Tecnologia auditiva assistiva em usuários de implante coclear em ambientes reverberantes com múltiplas fontes de ruído / Assistive listening technology in cochlear implant users in reverberant environments with multiple noise sources

RESUMO Objetivo Avaliar a contribuição da tecnologia de escuta assistida em usuários de implante coclear (IC) em situações de reverberação e ruído. Métodos Estudo transversal prospectivo aprovado pelo Comitê de Ética Institucional (CAAE 8 3031418.4.0000.0068). Foram selecionados adolescentes e adultos usuários de IC com surdez pré ou pós-lingual. Para usuários bilaterais, cada orelha foi avaliada separadamente. O reconhecimento de fala foi avaliado por meio de listas gravadas de palavras dissílabas apresentadas a 65 dBA a 0° azimute com e sem o Mini Microfone2 (Cochlear™) conectado ao processador de fala Nucleus®6. A reverberação da sala foi medida como 550 ms. Para avaliar a contribuição do dispositivo de escuta assistida (DEA) em ambiente reverberante, o reconhecimento de fala foi avaliado no silêncio. Para avaliar a contribuição do DEA em reverberação e ruído, o reconhecimento de fala foi apresentado a 0° azimute com o ruído proveniente de 8 alto-falantes dispostos simetricamente a 2 metros de distância do centro com ruído de múltiplos falantes usando relação sinal-ruído de +10dB. Para evitar viés de aprendizado ou fadiga, a ordem dos testes foi randomizada. A comparação das médias foi analisada pelo teste t para amostras pareadas, adotando-se nível de significância de p<0,005. Resultados Dezessete pacientes com idade média de 40 anos foram convidados e concordaram em participar, sendo 2 participantes bilaterais, totalizando 19 orelhas. Houve contribuição positiva significante do Mini Mic2 na reverberação e ruído+reverberação (p<0,001). Conclusão DEA foi capaz de melhorar o reconhecimento de fala de usuários de IC tanto em situações de reverberação quanto ruidosas.

ABSTRACT Purpose This study aimed to evaluate the contribution of assistive listening technology with wireless connectivity in cochlear implant (CI) users in reverberating and noise situations. Methods Prospective cross-sectional study approved by the Institutional Ethics Committee (CAAE 8 3031418.4.0000.0068). Adolescents and adults CI users with pre- or post-lingual deafness were selected. For bilateral users, each ear was assessed separately. Speech recognition was assessed using recorded lists of disyllabic words presented at 65 dBA at 0° azimuth with and without the Wireless Mini Microphone 2 (Cochlear™) connected to the Nucleus®6 speech processor. Room reverberation was measured as 550 ms. To assess the contribution of the assistive listening device (ALD) in a reverberating environment, speech recognition was assessed in quiet. To assess the contribution of the ALD in reverberation and noise, speech recognition was presented at 0° azimuth along with the noise coming from 8 loudspeakers symmetrically arranged 2 meters away from the center with multi-talker babble noise using signal to noise ratio of +10dB. To avoid learning bias or fatigue, the order of the tests was randomized. Comparison of means was analyzed by t test for paired samples, adopting significance level of p <0.005. Results Seventeen patients with a mean age of 40 years were invited and agreed to participate, with 2 bilateral participants, totaling 19 ears assessed. There was a significant positive contribution from the Mini Mic2 in reverberation, and noise+reverberation (p <0.001). Conclusion ALD was able to improve speech recognition of CI users in both reverberation and noisy situations.

Satisfação dos usuários de cadeiras de rodas da Região Metropolitana da Baixada Santista / Satisfaction of wheelchair users in the Baixada Santista Metropolitan Region

Resumo O objetivo deste artigo é identificar a satisfação dos usuários em relação às cadeiras de rodas e à prestação de serviços públicos e privados de saúde da Região Metropolitana da Baixada Santista. Estudo transversal com abordagem quantitativa. Os participantes responderam a um questionário sociodemográfico e à versão brasileira do Quebec Assistive Technology User Satisfaction Assessment. Os dados foram analisados utilizando a estatística descritiva e comparativa por meio do teste t de Student. Os tamanhos de efeito d de Cohen foram calculados. Os participantes (n = 42) estavam "mais ou menos satisfeitos" com as cadeiras de rodas e "pouco satisfeitos" com a prestação de serviços. Os usuários de cadeiras de rodas monobloco apresentaram satisfação significativamente maior com suas cadeiras em comparação com usuários de cadeiras de rodas acima de 90kg (p = 0,010, d = 1,04). Os usuários de serviços privados apresentaram satisfação significativamente maior com a prestação de serviço em comparação aos usuários de serviços públicos (p = 0,021, d = 0,75). Os usuários de cadeiras de rodas da Região Metropolitana da Baixada Santista estão mais satisfeitos com as cadeiras de rodas monobloco e menos satisfeitos com os serviços públicos.

Abstract This article seeks to identify user satisfaction in relation to wheelchairs and the provision of public and private health services in the Baixada Santista Metropolitan Region. It involved a cross-sectional study with a quantitative approach. Participants answered a sociodemographic questionnaire and the Brazilian version of the Quebec Assistive Technology User Satisfaction Assessment. Data were analyzed using descriptive and comparative statistics by means of Student's t test. Cohen's d effect sizes were also calculated. Participants (n = 42) were "more or less satisfied" with the wheelchairs and "quite satisfied" with the services provided. Rigid frame wheelchair users were significantly more satisfied with their wheelchairs compared to users of wheelchairs weighing over 198 lbs. (p = 0.010, d = 1.04). Users of private services showed significantly greater satisfaction with the provision of the service compared to public services users (p = 0.021, d = 0.75). Wheelchair users in the Baixada Santista Metropolitan Region are more satisfied with the rigid frame wheelchair and less satisfied with public services.

Método de Desenvolvimento das Habilidades de Comunicação no Autismo - DHACA: validação da aparência e do conteúdo / Method for Developing Communication Skills in Autism - DHACA: appearance and content validation

RESUMO Objetivo Validar a aparência e o conteúdo do método de Desenvolvimento das Habilidades de Comunicação no Autismo (DHACA). Método Trata-se de estudo de validação de abordagem quali-quantitativa. Participaram do estudo dez juízes fonoaudiólogos com expertise na área da comunicação alternativa. Os juízes receberam o livro de comunicação, bem como a descrição dos princípios, habilidades e estratégias do método DHACA e um formulário com itens relativos à apreciação da aparência e conteúdo do método. A validade foi calculada usando o índice de validade de conteúdo. Resultados A análise das respostas possibilitou o cálculo do grau de concordância entre os juízes e a elaboração da nova versão do instrumento. O cálculo do Índice de Validade de Conteúdo revelou uma validade de conteúdo excelente. Os juízes deram sugestões referentes aos aspectos de conteúdo do livro de comunicação, nos textos de participação do parceiro de comunicação e modelagem, uso de dicas e habilidades comunicativas. Conclusão O grau de concordância observado entre os juízes possibilitou a obtenção da validação da aparência e do conteúdo do método DHACA, considerando-se os itens isoladamente e o instrumento como um todo, podendo ter seu uso recomendado na prática clínica fonoaudiológica.

ABSTRACT Purpose To validate the appearance and content of the DHACA method to develop communication skills in autism. Methods This qualitative and quantitative validation study included 10 speech-language-hearing judges with expertise in alternative communication. The judges received the communication book, the description of the principles, skills, and strategies in the DHACA method, and a form with items for them to appraise the appearance and content of the method. The validity was calculated with the content validity index. Results The response analysis made it possible to calculate the degree of agreement between judges and develop the new instrument version. The calculation of the content validity index revealed excellent content validity. The judges made suggestions regarding the content of the communication book, texts regarding the participation of communication partners and modeling, using cues, and communicative skills. Conclusion The degree of agreement between judges ensured the validation of the appearance and content of the DHACA method, considering the items alone and the whole instrument. Hence, its use can be recommended for speech-language-hearing clinical practice.

Criterios de referencia y barreras para la atención de personas con baja visión en Santander

Objetivo: Identificar criterios de derivación y barreras percibidas por los optómetras para la rehabilitación de personas con baja visión en Santander. Métodos: Estudio de corte transversal que incluyó 82 optómetras de municipios de Santander, seleccionados mediante muestreo intencionado. Se diseñó un cuestionario con 36 preguntas para recolectar los datos que son reportados empleando estadística descriptiva. Resultados: El 47,5 % de los profesionales tiene claro el nivel de agudeza visual para clasificar a una persona con baja visión. Las principales barreras identificadas para el acceso a servicios de baja visión fueron: el proceso de derivación dentro del sistema de salud es engorroso (74,39 %), falta de servicios cerca (57,31 %) y considerar que los pacientes no pueden pagar las ayudas (48,78 %). Discusión: Es necesario fortalecer la formación de los optómetras para mejorar los procesos de identificación, atención y rehabilitación. Conclusiones: Es importante ubicar como prioritaria la discapacidad visual en Santander, para así robustecer la red de atención en salud.

Objective: To identify referral criteria and barriers perceived by optometrists for the rehabilitation of people with low vision in Santander. Methods: Cross-sectional study, which included 82 optometrists from municipalities of Santander, selected by purposive sampling. A questionnaire with 36 questions was designed to collect data that are reported using descriptive statistics. Results: A total of 47.5% of the professionals are clear about the level of visual acuity to classify a person with low vision. The main barriers identified for access to low vision services were: the referral process within the health system is cumbersome (74.39%), lack of services nearby (57.31%) and considering that patients cannot afford the aids (48.78%). Discussion: It is necessary to strengthen the training of optometrists to improve the processes of identification, care and rehabilitation. Conclusions: It is important to prioritize visual impairment in Santander in order to strengthen the health care network.

Improving assistive technology access to students with low vision and blindness in Delhi: A school-based model

Purpose: Assistive technology (AT) has recently received considerable attention around the world. Studies have shown poor access to assistive technology for visual impairment (ATVI) in schools for the blind in India. The present article aimed at designing a school?based model to improve AT access in schools and provide hands?on training, and identify types of ocular morbidities present among students. Methods: The vision rehabilitation (VR) team of a tertiary eye?care center visited schools for the blind as a part of community? based VR services. The team conducted a basic eye examination and assessed best?corrected vision acuity (BCVA) and provided VR services. Furthermore, two schools were selected to establish an ATVI learning center as a pilot model. Results: In total, 1887 students were registered for VR and obtained their disability certificates in 2019?20. Retina problems (25.7%), globe abnormalities (25.5%), optic nerve atrophy (13.6%), and squint (12.0%) were common ocular problems identified in students. Around 50.3% of students had BCVA ³ 1/60 in the better eye who would be benefited from visual?based AT, and the remaining students with visual substitution AT. Further, 20.8% of them who had near vision between N18 to N24 would be benefitted from large print books. Two schools were provided ATVI with support from the WHO. Familiarization, demonstration, and initial training for ATVI were carried out. Conclusion: A sizable number of the students would be benefitted from visual?based AT apart from visual substitutions AT. Students were interested to have such ATVI centers in the school for academic and non?academic skills development.

Ensino de tecnologia assistiva nos cursos de graduação em terapia ocupacional do Estado de São Paulo / Teaching assistive technology in undergraduate courses in occupational therapy in the State of São Paulo

Resumo Introdução O conhecimento sobre tecnologia assistiva relaciona-se aos aspectos do domínio da terapia ocupacional, assim, interroga-se se tal conhecimento tem sido abordado nos cursos de graduação. Objetivos Identificar os cursos de graduação em terapia ocupacional no estado de São Paulo que ofertam discipinas referentes à tecnologia assistiva, identificar as disciplinas, suas respectivas cargas horárias e o conteúdo presente em cada uma delas. Método A amostra foi composta por oito universidades, cinco públicas e três privadas. A busca foi feita nas matrizes curriculares, planos de ensino de disciplinas específicas e não específicas, objetivos e conteúdos disponibilizados on-line ou solicitados ao coordenador de curso. Realizou-se análise descritiva dos dados. Resultados Constatou-se a oferta do conteúdo de tecnologia assistiva nas universidades investigadas, com diferença entre a carga horária e o conteúdo ofertado. A análise por área de aplicação da tecnologia assistiva evidenciou que o conteúdo sobre órteses é oferecido em 100% dos cursos analisados, seguido de produtos assistivos para o desempenho de atividades cotidianas e de prótese, ambos conteúdos encontrados em 75% dos cursos; equipamentos para mobilidade; acessibilidade e desenho universal em 62,5%; comunicação alternativa em 50% dos cursos. Conclusão Os resultados apontam a relevância de uma maior homogeneidade de conteúdo entre as universidades investigadas e sugerem que este estudo tem potencial para fomentar discussões sobre a formação do terapauta ocupacional na área da tecnologia assistiva, uma vez que os resultados advêm da análise dos cursos de graduação localizados no estado que possui o maior número de cursos de terapia ocupacional no Brasil.

Abstract Introduction Knowledge about assistive technology is related to aspects of the field of occupational therapy, thus, it is questioned whether such knowledge has been addressed in undergraduate courses. Objectives To identify the undergraduate courses in occupational therapy in the state of São Paulo that offer disciplines related to assistive technology, identify the disciplines, their respective workloads and the content present in each of them. Method The sample consisted of eight universities, five public and three private. The search was made in the curricular matrices, teaching plans of specific and non-specific disciplines, objectives and contents available online or requested from the course coordinator. Descriptive data analysis was performed. Results It was found that assistive technology content was offered in the investigated universities, with a difference between the workload and the content offered. The analysis by assistive technology application area showed that the content on orthoses is offered in 100% of the analyzed courses, followed by assistive products for the performance of daily activities and prostheses, both contents found in 75% of the courses; mobility equipment; accessibility and universal design in 62.5%; alternative communication in 50% of the courses. Conclusion The results point to the relevance of greater homogeneity of content between the investigated universities and suggest that this study has the potential to foster discussions about the formation of occupational therapists in the assistive technology area, since the results come from the analysis of undergraduate courses located in the state which has the largest number of occupational therapy courses in Brazil.

Advantages and disadvantages of ureteroscope in the diagnosis and treatment of upper tract urothelial carcinoma / 现代泌尿外科杂志

Ureteroscopy plays an important role in the diagnosis and treatment of upper tract urothelial carcinoma (UTUC). Conventional ureteroscopy (URS) can not only identify the location, appearance and size of a tumor, but also assess tumor grade by biopsy. The continued development of electronic flexible ureteroscopy and assistive technologies has led to further advances in the diagnosis of UTUC. Ureteroscopic laser ablation can be used to treat low grade malignancy, renal insufficiency, or isolated kidney. However, the use of URS may have potential risks such as delay of radical treatment, increased surgical difficulty, intraoperative or postoperative complications and intravesical recurrence. This article reviews the advantages and disadvantages of ureteroscopy in the diagnosis and treatment of UTUC.

Accessible facilities construction and assistive technology application of public sports venues in Shenzhen, Guangdong, China / 中国康复理论与实践

ObjectiveTo investigate the current situation of accessible facilities construction and assistive technology application of existing sports venues in Shenzhen, and analyze the existing problems. MethodsFrom November 19, 2022 to Februry 17, 2023, using the standards for the construction of accessible sports venues, the accessible construction and services of public sports venues and the application of assistive technology in eight districts of Shenzhen were investigated and evaluated on the spot. ResultsThere were curb ramps and accessible public toilets for all the stadiums; surface indicator for 87.5% (7/8) stadiums; wheelchair ramps, accessible elevators and accessible wheelchair seats for 62.5% (5/8) stadiums; accessible route for 37.5% (3/8) stadiums; handrails for 12.5% (1/8) stadiums; accessible vehicles parking lots for 75% (6/8) stadiums; and 25% (2/8) stadiums used assistive technology. ConclusionThis study evaluated the accessibility of accessible facilities and assistive technologies in sports venues in Shenzhen, including entering the stadium, entering the interior of the stadium and taking exercise. In terms of accessible facilities, the number of venues for the construction of curb ramps and accessible public toilets is the most, the number of venues for the construction of accessible handrails is the least, and the application of assistive technology is the worst.

Exploration and development of rehabilitation and assistive devices at home and abroad / 上海预防医学

With a rapidly aging population， there is a huge potential demand for rehabilitation and assistive products and services. Especially in the global context where greater attention is given to disadvantaged groups， there is a need to cater to the needs of the elderly in terms of rehabilitation and assistive aid to improve their quality of life. Compared with developed countries， China’s rehabilitation aid industry is still in its early stages of development and needs to move away from traditional equipment manufacturing and integrate with intelligent manufacturing to provide more development possibilities and choices. International cooperation is expected to become one of the future research and development directions for rehabilitation aids. Taking typical cities and countries at home and abroad as examples， this paper explores the development of rehabilitation aids， and calls for the cultivation of more rehabilitation aid professionals to help more people in need.

Application value of new assistive technology in keratopathy-associated cataract surgery / 国际眼科杂志(Guoji Yanke Zazhi)

Keratopathy-associated cataract, that is, on the basis of corneal disease, and later the development of lens opacity, seriously damage visual quality. In order to avoid corneal transplantation for some patients, partial visual quality can be restored. A comprehensive and accurate evaluation of the effect of corneal opacity on visual function is of great improtance for determining cataract surgery alone. Due to the opacity of the cornea, the operation is very difficult and challenging. Therefore, it is of clinical value to develop and use new assistive technologies, including capsule staining, endoillumination, pupil dialation technology, femtosecond laser assisted technology, etc., avoiding problems such as limited visibility and decreased light flow caused by corneal opacity and facilitating cataract surgery. This article reviews progress of assistive technologies for keratopathy-associated cataract, hoping to guide clinical application.

Demand, supply and satisfaction of assistive technology in China based on rapid Assistive Technology Assessment data / 中国康复理论与实践

ObjectiveTo investigate the demand, supply and satisfaction of the Chinese people on assistive technology. MethodsBased on the data from the World Health Organization rapid Assistive Technology Assessment (rATA) questionnaire in six provinces and cities in China, the assistive technology of the whole population in China was described from three aspects of demand, supply and satisfaction. ResultsA total of 15 234 valid questionnaires were obtained. In terms of demand, the proportion of visual impairment was the highest in all the functional impairment categories, the highest demands in the list were glasses (low-vision, short/long distance etc.) and walking sticks (canes/sticks, tripod and quadripod), while the highest demand outside the list was anti-skid pad. In terms of supply, the private sector was the main one, followed by government facility and public hospital, and most users took "paid out-of-pocket (self)" to obtain assistive technology, the distance to access the assistive technology was concentrated at "less than five kilometers", and the biggest obstacle to obtain assistive technology was lack of knowledge about assistive technology. Overall satisfaction with assistive technology was optimistic, the adaptation degree and service quality of assistive technology were the most unsatisfactory factors for users. ConclusionIn China, the satisfaction of assistive technology is optimistic, and there is a few amount of unmet assistive technology. It is necessary to propagandize assistive technology, and its manual should be readable, the assistive technical service team should be multidisciplinary, enterprises should promote independent innovation, and the professionals should be regulated.

Ensaio sobre a aderência ao modelo nacional de bengala eletrônica Smart Mobb® como recurso auxiliar à mobilidade de pessoas com cegueira ou baixa visão / Essay on adherence to the national model of electronic walking stick Smart Mobb® as a resource to assist the mobility of people with blindness or low vision

Objetivo: O objetivo deste trabalho foi identificar, por meio da interposição de questionário, pontos favoráveis e pontos potencialmente impeditivos à compra da Smart Mobb® como tecnologia assistiva auxiliar à mobilidade de pessoas com deficiência visual. Métodos: A aplicação do questionário foi realizada na Fundação Dorina Nowill para Cegos, instituição especializada no atendimento e reabilitação de pessoas com deficiência visual. A entrevista consistiu em perguntas sobre o perfil socioeconômico, social, tecnológico, sob o contexto das tecnologias assistivas, e de saúde, relativas ao indivíduo e às dificuldades que ele enfrenta no dia a dia por causa do seu quadro de deficiência visual. Resultados: Foram entrevistados oito candidatos. Os resultados indicaram que a Smart Mobb® possui características que apresentam identidade com as preferências relatadas pelas pessoas que participaram do estudo, apresentando inconsistência apenas quanto ao valor médio mensal estimado para venda e ao que esses indivíduos estão dispostos a pagar. Conclusão: Verificou-se que existe o desejo, por parte dos potenciais demandantes, quanto a soluções em tecnologias assistivas que carreguem maior teor tecnológico e que surjam como proposta de solução para o problema da mobilidade urbana. Com relação ao preço, a maioria dos entrevistados está disposta a pagar um percentual médio mensal abaixo do mínimo estipulado para a aquisição da bengala eletrônica Smart Mobb® , o que configura um potencial fator impeditivo à adesão

Objective: The objective of this work was to identify, through the questionnaire, favorable points and potentially impeding points for the purchase of Smart Mobb® as an auxiliary mobility technology for people with visual impairments. Methods: The questionnaire was applied at the Dorina Nowill Foundation for the Blind, an institution specialized in the care and rehabilitation of visually impaired people. The interview consisted of questions about the socioeconomic profile; Social; technological, in the context of assistive technologies; and health, including the individual and the difficulties he faces on a daily basis using his visual impairment. Results: Eight candidates were interviewed. The results indicate that Smart Mobb® has features that display the identity with respect to the people who study, showing inconsistency only in terms of the estimated average monthly value for sale and that these items are available for payment. Conclusion: It was found that it exists or desires, on the part of users who demand as much solutions in assisted technologies that carry greater technological content, and that appear as a solution proposal for the problem of urban mobility. With regard to price, most respondents are willing to pay an average monthly percentage below the minimum stipulated for the purchase of the Smart Mobb® electronic cane, or to set up a potential impediment to adherence

Recursos de Acessibilidade e o Uso dos Dispositivos Móveis como Tecnologia Assistiva por Pessoas com Baixa Visão / Accessibility Resources and the Use of Mobile Devices as Assistive Technology by People with Low Vision

RESUMO: As dificuldades de implementação e de apropriação de recursos de Tecnologia Assistiva (TA) deriva do seu alto custo, desconforto social em utilizá-los, extravios dos dispositivos e da falta de funcionalidade em longo prazo. Paralelamente a esse contexto, diferentes possibilidades em TA vêm se popularizando entre as pessoas com deficiência visual, as quais têm sido descritas, timidamente, em pesquisas de levantamento que abordam o uso de TA por pessoas com baixa visão. Em razão da carência de conhecimento sobre a temática e a necessidade de descrever o perfil funcional e de uso dessas possibilidades, este artigo tem como objetivo caracterizar, a partir do ponto de vista dos usuários, o funcionamento e o uso de recursos de acessibilidade de smartphones e/ou tablets no cotidiano de pessoas com baixa visão. A metodologia adotada nesta investigação é de natureza descritiva, sob o delineamento de estudo de caso. Participaram do estudo 28 pessoas com baixa visão, membros de um grupo já existente no aplicativo WhatsApp. A coleta de dados aconteceu no espaço virtual desse aplicativo, individualmente, por meio de entrevista semiestruturada. Os dados foram transcritos e analisados com base na teoria fundamentada. Os resultados indicam que o uso dos recursos de acessibilidade é o principal diferencial dos smartphones e dos tablets, pois são eles os responsáveis pelo acesso independente a esses dispositivos. Eles são usados de maneira combinada, e os diferentes arranjos garantem variabilidade de opções em TA proporcionais à diversidade de necessidades do público com baixa visão.

ABSTRACT: The difficulties in implementing and appropriating Assistive Technology (AT) features derive from their high cost, social discomfort in using them, loss of devices and lack of functionality in the long term. Parallel to this context, different possibilities in AT have become popular among people with visual impairment, which have been described, timidly, in research that address the use of AT by people with low vision. Due to the lack of knowledge on the subject and the need to describe the functional profile and use of these possibilities, this article aims to characterize, from the users' point of view, the functioning and use of accessibility features of smartphones and/or tablets in the daily lives of people with low vision. The methodology adopted in this investigation is descriptive in nature, under the outline of a case study. Twenty-eight people with low vision participated in the study, members of an existing group in the WhatsApp application. Data collection took place in the virtual space of this application, individually, through semi-structured interviews and data analysis based on the grounded theory. The results indicate that the use of accessibility features is the main differential of smartphones and tablets, as they are responsible for independent access to these devices. They used in a combined manner, and the different arrangements guarantee variability of AT options proportional to the diversity of needs of the public with low vision.

Policies and Development of Assistive Technology Services for People with Disabilities in Australia / 中国康复理论与实践

Objective:To study the prevalence of people with disability, and the demand, service policies and service system for assistive technology (AT) services in Australia. Methods:Referring to policy recommendation and indicators in World Health Organizaion's Rehabilitation in Health Systems, Australia's assistive technology service policy framework, services development and trend of development were analyzed by the means of content analysis and development research. Results:There are about 4.4 million people with disability in Australia, of which 1.4 million (32%) with severe or profound disabilities. Federal, state and territorial governments have respectively issued legislation, policy and related service project, including the National Disability Strategy, National Disability Agreement, the National Disability Insurance Scheme, National Standards for Disability Services and others assistance programs to support disability services. There are about two million Australians with disabilities received AT services support from the mentioned programme and scheme. Australia provides more than ten thousands kinds of AT appliances per year, covering all kinds of products in WHO's Priority Assistive Products List. Conclusion:Australia has developed a federal National Disability Strategy, AT service policies and standards, and established federal and state AT insurance and financial support programs for people with disabilities based on the unmet needs of AT services, and federal and state networks for AT services have been established, and service coordination mechanisms at federal and state levels have been established through the National Disability Agreement, covering all types of people with demand of AT in Australia. It meets the requirements of the policy recommendations and assessment indicators in the WHO's Rehabilitation in Health Systems policy guidelines involving AT services. The future development areas in AT will focus on the fields of policy development, ICF implementation, service delivery system, upgrading of service quality and standard, and new technology application.

Construction of China Occupational Skills Standard of Assistive Technology Consultants / 中国康复理论与实践

Objective:To explore national standard of occupational skills for assistive technology consultants in China based on the study of relevant international standards. Methods:After analyzing the international and some other national job content, work requirements, professional education and vocational training, and vocational standards of assistive technology consultants, the national occupational skills standard for assistive technology consultants in China was established referring to the compiling rules of national occupational skills standard. Results:According to the compiling rules of national occupational skills standard, the national occupational skills standard for assistive technology consultants in China included career situation, basic requirements, job requirements, and weight table, etc. Conclusion:The vocational development, structural framework and content of professional capacity for assistive technology consultants are studied. The draft of national occupational skills standard for rehabilitation assistive technology consultants has been compiled.

Conceptual Discussion of Assistive Technology / 中国康复理论与实践

Objective:To introduce the basic knowledge on assistive technology and World Health Organization (WHO) latest understanding of assistive technology. Methods:The literatures in the field of assistive technology, including relevant documents of WHO since its establishment in 1948, and ISO 9999, as well as related articles published were reviewed. Results:The understanding of assistive technology can be divided into four stages: early (ignored), midterm (disabled persons needed rehabilitation engineering), recent (persons with disabilities needed assistive technology), and the latest (all the human needed assistive technology). The basic knowledge of assistive technology, including definition, characteristics, classification, function, selection and application were also introduced. Conclusion:The awareness of assistive technology is improved with the in-depth understanding of rehabilitation. Rehabilitation has become a part of the health service system, which means assistive technology is a subset of health technology.

Framework and Core Content of International Policy on Service of Assistive Technology / 中国康复理论与实践

Objective:To study the policy framework and core content of assistive technology (AT) services, compare the current status of AT in countries with different levels of development, and discuss the future development of international policies and services of AT. Methods:Based on the policy and theoretical framework of AT of the United Nations (UN) and World Health Organization (WHO), the policy framework and main contents of international AT services were analyzed; the policies, assistive products and service development of AT services in countries with different levels of development worldwide were compared; and the policy and innovative technology development hotspots of international AT were explored. Results:AT service is an important component of rehabilitation services, and the development of AT services is a key step toward achieving the UN Sustainable Development Goal 3, "Ensure healthy lifestyles and promote the well-being of people of all ages". UN and WHO advocated AT services policy. The framework is based on the UN Convention on the Rights of Persons with Disabilities (CRPD) on articles related to AT, and WHO documents of AT and rehabilitation, such as World Report on Disability, the Global Plan of Action on Disability, Rehabilitation in the Health System, and Rehabilitation in the Health System: A Guide to Action, as well as WHA 71.8 on Assistive Technology, Improving Access to Assistive Technology. The core elements of the international AT policy aim to build integrated, people-centered health services, emphasize the integration of AT into the health system and rehabilitation services, establish and develop AT services in six building blocks of WHO health system, thereby improving access to quality AT to achieve universal health coverage. Further in the fields of technology and service innovation, it proposed to establish a 5P model. High-income countries and low- and middle-income countries are facing many difficulties and large differences in AT service policies, assistive product provision, and service coverage. In the future, adoption of the 5P model proposed by WHO for policy and service delivery and technological changes, and the innovation of assistive product development and AT service models will be the hot spots of AT development. Conclusion:The policy on AT at international level is centered on the concept of UN CRPD and is based on prospect of policy documents issued by the UN and WHO on AT services, with the core objective of developing AT services to provide timely, appropriate, and affordable to persons with disabilities, aging, and people needed to improve their health, quality of life and well-being. It proposes to integrate AT into universal health coverage and to deliver AT service through primary health care in order to achieve the UN SDG 3 goal with full coverage of AT. It proposes to integrate AT into rehabilitation services, i.e. leadership and governance, financing, AT professionals, AT delivery, medicine and technology, and health information system monitoring AT services. There are differneces in AT products and AT delivery due to the globel differneces in economic and social development levels and challenges in access to AT services. It is necessary to develop relevant policies, planning and innovations in assistive products and AT services. AT development in the future will focus on the 5P model of AT to implement reforms in the field of product and service delivery as well as technological innovation in order to improve the coverage, availability, accessibility and affordability, integrate AT into the health system within the framework of universal health coverage, achieve full coverage of universal AT services, and enhance the quality of AT and improve consumers' well-being.

A rapid literature review on the strategies for collaboration between occupational therapists and speech-language therapists in the field of augmentative and alternative communication

@#An alternative and augmentative communication (AAC) device replaces or supplements a person’s natural speech. Speech-Language Pathologists (SLPs) collaborate with a team of healthcare professionals in the process of identification and use of the right AAC device for a person with complex communication needs (CCN). In the Philippines, occupational therapists (OTs) and SLPs are more likely to collaborate in the treatment of their clients due to their interprofessional education (IPE) experience. However, most Filipino SLPs do not engage in interprofessional collaboration (IPC) when rendering AAC services. Thus, there is a need to identify existing literature that tackles collaborative practices to raise the quality of service and care. Hence, this study aimed to identify and discuss existing literature that documented IPE and IPC strategies between OTs and SLPs in the field of AAC. The structure of this literature review was guided and adapted from the topics outlined in the preferred reporting items for systematic reviews and meta-analyses (PRISMA). Literature archived in two databases (Pubmed and Scopus) were reviewed. Two articles out of five studies were included in this review. Strategies found were “case based learning approach” for post-graduate students and the “Beyond Access model” in supporting practitioners. In conclusion, there is a dearth of literature on IPC practices among OTs and SLPs in the field of AAC. There is a need to report IPE and IPC efforts in the Philippines to provide applicable strategies to the local healthcare landscape.

Contribuições da comunicação alternativa no desenvolvimento da comunicação de criança com transtorno do espectro do autismo / Contributions of alternative communication in the development of communication in children with autism spectrum disorder

RESUMO Este artigo apresenta as contribuições do uso de um sistema de Comunicação Aumentativa e Alternativa de alta tecnologia no desenvolvimento das habilidades comunicacionais de uma criança com Transtorno do Espectro do Autismo (TEA). Para isso, foi realizado um estudo de caso com uma criança de 2 anos e 2 meses, durante 24 sessões de terapia, ao longo de oito meses. Como instrumentos de avaliação, foram utilizados o Autism Treatment Evaluation Checklist e o protocolo Avaliação da Comunicação no Transtorno do Espectro do Autismo. Durante as intervenções, utilizou-se o método Desenvolvimento das Habilidades Comunicacionais no Autismo e, como recurso de Comunicação Aumentativa e Alternativa, a prancha de alta tecnologia do aplicativo aBoard. De acordo com os resultados, após as intervenções foram observadas melhoras nos escores dos instrumentos de avaliação, quanto às habilidades de expressão, compreensão e interação social. Além disso, observou-se aumento do vocabulário da criança, com aquisição de novas categorias lexicais; realização de solicitações de objetos fora do alcance visual, utilizando a Comunicação Aumentativa e Alternativa, e melhor comunicação social no contexto familiar e educacional. De acordo com os resultados obtidos, puderam ser observadas as contribuições do uso de um sistema de alta tecnologia assistiva de Comunicação Aumentativa e Alternativa no desenvolvimento das habilidades comunicacionais de uma criança com TEA.

ABSTRACT This article presents the contributions of using a high-tech Augmentative and Alternative Communication (AAC) system in the development of the communication skills of a child with Autistic Spectrum Disorder (ASD). For this, a case study was carried out with a two-year-and-two-month-old child during 24 therapy sessions over 8 months. As assessment instruments, the Autism Treatment Evaluation Checklist (ATEC) and the protocol for Communication Assessment in Autism Spectrum Disorder (COATEA) were used. During the interventions, the Development of Communication Skills in Autism (DCSA) method was used and, as an AAC resource, the high-tech board from the aBoard app. Postintervention results showed improvements in the scores of the evaluation instruments for skills of expression, comprehension, and social interaction. The child's vocabulary also increased, with the acquisition of new lexical categories; initiative to request objects beyond his visual reach with the AAC; and better social communication in the family and educational context. The results point to contributions of the use of a high-tech assistive system of AAC in the development of communication skills of a child with ASD.

Advocacy coalition formation and key actors within the policy / Formación de coaliciones de defensa y actores clave dentro de la política / Formação de coalizão de defesa e atores chaves da política

Abstract The article discusses advocacy coalition formation and the roles of key actors in science, technology and innovation (ST&I) policies for social inclusion in a subnational context. The policy subsystem category and concept of advocacy coalition are used in the context of the advocacy coalition framework and address the need to understand the influences of key actors (policy broker and policy entrepreneur) on it. The policy subsystem was outlined using case-oriented research and the discourse was analyzed in order to understand the policy actors' beliefs. The analysis of two cases of ST&I policy processes for social inclusion (assistive technology and social technology) highlighted policy broker and policy entrepreneur key roles in the emergence of policy subsystems, but had different effects on advocacy coalition formation. The policy entrepreneur had a closer relationship with advocacy coalition building when setting up regular mechanisms to share beliefs and policy-oriented learning, as well as taking initiatives to coordinate the collective action of members in the early advocacy coalition. Although relevant in agenda setting and maintaining a specific social inclusion agenda in the policy process, the policy broker did not achieve a positive relationship with advocacy coalition building. The article corroborates the possibility of incorporating the concept of policy entrepreneur in analyses of the advocacy coalition framework and highlights this actor's characteristics through this analytical model.

Resumen El artículo analiza la formación de coaliciones de defensa y los roles de los actores clave en las políticas de ciencia, tecnología e innovación (PCTI) para la inclusión social en un contexto subnacional. Considerando el modelo de coalición de defensa (MCD), se utilizaron como referencia las categorías analíticas del subsistema de la política y de la coalición de defensa, para comprender las influencias de los actores clave, específicamente del policy broker (intermediario) y del emprendedor de políticas. El subsistema de la política se delimitó mediante el método de investigación basado en casos y se usó el análisis del discurso para comprender las creencias de los actores en la política. El análisis de dos casos del proceso de la PCTI para la inclusión social (tecnología social y tecnología de la rehabilitación) resaltó los roles de los actores clave en la aparición de subsistemas de la política, sin embargo tuvieron diferentes efectos en la formación de coaliciones de defensa. El emprendedor de políticas tuvo una mayor relación con la formación de una coalición de defensa al establecer mecanismos regulares para comunicar sus posiciones y aprendizajes orientados a la política, así como al tomar iniciativas para coordinar la acción colectiva en la naciente coalición de defensa. El policy broker no logró una relación positiva con la formación de las coaliciones de defensa analizadas, pero sí fue relevante para el establecimiento de la agenda y la permanencia de la pauta de inclusión social en el proceso de la política. Este trabajo corrobora la posibilidad de incorporar el concepto de emprendedor de política en los análisis de MDC y señala las características de este actor clave en el modelo analítico estudiado.

Resumo O artigo discute a formação de coalizão de defesa e o papel de atores chaves em políticas de Ciência, Tecnologia e Inovação (CT&I) para inclusão social em um contexto subnacional. No âmbito do Modelo de Coalizão de Defesa (MCD), utilizou-se as categorias analíticas do subsistema da política e da coalizão de defesa como referência e buscou-se compreender as influências de atores chaves nestas, especificamente o policy broker (mediador) e o empreendedor de política. O subsistema de política foi delimitado pelo método de pesquisa baseada em caso e a análise de discurso foi mobilizada para compreender as crenças dos atores da política. A análise de dois casos do processo de política de CT&I para inclusão social (tecnologia social e tecnologia assistiva) realçou os papéis de atores chaves na emergência dos subsistemas de política, porém estes tiveram diferentes efeitos sobre a formação de coalizões de defesa. O empreendedor da política teve maior relação com a formação de coalizão de defesa ao estabelecer mecanismos regulares para compartilhamento de crenças e aprendizados orientados para a política, bem como ao tomar iniciativas de coordenação da ação coletiva na coalizão de defesa nascente. O policy broker não alcançou relação positiva substancial com a formação das coalizões de defesa analisadas, embora tenha sido relevante para o agenda-setting e a permanência da pauta de inclusão social no processo da política. O artigo corrobora com a possibilidade de incorporação do conceito de empreendedor de política em análises do MDC e aponta características deste ator chave iluminadas pelo modelo analítico.