Assistive Technology Interventions Research Articles

Speech-to-text intervention to support text production among students with writing difficulties: a single-case study in nordic countries

Studies report that speech-to-text applications (STT) may support students with writing difficulties in text production. However, existing research is sparse, shows mixed results, and lacks information on STT interventions and their applicability in schools. Therefore, this study aimed to investigate whether a systematic and intensive assistive technology intervention focusing on STT can improve text production. A modified multiple-baseline across-subject design was used involving eight middle school students, four Norwegian and four Swedish. Their STT-produced narrative texts were collected during and after the intervention and the productivity, accuracy, and text quality were analysed. Keyboarding was the baseline control condition. The results demonstrated that seven of the eight students increased text productivity and that the proportion of word-level accuracy was maintained or improved. The use of punctuation progressed in participants with poor baseline skills. Most students’ STT-produced texts had at least a similar ratio of meaningfulness and text quality as keyboarding. However, the magnitude of the changes and development patterns varied, with three students showing the most notable impacts. In conclusion, this study’s intervention seemed beneficial in initially instructing STT, and the progress monitoring guided individually adapted future interventions such as balancing productivity and formal language aspects. Removing the spelling barrier with STT provided an opportunity for students to improve their higher-order skills, such as vocabulary diversity and overall text quality. Furthermore, visible progress, such as the ability to produce longer texts, might motivate continued STT usage. However, such development may not always be immediate.

Assistive technology: Occupational therapy assessment and services for people with dementia

Introduction: Research suggests that services are not effectively providing suitable assistive technology for people with dementia. There is a need to understand the challenges facing practitioners to identify where service changes should be focussed to improve this situation. Method: This study used an online survey to explore the experiences of 41 occupational therapists working with people with dementia, and/or assistive technology. Eight participants subsequently agreed to participate in online discussion groups. Group discussions were transcribed and checked. Data responses from group discussions and open questions in the survey were analysed thematically using the person-centred framework to identify domains supporting or obstructing effective assistive technology service delivery. Results: Forty-one occupational therapist participants described challenges to providing person-centred assistive technology services. These included restricted access to assistive technology interventions, limited knowledge regarding developments in the field, variable funding, unsupportive systems, limited relevant training and difficulties working across health and social care sectors. Conclusion: There is a need to revise the systems surrounding the provision of assistive technology for people with dementia. Occupational therapists need access to training relative to this field, and systems need to be adapted to support the provision of person-centred care by widening access to assistive technology.

A Scoping Review of Studies on Assistive Technology Interventions and Their Impact on Individuals with Autism Spectrum Disorder in Arab Countries.

To review the current literature on the AT interventions and outcomes reported for individuals with ASD in Arab countries. A scoping review adhering to PRISMA guidelines was undertaken to explore the utilization of AT, segmented into three categories: low-technology (low-tech), mid-technology (mid-tech), and high-technology (high-tech) devices. Twelve studies had a pooled sample of 1547 participants, primarily male school-aged children with ASD. The AT applications evaluated ranged from low-tech visual schedules and support to high-tech virtual reality systems. Studies have reported the potential benefits of AT in improving communication, social, academic, adaptive, and functional abilities; however, comparative evidence between AT interventions is limited. The identified barriers to the adoption of AT included caregiver uncertainty about the use of AT and a lack of awareness of AT among professionals and the Arab community in general. Available studies suggest that the adoption of AT can enhance the skills of individuals with ASD in Arab countries. However, more rigorous studies across diverse demographic groups and Arab national regions are needed to strengthen the evidence base and provide appropriate recommendations.

Sensory Processing Differences in Individuals With Autism Spectrum Disorder: A Narrative Review of Underlying Mechanisms and Sensory-Based Interventions.

Autism spectrum disorder (ASD) is a neurodevelopmental condition characterized by difficulties with social interaction and restricted, repetitive patterns of behavior. Altered sensory processing and perception are consideredcharacteristics of ASD. Sensory processing differences (SPDs) are commonly observed in individuals with ASD, leading to atypical responses to sensory stimuli.SPDs refer to the way in which individuals receive, process, and respond to sensory information from the environment. People with SPDs may be hypersensitive (over-reactive) or hyposensitive (under-reactive) to sensory input, or they may experience fragmented or distorted perceptions. These differences can make it difficult for individuals with SPDs to filter out irrelevant sensory information, and to integrate sensory information from different sources. This study intends to investigate the underlying mechanisms contributing to SPDs in individuals with autism and determine the effectiveness of sensory-based therapies in addressing these challenges. The literature suggests that altered neural pathways, sensory gating dysfunction, and atypical sensory modulation contribute to SPDs in individuals with ASD. Assistive technology, environmental changes, and sensory-based interventions like sensory integration therapy (SIT) have all shown promise in improving sensory functioning and reducing associated behavioral issues. However, further research is needed to improve our understanding of sensory processing in autism and to optimize interventions for individuals with ASD.

Assisted Technology and Mental Health

This manuscript discusses the potential use of assistive technology in promoting the mental health and well-being of the growing elderly population in the Arab world. While the use of assistive technology to address physical needs has been around for some time, its use in enhancing mental health and well-being is still in its early days. The manuscript highlights that assistive technology interventions have been shown to benefit the mental health of older adults. However, there are limited publications on the use of assistive technology in the Arab world, and certain assumptions held by healthcare professionals may hinder the access of older adults to these programs. The manuscript suggests introducing the topic of assistive technology in the medical and nursing undergraduate curriculum to address any misconceptions and make the technology more user-friendly. The manuscript also describes two specific types of assistive technology, mental health chatbots, and GPS trackers, and their potential benefits for older adults.

Understanding the use and benefits of assistive devices among young children with cerebral palsy and their families in Norway: a cross-sectional population-based registry study

Purpose Assistive technology intervention has become an important strategy in enhancing function in young children with cerebral palsy. This study aimed to provide an in-depth knowledge of the use of assistive devices by describing their purposes, the environments in which they are used, frequency of use and perceived benefits from the caregiver’s perspective. Material and methods This is a cross-sectional population-based study using data from national cerebral palsy registers in Norway. Of a total of 202 children, 130 participated (mean age 49.9 months, SD 14.0 months). Results The 130 children and their families used a median of 2.5 assistive devices (range 0–12) to support positioning, mobility, self-care and training, stimulation and play. Devices most commonly had one or two main purposes and were used both at home and in kindergarten/school. The usage rate varied from less than twice a week to several times a day. The majority of parents reported significant benefits for caregiving and/or the child’s functioning. Total use increased in accordance with the level of the child’s gross motor limitations and was associated with restrictions imposed by housing concerns. Conclusions The frequent use of a wide range of devices, and the intended and perceived benefits, demonstrates that early provision of assistive devices can be an effective function-enhancing strategy in young children with cerebral palsy. However, the findings also indicate that factors others than the child’s motor abilities must be considered when integrating the use of devices into the child’s daily routines and activities. Implications for Rehabilitation Early provision of assistive devices can be a powerful strategy to support everyday functioning and facilitate care in young children with cerebral palsy. Assistive devices seems to be most effective when they are well integrated into the child’s daily routines and activities across environments. The clinical classifications of motor abilities (Gross Motor Function Classification System and Manual Ability Classification System) can be used to estimate the need for assistive devices, however, factors others than the child’s motor function seem to be critical for optimum effectiveness, such as type of equipment, its physical and social environment and the intended benefits of use.

Assistive Technology and the Wellbeing of Societies from a Capabilities Approach

This Special Issue considers two core facilitators of functioning: assistive technology and environmental intervention [...]

Occupational therapists’ perspectives on an evidence-based, client-centered assistive technology intervention

Introduction: Reviews within the field of assistive technology have shown that a client-centered approach is important for user satisfaction, and that assistive technology service delivery should be evidence-based, systematic, and structured. However, client-centered instruments and systematic, structured models are not used consistently. As part of a larger research project, an evidence-based, client-centered assistive technology service delivery process was developed and piloted. The purpose of this study was to investigate occupational therapists’ perspectives on this evidence-based, client-centered assistive technology intervention. Method: Ten occupational therapists, from two Danish municipalities, participated in focus groups. Data were analyzed based on a hermeneutic approach. Results: Three themes emerged from the analysis: a more refined collaboration with clients; advantages of using theoretical frameworks, structured models and instruments and challenges in using the intervention. Conclusion: By using the evidence-based, client-centered intervention, the occupational therapists found that the collaboration with the clients was refined—more emphasis was placed on shared responsibility. They found that the intervention was time-efficient in the long run; however, there seems to be a particular challenge in designing services that are inclusive of clients with cognitive limitations.

Ações em tecnologia assistiva com mulheres hospitalizadas

Abstract Introduction Hospitalization can render women’s health more fragile for a variety of reasons, potentially impacting their autonomy and independence. Within this scenario, interventions using assistive technology can enhance women’s occupational performance. Objective To discern the assistive technology actions undertaken by occupational therapists for women in hospital settings. Method This descriptive, retrospective, and exploratory study with a quantitative approach was conducted from August to December 2021. It utilized secondary data from 155 medical records of women who received occupational therapy in neurology, oncology, and mental health wards at a university hospital in Recife, state of Pernambuco, Brazil. Instruments included a structured questionnaire for characterization and a checklist to trace assistive technology actions. Data analysis was performed using Microsoft Excel. Results Out of 155, 48 patients benefited from assistive technology interventions by occupational therapists. These interventions included evaluation services, prescription, manufacturing, use guidance, and training. The primary devices were orthoses for upper limbs and aids for activities of daily living in the neurology sector, with cushions being prominent in the oncology sector. A common goal was the enhancement of occupational performance. Conclusion Most assistive technology actions occurred in the oncology and neurology wards, focusing on low-cost products. There is a recognized need to refine the monitoring process for assistive technology use, invest more in assistive technology services, and promote research in this field to generate further evidence.

Assistive Technology Is a Resource for Building Capabilities, but Is It Just Addressing the Symptoms of Inequality?

Advocacy for assistive technology interventions is compatible with the capabilities approach but is insufficient for addressing the disadvantage experienced by people with disability. This paper reflects on equality as an objective of the capabilities approach arising from economics, and it summarises how assistive technology and accessibility are mechanisms for achieving equality in the contemporary legal context of international disability rights. Research and advocacy for assistive technology have failed to communicate a coherent set of actions for policy makers to adopt. Defined concepts and interventions are required to prioritise and coordinate action to support individuals with assistive technology in parallel with improving collective resources by improving accessibility. Radical change in economic paradigms and societal structures that drive poverty and disability may be required for the effective adoption of assistive technology and closure of capability gaps.

Towards Co-Design in Delivering Assistive Technology Interventions: Reconsidering Roles for Consumers, Allied Health Practitioners, and the Support Workforce.

A complexity of factors, from health and technology innovations to policy redesign to achieve consumer-directed care, are impacting traditional roles for Australian allied health practitioners (AHPs). This pilot study considers roles for AHPs in relation to assistive technology (AT) interventions. Articulating 'who does what' may serve a number of purposes including de-professionalization of the discourse; better utilization of support networks and workforces; and alignment with contemporary policy. Yet, a suitable framework to assist with collaborative AT implementation between relevant stakeholders was not identified within the existing literature. This research aimed to develop and pilot an AT collaboration tool which enables AHPs, consumers, their support networks and the support workforce, to navigate policy redesign toward ethical consumer-directed implementation of AT interventions. An AT collaboration tool was developed based upon practice-based knowledge, relevant regulatory and practice evidence and identifies relevant stakeholders, AT service steps and roles, and quality indicators to support competent practice. The tool was piloted in four separate and diverse practice analyses of AT interventions (custom prosthetics, home enteral nutrition, communication devices, and vehicle modifications) considering four allied health professions (prosthetics and orthotics, dietetics, speech pathology, occupational therapy). Pilot testing of the tool supports the feasibility of re-framing AT provision using competency-based and risk-informed approaches and enabling more inclusive roles for consumers and the support workforce. Further testing of the tool is indicated, followed by strategic actions for uptake by individuals, professions and policymakers. The AT collaboration tool has potential to enable AHPs to fulfil ethical obligations for consumer-centered practice, and to facilitate consumer choice, both in Australia and internationally.

Increasing participation in computer activities using eye-gaze assistive technology for children with complex needs

Purpose Eye-gaze assistive technology offers children with severe motor and communication difficulties the opportunity to access and control a computer through eye movements. The aim of this study was to examine the impact of eye-gaze assistive technology intervention on participation in computer activities and technology usability among children with complex needs in Taiwan. Materials and methods This study involved a multiple baseline design across individuals. The participants were four children aged three to six years with severe motor and communication difficulties and low eye-control skills. The six-month intervention consisted of two collaborative team meetings and 12 individual supports to facilitate the use of eye-gaze assistive technology at home or in educational environments. Participation in computer activities (diversity, frequency, and duration) was repeatedly measured through a computer use diary. Other outcomes included assessments of goal achievements and parents/teachers’ ratings on children’s performance in computer activities. Results The young children increased the diversity of their computer activities and their frequency and duration of computer use from baseline to the intervention phase. The children attained six of eight predefined goals related to play, communication, and school learning. Parents and teachers perceived the children’s changes in performance as meaningful. Conclusion This study strengthens the evidence that eye-gaze assistive technology is useful in everyday contexts for children with complex needs in Taiwan. The findings add knowledge that children with weak eye-control skills increased participation in computer activities as a result of the eye-gaze assistive technology. Implications for Rehabilitation Eye-gaze assistive technology (EGAT) as an access method to control a computer can provide opportunities for children with severe motor and communication difficulties to participate in computer activities. Children with severe motor and communication difficulties and low eye-control skills with sufficient practice can learn to use EGAT for communication and learning, with support from stakeholders and collaborative service. EGAT could be introduced for children with complex needs at early ages as a means of using computers for play, communication, and school learning, which could be helpful for later education and learning. Stakeholders in educational environments could include EGAT in educational computer systems so that pupils with severe motor and communication difficulties could interact with a computer, thereby enhancing their engagement and learning.

Change in care hours, cost, and functional independence following continence and assistive technology intervention in an acquired brain injury population

Purpose After acquired brain injury (ABI) dependence on intervention for continence management is common. This preliminary investigation aimed to (i) quantify toileting care hours and costs in a community-based ABI rehabilitation and disability setting, and (ii) measure change in care needs, costs, and functional independence after intervention with assistive technologies (ATs). Method Pragmatic pre-post intervention pilot study of 14 adults with ABI and toileting disability accessing community-based neurorehabilitation or disability support in Western Australia. Toileting and functional independence were assessed monthly from baseline (T 0) to 3-month follow-up (T 3). Basic and nursing care hours (Northwick Park Dependency Score), cost of care estimates (Northwick Park Care Needs Assessment), functional independence (Functional Independence and Assessment Measure), and cost of consumables were examined pre- and post-intervention with ATs. Multilevel mixed-effects models with bootstrap estimation were conducted. Results Cost of consumables significantly declined (AU$69/week), and functional independence significantly improved following intervention (+23.5 points). There was a non-significant reduction in care needs for toileting (4 h/week) and in the cost of toileting care (AU$633/week). Conclusion Toileting disability substantially impacts care hours and costs. This study provides preliminary evidence that comprehensive continence management is beneficial in reducing costs and supporting people with an ABI to increase their independence. IMPLICATIONS FOR REHABILITATION A comprehensive continence assessment and management plan reduces the number of care hours, cost of care, and cost of continence products in a neurorehabilitation and disability support sample for people with acquired brain injury (ABI). Assistive technologies for continence management are beneficial in supporting people with ABI to increase independence, and reduce costs. Providing comprehensive continence assessment and management plan reduces reliance on staff for continence care, and improves functional independence.

Assessing the usefulness of an mHealth strategy to support implementation of multi-faceted adaptive feeding interventions by community-based rehabilitation workers

ABSTRACT To assess the usefulness of an mHealth strategy to support assimilation of adaptive feeding interventions into daily practices of community-based rehabilitation (CBR) workers. The mHealth strategy was evaluated in a 4-week field test. At baseline, all participants received a 1-hour, hands-on training on adaptive feeding techniques. The intervention group (n = 12) subsequently received smartphones pre-loaded with training and demonstration videos; control group members (n = 12) did not. All were instructed to recommend adaptive feeding interventions to families on their caseload when appropriate. Both groups received weekly calls to monitor progress and discussed their experiences in post-study focus groups. The intervention group saw over twice the number of families with a child with cerebral palsy compared to the control group. For intervention group members, on-demand access to the videos increased their overall usefulness in everyday practice, enhanced their self-confidence, clarified their recommendations, and increased credibility with caregivers. In contrast, control group members implemented the adaptive feeding strategies less frequently and less confidently. mHealth strategies are a promising option for supporting geographically dispersed CBR workers implementing multi-faceted assistive technology interventions. The portability of video content reinforced learning, increased implementation of the adaptive feeding interventions, and enhanced communication with consumer.

Educating rehabilitation professionals on clinical skills for postural care services: A scoping review.

Background: This scoping review aims to identify evidence-based practices for educating rehabilitation professionals who provide assistive technology interventions, specifically night-time postural care, to children with cerebral palsy.Methods: A review of both peer-reviewed and grey literature published between 2000 and 2021 was undertaken in June 2021. The articles were analyzed using a process outlined by Arksey and O’Malley in 2005: scanning abstracts, completing initial and critical reviews, collating and summarizing data into themes.Results: The search resulted in 15 articles, predominantly from the United Kingdom and the United States: 10 primary research, two reviews, two conceptual/theoretical, and one gray-literature source. Four themes emerged (1) Successful service delivery required competence, (2) Benefits of incorporating practice, collaboration, and feedback, (3) Effective online education through multifactorial approaches, (4) Considering different learning requirements among team members.Conclusions: There’s beginning evidence that rehabilitation professionals’ competence with night-time postural care might be achieved via active, interactive, multi-factorial online training.

INTERVENTION OF ASSISTIVE TECHNOLOGY ON PERFORMANCE OF VISUALLY IMPAIRED STUDENTS IN KISWAHILI LANGUAGE IN PUBLIC PRIMARY TEACHERS’ COLLEGES IN KENYA

Education is a universal right to all including those with disabilities. Students with visual impairments can struggle with a wide variety of challenges in a mainstreamed classroom setting. Assistive Technology intervention by use of assistive devices in teaching, use of assistive teaching methods, taking care of visually impaired severity and boosting positively the student-teacher related factors improve their performance. The purpose of this study was to examine the intervention of Assistive Technology on performance of Visually Impaired students in Kiswahili in Public Primary Teachers’ Colleges in Kenya. The paper adopts a quasi-experimental design by use of a pre-test and post-test. It has been appropriate to analyze the treatment effect of using AT in teaching VI students in one group while applying the natural teaching methods on the control group. The target population was three teachers’ colleges in Kenya (Asumbi, Machakos and Mosoriot). A standardized examination was given to the two groups. Another examination was given to the two groups after giving one group a treatment of use of discussion groups, peer consultation and use of teacher assistive teams. The AT devices were critical in teaching VI students in order to improve their performance in languages and therefore their adequacy in college determined the rate of students’ performance. The researcher found out that the attitude of the teachers in teaching VI students was positive but the challenges in ensuring quality teaching of Languages included the students having a negative attitude towards languages, teachers have a negative attitude towards their career and lack of adequate teaching and learning materials. The researcher found out that the most significant methods that the teachers used to teach Languages to students with VI were: lectures, assignments and group discussions. The findings inferred that the partially blind students were better suited for the natural teaching methods than the totally blind students as they performed higher when taught using natural teaching methods. The paper recommends that the management of tertiary institutions should invest on interventions like the assistive technology in enhancing their academic performance. The researchers further recommends that other strategies for teaching VI students like use of peer consultations between the VI students with sighted students, use of quieter rooms, teacher assistance teams; extended exam time for VI students and shorter assignments to the VI students should also be employed to enhance Language to students with visual impairment. The significance of the study is that AT device intervention such as use of digital recorder in teaching can improve students’ academic performance.

Collective making: Co-designing 3D printed assistive technologies with occupational therapists, designers, and end-users

ABSTRACT In this study, we conducted four participatory workshops to facilitate co-designing 12 writing assistive technology (AT) interventions with occupational therapists, industrial designers, and an end-user with physical impairments. We observed participants’ activities during the workshops and held a post-workshop follow-up reflection session where we invited the OTs and the end-user to share their experience about the co-design activities and co-created devices. The study findings revealed characteristics of the clinical-technical-individual co-design contributions that are conducive to the collective making of usable and useful AT prototypes. We propose CoDEA (Codesigning Assistive Technologies), a potential framework that offers to follow four stages of co-experimentation, co-development, co-evaluation, and co-refinement and define specific roles and activities of OT-designer-user in each step to co-design 3D printed ATs successfully. We recommend utilizing a comprehensive approach to co-designing ATs by using prototyping toolkits/3D printing together with a designerly way of thinking to achieve state-of-the-art AT solutions.

A TRIZ-driven conceptualisation of finger grip enhancer designs for the elderly

Background: Elderly people with severe finger weakness may need assistive health technology interventions. Finger weakness impedes the elderly in executing activities of daily living such as unbuttoning shirts and opening clothes pegs. While studies have related finger weakness with ageing effects, there appears to be no research that uses an algorithmic problem-solving approach such as the theory of inventive problem-solving (TRIZ) to recommend finger grip assistive technologies that resolve the issue of finger weakness among the elderly. Using TRIZ, this study aims to conceptualise finger grip enhancer designs for elderly people. Methods: Several TRIZ tools such as the cause-and-effect chain (CEC) analysis, engineering contradiction, physical contradiction, and substance-field analysis are used to conceptualise solutions that assist elderly people in their day-to-day pinching activities. Results: Based on the segmentation principle, a finger assistant concept powered by a miniature linear actuator is recommended. Specific product development processes are used to further conceptualise the actuation system. The study concluded that the chosen concept should use a DC motor to actuate fingers through tendon cables triggered by a push start button. Conclusions: Finger pinch degradation worsens the quality of life of the elderly. A finger grip enhancer that assists in day-to-day activities may be an effective option for elderly people, not only for their physical but also their mental well-being in society.

A TRIZ-driven conceptualisation of finger grip enhancer designs for the elderly.

Background: Elderly people with severe finger weakness may need assistive health technology interventions. Finger weakness impedes the elderly in executing activities of daily living such as unbuttoning shirts and opening clothes pegs. While studies have related finger weakness with ageing effects, there appears to be no research that uses an algorithmic problem-solving approach such as the theory of inventive problem-solving (TRIZ) to recommend finger grip assistive technologies that resolve the issue of finger weakness among the elderly. Using TRIZ, this study aims to conceptualise finger grip enhancer designs for elderly people. Methods: Several TRIZ tools such as the cause-and-effect chain (CEC) analysis, engineering contradiction, physical contradiction, and substance-field analysis are used to conceptualise solutions that assist elderly people in their day-to-day pinching activities. Results: Based on the segmentation principle, a finger assistant concept powered by a miniature linear actuator is recommended. Specific product development processes are used to further conceptualise the actuation system. The study concluded that the chosen concept should use a DC motor to actuate fingers through tendon cables triggered by a push start button. Conclusions: Finger pinch degradation worsens the quality of life of the elderly. A finger grip enhancer that assists in day-to-day activities may be an effective option for elderly people, not only for their physical but also their mental well-being in society.

Assistive technology and telecare to maintain independent living at home for people with dementia: the ATTILA RCT.

Assistive technology and telecare have been promoted to manage the risks associated with independent living for people with dementia, but there is limited evidence of their effectiveness. This trial aimed to establish whether or not assistive technology and telecare assessments and interventions extend the time that people with dementia can continue to live independently at home and whether or not they are cost-effective. Caregiver burden, the quality of life of caregivers and of people with dementia and whether or not assistive technology and telecare reduce safety risks were also investigated. This was a pragmatic, randomised controlled trial. Blinding was not undertaken as it was not feasible to do so. All consenting participants were included in an intention-to-treat analysis. This trial was set in 12 councils in England with adult social services responsibilities. Participants were people with dementia living in the community who had an identified need that might benefit from assistive technology and telecare. Participants were randomly assigned to receive either assistive technology and telecare recommended by a health or social care professional to meet their assessed needs (a full assistive technology and telecare package) or a pendant alarm, non-monitored smoke and carbon monoxide detectors and a key safe (a basic assistive technology and telecare package). The primary outcomes were time to admission to care and cost-effectiveness. Secondary outcomes assessed caregivers using the 10-item Center for Epidemiological Studies Depression Scale, the State-Trait Anxiety Inventory 6-item scale and the Zarit Burden Interview. Of 495 participants, 248 were randomised to receive full assistive technology and telecare and 247 received the limited control. Comparing the assistive technology and telecare group with the control group, the hazard ratio for institutionalisation was 0.76 (95% confidence interval 0.58 to 1.01; p = 0.054). After adjusting for an imbalance in the baseline activities of daily living score between trial arms, the hazard ratio was 0.84 (95% confidence interval 0.63 to 1.12; p = 0.20). At 104 weeks, there were no significant differences between groups in health and social care resource use costs (intervention group - control group difference: mean -£909, 95% confidence interval -£5336 to £3345) or in societal costs (intervention group - control group difference: mean -£3545; 95% confidence interval -£13,914 to £6581). At 104 weeks, based on quality-adjusted life-years derived from the participant-rated EuroQol-5 Dimensions questionnaire, the intervention group had 0.105 (95% confidence interval -0.204 to -0.007) fewer quality-adjusted life-years than the control group. The number of quality-adjusted life-years derived from the proxy-rated EuroQol-5 Dimensions questionnaire did not differ between groups. Caregiver outcomes did not differ between groups over 24 weeks. Compliance with the assigned trial arm was variable, as was the quality of assistive technology and telecare needs assessments. Attrition from assessments led to data loss additional to that attributable to care home admission and censoring events. A full package of assistive technology and telecare did not increase the length of time that participants with dementia remained in the community, and nor did it decrease caregiver burden, depression or anxiety, relative to a basic package of assistive technology and telecare. Use of the full assistive technology and telecare package did not increase participants' health and social care or societal costs. Quality-adjusted life-years based on participants' EuroQol-5 Dimensions questionnaire responses were reduced in the intervention group compared with the control group; groups did not differ in the number of quality-adjusted life-years based on the proxy-rated EuroQol-5 Dimensions questionnaire. Future work could examine whether or not improved assessment that is more personalised to an individual is beneficial. Current Controlled Trials ISRCTN86537017. This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 25, No. 19. See the NIHR Journals Library website for further project information.