Assistive lighting for people with sight loss

Abstract

This paper affirms the importance of lighting as a technology in the context of people with sight loss. Its importance lies in the ability of appropriate lighting interventions to support independent living and to reduce the likelihood of falls and accidents. The concept of “assistive lighting” is introduced with a set of tenets by which the merits of different lighting interventions can be considered. The tenets are derived from research on lighting and sight loss, including a thorough review of the literature; and consultation in the period from 2008 to 2010 with over 80 rehabilitation workers and occupational therapists in the United Kingdom. They affirm the need for lighting to be appropriate, sufficient, even, adjustable, sustainable and energy efficient, simple and adaptable. Examples of different lighting interventions are provided and these are considered in relation to the tenets. One of the key outcomes of the research was publication of a guide to good practice on lighting interventions for people with sight loss.

• Implications for Rehabilitation

• Assistive lighting has important implications for rehabilitation in relation to people with sight loss.

• Simple lighting interventions carry the potential for improving the independence and quality of life of people with sight loss and can reduce the risk of accidents.

• The tenets by which options for lighting interventions can be considered can assist rehabilitation officers and occupational therapists in their work.

• Lighting can be considered as a factor of increasing importance within the broader context of universal design.

     

Assistive technology outcomes in post-secondary students with disabilities: the influence of diagnosis,gender, and class-level

This study investigated how outcomes of assistive technology (AT) services for college students with disabilities are influenced by diagnosis, gender and class-level (e.g., Freshman). Students’ pre- and post-intervention ratings of their performance and satisfaction of common academic tasks (using the Canadian Occupational Performance Measure, COPM) were analyzed, as well as students’ responses on a survey about AT service provision, use, and preferences. Data from 455 students revealed “learning disability” to be the most prevalent diagnosis (38%), similar numbers of females and males served, and Freshmen (23.1%) as the largest class-level seeking AT services. For COPM data, each two-way analysis of variance (ANOVA) (grouping variable?=?diagnosis) revealed that pre-post change scores significantly improved for the entire sample, and that students with a mood disorder experienced the greatest changes compared to other diagnoses. COPM scores significantly and similarly improved for females and males, and across class levels. AT Survey ratings about timeliness of services and independent AT use were significantly lower for students with mobility deficits/pain and neurological damage, respectively. Gender and class-level variables did not significantly impact AT Survey ratings. The study results reveal that features of a college student’s diagnosis may influence AT service outcomes, and student-perceptions of AT services ability to use AT.

• Implications for Rehabilitation

• College students who are Freshman and/or who have a learning disability are the most prevalent students referred for campus-based assistive technology services.

• While student ratings of academic task performance significantly increase across diagnostic groupings, these improvements were greatest for those with a mood disorder compared to other diagnostic groups.

• Service-providers should consider that features of certain diagnoses or disabilities may influence the student?s perception of AT service provision and their ability to use AT.

• A student's gender and class-level (e.g., Freshman) do not appear to influence the outcomes of AT services for college students with disabilities.

     

Assistive technology for promoting adaptive skills of children with cerebral palsy: ten cases evaluation

Abstract

Objectives: To extend the use of assistive technology for promoting adaptive skills of children with cerebral palsy. To assess its effects on positive participation of ten participants involved. To carry out a social validation recruiting parents, physiotherapists and support teachers as external raters.

Method: A multiple probe design was implemented for Studies I and II. Study I involved five participants exposed to a combined program aimed at enhancing choice process of preferred items and locomotion fluency. Study II involved five further children for a combined intervention finalized at ensuring them with literacy access and ambulation responses. Study III recruited 60 external raters for a social validation assessment.

Results: All participants improved their performance, although differences among children occurred. Indices of positive participation increased as well. Social raters favorably scored the use of both technology and programs.

Conclusion: Assistive technology-based programs were effective for promoting independence of children with cerebral palsy.

• Implications for Rehabilitation

• A basic form of assistive technology such as a microswitch-based program may be useful and helpful for supporting adaptive skills of children with cerebral palsy and different levels of functioning.

• The same program may improve the participants' indices of positive participation and constructive engagement with beneficial effects on their quality of life.

• The positive social rating provided by external experts sensitive to the matter may recommend a favorable acceptance and implementation of the program in daily settings.

     

Support in everyday activities with a home-based electronic memory aid for persons with memory impairments

Purpose.?The purposes of this study was to examine the possibilities of a home-based electronic memory aid with sensors for persons with memory impairments, as support to carry out everyday activities in their own home environments.

Method.?The method involved a single-subject study with a multiple baseline AB design. Five participants identified three activities each that they usually forget to carry out. An electronic memory aid with individually spoken reminders was installed in the participant's home. There were automatic computer registrations of completed activities during the study phase of 12 weeks. Assessments of functioning and quality of life (QoL) were conducted before and after the intervention and at follow-up after 2 months.

Results.?Four participants improved in completing most of the self-chosen activities when the electronic memory aid was used. Performance and satisfaction with performance and QoL improved, but there was no memory function improvement. There were technical problems with the aid, which had a negative effect for users.

Conclusions.?Electronic memory aids have a large potential for supporting persons with cognitive impairments. It is important to conduct follow-up afterwards, because the use of an aid and the need of support change over time and put high demands on technical reliability of the electronic memory aid.     

Assistive technology for students with visual disability in schools for the blind in Delhi

Abstract

Background: To understand the awareness and utilization of assistive technology in students at schools for the blind in Delhi.

Methods: A cross sectional study was conducted among 250 students selected randomly from 10 blind schools in Delhi. Binocular distance presenting and pinhole vision acuity were assessed using Snellen “E” chart and a multiple pinhole occluder. Students were also interviewed using a questionnaire about 42 assistive devices to understand their awareness and use.

Results: Male participants were 72.8%. Of the total, 27.6% students had best corrected visual acuity <6/18 to 1/60, and the rest had <1/60 vision. The awareness about tactile and sound-based technology was good among students: Braille books (98%), Braille slate and stylus (99.2%), handheld audio recorders (77.6%) and screen readers (77.2%). Good awareness was reported for abacus (88.8%), walking long canes (94.4%) and smart cane (89.6%), audible balls (96%), Braille chess (82.8%) and talking watch (98%). Among the students with <6/18 to 1/60 vision, the awareness of visual based technology ranged from 0.8% (typoscope) to 43.6% (video magnifiers). Braille technology was used for reading by 96.4% (books) and for writing by 96.8% (Braille slate and stylus) irrespective of visual status. Other devices were poorly used ranging from nil (typoscope) to 55% (screen readers). The use of math and science learning devices was poor (<20%). Walking canes were used by 59% of students whereas 87.2% students used audible ball for games.

Conclusion: The results showed that majority of students used tactile based technology irrespective of visual status.

• Implications for rehabilitation

• Students with visual disability need assistive technology for a wide range of activities including academic learning.

• Students in schools for the blind who have binocular best corrected vision acuity of 1/60 or better should be encouraged to use visual based assistive technology instead of tactile based.

• Students with binocular best corrected vision acuity less than1/60 should be encouraged to use other available tactile and sound-based assistive technologies as well as Braille books and Braille slate and stylus for their academic activities including maths and sciences.

• Teachers should be trained in the use of various assistive technologies for reading, writing, maths, sciences, sports, mobility and activities of daily living.

     

Training to use a commercial brain-computer interface as access technology: a case study

Purpose: This case study describes how an individual with spastic quadriplegic cerebral palsy was trained over a period of four weeks to use a commercial electroencephalography (EEG)-based brain-computer interface (BCI). Method: The participant spent three sessions exploring the system, and seven sessions playing a game focused on EEG feedback training of left and right arm motor imagery and a customised, training game paradigm was employed. Results: The participant showed improvement in the production of two distinct EEG patterns. The participant’s performance was influenced by motivation, fatigue and concentration. Six weeks post-training the participant could still control the BCI and used this to type a sentence using an augmentative and alternative communication application on a wirelessly linked device. Conclusions: The results from this case study highlight the importance of creating a dynamic, relevant and engaging training environment for BCIs.

• Implications for Rehabilitation

• Customising a training paradigm to suit the users’ interests can influence adherence to assistive technology training.

• Mood, fatigue, physical illness and motivation influence the usability of a brain-computer interface.

• Commercial brain-computer interfaces, which require little set up time, may be used as access technology for individuals with severe disabilities

     

The use of mobile devices as assistive technology in resource-limited environments: access for learners with visual impairments in Kenya

Purpose: In this paper, the authors explore the use of mobile devices as assistive technology for students with visual impairments in resource-limited environments. This paper provides initial data and analysis from an ongoing project in Kenya using tablet devices to provide access to education and independence for university students with visual impairments in Kenya. Method: The project is a design-based research project in which we have developed and are refining a theoretically grounded intervention – a model for developing communities of practice to support the use of mobile technology as an assistive technology. We are collecting data to assess the efficacy and improve the model as well as inform the literature that has guided the design of the intervention. Results: In examining the impact of the use of mobile devices for the students with visual impairments, we found that the devices provide the students with (a) access to education, (b) the means to participate in everyday life and (c) the opportunity to create a community of practice. Conclusions: Findings from this project suggest that communities of practice are both a viable and a valuable approach for facilitating the diffusion and support of mobile devices as assistive technology for students with visual impairments in resource-limited environments.

• Implications for Rehabilitation

• The use of mobile devices as assistive technology in resource-limited environments provides students with visual impairments access to education and enhanced means to participate in everyday life.

• Communities of practice are both a viable and a valuable approach for facilitating the diffusion and support of mobile devices as assistive technology for students with visual impairments in resource-limited environments.

• Providing access to assistive technology early and consistently throughout students’ schooling builds both their skill and confidence and also demonstrates the capabilities of people with visual impairments to the larger society.

     

Using assistive technology for schoolwork: the experience of children with physical disabilities

Aim.?This study explored the experience of children with physical disabilities using assistive technology for participation with schoolwork to gain a greater understanding of their perspectives and subjective experiences.

Method.?A qualitative study involving thematic analysis of in-depth interviews of the child with a parent or significant adult. Purposeful sampling from a larger study recruited five children aged between 10 and 14 years, with differing physical disabilities who attended mainstream schools. All children used computer-based assistive technology.

Results.?All of the children recognised that assistive technology enabled them to participate and reduced the impact of their physical disability, allowing independent participation, and facilitated higher learning outcomes. Issues related to ease of use, social implications and assistive technology systems are discussed.     

Systems thinking for assistive technology: a commentary on the GREAT summit

Abstract

The area of assistive technology has a long history of technological ingenuity and innovation. In order to ensure that the benefits of assistive technology are equitably distributed across the population and life course, it is necessary to adopt a systemic approach to the area. We describe examples of systems thinking and non-systems thinking across 10?Ps. These Ps are People (or users, as the primary beneficiaries of assistive technology), Policy, Products, Personnel, Provision (as key strategic drivers at systems level); and Procurement, Place, Pace, Promotion and Partnership (as key situational factors for systems). Together these Ps should constitute a framework for an “open” system that can evolve and adapt, that empowers users, inter-connects key components and locates these in the reality of differing contexts. The adoption of a stronger systems thinking perspective within the assistive technology field should allow for more equitable, more resilient and more sustainable assistive technology across high, middle- and low-income contexts and countries.

• Implications for Rehabilitation

• The progress of assistive technology provison has been hampered by disconnected initiatives and activities and this needs to be corrected.

• Systems thinking is a way of thinking about the connections between things and how these are influenced by contextual and other factors.

• By encouraging the providers and users of assitive technology to think more systemically we can provide a more cohesive and resilient systems.

• The user experience is the central component of systems thinking in assistive technologies.

     

Feasibility of school-based computer-assisted robotic gaming technology for upper limb rehabilitation of children with cerebral palsy

Introduction: We investigated the feasibility of using computer-assisted arm rehabilitation (CAAR) computer games in schools. Outcomes were children's preference for single player or dual player mode, and changes in arm activity and kinematics. Method: Nine boys and two girls with cerebral palsy (6–12 years, mean 9 years) played assistive technology computer games in single-user mode or with school friends in an AB–BA design. Preference was determined by recording the time spent playing each mode and by qualitative feedback. We used the ABILHAND-kids and Canadian Occupational Performance Measure to evaluate activity limitation, and a portable laptop-based device to capture arm kinematics. Results: No difference was recorded between single-user and dual-user modes (median daily use 9.27 versus 11.2?min, p?=?0.214). Children reported dual-user mode was preferable. There were no changes in activity limitation (ABILHAND-kids, p?=?0.424; COPM, p?=?0.484) but we found significant improvements in hand speed (p?=?0.028), smoothness (p?=?0.005) and accuracy (p?=?0.007). Conclusion: School timetables prohibit extensive use of rehabilitation technology but there is potential for its short-term use to supplement a rehabilitation program. The restricted access to the rehabilitation games was sufficient to improve arm kinematics but not arm activity.

• Implications for Rehabilitation

• School premises and teaching staff present no obstacles to the installation of rehabilitation gaming technology.

• Twelve minutes per day is the average amount of time that the school time table permits children to use rehabilitation gaming equipment (without disruption to academic attendance).

• The use of rehabilitation gaming technology for an average of 12 minutes daily does not appear to benefit children's functional performance, but there are improvements in the kinematics of children's upper limb.

     

Working toward equitable opportunities for science students with disabilities: Using professional development and technology

As a result of federal legislation, adolescents with disabilities and other exceptionalities are increasingly included in science and math classes alongside their peers who are typically developing. The effectiveness of this placement option, however, is largely dependent on the skill level of the general educator and the support afforded to this teacher through various channels. Efforts arising from two National Science Foundation grants address both skill and support. Center's Lesson Adaptations for Student Success (CLASS) project used summer professional development opportunities to equip teachers with the knowledge and skills needed to provide students with physical, sensory and learning disabilities equitable access to laboratory and field experiences. Second, to support teachers back in their classrooms, the Ohio Resource Center's Lesson Adaptations for Student Success (OR-CLASS) uses web resources to share high quality, peer-reviewed lesson plans, complete with specific recommendations on adaptations for students with a variety of exceptional learning needs.     

The segway personal transporter as an alternative mobility device for people with disabilities: a pilot study

Sawatzky B, Denison I, Langrish S, Richardson S, Hiller K, Slobogean B. The Segway Personal Transporter as an alternative mobility device for people with disabilities: a pilot study.

Objectives

To determine the functional measures that best correlate with the skill levels of people with disabilities who operate a Segway Personal Transporter, and—using a qualitative analysis—to explore subjects’ experience with the Segway.

Design

A prospective study encompassing 3 training sessions with the Segway to correlate subjects’ functional ability (eg, cognition, balance, mobility, muscle strength) with their skill level on the device.

Setting

A provincial adult rehabilitation center.

Participants

Twenty-three subjects (age range, 19−65y) with a wide range of disabilities (eg, multiple sclerosis, spinal cord injury, amputation) who could walk at least 6m with or without assistance.

Interventions

Not applicable.

Main Outcome Measures

Segway Task Assessment, Berg Balance Scale, and Timed Up & Go test.

Results

No correlation was found because all participants successfully completed the final Segway Task Assessment, regardless of scores on functional assessments.

Conclusions

The Segway is a useful device for a broad range of populations with functional disabilities. Subjects found the Segway easy to use and were excited about its potential as an assistive device for use in their communities.     

临床意义未知的拷贝数变异分析提示9p23区域可能和智力发育障碍相关

目的对全基因组拷贝数芯片分析(CMA)中临床意义未知的拷贝数变异(VUS)与患者表型进行分析,试图寻找和表型相关的拷贝数变异区域。方法对38例全基因组芯片未见明显结构性变化患者的结果和详细表型(智力水平、发育水平、面容是否异常和头围是否正常)进行分组统计,分析临床意义VUS和表型之间的联系,并在45名正常对照中验证拷贝数变异,排除正常多态性可能。结果发现9号染色体p23区域的缺失在智力落后患者与智力水平正常但合并其它表型患者中出现,差异有明显的统计学意义(P0.01),并且在正常对照中未见该区域的缺失,提示9p23区域可能和儿童智力发育相关。结论临床意义VUS分析可以帮助提示和患者表型相关的信息,确认临床意义VUS将有助于提高基因组芯片的诊断效率,揭示新的可疑致病区域。     

The feasibility and appropriateness of a peer-to-peer,play-based intervention for improving pragmatic language in children with autism spectrum disorder

Abstract

Purpose: This study trialled a play-based, peer-to-peer intervention with children with autism spectrum disorder (ASD) to identify suitable instruments for measuring changes in pragmatic language following the intervention, and evaluate preliminary effectiveness. It also aimed to investigate the appropriateness of the intervention for participants.

Method: Ten children with ASD, their typically developing peers, and parents participated. The Pragmatics Observational Measure (POM), Social Emotional Evaluation (SEE) and Profiling Elements of Prosody in Speech Communication (PEPS-C) measured the participant’s social communication skills before, after, and 2-months following the intervention. Parent interviews were conducted two months after the intervention and responses were analysed using a thematic approach.

Result: Children demonstrated gains in pragmatic language on the POM (χ²(3)?=?11.160, p?=?0.011) and related higher-level language on the SEE (χ²(2)?=?6.686, p?=?0.035). The PEPS-C did not produce any significant results. Parent interview responses indicated the intervention was appropriate for the children and families involved.

Conclusion: The intervention warrants further investigation of effectiveness with a more robust research design. Consideration should be given to using observational measures of pragmatic language away from the clinic environment to evaluate generalisation, and future development of the intervention might consider variations in playmates and group size.     

“Now I am a techie too” – parental perceptions of using mobile technology for communication by children with complex communication needs in the Global South

Abstract

Purpose: Parental perceptions are key to the uptake of augmentative and alternative communication (AAC) devices for their children with complex communication needs. This study aimed to explore the perceptions of parents in a resource poor Global South country on the use of mobile technology as AAC devices.

Materials and methods: Sixteen participants (11 female; 5 male) were included in the study. Focus group discussions, face-to-face interviews and telephone interviews were conducted with the aid of an interview guide. The interview data were analysed using the key principles of Framework analysis and through the lens of critical disability studies.

Results: Six broad themes emerged. Most participants indicated a penchant for mobile technology, though its current use with their children was mainly as a teaching tool rather than a communication device. Concerns were raised about the cost of mobile technology, which if used within communication, was only as a temporary stop-gap measure with limited knowledge. The power of mainstream technology to challenge prevalent notions of disability was also highlighted by the participants.

Conclusions: There is an openness to using mainstream mobile technology by parents with their children with complex communication needs. This use is currently reserved mainly for educational purposes while its power to challenge disability-related stereotypes is acknowledged. More parent training is required to encourage the use of mobile technology as AAC devices for communication.

• Implications for rehabilitation

• Current parent perspectives on mobile technology as AAC devices must be explored, given its potential impact on the uptake of these devices to support communication in their children with complex communication needs.

• Mainstream mobile technology could challenge perceptions of disability and therefore, be more acceptable to parents for their children with complex communication needs.

• Parental training is required to increase knowledge on the use of mobile technology as AAC devices for communication to enable informed choice-making.