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Definition, objectives and context of Assistive Technology

A formal, legal definition of assistive technology was first published in the Technology - Related Assistance for Individuals with Disabilities Act of 1988 (The Tech Act). This act was amended in 1994; in 1998, it was repealed and replaced with the Assistive Technology Act of 1998 (AT Act).

Throughout this history, the original definition of assistive technology remained consistent. This same definition was used in the Access Boards Electronic and Information Technology Accessibility Standards, developed as required by 1998 amendments to Section 508 of the Rehabilitation Act.

Assistive technology is any item, piece of equipment, or product system whether acquired commercially on the shelf, modified or customized, that is used to increase, maintain, or improve functional capabilities of individuals with disabilities.

Disability in the ICF classification serves as an umbrella term for impairments, activity limitations or participation restrictions.

Assistive Technology (AT) can be a very complex and multifaceted field, yet in some cases be a relatively easy and creative problem solving process.

AT can have numerous definitions, depending upon the population, the desired outcomes, the type of technology used, and the experience and orientation of the consumers and professionals involved.

The terms, assistive device and adaptive device, are frequently used as a single phrase when discussing the general topic. In reality, many people use them interchangeably. The evolving trend is to use the term, assistive technology, to encompass both types of devices, plus services associated with their use.

One definition of assistive technology may be a system of no-tech, low-tech, and high-tech tools and strategies that match a persons needs, abilities, and tasks. AT is a tool to assist in the accomplishment of tasks that would be difficult or impossible to complete without assistance using only the available resources in the available time.

Assistive Technology Products can enable people with disabilities to accomplish daily living tasks, assist them in communication, education, work or recreation activities, in essence, help them achieve greater independence and enhance their quality of life.

Assistive Technology devices can help improve physical or mental functioning, overcome a disorder or impairment, help prevent the worsening of a condition, strengthen a physical or mental weakness, help improve a persons capacity to learn, or even replace a missing limb.

AT can help individuals increase their independence, build self confidence and self esteem, improve the quality of life, and break down barriers when providing the tools for possible employment and educational opportunities.

The benefits of Assistive Technology cross age, disability and/or health challenges. From young children to seniors, a person may face a range of possible physical and or cognitive challenges.

Some examples are: a Learning Disability (LD), Blindness or Low Vision, Hearing Loss, Speech Impairments, Mobility Impairments, Muscular Dystrophy, Multiple Sclerosis (MS), Cerebral Plasy (CP), a Developmental Disability, Autism, ADHD, PDD, Brain Injury and so on.

In General, any technology that enables someone to do something they otherwise couldnt, can be termed as Assistive Technology, facilitating access and achieving previously unreachable goals. Individuals challenged by a disability can benefit from technology in many facets of their personal life; education, employment, recreation and social, any item, piece of equipment or system that helps bypass, work around or compensate for learning difficulties.

The potential application of assistive technology is greatly enhanced through a strong foundation of knowledge coupled with creativity and problem solving strategies. The consumer would certainly include the individual user and possibly family members. The range of professionals involved in considering AT may include: Teachers, Educational Consultants, Learning Disability (LD) Specialists, Educational Assistants, Speech Language Pathologists (SL-P), Occupational Therapists (O.T.), Early Interventionists, Employment Counsellors, Rehabilitation Counsellors, Rehabilitation Technologists, AT Consultants, Disability Specialists, Support Workers and Advocates. Assistive Technology as applied to persons with disabilities can often be referred to as Adaptive Technology, usually in the context of computer - related accessibility.

However, computer access can be referred to as "Access Technology". While Access Technology and Adaptive Technology essentially have the same implied meaning, Adaptive Technology functions to provide access to computer systems. Assistive Technology, in a broader sense, is a technology that helps someone participate in his or her environment through adaptation and accessibility whether it is computers, environmental access and control (electronic aid) or Augmentative and Alternative Communication (AAC).

Assistive technology can include mobility devices such as walkers and wheelchairs, as well as hardware, software, and peripherals that assist people with disabilities in accessing computers or other information technologies. For example, people with limited hand function may use a keyboard with large keys or a special mouse to operate a computer, people who are blind may use software that reads text on the screen in a computer-generated voice, people with low vision may use software that enlarges screen content, people who are deaf may use a TTY (text telephone), or people with speech impairments may use a device that speaks out loud as they enter text via a keyboard.

Summarising we can say that Assistive technologies include mechanical, electronic, and microprocessor - based equipment, non-mechanical and non - electronic aids, specialized instructional materials, services, and strategies that people with disabilities can use either to (a) assist them in learning, (b) make the environment more accessible, (c) enable them to compete in the workplace, (d) enhance their independence, or (e) otherwise improve their quality of life. These may include commercially available or home made devices that are specially designed to meet the idiosyncratic needs of a particular individual.

Assistive Technology can be devices or services.


Assistive Technology Services support people with disabilities or their caregivers to help them select, acquire, or use adaptive devices. Such services include functional evaluations, training on devices, product demonstration, and equipment purchasing or leasing.There are several ways of classifying AT, depending on the purpose. The most widespread classification, the ISO 9999/EN29999 Classification of Technical Aids, is product-oriented. It groups assistive devices into ten classes based on their main objective:
  • Aids for therapy and training
  • Prostheses and orthoses
  • Aids for personal care and protection
  • Aids for personal mobility
  • Housekeeping aids
  • Furnishing and adaptations to home and other premises
  • Aids for communication, information and signalling
  • Aids for handling products and goods
  • Aids and equipment for environmental improvements, tools and machines
  • Aids for recreation
This classification is widely used all over the world for database and catalogue compilation, so knowing it is a must for anybody interested in the field. Data base available through internet connection on the Siva Homepage http://portale.siva.it/bancadati/ausili/default.asp Other links: http://www.ars-coop.it/ http://www.anastasis.it/ http://www.leonardoausili.com/aac.htm AT is always connected with an individuals needs. There are some examples what kind of technology can be used for different kinds of impairments.

A. Cognitive Disabilities (i.e. Traumatic Brain Injury, Learning/Speech Impairment) For individuals with speech problems, electro larynxes enable the person to speak using the vibrating mechanism placed against the neck. Augmentative communications systems provide synthesized speech from typed data. Newer models care roughly the size of a calculator and run on AAA batteries. Individuals with TBI and learning disabilities may obtain di erent types of software, which in educational, vocational communicative advancement.

B. Mobility Disabilities (i.e. Spinal Cord Injury, Stroke) Electric scooters and wheelchairs are very popular. Many accessories such as clamp-on desks, mobile arm supports, camera mounts, help wheelchair users to enjoy greater freedom and independence in their work and home environments. Several types hands-free computer access software using speech-recognition and 'point-of-gaze' technologies such as Eye-Gaze enable the individual to do computer allows the disabled invidual to operate a variety of electrical appliance (i.e. stereo, bed, telephone) remotely.

C. Sensory Disabilities (i.e. Blind/Low Vision, Deaf/HoH) Books on tape, talking watches and clocks make life easier for individuals who are blind or with low vision. Also, talking calculators, thermometers and hand-held scanners that convert print to synthesized speech are available. New voice synthesizing such as JAWS and outSPOKEN convert computer text and graphics to voice. Although they are expensive, they are incredibly helpful for the blind user. For individuals with low vision, large display digital and analogue timepieces, large print publications and large numbered phone sets are often used. Adaptive software for word processing programs such as Eye Relief, VisAbility or ZoomText can enlarge text up to 1.5 on a computer screen, an improvement over the usual fonts. For individuals who are deaf or hard-of-hearing (hoh), lights added to telephones and doorbells flash when the phone rings or someone comes to the door. Some fire alarms have strobe lights that flash when activated. Through all television set with screens, 13 or larger have built-in closed captioning systems since 1993, set top decoders can work with older or smaller sets. Hearing aids are becoming tinier, yet more powerful than before. Text Telephones (TTY's) and other telecommunication devices are on sale in many stores and are widely in use. Handset amplifiers allow voice telephone conversations. Wireless listening amplification systems are available and it consists of a clip-on microphone transmitter and a receiver. Some public facilities such as theatres and classrooms have listening systems built in that work with the hearing-aid or with a special receiver. These can be very useful in lectures, meetings and other cases where understanding every word is imperative. Some recent technologies in wide use also benefit deaf/HoH people such as fax, E-mail and vibrating pagers.

History


Assistive Technology (AT) is a part of societys attempt to cope with the misfortunes of physical or sensory impairments and resulting handicaps. In the very beginning nature did its regulating task by just letting the victim of a functional impairment die. When the care of infections and the chance of survival improved for people with disabilities, their sources of help were members of the clan, neighbours or paid servants. With the increasing importance of tools and industrialization, 'tools for living' (an expression created by Prof. Heinz S.Wolfe in the early 70s in England) became more and more important. The more they are used by people with disabilities, the more they represent what we understand as Assistive Technology (AT). A number of factors have advanced AT:

  • Events like wars or the thalidomide disaster
  • Key persons
  • Special technologies
  • Visions and ideas of user
  • Financial resources
  • Public awareness
  • Activity of lobbies
  • Personal commitment of persons in responsible positions
Examples of technical aids (e.g. wheeled chairs) that compensate for permanent impairment can be found even in ancient times, mainly made by artisans for persons with high social status who had disabilities. In the XVI century a relevant interest in the field of limb replacement is reported in literature.

However, since that time until recently the application of technology to people with disabilities was mainly restricted to the field of prosthetics (technology replacing missing body functions) and orthotics (technology supporting existing although damaged functions), with a view to re-build a situation as near as possible to bodily normality.

The main areas of interest were limb impairment and hearing loss. Blind war veterans gained great public awareness and sympathy throughout their nations. Institutions like the Perkins School for the Blind in the USA, the Royal National Institute for the Blind in Great Britain or the deutsche Blindenstudienanstalt in Germany did pioneer work in AT by promoting the use of Braille for reading and writing, by producing and selling Braille printing devices and by organizing the provision of literature printed in Braille.

Sir Ludwig Guttmann, the 100th anniversary of whose birth was celebrated in July this year, had to flee from Germany in the 1930s. At Stoke Mandeville, England, he took care of the numerous war victims with lesions due to injuries of spinal cord. In addition to developing the treatment of secondary medical problems, he created and promoted the idea that the goal of treatment should be full social integration, and not simply the necessary medical care. So he can be seen as the founder of multidisciplinary rehabilitation. This includes vocational training, self-support, independence, sports, and, last but not least, assistive technology. Since Guttmanns day, this idea has been primarily pursued by occupational therapists. Europeans admired the consistent manner in which the Swedes took care of their handicapped people, helping them to gain self-confidence and increasing public awareness. It goes without saying that the Swedish Institute included a department for technical aids where research, testing, assessment and the dissemination of information have been done in an exemplary manner. A big push towards a major development in the field came from the Second World War, where the great number of veterans with disabilities posed a dramatic social problem and prompted the US Veterans Administration to launch firstly a prosthetic and sensory aids program, followed by many initiatives that gave birth to modern research into rehabilitation and AT. Gradually the idea took shape that a person with a disability should not necessarily aim at bodily normality but rather at life normality, which inspired the first programmes of vocational rehabilitation aimed at regaining access to work and productive life. In addition to wars, AT has been advanced in a number of other ways, for example thalidomide in the 1960s. Prosthetics and orthotics grew to new heights, and the development of many sophisticated ADLs (aids for daily living) date from that time. Widespread publicity and almost unlimited financial resources helped here. There are even indications that in some cases the enthusiasm of researchers carried them too far, being guided more by set ideas and not enough by the personal needs and wishes of the users. Certain technologies stimulated the development of AT, e.g. piezo-electronics, which led to the development of the Optacon (a Silicon Valley product). Optacon made it possible for blind people to read normal printed material. After an intensive but manageable phase of learning to use the technology, printed material could be identified by the shape of a letter using a vibrating tactile display of fingertip size.

In Germany alone, about 130 blind computer programmers between 1971 and 1990 have had vocational training based on the Optacon. Times and technology have changed, and nowadays the peculiarities of computer-access for the blind and the partially sighted is the subject of many conferences, seminars and papers. Visions and obsessions are the most frequent contributors to the advancement of AT. Just one example: the dream of stair-climbing is as old as the wheelchair itself. In 1972, USA engineers proposed a stair-climbing wheelchair. It was to have four low - pressure tires of about 50 cm diameter and be pulled forward by a hand lever drive. This might have worked on steps, but how far could the user have gone afterwards with such tires and so large a chair after having struggled up a flight of steps? Until now technology has only definitely proven that a stair-climbing wheelchair is possible. Some years ago, with the support of private funds in Germany, the Rollsteiger was produced in limited series. But approximately 80% of the weight went for battery and electro-mechanics necessary for stair-climbing, making the chair excessively heavy and virtually immovable when used in flat areas. This thus convincingly demonstrated that the stair-climbing device should be separate from the wheelchair.

The principle of equal opportunities had great penetration in society all over the world and was gradually endorsed by authoritative Bodies like the United Nations, US Federal Legislature, and European Commission of European Union. In 1993 the UN issued the so called Standard Rules for equalization of opportunities for persons with disabilities, where AT, environmental accessibility and personal assistance are recognized as fundamental supports to enable disabled persons to participate in society on an equal footing; likewise, the US Americans with Disabilities Act introduced, in 1990, the principle of non-discrimination (e.g. when recruiting workers), and described AT as a tool to ensure that reasonable accommodation of the worksite is provided in order to fully exploit the worker's potential. Parallel to these cultural trends, technological developments in the AT field dramatically grew and expanded far beyond the traditional prosthetics field.

After the first wheelchair inspired by a modern view of the persons autonomy was designed by Everest & Jennings at the beginning of this century, a wealth of technical aids have been designed to accommodate mobility problems, personal hygiene and self-care, housekeeping, building adaptations, communication, environmental control, worksite adaptation and leisure activities. It is possible to say that virtually any activity of a human being, even if severely disabled, can be accommodated today: especially in the worksite, where today it is not su

client to consider just the individuals abilities, but the bipole composed of the individual and his or her technology that augments, extends or expands such abilities.
The need for technical expertise in building and applying AT gave rise to new professions. PhDs in Rehabilitation Engineering were launched in US in the early 80s by the University of Pittsburgh and Charlottesville, followed by many Universities through out the world: AT background started to be considered also in curricula for clinical, social, and education professions.

AT grew to be recognised as a specific discipline, and scientific societies were initiated like the Rehabilitation Engineering Society of North America (RESNA, founded 1980) or the Association for the Advancement of AT in Europe (AAATE, founded 1995). ICTA Europe (International Commission for Technology and Accessibility) as a part of ICTA Global, which is a Commission of Rehabilitation International (RI) has brought many initiatives in area started in the early 1960s.

There were few international bodies working with technical solutions to facilitate activities of daily life for older people or people with disabilities. In the early years RI Commission activities were expected to be self supporting, however, this depended on the bearers having available resources and back up. In fact at that time the election of the most senior ocer was dependent on this premise. In earlier years the Swedish Handicap Institute provided a considerable personal and financial support for the ICTA Information Centre and resources for publications, such as ICTA Inform. Major projects such as creating the International Symbol of Access in1969, were carried through.

Aids for disability - glossary


Information technology A tremendous variety of assistive technology is available today, providing the opportunity for nearly all people to access information technology (IT). However, an individual having proper assistive technology has no guarantee having an access. IT accessibility is dependent on accessible design. IT products must be designed and created in ways that allow all users to access them, including those who use assistive technologies. For more information, see the Access IT Knowledge Base article What is accessible electronic and information technology? Accessible electronic and information technology is technology that can be used by people with a wide range of abilities and disabilities. It incorporates the principles of universal design. Each user is able to interact with the technology in ways that work best for him or her. Accessible technology is either directly accessible - in other words, it is usable without assistive technology - or it is compatible with standard assistive technology. Just as buildings that have ramps and elevators are accessible to wheelchair users, products that adhere to accessible design principles are usable by people with a wide range of abilities and disabilities. Examples of accessible electronic and information technology:

Accessible software applications may include features specifically designed for users with disabilities. However, they always give users more than one way of accomplishing a task. They use established standards for displaying menus and prompts that can be interpreted by assistive technology. They allow users to use the mouse alone, the keyboard alone, or a combination of the two. They rely on more than color to convey information. Installation instructions, user guides, and other documentation are available in alternate formats, such as large print, Braille, and electronic text.

Accessible multimedia products, which may be distributed on videotapes, CDs, DVDs, or the World Wide Web, include synchronized text captions for spoken information and other audio content and provide synchronized audio descriptions for visual content. They o er more than one way to input commands or respond to prompts. For instance, imagine that a character's voice on a CD tells a child to click on an animal to learn more about it. Children who are deaf or hard of hearing cannot hear the instructions. Children who are blind cannot click on the animal because they cannot see what is on the computer screen. Providing captions in addition to spoken instructions allows children with hearing impairments who can read to participate. Providing keyboard commands for all functions of the software allows children with visual impairments to participate. Captioning and alternative ways of navigating can make a big di erence in the ability of students with disabilities to use these technologies independently. Descriptive narration and audio navigation (talking menus) are also essential in order for those with vision impairments to access videos and DVDs independently.

Accessible websites are designed to be usable by individuals with a broad range of abilities and disabilities; they are designed so that all visitors can navigate the site, access content, and participate in interactive web activities. Accessible web sites provide a text equivalent (typically a description) for all nontext elements, such as audio, video, graphics, animation, graphical buttons, and image maps. This allows those who cannot see the screen to access the information with a screen reader that can read the description of a picture but cannot read the picture.

Accessible copy machines can be operated in more than one way using keypads, touch screens, or voice recognition. Height and position can be adjusted so that controls are within easy reach and the display can be viewed easily. Document feeders are located at desk height, putting them within reach. Ergonomics plays a very important role in proper arrangement of accessible human - machines or human - computer interfaces.

Ergonomics. A discipline that has as its object the human activity in relation to the environmental conditions, instrumental and organizational, in which it is carried out. It has the aim of the adaptation of such conditions to the requirements of the man, defined from its characteristics and its activities. This discipline rose with the task to study and to enforce, in the planning, some norms that protect the life of the worker and increase the efficiency and the reliability of the man-machine systems. The application field has been extended in function of the recent changes in well-being and health issues. Currently it contributes to the planning of objects, services, atmospheres of life and work so that they respect the human limits, in order to empower the operating abilities and to reduce the uneasiness and the malaises. It reaches to the scientific and technological acquisitions that promise to improve the quality of the living conditions, in all the daily activities. It has appeared in Italian dictionaries since the beginning of the 1980s. Ergonomic is an ancient term that has recently acquired various important meanings; it indicates, in a generalized manner, every type of balanced relationship between an agent and its context. It is no longer simply concerned, as in the past, with rehabilitation or its related aids, but now also with techniques and accessories that can easily enter in the daily life as supports that can avoid waste of energy. Ergonomics in the work place is intended to improve:
  • The relationship man-machine-environment and man-process.
  • The workstations and the organization of the job in order to prevent the effects of stress and the muscular and mental hard work.
  • The organization of the security and reliability of the systems.
  • Application fields:
  • Appraisal and ergonomic planning of software and interfaces.
  • Planning of control panels, machine commands or installations.
  • Study of the organization of the job for the improvement of interpersonal relationships, performance and security.
  • Ergonomic analysis of the organization of the job for the improvement of the level of the health, of the quality of the life, of the services and products.
  • Planning of usable and safe tools.
  • Appraisal and planning of comfortable and safe workstations for people with disabilities.
  • Appraisal of mental and physical effort and of stress.
  • Interactive planning and appraisal software used invirtual reality for the training and information of the workers. Training and modernization in the field of the ergonomics and the security of complex systems.

Bibliography


1. ICF International Classification of Functioning, Disability and Health,
http://www3.who.int/icf/cftemplate.cfm
2. R. Andrich, D. Simsik, A. Galajdova:The Assistive Technology Handbook, Tempus Phare 14 226-1999, Technical University of Kosice, 2000, ISBN 80- 7099-953-5, EAN 9788070999530.
3. C. Buhler and H. Knops (Eds.): Assistive Technology on the Threshold of the New Millennium, IOS Press, 1999,AAATE 99 Conference. European Conference for the Advancement of AT in Europe.
4. Technology-related Assistance for Individuals with Disabilities Act of 1988, Public Law 100-07, August 9, 1988.
5. Proc of the AAATE 99 Conference. European Conference for the Advancement of AT in Europe, 1999.
6. A.E. Blackhurst, and D.L. Edyburn: A brief history of special education technology, Special Education Technology Practice, 2(1), 2000, 21-35.
7. http://www.washington.edu/accessit/index.php
8. http://sweb.uky.edu
9. http://natri.uky.edu