Consumers as partners in inclusive assistive technology research

While there is a general favorable predisposition to the involvement of consumers in rehabilitation and assistive technology research, it remains the case that few research studies are conducted using a participatory approach (participatory action research, inclusive research, emancipatory research). Advantages as well as barriers to the conduct of participatory research are discussed with an emphasis on two research frameworks that have particular relevance to assistive technology and have the potential to make participatory research more viable.

Re-conceptualizing disability and assistive technology : Australian consumers driving policy change

For people living with a disability, enablers such as assistive technologies, environmental modifications and personal care can make the difference between living fully and merely existing. This article is written from the standpoints of people with disabilities and professionals in one Australian State who found their government and service system to be a constraining rather than an enabling force. It presents two key components of policy and practice change in the area of assistive technology: challenging understandings of disability, assistive technology, and the desired life outcomes that assistive technology contributes to; and building a public evidence base through consumer-focussed research. In short, government funding of assistive technology needs to move beyond a limited focus on functional needs and take responsibility for fully equipping people to live the lives they aspire to.

The equipping inclusion studies : assistive technology use and outcomes in Victoria ; key findings and policy implications, study 1 - the equipment study, study 2 - the economic study

Approximately one in five of the Australian population lives with disability (AIHW 2006a; ABS 2003). Of these, almost 1.9 million rely on assistive technologies to live independently (Hobbs, Close, Downing, Reynolds & Walker 2009).

Assistive Technology (AT) is defined as,

‘any device, system or design, whether acquired commercially or off the shelf, modified or customised, that allows an individual to perform a task that they would otherwise be unable to do, or increase the ease and safety with which a task can be performed’ (Independent Living Centres Australia n.d).

‘Assistive Technology solutions’ have been defined as entailing a combination of devices (aids and equipment), environmental modifications (both in the home and outside of it), and personal care (paid and unpaid) (Assistive Technology Collaboration n.d).

Despite a large number of Australians relying on AT, there is little data available about life for these Australians, the extent of AT use, or unmet need for AT. Existing research in Australia suggests that aids and equipment provision in Australia is ‘fragmented’ across a plethora of government and non government programs (AIHW 2006a:35). In Victoria, one of the prime sources of government funding for AT is the Victorian Aids and Equipment Program (VAEP) which is a subsidy program for the purchase of aids and equipment, home and vehicle modifications for people with permanent or long term disability. Recent research suggests that waiting times for accessing equipment through the VAEP are high, as is the cost burden to applicants (Wilson, Wong & Goodridge 2006). In addition, there appears to be a substantial level of unmet need (KPMG 2007).

Additionally, there is a paucity of literature around the economic evaluation of AT interventions and solution packages, resulting in little evidence of their cost-effectiveness credentials.

The equipping inclusion studies : assistive technology use and outcomes in Victoria ; key findings and policy recommendations

Approximately one in five of the Australian population lives with disability (AIHW 2006a; ABS 2003). Of these, almost 1.9 million rely on assistive technologies to live independently (Hobbs, Close, Downing, Reynolds & Walker 2009).

Assistive Technology (AT) is defined as,

‘any device, system or design, whether acquired commercially or off the shelf, modified or customised, that allows an individual to perform a task that they would otherwise be unable to do, or increase the ease and safety with which a task can be performed’ (Independent Living Centres Australia n.d).

‘Assistive Technology solutions’ have been defined as entailing a combination of devices (aids and equipment), environmental modifications (both in the home and outside of it), and personal care (paid and unpaid) (Assistive Technology Collaboration n.d).

Despite a large number of Australians relying on AT, there is little data available about life for these Australians, the extent of AT use, or unmet need for AT. Existing research in Australia suggests that aids and equipment provision in Australia is ‘fragmented’ across a plethora of government and non government programs (AIHW 2006a:35). In Victoria, one of the prime sources of government funding for AT is the Victorian Aids and Equipment Program (VAEP) which is a subsidy program for the purchase of aids and equipment, home and vehicle modifications for people with permanent or long term disability. Recent research suggests that waiting times for accessing equipment through the VAEP are high, as is the cost burden to applicants (Wilson, Wong & Goodridge 2006). In addition, there appears to be a substantial level of unmet need (KPMG 2007).

Additionally, there is a paucity of literature around the economic evaluation of AT interventions and solution packages, resulting in little evidence of their cost-effectiveness credentials.

Assistive technology costs and outcomes

Assistive technologies (AT or aids and equipment) are a key intervention used by occupational therapists and others to minimise the impact of disability or the effects of ageing upon life participation. Our capacity to provide optimal AT is however subject to pragmatic factors such as the availability of public funding and the complexities of government policy and service provision. The Equipping Inclusion Studies conducted in Victoria between 2008 and 2010 were designed to encompass both health sector and individual perspectives on the effectiveness of AT as it is currently delivered, compared with optimal delivery.

Assistive technology costs and outcomes

Assistive technologies (AT or aids and equipment) are a key intervention used by occupational therapists and others to minimise the impact of disability or the effects of ageing upon life participation. Our capacity to provide optimal AT is however subject to pragmatic factors such as the availability of public funding and the complexities of government policy and service provision. The Equipping Inclusion Studies conducted in Victoria between 2008 and 2010 were designed to encompass both health sector and individual perspectives on the effectiveness of AT as it is currently delivered, compared with optimal delivery.

Pathways to non-complex assistive technology for HACC clients in WA : full report

The project aims to identify, evaluate and make recommendations to improve the pathways by which West Australian (WA) Home and Community Care (HACC) clients access daily living equipment. Otherwise known as assistive technology (AT), these devices are largely non-complex and often low cost. Funded by HACC and conducted within the context of the WA Assessment Framework (WAAF), the project seeks to answer the following question:

What are seating clinicians thinking?

In response to an influx of commercially available seating product, research was undertaken to examine how clinicians, experienced in seating prescriptions make decisions when assisting their clients to choose the most appropriate seating systems for their wheelchairs. This paper will present findings from research undertaken in 2005, into the decision-making processes (known as Clinical Reasoning) used by six clinicians working in Victoria. The paper will discuss the successes and barriers these clinicians encounter when selecting ready-made products, off the shelf, to trial and what parameters arose that required custom-made products. The research findings illuminate the clinicians' considerations for successful client collaboration and the essentials for effective supplier-clinician partnerships when selecting from an overwhelming array of new products and available technologies to accommodate generally a more informed consumer base. The availability of ready-made product has altered consumer perceptions that wheelchair seating is no longer a specialized area and that all clinicians should be competent to prescribe. This paper will reveal how experience seating clinicians assess, make decisions and evaluate the client's needs when undertaking equipment trials and prescribing seating products for complex consumer needs. This is of interest to all who are involved in prescribing and supplying products for wheelchair consumers.

Assisting independence with "the latest and greatest" of technologies

A case study of a long term wheelchair user: This presentation will highlight the difficulties associated with matching client's environmental access, seating and mobility needs using multi-functional systems, which also happen to be the "latest and greatest" technologies. The paper addresses the issues experienced by these clinicians when prescribing systems with minimal trial history (due to their newness) and the compatibility issues encountered by the supplier when matching the new with the old of the current powered wheelchair for a particularly motivated wheelchair user.

Comparative effectiveness report : online survey tools

Purpose. A group of Australian researchers seeking an accessible online survey tool discovered to their concern that most commercially available survey tools are not actually ‘useable’ by a significant number of assistive technology users.
Method. Comparative effectiveness analysis of 11 popular survey tools. A bespoke survey tool was subsequently created to meet all accessibility guidelines and useability criteria as determined by the wide range of assistive technology users with whom the research team was working.
Results. Many survey tools claim accessibility status but this does not reflect the actual situation. Only one survey met all compliance points; however, it was limited by inflexible layout and few options for question types; some surveys proved unusable by screen reader. All surveys reviewed represented a compromise between accessibility and breadth of functionality.
Conclusion. It would appear the voices of a proportion of people living with disability are absent from the data collected by surveys, and that current accessibility guidelines, even where implemented, still fall short of assuring useable survey tools. This article describes one online solution created to successfully survey a broad population, and outlines a design approach to encompass user diversity.

Cognitive intervention in autism using multimedia stimulus

We demonstrate an open multimedia-based system for delivering early intervention therapy for autism. Using exible multi-touch interfaces together with principled ways to access rich content and tasks, we show how a syllabus can be translated into stimulus sets for early intervention. Media stimuli are able to be presented agnostic to language and media modality due to a semantic network of concepts and relations that are fundamental to language and cognitive development, which enable stimulus complexity to be adjusted to child performance. Being open, the system is able to assemble enough media stimuli to avoid children over-learning, and is able to be customised to a specific child which aids with engagement. Computer-based delivery enables automation of session logging and reporting, a fundamental and time-consuming part of therapy.

A context-sensitive device to help people with autism cope with anxiety

We describe a smartphone application that helps people with Autism Spectrum Disorder (ASD) cope with anxiety attacks. Our prototype provides a one-touch interface for indicating a panic level. The device's response-to instruct, soothe, and/or contact carers-is sensitive to the user's context, consisting of time, location, ambient noise, and nearby friends. Formative evaluation unearths a critical challenge to building assistive technologies for ASD sufferers: can regimented interfaces foster flexible behaviour? Our observations suggest that a delicate balance of design goals is required for a viable assistive technology.