Technology and Disability

At present, persons with dementia and their family caregivers in the Netherlands are not adequately supported to modify their dwellings to match their personal needs.

To facilitate aging-in-place for persons with dementia, a website was designed.

The website was designed with persons with dementia and their spouses. In consultation sessions existing websites were discussed. Based on this discussion, a demonstration website was created and then discussed with and judged by the participants. Visits to the website were monitored using Google Analytics.

Participants prefer a website that is easy to print. In addition, the navigation menu should have a maximum of three levels, and the website menu should be positioned on the left. Participants dislike the use of meaningless photographs because these do not add any value to the information given.

Participants prefer a website that is as accessible as reading a book. Some differences are related to culture, such as the participants dislike for the use of English terms. Therefore, preferences or dislikes of items on a website could not be generalized as such. However, the preferences and dislikes may provide useful input for the design process of an appropriate website.

The aim was to develop a framework for prescribing assistive technology (AT) for people with cognitive impairment and provide guidelines for clinical practice.

A qualitative approach was used to develop and validate the guide.

The guide is directed mainly towards occupational therapists and neuropsychologists. It comprises six main steps, 1. Meeting the client, 2. Goal setting, 3. Assessment, 4. Choice of relevant devices, 5. Teaching and training plan, 6. Evaluation and follow-up. Special emphasis is put on the empowerment of the client and their significant others in the process. The guide applies to a wide range of clinical diagnoses involving cognitive impairment.

The guide involves a number of steps requiring substantial clinical resources, which is a challenge but at the same time it might promote an understanding for the complexity of the process among clients, their significant others, rehabilitation professionals and resource providers. The expectations are that more structured and individually adjusted procedures result in a more successful long term use of AT.

Upper limb ataxia is one of the most common motor disorders associated with cerebellar damage and it might lead to motor impairment and disability.

In this study, a subject with disabling upper limb ataxia and intention tremor underwent a six weeks intervention of robot-assisted training combined with Botulinum Toxin Type A (BTX-A).

Robot-assisted therapy which includes repetitive, goal-directed reaching movements was administered after upper-limb BTX-A injections. Improvements in arm coordination and motor performance were assessed throughout a kinematic analysis and an activity daily living – based questionnaire.

After this six weeks training program all spatio-temporal parameters were improved with no additional functional gains.

The positive effects on motor coordination in our subject might help to design clinical trials that combine BTX-A injections and robot-assisted therapy in order to improve upper-limb coordination in subjects with ataxia. Furthermore, if exercises focused on ADLs will be included, they might help to regain a functional use of the arm.

The Assistive Technology Service Method (ATSM) is an innovative evidence-based process standard to support the provision of person centered, evidence-based, and interdisciplinary assistive technology services.

This paper defines challenges with adoption of innovative practices and discusses strategies to diffuse the ATSM for training, education, and gathering knowledge.

Important central components for the diffusion of innovations are reviewed to include strategies for transferring the evidence into practice and other outcomes of the process.

This paper discusses key issues and challenges to professional practice for assistive technology services, presents data on the current state of practice, and delivers strategies to promote innovative interventions and techniques.

Strategies to implement the adoption of an interdisciplinary service delivery method must consider provider knowledge and awareness of need with development of tools for effective use of the innovation.

Programming Lego Mindstorms robots is used for problem-based learning in science. Children with physical disabilities and complex communication needs may be limited in their ability to participate.

To involve a 12 year old student with cerebral palsy in programming Lego robots in the classroom by using her speech generating device (SGD). To evaluate the effectiveness and efficiency of using the two-switch scanning mode on the SGD for programming.

The participant tested classmates’ robot programs using infrared on her SGD, and she accessed the programming software via a customized mouse manipulation page. Her participation in programming activities was measured with Goal Attainment Scaling, descriptive observations, and measures of effectiveness and efficiency.

The participant progressed from observing classmates to independently testing robot programs in the classroom. In individualized sessions she wrote a simple program, with support. Limitations in scanning led to unwanted cursor movements and long task times.

The participant actively participated in the robot programming activity. Actually programming was better suited to individual instruction because of her scanning inefficiency. Using the SGD for robot control affords the potential to also discuss concepts, but this novice user did not yet have the skills to utilize this aspect.