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“You have to argue the right way”: user involvement in the service delivery process for assistive activity technology

PEDERSEN, Heidi
KERMIT, Patrick S
SÖDERSTRÖM, Sylvia
2020

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Purpose: 

This article critically examines user-involvement in the service delivery process for assistive activity technology.

 

Methodology:

Data were collected in semi-structured interviews with 44 end users of assistive activity technology and in focus group interviews with 11 professionals at Norway’s Assistive Technology Centre. Data was analysed according to a stepwise deductive–inductive approach.

 

Findings: 

Flawed organisational principles like division of responsibility, unclear regulations, and a lack of competence with assistive activity technology among service professionals have hindered user involvement in the service delivery process.

 

Conclusion:

 A missing knowledge of assistive activity technology among professionals and the current organisation of services creates barriers for a positive collaboration with users in the service delivery process of assistive activity technology.

Policy brief: Access to assistive technology

WORLD HEALTH ORGANISATION (WHO)
2020

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This brief is for policy-makers in any ministry involved in designing assistive technology policies and programmes (such as ministries of health, finance and social welfare), especially those involved in designing universal health coverage programmes. It is also relevant for all stakeholders working in these areas. The brief highlights key challenges in ensuring equitable access to high-quality, affordable assistive technology and suggests actions to improve access within universal health coverage or any other national health/welfare programme.

Accuracy of school-based vision screening by teachers in Pakistan: A qualitative study

BECHANGE, STEVENS
January 2020

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Main objectives

1 – To explore the knowledge and competencies of teachers in carrying out visual acuity testing.

2 – To investigate how visual acuity testing practices were applied.

3 – To determine teachers’ motivations and attitudes towards carrying out school-based visual acuity testing.

Summary

Although the school-based vision screening programme was well received and supported by the schools and health providers, limited time allocated for training and practice; limited supervision and the lack of refresher training; trainers insufficiently experienced in training non-health staff and teachers’ involved had many other responsibilities and could not allocate sufficient time to conduct the activity properly which undermined the effectiveness and efficiency of the programme.

Value beyond function: analyzing the perception of wheelchair innovations in Kenya

BARBARESCHI, Giulia
DAYMOND, S
HONEYWILL, J
SINGH, A
NOBLE, D
MBUGUA, N
HARRIS, I
AUSTIN, Victoria
HOLLOWAY, Catherine
2020

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Innovations in the field of assistive technology are usually evaluated based on practical considerations related to their ability to perform certain functions. However, social and emotional aspects play a huge role in how people with disabilities interact with assistive products and services. Over a five months period, we tested an innovative wheelchair service provision model that leverages 3D printing and Computer Aided Design to provide bespoke wheelchairs in Kenya. The study involved eight expert wheelchair users and five healthcare professionals who routinely provide wheelchair services in their community. Results from the study show that both users and providers attributed great value to both the novel service delivery model and the wheelchairs produced as part of the study. The reasons for their appreciation went far beyond the practical considerations and were rooted in the fact that the service delivery model and the wheelchairs promoted core values of agency, empowerment and self-expression.

 

ASSETS '20: The 22nd International ACM SIGACCESS Conference on Computers and Accessibility.; 2020

https://discovery.ucl.ac.uk/id/eprint/10110230/

Disability inclusion annual report 2019

UNITED NATIONS RELIEF AND WORKS AGENCY FOR PALESTINE REFUGEES IN THE NEAR EAST
December 2019

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United Nations Relief and Works Agency (UNRWA) adopts a twin-track approach to ensure the full inclusion of Palestine refugees with disabilities. This entails ‘disability mainstreaming’, whereby all UNRWA programmes and services are universally designed to ensure that they are usable by and/or reach beneficiaries with disabilities, coupled with the provision of ‘targeted/tailored interventions’. During 2019, UNRWA implemented the following activities to address the specific needs of Palestine refugees with disabilities:

  • Direct Specialized Services for Persons with Disabilities
  • Disability Inclusion through Programmes
  • International Cooperation

Hearing Aids Product Narrative: A market landscape and strategic approach to increasing access to hearing aids and related services in Low and Middle Income Countries

SAVAGE, Margaret
CLINTON HEALTH ACCESS INITIATIVE
December 2019

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This product narrative was developed to support the identification of activities that will increase and sustain access to appropriate, affordable hearing aids

Five strategic objectives (SO) that can strengthen the market in both the near and longer-term are identified 

Content and Quality of Motor Initiatives in the Support of People With Profound Intellectual and Multiple Disabilities

VAN ALPHEN, Helena J M
WANINGE, Aly
MINNAERT, Alexander E M G
VAN DER PUTTEN, Annette A J
2019

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Motor activation is rarely integrated into the support of people with profound intellectual and multiple disabilities (PIMD), which might be the result of the limited evidence-based knowledge in this field. Practitioners have recently been developing several motor initiatives for people with PIMD, but it remains unclear about what core elements the motor initiatives actually consist of and to what level of quality it is implemented in practice. This study aims to offer an overview and analysis of the content and quality of motor initiatives actually in use for people with PIMD. Motor initiatives were explored by asking practitioners to complete an online inventory form. Documents, expert knowledge, and observations were used to collect data about the characteristics of the motor initiatives. The quality of the motor initiatives which met our eligibility criteria, was analyzed on the basis of the level of evidence for their effectiveness. The inventory yielded 118 motor initiatives of which 17 met the eligibility criteria. We identified four motor initiatives reflecting an approach to motorically activate people with PIMD within various activities, three including power-assisted exercises, three with aquatic exercises, two frameworks which integrated motor activities into their daily programs, two methods which included small-scale activities, two rhythmic movement therapies, and one program including gross motor activities. We found limited indications for descriptive evidence from 17 initiatives, limited or no indications for theoretical evidence from 12 and five initiatives respectively, and none of the initiatives provided a causal level of evidence for effectiveness. A wide variety of motor initiatives is used in current practice to activate persons with PIMD, although their effectiveness is actually unproven. Science and practice should cooperate to develop an evidence-based understanding to ensure more evidence-based support for the motor activation of people with PIMD in the future.

Making the future of work inclusive of people with disabilities

ILO GLOBAL BUSINESS AND DISABILITY NETWORK
FUNDACION ONCE
November 2019

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This is a first exercise to connect different areas of debate, looking at the key trends of the future of work from a disability perspective and seeking to identify specific action needed in order to shape the future of work in a more disability-inclusive way.

Chapters include: Work and disability - overview of current situation; megatrends of future work and persons with disability (technological revolution, skills revolution, cultutral change, demographic change and climate change); and Roadmap for an inclusive future of work.

 

The following five key objectives for the inclusion of persons with disabilities in the future of work have been identified:

1. New forms of employment and employment relations integrate disability inclusion

2. Skills development and life-long learning made inclusive of persons with disabilities

3. Universal Design embedded in development of all new infrastructure, products and services

4. Assistive technologies, existing and newly developed, to be made affordable and available

5. Measures to include persons with disabilities in growing and developing areas of the economy

 

Governments, companies, disability NGOs, trade unions and academia must be encouraged to commit and contribute towards achieving these objectives through different actions. An inclusive future of work can be reached through coordination and alliances among the different stakeholders

Capability of deaf children with a cochlear implant

RIJKE, Wouter J
VERMEULEN, Anneke M
WENDRICK, Karine
MYLANUS, Emmanuel
LANGEREIS, Margreet C
VAN DER WILT, Gert Jan
November 2019

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Introduction: The main idea underlying this paper is that impairments such as deafness are particularly relevant to the extent that they lead to deprivation of capability. Likewise, the impact of healthcare services such as cochlear implants and subsequent rehabilitation can best be inferred from the extent that they protect or restore capability of those affected.

 

Methods: To explore children’s post-implant capabilities, we tested two newly developed digital, adaptive child self-report and parent-report questionnaires in 19 deaf children (aged 8–12 years) and their parents during rehabilitation, as well as in 23 age peers with normal hearing.

 

Results: Despite the impressive speech-language results that were recorded with cochlear implants, the post-implant capabilities of the deaf children we evaluated differed from those of their hearing peers, with the cochlear implant group appearing particularly disadvantaged in areas such as accessing information, communication, social participation, and participation in school.

 

Conclusion: Deaf children with cochlear implants who are performing well on linguistic and auditory tests can still experience serious limitations in desired functioning. Our findings suggest that a capability approach may reveal aspects of what is being achieved through rehabilitation that might otherwise remain unnoticed, and that could help to further improve the well-being of our patients.

Bridging the mobile disability gap in refugee settings

DOWNER, Matthew
September 2019

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This case study highlights refugees with disabilities’ access to mobile services and the benefits and challenges associated with using these services in three different humanitarian contexts. The analysis is based on a representative survey of refugees in three contexts: Bidi Bidi refugee settlement (Uganda), Kiziba refugee camp (Rwanda) and with urban refugees in Jordan. It also includes qualitative data drawn from two focus groups conducted with refugees with disabilities in Bidi Bidi and Kiziba. The survey used the Washington Group Questions (WGQs) to assess prevalence of disability amongst the refugee population

Health-Related Quality of Life of Wheelchair Fencers, Sedentary People with Disability and Conventional Fencers in Brazil, Assessed by Short Form 36 (SF-36)

CLEMENTE, Mirna
MIGUEL, Marilis Dallarmi
FELIPE, Karina Bettega
SCHWANTES, Ivan Marangon
JUNIOR, Darlan França Ciesielski
SCHWANTES, Athos Marangon
SCHONHOFEN, Christian Burmeister
ALVES, Tabea Epp Kuster
BRAZ, Tiago Volpi
FERNANDES, Luiz Claudio
MIGUEL, Obdulio Gomes
2019

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Purpose: It is well established that physical exercise, in general, decreases anxiety and depression. Para sport or sport for people with disabilities is used as a rehabilitation strategy to improve their quality of life. This study aimed to investigate people with disabilities who practise wheelchair fencing, sedentary people with physical disability and conventional fencers, assessed by Short Form 36 (SF-36), by comparing the groups.

 

Method: Forty-two people from Physical Disability Association of Parana (ADFP) answered SF-36 and were divided into three groups: Conventional Fencers (CF), Wheelchair Fencers (WF), and Sedentary People with Physical Disability (SD).

 

Results: This study was the first to report the Health-Related Quality of Life (HRQOL) of conventional fencers, wheelchair fencers, and sedentary people with physical disability, using SF-36. The data demonstrated high scores in CF and WF, on seven SF-36 scales of the eight-scale profile, including functional and mental health, role physical, bodily pain, general health perception, vitality, social functioning, mental health. Moreover, the sedentary group had lower scores in most of the domains when they were compared to CF.

 

Conclusion: The results might provide supportive evidence that HRQOL of WF has demonstrated a positive effect on people with disability since para sport has been used as a rehabilitation programme.

 

Implication: The implementation of a public campaign is recommended, about sport as a health promoter for disability and rehabilitation. By involving healthcare providers from the area, people with disabilities can be encouraged to participate in para sport.

‘Enabling Access’: A Pilot Study on Access and Use of Assistive Products in the Northern Province, Sri Lanka

HETTIARACHCHI, Shyamani
SUBRAMANIAM, V
RAJAH, Emil
GOWRITHARAN, Paramaguru
NIZAR, Shamra
SALEEM, Shakeela
2019

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Purpose: The need for suitable assistive technology is growing all over the world, not only for people with disabilities but also for the ageing population with functional decline and non-communicable diseases. Access to assistive technology promotes access to education, employment and active societal participation. The aim of this study was to assess the self-reported need by persons with disabilities and by people who were 65 years and older without disabilities in the Northern Province of Sri Lanka, for assistive products; and to identify barriers to accessing these assistive products.

 

Method: This mixed-methods pilot study included 76 participants who were either persons with disabilities or their caregiver or persons 65 years and older, from the Northern Province of Sri Lanka, affected by the now-ended 30-year civil war.  To ascertain trends in the local need for assistive products, a translated version of the World Health Organisation’s Priority Assistive Products List of 50 items was used. In addition, semi-structured interviews with key participants were conducted, to gain some insights into the barriers to accessing assistive products. 

 

Results: The most widely used assistive products among persons with disabilities were connected to war-related injuries. In contrast, those used by the older age group of persons without disabilities were connected to non-communicable diseases and age-related frailty. The assistive products requested by both groups were aids to promote independence in daily activities and to support access to education and employment. The emergent themes included affordability, employment, independence in activities of daily living, stigma and psychological impact, and a lack of awareness and guidance in the use of assistive devices.

 

Conclusion: The findings highlight the need for policies and practices to be informed by local socio-cultural, historical and geographical realities.

Wheelchair Product Narrative: A market landscape and strategic approach to increasing access to wheelchairs and related services in Low and Middle Income Countries

SAVAGE, Margaret
CLINTON HEALTH ACCESS INITIATIVE
August 2019

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This product narrative was developed to support identification of activities that will increase and sustain access to appropriate, affordable wheelchairs. The market landscape, context, assessment and challenges is described. Four strategic approaches to market shaping are made.

A conceptual framework for designing Ambient assisted living services for individuals with disabilities in Uganda and South Africa

KYAZZE, Michael
WESSON, Janet
NAUDE, Kevin
August 2019

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Background: Individuals with disabilities experience difficulty in using various everyday technologies such as computers and smartphones.

 

Objectives: To propose a conceptual framework that will lead to the development of practical and user friendly assistive technology.

 

Method: A literature review of challenges faced by individuals with physical disabilities was carried out. Interviews with adults with physical disabilities in Kampala, Uganda, and Port Elizabeth, South Africa, identified three main challenges with regard to using technology: using a mobile phone, controlling an electronic environment and using a computer.

 

Results: The challenges identified can be solved by taking into consideration the needs of individuals with disabilities. However, the design of new technologies and interaction techniques, such as natural hand gestures and voice, as input mechanisms has able-bodied individuals in mind. Individuals with disabilities are considered as an afterthought. The main reason for this is that individuals with a disability are a minority and hence it may not make economic sense for technology innovators to cater for their unique needs. A lack of practical guidelines on how to design for individuals with disabilities is another reason why designing for individuals with disabilities is often an afterthought.

 

Conclusion: This article proposes a conceptual framework that can be used by researchers and technology designers in order to design products that could cater for the unique needs of individuals with disabilities. The article also emphasises the importance of exploring alternative interaction techniques, as they could enable individuals with disabilities to fully utilise technologies such as smart phones, computers and smart home electronics.

 

 

African Journal of Disability, Vol 8, 2019

Assistive technology enables inclusion in higher education: The role of Higher and Further Education Disability Services Association

LYNER-CLEOPHAS, Marcia
August 2019

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Background: Using assistive technology is one way to foster inclusion of students in the post-school education and training (PSET) sector.

 

Objectives: Higher and Further Education Disability Services Association (HEDSA) enables the sharing of new knowledge about assistive technologies through its symposia, and making information available on its website. Additionally, it facilitates dialogue and collaboration amongst institutions in the PSET network using a listserv and newsletters, given that PSET institutions are spread countrywide.

 

Method: This is an article based on a presentation at the 5th African Network of Evidence-to-Action in Disability (AfriNEAD) conference in Ghana in 2017 that focused on the value of assistive technology for students pursuing studies in the PSET sector and the role played by HEDSA in South Africa.

 

Results: The positive gains and existing gaps in disability inclusion in the higher education sector in South Africa are highlighted, with reference to access to technology. All higher education institutions have internet access and can thereby make use of listservs to communicate information. MapAbility is a way that prospective students can gain a snapshot view of available resources at institutions of learning, using the internet.

 

Conclusion: An association such as HEDSA plays a critical role in the PSET sector to enhance disability inclusion using online tools to disseminate information.

 

 

African Journal of Disability, Vol 8, 2019

Perspectives on a mobile application that maps assistive technology resources in Africa

VISAGIE, Surona
MATTER, Rebecca
KAYANGE, George
CHIWAULA, Mussa
HARNISS, Mark
KAHONDE, Callista
August 2019

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Background: Access to assistive technology (AT) is poor in African countries because of a lack of knowledge, resources, services and products. A mobile application, the AT-Info-Map, was developed to map AT availability in southern Africa.

 

Objectives: This article aimed to describe users’ and suppliers’ perceptions of the AT-Info-Map app.

 

Method: Qualitative data were collected in Zambia, Botswana, Malawi and Lesotho, through nine focus group discussions with 72 participants. Participants included AT users, AT suppliers and representatives of disability organisations. Data were thematically analysed.

 

Results: Two broad themes, that is, usefulness of the AT-Info-Map application and technical issues and content, emerged from the data analysis. Subthemes under usefulness focused on the importance of using current technology, convenience of the app, the need for accuracy, responsiveness of supplier to user’s needs, influence on AT market and how the app creates an opportunity for networking. Challenges to download and navigate the app, the need for training in its use, exclusion of those not literate in English and those with visual impairments were subthemes under technical issues and content.

 

Conclusion: The app was perceived as an important step to increase access to AT for persons with disabilities in less resourced settings. The challenges that emerged from the data analysis have led to the development of a web-based system that will complement or replace the app and improve AT information provision. However, the information provided by the app and website is still only a partial solution to improve AT access in Southern Africa.

 

 

African Journal of Disability, Vol 8, 2019

Effects of assistive technology for students with reading and writing disabilities

SVENSSON, Idor
NORDSTRÖM, Thomas
LINDEBLAD, Emma
GUSTAFSON, Stefan
BJÖRN, Marianne
SAND, Christina
ALMGREN/BÄCK, Gunilla
NILSSON, Staffan
2019

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Background: 

Assistive technology has been used to mitigate reading disabilities for almost three decades, and tablets with text-to-speech and speech-to-text apps have been introduced in recent years to scaffold reading and writing. Few scientifically rigorous studies, however, have investigated the benefits of this technology.

 

Purpose: 

The aim was to explore the effects of assistive technology for students with severe reading disabilities.

 

Method: 

This study included 149 participants. The intervention group received 24 sessions of assistive technology training, and the control group received treatment as usual.

 

Results: 

Both the intervention and control groups improved as much in 1 year as the normed population did. However, gains did not differ between the groups directly after the intervention or at 1 year of follow-up.

 

Conclusions: 

The use of assistive technology seems to have transfer effects on reading ability and to be supportive, especially for students with the most severe difficulties. In addition, it increases motivation for overall schoolwork. Our experience also highlights the obstacles involved in measuring the ability to assimilate and communicate text.

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