A commentary on influences on selection of assistive technology for young children in South Africa: perspectives from rehabilitation professionals

  • David Banes Access and Inclusion Services
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This commentary explores the issues raised in the original article and seeks to suggest how the systems and processes that the professionals utilize shape the challenges and issues they face. Furthermore, it asks the question as to the extent to which self-determination in the selection of many forms of assistive technology would address and resolve the barriers identified. • IMPLICATIONS FOR REHABILITATION • The implications of the study and experiences of the professionals are highly relevant for the planning of future rehabilitation services. With increasing global demand for service, and an associated understanding that the client carries significant knowledge and experience it could be suggested that the underlying client/provider relationship is changing and will continue to change. • There is potential for a shift from community-based rehabilitation services, to community led rehabilitation services, where the self-determination of solutions to need is led by the individual, with curated input from the professional, mediated through machine learning and artificial intelligence. Such a model of delivery could effectively support many of those with a disability, where the client has extensive experience, allowing the professional to spend increased resources on those who lack the experience to engage confidently in decision making. • The recognition and validation of the knowledge held by clients, against which options can be mapped could ensure extended reach and reduce the cost and efficiency of future services.

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... Fragmentation of knowledge and information, inconsistency in assessment methodology and heterogeneity in the competence of assistive technology professionals, has led to a growing interest in the opportunities that data sciences, including AI, hold for the future of the assistive technology sector, as a supportive and constructive mechanism in any decision-making process [14]. ...
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Introduction The impact of assistive technology use on the lives of people with disabilities has long been demonstrated in the literature. Despite the need for assistive technologies, and a wealth of innovative, afford-able, and accessible products, a low rate of assistive technology uptake is globally maintained. One of the reasons for this gap is related to data and knowledge formation and management. Low access to information and a lack of assessment services is evident. Fragmentation of data, inconsistency in assessment methodology and heterogeneity in the competence of assistive technology professionals, has led to a growing interest in the opportunities that data sciences, including AI, hold for the future of the assistive technology sector, as a supportive and constructive mechanism in any decision-making process. Objectives In this short paper, we seek to describe some of the principles that such an AI-based recommendation system should be built upon, using the Atvisor platform as a case study. is an AI-based digital platform that supports assistive technology assessments and the decision-making process. Recommendations Our recommendations represent the aggregated insights from two pilots held in Israel, testing the platform in multiple environments and with different stakeholders. These recommendations include ensuring the continuum of care and providing a full user journey, incorporating shared decision making and self-assessment features, providing data personalisation and a holistic approach, building a market network infrastructure and designing the tool within a wider service delivery model design. Assessment and decision-making processes, crucial to optimal uptake, cab be leveraged by technology to become more accessible and personalised. • IMPLICATIONS FOR REHABILITATION • Provides principles for the development of an AI-based recommendation system for assistive technology decision making. • Promotes the use of artificial intelligence to support users and professionals in the assistive technology decision making process. • Personalization of data regarding assistive technology, according to functional, holistic and client centered profiles of users, ensures optimal match and better use of assistive technology. • Self-assessment and professional assessment components are important for enabling multiple access points to the assistive technology decision making process, based on the preferences and needs of users.
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The purpose of this paper is to indicate a framework for exploiting the potential role of assistive technology (AT) in supporting care and participation of people with disabilities and elderly people through appropriate service delivery systems (SDS). The paper is based on the findings of the AAATE/EASTIN workshop Service Delivery Systems on Assistive Technology in Europe (held in Copenhagen on May 21-22, 2012, under the patronage of the Danish EU Presidency), on the roadmaps indicated by the previous HEART Study published in 1995 by the European Commission, and on a consensus process within the Board of the AAATE (Association for Advancement of Assistive Technology in Europe) and the EASTIN Association (European Assistive Technology Information Network). The first chapter Background) discusses the reasons why a position paper on this issue was deemed useful; it also summarises the key themes of the Copenhagen workshop and recalls the HEART Study. The second chapter (The scope of an AT SDS), discusses the concept of assistive solutions-intended as individualised interventions providing users with appropriate environmental facilitators (AT products, personalised environmental modifications, personal assistance) to overcome disability and enable participation in all aspects of life-and the mission of a SDS-ensuring that all people with disabilities can access appropriate assistive solutions that are able to support autonomy in their life environment. The paper also points out that AT service delivery policies should be well coordinated with accessibility policies i.e. those related to infrastructural interventions ensuring that the mainstream environment, products and services are usable by all people, including those with reduced function or who depend on assistive technology. The third chapter (Basic features of an AT SDS) discusses why public SDS are needed for AT, what the main AT SDS models are, and how a SDS process can be described and monitored in terms of quality. The discussion is organised into answers to eight recurring questions: 1) Are assistive technology products going to disappear in the future, due to the embodiment of accessibility features in mainstream products; 2) Why shouldn't assistive technology products be dealt with as common consumer goods, purchased directly by users without the intermediation of service delivery systems; 3) Are there different approaches for AT service delivery; 4) When can a medical model, or a social model, or a consumer model be considered appropriate; 5) Independently of the model and the Country or Region, is it possible to identify common steps in the service delivery process; 6) How does each step influence the costs and the outcomes of the whole process; 7) How can the SDS process be monitored by quality indicators; and 8) How can information support the service delivery process. The last chapter (Some recommendations) provides a number of useful recommendations for those who are engaged in the design, development and implementation of AT SDS policies. The recommendations are clustered round the six SDS quality indicators suggested by the HEART Study: Accessibility, Competence, Coordination, Efficiency, Flexibility, User Influence.
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Assistive aids can support some people with dementia in their daily life. Examples are devices designed to facilitate time orientation, use the telephone, and cooker monitors that switch the gas off in case of over-heating. However, there is a dearth of knowledge about the feasibility of using different assistive aids and how to assess the usefulness of such products to the patient and the carer, as well as their costs and benefits for society. This article describes the development of a protocol for a multinational assessment study of different assistive aids to be used by people with dementia living in their own home. Experiences of using the protocol are also reported in this article. This work is part of the ENABLE project.
Assistive technology (AT) is a powerful enabler of participation. The World Health Organization’s Global Collaboration on Assistive Technology (GATE) programme is actively working towards access to assistive technology for all. Developed through collaborative work as a part of the Global Research, Innovation and Education on Assistive Technology (GREAT) Summit, this position paper provides a “state of the science” view of AT users, conceptualized as “People” within the set of GATE strategic “P”s. People are at the core of policy, products, personnel and provision. AT is an interface between the person and the life they would like to lead. People’s preferences, perspectives and goals are fundamental to defining and determining the success of AT. Maximizing the impact of AT in enabling participation requires an individualized and holistic understanding of the value and meaning of AT for the individual, taking a universal model perspective, focusing on the person, in context, and then considering the condition and/or the technology. This paper aims to situate and emphasize people at the centre of AT systems: we highlight personal meanings and perspectives on AT use and consider the role of advocacy, empowerment and co-design in developing and driving AT processes.
Individuals with disabilities constitute a marginalized group in health services research, and their experiences within the health-care system are not well understood. This article examines the access barriers to primary, specialist, and rehabilitative care, and their consequences for individuals' health, functioning, well-being, and health services utilization. The findings are based on an in-depth analysis of 30 qualitative interviews. Access problems are grouped into environmental, structural, and process barriers. The findings highlight the complex nature of access barriers for people with disabilities and underscore the importance of disability literacy in the health service delivery process.
Underemployment of people with visual impairments is an important problem in the world of work. Barriers to successful employment include the lack of informed decision making concerning AT as a workplace accommodation. Choosing effective Assistive Technology (AT) as an accommodation solution is imperative to successful employment of individuals with vision impairments. While not all jobs require AT as a part of an accommodation, when AT is needed, an informed choice is the best approach. This article describes the five step process for selecting appropriate AT for individuals with vision impairments in workplace accommodations developed by the Job Accommodation Network (JAN). Cases from the JAN database that involve people with vision impairments were examined. Resources to enable readers to further evaluate and implement effective AT solutions are provided.
Assistive technology for people with disabilities and older people: a discussion paper. Dublin: Enable Ireland and Disability Federation Ireland
  • Enable Ireland
  • Disability Federation
  • Ireland
The SETT Framework: critical areas to consider when making informed assistive technology decisions
  • J Zabala
Least resistance: how desire paths can lead to better design. 99% Invisible
  • K Kohlstedt