Using virtual robot-mediated play activities to assess cognitive skills

Abstract

Purpose: To evaluate the feasibility of using virtual robot-mediated play activities to assess cognitive skills. Method: Children with and without disabilities utilized both a physical robot and a matching virtual robot to perform the same play activities. The activities were designed such that successfully performing them is an indication of understanding of the underlying cognitive skills. Results: Participants' performance with both robots was similar when evaluated by the success rates in each of the activities. Session video analysis encompassing participants’ behavioral, interaction and communication aspects revealed differences in sustained attention, visuospatial and temporal perception, and self-regulation, favoring the virtual robot. Conclusions: The study shows that virtual robots are a viable alternative to the use of physical robots for assessing children’s cognitive skills, with the potential of overcoming limitations of physical robots such as cost, reliability and the need for on-site technical support.

• Implications for Rehabilitation

• Virtual robots can provide a vehicle for children to demonstrate cognitive understanding.

• Virtual and physical robots can be used as augmentative manipulation tools allowing children with disabilities to actively participate in play, educational and therapeutic activities.

• Virtual robots have the potential of overcoming limitations of physical robots such as cost, reliability and the need for on-site technical support.

     

Access to hands-on mathematics measurement activities using robots controlled via speech generating devices: three case studies

Abstract

Purpose: To examine how using a robot controlled via a speech generating device (SGD) influences the ways students with physical and communication limitations can demonstrate their knowledge in math measurement activities. Method: Three children with severe physical disabilities and complex communication needs used the robot and SGD system to perform four math measurement lessons in comparing, sorting and ordering objects. The performance of the participants was measured and the process of using the system was described in terms of manipulation and communication events. Stakeholder opinions were solicited regarding robot use. Results: Robot use revealed some gaps in the procedural knowledge of the participants. Access to both the robot and SGD was shown to provide several benefits. Stakeholders thought the intervention was important and feasible for a classroom environment. Conclusions: The participants were able to participate actively in the hands-on and communicative measurement activities and thus meet the demands of current math instruction methods.

• Implications for Rehabilitation

• Current mathematics pedagogy encourages doing hands-on activities while communicating about concepts.

• Adapted Lego robots enabled children with severe physical disabilities to perform hands-on length measurement activities.

• Controlling the robots from speech generating devices (SGD) enabled the children, who also had complex communication needs, to reflect and report on results during the activities.

• By using the robots combined with SGDs, children both exhibited their knowledge of and experienced the concepts of mathematical measurements.

     

Parental perceptions of barriers to physical activity in children with developmental disabilities living in Trinidad and Tobago

Abstract

Background: Parents have a strong influence on their child’s engagement in physical activities, especially for children with developmental disabilities, as these children are less likely to initiate physical activity. Knowledge is limited regarding parents’ perceptions of this phenomenon in low- and middle-income countries (LMICs); yet many rehabilitation providers work with children with developmental disabilities and their parents in these contexts. Purpose: The aim of this study was to explore the barriers perceived by parents of children with developmental disabilities to their children’s engagement in physical activity. Methods: An occupational perspective was used to explore how parents speak about barriers to their child’s engagement in physical activity. Interviews were conducted with nine parents in Port-of-Spain, Trinidad and Tobago. Findings: Parent’s perceived barriers were categorized into four themes: family priorities, not an option in our environment, need to match the activity to the child’s ability, and need for specialized supports. Conclusions: Findings provide opportunities for future rehabilitation and community programming in LMICs.

• Implications for Rehabilitation

• Children living with a developmental disability may engage more in solitary and sedentary pursuits as a result of parents choosing activities that do not present extensive social and physical demands for their child.

• Therapists can play an important role in providing knowledge to parents of appropriate physical activity and the benefits of physical activity for children with developmental disabilities in order to promote children’s participation.

• In environments where there is limited social support for families, therapists need to consider and be particularly supportive of parental priorities and schedules.

     

Realizing the potential of accessible ICTs in developing countries

Purpose: To raise the awareness of policy makers, economic development practitioners, and service providers about the importance of making information and communication technology (ICT) based international economic development in low- and middle-income countries inclusive of people with disabilities and to discuss the role and importance of addressing the complete ICT and assistive technology (AT) ecosystem to ensure sustainable, scalable, and affordable access to ICTs and ICT-based programs. Method: This commentary piece draws upon recent literature and practice cases to examine the role of accessible ICTs in international development. Results: Accessible ICTs can enhance economic participation and prevent exclusion from participation in international development programs. Access to and use of accessible technologies are largely determined by the ecosystem in which they exist and can be enhanced or hindered by government policy and legislation and the quality of the service delivery systems and financing mechanisms. Conclusions: People with disabilities in developing countries face daunting barriers to socioeconomic participation. Accessible ICTs can eliminate or mitigate some of these barriers. However, technology advancements do not solely promote penetration, affordability, or scalability of ICT-based development for persons with disabilities. A comprehensive ecosystem approach can help in developing sustainable mechanisms for access, affordability, and availability.

Implications for Rehabilitation

• Accessible ICTs are unavailable to the majority of people with disabilities living in low- and middle-income countries thus posing barriers to socioeconomic participation and ICT enabled social and economic development programs (ICT4D).

• Availability of and access to ICT is determined by the nature and components (individual, social, financial, and government actors and systems) of its ecosystem.

• The promise of ICTs for people with disabilities cannot be realized in low- and middle-income countries without supportive legislation, policy, infrastructure and financing.

• The ICT ecosystem will promote successful outcomes when its stakeholders, policy structures, and resources align to strengthen and support one another.

     

A multidimensional model of optimal participation of children with physical disabilities

Abstract

Purpose: To present a conceptual model of optimal participation in recreational and leisure activities for children with physical disabilities. Methods: The conceptualization of the model was based on review of contemporary theories and frameworks, empirical research and the authors’ practice knowledge. A case scenario is used to illustrate application to practice. Results: The model proposes that optimal participation in recreational and leisure activities involves the dynamic interaction of multiple dimensions and determinants of participation. The three dimensions of participation are physical, social and self-engagement. Determinants of participation encompass attributes of the child, family and environment. Experiences of optimal participation are hypothesized to result in long-term benefits including better quality of life, a healthier lifestyle and emotional and psychosocial well-being. Conclusion: Consideration of relevant child, family and environment determinants of dimensions of optimal participation should assist children, families and health care professionals to identify meaningful goals and outcomes and guide the selection and implementation of innovative therapy approaches and methods of service delivery.

• Implications for Rehabilitation

• Optimal participation is proposed to involve the dynamic interaction of physical, social and self-engagement and attributes of the child, family and environment.

• The model emphasizes the importance of self-perceptions and participation experiences of children with physical disabilities.

• Optimal participation may have a positive influence on quality of life, a healthy lifestyle and emotional and psychosocial well-being.

• Knowledge of child, family, and environment determinants of physical, social and self-engagement should assist children, families and professionals in identifying meaningful goals and guiding innovative therapy approaches.

     

What does the literature say about using robots on children with disabilities?

Purpose: The purpose of this study is to examine the extent and type of robots used for the rehabilitation and education of children and young people with CP and ASD and the associated outcomes.

Methods: The scholarly literature was systematically searched and analyzed. Articles were included if they reported the results of robots used or intended to be used for the rehabilitation and education of children and young people with CP and ASD during play and educative and social interaction activities.

Results: We found 15 robotic systems reported in 34 studies that provided a low level of evidence. The outcomes were mainly for children with ASD interaction and who had a reduction in autistic behaviour, and for CP cognitive development, learning, and play.

Conclusion: More research is needed in this area using designs that provide higher validity. A centred design approach is needed for developing new low-cost robots for this population.

• Implications for rehabilitation

• In spite of the potential of robots to promote development in children with ASD and CP, the limited available evidence requires researchers to conduct studies with higher validity.

• The low level of evidence plus the need for specialized technical support should be considered critical factors before making the decision to purchase robots for use in treatment for children with CP and ASD.

• A user-entered design approach would increase the chances of success for robots to improve functional, learning, and educative outcomes in children with ASD and CP. We recommend that developers use this approach.

• The participation of interdisciplinary teams in the design, development, and implementation of new robotic systems is of extra value.

• We recommend the design and development of low-cost robotic systems to make robots more affordable.

     

Barriers and facilitators of sports in children with physical disabilities: a mixed-method study

Abstract

Purpose: This study explored barriers and facilitators of sports participation of children with physical disabilities from the perspective of the children, their parents and their health professionals. Method: Thirty children and 38 parents completed a questionnaire, and 17 professionals were interviewed in a semi-structured way. Data from the three groups were combined in a mixed-method design, after which the results were triangulated. Results: Mean age (SD) of the children was 14.1 (2.9) years old, 58% were boys. Sixty-seven percent of the children had cerebral palsy and 77% participated in sports after school. Most commonly practiced sports were swimming, cycling and football. Children specifically experienced dependency on others as a barrier, parents did not have enough information about sports facilities, and professionals observed that the family’s attitude had influence on the child’s sports participation. Facilitators were health benefits, fun and social contacts. Conclusion: Sports participation of children with physical disabilities is a complex phenomenon because children, their parents and professionals reported different barriers. Sports participation is more physically challenging for children with severe physical disabilities, as their daily activities already require much energy. However, the psychosocial benefits of sports are applicable to all children with physical disabilities.

• Implication for Rehabilitation

• Perceived barriers seemed to differ for children, parents and health professionals, suggesting that sports participation is a complex phenomenon.

• Sports might be more physically challenging for children with severe physical disabilities, as their daily activities already take much energy.

• The psychosocial benefits of sports should be emphasized by rehabilitation professionals when advising children with physical disabilities about sports.

     

Participation-based therapy for children with physical disabilities

Purpose: Optimizing home and community participation of children with physical disabilities is an important outcome of rehabilitation. Method: A review of literature identified research and theory on participation of children with physical disabilities. The authors’ incorporated current knowledge to conceptualize the experience of optimal participation, formulate principles of participation-based physical and occupational therapy, and develop a five-step process for intervention. A case report was completed to illustrate application to practice. Results: Optimal participation involves the dynamic interaction of determinants (attributes of the child, family, and environment) and dimensions (physical, social, and self engagement) of participation. Real-life experiences enable children to learn new activities and develop skills that optimize their participation and self-determination. Interventions are: goal-oriented, family-centered, collaborative, strengths-based, ecological, and self-determined. A distinguishing feature of intervention is that the therapist’s primary role is to support the child and family to identify challenges to participation and solutions to challenges. The therapist is a consultant, collaborating with the child, family, and community providers to share information, educate, and instruct in ways that build child, family, and community capacity. Conclusion: The model may have utility for collaboration with families and community providers, determining goals for participation, and providing evidence-informed interventions.

Implications for Rehabiliation

• Home and community participation of children with physical disabilities is an important outcome of rehabilitation.

• Optimal participation is conceptualized as the dynamic interaction of determinants (attributes of the child, family, and environment) and dimensions (physical, social, and self engagement) of participation.

• Participation-based physical and occupational therapy is based on the assumption that real-life experiences enable children to learn new activities and develop skills and that the empowerment of families enables them to advocate for the full inclusion and integration of their children in society.

• In participation-based therapy, the therapist is a consultant, collaborating with the child, family, and community providers to share information, educate, and instruct in ways that build child, family, and community capacity.

     

Access to health and therapy services for families of children with disabilities in China

Abstract

Purpose: China has more than five million children with disabilities. According to national statistics, most of them (63%) do not receive the health and therapy services they need, which threatens their lives, wellbeing and opportunities in adult life. Method: The article applies mixed methods (secondary data analysis and case study interviews) to analyse the efforts of families of children with disabilities to obtain health and therapy services to understand why most children do not receive the support they need. Results: The findings are that reasons include poor information, shortage of services and affordability. While these reasons are common across China, the local context, such as resources and social policy implementation, affect the degree to which families obtain the support they need. Conclusions: These circumstances will not change until local communities and government policies at all levels prioritise policy implementation to fulfil the rights of children with disabilities in China.

• Implications for Rehabilitation

• Most children with disabilities in China do not receive the health and therapy support they need.

• Access to support is hampered by poor information, shortage of services and affordability, which are accentuated by local resources and local policy implementation.

• Central and provincial government resource allocation and local government policy commitment to implementation are critical to children receiving the support they need in their local communities.

     

Obesity prevention for children with physical disabilities: a scoping review of physical activity and nutrition interventions

Abstract

Purpose: Children with disabilities are at higher risk of obesity, engage in less physical activity and report poorer quality dietary habits than their non-disabled peers. This study reviewed current evidence on interventions designed to facilitate weight management and/or weight-related behaviors (i.e. physical activity and/or healthy eating habits) in children with physical disabilities. Methods: A scoping review was performed using established methodology. Data from studies meeting specific inclusion criteria were extracted and analyzed using summary statistics, and common characteristics thematically identified. Results: Thirty-four articles were included in the synthesis. No long-term obesity prevention interventions were identified. The majority of research focused upon children with cerebral palsy, and had case study, quasi- or non-experimental designs. All interventions reporting positive outcomes (n?=?18) addressed physical activity, with common themes including using motivational strategies for the child and child self-direction. Incremental increases in workload and engaging in strength training for longer than 15 minutes were also effective. Interventions targeting body weight/composition did not report success in the long term. Conclusions: A robust evidence base is lacking for long-lasting obesity interventions for children with physical disabilities. Current research provides some insights into the specific components that should be considered when planning such interventions in the future.

• Implications for Rehabilitation

• Clinicians should be aware of the high risk of obesity, physical inactivity and poor diet in children with physical disabilities.

• The use of motivational strategies, child direction in activities and incremental increases in workload all appear promising approaches, yet require further evaluation.

• Evidence-based interventions are needed to improve both short- and long-term health and quality of life for children with physical disabilities.

     

Computer-based assistive technology device for use by children with physical disabilities: a cross-sectional study

Objective: To investigate the prevalence of children with physical disabilities who used a computer-based ATD, and to examine characteristics differences in children and youths who do or do not use computer-based ATDs, as well as, investigate differences that might influence the satisfaction of those two groups of children and youths when computers are being used for in-school and outside school activities.Method: A cross-sectional survey about computer-based activities in and outside school (n?=?287) and group comparisons.Results: The prevalence of using computer-based ATDs was about 44 % (n?=?127) of the children in this sample. These children were less satisfied with their computer use in education and outside school activities than the children who did not use an ATD.Conclusion: Improved coordination of the usage of computer-based ATDs in school and in the home, including service and support, could increase the opportunities for children with physical disabilities who use computer-based ATDs to perform the computer activities they want, need and are expected to do in school and outside school.

Implications for Rehabilitation

• The prevalence of using a computer-based ATD in school was 44%, that is, it was common for children and youths with physical disabilities to use ATDs. Improved coordination of the usage of computer-based ATDs in school and in the home, including service and support, could increase the opportunities for children with physical disabilities who use computer-based ATDs to perform the computer activities they want, need and are expected to do in school and outside school.

• Children with physical disabilities who used a computer-based ATD were dissatisfied with the service provided for their ATDs. It important to use existing assessments to a high degree to augment the children’s and youth’s satisfaction with their access to and their use of computer-based ATDs for participation in ICT-activities in everyday activities. Further research is certainly needed to validate the use of any eventual existing instruments or to identify the needs with the aim to developing new ones for children and youths with disabilities where there is a deficiency.

     

Usability testing of a developed assistive robotic system with virtual assistance for individuals with cerebral palsy: a case study

This paper presents a novel application of an assistive robotic system with virtual assistance to enhance manual performance of individuals with cerebral palsy. Cerebral palsy affects one’s voluntary motor movements resulting in limited opportunities to actively engage in physical manipulative activities that require fine motor movements and coordination. Lack of object manipulation and environmental exploration can result in further impairments such as cognitive and social delays. The proposed assistive robotic system has been developed to enhance hand movements of people with disabilities when performing a functional task colouring. This paper presents the usability testing of the effectiveness of the developed system with an individual with cerebral palsy in a set of colouring tasks. Assisted and unassisted approaches were compared and analysed through quantitative and qualitative measures. The robotic-based approach was further compared with the participant’s typical alternate access method to perform the same proposed tasks. The robotic system with virtual assistance was clinically validated to be significantly more effective, compared to both unassisted and typical approaches, by increasing the hand controllability, reducing the physical load and increasing the easiness of maintaining movements within the lines. Future studies will inform the use of the system for children with disabilities to provide them with assisted play for functional and playful activities.

• Implications for rehabilitation

• Robotic system can enhance manual performance in individuals with disabilities.

• Participating in a robot-mediated play activity could increase children’s motivation and engagement.

• The developed robotic system can contribute to a basis for clinical and home-based implementation of the technology to promote manual play activities for children with disabilities.

     

Perceived social support as a moderator between perceived discrimination and subjective well-being among people with physical disabilities in Israel

Purpose: Perceived social support has gained importance as a significant preventive factor of depressive symptoms and as helpful for rebuilding feelings of self-worth and subjective well-being among people with physical disabilities. The current study examined whether perceived social support moderates the association between perceived discrimination and subjective well-being among people with physical disabilities in Israel.

Materials and methods: Data were collected by means of structured questionnaires among a convenience sample of 433 people with physical disabilities in Israel and hierarchical multiple regression was performed.

Results and conclusions: The findings reveal that perceived social support has a moderating role in the association between perceived discrimination and subjective well-being among people with physical disabilities, such that those with low and moderate levels of perceived social support showed a negative association between perceived discrimination and subjective well-being, while those with high levels of perceived social support showed no association between perceived discrimination and subjective well-being. Findings are discussed in light of the social model of disability, and practical implications are suggested.

• Implications for Rehabilitation

• A negative association was found between perceived discrimination and subjective well-being among people with physical disabilities with low and moderate levels of perceived social support.

• Professionals working with people with physical disabilities must acknowledge the importance of social support for people with physical disabilities and for their families.

• Professionals working with people with physical disabilities should take a proactive approach to locating disabled people who do not receive or do not have adequate social support and offer them assistance.

• Professionals working with people with physical disabilities should engage in wide social activities aimed at providing resources and opportunities to service beneficiaries.

• Society bears the collective responsibility to act in order to reduce the social problem of discrimination against people with disabilities, as well as to raise public awareness of this issue.

     

Community participation of persons with disabilities: volunteering,donations and involvement in groups and organisations

Purpose: This study examined similarities and differences between persons with and without disabilities on volunteering, donations and group participation. Method: A sample of 1548 individuals participated and 60% of the sample were persons with disabilities. Data for this research was drawn from a major statewide survey in a Midwestern state in the United States. Community participation was measured through involvement with civic, religious and other community-based groups, volunteering activities and donations. Logistic regression was pursued to test the effect of disability on community participation. Results: Findings support different trends in participation between persons with and without disabilities. Individuals without disabilities are more likely to volunteer, donate money and participate in civic organisations (e.g. clubs) and other groups. Employment and household income have a significant contribution in explaining these differences.

Conclusions: This study found significant differences in community participation between persons with disabilities and persons without disabilities. Regression analysis outcomes underscore the importance of employment and income in eliminating disparities in community involvement between persons with and without disabilities.

• Implications for Rehabilitation

• Policy change in rehabilitation agencies to fund supported volunteering services.

• Improve the representation of persons with disabilities in volunteering pursuits by making volunteering positions accessible to them (educate persons with disabilities to be more aware of these opportunities, provide reasonable accommodations at work sites, etc.).

• Educate stakeholders about the benefits of volunteering and being part of civic, and other community based groups in improving the quality of life of persons with disabilities.

• Identification of barriers for persons with disabilities in these pursuits (physical and attitudinal barriers, lack of resources).

• Identifying and utilising natural supports in the work site for persons with disabilities to receive peer support on the job from full-time employees.

     

Parental perceptions of information needs and service provision for children with developmental disabilities in rural Australia

Abstract

Purpose: Rural Australians comprise a third of the population. However, there are relatively few research studies that have focused on issues for children with developmental disabilities in rural regions. In particular, there is very limited research that gives voice to parents regarding challenges faced by them due to their location in rural regions. Methods: This article is based on the qualitative component of a mixed-methods study undertaken in rural settings. In-depth, face-to-face interviews were conducted with 17 parents yielding 30?h of information rich taped data. Thematic analysis techniques were used to identify major issues. Results: Three core themes emerged from analysis of the qualitative data regarding information and support needs: an ongoing lack of timely and relevant information about disabilities and support services; inadequacies in interactions with service providers particularly doctors and allied health staff; and considerable challenges and barriers to access and use of health services. Conclusions: Within the constraints of limited rural service provision, there are still opportunities for considerable improvements, through focussed in-service training to narrow the information gap, improve provider-client interaction around attitudinal issues and uptake of tele-health to minimise the long waiting times and the need to regularly travel long distances to access services and setting up online support groups.

• Implications for Rehabilitation

• There is limited information on challenges faced by parents of children with developmental disabilities in rural Australia.

• The challenges around lack of information about support systems available add to parental stress as does limited experience, frequent staff turnover and poor attitude of many service providers.

• There is a need to improve rural service provision. Feasible options within resource constraints include focussed in-service training to narrow the information gap, improve provider-client interaction around attitudinal issues, and uptake of tele-health services.

• Setting up of parent-professional support groups as well peer support groups using digital technologies will help reduce the sense of isolation for rural carers and minimise impediments related to travelling long distances.

     

Communicating about obesity and weight-related topics with children with a physical disability and their families: spina bifida as an example

Purpose: The purpose of this study was to explore the experiences of children with spina bifida (SB), their families and healthcare professionals (HCPs) when discussing weight-related topics. Method: In-depth qualitative interviews were conducted with HCPs from Canadian outpatient SB clinics (n?=?13), children aged 6–18 years with SB (n?=?17) and their parents (n?=?20). Data were analyzed using a phenomenological approach within an interpretative paradigm. Results: Many HCPs were not confident talking about weight, concerned that they would damage relationships with children and families. Parents wanted routine weight surveillance, but were worried about their children’s self-esteem if their weight was discussed. They wanted HCPs to acknowledge the challenges of weight management in children with a physical disability and provide specialized solutions. Children wanted a positively framed and tailored approach to weight discussions, although this had generally not been their experience. Conclusions: Stakeholders describe therapeutic relationships that are currently disconnected around the issue of weight and obesity. However, children, parents and HCPs all believed that discussing this topic was critical. Positively framed, strengths-based and tailored approaches to weight-related discussions are warranted.

• Implications for Rehabilitation

• Rates of overweight and obesity in children and youth with physical disabilities are substantially higher than their typically developing peers.

• Healthcare professionals, children with physical disabilities and families often find weight-related discussions challenging and disconnected.

• Weight-related discussions should be tailored to the child and family’s circumstances and priorities.

• Positively framed and strengths-based approaches to weight-related discussions are warranted.

     

“It means you are grounded” – caregivers’ perspectives on the rehabilitation of children with neurodisability in Malawi

Purpose: Rates of childhood disability are estimated to be high in African settings; however, services to provide information and support are limited. This study aims to explore perspectives and experiences of caregivers of children with disabilities (CWD) from acquired brain injury to inform the development of training packages for health-workers (HW) in hospital settings. Methods: The study was conducted in a tertiary hospital using qualitative methods. Fourteen in-depth interviews (IDIs) were conducted with parents/carers (PC), and 10 IDIs and 4 focus-group discussions (FGDs) with HW. Data were audio-recorded, transcribed, translated and analysed using thematic approaches. Results: HWs and PCs held varying perspectives on aetiology and prognosis for CWD. HWs raised concerns about impact on families, risks of neglect and abuse. Barriers to care and support included prioritisation of acute illness, lack of HW knowledge and confidence, stigma, poor communication, focus on physical disability, and poor availability of services. Among ideas for improvement, good communication and counselling was seen as a priority but not often achieved. Conclusion: A range of family, health service and wider contextual factors affect care for CWD. Training for HW should emphasise disability rights, access to services, a range of disabilities and specific training on counselling.

• Implications for Rehabilitation

• To create good training programmes for workers who manage children with neurodisability, workers’ views on their training needs, as well parents’ views of what feel they need to know most, must be taken into account.

• The need for training regarding communication skills is a priority for health-workers (HW), who manage children with neurodisability in Malawi and confidence in this area is likely to be vital in providing support for these families.

• Disability rights and inclusion should be imperative in any training programme for managing children with neurodisability in hospital settings.

• Even in low-resource settings such as Malawi, it is vital that the links between hospital management and the limited resources in the community are updated and maintained.

     

A home-based individualized information communication technology training program for older adults: a demonstration of effectiveness and value

Purpose: To demonstrate the effectiveness and value of a home-based information communication technology (ICT) training program for older adults. Methods: Thirteen older adults were provided in-home ICT training by graduate occupational therapy students using an iPad. The breadth and frequency of ICT use, perspectives on technology, and perceived independence were recorded at baseline, during the 3-month training and at follow-up, along with an end-of-study questionnaire. Non-parametric Friedman analysis was conducted to verify trends in the outcome measures. The qualitative data were examined by content analysis. Results: Participants’ breadth of ICT activities showed a significant trend across 6 months. Leisure accounted for the significant increase, while health management and social connections activities increased modestly. A positive trend in participants’ perspectives on technology was evident along with a marginal increase in perceived independence. Participants’ perspectives were thematically categorized as technology experiences, interactions with coach, training approach, and specific activities. As reflection of the training program’s value, 12 of the 13 participants took ownership of the iPad at the end of the study. Conclusion: Building capacity of older adults to utilize the multifaceted potential of ICT is critical in addressing declines in health, impending disabilities, and social isolation.

• Implications for Rehabilitation

• A one-on-one home-based individualized information communication technology (ICT) training program for older adults could result in a progressive increase in the breadth of online activities carried out by them.

• Specifically, the increase in their usage of ICT could be expected in leisure-based online activities.

• Individualized training programs designed based on needs, priorities, and learning style of older adults could have a positive impact on their technological perspectives and intrinsic motivation to adopt ICT.