Impact of assistive technologies on caregiver burden and perseverance for people with dementia at home

Purpose: To review the knowledge base regarding assistive technology (AT) and the education of people with a hearing impairment. Also, evaluating to what extent has the use and/or impact of AT for individuals with a hearing impairment been determined through evidence-based research in post-school education.Materials and method: Literature pertaining to the effect of AT on the educational performance of students with impaired hearing in the post-school sector was examined for the period from 1998 to 2018 (20 years). A total of 477 articles that contained evidence-based research and reports on the effect of AT in practice were located and reviewed.Results: It was found that, of the 20 studies that met all the inclusion criteria, only seven provided promising, evidence-based reports on the impact of assistive hearing technology on educational performance.Conclusion: This review concluded that the limited research speaks to the positive impact of AT on educational outcomes. Additionally, for students with a hearing impairment to be able to receive high-quality AT that will enhance their educational success, more evidence-based research on the efficacy of hearing AT needs to be conducted, especially as newer technologies emerge in this technological era.Implications for rehabilitationThe use of appropriate hearing assistive technology (AT) is a key facilitator within the educational environment and has a positive impact on the educational outcomes for students studying at college or university.This rapid review revealed the need to develop a body of scientifically based research that examines the relationship between academic achievement of participation by deaf learners and the use of AT – this is needed to develop a more comprehensive understanding of the benefits and limitations of educational technologies, especially as newer technologies emerge in this technological era.This study further highlights the need for more concrete research on the effectiveness of hearing-related AT so that the case can be made for students with hearing impairment to receive high quality, appropriate AT that will enhance their educational success.Ultimately, it is hoped that this article elicits the need for much more investigation into this topic to work towards finding solutions that lead to increased participation of deaf learners in the higher education arena, as well as providing evidence-based results to inform future policy and practice.

IntroductionAssistive technology and telecare (ATT) may alleviate psychological burden in informal caregivers of people with dementia. This study assessed the impact of ATT on informal caregivers’ burden and psychological well‐being.MethodsIndividuals with dementia and their informal caregivers were recruited to a randomized‐controlled trial assessing effectiveness of ATT. Caregivers were allocated to two groups according to their cared‐for person's randomization to a full or basic package of ATT and were assessed on caregiver burden, state anxiety, and depression. Caregivers’ data from three assessments over 6 months of the trial were analyzed.ResultsNo significant between‐ or within‐group differences at any time point on caregivers’ burden, anxiety, and depression levels were found.DiscussionFull ATT for people with dementia did not impact caregivers’ psychological outcomes compared to basic ATT. The length of follow up was restricted to 6 months.

Deaf individuals often experience communication difficulties in face-to-face interactions with hearing people. In order to support deaf individuals in such situations, an active stream of assistive technology (AT) research focuses on real-time translation of sign language. We investigate the impact of real-time translation-based ATs on communication quality between deaf and hearing individuals. We conducted a focus group and aWizard of Oz study in which deaf and hearing participants jointly interacted with different assistive technologies. We find that while ATs facilitate communication, communication quality is degraded by to breaks in the conversation. Using Co-Cultural Theory, we identify deaf people as a subordinate group inside a hearing society. Our results indicate that current ATs reinforce this subordination by emphasizing deficiency of mastering the dominant form of communication. Based on our findings, we propose a change in design perspective by enabling the hearing to sign rather than the deaf to "hear". We argue that ATs should not be seen as "just" a tool for the Deaf but rather as a collaborative technology.

Integrating assistive technologies in education is crucial for enhancing English learning outcomes among students with disabilities. This meta-narrative analysis aims to synthesize existing research on the impact of assistive technologies in improving English language skills in this population. We conducted a comprehensive search across databases, including Taylor and Francis and Scopus, identifying relevant studies published from 2020 to 2023. Eleven peer-reviewed articles met the inclusion criteria, focusing on empirical studies that evaluated tools such as EducaPlay, Rosetta Stone, PECS, AR applications, inclusive videos, LEA tools, VAS and multimedia tools, web-based drill programs, the AMALL application, and various assistive technologies like JAWS, MELDICT, OCR scanners, and Braille devices. Data collection involved extracting critical information on the effectiveness of the learning tools, types of disabilities, and educational outcomes related to language skills in using technology learning tools to study the English language for disabled students. The analysis revealed significant improvements in vocabulary, reading comprehension, and writing skills, demonstrating the positive impact of assistive technologies on English learning. The findings suggest that these technologies enhance engagement and motivation, offering personalized support that addresses individual needs. The discussion highlights the variability in effectiveness across different technologies and the importance of proper implementation and training for educators.

Purpose: To systematically review the literature on the effects of assistive technology (AT) on family caregivers of children with physical disabilities. Method: Electronic searches of Medline, CINAHL Plus, PubMed, and PsychInfo were conducted. The main search terms were AT, caregiver, physical disability, cerebral palsy and quality of life. Studies were included if they related to the impact of AT on the family caregiver of children with physical impairment. Data extraction and quality assessments were conducted by three reviewers. Results: Five articles were eligible for inclusion. Two studies rated weak quality of evidence (level 5), two studies rated moderate quality of evidence (level 3), and one article was a systematic review, rating high level of quality (level 1). A paucity of literature, small sample sizes, descriptive study designs and weak methodological quality meant a narrative review was possible. Three articles reported that AT lightened caregiver assistance in the areas of mobility, self- care and social function. Conclusions: Evidence suggests that AT has a positive impact on children with physical impairments and their caregivers. Future studies in this area could include valid and reliable outcome measures of AT use and the psychological impacts of AT on caring for a child with physical impairments.Implications for RehabilitationAssistive technology can decrease effort and energy expenditure for family caregivers of children with disabilities.Assistive technology can increase child independence, therefore decrease family caregiver burden.Therapists need to educate and guide family caregivers on the use of assistive technology for their child in order to enhance adoption and competence.

(1) Background: Recent reforms in Australia, providing people with disability and older people with choice and control over allocated funding, have altered consumer expectations and transformed the landscape of assistive technology (AT) service provision. The purpose of this study is to report on the routine AT outcomes of people who accessed an AT consultation service and examine how well these capture the impact of AT on their lives; (2) Methods: This study, which uses mixed methods for concurrent triangulation of the data, reports on the outcomes for 127 people who acquired a range of assistive technology in 2015 and examines the adequacy of an existing service outcome framework in capturing the true value of these technologies to AT users. Outcome data was routinely collected by a community service 2–4 months following an AT consultation. A telephone or face-to-face interview gathered demographic information as well as AT outcomes, using two standardized tools, the Individualized Prioritised Problem Assessment (IPPA) and the EATS 6D. Qualitative comments relating to the impact of the AT on the person’s life were also documented; (3) Results: The acquired AT generally met or exceeded expectations of the person using the AT and the attending health professional. Overall, people experienced decreased difficulty and increased feelings of autonomy, with most of the reported improvements identified in mobility and usual activities; (4) Conclusion: Routine outcome data provide some evidence of the value of AT in addressing concerns as identified by clients. Qualitative data, which captured the impact of AT on people’s lives, suggest that the empowering and transformative aspects of AT are not currently being captured by existing measures.

Parkinson's disease (PD) is the fastest growing neurological disease worldwide with more than 8.5 million people diagnosed. Assistive technologies for people with PD support the user to maximize independence. The purpose of this integrative literature review was to critique and synthesize the literature on the impact of assistive technologies on quality of life of home-dwelling individuals with PD. A literature search for studies on assistive technologies for people with PD with a primary outcome measure of quality of life was conducted. Of 156 articles screened for eligibility, 6 met selection criteria, including 4 quantitative studies, 1 qualitative study, and 1 mixed-method. Levels of evidence were scored as a percentage of quality criteria met, from 60% to 100% using the Mixed Methods Appraisal Tool. Using home monitoring devices was associated with significant improvements in walking, especially during freezing of gait. Evidence supports the use of assistive technologies including voice-activated technology, home automation, and home monitoring devices. Further research is needed to determine the effect of assistive technology on quality of life.

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 refined measurement 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 interventions and outcomes for assistance users and their informal caregivers andCONTENTS5.1 Introduction 83 5.2 Overview of Current Literature 84

Barriers and facilitators of assistive technology use among adolescent students with learning disabilities: A mixed methods comparison of daily and less frequent users.

Purpose: The current study explored domains of assistive technology (AT) device outcomes that are most valued by AT users. A secondary objective was to identify elements in the device acquisition process that affect outcomes.Method: Focus groups were conducted at geographically dispersed locations within the USA. The groups were moderated by experienced AT practitioners who followed a detailed procedure emphasizing a nominal group facilitation technique.Results: Twenty-four adult AT users, representing a range of ages and disability populations, participated in four focus groups. Many had over 15 years of experience with multiple device types. Qualitative analysis yielded 13 threads that embodied salient outcome domains (e.g. independence, subjective well-being, participation in work and school, cost-effectiveness) and key factors associated with the device acquisition process (e.g. lengthy periods of frustration, variable quality of service providers). Ironically, these data were evoked only after the term “outcomes” was omitted from focus group questions.Conclusions: AT outcomes studies are needed that report data regarding (a) the impact of AT on participation, (b) costs of AT provision and (c) key elements in the AT service delivery process. Future studies will be further strengthened to the extent that their methodologies actively assimilate consumer perspectives.Implications for RehabilitationConsumers highly value the impact of AT devices on their independence, subjective well-being and participation in work and school.The process of acquiring assistive technology devices is often lengthy and frustrating for consumers.Future AT outcomes research should report descriptive data regarding service delivery processes, as well as long-term impacts for consumers.Practitioners and researchers should avoid the use of potentially confusing professional jargon when administering surveys to consumers.

(1) Knowledge about the assistive technology (AT) needs and psychosocial impact of AT in different populations is needed because the adoption, retention, or abandonment of AT may be influenced by the psychosocial impact that AT has on its users. The aims of this study were to: (a) identify the AT needs of a sample of Hispanic older adults with functional limitations, (b) describe the psychosocial impact of these technologies on the sample’s quality of life, and (c) describe the methodological challenges in using the Puerto Rican version of the Psychosocial Impact of Assistive Device Scale (PR-PIADS) with a Hispanic sample. (2) Methods: This study used a cross-sectional design conducted with a sample of 60 participants. Data was collected using the Assistive Technology Card Assessment Questionnaire (ATCAQ) and the PR-PIADS. Data analyses included descriptive statistics and bivariate analysis. (3) Results: The sample’s most frequently reported needs for AT devices were in the areas of cooking, home tasks, and home safety activities. The sample reported a positive impact of AT use in their quality of life. Several methodological challenges of the PIADS were identified. (4) Conclusions: The sample has unmet needs for using AT devices to overcome difficulties in daily living activities.

Purpose: Active ageing is defined as the process of optimizing opportunities for physical, social and mental health to enable older people to actively take part in society without discrimination and to enjoy independence and good quality of life. The World Health Organization assumed this to be a process for increasing and maintaining an individual’s participation in activities to enhance his/her quality of life. In this survey, the authors addressed the following question: is assistive technology (AT) for mobility contributing to enhancement of lifelong capacity and performance? Method: From June 2015 until February 2016, 96 community dwelling adults, AT users for mobility (powered wheelchairs, manual wheelchairs, lower limb prostheses, walkers, crutches and canes), aged 45–97, mean 67.02 ± 14.24 years old, 56.3% female, were interviewed using the Psychosocial Impact of Assistive Devices Scale (P-PIADS), the Activities and Participation Profile related to Mobility (APPM) and demographics, clinical and questions about AT use and training. Results and Discussion: The participants’ profiles revealed moderate limitation and restrictions in participation, measured by the APPM (2.03). Most participants displayed a positive impact from AT; average scores obtained from the P-PIADS subscales were: Self-esteem 0.62, Competency 1.11 and Adaptability 1.10. The P-PIADS total was 0.96, with the powered wheelchair users scoring the highest (1.53) and the walker users scoring the lowest (0.73). All subscales and the P-PIADS total were positively correlated with the activities and participation profile. There was no relation between age and the psychosocial impact of AT or activities and participation profile. These results encourage the authors to follow up with these participants for a lifelong intervention. To accomplish that aim, currently, the protocol is implemented at the AT prescribing centers in Coimbra, Portugal in order to assess the impact of AT on participation in society, one of the domains of the Active Ageing Index, a new analytical tool to help policy makers in developing policies for active and healthy ageing.

Recent technological developments, such as the near universal spread of mobile phones and portable computers and improvements in the accessibility features of these devices, give children and young people with low vision greater independent access to information. Some electronic technologies, such as closed circuit TV, are well established low vision aids and newer versions, such as electronic readers or off-the shelf tablet computers, may offer similar functionalities with easier portability and at lower cost. To assess the effect of electronic assistive technologies on reading, educational outcomes and quality of life in children and young people with low vision. We searched CENTRAL (which contains the Cochrane Eyes and Vision Group Trials Register) (2014, Issue 9), Ovid MEDLINE, Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily, Ovid OLDMEDLINE (January 1946 to October 2014), EMBASE (January 1980 to October 2014), the Health Technology Assessment Programme (HTA) (www.hta.ac.uk/), the metaRegister of Controlled Trials (mRCT) (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrials.gov) and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic searches for trials. We last searched the electronic databases on 30 October 2014. We intended to include randomised controlled trials (RCTs) and quasi-RCTs in this review. We planned to include trials involving children between the ages of 5 and 16 years with low vision as defined by, or equivalent to, the WHO 1992 definition of low vision. We planned to include studies that explore the use of assistive technologies (ATs). These could include all types of closed circuit television/electronic vision enhancement systems (CCTV/EVES), computer technology including tablet computers and adaptive technologies such as screen readers, screen magnification and optical character recognition (OCR). We intended to compare the use of ATs with standard optical aids, which include distance refractive correction (with appropriate near addition for aphakic (no lens)/pseudophakic (with lens implant) patients) and monocular/binoculars for distance and brightfield magnifiers for near. We also planned to include studies that compare different types of ATs with each other, without or in addition to conventional optical aids, and those that compare ATs given with or without instructions for use. Independently, two review authors reviewed titles and abstracts for eligibility. They divided studies into categories to 'definitely include', 'definitely exclude' and 'possibly include', and the same two authors made final judgements about inclusion/exclusion by obtaining full-text copies of the studies in the 'possibly include' category. We did not identify any randomised controlled trials in this subject area. High-quality evidence about the usefulness of electronic AT for children and young people with visual impairment is needed to inform the choice healthcare and education providers and family have to make when selecting a technology. Randomised controlled trials are needed to assess the impact of AT. Research protocols should carefully select outcomes relevant not only to the scientific community, but more importantly to families and teachers. Functional outcomes such as reading accuracy, comprehension and speed should be recorded, as well as the impact of AT on independent learning and quality of life.

Purpose – The purpose of this paper is to evaluate the impact of assistive technology (AT) on social care services and on the quality of life (QOL), particularly the independence, of people with intellectual disabilities. In addition, to make recommendations about an ethical approach to implementing AT. Design/methodology/approach – The evaluation is based on consideration of relevant research, particularly, research undertaken at the Welsh Centre for Learning Disabilities at Cardiff University. Findings – AT can promote independence and prevent harm. There also appear to be benefits to social care services in terms of changes in staff input levels and reduced costs. However, the data are limited and existing studies have shown mixed results. Research limitations/implications – This is not a systematic review. Revised research methods may be needed to detect key outcomes from AT. Practical implications – A focus is needed on individual planning and robust and transparent processes to balance organisational and user benefits. There are implications for care management, person-centred planning and care commissioning to ensure good QOL outcomes are targeted by AT and that the delivery of these outcomes is monitored and ensured. Originality/value – Based on the existing literature on the impact of AT on people with intellectual disabilities, recommendations are made about an ethical approach to implementing AT.

ABSTRACTThe impact of assistive technology (AT) services for college students with less-apparent disabilities is under-reported. Using the Canadian Occupational Performance Measure (COPM), we assessed student Performance and Satisfaction ratings of common academic tasks at the start and end of a semester during which 105 student-clients with less-apparent disabilities received AT services. We examined if COPM scores related to personal characteristics of gender, class-level (e.g., Sophomore), and STEM education; if personal characteristics predicted a student’s follow-through with an AT service referral (n=231); and if personal characteristics and initial COPM scores predicted dropout from AT services (n=187). COPM ratings significantly increased in all academic tasks (p<.001). Gender predicted initial Satisfaction (male ratings > female ratings; p=.01), and Performance changes (females were more likely to have a service-meaningful change; p=.02). Higher class-level predicted better follow-through with a referral for AT services (p=.006). Increasing class-level (p=.05) and higher initial studying (p<.006) and reading (p<.029) ratings predicted a lower likelihood for dropout. These findings demonstrate that college students with less-apparent disabilities experience substantial improvements in their self-ratings of academic performance and satisfaction following AT services. Gender, class-level, and initial self-perceived reading and studying abilities may influence if and how the student participates with AT services.