Emma Maria Smith

• Doctor of Philosophy
• PostDoc Position at National University of Ireland, Maynooth

The benefits of participation in sport are widespread, and include not only improved health and wellness, but also support social participation and the realization of rights. Research on the use of assistive products in sport participation has previously focused largely on the use of specialized products in elite sport and has not addressed the imp...

Purpose: In less-resourced settings, 80% of people with spinal cord injuries die from pressure ulcer complications within two years. Appropriately constructed wheelchair cushions are effective in reducing incidence and severity of pressure ulcers. The Tuball is an inexpensive wheelchair cushion designed for users in less-resourced settings, which c...

The benefits of engagement in sport are widespread, and include not only improved health and wellness, but also engagement in social participation and the realization of rights. Research on the use of assistive products in sport participation has previously focused largely on the use of specialized products in elite sport and has not addressed the...

National Assistive Product Lists (APLs) play an important role in improving access to assistive products (APs). Assistive products are critical to enhancing the health, well-being, and quality of life of persons with disabilities and other functional limitations, including those associated with aging. Comparing national APL development across Malaw...

Capturing the outcomes of assistive technology (AT) is essential to know what works and what is needed. People across the globe are working to close the gap of unmet need for AT, and to enable access to quality AT products and services. Inconsistent terminology, measures and a lack of coordinated systems prevent the sharing of knowledge, and the la...

Background Many people with disabilities in low-income settings, such as Sierra Leone, do not have access to the assistive technology (AT) they need, yet research to measure and address this issue remains limited. This paper presents a case study of the Assistive Technology 2030 (AT2030) funded Country Investment project in Sierra Leone. The resear...

According to the World Health Organization Wheelchair Provision Guidelines (2023) wheelchair training is a critical component of the wheelchair provision process. In fact, the guidelines ‘strongly recommend’ that training for power and manual wheelchairs needs to be provided to enable maximum use and prevent abandonment and secondary injuries. More...

Background Assistive technology is central to the realization of the rights of persons with disabilities. However, there remains limited access to assistive technology throughout much of the world, with particularly poor access in lower- and middle-income countries. Evaluating stakeholder engagement in assistive technology networks has been used as...

Policy development and implementation are key to improving access to Assistive Technology (AT). In this paper, we describe a strength-based framework for doing this at national level. We used an action research approach, with the United Nations Conventions on the Rights of Persons with Disability (UNCRPD) as the primary frame of reference. Primary...

Unlabelled: Participation in sports is identified in the UN Convention on the Rights of Persons with Disabilities as a fundamental right and is facilitated by the use of specialized Assistive Products (AP). However, little is known about the role everyday AP plays in promoting sport participation. Purpose: This study explores how the 50 priority...

Occupational therapy, people, and assistive technology have a longstanding relationship. Occupational therapists have the broadest scope of allied health practice across the breadth of assistive products and advisory services. This commentary revisits key foundations of occupational therapy and assistive technology practice. It then examines the re...

Purpose: In 2016 WHO launched the priority assistive products list (APL) consisting of 50 products and recommended that using this as a reference, countries should develop their own contextually relevant national APLs. This paper describes the development of Malawi's APL. Methods: Two hundred and ninety-six persons with disabilities participated...

Background Assistive technologies promote participation and quality of life for people with disabilities and other functional limitations. There is a global call to develop and implement policies to improve access to assistive technologies. In response, a stakeholder led initiative in Malawi is working towards the development of such a policy. Obj...

Assistive technologies are critical to supporting the participation and engagement of persons with disabilities and others who experience functional difficulties in daily life. Assistive products have been demonstrated to be related to the achievement of the Sustainable Development Goals (SDGs); however, no previous research has explored the relati...

Systems-thinking is a useful approach to deepen our understanding of the linkages, relationships, interactions, and behaviours that, together, comprise and shape our health systems. Offering a comprehensive range of opinion and scholarship from experts located across the world (Europe, North-America, Africa, Asia, and Oceania), spanning a wide rang...

Purpose: In this paper, we highlight examples of how AT may play a role in realizing each of the fundamental rights affirmed in the UNCRPD. Materials and methods: We conducted an indicative literature search for relevant literature to each of the substantive articles of the CRPD. Results: Assistive technology plays a critical role in achieving...

Purpose Global population growth and increasing longevity means that the need for Assistive Technology (AT) will continue to increase. The level of unmet need for AT is greatest in low-income settings. The aim of this study is to identify age-related increase in impairment and to estimate the AT needs. Materials and Methods We analysed secondary d...

Introduction To improve access to assistive products (APs) globally, data must be available to inform evidence-based decision-making, policy development and evaluation, and market-shaping interventions. Methods This systematic review was undertaken to identify studies presenting population-based estimates of need and coverage for five APs (hearing...

Participation in sports is a fundamental right for persons with disabilities and is facilitated by the use of specialized Assistive Technology (AT). However, little is known about the role every-day AT plays in promoting sport participation. This study explores how the 50 priority assistive products on the World Health Organization’s Assistive Prod...

The supply of and market demand for assistive products (APs) are complex and influenced by diverse stakeholders. The methods used to collect AP population-level market data are similarly varied. In this paper, we review current population-level AP supply and demand estimation methods for five priority APs and provide recommendations for improving n...

Global participation at the Paralympic Games has been steadily growing in the past 60 years. However, inequities in relation to geographic representation of Paralympians, sex representation, access to assistive technology, and medal success remain. The objectives of this research are to describe and compare trends in Paralympians’ participation and...

Cognition is an important factor affecting power mobility device (PMD) use. However, a gap in knowledge on the role of cognition in PMD use limits evidence of best practices for screening, assessment and training. The overall goal of this research activity was to identify strategic research priorities to delineate the next steps in research. Follow...

Empirical research and data are necessary for policy, planning and provision of services for persons with disabilities. Research data may be available but still not used by researchers and policy makers. The aim of this study is to explore existing empirical research and sources of data on Assistive Technology (AT) in Malawi in order to facilitate...

This paper aims to address the information gap on the influence of socio-demographic factors on access and utilization of Assistive Technology (AT) among children with disabilities in Malawi. Thus, it contributes towards the realization of the recommendations of the UN Convention on the Rights of Persons with disabilities and the development of a f...

Background Equity and inclusion are important principles in policy development and implementation. The aim of this study is to explore the extent to which equity and inclusion were considered in the development of Malawi’s National Disability Mainstreaming Strategy and Implementation Plan. Methods We applied an analytical methodology to review the...

Purpose To address the data gap on efforts to assess use of assistive technology among children with disability in sub-Saharan Africa. Contribute towards efforts examining access to assistive technologies in sub-Saharan Africa. Materials and methods The paper uses data from the 2017 survey on Living conditions among persons with disabilities in Ma...

Background Assistive technology is the products and services used by individuals with functional limitations to enable participation in society and realisation of rights afforded by the United Nations Convention on the Rights of Persons with Disabilities. The Assistive Product List is a comprehensive list of products identified as essential for acc...

Background: Assistive Technology is important for the achievement of the Sustainable Development Goals (SDGs) for persons with disabilities. Increasingly, studies suggest low demand and provisions of Assistive Technology (AT) for persons with disabilities in low- and middle-income settings. Evidence from high income countries highlight the importan...

Background Powered wheelchairs promote participation for people with mobility limitations. For older adults with cognitive impairment, existing training methods may not address learning needs, leading to difficulty with powered wheelchair skills. Error-minimized training, facilitated by shared control technology, may provide learning opportunities...

Background: The coronavirus disease 2019 (COVID-19) pandemic has impacted all segments of society, but it has posed particular challenges for the inclusion of persons with disabilities, those with chronic illness and older people regarding their participation in daily life. These groups often benefit from assistive technology (AT) and so it is imp...

Introduction Assistive technology (AT) is important for the achievement of the sustainable development goals (SDGs) for persons with disabilities (PWD). Increasingly, studies suggest a significant gap between the need for and demand for and provisions of AT for PWD in low-income and middle-income settings. Evidence from high income countries highli...

Assistive technology is a critical component of maintaining health, wellbeing, and the realization of rights for persons with disabilities. Assistive technologies, and their associated services, are also paramount to ensuring individuals with functional limitations have access to important health and social service information, particularly during...

Novel technologies such as the Nino® two-wheeled powered mobility device are promoted as offering an intuitive improved experience compared to conventional wheelchair mobility use. The Nino® has a smaller footprint than a power wheelchair, a zero-degree turning radius, tiller-based steering, and relies on the user leaning forwards and back to move...

Background Powered wheelchair use promotes participation in individuals with limited mobility, however training is required for safe and effective use. There is limited evidence on the task demands of powered wheelchair use to inform an evidence-based skills training programme. Objective To conduct a systematic exploration of the task demands of i...

Background Equity and inclusion are important principles in policy development and implementation. The aim of this study is to explore the extent to which equity and inclusion were considered in the development of Malawi’s National Disability Mainstreaming Strategy and Implementation Plan. Methods We applied an analytical methodology to review the...

Background: Equity and inclusion are important principles in policy development and implementation. The aim of this study is to explore the extent to which equity and inclusion were considered in the development of Malawi’s National Disability Mainstreaming Strategy and Implementation Plan. Methods: We applied an analytical methodology to review th...

Background Equity and inclusion are important principles in policy development and implementation. The aim of this study is to explore the extent to which equity and inclusion were considered in the development of Malawi’s National Disability Mainstreaming Strategy and Implementation Plan. Methods We applied an analytical methodology to review the...

Background Assistive technologies promote participation and quality of life for people with disabilities and other functional limitations. There is a global call to develop and implement policies to improve access to assistive technologies. In response, a stakeholder led initiative in Malawi is working towards the development of such a policy. The...

Background: Around the world, variations and inequities in access to assistive technology (AT) are evident. Development of legislation, policies, and programmes has not kept pace with the increasing demand for AT. Therefore, context-specific needs assessment is required, which can assist in anticipating the accessibility and human support needs of...

Importance: Powered wheelchairs provide independence for people with mobility impairments; however, current training practices may not meet the needs of those with cognitive impairments. Shared-control teleoperation may have utility in a clinical setting when developing training suited to this population. Objective: To explore the clinical utili...

The development and implementation of assistive technology policy that meets the needs of citizens is dependent on accurate data collection and reporting of assistive technology use and unmet needs on a national level. This study reviews the methodology from instruments intended to capture national statistics on assistive technology use across eigh...

Background.: Powered-wheelchair use improves participation for people with mobility limitations; however, many individuals do not receive powered-wheelchair skills training that meets their learning needs. Purpose.: The aim of this work is to evaluate the feasibility of a powered-wheelchair training program for older adults with cognitive impair...

Objectives: To determine the influence of a bootcamp training approach on students’ self-efficacy for assessing, training, spotting, documenting, and performing manual and power wheelchair skills. Methods: In a pre-post design, students in their final year of an entry-to-practice master of occupational therapy program completed a two-day manual (6....

Smart wheelchairs are powered wheelchairs equipped with technologies that can collect information on powered wheelchair use, the driver, and interaction with the environment, and can use this information to modify wheelchair and/or driver behavior. These technologies could potentially be used to create tools to optimize design of training sessions,...

Increased awareness, interest and use of assistive technology (AT) presents substantial opportunities for many citizens to become, or continue being, meaningful participants in society. However, there is a significant shortfall between the need for and provision of AT, and this is patterned by a range of social, demographic and structural factors....

Background and Methods: This paper reviews the current capacity of personnel in enabling access to assistive technology (AT) as well as the systems and processes within which they work, and was reviewed, discussed, and refined during and following the Global Research, Innovation, and Education in Assistive Technology (GREAT) Summit. Findings: Key c...

Background Mobility limitations represent the third most prevalent cause of disability, affecting more than 1.9 million community-dwelling Canadians. Walking aids are often prescribed to reduce the impacts of mobility impairments. There are limited data on walking aids since 2004. Objective The objective of this study was to investigate the preval...

Background. The development and clinical implementation of custom wheelchair seating technologies have improved the lives of many wheelchair users worldwide. Nonetheless, many such technologies (e.g., 3-D scanning, digital fabrication, CNC Milling, 3-D printing, telerehabilitation) remain underutilized by clinicians who, instead, employ low-tech cu...

Background: Wheelchairs, scooters, and related equipment are essential for the well-being of individuals with limited mobility and impact participation, health, and quality of life. Purpose: Our objective was to identify and evaluate policies governing equipment funding for Canadian adults. We reviewed funding legislation and program documentati...

Objectives: The aim of this study was to evaluate the internal consistency, test-retest reliability and responsiveness of the Self-Efficacy in Assessing, Training and Spotting manual wheelchair skills (SEATS-M) and Self-Efficacy in Assessing, Training and Spotting power wheelchair skills (SEATS-P). Methods: A 2-week test-retest design was used w...

Smart wheelchairs are powered wheelchairs equipped with technologies that can collect information on powered wheelchair use, the driver, and interaction with the environment, and can use this information to modify wheelchair and/or driver behavior. These technologies could potentially be used to create tools to optimize design of training sessions,...

Background: People with disabilities often require assistive devices, modifications to their home environment, and physical assistance to facilitate mobility. This study examines self-reported met and unmet needs of people with disabilities who use wheeled mobility devices, compared with non-users. Data and methods: The 2012 Canadian Survey on D...

Purpose: To determine if older adult, novice wheelchair users who drive a power wheelchair with a JoyBar control complete maneuverability tasks in less time and with less error than those who drive a power wheelchair with a standard joystick control. Materials and methods: A parallel randomized controlled trial design conducted at a medical rehabil...

Purpose: The aim of this study was to adapt the WheelCon-M, an outcome measure used to assess confidence with manual wheelchair use, into a version that is applicable for power wheelchair users (WheelCon-P). Methods: Adaptation of the WheelCon-M into the WheelCon-P occurred in two phases: (1) item modification was conducted using focus groups and (...

Purpose: The purpose of this study is to estimate the interrater and intrarater reliability of the Wheelchair Skills Test (WST) Version 4.2 for powered wheelchairs operated by adult users. Materials and methods: Cohort study with a convenience sample of occupational therapists (n = 10). For the main outcome measure, participants viewed and scored e...

Study design: PRISMA guided systematic review. Objectives: To summarize and characterize the literature pertaining to the nature of and factors associated with caregiving services provided to individuals with spinal cord injury (SCI) and identify areas for interventional research to address the needs of care recipients. Data sources: PUBMED/Me...

Background: Mobility impairments are the third leading cause of disability for community-dwelling Canadians. Wheelchairs and scooters (WCSs) help compensate for these challenges. There is limited data within the last decade estimating the prevalence of WCS use in Canada. Objective: To estimate the prevalence of wheelchair and scooter use in Cana...

Study design: Cross-sectional national survey. Objectives: To explore the association between fatigue and community participation frequency and provide an adjusted model of the relationship including important covariates. Setting: Canada; Community. Methods: Data were obtained from the Rick Hansen Spinal Cord Injury Registry Community Survey. We us...

The aim of this study was to adapt the WheelCon-M, an outcome measure used to assess confidence with manual wheelchair use, into a version that is applicable for power wheelchair users (WheelCon-P). Adaptation of the WheelCon-M into the WheelCon-P occurred in two phases: (1) item modification was conducted using focus groups and (2) item refinement...

Objective: To systematically identify factors associated with participation in social and community activities for adult wheelchair users (WCUs). Data sources: PubMed/MEDLINE, CINAHL, PsycINFO and EMBASE. Study selection: Quantitative and qualitative peer-reviewed publications were included, which were written in English, reported original res...