Electronic Assistive Technology Research Articles

Near prescribing trends in two low vision rehabilitation clinics over a ten-year period

ABSTRACT Clinical relevance Optical magnification (OM), electronic magnification (EM), and assistive technology (AT) can be prescribed in low vision rehabilitation (LVR) clinics for near vision goals of patients. This study shows the prescription of OM has not decreased with increased availability of EM and AT. Background Near visual goals are a primary concern for patients with visual impairment. LVR providers can prescribe OM, EM and/or AT to help. With the rapid evolution and availability of EM and AT, we aim to evaluate if there have been changes in the prescription patterns of clinicians with respect to OM over time. We hypothesise that the increased availability of technology may result in declining prescriptions of OM and increasing prescription of EM and AT over time. Methods This retrospective study investigated near prescribing between 2008–2017 for 530 new patients to the LVR clinics. Examinations were performed by optometrists specialising in low vision. Near devices prescribed included OM and EM and AT. Results Most patients attending the LVR clinics were female, over 60 years old and had age related macular degeneration. Near visual goals were a primary concern of 97.2% of the patients. OM was most prescribed in the 0–19 and >60-year-old age groups. Within the 20–39-year-old age group there was the greatest number of both EM and AT prescriptions. OM was most prescribed in patients with visual acuity better than 6/60. EM and AT showed a trend of increasing prescription as visual acuity decreased. EM prescription peaked in <6/60 to 6/240 category while AT trended upwards from <6/21 to no light perception and peaked in patients with no light perception. Referral rates for additional rehabilitation services were 75.7%. Conclusions This study shows that the prescription of OM is not declining even as the prescription and the breadth of electronic magnification and assistive technology available is expanding. OM continues to be a viable option for patients, especially in the youngest and oldest cohorts.

Evaluation of the Effectiveness of Assistive Technology for Executive Function Support for People With Acquired Brain Injury: Protocol for Single-Case Experimental Designs.

Executive function, including prospective memory, initiating, planning, and sequencing everyday activities, is frequently affected by acquired brain injury (ABI). Executive dysfunction necessitates the use of compensatory cognitive strategies and, in more severe cases, human support over time. To compensate for the executive dysfunction experienced, growing options for electronic mainstream and assistive technologies may be used by people with ABI and their supporters. We outline the study protocol for a series of single-case experimental designs (SCEDs) to evaluate the effectiveness of smart home, mobile, and/or wearable technologies in reducing executive function difficulties following ABI. Up to 10 adults with ABI who experience executive dysfunction and have sufficient cognitive capacity to provide informed consent will be recruited across Victoria and New South Wales, Australia. Other key inclusion criteria are that they have substantial support needs for everyday living and reside in community dwellings. On the basis of the participant's identified goal(s) and target behavior(s), a specific electronic assistive technology will be selected for application. Both identification of the target behavior(s) and selection of the assistive technology will be determined via consultation with each participant (and their key support person, if applicable). The choice of SCED will be individualized for each participant based on the type of technology used in the intervention, the difficulty level of the behavior targeted for change, and the anticipated rate of change. For each SCED, repeated measurements of the target behavior(s) during the baseline condition will provide performance data for comparison with the performance data collected during the intervention condition (with technology introduced). Secondary outcome measures will evaluate the impact of the intervention. The protocol includes 2 customizable Microsoft Excel spreadsheets for electronic record keeping. Recruitment period is June 2022 through March 2024. Trial results for the individual participants will be graphed and analyzed separately using structured visual analysis supplemented with statistical analysis. Analysis will focus on important features of the data, including both within- and between-phase comparisons for response level, trend, variability, immediacy, consistency, and overlap. An exploratory economic evaluation will determine the impact on formal and informal support usage, together with quality of life, following the implementation of the new technological intervention. The study has been designed to test the cause-effect functional relationships between the intervention-in this case, electronic assistive technology-and its effect in changing the target behavior(s). The evaluation evidence gained will offer new insights into the application of various electronic assistive technologies for people who experience executive dysfunction following ABI. Furthermore, the results will help increase the capacity of key stakeholders to harness the potential of technology to build independence and reduce the cost of care for this population. Australian New Zealand Clinical Trials Registry (ANZCTR) ACTRN12622000835741, https://www.anzctr.org.au/ACTRN12622000835741.aspx. DERR1-10.2196/48503.

Comparative Study of Third Eye for Visually Challenged with Alternate Solution

Deficiency that cannot be reformed in the eye is the blindness. This research aims to investigate the potential benefits and limitations of incorporating electronic sensors and assistive technologies into traditional blind sticks to create a smart blind stick. A smart blind stick is a wearable device that provides additional functionality and features to help visually impaired individuals navigate their surroundings more safely and independently. A smart stick is planned with impediment identification module and object detection. A stick is made in a way that it can sense obstacles and staircases by using sensors. It also intimates the presence of water and manhole. Global Positioning System (GPS) is used to locate the visually impaired person as it is incorporated in the stick used. Global system for Mobile Communication (GSM) is also used. Status of the blind person will be notified to the guardian with the image and location. Overall, this research contributes to the development and improvement of assistive technologies for visually impaired individuals and provide insights for researchers, healthcare professionals, and policymakers on how to better support individuals with visual impairments.

Influence of Electronic Communication Devices, Assistive Technologies, and Internet Use on Social Integration of Individuals Living With Tetraplegia

Abstract Date Presented 04/02/2022 The aim is to examine whether electronic communication devices (ECDs), assistive technology (AT), and Internet use increases the odds of high social integration (HSI) after tetraplegia injury. A binary logistic regression determined the use of ECD, AT, and Internet increased the odds of HSI by 300% after tetraplegia injury. Prioritizing ECD independence in this population by evaluating and addressing AT needs could significantly improve access to socialization opportunities and participation. Primary Author and Speaker: Stephanie Kubiak Contributing Authors: Elliot Sklar

Electronic assistive technology use and supported employment.

Level of electronic assistive technology use by people with intellectual disabilities is lower than for other disability groups. In this mixed-methods exploratory study during the pandemic, staff (online survey) and executive administration (focus group) from a regional supported employment service provider in the Midwest US were surveyed about use of and barriers to use of electronic assistive technology for their clients with intellectual disabilities. Forty percent of staff reported 'not' using any of the assistive technologies with their clients. Executive administration perceived that they should be providing technology resources to clients and staff. Both groups rated expense, access, and complexity as barriers to assistive technology use at the client's worksite. Identifying the types of assistive technologies that can be most easily accessed and most cost-effective, including lower-cost consumer market devices, as employment supports for people with intellectual disabilities may be a first step in helping to overcome perceived barriers to use.

A Human-Machine Interface for Electronic Assistive Technologies

Human-machine interaction (HMI) refers to the two-way exchange of information and actions between a human and a machine via the latter's user interface. Gestures and other forms of natural user interfaces are becoming increasingly popular because they allow humans to interact with technology in ways that feel more natural to them. Gesture-based HMI uses a sensor like the Microsoft Kinect to detect human motion and posture, which is then translated into machine input. Using Kinect's data—which includes RGB (red, green, and blue), depth, and skeleton information—to recognize meaningful human motions is the core function of gesture-based HMI. This article provides an introduction of electronic assistive technologies (EATs) and discusses the importance of human-machine interfaces (HMIs) in their development. HMIs for EATs must consider accessibility, personalization, safety, and user-centered design elements to meet the needs and preferences of users with disabilities or limited mobility. There are benefits and drawbacks to using each type of human-machine interface currently in use, such as brain-computer interfaces, touchscreens, switches, and sensors, and voice recognition software. Good design has the potential to increase the usability and performance of these technologies, as evidenced by studies of successful HMIs in EATs. Constant research and improvement of HMIs for EATs is necessary to increase accessibility and quality of life for people with impairments or restricted mobility.

Carers’ involvement in telecare provision by local councils for older people in England: perspectives of council telecare managers and stakeholders

AbstractThis paper explores telecare manager and other ‘stakeholder’ perspectives on the nature, extent and impact of family and other unpaid/informal carers’ involvement in the provision of telecare equipment and services for older people. Data used in the paper are derived from a larger study on telecare provision by local councils in England. The paper aims to add to the growing evidence about carers’ engagement with electronic assistive technology and telecare, and considers this in the context of typologies of professionals’ engagement with carers. How carers are involved in telecare provision is examined primarily from the perspectives of senior managers responsible for telecare services who responded to an online survey and/or were interviewed in 2016 as part of a wider study. The perspectives of three unpaid carers were captured in a separate strand of the main study, which comprised more detailed case study interviews within four selected councils. Thematic and comparative analysis of both qualitative and quantitative survey data revealed the varied involvements and responsibilities that carers assumed during the telecare provision process, the barriers that they needed to overcome and their integration in local council strategies. Findings are discussed in the context of Twigg and Atkin's typology of carer support. They suggest that carers are mainly perceived as ‘resources’ and involvement is largely taken for granted. There are instances in which carers can be seen as ‘co-workers’: this is mainly around responding to alerts generated by the telecare user or by monitored devices, but only in those councils that fund response services. Though some participants felt that telecare devices could replace or ‘supersede’ hands-on care that involved routine monitoring of health and wellbeing, it was also acknowledged that its use might also place new responsibilities on carers. Furthermore, the study found that meeting carers’ own rights as ‘co-clients’ was little acknowledged.

A joint-feature learning-based voice conversion system for dysarthric user based on deep learning technology.

Dysarthria speakers suffer from poor communication, and voice conversion (VC) technology is a potential approach for improving their speech quality. This study presents a joint feature learning approach to improve a sub-band deep neural network-based VC system, termed J_SBDNN. In this study, a listening test of speech intelligibility is used to confirm the benefits of the proposed J_SBDNN VC system, with several well-known VC approaches being used for comparison. The results showed that the J_SBDNN VC system provided a higher speech intelligibility performance than other VC approaches in most test conditions. It implies that the J_SBDNN VC system could potentially be used as one of the electronic assistive technologies to improve the speech quality for a dysarthric speaker.

Technology combined with expert, relationship-based care.

In his Systems, Not Structures report, minister for health in Northern Ireland (NI) Raphael Bengoa notes: 'Advances in telecare, telemonitoring and electronic assistive technologies are making a significant difference to the way services are delivered. Used effectively, they can make a valuable contribution to the quality of services by improving coordination of services, overcome geographical distances between patients and providers, enable patients to live independent lives for longer and engage patients in their own health and well-being.' After setting out the UK and NI contexts for electronic assistive technologies, this article reflects on the role of triage nurses as 'e-nurses' in the former NI remote telemonitoring service model. It aims to provide nurses involved in service transformation and workforce planning opportunities to consider how e-nurses and 'virtual care' could transform care delivery, while empowering patients.

The use of electronic assistive technology for social networking by people with disability living in shared supported accommodation

Background: This study aimed to examine use of electronic assistive technology for social networking by people with disability living in shared supported accommodation (SSA), and compare participants’ Electronic Social Networking (ESN) integration with Australian ESN normative data.Method: Telephone surveys and the ESN subscale of the Community Integration Questionnaire-Revised (CIQ-R) were administered with SSA managers. Surveys gathered demographic data, and data on Internet access, technology use and ESN integration, of 91 people with disability who were identified technology users and living in SSA. Participant ESN data were then matched with existing CIQ-R ESN normative data (N = 359). Relative risk of reduced ESN integration was calculated.Results: This study identified that, despite access to mainstream technologies, people with disability living in SSA experience low ESN integration, and use ESN for social contact less than other Australians. This group were 210% more likely to report reduced ESN integration than the matched normative sample when key demographic variables were held constant.Conclusions: Factors related to disability, including high care and support needs and greater time spent completing essential activities of daily living (such as personal care), may explain the low electronic social networking integration for people with disability living in SSA identified in this study. Further research that examines factors that influence ESN access and use following disability is necessary to inform practice to bridge the digital divide that exists between this group and other Australians.

Randomized Trial of Tablet Computers for Education and Learning in Children and Young People with Low Vision.

SIGNIFICANCEMobile devices such as tablet computers have become widely available as mainstream devices and are also used in some schools, but there is an absence of robust information regarding the efficacy of any optical/electronic low vision device or tablet computer in supporting education of young people with low vision.PURPOSEA randomized controlled trial (RCT) is needed to measure the impact of tablet computers on education, specifically on independent access to educational material, in children and young people with low vision. We conducted a pilot RCT to determine the feasibility of conducting a full-scale trial.METHODSThis was a randomized multicenter pilot trial across two sites in the United Kingdom and one site in India. Forty children and young people aged 10 to 18 years with low vision (best-corrected visual acuity for distance between <20/60 [0.48 logMAR] and 20/400 [1.30 logMAR] in the better eye) in the United Kingdom (n = 20) and India (n = 20) were randomized to two parallel arms, with a 1:1 allocation ratio, to control (n = 20) or intervention (n = 20). Control group participants received standard low vision care. The intervention group received a tablet computer (iPad) with low vision applications and instruction in its use, including accessibility features. Four primary outcomes included (1) 6-month recruitment rate, (2) retention of participants for 3 months, (3) acceptance/usage of device, and (4) accessibility of device.RESULTSNineteen participants (95%) enrolled within 6 months in the United Kingdom, and 20 participants (100%), in India. Retention at 3 months was 85% (n = 17) in the United Kingdom and 95% (n = 19) in India. More than one half of participants reported using a tablet computer at school at least once every day. The majority (90%) found it easily accessible.CONCLUSIONSThis study demonstrated that it is feasible to recruit children and young people with low vision into an international multicenter RCT of electronic assistive technology. Regardless of geographical location, children and young people with low vision reported using tablet computers at least once a day at school and accessed them easily.

Digital Revolution – Implementation of an Electronic Assistive Technology Pilot Project in a Neuro-Rehabilitation Setting

Introduction: Electronic Assistive Technology (EAT) including communication devices, environmental control systems and personal computers have always been seen an important component of patients’ rehabilitation. At the National Rehabilitation Hospital (NRH) this inclusion of EAT had been largely unsystematic and challenging due to limited EAT knowledge and skill. In addition inefficiencies in trialing equipment without technical support had prevented timely access to EAT. This paper describes a developing integrated EAT service. Context: The Electronic Assistive Technology (EAT) Clinic is a joint Occupational Therapy (OT) & Speech and Language Therapy (SLT) service. Referrals are received from speech & language therapists or occupational therapists. The clinic offers assessment, trial, loan and support services for electronic assistive devices for inpatients across all NRH Programs (Brain Injury, Spinal Cord Injury, Prosthetic and Orthotic Rehabilitation and Peadiatrics). Key Objectives of the EAT clinic: To deliver an effective and efficient EAT service to meet the needs of the population of inpatients within the NRH. Develop systems to ensure that clinic staff are continuously up-skilled in the rapidly developing area of EAT in order to ensure highest quality service provision for patients To provide access to technology that can enable independence for patients and create efficiencies in providing the most appropriate EAT solution. Provide EAT recommendations and/or solutions to patients upon discharge. Outcomes of the Project to date: The EAT clinic has progressed through investment in stock, securing a physical clinic space, upskilling key staff, allocation of protected staff time and the approval of a therapy assistant. This pilot has resulted in onsite delivery of individualised EAT solutions for inpatients by Occupational Therapy (OT) and Speech and Language Therapy (SLT) Departments. There have been significant cost savings in terms of staff time as well as a reduction in the number of inappropriate devices being purchased. Service users now have the opportunity to engage in assessment with an EAT team and trial one or more EAT solutions during their rehabilitation. In addition the clinic provides education for less experienced clinicians, patients and their families. Future Plans: Global increasing digital literacy demands that EAT be seamlessly integrated into rehabilitation settings. This EAT Clinic plays an important role in the promotion and adoption of mainstream technology devices and specialised assistive technology devices to improve patient outcomes. The continued aim of the EAT Clinic is to provide service-users with the opportunity to experience electronic assistive technologies during their rehabilitation while being supported by skilled therapists. A business plan has been composed to support contingency planning for the service into the future as well as identifying opportunities for continuing professional development and developing specialisations in the area of EAT.

An exploration of the experience of using calendar reminders for people with dementia and family carers

People with dementia and family carers often use calendars to support time orientation to maintain routine. However, little is known about the use of calendars as a compensatory strategy. This study examines the experience and practicalities of using calendar reminders from the perspective of people with dementia and family carers. Six dyads were recruited and interviewed at home. Interpretative Phenomenological Analysis was used to develop a narrative interpreted from an occupational therapy perspective. The themes were reflected on during two subsequent focus groups. Findings suggested that calendars are used either intensively as external memory records or more casually and randomly for reassurance. The familiarity and location of the calendar and its utility to the person with dementia and carer, all contribute to its efficacy. For carers the experience of supporting calendar reminders encompasses practical, cognitive and emotional effort. There was little awareness amongst participants of electronic assistive technology.

A systematic review of electronic assistive technology within supporting living environments for people with dementia.

Health and social care provision needs to change in order to meet the needs of an increase in the number of people living with dementia. Environmental design, technology and assistive devices have the potential to complement care, help address some of the challenges presented by this growing need and impact on the lived experience of this vulnerable population. This systematic review was undertaken to identify the research on the use of electronic assistive technology within long-term residential care settings. A total of 3229 papers published from the inception of each of the databases up until May 2016 were retrieved from searches in four major databases. Sixty-one were identified to be included in the review. The inclusion criteria were: original peer reviewed journals; an electronic assistive technology intervention; with residents or tenants living with dementia or their family or paid caregivers; in supported living environments or residential care. The data extracted from the included studies focused on the methodology, technology, outcomes and the role of people living with dementia within the research. Overall, an extensive variety of technical interventions were found, with a broad range of methodological heterogeneity to explore their effect. Additionally, wide-spanning outcomes to support the potential of technology solutions and the challenges presented by such intervention were found.

Electronic assistive technology use in Australian shared supported accommodation: rates and user characteristics

Electronic assistive technologies (EATs) are fast becoming considered an essential component of everyday life. To date, there has been little research on the use of EAT by people living in shared supported accommodation (SSA), one of the major community-based housing options for people with disability (PwD) in Australia. This study aimed to (1) audit current EAT use by PwD living in SSA, (2) describe the impact of Internet access on EAT use, and (3) examine potential relationships between individual characteristics and EAT use. A customized survey administered with 32 house managers, representing 52 SSAs, gathered data on the EAT use of 254 people. Only 45.7% of residents used EAT, and devices available to the mainstream market were most frequently used. Access to home-based Internet was not a predictor of the number of devices in use. Disability type (congenital or acquired) was found to be significantly correlated with the number of devices in use, however, associations across a number of variables suggest complex mediational interactions. These findings provide an insight into the EAT use trends of PwD living in SSA, indicating that further work needs to be done to support the uptake and continued use of EAT by PwDImplications for RehabilitationFurther work needs to be done to promote the uptake and use of electronic assistive technology (EAT) by people with disability (PwD).Personal characteristics and experiences need to be considered in the prescription of EAT to PwD, as these may explain variations in use between individuals.

Assistive technology for memory support in dementia.

The sustained interest in electronic assistive technology in dementia care has been fuelled by the urgent need to develop useful approaches to help support people with dementia at home. Also the low costs and wide availability of electronic devices make it more feasible to use electronic devices for the benefit of disabled persons. Information Communication Technology (ICT) devices designed to support people with dementia are usually referred to as Assistive Technology (AT) or Electronic Assistive Technology (EAT). By using AT in this review we refer to electronic assistive devices. A range of AT devices has been developed to support people with dementia and their carers to manage their daily activities and to enhance safety, for example electronic pill boxes, picture phones, or mobile tracking devices. Many are commercially available. However, the usefulness and user-friendliness of these devices are often poorly evaluated. Although reviews of (electronic) memory aids do exist, a systematic review of studies focusing on the efficacy of AT for memory support in people with dementia is lacking. Such a review would guide people with dementia and their informal and professional carers in selecting appropriate AT devices. Primary objectiveTo assess the efficacy of AT for memory support in people with dementia in terms of daily performance of personal and instrumental activities of daily living (ADL), level of dependency, and admission to long-term care. Secondary objectiveTo assess the impact of AT on: users (autonomy, usefulness and user-friendliness, adoption of AT); cognitive function and neuropsychiatric symptoms; need for informal and formal care; perceived quality of life; informal carer burden, self-esteem and feelings of competence; formal carer work satisfaction, workload and feelings of competence; and adverse events. We searched ALOIS, the Specialised Register of the Cochrane Dementia and Cognitive Improvement Group (CDCIG), on 10 November 2016. ALOIS is maintained by the Information Specialists of the CDCIG and contains studies in the areas of dementia prevention, dementia treatment and cognitive enhancement in healthy people. We also searched the following list of databases, adapting the search strategy as necessary: Centre for Reviews and Dissemination (CRD) Databases, up to May 2016; The Collection of Computer Science Bibliographies; DBLP Computer Science Bibliography; HCI Bibliography: Human-Computer Interaction Resources; and AgeInfo, all to June 2016; PiCarta; Inspec; Springer Link Lecture Notes; Social Care Online; and IEEE Computer Society Digital Library, all to October 2016; J-STAGE: Japan Science and Technology Information Aggregator, Electronic; and Networked Computer Science Technical Reference Library (NCSTRL), both to November 2016; Computing Research Repository (CoRR) up to December 2016; and OT seeker; and ADEAR, both to February 2017. In addition, we searched Google Scholar and OpenSIGLE for grey literature. We intended to review randomised controlled trials (RCTs) and clustered randomised trials with blinded assessment of outcomes that evaluated an electronic assistive device used with the single aim of supporting memory function in people diagnosed with dementia. The control interventions could either be 'care (or treatment) as usual' or non-technological psychosocial interventions (including interventions that use non-electronic assistive devices) also specifically aimed at supporting memory. Outcome measures included activities of daily living, level of dependency, clinical and care-related outcomes (for example admission to long-term care), perceived quality of life and well-being, and adverse events resulting from the use of AT; as well as the effects of AT on carers. Two review authors independently screened all titles and abstracts identified by the search. We identified no studies which met the inclusion criteria. This review highlights the current lack of high-quality evidence to determine whether AT is effective in supporting people with dementia to manage their memory problems.

Electronic assistive technology used by people with acquired brain injury in shared supported accommodation: Implications for occupational therapy

Introduction People with severe acquired brain injury often require lifetime support, sometimes received from paid workers if living in shared supported accommodation. Electronic assistive technology may offer a less intrusive method of support that can enable autonomous participation and deliver cost savings. However, research on rates, barriers, and facilitators of electronic assistive technology uptake is lacking. This study aimed to identify electronic assistive technology types used by people with acquired brain injury living in shared supported accommodation, assess user satisfaction and psychosocial impact of electronic assistive technology, detail the impact of technology use on respondents’ participation and support needs, and describe barriers and/or facilitators to electronic assistive technology uptake and ongoing use. Method Participants were identified electronic assistive technology users with acquired brain injury living in shared supported accommodation in Australia ( N = 22). Mixed methods data were collected using semi-structured interviews and published measures of support need, electronic assistive technology satisfaction, and psychosocial impact. Results Participants reported satisfaction with the devices they used, and positive psychosocial outcomes. Areas impacted by electronic assistive technology, key facilitators and barriers to electronic assistive technology use, and implications for occupational therapists working to deliver electronic assistive technology solutions were identified. Conclusion Electronic assistive technology use by this group can positively influence both everyday functioning and participation. Skilled prescription and ongoing support services are necessary to maximise uptake and use.

Portable electronic assistive technology to improve vocational task completion in young adults with an intellectual disability: A review of the literature.

This article summarizes a review of empirical literature from 2000 to 2015 that involved the use of specific portable technology to support persons with an intellectual disability in completing work-related tasks. Nineteen studies were identified for review, with an emphasis on the identification of (a) the characteristics of participants and settings, (b) the types of portable technology and prompting formats used, (c) the research designs utilized, (d) the independent and dependent variables, (e) the measures of reliability and validity, and (f) the overall effectiveness of the interventions. The authors provide an interpretation of the findings as well as the implications of the results and recommended areas for future research.

Occupational therapy contributions to people with neurological conditions: Time to set research priorities

People with neurological conditions experience many challenges in their daily lives, ranging from basic activities of daily living through to more complex occupations such as driving a car, maintaining paid employment, or going on vacation with family or friends. Challenges evolve over time for many reasons – progression of the condition (in some cases), normal aging, new responsibilities at home or work, residential moves, or shifts in social or financial circumstances, just to name a few. The potential for occupational therapists to make a positive impact on the lives of people with neurological conditions is high, given our focus on enabling occupation. But what does the evidence say? A quick search of the Cochrane Library using the term ‘occupational therapy’ uncovered a total of 49 reviews, five of which explicitly addressed the effectiveness of occupational therapy for people with neurological conditions (multiple sclerosis, stroke, Parkinson’s disease). Only one review, which focused on people with stroke (Legg et al., 2006), offered a positive conclusion about occupational therapy interventions. The authors found that ‘for every 11 (95%, CI 7 to 30) patients receiving an occupational therapy intervention to facilitate personal activities of daily living, one patient was spared a poor outcome’ (Legg et al., 2006: 2). The four remaining Cochrane reviews all concluded that there was insufficient evidence to support occupational therapy interventions for the specific population targeted (that is, people with multiple sclerosis, people with stroke in care homes, people with cognitive impairment from stroke, people with Parkinson’s disease). Each group of authors noted the lack of high-quality randomized trials for inclusion in the review process. There may be many reasons that occupational therapy researchers are not conducting these trials, but it is clear that the time has come to address them. One option is to model the research priority setting meetings hosted by the National Multiple Sclerosis Society in the United States (National Multiple Sclerosis Society, 2015), which are used to set a path forward for researchers and funders around a specific area of concern. Of note is that these meetings include people with the condition, researchers, funders, and other key stakeholders from around the world. Two other quick searches were conducted to identify sources of synthesized evidence about occupational therapy for people with neurological conditions – one in the Campbell Collaboration Library (www.campbellcollaboration.org) and one in OTseeker (www.otseeker.com). What was interesting about the findings from both of these sources was that the relevant reviews were about specific interventions occupational therapists might employ (for example, electronic assistive technology) rather than about occupational therapy per se. Several reviews concluded that the intervention was effective. The conclusions focused on the intervention rather than the delivering discipline. The findings from these three simple searches point to the need for more focused efforts to set research priorities about occupational therapy for people with neurological conditions. In addition, the differences across the three searches raise some interesting questions about the ways in which evidence is summarized and communicated, and what the implications might be for different stakeholders. Should we be examining the effectiveness of the discipline (which presumably uses a range of interventions) or the effectiveness of a specific intervention (which might be employed by several different disciplines treating people with neurological conditions)? To what extent should we be comparing the outcomes of specific interventions delivered by occupational therapists with the outcomes of other disciplines using the same intervention – if the evidence is

Assistive technology for children and young people with low vision.

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.