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Technology and Disability communicates knowledge about the field of assistive technology devices and services, within the context of the lives of end users - persons with disabilities and their family members. While the topics are technical in nature, the articles are written for broad comprehension despite the reader's education or training.
Technology and Disability's contents cover research and development efforts, education and training programs, service and policy activities and consumer experiences.
The term Technology refers to assistive devices and services.
- The term Disability refers to both permanent and temporary functional limitations experienced by people of any age within any circumstance.
- The term and underscores the editorial commitment to seek for articles which see technology linked to disability as a means to support or compensate the person in daily functioning.
The Editor also attempts to link the themes of technology and disability through the selection of appropriate basic and applied research papers, review articles, case studies, programme descriptions, letters to the Editor and commentaries. Suggestions for thematic issues and proposed manuscripts are welcomed.
Abstract: The provision of assistive devices to improve functional independence is a well established component of occupational therapy practice. Recent research efforts in relation to assistive devices have indicated high levels of abandonment of devices in some client groups and for particular devices. Recommendations to address abandonment have focused primarily on training and follow-up of clients, apparently assuming abandonment relates to clients' skill levels and confidence in using devices. This article argues that abandonment also relates to people's perception of themselves as disabled, and to broader issues of identity. Factors for therapists to consider when working with persons who may benefit…from assistive devices are suggested, based on concepts drawn from psychology, the social sciences, and consumer research.
Abstract: Reducing back injury in health care workers is important, and the use of non-mechanical handling devices is recommended as one method of reducing risk of injury when manual handling is unavoidable. A user evaluation of 15 non-mechanical devices designed to help carers move dependent people (people who require assistance with transfers) in bed was conducted by the Medical Devices Agency, an Executive Agency of the Department of Health, UK. Sixty volunteer carers in hospitals, nursing homes and the community were randomly allocated to test devices in one of four groups: sliding sheets, short low friction rollers, long low friction rollers,…miscellaneous handling devices. Opinions of the products were collected using questionnaires. The short low friction rollers were rated highest for perceived overall usefulness (75%) Envisaged use was appreciably lower than perceived usefulness. Several factors may account for this, and carers commented on the time taken to position the devices and the comfort for the dependent person. Such factors need to be addressed when training people in the use of such devices, to improve usage.
Keywords: assistive devices, manual handling, user evaluation, nursing, non-mechanical devices
Abstract: Seating and wheelchair technology continues to progress at a rapid rate. Literature and research in this area is abundant except when referring to the developing world. Awareness of the need for seating technology in underdeveloped countries continues to expand. Of the 20 million people in developing countries who require wheelchairs, less than 1% Production of seating technology locally appears to be a better solution than relying on outside donations. This incorporates the use of “appropriate” technology (using local resources), involving the community and the disabled, localizing seating/wheelchair production, designing seating systems compatible with the cultural, psychological and physical environments and,…the use of a teamwork approach.
Abstract: For persons with tetraplegia, improvements in function and independence are promoted by augmenting residual hand function. Assistive technology offers ways to enhance independence through enabling activities of daily living (ADL) performance. Splints and adaptive aids have traditionally been used to address functional hand deficits in persons with tetraplegia secondary to spinal injury. The Freehand System® offers a brace free alternative for persons with C5 or C6 tetraplegia. By employing functional electrical stimulation (FES), The Freehand System® provides stimulated grasp and release to paralyzed muscles of the hand. Occupational therapy plays an important role in assessment and implementation…of the Freehand System. Clinical reasoning is used to develop a comprehensive plan for surgical planning, rehabilitation and functional training to meet individual needs. Training incorporates education on operation and care of the system and functional application toward valued ADL. Research with the Freehand system is ongoing. Clinical trials of the Freehand system with both adult and adolescent subjects have demonstrated measurable improvement in pinch force, hand function and level of independence in ADL [9,12]. Current focus of research by occupational therapists with the Freehand system has been the examination of home use and user satisfaction.
Abstract: Objectives: Traditional habilitation recommends the use of single switch control and simple computer games as pre-training of cause-effect relationships and joystick control before training in use of a powered wheelchair. Findings from studies of individuals at an early developmental level driving a powered wheelchair suggest it may be more effective to reverse order. Methods: We studied the outcome of powered wheelchair activity in context (self-directed locomotion). Participants included 40 disabled individuals and 17 typically developed infants functioning at an early developmental level. The activity in the wheelchair was paralleled with the use of single switch controls connected both…to toys and to a computer with simple “press-action” software. Results: The cognitive understanding of the simple cause-effect (use of joystick causes the effect of motion of the wheelchair) developed earlier than the understanding (press on single switch causes activation of toy or apparatus). Conclusion: The recommendation to use single switch controls as pre-training for driving a powered wheelchair corresponds with individuals with quite good cognitive function but not with individuals who function at an early developmental level. For individuals with severe or profound mental retardation the possibilities to understand cause-effect relationships are found in tools that affect all their senses, their whole body. A powered wheelchair is such a tool. When the individual activates the joystick, the wheelchair moves, affecting all senses and the individual’s position in space. This event provides arousal, interest and motivation to further manipulate and explore the cause of the effect.
Keywords: cause-effect relationships, powered wheelchair, single switch control, early developmental level, mental retardation, visual impairment
Abstract: Nine normal male subjects 60–79 years old participated in a study of the effect of wrist immobilisation on upper limb function. An upper limb measurement system using the Motion Analysis System, Expertvision™ was developed and used to quantify and describe the three dimensional movement of subjects during performance on the Jebsen Hand Function Test. Comparisons were made of time, and range of upper limb movement between the free and immobilised wrist condition. Results revealed statistically significant increases in the time taken and the total degree of shoulder motion used, as well as significant decreases in the total elbow motion during…the immobilised condition. Results also showed great variation in the effect of wrist immobilisation on upper limb joints. The results reinforce the need for occupational therapists to evaluate the upper limb as an entity and to evaluate each client on an individual basis when immobilising the wrist. The upper limb measurement system in this study provides future direction for research methodology that can analyse the effects of orthotic intervention on everyday occupational performance.
Abstract: This study evaluated the effectiveness of splinting in relieving symptoms and improving functional status of clients with work-related carpal tunnel syndrome. The study used a quasi-experimental, time series, within-subject design. Twenty-two participants sampled from a hospital were examined and treated with the modified ulnar gutter wrist splint; they filled out self-administered questionnaires twice before splinting (1--2 weeks and immediately) and twice after splinting (2 weeks and 10--12 weeks). Participants showed significant improvement in symptom severity and functional status three months after splinting. Duration of symptoms, other medical conditions, work conditions, and non-compliant to splint wear seemed to be factors associated…with the treatment outcome. Future studies are recommended with a longer follow-up period, a larger number of participants, a randomized sample, and a control group for better generalization and increased validity of the results.
Keywords: splinting, work-related CTS, symptom severity, functional status
Abstract: This article explains the protocol drawn up on behalf of the Dutch Federation of Occupational Therapists. It sets out for consultants the method of giving professional written advice on home adaptations and devices. In the Netherlands in 1994, a change in legislation made the local authorities responsible for home adaptations and technical aids for inhabitants with disabilities. As the authorities were not adequately staffed, this opened the possibility for occupational therapists (OT's) to work not only as consultants in health institutes but also for the local authorities. At present the local authorities are required to contract with a consultant who…has knowledge in the medical, social, ergonomic and technical fields. Occupational therapists have this knowledge. In 1997, the Dutch Federation of OT formed a group of OT's working in this sector, to develop a protocol for professional OT advice. The protocol contains (1) the steps to obtain professional advice; (2) the criteria of contracting an external consultant; (3) the criteria for the ``advice'' document; (4) the minimum level of qualification and experience; (5) the responsibilities of an OT consultant; (6) the cooperation between the OT advisor and the attending OT.
Abstract: This article provides an overview of the baby care assistive technology work at Through The Looking Glass (TLG). TLG is a non-profit organization in Berkeley, California which since 1991 has been designing, fabricating and researching the impact of babycare assistive technology for parents with physical disabilities. TLG provides direct services, information and referral to a diverse group of parents with disabilities and parents of children with disabilities. In 1998, the first U.S. National Resources Center for Parents with Disabilities was established under the auspices of TLG.
Abstract: Objectives: To determine the impact of assistive technology device (ATD) use on child and family function and whether use by young children is related to caregiver satisfaction with a device. Study design: Preliminary study of a state-based ATD Program for young children (< 4 years old). Information on device and child characteristics, service delivery, satisfaction with the device (QUEST), and child and family function (PEDI) was collected through program record review (n=21), telephone surveys (n=13) and face-to-face interviews with caregivers (n=4). Descriptive, non-parametric and qualitative procedures were used. Results: High ranked satisfaction scores were more likely…(p=0.03) for children using the device as intended than for those underutilizing the device. For 3 out of 4 children receiving a mobility device, functional mobility and amount of caregiver assistance improved. Conclusion: Application of this preliminary study’s methods will provide valuable information on the effectiveness of ATDs for young children with special needs.
Abstract: The Technology and Transition project has established a collaborative model for providing and coordinating assistive computer technology (ACT) services to students with disabilities to support the transition process. The model addresses areas mandated by federal legislation including: (a) support for the role of occupational therapy in secondary settings and in the transition process; (b) provision of assistive technology services to students with disabilities in these settings; and (c) facilitation of successful transition outcomes for students with disabilities. The Technology and Transition model has 4 interrelated components: (a) ACT service delivery including evaluation, student training in the use of devices, and…coordination of ACT with the technology used in the school; (b) the provision of ACT devices through a Lending Library, a key component of the model. Seventy-four percent of the participants borrowed equipment from the library; (c) an education component including a website providing transition related materials and resources and a summer training program in which students learn computer literacy skills; and (d) working with school personnel to facilitate coordination and collaboration between the student, family, school personnel, employers, and adult service providers. Occupational therapists have the skills and expertise vital in facilitating the successful transition of students with disabilities from secondary education to adult settings and have been instrumental in the development and implementation of the Technology and Transition model. Preliminary results indicate successful outcomes. Twenty seven students have participated in the project to date; 12 are in college and two are in job training programs with ACT in place, two withdrew from the project and the remaining students continue in secondary education with ACT from the lending library.
Keywords: assistive technology, transition programs and services, occupational therapy
Abstract: Engagement in leisure activity is a complex and subjective concept. It may be difficult for older adults who currently have physical and/or sensory disabilities to continue participation in home-based leisure choices they formerly enjoyed. Disability and social isolation may negatively impact on their pattern of leisure participation in the home. The purpose of this study was to examine the use of assistive devices to increase participation in valued home-based leisure activities by older adults who have physical and/or sensory disabilities. The study considered the need for custom made, or specifically adapted devices, to accomplish valued leisure activities by…this target population. A random sample of 25 participants was drawn from the Consumer Assessment Study (CAS) at the University at Buffalo Rehabilitation Engineering Research Center on Aging (RERC-Aging). Participants were seen in their homes for an interview regarding current living arrangement, work history, regard for inclusion of leisure as valued activity, past and current patterns of leisure activity engagement, and temporal use of leisure in their present daily routine. For 17 of the 25 participants, a target leisure activity was identified for intervention using assistive devices. The investigator analyzed the activity and searched for assistive devices to address the need. Assistive devices included commercially available products, devices from vendors who cater to special needs populations, custom adaptations and/or custom designed devices. Participants were supplied with devices and trained to use them. A subsequent contact at their home and/or phone interview was conducted to ascertain the participant's pattern of device use and current satisfaction with the target leisure activity. Twenty devices were supplied to 17 participants. The three custom made devices and one custom adapted device were used with maximum satisfaction by participants. Of the eight commercial devices targeted for persons with disabilities, five participants were very satisfied and three were satisfied with device use. Of the eight general commercial devices supplied, four participants were very satisfied, one was satisfied, and three were not satisfied. Considering the reported combined satisfaction with commercially available, leisure related devices being at 100% publicly accessed devices, it is questionable whether it is necessary to provide customized or custom-adapted devices for most people. In fact, given the findings of this study, it seems more practical to provide commercially available devices except in situations when another device cannot be found or when a person's needs fluctuate drastically enough to demand that a very sensitive solution be tried.