Pub Date : 2023-07-12DOI: 10.1080/10400435.2023.2229891
Natasha Layton, L Callaway, E Wilson, D Bell, M Prain, M Noonan, A Volkert, E Doyle
AT outcomes research is the systematic investigation of changes produced by AT in the lives of AT users and their environments. In contrast to focal outcome measures, My Assistive Technology Outcomes Framework (MyATOF) envisions an alternative starting point, co-designing a holistic and evidence-based set of outcome dimensions enabling AT users to quantify their own outcomes. International classification systems, research evidence, regulatory and service delivery frameworks underpin six optional tools: supports, outcomes, costs, rights, service delivery pathway and customer experience. Designed to empower the consumer-as-researcher and self-advocate, MyATOF has the potential to fill an identified gap in policy-relevant, consumer-focussed and consumer-directed outcome measurement in Australia and internationally. This paper presents the need for consumer-focussed measurement and articulates the conceptual foundations of MyATOF. The iterative development and results of MyATOF use-cases collected to date are presented. The paper concludes with next steps in using the Framework internationally, as well as its future development.
{"title":"My assistive technology outcomes framework: rights-based outcome tools for consumers to 'measure what matters'.","authors":"Natasha Layton, L Callaway, E Wilson, D Bell, M Prain, M Noonan, A Volkert, E Doyle","doi":"10.1080/10400435.2023.2229891","DOIUrl":"10.1080/10400435.2023.2229891","url":null,"abstract":"<p><p>AT outcomes research is the systematic investigation of changes produced by AT in the lives of AT users and their environments. In contrast to focal outcome measures, My Assistive Technology Outcomes Framework (MyATOF) envisions an alternative starting point, co-designing a holistic and evidence-based set of outcome dimensions enabling AT users to quantify their own outcomes. International classification systems, research evidence, regulatory and service delivery frameworks underpin six optional tools: supports, outcomes, costs, rights, service delivery pathway and customer experience. Designed to empower the consumer-as-researcher and self-advocate, MyATOF has the potential to fill an identified gap in policy-relevant, consumer-focussed and consumer-directed outcome measurement in Australia and internationally. This paper presents the need for consumer-focussed measurement and articulates the conceptual foundations of MyATOF. The iterative development and results of MyATOF use-cases collected to date are presented. The paper concludes with next steps in using the Framework internationally, as well as its future development.</p>","PeriodicalId":51568,"journal":{"name":"Assistive Technology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-07-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9829097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-04DOI: 10.1080/10400435.2022.2044407
Alexandria M James, Gede Pramana, Richard M Schein, Anand Mhatre, Jonathan Pearlman, Matthew Macpherson, Mark R Schmeler
Wheeled mobility and seating (WMS) devices allow users to achieve greater mobility independence. Previous studies determined that 53% of wheelchair users required one or more repairs over a 6-month period; however, there are a limited number of studies that have evaluated types of repairs. The purpose of this study was to describe the types of manual wheelchair, power wheelchair, and scooter repairs within the Wheelchair Repair Registry (WRR) and examine the association between WMS devices and the frequency of repairs. A dataset of 4,645 devices distributed in the United States was collected from equipment suppliers who performed and logged community-based wheelchair repair services. The results demonstrated common repairs found across devices were within the wheels/tires/forks and batteries/cables categories. Device type was the most significant predictor of variance in the number of repairs. Customizable manual wheelchairs, tilt-in-space, Groups 2 & 3 power wheelchairs, and scooters were associated with higher number of repairs compared to non-customizable manual wheelchairs, pediatric, heavy-duty manual wheelchairs, and Group 4 power wheelchairs. The higher failure rate found in specific devices may be associated with a population of more active users, environment/conditions where equipment is used, time spent in equipment, additional features on device, or lower durability.
{"title":"A descriptive analysis of wheelchair repair registry data.","authors":"Alexandria M James, Gede Pramana, Richard M Schein, Anand Mhatre, Jonathan Pearlman, Matthew Macpherson, Mark R Schmeler","doi":"10.1080/10400435.2022.2044407","DOIUrl":"https://doi.org/10.1080/10400435.2022.2044407","url":null,"abstract":"<p><p>Wheeled mobility and seating (WMS) devices allow users to achieve greater mobility independence. Previous studies determined that 53% of wheelchair users required one or more repairs over a 6-month period; however, there are a limited number of studies that have evaluated types of repairs. The purpose of this study was to describe the types of manual wheelchair, power wheelchair, and scooter repairs within the Wheelchair Repair Registry (WRR) and examine the association between WMS devices and the frequency of repairs. A dataset of 4,645 devices distributed in the United States was collected from equipment suppliers who performed and logged community-based wheelchair repair services. The results demonstrated common repairs found across devices were within the wheels/tires/forks and batteries/cables categories. Device type was the most significant predictor of variance in the number of repairs. Customizable manual wheelchairs, tilt-in-space, Groups 2 & 3 power wheelchairs, and scooters were associated with higher number of repairs compared to non-customizable manual wheelchairs, pediatric, heavy-duty manual wheelchairs, and Group 4 power wheelchairs. The higher failure rate found in specific devices may be associated with a population of more active users, environment/conditions where equipment is used, time spent in equipment, additional features on device, or lower durability.</p>","PeriodicalId":51568,"journal":{"name":"Assistive Technology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10018277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-04Epub Date: 2022-04-18DOI: 10.1080/10400435.2022.2061085
Aisha Jaddoh, Fernando Loizides, Omer Rana
In recent years, rapid advancements have taken place for automatic speech recognition (ASR) systems and devices. Though ASR technologies have increased, the accessibility of these novel interaction systems is underreported and may present difficulties for people with speech impediments. In this article, we attempt to identify gaps in current research on the interaction between people with dysarthria and ASR systems and devices. We cover the period from 2011, when Siri (the first and the leading commercial voice assistant) was launched, to 2020. The review employs an interaction framework in which each element (user, input, system, and output) contributes to the interaction process. To select the articles for review, we conducted a search of scientific databases and academic journals. A total of 36 studies met the inclusion criteria, which included use of the word error rate (WER) as a measurement for evaluating ASR systems. This review determines that challenges in interacting with ASR systems persist even in light of the most recent commercial technologies. Further, understanding of the entire interaction process remains limited; thus, to improve this interaction, the recent progress of ASR systems must be elucidated.
{"title":"Interaction between people with dysarthria and speech recognition systems: A review.","authors":"Aisha Jaddoh, Fernando Loizides, Omer Rana","doi":"10.1080/10400435.2022.2061085","DOIUrl":"10.1080/10400435.2022.2061085","url":null,"abstract":"<p><p>In recent years, rapid advancements have taken place for automatic speech recognition (ASR) systems and devices. Though ASR technologies have increased, the accessibility of these novel interaction systems is underreported and may present difficulties for people with speech impediments. In this article, we attempt to identify gaps in current research on the interaction between people with dysarthria and ASR systems and devices. We cover the period from 2011, when Siri (the first and the leading commercial voice assistant) was launched, to 2020. The review employs an interaction framework in which each element (user, input, system, and output) contributes to the interaction process. To select the articles for review, we conducted a search of scientific databases and academic journals. A total of 36 studies met the inclusion criteria, which included use of the word error rate (WER) as a measurement for evaluating ASR systems. This review determines that challenges in interacting with ASR systems persist even in light of the most recent commercial technologies. Further, understanding of the entire interaction process remains limited; thus, to improve this interaction, the recent progress of ASR systems must be elucidated.</p>","PeriodicalId":51568,"journal":{"name":"Assistive Technology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9973444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-04DOI: 10.1080/10400435.2022.2079763
Kamiar Ghoseiri, Mohammad Yusuf Rastkhadiv, Mostafa Allami, Phillip Page, Lars L Andersen, Duane C Button
The association of localized pain sensitivity in the residual limb and prosthesis use has clinical implications, however, rarely been assessed. This study aimed to investigate pain sensitivity and explore its range, variability, and association with prosthesis use alongside other demographic and clinical characteristics of veterans with transtibial amputation. Pain sensitivity was determined as pressure pain threshold (PPT) and pressure tolerance (PT) in 19 male veterans with a mean age of 49.5 years using pressure algometry at 12 anatomical locations on the residual limb. A comparison of pain sensitivity at each location, and among anatomical locations and participants was explored using independent t-test, analysis of variance, and Kruskal-Wallis tests, respectively. Pain sensitivity range (PSR), the difference between PT and PPT, was significantly different (p < 0.05) at mid-patellar tendon, medial tibial flare, and the distal end of the tibia. The lowest PPT and PT (20.5 and 33 Ncm-2, p = 0.13) were recorded at the distal end of the residual limb, and the highest PPT and PT (73.4 and 94.3 Ncm-2, p = 0.03) were recorded at the mid-patellar tendon. Pain sensitivity was significantly different among anatomical locations and participants. The correlation tests (Pearson and partial eta squared) showed non-significant associations of pain sensitivity with participants' demographic and clinical characteristics except for daily prosthesis use. The mid-patellar tendon, medial tibial flare, and distal end of the tibia revealed the lowest pain hypersensitivity due to higher PSR. Longer daily prosthesis use was associated with increased pain sensitivity.
残肢局部疼痛敏感性与义肢使用的关联具有临床意义,但很少被评估。本研究旨在调查退伍军人的疼痛敏感性,并探讨其范围、变异性以及与假体使用以及其他人口统计学和临床特征的关系。对19例平均年龄49.5岁的男性退伍军人残肢12个解剖位置采用压力测量法测定其疼痛敏感性为压力痛阈值(PPT)和压力耐受性(PT)。分别采用独立t检验、方差分析和Kruskal-Wallis检验对各部位、解剖部位和参与者的疼痛敏感性进行比较。疼痛敏感范围(PSR), PT和PPT的差异,在髌中肌腱、胫骨内侧耀斑和胫骨远端有显著差异(p 0.05)。残肢远端PPT和PT最低(20.5和33 Ncm-2, p = 0.13),髌中肌腱PPT和PT最高(73.4和94.3 Ncm-2, p = 0.03)。不同解剖部位和参与者的疼痛敏感性有显著差异。相关检验(Pearson和偏eta平方)显示,除日常义肢使用外,疼痛敏感性与受试者的人口学和临床特征无显著相关性。髌中肌腱、胫骨内侧耀斑和胫骨远端显示,由于较高的PSR,疼痛超敏反应最低。每天更长时间的假体使用与疼痛敏感性增加有关。
{"title":"The association of the localized pain sensitivity in the residual limb and prosthesis use in male veterans with transtibial amputation.","authors":"Kamiar Ghoseiri, Mohammad Yusuf Rastkhadiv, Mostafa Allami, Phillip Page, Lars L Andersen, Duane C Button","doi":"10.1080/10400435.2022.2079763","DOIUrl":"https://doi.org/10.1080/10400435.2022.2079763","url":null,"abstract":"<p><p>The association of localized pain sensitivity in the residual limb and prosthesis use has clinical implications, however, rarely been assessed. This study aimed to investigate pain sensitivity and explore its range, variability, and association with prosthesis use alongside other demographic and clinical characteristics of veterans with transtibial amputation. Pain sensitivity was determined as pressure pain threshold (PPT) and pressure tolerance (PT) in 19 male veterans with a mean age of 49.5 years using pressure algometry at 12 anatomical locations on the residual limb. A comparison of pain sensitivity at each location, and among anatomical locations and participants was explored using independent <i>t</i>-test, analysis of variance, and Kruskal-Wallis tests, respectively. Pain sensitivity range (PSR), the difference between PT and PPT, was significantly different (<i>p <</i> 0.05) at mid-patellar tendon, medial tibial flare, and the distal end of the tibia. The lowest PPT and PT (20.5 and 33 Ncm<sup>-2</sup>, <i>p</i> = 0.13) were recorded at the distal end of the residual limb, and the highest PPT and PT (73.4 and 94.3 Ncm<sup>-2</sup>, <i>p =</i> 0.03) were recorded at the mid-patellar tendon. Pain sensitivity was significantly different among anatomical locations and participants. The correlation tests (Pearson and partial eta squared) showed non-significant associations of pain sensitivity with participants' demographic and clinical characteristics except for daily prosthesis use. The mid-patellar tendon, medial tibial flare, and distal end of the tibia revealed the lowest pain hypersensitivity due to higher PSR. Longer daily prosthesis use was associated with increased pain sensitivity.</p>","PeriodicalId":51568,"journal":{"name":"Assistive Technology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10013386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-04DOI: 10.1080/10400435.2022.2043954
Bethany Frick, Jamie B Boster, Skylar Thompson
Animation has been studied in the augmentative and alternative communication (AAC) literature regarding increasing transparency of symbols and decreasing operational demands of the interface design. This study investigated a sample of AAC devices to determine the presence and purpose of animation in the systems. We found that the majority of the animation found on AAC devices serve the function of providing feedback to the user. Future exploration of the use of animation in AAC through capitalizing on previous research, new technology, and as a method to foster linguistic and operational competence are considered. Clinical and research implications of these findings are discussed.
{"title":"Animation in AAC: Previous research, a sample of current availability in the United States, and future research potential.","authors":"Bethany Frick, Jamie B Boster, Skylar Thompson","doi":"10.1080/10400435.2022.2043954","DOIUrl":"https://doi.org/10.1080/10400435.2022.2043954","url":null,"abstract":"<p><p>Animation has been studied in the augmentative and alternative communication (AAC) literature regarding increasing transparency of symbols and decreasing operational demands of the interface design. This study investigated a sample of AAC devices to determine the presence and purpose of animation in the systems. We found that the majority of the animation found on AAC devices serve the function of providing feedback to the user. Future exploration of the use of animation in AAC through capitalizing on previous research, new technology, and as a method to foster linguistic and operational competence are considered. Clinical and research implications of these findings are discussed.</p>","PeriodicalId":51568,"journal":{"name":"Assistive Technology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10018279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The population of Korea is aging rapidly, and this has led to a care burden for caregivers. Without adequate caregivers to address the increased burden, people with significant disabilities and older adults with disabilities who have greatly reduced mobility are at risk. The aim of this study was to determine suitable types of care robots for care applications in Korea and formulate a strategy for a future care robot R&D plan through a user participation study. We categorized nine types of care robots that are suitable for the care needs in Korea. By adopting a mixed research methodology involving user participation, we conducted discussions with caregivers, care receivers, and other stakeholders under a public-private-people partnership model. We also identified five primary strategies for care robot R&D: (1) intensive investment to match the needs of people with very severe disabilities to care robot technologies, particularly for transfer, repositioning, toileting, and feeding; (2) translational research and technology development; (3) realization of smart-care through fourth industrial revolution (i.e., digital) technologies; (4) user-centered research with stakeholders; and (5) building of a care robot ecosystem. The formulated plan would be shared with other developers and clinical experts to drive development of suitable care robots.
{"title":"Care robot research and development plan for disability and aged care in Korea: A mixed-methods user participation study.","authors":"Myung-Joon Lim, Won-Kyung Song, Hyosun Kweon, Eun-Rae Ro","doi":"10.1080/10400435.2022.2038307","DOIUrl":"https://doi.org/10.1080/10400435.2022.2038307","url":null,"abstract":"<p><p>The population of Korea is aging rapidly, and this has led to a care burden for caregivers. Without adequate caregivers to address the increased burden, people with significant disabilities and older adults with disabilities who have greatly reduced mobility are at risk. The aim of this study was to determine suitable types of care robots for care applications in Korea and formulate a strategy for a future care robot R&D plan through a user participation study. We categorized nine types of care robots that are suitable for the care needs in Korea. By adopting a mixed research methodology involving user participation, we conducted discussions with caregivers, care receivers, and other stakeholders under a public-private-people partnership model. We also identified five primary strategies for care robot R&D: (1) intensive investment to match the needs of people with very severe disabilities to care robot technologies, particularly for transfer, repositioning, toileting, and feeding; (2) translational research and technology development; (3) realization of smart-care through fourth industrial revolution (i.e., digital) technologies; (4) user-centered research with stakeholders; and (5) building of a care robot ecosystem. The formulated plan would be shared with other developers and clinical experts to drive development of suitable care robots.</p>","PeriodicalId":51568,"journal":{"name":"Assistive Technology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10007089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-04DOI: 10.1080/10400435.2022.2075487
Audrey Landuran, Hélène Sauzéon, Charles Consel, Bernard N'Kaoua
People with Down syndrome (DS) encounter difficulties in their daily lives. In recent years, smart homes have provided some answers to the problem of residential autonomy. In fact, smart homes can provide support for complex routines and activities, while adjusting to the person's behaviors and needs and offering maximum control of the environment. In this context, the objectives of this study were to assess (i) the usability of the smart home platform as well as (ii) the impact of the use (for 6 months) of this platform by adults with DS on many dimensions such as residential autonomy, projection into the future, the development of a life plan, self-determination, quality of life, self-esteem, anxiety, and psychological well-being. The first objective of a preliminary study was to verify that the support platform we use is suitable and can be used effectively by people with DS. For the preliminary study, the evaluations show effective, satisfactory and efficient use of all applications. Regarding the objective of our study, the evaluations show positive impacts on many dimensions such as living skills, self-determination, quality of life, self-esteem, anxiety and certain components of life psychological well-being.
{"title":"Evaluation of a smart home platform for adults with Down syndrome.","authors":"Audrey Landuran, Hélène Sauzéon, Charles Consel, Bernard N'Kaoua","doi":"10.1080/10400435.2022.2075487","DOIUrl":"https://doi.org/10.1080/10400435.2022.2075487","url":null,"abstract":"<p><p>People with Down syndrome (DS) encounter difficulties in their daily lives. In recent years, smart homes have provided some answers to the problem of residential autonomy. In fact, smart homes can provide support for complex routines and activities, while adjusting to the person's behaviors and needs and offering maximum control of the environment. In this context, the objectives of this study were to assess (i) the usability of the smart home platform as well as (ii) the impact of the use (for 6 months) of this platform by adults with DS on many dimensions such as residential autonomy, projection into the future, the development of a life plan, self-determination, quality of life, self-esteem, anxiety, and psychological well-being. The first objective of a preliminary study was to verify that the support platform we use is suitable and can be used effectively by people with DS. For the preliminary study, the evaluations show effective, satisfactory and efficient use of all applications. Regarding the objective of our study, the evaluations show positive impacts on many dimensions such as living skills, self-determination, quality of life, self-esteem, anxiety and certain components of life psychological well-being.</p>","PeriodicalId":51568,"journal":{"name":"Assistive Technology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10018744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-04DOI: 10.1080/10400435.2023.2240212
Emma M Smith
The field of assistive technology is growing globally, thanks to increased investment in awareness and research from advocacy organizations, national and international non-governmental organizations, academic partners, and others. We are witnessing this growth and increased awareness in the increase in relevant research, resolution 71.8 on Improving Access to Assistive Technology at the World Health Assembly in 2018 (World Health Assembly, 2018), and the publication of the Global Report on Assistive Technology in 2022 from the World Health Organization and UNICEF (World Health Organization, 2022). With this growth comes an increased recognition of the need for high-quality research to support evidence-informed assistive product development, service delivery standards and processes, and improved public policy. The recent publication of the WHO Wheelchair Provision Guidelines (World Health Organization, 2023) highlights the challenge of limited highquality research to support many of the recommendations in the document, despite wheelchair research being one of the more developed areas of evidence in the field. Assessment of research quality in health-related fields has historically been based largely on the perceived strength of the methodology used to conduct the research, with considerations for how the research was carried out, and by whom. In general, randomized controlled trials (RCTs) are perceived to be a higher quality of evidence when creating guidelines, while observational studies are perceived to be of lower quality of evidence. A variety of additional factors are considered in the critical appraisal of research which may further impact the perception of quality. We perceive systematic reviews and meta-analyses to provide the highest levels of evidence for decision-making. These levels of evidence are largely based on a medical model of research, and an assumption that an intervention may have a single causative effect on an outcome. However, in complex interventions, like assistive technology provision, adherence to this model of evidence quality is problematic. Assistive technology provision is multi-faceted, individualized, and contextual. Even an intervention that looks the same on the surface – the provision of a specific product to address a specific functional limitation – will vary significantly in its application. The person’s needs, preferences, and functional capacity, existing skillset of the person, the product and its personalized specifications, set-up of the product and training around its use, role of the service provider, support networks around the person, and social, physical, and institutional environments in which the product is used all will have an impact on the resulting outcomes. To measure and evaluate outcomes of any one of these is challenging. To address the potential contribution of each of them in the context of a controlled trial is nearly impossible. Furthermore, placebo-controlled trials are impossible
{"title":"The challenge of complexity: research quality in assistive technology.","authors":"Emma M Smith","doi":"10.1080/10400435.2023.2240212","DOIUrl":"https://doi.org/10.1080/10400435.2023.2240212","url":null,"abstract":"The field of assistive technology is growing globally, thanks to increased investment in awareness and research from advocacy organizations, national and international non-governmental organizations, academic partners, and others. We are witnessing this growth and increased awareness in the increase in relevant research, resolution 71.8 on Improving Access to Assistive Technology at the World Health Assembly in 2018 (World Health Assembly, 2018), and the publication of the Global Report on Assistive Technology in 2022 from the World Health Organization and UNICEF (World Health Organization, 2022). With this growth comes an increased recognition of the need for high-quality research to support evidence-informed assistive product development, service delivery standards and processes, and improved public policy. The recent publication of the WHO Wheelchair Provision Guidelines (World Health Organization, 2023) highlights the challenge of limited highquality research to support many of the recommendations in the document, despite wheelchair research being one of the more developed areas of evidence in the field. Assessment of research quality in health-related fields has historically been based largely on the perceived strength of the methodology used to conduct the research, with considerations for how the research was carried out, and by whom. In general, randomized controlled trials (RCTs) are perceived to be a higher quality of evidence when creating guidelines, while observational studies are perceived to be of lower quality of evidence. A variety of additional factors are considered in the critical appraisal of research which may further impact the perception of quality. We perceive systematic reviews and meta-analyses to provide the highest levels of evidence for decision-making. These levels of evidence are largely based on a medical model of research, and an assumption that an intervention may have a single causative effect on an outcome. However, in complex interventions, like assistive technology provision, adherence to this model of evidence quality is problematic. Assistive technology provision is multi-faceted, individualized, and contextual. Even an intervention that looks the same on the surface – the provision of a specific product to address a specific functional limitation – will vary significantly in its application. The person’s needs, preferences, and functional capacity, existing skillset of the person, the product and its personalized specifications, set-up of the product and training around its use, role of the service provider, support networks around the person, and social, physical, and institutional environments in which the product is used all will have an impact on the resulting outcomes. To measure and evaluate outcomes of any one of these is challenging. To address the potential contribution of each of them in the context of a controlled trial is nearly impossible. Furthermore, placebo-controlled trials are impossible","PeriodicalId":51568,"journal":{"name":"Assistive Technology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9982171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-04DOI: 10.1080/10400435.2022.2053895
S K Fager, T Sorenson, E Jakobs, H Koester, T Jakobs, D R Beukelman
Individuals with severe motor impairments often require alternative means to access computers and communication technology. A range of alternative access devices exist; however, most rely on use of a single access modality. While this approach works for some individuals, it can be limiting for others. This study explored the use of a multi-modal prototype (eye-tracking + switch-scanning) on typing performance with a range of individuals with motor impairments. The multi-modal prototype was compared to eye-tracking alone for this study. Results indicated that the multi-modal prototype had significantly slower typing rate but significantly lower total errors compared to eye-tracking alone. Analysis of individual data revealed four subgroups of clinical relevance including individuals that 1) benefit from multi-modal, 2) benefit from eye-tracking, 3) demonstrate learning and 4) demonstrate fluctuating performance.
{"title":"Multi-modal access method (eye-tracking + switch-scanning) for individuals with severe motor impairment: A preliminary investigation.","authors":"S K Fager, T Sorenson, E Jakobs, H Koester, T Jakobs, D R Beukelman","doi":"10.1080/10400435.2022.2053895","DOIUrl":"https://doi.org/10.1080/10400435.2022.2053895","url":null,"abstract":"<p><p>Individuals with severe motor impairments often require alternative means to access computers and communication technology. A range of alternative access devices exist; however, most rely on use of a single access modality. While this approach works for some individuals, it can be limiting for others. This study explored the use of a multi-modal prototype (eye-tracking + switch-scanning) on typing performance with a range of individuals with motor impairments. The multi-modal prototype was compared to eye-tracking alone for this study. Results indicated that the multi-modal prototype had significantly slower typing rate but significantly lower total errors compared to eye-tracking alone. Analysis of individual data revealed four subgroups of clinical relevance including individuals that 1) benefit from multi-modal, 2) benefit from eye-tracking, 3) demonstrate learning and 4) demonstrate fluctuating performance.</p>","PeriodicalId":51568,"journal":{"name":"Assistive Technology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9576815/pdf/nihms-1802517.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10014379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-04DOI: 10.1080/10400435.2022.2113180
Katarzyna Kabacińska, Kim Vu, Mallorie Tam, Olivia Edwards, William C Miller, Julie M Robillard
Despite the benefits of assistive technology (AT), barriers to technology adoption still exist and are uniquely affecting older populations. Improving technology adoption can be achieved by involving end-users in the development and evaluation process. However, existing AT evaluation tools rarely take into account older adults' experiences. The goal of this study was to fill this gap by determining which AT evaluation criteria are important for older adults. We conducted 4 nominal group meetings with 21 participants aged 50+ in Vancouver, Canada. In the meetings, participants generated AT evaluation criteria and organized them in the order of importance. The content from the meetings was analyzed using qualitative content analysis. Final rankings were collated to reveal which criteria were the most important across the groups. We found that promotion of independence, affordability, ease of use and ethics are the most important AT evaluation criteria for older adults. Some aspects of ATs that older adults value, such as reliability, are not featured in AT evaluation tools. This study provides insight into older adults' priorities for AT evaluation criteria, and concerns that older adults have about AT use. The findings are supplemented with a comprehensive analysis of the group discussions that contextualizes the criteria.
{"title":"\"Functioning better is doing better\": older adults' priorities for the evaluation of assistive technology.","authors":"Katarzyna Kabacińska, Kim Vu, Mallorie Tam, Olivia Edwards, William C Miller, Julie M Robillard","doi":"10.1080/10400435.2022.2113180","DOIUrl":"https://doi.org/10.1080/10400435.2022.2113180","url":null,"abstract":"<p><p>Despite the benefits of assistive technology (AT), barriers to technology adoption still exist and are uniquely affecting older populations. Improving technology adoption can be achieved by involving end-users in the development and evaluation process. However, existing AT evaluation tools rarely take into account older adults' experiences. The goal of this study was to fill this gap by determining which AT evaluation criteria are important for older adults. We conducted 4 nominal group meetings with 21 participants aged 50+ in Vancouver, Canada. In the meetings, participants generated AT evaluation criteria and organized them in the order of importance. The content from the meetings was analyzed using qualitative content analysis. Final rankings were collated to reveal which criteria were the most important across the groups. We found that promotion of independence, affordability, ease of use and ethics are the most important AT evaluation criteria for older adults. Some aspects of ATs that older adults value, such as reliability, are not featured in AT evaluation tools. This study provides insight into older adults' priorities for AT evaluation criteria, and concerns that older adults have about AT use. The findings are supplemented with a comprehensive analysis of the group discussions that contextualizes the criteria.</p>","PeriodicalId":51568,"journal":{"name":"Assistive Technology","volume":null,"pages":null},"PeriodicalIF":1.8,"publicationDate":"2023-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10016764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}