My assistive technology outcomes framework: rights-based outcome tools for consumers to 'measure what matters'.

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.

Being reliable: issues in determining the reliability and making sense of observations of adults with congenital deafblindness?

BACKGROUND: Most research into interactions with people who are congenitally deafblind involves observational data. In order for practitioners and researchers to have confidence in the findings of observational studies, researchers need to demonstrate that the processes employed are replicable and trustworthy. This paper draws on data from an observational study of adults with congenital deafblindness to illustrate issues in determining inter-rater reliability, and interpreting observational data. METHOD: Data from 34 10-min observations of adults with congenital deafblindness and their interactions with support staff were assessed for inter-rater reliability using percentage agreement calculated in three different ways and Cohen's κ. RESULTS: Large variation resulted from the different ways in which inter-rater reliability was calculated, largely due to high levels of non-occurrence of many behaviours in the coding tool used. CONCLUSION: This study highlights the need to exercise caution when ascertaining the reliability of observational studies and demonstrates the value in using multiple methods for calculating inter-rater reliability. The paper concludes with an examination of the potential merits of using consensus coding in observational studies of interactions with people with congenital deafblindness or profound intellectual and multiple disabilities.