (WT PA), 57, 121

World Health Organization Disability

Assessment Schedule (WHODAS), 28

Y-shaped model (rehabilitation process), 18–19

People with Intellectual and Sensory Disabilities Triggering a Tablet’s Delivery of Task Instructions by Walking to the Tablet: Proof-of-Concept Study (Preprint)

Article

Apr 2024

Background People with intellectual and sensory or sensory-motor disabilities tend to have problems performing multistep tasks. To alleviate their problems, technological solutions have been developed that provide task-step instructions. Instructions are generally delivered at people’s request (eg, as they touch an area of a computer or tablet screen) or automatically, at preset intervals. Objective This study carried out a preliminary assessment of a new tablet-based technology system that presented task-step instructions when participants with intellectual and sensory disabilities walked close to the tablet (ie, did not require participants to perform fine motor responses on the tablet screen). Methods The system entailed a tablet and a wireless camera and was programmed to present instructions when participants approached the tablet, that is, when the camera positioned in front of the tablet detected them. Two instructions were available for each task step. One instruction concerned the object(s) that the participants were to collect, and the other instruction concerned the “where” and “how” the object(s) collected would need to be used. For 3 of the six participants, the two instructions were presented in succession, with the second instruction presented once the required object(s) had been collected. For the other 3 participants, the two instructions were presented simultaneously. Instructions consisted of pictorial representations combined with brief verbal phrases. The impact of the system was assessed for each of the 2 groups of participants using a nonconcurrent multiple baseline design across individuals. Results All participants were successful in using the system. Their mean frequency of correct task steps was close to or above 11.5 for tasks including 12 steps. Their level of correct performance tended to be much lower during the baseline phase when they were to receive the task-step instructions from a regular tablet through scrolling responses. Conclusions The findings, which need to be interpreted with caution given the preliminary nature of the study, suggest that the new tablet-based technology system might be useful for helping people with intellectual and sensory disabilities perform multistep tasks.

Benefits and challenges of using assistive technology in the education and rehabilitation of Individuals with visual impairments

Article

Apr 2024

Sonja Alimovic

Purpose: Individuals with visual impairments use assistive technology in various aspects of life. Professionals who work with visually impaired people need to know about assistive technologies. The purpose of this study was to analyse the benefits and challenges of assistive technologies by assessing the degree of satisfaction with assistive technologies in different life situations expressed both by users and by professionals.Materials and Methods: Data were collected from 36 individuals with visual impairments and 27 professionals using online questionnaires. Further information was obtained from five individuals with visual impairments through focus group interviews.Results: The results show that 26 (72.2%) individuals with visual impairments and almost all professionals (N = 25; 92.6%) acknowledge the benefits of using assistive technology. They recognise the importance of assistive technology in independent living for individuals with visual impairments. However, 27 (75%) individuals with visual impairment and 26 (96.3%) professionals consider financial constraints to be the biggest problem.Conclusion: More cost-effective technologies need to be developed, and social policies and opportunities created so that every individual with visual impairment can obtain assistive technologies that meet their needs. This would increase the independence of individuals with visual impairments in all areas of life.

Assistive technologies and habit development: A Semiotic Model of Technological Mediation

Article

Full-text available

Nov 2023

In the field of philosophy of technology, the concept of mediation is central to understanding how technology shapes human experience and behavior. Our aim in this paper is to contribute to the understanding of technological mediation, in particular how andwhy it is possible. Technologicalmediation occurs within a mediation space between the technological realm and the user realm. In the technological realm, technology regularizes events and actions, while in the user realm, the user interprets the significative potential of the technology. This interpretation process is identical with use and involves the formation of user habits,which are constrained by technological, cognitive, and sociocultural factors. To provide a theoretical framework for our analysis, we propose the Semiotic Model of Technological Mediation (SMTM), which draws on Charles Peirceʼs semiotics. To illustrate our argument, we focus on assistive technology and provide a recurring example of the Medimi®Smart, a digital, comprehensive system for medication handling.

A Systematic Review of Available Assistive Technology Outcome Measures (Preprint)

Article

Full-text available

Jul 2023

Background: World Health Organization claimed that measuring outcomes is necessary to understand the benefits of assistive technology and create evidence-based policies and systems to ensure universal access to it. Specifically, in clinical practice, there is an increasing need for standardized methods to track individual assistive technology (AT) interventions using outcome assessment. Objective: This review has been undertaken to provide an overview of available outcome measures that can be used at the follow-up stage of any AT interventions and integrated into the daily clinical or service practice. Methods: We systematically searched for original manuscripts regarding available and used AT outcome measures by looking for titles and abstracts in the PubMed, Scopus, and Web of Science databases up to March 2023. Results: We analyzed 955 articles, of which 50 were included. Within these, 53 instruments have been mentioned and used to provide an AT outcome assessment. The most widely used tool is the Quebec User Evaluation of Satisfaction with Assistive Technology, followed by the Psychosocial Impact of Assistive Technology Scale. Moreover, the identified measures address eight AT outcome domains: functional efficacy, satisfaction, psychosocial impact, caregiver burden, quality of life, participation, confidence and usability. The AT category "Assistive products for activities and participation relating to personal mobility and transportation" was the most involved in the reviewed articles. Conclusions: Among the 53 cited instruments, only 17 scales (about 30%) were designed to evaluate specifically assistive devices. 34 instruments were only mentioned once to denote poor uniformity and concordance in the instruments to be used, limiting the possibility of comparing the results of studies. This work could represent a good guide for promoting the use of validated AT outcome measures in clinical practice that can be helpful to AT assessment teams in their everyday activities and the improvement of clinical practice.

My assistive technology outcomes framework: rights-based outcome tools for consumers to ‘measure what matters’

Article

Jul 2023

AT outcomes research is the systematic investigation of changes produced by AT in the lives of AT users and their environments. In contrast to focal outcome measures, My Assistive Technology Outcomes Framework (MyATOF) envisions an alternative starting point, co-designing a holistic and evidence-based set of outcome dimensions enabling AT users to quantify their own outcomes. International classification systems, research evidence, regulatory and service delivery frameworks underpin six optional tools: supports, outcomes, costs, rights, service delivery pathway and customer experience. Designed to empower the consumer-as-researcher and self-advocate, MyATOF has the potential to fill an identified gap in policy-relevant, consumer-focussed and consumer-directed outcome measurement in Australia and internationally. This paper presents the need for consumer-focussed measurement and articulates the conceptual foundations of MyATOF. The iterative development and results of MyATOF use-cases collected to date are presented. The paper concludes with next steps in using the Framework internationally, as well as its future development.

Models and frameworks for guiding assessment for aided Augmentative and Alternative communication (AAC): a scoping review Models and frameworks for guiding assessment for aided Augmentative and Alternative communication (AAC): a scoping review

Article

Jul 2023

Background: Augmentative and Alternative Communication (AAC) supports individuals with complex communication needs. Conceptual models and frameworks exist to evaluate, implement, and assess the needs of persons with communication disabilities, however, it is unknown which models were grounded in previous evidence-based research. Objective: What are the models and frameworks grounded in empirical or conceptual research that enable communication outcomes for persons who require aided AAC systems? Eligibility criteria: The study had to be the original publication of a defined model or framework that included aided AAC and the model had to be developed through research, either conceptual or empirical. Sources of evidence: Eleven databases were searched using terms associated with AAC devices, conceptual models, and assessment processes. Fifteen articles presenting 14 independent assessment models were included. Charting methods: A custom data extraction form included model development using existing models and research evidence, the model's input parameters, and explicit outcome measures. Results: Four models were specific to AAC while ten models were general evaluations for assistive technology systems. Models used a variety of descriptive traits during assessment including: person, technology, environment and context, and the activity or task. Only nine models sought to iteratively assess the client. Eleven of the models identified the inclusion of members from different disciplines in the assessment process. Conclusions: There is a need to standardize descriptive traits: personal abilities, environmental characteristics, potential assistive technology, and contextual factors. Models should include teams of different disciplines to provide holistic assessments. Models should include outcomes and include iterative solutions.Implications for RehabilitationStandardizing the definitions of descriptive traits used in the assessment of the personal abilities, environmental characteristics, potential assistive technology, and contextual factors would enable better evaluation of outcomes across disciplines and abilities.By identifying what factors are instrumental in the successful recommendation of assistive technology, professionals may achieve a well-organized and efficient assessment tool.An assessment model tailored specifically to individuals who may benefit from Augmentative and Alternative Communication (AAC) should be considered that are rooted in existing theories, research evidence, and the experiences of those in the AAC community.An AAC specific model would allow for consistent outcome tracking across individuals or assessment teams and the comparison of the effectiveness of various models for research purposes.

Pediatric Brain–Computer Interfaces: An Unmet Need

Chapter

Jul 2023

Acceptance of Assistive Technology by Users with Motor Disabilities Due to Spinal Cord or Acquired Brain Injuries: A Systematic Review

Article

Full-text available

Apr 2023

Acquired motor limits can be provoked by neurological lesions. Independently of the aetiologies, the lesions require patients to develop new coping strategies and adapt to the changed motor functionalities. In all of these occasions, what is defined as an assistive technology (AT) may represent a promising solution. The present work is a systematic review of the scientific AT-related literature published in the PubMed, Cinahl, and Psychinfo databases up to September 2022. This review was undertaken to summarise how the acceptance of AT is assessed in people with motor deficits due to neurological lesions. We review papers that (1) dealt with adults (≥18 years old) with motor deficits due to spinal cord or acquired brain injuries and (2) concerned user acceptance of hard AT. A total of 615 studies emerged, and 18 articles were reviewed according to the criteria. The constructs used to assess users’ acceptance mainly entail people’s satisfaction, ease of use, safety and comfort. Moreover, the acceptance constructs varied as a function of participants’ injury severity. Despite the heterogeneity, acceptability was mainly ascertained through pilot and usability studies in laboratory settings. Furthermore, ad-hoc questionnaires and qualitative methods were preferred to unstandardized protocols of measurement. This review highlights the way in which people living with acquired motor limits greatly appreciate ATs. On the other hand, methodological heterogeneity indicates that evaluation protocols should be systematized and finely tuned.

Low-cost Technology-aided Programs for Supporting People with Motor, Visual, and Intellectual Disabilities in Functional Forms of Occupation and Communication: Proof of Concept Study (Preprint)

Article

Full-text available

Nov 2022

Background: People with motor, visual, and intellectual disabilities may have serious problems in independently accessing various forms of functional daily occupation and communication. Objective: The study was aimed at developing and assessing new, low-cost technology-aided programs to help people with motor or visual-motor and intellectual disabilities independently engage in functional forms of occupation and communication with distant partners. Methods: Two programs were set up using a smartphone interfaced with a 2-switch device and a tablet interfaced with 2 pressure sensors, respectively. Single-subject research designs were used to assess (1) the first program with 2 participants who were blind, had moderate hand control, and were interested in communicating with distant partners through voice messages; and (2) the second program with 2 participants who possessed functional vision, had no or poor hand control, and were interested in communicating with their partners through video calls. Both programs also supported 2 forms of occupational engagement, that is, choosing and accessing preferred leisure events consisting of songs and music videos, and listening to brief stories about relevant daily topics and answering questions related to those stories. Results: During the baseline phase (when only a conventional smartphone or tablet was available), 2 participants managed sporadic access to leisure or leisure and communication events. The other 2 participants did not show any independent leisure or communication engagement. During the intervention (when the technology-aided programs were used), all participants managed to independently engage in multiple leisure and communication events throughout the sessions and to listen to stories and answer story-related questions. Conclusions: The findings, which need to be interpreted with caution given the nature of the study and the small number of participants, seem to suggest that the new programs may be viable tools for helping people with motor or visual-motor and intellectual disabilities independently access leisure, communication, and other forms of functional engagement.

Involving autism stakeholders in identifying priorities for interventions based on augmented reality

Article

Sep 2022

Purpose Literature supports the use of technological tools such as augmented reality, 3 D avatars and mobile devices to improve individuals with autism spectrum disorder skills. Possibilities of including these technological tools in intervention and the critical issues related to intervention design are essential research questions. The aim of the current work is to present an interdisciplinary research study on the design of an autism intervention considering these technologies. Materials and methods This study used qualitative evidence and thematic analysis to identify the main design guidelines. A semi-structured interview was administered to a total of twenty participants representing four stakeholder categories: ASD, clinicians, therapists and caregivers. Interviews focussed on three dimensions related to user, technology and environment since they represent a complex system within which the individual using technology is situated. Results Thematic analysis of the interviews identified a total of 10 themes considered central to the design of the technological intervention. Conclusions Since the application of technology in autism intervention is a relatively new area, the guidelines related to the potential incentives and barriers of the proposed technology are helpful to inform future treatment studies. • Implications for Rehabilitation • This study highlights the strengths and barriers associated with the use of smartphones and augmented reality in autism spectrum disorder interventions considering the dimensions within which the user using assistive technology is located. • Strengths and major concerns that emerged are key points to consider during the development of the technological intervention. • Considering these points can foster the use of technology within the intervention and promote its effectiveness.

Tenacious Goal Pursuit and Flexible Goal Adjustment: Explication and Age-Related Analysis of Assimilative and Accommodative Strategies of Coping

Article

Full-text available

Mar 1990

Crises and critical life transitions activate 2 distinct but complementary modes of coping, (a) transforming developmental circumstances in accordance with personal preferences (assimilative tendency) and (b) adjusting personal preferences to situational constraints (accommodative tendency). Assimilative and accommodative tendencies were measured by a questionnaire comprising 2 independent scales (Tenacious Goal Pursuit and Flexible Goal Adjustment). Both scales predict high life satisfaction and low depression and are positively related to generalized internal control beliefs. The scales evinced an opposite relation to age: Cross-sectional analyses on a sample of 890 Ss in the age range from 34 to 63 years revealed a gradual shift from an assimilative to an accommodative mode of coping. Implications for theories of depression and successful aging are discussed.

Augmentative and Alternative Communication and Remote Learning

Article

Dec 2021

For rural locations, the use of remote learning may provide schools the opportunity to meet student needs without the need for students to travel long distances to access services. It is critical that teachers of students with disabilities understand how to support learning and know how to use the accommodations, modifications, and assistive technologies listed in student Individualized Education Programs (IEPs) in online classrooms. Students with language disabilities sometimes require augmentative and alternative communication (AAC) systems to effectively communicate. This article provides teachers with practical tips of teaching students to use AAC online and supporting its continued use in the virtual classroom.

Self-Efficacy in Sport

Book

Jan 2008

This book provides a reference for sport psychology lecturers, students, coaches and other professionals with an interest in the field. Self-belief, known as 'self-efficacy' by sports psychologists is widely believed to be an essential component of sporting success. This book examines the nature of efficacy as it applies to sporting behaviour in coaches, athletes and teams. It is the first reference book entirely devoted to the concept of self-efficacy in sport. It provides readers with a basic background of research on the topic, as well as current and future trends; offers research-tested guidelines and recommendations for using efficacy techniques with individual athletes and teams; and, includes a comprehensive annotated bibliography of references on the topic.

A Follow-up Study of the Mowat Sensor's Applications, Frequency of Use, and Maintenance Reliability

Article

Jun 1981

A survey was conducted of fifteen veterans who had been issued Mowat Sensors to determine applications, frequency of use, and device reliability. All subjects reported the aid to be helpful and continued to employ it although the amount of use varied. Reports of mechanical reliability were high. Particular uses of the Mowat are specified.

Psychosocial Impact of Assistive Devices Scale (PIADS)

Article

Sep 2002
Tech Disabil

The Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST 2.0): An overview and recent progress

Article

Sep 2002
Tech Disabil

Manuale di optometria e contattologia, 2° edizione

Book

Apr 2003

A textbook aimed to link vision science fundamentals and clinical practice methods, in a wide and general approach to optometry practice. Suitable as textbook for professional secondary school courses and foundation university courses.

An introduction to rehabilitation engineering

Book

Jan 2006

Answering the widespread demand for an introductory book on rehabilitation engineering (RE), Dr. Rory A. Cooper, a distinguished RE authority, and his esteemed colleagues present An Introduction to Rehabilitation Engineering. This resource introduces the fundamentals and applications of RE and assistive technologies (ATs). After providing a.

The evaluation of accessibility, usability, and user experience

Chapter

Jan 2009

Developers work to create eSystems that are easy and straightforward for people to use. Terms such as user friendly and easy to use o en indicate these characteristics, but the overall technical term for them is usability. e ISO 9241 standard on Ergonomics of Human System Interaction2 (Part 11, 1998) defines usability as: e extent to which a product can be used by specified users to achieve specified goals with effectiveness, efficiency and satisfaction in a specified context of use.

Factors Influencing the Use of Mobility Technology in Community-Based Long-Term Care

Article

Apr 2004
J AGING HEALTH

Objectives: This article adapts a framework commonly used to model personal long-term care services to examine factors influencing the use of mobility-related assistive devices, both in isolation and in combination with personal care. Methods: The authors analyze data from Phase 2 of the 1994-1995 National Health Interview Survey Disability Supplements to compare predictors of equipment use with those for personal care and rank the probabilities of using particular combinations according to health needs, access, and personal and family characteristics. Results: The authors find that underlying health needs are the dominant factor related to the type of care arrangement used. The typical person with a mobility-related disability is most likely to use equipment alone; only at younger ages or at greater levels of severity are other arrangements expected to dominate. Discussion: Research on the dynamic acquisition process, with attention to age and trajectories of disability severity, is needed to fully understand the integration of technology and personal care.

Assistive Technology Assessment Handbook

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