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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.

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

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.

Background: The challenges of wheelchair provision and use in less resourced settings are the focus of global efforts to enhance wheelchair service delivery. The shortage of professional wheelchair service providers in these settings necessitates the collaboration of multiple stakeholders, including community-based rehabilitation (CBR) workers, whose role needs to be further understood.

Objectives: The aim of this study was to determine what CBR workers in three areas of Uganda perceived as (1) the challenges with wheelchair provision and use, (2) the factors contributing to these challenges, (3) the role they themselves can potentially play and (4) what facilitators they need to achieve this.

Method: This qualitative study in the transformative paradigm comprised focus group discussions to gather perceptions from 21 CBR workers in three areas of Uganda, each with an operational wheelchair service, participant observations and field notes. Thematic analysis of data was implemented.

Results: Community-based rehabilitation workers’ perceptions of challenges were similar while perceived causes of challenges differed as influenced by location, historical and current wheelchair availability and the CBR workers’ roles. Their main responsibilities included assistance in overcoming barriers to access the service, transfer of skills and knowledge related to wheelchairs, follow-up of users for wheelchair-related problem-solving, and user and community empowerment.

Conclusion: Community-based rehabilitation workers can contribute in various ways to wheelchair service delivery and inclusion of wheelchair users; however, their capabilities are not consistently applied. Considering the diversity of contextual challenges, CBR workers’ range of responsive approaches, knowledge of networks and ability to work in the community make their input valuable. However, to optimise their contribution, specific planning for their training and financial needs and effective engagement in the wheelchair services delivery system are essential.

African Journal of Disability, Vol 8, 2019

Purpose: 

To develop a predictive model to inform the probability of lower limb prosthesis users’ functional potential for ambulation.

Materials and Methods: 

A retrospective analysis of a database of outcomes for 2770 lower limb prosthesis users was used to inform a classification and regression tree analysis. Gender, age, height, weight, body mass index adjusted for amputation, amputation level, cause of amputation, comorbid health status and functional mobility score [Prosthetic Limb Users Survey of Mobility (PLUS-M™)] were entered as potential predictive variables. Patient K-Level was used to assign dependent variable status as unlimited community ambulator (i.e., K3 or K4) or limited community/household ambulator (i.e., K1 or K2). The classification tree was initially trained from 20% of the sample and subsequently tested with the remaining sample.

Results: 

A classification tree was successfully developed, able to accurately classify 87.4% of individuals within the model’s training group (standard error 1.4%), and 81.6% within the model’s testing group (standard error 0.82%). Age, PLUS-M™ T-score, cause of amputation and body weight were retained within the tree logic.

Conclusions: 

The resultant classification tree has the ability to provide members of the clinical care team with predictive probabilities of a patient’s functional potential to help assist care decisions.

Purpose: Despite the importance of the evaluation process in lower limb prosthetic rehabilitation, prostheses are rarely evaluated properly in the Arab world. This is partly due to the absence of any suitable Arabic evaluative tool. The aim of this study is to translate TAPES-R (a standardised evaluative questionnaire) into Arabic and to investigate its psychometric properties on lower limb amputees. Such a tool would ultimately be of benefit for clinical follow-up and research purposes.

Method: International standards were followed for the forward- and back-translation of the TAPES-R questionnaire. A sample of 111 Arabic-speaking volunteers with lower limb amputation completed the translated version of the questionnaire. The responses were then statistically analysed using factor analysis and Cronbach’s α to assess the content and construct validity, and internal consistency (reliability) respectively.

Results: Factor analysis showed that the questionnaire’s items (included in the analysis) can be divided into three distinct dimensions as was originally suggested. The distribution of the items within the three dimensions is comparable with the original questionnaire. All three parts of TAPES-R showed high reliability; where Cronbach’s α were .892, .894, and .873 respectively.

Conclusion: This study found that the Arabic version of TAPES-R represents a valid and reliable tool.

Limitations: The questionnaire is designed to be emailed or posted, but the majority of the amputee population in Jordan did not have these services, so direct contact with each participant was necessary.

Disability, CBR and Inclusive Development, Vol 30, No 1 (2019)

Access to human rights of persons with disabilities who use prosthetic and orthotic assistive devices was assessed, and groups of participants were compared in terms of gender, residential area, income, and type and level of assistive device. The addressed areas were rights to: health, a standard of living adequate for health, education, marry and establish a family, vote, and work.

Questionnaires were used to collect self-reported data from 139 lower-limb prosthetic and orthotic users in Sierra Leone

Journal of Disability and Rehabilitation, Volume 42, 2020 - Issue 8

https://doi.org/10.1080/09638288.2018.1515267

Access to assistive products (AP) is an under-researched public health issue. Using an adaptation of a draft World Health Organization tool—the ‘Assistive Technology Assessment—Needs (ATA-N)’ for measuring unmet needs and use of AP, we aimed to understand characteristics of AP users, self-reported needs and unmet needs for AP, and current access patterns in Bangladesh. The ATA-N was incorporated in a Rapid Assessment of Disability (RAD), a population-based survey to estimate prevalence and correlates of disability. In each of two unions of Kurigram and Narsingdi districts, 60 clusters of 50 people each aged two years and older were selected using a two-staged cluster random sampling process, of whom, 4250 (59% Female; 41% Male) were adults, including 333 using AP. We estimate 7.1% of the studied population used any AP. AP use is positively associated with age and self-reported functional difficulty. The proportion of people using AP is higher for mobility than for sensory and cognitive difficulties. Of all people with any functional difficulty, 71% self-reported an unmet need for AP. Most products were home or self-made, at low cost, but provided benefits. Needs and unmet needs for AP are high, especially for people with greater functional difficulties. Assessing unmet needs for AP revealed important barriers to scale that can inform policy and practice.

Int. J. Environ. Res. Public Health 2018, 15(12), 2901;
doi:10.3390/ijerph15122901

Purpose: The purpose of this study was to explore support persons’ views on remote communication for persons with communicative and cognitive disabilities, and on factors enabling self-determination and participation.

Materials and methods: Five focus groups with 21 support persons were conducted. They were recorded and transcribed and data were analyzed qualitatively using focus group analysis methodology.

Results: The participants experience how remote communication can enable users to have increased control in their lives and how remote communication can enable self-determination and participation. Access to remote communication has a dual effect on safety. There are experiences about communicative rights of the users not being met and there is a need for better access to technology, information, and experts. There is also a need for more competence and coordination among staff and support to the users. Challenges emerge in the support persons’ dedication to the users’ right to communicate.

Conclusion: People with communicative and cognitive disabilities need access to remote communication in order to have control over their own lives and to achieve self-determination and participation in society. Support persons carry a large responsibility and can provide valuable insights of users’ communication situation.