Guidelines for assistive technology service provision - A scoping review.

PURPOSE: Despite the high unmet need for effective AT provision, multiple service delivery models across different countries, and a shortage of personnel trained in this field, no widely useable and accepted Assistive Technology (AT) service provision guidelines currently exist. This review aims to provide an overview of the literature regarding AT service provision guidelines to inform the development of globally useable AT provision guidance, aligned with contemporary global initiatives to improve access to AT. MATERIALS AND METHODS: The rapid scoping review method used a two-tiered approach to identifying relevant publications: (1) systematic search of academic databases (Medline, CINAHL, SCOPUS, and Google Scholar); (2) consultation with international AT organisations and experts. The search was conducted in March 2023 with no date limitations. Analysis was guided by the TIDE-funded HEART research on quality AT provision and service delivery processes in Europe, as well as the WHO-GATE 5 P framework for strengthening access to AT. RESULTS: 35 publications were identified from various countries, and directed at differing assistive products, personnel, and provision contexts. No established guidelines for AT service provision currently exist. However, despite the variety in contexts, the range of assistive products and the range of stakeholders to whom guidelines are directed, several key service delivery steps were identified that may form part of such guidelines. CONCLUSIONS: This review offers a strong starting point for developing guidance for AT provision to meet global needs. Careful consideration of vocabulary, process, and application to the diversity of assistive products is recommended in systematizing globally applicable guidance.

Guidelines offer accepted benchmarks for clinical practice.Evidence-based guidelines ensure consistent and appropriate interventions, including assistive technology provision.The evidence suggests global guidance is required, and a substantial evidence base can be drawn upon to formulate such guidelines.

Using a Social Robot to Engage Older Adults Living in Residential Care Homes in Cognitive Training: Preliminary Results from the SHAPES Project.

The employment of socially assistive robotics (SAR) is increasingly being considered a credible solution to support healthcare systems in dealing with an aging society. In this contribution, we explore the experience of older adults (n = 11) living in a residential facility with a cognitive training intervention conducted with the support of a SAR. Within the HORIZON2020 Project SHAPES, a mixed-method study has been conducted to collect preliminary evidence on users' engagement and acceptance of the proposed SAR-based intervention. The results suggest that the SAR-based cognitive training intervention conducted was accepted by all stakeholders. Data on enjoyment of participants indicate that users did not experience a "novelty effect" of the proposed innovation, but longer sessions are needed to confirm this result.

Towards a Model for the Transfer of Technology-Driven Innovation in Accessible and Inclusive Public Transport.

This article reports on work undertaken by AAATE researchers in the framework of the EU-funded TRIPS Project. The project (2021-2023) has aimed to contribute to transforming public transport in Europe and beyond toward more inclusive models, leaving no one behind. The reported findings refer to a specific aspect of the transformation process that has been investigated by the authors, namely the factors that impact the transfer of innovation in accessibility by the public transport providers. A framework model was created due to a process of factor extraction from existing literature and their validation by a sample of decision-makers in the public transport sector.

Adapting the World Health Organization rapid Assistive Technology Assessment (rATA) to the Italian context: implementation of a TRAPD-based approach.

BACKGROUND: Measuring access to assistive technology (AT) has become a global priority. Recently, the World Health Organization (WHO) has developed the rapid assistive technology assessment (rATA), a population-based household survey that measures the use, need, unmet need, and barriers to accessing AT. OBJECTIVE: The aim of this paper is to report on the translation and adaptation process undertaken to implement the rATA survey in the Italian context. METHOD: The Translate, Review, Adjudicate, Pretest, and Document (TRAPD) approach was used to translate and adapt the rATA from English to Italian. Eleven independent reviewers and 23 AT users were involved to validate the Italian translation of the rATA and pilot the survey, respectively. RESULTS: The feedback provided by the first users of the rATA indicate that the data collected are reliable and well reflect the state of AT provision in Italy. CONCLUSION: This study confirmed the applicability of the rATA survey to the Italian context. The Italian version of the rATA can be used to support the government, the health system as well as the civil society to monitor the current state of AT access (and abandonment) in the country.

A reflection on participatory research methodologies in the light of the COVID-19 - lessons learnt from the European Research Project TRIPS.

The coronavirus disease (COVID-19) outbreak has had considerable impacts on research projects, particularly those adopting participatory approaches. This paper reflects on the methodological adaptations employed by the European research project TRIPS to facilitate co-design and open innovation practices towards the development of accessible mobility solutions. The article reports how the methods were adapted to facilitate participatory research with almost no physical meetings. In doing so, the paper presents the alternative 'distanced-based' participatory approaches employed to engage users with disabilities and institutional stakeholders in the transport ecosystem, like online workshops, social media content analysis, online surveys and peer-to-peer telephone interviews. Lessons learnt and practical guidelines for distance-based participatory research are presented and discussed with the aim of increasing resilience in the light of future changes.

Opening the GATE: systems thinking from the global assistive technology alliance.

Purpose: This paper describes international actions to collaborate in the assistive technology (AT) arena and provides an update of programmes supporting AT globally. Methods: The World Health Organisation (WHO) identifies the severe global uneven distribution of resources, expertise and extensive unmet need for AT, as well the optimistic substantial capability for innovations and developments in appropriate and sustainable AT design, development and delivery. Systems thinking and market shaping are identified as means to address these challenges and leverage the ingenuity and expertise of AT stakeholders. Results: This paper is a 'call to action', showcasing emerging AT networks as exemplars of a distributed, but integrated mechanism for addressing AT needs globally, and describing the Global Alliance of Assistive Technology Organisations (GAATO) as a vehicle to facilitate this global networking. Conclusion: Partners in this Global Alliance aim to advance the field of assistive technology by promoting shared research, policy advocacy, educating people and organisations within and outside the field, teaching, training and knowledge transfer by pulling together broad-based membership organisations.Implications for RehabilitationCollegial, cross discipline and multi-stakeholder collaborations support assistive technology research and practice.Knowledge exchange within and across countries and regions is mutually beneficial.Self-organising assistive technology communities are emerging and supported by global movements such as WHO GATE and GAATO.

Assistive technology policy: a position paper from the first global research, innovation, and education on assistive technology (GREAT) summit.

Increased awareness, interest and use of assistive technology (AT) presents substantial opportunities for many citizens to become, or continue being, meaningful participants in society. However, there is a significant shortfall between the need for and provision of AT, and this is patterned by a range of social, demographic and structural factors. To seize the opportunity that assistive technology offers, regional, national and sub-national assistive technology policies are urgently required. This paper was developed for and through discussion at the Global Research, Innovation and Education on Assistive Technology (GREAT) Summit; organized under the auspices of the World Health Organization's Global Collaboration on Assistive Technology (GATE) program. It outlines some of the key principles that AT polices should address and recognizes that AT policy should be tailored to the realities of the contexts and resources available. AT policy should be developed as a part of the evolution of related policy across a number of different sectors and should have clear and direct links to AT as mediators and moderators for achieving the Sustainable Development Goals. The consultation process, development and implementation of policy should be fully inclusive of AT users, and their representative organizations, be across the lifespan, and imbued with a strong systems-thinking ethos. Six barriers are identified which funnel and diminish access to AT and are addressed systematically within this paper. We illustrate an example of good practice through a case study of AT services in Norway, and we note the challenges experienced in less well-resourced settings. A number of economic factors relating to AT and economic arguments for promoting AT use are also discussed. To address policy-development the importance of active citizenship and advocacy, the need to find mechanisms to scale up good community practices to a higher level, and the importance of political engagement for the policy process, are highlighted. Policy should be evidence-informed and allowed for evidence-making; however, it is important to account for other factors within the given context in order for policy to be practical, authentic and actionable. Implications for Rehabilitation The development of policy in the area of asssitive technology is important to provide an overarching vision and outline resourcing priorities. This paper identifies some of the key themes that should be addressed when developing or revising assistive technology policy. Each country should establish a National Assistive Technology policy and develop a theory of change for its implementation.

Enabling appropriate personnel skill-mix for progressive realization of equitable access to assistive technology.

BACKGROUND AND METHODS: This paper reviews the current capacity of personnel in enabling access to assistive technology (AT) as well as the systems and processes within which they work, and was reviewed, discussed, and refined during and following the Global Research, Innovation, and Education in Assistive Technology (GREAT) Summit. FINDINGS: Key concepts addressed include a person-centred team approach; sustainability indicators to monitor, measure, and respond to needs for service design and delivery; education, research, and training for competent practice, using the six rehab-workforce challenges framework; and credentialing frameworks. We propose development of a competence framework and associated education and training programs, and development and implementation of a certification framework for AT personnel. CONCLUSIONS: There is a resolve to address the challenges faced by People globally to access assistive technology. Context specific needs assessment is required to understand the AT Personnel landscape, to shape and strengthen credentialing frameworks through competencies and certification, acknowledging both general and specific skill mix requirements. Implications for Rehabilitation Personnel in assistive technology (AT) provision should be trained using a person-centred team approach, which emphasizes appropriate skill-mix to address multiple needs within the community. Sustainability indicators should be used which allow personnel to monitor, measure and respond to needs for service design and delivery. A competence framework with associated education and training program, coupled with the development and implementation of a certification framework for AT personnel needs, will promote quality in AT personnel training globally.

Perceptions and Use of Technology to Support Older Adults with Multimorbidity.

Digital technologies hold great potential to improve and advance home based integrated care for older people living with multiple chronic health conditions. In this paper, we present the results of a user requirement study for a planned digital integrated care system, based on the experiences and needs of key stakeholders. We present rich, multi-stakeholder, qualitative data on the perceptions and use of technology among older people with multiple chronic health conditions and their key support actors. We have outlined our future work for the design of the system, which will involve continuous stakeholder engagement through a user-centred co-design method.

Exploring the Use of a Humanoid Robot to Engage Children with Autism Spectrum Disorder (ASD).

We present a study aimed at exploring whether a humanoid robot may improve the effectiveness of educational interventions targeting children with autism spectrum disorders (ASD). Preliminary results with three preschool children with ASD indicate that interacting with a humanoid robot may facilitate engagement and goal achievement in educational activities.

A Self-Assessment Framework for Inclusive Schools Supporting Assistive Technology Users.

In order to support schools to assess their performance in supporting children with disabilities in their ICT and ICT-AT needs, a self-assessment framework was developed by a task force of partners and associate partners of the ENTELIS project. The self-assessment tool aims to help educational establishments that welcome learners with disabilities to assess their current outcomes and to plan improvements in supporting these students in increasing digital literacy and developing digital skills. This includes the use of mainstream Information and Communication Technology (ICT) and specially designed digital Assistive Technologies (ICT-AT). This can only successfully happen if schools fully embrace an inclusive approach to education. In this paper the authors describe the development of the framework and the further steps for its use.

A conceptual framework related to ICT-AT competence development: The theoretical foundations of ENTELIS.

This paper provides an overview of the construction of a conceptual framework regarding ICT-Assistive Technology (ICT-AT) competence development, designed to gain awareness of the elements involved and to facilitate the understanding and exchange among stakeholders of the ENTELIS (European Network for Technology Enhanced Learning in an Inclusive Society) project. The framework was designed based on the basic principles of Activity Theory, which however have been adapted and adjusted to the project's objectives. Hence, it includes a map of actors and other parameters functioning in a person surrounding "ecosystem", and it allows us to understand and map roles, expectations, barriers, as well as to devise solutions to tackle digital divide. Taking as a starting and central point the person and his/her wish to self-determination and fulfilment (quality of life) and the related needs, it provides a map of how the various concepts and variables interact within the theoretical and methodological perspective of the collection, description and assessment of experiences in ICT-AT education and competences development of persons with disabilities (PwD) of all ages. The conceptual framework represents two interacting learning activity systems: (a) the internal system of the end-user, which includes the end-user and his/her needs, the setting where learning takes place and the other actors involved, and (b) the external system, which embraces the internal system but also wider issues of policy and practice and experiences and 'actors' that contribute to the development and use of ICT and ICT-AT skills in all areas of life. The elements of these systems and their interaction provide the basis for analysing experiences and advancing knowledge relevant for bridging the digital divide.

The user-centered design as novel perspective for evaluating the usability of BCI-controlled applications.

Albeit research on brain-computer interfaces (BCI) for controlling applications has expanded tremendously, we still face a translational gap when bringing BCI to end-users. To bridge this gap, we adapted the user-centered design (UCD) to BCI research and development which implies a shift from focusing on single aspects, such as accuracy and information transfer rate (ITR), to a more holistic user experience. The UCD implements an iterative process between end-users and developers based on a valid evaluation procedure. Within the UCD framework usability of a device can be defined with regard to its effectiveness, efficiency, and satisfaction. We operationalized these aspects to evaluate BCI-controlled applications. Effectiveness was regarded equivalent to accuracy of selections and efficiency to the amount of information transferred per time unit and the effort invested (workload). Satisfaction was assessed with questionnaires and visual-analogue scales. These metrics have been successfully applied to several BCI-controlled applications for communication and entertainment, which were evaluated by end-users with severe motor impairment. Results of four studies, involving a total of N = 19 end-users revealed: effectiveness was moderate to high; efficiency in terms of ITR was low to high and workload low to medium; depending on the match between user and technology, and type of application satisfaction was moderate to high. The here suggested evaluation metrics within the framework of the UCD proved to be an applicable and informative approach to evaluate BCI controlled applications, and end-users with severe impairment and in the locked-in state were able to participate in this process.

A brain-computer interface as input channel for a standard assistive technology software.

Recently brain-computer interface (BCI) control was integrated into the commercial assistive technology product QualiWORLD (QualiLife Inc., Paradiso-Lugano, CH). Usability of the first prototype was evaluated in terms of effectiveness (accuracy), efficiency (information transfer rate and subjective workload/NASA Task Load Index) and user satisfaction (Quebec User Evaluation of Satisfaction with assistive Technology, QUEST 2.0) by four end-users with severe disabilities. Three assistive technology experts evaluated the device from a third person perspective. The results revealed high performance levels in communication and internet tasks. Users and assistive technology experts were quite satisfied with the device. However, none could imagine using the device in daily life without improvements. Main obstacles were the EEG-cap and low speed.