The impact of a crisis on the provision of assistive technology in Sweden: The case of COVID-19

Brain-computer interface (BCI) can provide people with motor disabilities with an alternative channel to access assistive technology (AT) software for communication and environmental interaction. Multiple sclerosis (MS) is a chronic disease of the central nervous system that mostly starts in young adulthood and often leads to a long-term disability, possibly exacerbated by the presence of fatigue. Patients with MS have been rarely considered as potential BCI end-users. In this pilot study, we evaluated the usability of a hybrid BCI (h-BCI) system that enables both a P300-based BCI and conventional input devices (i.e., muscular dependent) to access mainstream applications through the widely used AT software for communication “Grid 3.” The evaluation was performed according to the principles of the user-centered design (UCD) with the aim of providing patients with MS with an alternative control channel (i.e., BCI), potentially less sensitive to fatigue. A total of 13 patients with MS were enrolled. In session I, participants were presented with a widely validated P300-based BCI (P3-speller); in session II, they had to operate Grid 3 to access three mainstream applications with (1) an AT conventional input device and (2) the h-BCI. Eight patients completed the protocol. Five out of eight patients with MS were successfully able to access the Grid 3 via the BCI, with a mean online accuracy of 83.3% (± 14.6). Effectiveness (online accuracy), satisfaction, and workload were comparable between the conventional AT inputs and the BCI channel in controlling the Grid 3. As expected, the efficiency (time for correct selection) resulted to be significantly lower for the BCI with respect to the AT conventional channels (Z = 0.2, p < 0.05). Although cautious due to the limited sample size, these preliminary findings indicated that the BCI control channel did not have a detrimental effect with respect to conventional AT channels on the ability to operate an AT software (Grid 3). Therefore, we inferred that the usability of the two access modalities was comparable. The integration of BCI with commercial AT input devices to access a widely used AT software represents an important step toward the introduction of BCIs into the AT centers’ daily practice.

People with disabilities are entitled to access assistive technology (AT) to facilitate their full and effective participation in society and may reasonably expect to be central to the decision-making processes of services that provide these technologies. European projects have improved the knowledge and resources available for AT service delivery in many countries, but the outputs are not consistently implemented or published in scientific literature. This article examines European developments in AT service delivery and the barriers to its effective provision. Specifically, it analyzes the role of the International Classification of Functioning, Disability, and Health in service delivery improvement. Published scientific papers, as well as reports from and descriptions of European projects related to AT service delivery, were reviewed. The publications were analyzed in relation to six criteria for AT service delivery described in an earlier, major European project. The findings and recommendations from the publications are synthesized in this article to identify advances and gaps in AT service delivery and to assess the current status and direction of AT service delivery improvement in Europe. Multicountry projects have brought together AT researchers from across Europe to work together and produced promising results that are contextually relevant. Access to AT information and training of practitioners has improved, and efforts are being made to facilitate user involvement. More effort should be put into integrating research and resources from European projects into practice. Use of the International Classification of Functioning, Disability, and Health model and terminology may support coordination of service delivery systems. The AT research and practice communities in Europe may be able to learn from developments in North America, while continuing to work together, sharing resources and strategies, and communicating results internationally.

Purpose Co-design involves engaging with the end-user in the design process and may help reduce the barriers to assistive technology use. Previous research has used co-design in the provision of assistive technology, but no research has looked at applying it within a healthcare setting. This service evaluation examines the use of co-design in providing customized assistive devices within a current UK healthcare based Rehabilitation Engineering department. Methods This evaluation reports on three case studies. Individuals identified a range of challenges in daily living. The participants worked with the clinician in trialling prototypes and providing feedback to develop custom devices. A mixed-method approach of questionnaires and semi-structured interviews were used to evaluate the devices provided and the co-design approach. The resources required to provide the device were also calculated. Results Five different devices were developed, which were able to overcome the challenges identified. Results indicated participants were satisfied with both the devices and service provided. Participants expressed other benefits including increased independence, increased positive emotions and reduced mental load. Participants indicated they liked being involved in the design process and their feedback helped ensure the devices were customized to their needs. Conclusions The use of co-design was able to produce customized assistive device that met the needs of the individuals within a current healthcare service. Further work is required to assess the feasibility of utilising a co-design approach for the provision of other custom assistive technology in the future and explore if this can overcome the barriers to assistive technology use. Implications for rehabilitation End-user involvement, the design process can help enable customized assistive devices to be provided that better meet the user’s needs. The custom assistive devices provided not only helped the individuals overcome the challenges identified but had wider reaching benefits for the individuals physical and mental health and wellbeing. End-users valued being able to input into the co-design process and working closely with the clinician in developing the device.

Assistive Technology and Older Persons with Physical/Sensory Disabilities: Case Studies (Marie, Lena and Paul) Get access Assistive Technology and Older Persons with Physical/Sensory Disabilities: Case Studies (Marie, Lena and Paul), ½″ videocassette/61 min/color/1992. Producer, Kevin Crosby, PhD. Distributor, Center for Assistive Technology, 515 Kimball Tower, University of Buffalo, Buffalo, NY 14214-3079. 716/829-3141. $50, no rental. A.W.N. A.W.N. Search for other works by this author on: Oxford Academic PubMed Google Scholar The Gerontologist, Volume 35, Issue 5, October 1995, Page 720, https://doi.org/10.1093/geront/35.5.720 Published: 01 October 1995

BackgroundWhilst assistive technology (AT) can play an important role to improve quality of life, health inequity regarding access to appropriate AT for people with intellectual disabilities (ID) is still very much present especially in low resource countries.ObjectivesThis study focused on exploring factors that influence access to and continued use of AT by people with ID in the Western Cape province of South Africa and to suggest potential implications of these findings and actions required to promote access to AT.MethodA qualitative approach was used to explore the experiences of people with ID and providers of AT. Face-to-face interviews with 20 adults with mild to profound ID, and 17 providers of AT were conducted and the data were analysed thematically.ResultsPeople with ID within the study setting faced many challenges when trying to access AT and for those who managed to acquire AT, its continued usage was influenced by both personal characteristics of the user and environmental factors. Important factors that influence AT access and use for people with ID found in this study were (1) attitudes from the community, (2) knowledge and awareness to identify AT need and (3) AT training and instructions to support the user and care network.ConclusionWith the perspectives of both the providers and users of AT, this study identified priority factors, which could be addressed to improve AT access and use for people with ID in the Western Cape province.

Background: Assistive technology (AT) can support autistic adults in navigating employment-related challenges. However, limited research has explored autistic adults’ actual needs and experiences with AT in the workplace. Existing studies often overlook how well current AT solutions align with the real-world demands autistic adults face across the employment process. To address this gap, this study conducted a needs assessment to explore autistic adults’ perceived AT and AT service needs across employment stages, identify satisfaction and discontinuation patterns, and examine barriers and facilitators to effective use. Methods: A total of 501 autistic adults were recruited through an online crowdsourcing platform, Prolific. Participants completed a needs assessment that included Likert-scale items and open-ended questions. Quantitative data were analyzed using descriptive statistics and weighted needs scoring procedures. Thematic analysis was applied to qualitative responses regarding satisfaction, discontinuation, and general reflections on AT use. Results: Job retention received the highest total weighted needs score, followed closely by skill development and job performance. Participants reported lower perceived needs for AT in the job development and placement domain. Qualitative findings revealed that AT was described as essential for daily functioning and independence, but barriers such as limited access, inadequate training, and social stigma affected use. Participants also emphasized the need for more person-centered and context-specific AT services. Conclusions: AT has the potential to significantly enhance employment outcomes for autistic adults. However, current services often lack personalization and alignment with real-world needs. Findings support the development of more inclusive, tailored, and accessible AT solutions across all employment stages.

Purpose: People with disability have a right to assistive technology devices and services, to support their inclusion and participation in society. User-centred approaches aim to address consumer dissatisfaction and sub-optimal outcomes from assistive technology (AT) provision, but make assumptions of consumer literacy and empowerment. Policy discourses about consumer choice prompt careful reflection, and this paper aims to provide a critical perspective on user involvement in assistive technology provision. Methods: User-centred approaches are considered, using literature to critically reflect on what user involvement means in AT provision. Challenges at the level of interactions between practitioners and consumers, and also the level of markets and policies are discussed, using examples from Australia. Results: There is no unanimous conceptual framework for user-centred practice. Power imbalances and differing perspectives between practitioners and consumers make it difficult for consumers to feel empowered. Online access to information and international suppliers has not surmounted information asymmetries for consumers or lifted the regulation of publicly funded AT devices. Conclusions: Ensuring access and equity in the public provision of AT is challenging in an expanding market with diverse stakeholders. Consumers require personalised information and support to facilitate their involvement and choice in AT provision.Implications for RehabilitationVariations in approaches informing AT provision practices have a profound impact on equity of access and outcomes for consumers.An internationalised and online market for AT devices is increasing the need for effective information provision strategies and services.Power imbalances between practitioners and consumers present barriers to the realisation of user-centred practice.

This paper presents visually impaired students’ experiences on the utilization of assistive technologies to access digital information resources for academic work. It reports preliminary findings from an ongoing Doctoral study on Information Practices of Students with Visual Impairment using Digital Information Resources in Public University Libraries in Uganda. Using a qualitative approach; stratified purposeful, snowball and convenience sampling techniques were used. Data was obtained from twenty visually impaired students using face to face in-depth open ended interviews. Data was analyzed using software Atlas ti v.7.5.5 following the study themes. Findings revealed exclusion in the provision and utilization of assistive technologies in the libraries studied. Skills, competency and capacity constraints by both staff and visually impaired students on the use of assistive technologies, coupled with insufficient assistive technologies impacted on the gainful utilization of digital information resources for academic undertaking. Obsolescence, limited supervisory and technical support from the librarians, and inadequate information, communication and technology (ICT) facilities were major impediments to utilization of assistive technologies to access digital information resources among visually impaired students. Provision of assistive technologies does not guarantee their utilization therefore, the study recommends designing tailor-made courses in ICT for visually impaired students for library staff, equipping visually impaired students with requisite skills and competencies, purchasing or subscribing to up-to-date assistive technologies, acquiring more computers and designating library staff to manage the special needs section in libraries.

Policy development and implementation are key to improving access to Assistive Technology (AT). In this paper, we describe a strength-based framework for doing this at national level. We used an action research approach, with the United Nations Conventions on the Rights of Persons with Disability (UNCRPD) as the primary frame of reference. Primary data were collected using the World Health Organisation’s rapid Assistive Technology Assessment (rATA). We describe the process of applying our emergent framework and how our findings support it. We identified seven guiding principles for effective policy process: Participatory, Resource aware, Outcomes focused, Collaborative, Evidence-informed, supporting good practices, and System strengthening – which can be summarized by the acronym PROCESS. Five crucial building blocks for effective AT policy development emerged: Identification of the assistive technology ecosystem, Demography of disability and AT use, Evaluation of inclusion and participation in existing policy, Alignment with UNCRPD and Sustainable Development Goals (SDGs), and Locality of implementation – which can be summarized with the acronym IDEAL. The IDEAL PROCESS incorporates key content building blocks and core process principles, constituting a systematic framework for guiding the development of context sensitive AT policy and a strength-based pathway to improving access AT.

Purpose Assistive technology can provide a key tool to enabling independence, greater inclusion and participation in society for individuals with chronic conditions. This potential is currently not always realized due to barriers to accessing and using assistive technology. This review aims to identify the common barriers to acquiring and using assistive technology for users with chronic conditions through a systematic meta-synthesis. This differs from other systematic reviews by applying a transdiagnostic approach to identify if barriers are common across chronic conditions. Materials and methods A systematic literature search of five scientific databases (PubMed, SCOPUS, PsycINFO, CINAHL and Medline) was conducted to identify relevant qualitative studies. The search was conducted in November 2019. For the identified articles, thematic content analysis was conducted and the methodological quality was evaluated using the Critical Appraisal Skills Programme (CASP) checklist for qualitative research. Results Forty papers met the inclusion criteria and were included in the analysis. Fifty-one descriptive themes grouped into six overarching analytical themes were identified from the studies. The analytical themes identified were: the design and function of the assistive technology, service provision, information and awareness, psychological barriers, support network and societal barriers. Conclusions The barriers are interconnected and common across different health conditions. More involvement in personalized care for developing strategies, adaptation of home technologies and provision of assistive technology could overcome the service provision and design barriers to assistive technology. Accessible information and providing greater awareness will be important to overcoming information, psychological and societal barriers to assistive technology. Implications for rehabilitation Individuals with chronic conditions face complex barriers to acquiring and using assistive technology as a result of the devices themselves, their individual context, the healthcare context where assistive technology is provided and wider societal barriers. The provision of assistive technology needs to change away from the traditional medical model of the “expert” clinician and instead focus on more user involvement to deliver personalised care that utilises the users lived knowledge and experiences. Assistive technology provision should be considered alongside how to adapt everyday mainstream technology to meet user needs; the provision of devices should encourage creative problem solving rather then relying on pre-defined prescription lists of assistive technology.

Aim: To examine what demographics and clinical factors are associated with the provision of assistive technology (AT) devices in a low-income country. Method: Retrospective cross-sectional exploratory study design including 15 of the 20 localities across Bogotá D.C., Colombia, a city with 6 776 009 inhabitants. Results: The type of AT device provided was significantly dependent (p < 0.001) on the client’s diagnosis, impairment, age, and socio-economic strata, whether the client has a care giver, the geographical zone in which the client lives, the year of the AT provision, and the total number of AT delivered. In contrast, the client’s gender (p > 0.05) and the client’s affiliated type of healthcare service had no effect. In addition to that, the client’s age, the client’s socio-economic strata, the number of AT devices provided to the client, and the diagnostic type were the factors with the strongest level of association with the type of AT device provided. Conclusions: Our research showed that the provision of AT in Bogotá D.C. prioritizes both people who are at the highest levels of vulnerability, and as many people as possible with the budget. That is, the low socio-economic strata, younger and older people, and the provision of at least one AT device.Implications for RehabilitationProvision of AT is intended for equal opportunities for the social participation of people with a disability. Also, people with disabilities have the right to access AT regardless of the type of limitation, gender, race, age or region where they live.Research regarding AT in developing countries is scarce; thus, there is a need to conduct studies in such contexts. This study provides scientific evidence to support the development of models, approaches and strategies of AT provision in low-income countries where resources for rehabilitation are scarce.

Objective. In clinical rehabilitation practice, assistive technology (AT) is chosen for each individual efficiently by a skilled multidisciplinary team. Due to demographic and societal changes in the developed world, these professionals are overloaded, so the selection more and more often has to be performed within an unskilled team. The process of selection can be time and resource consuming, as &amp;ndash; among other issues &amp;ndash; it is not clear what is the learning period required for use of a given AT. Hence, the article presents a study of a new approach to test and select appropriate computer access AT (CAT) for people with motor impairments based on the learning process.

ABSTRACTThis article considers the impact of a two-year collaborative European Union-funded project. The ‘Sustainable Ways to Increase Higher Education Students’ Equal Access to Learning Environments’ (SWING) project, brought together four European higher education institutions, one institution in Egypt and two in Morocco. It aimed to promote equal access to university education, and future career opportunities, for students with disabilities in the North African countries, using accessible assistive technology. Appreciative inquiry was used to explore the impact of the project processes and outcomes. We will share how the focus on assistive technology addressed the invisibility of students with disabilities by promoting individual and collective student agency. Students’ emerging sense of empowerment is attributed to two factors that inform the wider inclusive education debate: the power of technology as a mediator of change and the importance of a bottom-up/top-down dynamic.

This research aims to empower disabled makers and engineers to participate in collaborative engineering activities. First, this research identifies barriers to and benefits of applying makerspace culture precepts to the creation of DIY Assistive Technologies (DIY-AT). From this data, we will be developing a hybrid online and in-person community for supporting DIY-AT makers. Simultaneously, this research aims to identify the basic structure and vocabulary of human haptic communication. From that data, we will design an anthropomorphic human-robot interaction for assistive technologies, using the haptic channel to facilitate fluid assistive interactions. Together, these become a program of research that will support disabled makers and engineering students in collaborating with diverse teams of other creators with improved situational awareness and collaboration.

Objective. A client-centred approach has not been fully realised in Assistive Technology (AT) provision and, in response, there have been moves toward enhancing choice through the use of individual budgets. Choice is advocated in healthcare to enhance quality and strengthen individual rights, but in a market environment can leave customers overwhelmed rather than empowered if not supported by independent advice and information. Can client choice be extended to those who seek and can benefit from choice have access, while providing practitioner support for those who want or need it?