Bridging Technology Access and Digital Independence for Persons with Disabilities: India and Global Strategies

Service provision in psychiatric and social care is increasingly guided by recovery principles. However, little is known about the degree of consensus among stakeholders in diverse contexts on the components of care that most promote recovery. This study aimed to identify specific items of care that key stakeholders regard as most important in promoting recovery for people with longer-term mental health problems in institutional care, to measure consensus between and across stakeholder groups and countries, and to develop a conceptual framework of the most important domains of care. Ten European countries in various stages of deinstitutionalization participated in a series of conventional three-round iterative Delphi exercises. In each country individuals in four separate expert groups (service users, mental health professionals, caregivers, and advocates) identified components of care that they considered important to recovery and then rated their group's suggestions in terms of importance. Median and consensus ratings were measured. High-ranking items were grouped into domains. A total of 4,098 separate items of care were proposed by the 40 participating groups. Eleven broad domains of care important for recovery were identified: social policy and human rights, social inclusion, self-management and autonomy, therapeutic interventions, governance, staffing, staff attitudes, institutional environment, postdischarge care, caregivers, and physical health care. Consensus between groups and countries was generally high, but some modest differences in priorities were noted. The most consistently highly rated consensus domain was therapeutic interventions. Domains and components of care related to recovery principles were also viewed as important across stakeholder groups.

The aim of this study was to explore the views of family caregivers of adults with cerebral palsy and complex communication needs (CCN) on their roles in the hospital setting and what would help them in these roles. As part of a larger study we conducted one focus group with six family caregivers who together explored issues surrounding involvement of family caregivers on the hospital ward. Participants described being involved in supporting communication and providing valuable information and guidance to hospital staff in caring for adults with cerebral palsy and CCN. The participants also suggested strategies to support family caregivers in their roles, to improve collaboration, and to benefit the patient with cerebral palsy and CCN. In this paper the authors present results of the focus group and discuss implications for policy and practice. © Springer Science + Business Media, LLC 2007

Disabilities, such as those caused by spinal cord injury, stroke, cerebral palsy, amyotrophic lateral sclerosis and amputations, can impair upper limb function and limit eating autonomy, requiring third-party assistance. Thus, assistive technologies have emerged as viable alternatives for promoting greater independence and social inclusion. This article presents the development of an educational robotic arm with 5 degrees of freedom for use as a meal-assist robot. A 3D printer was used for the utensils and wood for the base. To receive user commands, a voice recognition module was implemented to identify the five programmed commands. To verify the effectiveness of the proposed method, several tests were conducted, including a water transfer test and execution time measurement. The assistive device successfully transported more than 75% of the water and completed each feeding cycle in 21 s, demonstrating its effectiveness in aiding the feeding process.

The purpose of this article was to provide a comprehensive overview of the available peer-reviewed and gray literature on assistive technology (AT) access and usage barriers among African Americans with disabilities. Authors completed a historical review (Onwuegbuzie & Frels, 2016) of the extant literature on AT and disability public policy mandates by framing the context on AT access and usage disparities among African Americans with disabilities and discussing AT impacts on employment for African Americans. The authors also presented recommendations that might be considered by the field for increasing AT access and usage among African Americans with disabilities. It is clear that AT and associated assistive products are important commodities to the lives of individuals with disabilities in the United States; however, there are historical inequities between African Americans and Whites. As a result of these findings, the authors implore rehabilitation counselors in education and practice to further examine ways to alleviate the AT access and usage gaps for African Americans with disabilities within public policy, vocational rehabilitation service delivery, and institutional infrastructure systems.

Purpose The purpose of this paper is to consider the accessibility of Apple’s iPad. The discussion focusses on the accessibility of this technology to children and young people with cerebral palsy (CP), reviewing a range of literature. Terms including “inclusion” are debated alongside the practicalities associated with implementing assistive technologies in educational settings. The benefits of technology for those with CP are explored, with examples including augmentative and alternative communication systems. The current suitability of the iPad for children and young people with CP is discussed, alongside ways in which eye-gaze technology may be employed to increase inclusivity. Design/methodology/approach The paper provides a consideration of multiple methods for evaluating the inclusivity of mainstream technologies. It is contended that the universal design for learning (UDL) principles are likely to be the most appropriate, due to their applicability to educational settings. Furthermore, the UDL principles acknowledge the heterogeneity of those with CP, and this is suggested to be useful due to its ability to be integrated alongside some of the principles of assistive technology. Findings The discussion contends that Apple’s iPad may be redesigned in order to meet the needs of users with CP. Eye-gaze technology is suggested as one way to include this group of users, due to the altered interface interaction. Despite some challenges with the eye-gaze technology, the paper suggests that this alteration to the iPad may result in increased accessibility not only for those with CP, but also others with fine motor difficulties. It is concluded that the integration of eye-gaze technology with Apple’s iPad may be a potential avenue for future investigation. Practical implications By altering the interface interaction on Apple’s iPad, the device may be more accessible to users with fine motor difficulties, such as those with CP. It is suggested that the paper may inspire future research concerning the practicalities of integrating eye-gaze technology on a small, portable device. Social implications Those who are of lower socioeconomic status are less likely to have access to assistive technologies; the cost of Apple’s devices is relatively higher than those produced by other technology companies, confining their availability to wealthier consumers. This may also lead to a divide in inclusive technical capital (Hayhoe, 2015), whereby wealthier users may have an increased potential to access inclusive assistive technologies and thus increase their capital. Originality/value The paper integrates a discussion of the UDL principles with their application to both assistive technologies and educational settings. It is speculated that this paper may be valuable to those researching in the field of assistive technologies, who may build upon the present discussion with a research study. It is also anticipated that the consideration of the use of the iPad for children and young people with CP may be of use to those working in education who wish to integrate technology into the education of those with a range of special educational needs.

Introduction Mental health services in developed nations have a recovery orientation. In this context, ‘recovery’ does not mean being symptom-free, but instead indicates that a person is ‘living a satisfying, hopeful and contributing life even with the limitations caused by illness’ (Anthony, 1993; p. 975). Australia’s Fourth National Mental Health Plan sets social inclusion as its first priority and prescribes work integration as a key action and outcome by which people with mental illness achieve both social and economic inclusion. Research has identified the core components of recovery as: hope, social inclusion or connexion, empowerment and wellbeing, with ‘hope’ being the first and central requirement. This study explored the relationships between hope, social inclusion and mental wellbeing in a sample of people in recovery from mental illness. Methods Participants were 70 adults (60% male) with a psychiatric disability (71.4% schizophrenia) who were engaged in supported employment (i.e., they were receiving a productivity-based wage). All completed a battery of psychometric measures and open-ended questions. Result Compared to clinical samples of people diagnosed with a mental disorder, the participants in this study had higher levels of hope, social inclusion and mental wellbeing, and lower levels of psychological distress. Hope and social inclusion predicted mental wellbeing, with social inclusion partially mediating the relationship between the other two constructs. Participants reported experiencing the psychosocial benefits of work (e.g., structured activity and a shared purpose) but were dissatisfied with their wages. Discussion Work integration through supported employment provides an opportunity for social inclusion and the prevention of long-term work disability. Engagement in work significantly mediates recovery from severe mental illness and facilitates a healthy level of mental wellbeing. Work integration can be achieved in the presence of ongoing symptoms and despite the absence of full economic inclusion. Australian health policy is supported.

Lists, Spatial Practice and Assistive Technologies for the Blind

Self-concept is the perception that individuals have of themselves across different aspects of life such as academic performance or appearance. The Self-Concept Feedback Loop proposed for this research program conceptualised self-concept as developing through an interactive and iterative process involving social experiences and the cognitive processes of individuals. Through this process, individuals evaluate their behaviour or attributes against their internal standards. Subsequently, this evaluation influences their self-concept. In the general population, low self-concept has been linked to a range of negative outcomes, including poor academic achievement, and behaviour and mental health problems. However, research into the self-concept of children with cerebral palsy (CP) is rare. The motor and accompanying impairments associated with CP limit participation opportunities for children with CP, creating a unique social experience for these children that are likely to differ from typically developing (TD) children. Given this unique social experience, children with CP may perceive their self-concept differently from TD children as well as be at potential risk for low self-concept. The overall aim of this research program was to examine the self-concept of children with CP after identifying or developing a CP-specific self-concept instrument suitable for this purpose. In Study 1, a systematic review was undertaken to identify self-concept instruments suitable for children with CP. Five studies that measured the self-concept of preadolescent children with CP that had population-specific psychometric data were identified. Examination of the psychometric properties of the instruments utilised in those studies identified no CP-specific self-concept instruments, whilst existing instruments developed for TD children did not have strong psychometric support for their use with children with CP. In Study 2, a three-round Delphi consensus survey was conducted to identify self-concept domains relevant to children with CP. Three groups were recruited: professionals working with children with CP (n=21), caregivers of children with CP (n=18), and children with CP (n=12, 7 boys). Findings demonstrated that children with CP generally conceptualise self-concept using similar domains to TD children. However, several CP-specific domains were identified. Based on these findings, it was determined that the construction of a population-specific instrument which incorporates CP-specific domains was necessary in order to provide a comprehensive evaluation of self-concept for children with CP. The myTREEHOUSE Self-Concept Assessment (myTREEHOUSE) was developed using classical test theory based on the rational-empirical approach. Self-concept is measured by the child’s appraisal of their performance for 26 items across eight domains. The child’s appraisal is rated from three perspectives: Personal, Social, and Perceived. In addition, children also complete an Importance Rating. The discrepancy between the Importance Rating and the Personal Performance Perspective for each item is summed to achieve a Personal Concern Score which indicates the presence and severity of self-concept concerns. In Study 3, the validity and reliability of myTREEHOUSE was examined. Support for face and content validity was ascertained through semi-structured interviews with seven experts. myTREEHOUSE demonstrated strong internal consistency assessed with 50 children with CP (29 boys). Moderate test-retest reliability was demonstrated with a subset of 35 children (20 boys). Study 4 explored the profile of self-concept using myTREEHOUSE for 50 children with CP (29 boys) in relation to age, gender, and motor, communication, and cognitive function. Children with CP in this cohort reported high self-concept. Findings also demonstrated that self-concept was not associated with age, gender, motor function, or communication function. Cognitive function was found to be associated with the self-concept domains of Social Skills and Learning Skills. Study 5 investigated the relationship between self-concept and quality of life measured using two population-specific instruments; myTREEHOUSE for self-concept and CP QOL-Child for quality of life. Higher self-concept was associated with higher quality of life in this cohort of 25 children with CP (13 boys). The relationships between self-concept with child-reported quality of life were stronger than proxy-reported quality of life. Through this research program, it was ascertained that existing self-concept instruments are not suitable for children with CP, given their weak psychometric data and the absence of CP-specific domains. In response, the myTREEHOUSE Self-Concept Assessment was developed and preliminary validation undertaken. Findings from this research program present the first self-concept profile of children with CP and provide a deeper understanding about how these children perceive their self-concept and quality of life.

This paper comprehensively reviews mobility assistive technology (MAT) use in children with Cerebral Palsy (CP). Currently, 9 million people are severely affected by CP, the most serious form of movement disability, characterised by deficits in movement, posture, and more, alongside cognitive and sensory deficits. These impairments restrict the child's functionality in self-care, performing tasks associated with daily living, and socialisation. The primary purpose of this paper is to establish the role of MAT in supporting children with CP and assess its impact on their lives. This review describes a range of devices that enhance mobility in motor-disabled patients, such as powered wheelchairs, robotic exoskeletons, ankle-foot orthoses (AFO), and gait trainers. It examines their effects on the psychosocial well-being and physical growth of children with CP. A methodical search within the PRISMA framework enabled us to analyse papers from 2010 to 2024, discussing the advantages and disadvantages of assistive technology (AT). It was noted that although ATs can improve independence, social involvement, and mobility, challenges such as high costs, poor design, and unavailability of these resources in underprivileged regions remain. New information technologies, including intelligent systems and virtual reality (VR) training tools, effectively address health-related issues; however, optimising these techniques over a long period needs further study. This paper underscores the importance of a more child-centred design of AT devices and additional policy adjustments to enhance accessibility across different socio-economic strata. Through this review, we seek to advance the emerging understanding of the role of mobility AT in enhancing the lives of children with CP, focusing on identifying weaknesses in the existing research and suggesting possible advancements.

Assistive technologies: time for a shift in thinking

Patients with intellectual/developmental disabilities (IDD) present many challenges to mental health professionals. The capacity to work with such patients requires a working knowledge of IDD as well as an awareness and understanding of the factors that affect the clinical presentation of mental health disorders across the spectrum of IDD.

Persons with cerebral palsy (CP) have an increased risk for secondary chronic conditions during childhood, including mental health disorders. However, little is known about how these disorders affect adults with CP. To determine the prevalence of mental health disorders among adults with CP compared with those without CP. Cross-sectional. 2016 Optum Clinformatics Data Mart. 8.7 million adults (including 7348 adults with CP). Other neurodevelopmental comorbid conditions (intellectual disabilities, autism spectrum disorders, epilepsy) and 37 mental health disorders (as 6 categories) were identified on the basis of diagnosis codes. Direct age-standardized prevalence of the mental health disorder categories was estimated by sex for adults with CP alone, adults with CP and neurodevelopmental disorders, and adults without CP. Men with CP alone had higher age-standardized prevalence than men without CP for schizophrenic disorders (2.8% [95% CI, 2.2% to 3.4%] vs. 0.7%), mood affective disorders (19.5% [CI, 18.0% to 21.0%] vs. 8.1%), anxiety disorders (19.5% [CI, 18.0% to 21.0%] vs. 11.1%), disorders of adult personality and behavior (1.2% [CI, 0.8% to 1.6%] vs. 0.3%), and alcohol- and opioid-related disorders (4.7% [CI, 3.9% to 5.5%] vs. 3.0%). The same pattern was observed for women. Compared with adults with CP alone, those with CP and neurodevelopmental disorders had similar or higher age-standardized prevalence of the 6 mental health disorder categories, except for the lower prevalence of alcohol- and opioid-related disorders in men. Single claims code was used to define the cohort of interest. Information on the severity of CP was not available. Compared with adults without CP, those with CP have an elevated prevalence of mental health disorders, some of which may be more pronounced in patients with comorbid neurodevelopmental disorders. National Institute on Disability, Independent Living, and Rehabilitation Research.

To examine the prevalence of mental health disorders among children with and without cerebral palsy (CP), and to examine how physical risk factors in children with CP might mitigate any elevated risk of mental health disorders in this population. Children from 6 years to 17 years of age with (n=111) and without (n=29 909) CP from the 2016 National Survey of Children's Health were included in this cross-sectional study. Mental health disorders included depression, anxiety, behavior/conduct problems, and attention deficit disorder/attention-deficit/hyperactivity disorder (ADHD). Physical risk factors included physical activity (number of active days ≥60min), sleep duration, and pain. Adjusting for sociodemographics, children with CP had higher odds of mental health disorders (odds ratio [OR]=2.7-7.1, p<0.05) except for attention deficit disorder/ADHD (OR=2.5; 95% confidence interval [CI]=0.9-7.1). Further adjusting for physical factors, the odds of depression were no longer increased (i.e. attenuated) in children with CP (OR=1.0; 95% CI=0.3-3.3); however, the odds of anxiety (OR=3.8; 95% CI=1.9-7.8) and behavior/conduct problems (OR=3.8; 95% CI=1.3-11.1) remained elevated. Assessed individually, low physical activity and pain attenuated the odds of depression in children with CP (OR=1.9; 95% CI=0.7-5.3; OR=1.4; 95% CI=0.6-3.8 respectively). Children with CP have an elevated prevalence of mental health disorders even after accounting for physical risk factors. Low physical activity and pain partially accounts for the association between CP and depression. Children with cerebral palsy (CP) have an elevated risk of developing mental health disorders. Physical factors do not fully account for higher mental health disorder prevalence. Physical activity partially accounts for the relationship between CP and depression. Pain partially accounts for the relationship between CP and depression.

Many quantitative cross-cultural research studies assume that cultural groups consist of anyone born and raised in the same country. Applying these criteria to the formation of study samples may produce cohorts that share a country but are heterogeneous in relevant domains of culture. For example, in Canada, Franco- and Anglo-Canadians are generally assumed to represent different linguistic groups but the same cultural group. However, speaking a different first language also can mean exposure to different media, information, and conventions, which are known to shape certain cultural domains, such as social values. Other factors may also produce cultural heterogeneity. For example, ancestral origins and recency of familial migration may influence endorsed social values after exposure to diverse cultures or norms. Mental health status or psychiatric conditions may also influence subscription of social values due to different lifestyle demands. Understanding the nuanced contributions of diverse backgrounds to cultural membership and fit (i.e., the degree to which an individual behaves like other cultural members) is useful when performing quantitative cross-cultural studies to minimize alternative explanations for statistical outcomes. This study used Cultural Consensus Analysis (CCA) to assess the cultural fit of social values for 222 Canadians, who had participated in cross-cultural neuropsychological experiments. CCA is an anthropological statistical method for evaluating cultural agreement of a sample. Participants were systematically evaluated by linguistic groups (French and English), migratory generation (1st–3rd+), and mental health status (healthy and patient). Group and individual variances were statistically interrogated. Results demonstrated that Franco- and Anglo-Canadians represent different cultural groups cohabitating in Quebec. Social values dividing Franco- and Anglo-Canadians were also identified. Second and third generation Canadians held more heterogeneous social values than Canadians, whose families had migrated earlier. Second generation Canadians with psychiatric disorders showed notably reduced cultural fit with other Canadians, which supports other literature reporting difficulties experienced by second generation migrants. However, third and later generations of Canadians with psychiatric disorders held a greater range of social values compared to healthy Canadians but still were good fits for Canadian culture. This study concluded that linguistic group and migratory generation partially determines cultural group for the social values domain while mental health status does not, contrary to theories proposed by previous literature.

This paper presents the work of Maria Teixeira School-MTS as a pedagogical methodology of social and educational inclusion, and making a historical review of its trajectory. MTS is a non-profit institution located in the countryside of Luziânia city, (Brazil), promoting 1st phase of elementary school and youth and adult education. In 2013, offered free and quality educational service for 208 students, among children, teenagers and adults from low-income families in the common and special, under the educational inclusion. About 60 students have some type of disabilities, such as: Down syndrome, autism, mental, physical, auditory deficiencies. The proposal is based on constructivism and educational, technological and social inclusion. Founded in 1994, MTS has worked since its origin with the “pedagogy of respect for differences”, understanding difference as richness. Stimulates the development of efficiencies instead of highlighting the deficiencies. Luziânia is considered the 16th most violent city in Brazil, with few opportunities for young people at social risk. MTS adopts the Brazilian Sign Language as a discipline. Everyone learns LIBRAS, not just the deaf students. In addition, LIBRAS is used as an alternative communication to listeners students with difficulty speech, with great results. MTS has an ecological action with recycled material, promoting sustainable productive chain, avoiding waste, generating income with craft workshops from the transformed objects sale. MTS presented their demands to the group of engineers involved in humanitarian technology, being an NGO-partner of the IEEE-SIGHT-PUCMinas because of the need for accessible and assistive technologies appropriate technologies and innovative teaching methodology.