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Appropriate paper-based technology (APT) is used to provide postural support for children with cerebral palsy (CP) in low-resourced settings. This pilot study aimed to evaluate the impact of APT on the children's and families' lives. A convenience sample of children with CP and their families participated. Inclusion was based on the Gross Motor Function Classification System levels IV and V. APT seating or standing frames were provided for six months. A mixed methods impact of APT devices on the children and families included the Family Impact Assistive Technology Scale for Adaptive Seating (FIATS-AS); the Child Engagement in Daily Life (CEDL) questionnaire; and a qualitative assessment from diary/log and semi-structured interviews. Ten children (median 3 years, range 9 months to 7 years). Baseline to follow-up median (IQR) FIATS-AS were: 22.7 (9.3) and 30.3 (10.2), respectively (p=.002). Similarly mean (SD) CEDL scores for "frequency" changed from 30.5 (13.2) to 42.08 (5.96) (p=.021) and children's enjoyment scores from 2.23 (0.93) to 2.91 (0.79) (p=.019). CEDL questionnaire for self-care was not discriminatory; seven families scored zero at both baseline and 6 months. Qualitative interviews revealed three key findings; that APT improved functional ability, involvement/interaction in daily-life situations, and a reduced family burden of care. APT devices used in Kenyan children with non-ambulant CP had a meaningful positive effect on both the children's and their families' lives. Assistive devices are often unobtainable for children with cerebral palsy (CP) in low-income countries. APT is a low cost and sustainable solution to make seating and standing devices for disabled children in Kenya. The regular use of a postural support device enhanced the children's motor skills, ability to function and participate in everyday activities, reduced the burden of care for the families and promoted the children's social interaction. The postural support devices were highly valued and utilised by the children and families in this study. [ABSTRACT FROM AUTHOR]

This systematic review examines the impact of assistive technology (AT) on educational and psychosocial outcomes for students with disabilities (SWDs) in higher education. Qualitative, quantitative and mixed method studies were identified through systematic searches of five databases: PsycINFO, PubMed, CINAHL, ERIC and Web of Science (Social Science Citation Index). The search was conducted in January 2018. Thematic synthesis was carried out to collate findings across papers and the methodological quality of included papers was assessed using a Mixed Methods Appraisal Tool (MMAT). Twenty-six papers were included for analysis. Four analytic themes were identified; "AT as an enabler of academic engagement"; "barriers to effective AT use can hinder academic engagement"; "the transformative possibilities of AT from a psychological perspective"; and "AT as an enabler of participation". This systematic review identifies that AT can promote educational, psychological and social benefits for SWD. However, AT users and AT officers must be aware of certain factors, such as inadequate AT training, inadequacies of devices, availability of external support and the challenge of negotiating multiple information sources, can hinder effective AT use and thus restrict engagement in the higher education environment. Future AT practices should focus on harnessing the potential of mainstream devices as AT for all students, thus facilitating inclusion and reducing stigma. Students with disabilities face academic, psychological and social challenges within the higher education environment. Assistive technology (AT) use can enable academic engagement and social participation and be transformative from a psychological perspective. Disability support staff in higher education should ensure that the AT needs of students with disabilities are met in order to enhance the educational experience. Harnessing the potential of mainstream devices as AT for all students will facilitate inclusion and reduce stigma. [ABSTRACT FROM AUTHOR]

Covid-induced lockdowns have increased the importance of technology in education. Though access to technology as well as availability of the internet remain a major concern for a lot of children in the global south, children with intellectual disabilities are disadvantaged even more as most of the e-content is developed keeping in mind the average learner. Unstructured interviews were conducted with children with intellectual disabilities studying in government schools in Haryana as well as their teachers and parents. Thematic analysis of the interviews was conducted to understand the use-patterns of mobile phones by children with intellectual disabilities. Findings suggest that these children are learning to use mobile phones on their own or with some support and are able to navigate the complexities of these smartphones quite well. They use these devices mostly for their entertainment. This paper then reflects on the need and strategies to develop these technologies in ways that they can be used as effective tools for teaching children with intellectual disabilities, especially in the inclusive education system in developing countries. The paper reflects on the need to develop technology and tools using flexible and exploratory designs to enhance the learning processes for children with intellectual disabilities from the lower income strata. This study highlights the importance of being able to use mobile phones by children with intellectual disabilities belonging to low income families. Following this, the article argues for designing of mobile phones suitable for use by children with intellectual disabilities using playfulness and explorations, and Building e-content keeping the elements of playfulness and exploration which can enhance the learnings of this group of students which is often ignored. [ABSTRACT FROM AUTHOR]

This paper considers the possibilities of analysing children's own designs to contribute to the design of inclusive paediatric mobility interventions. The aim of this paper is threefold: (1) to develop a framework for child-centred design analysis, (2) to analyse children's designs to explore both quantitative and qualitative insights and (3) to explore how children's voice could be elevated through design research. A Child-centred Design Analysis Framework is developed in an interdisciplinary manner, comprising four dimensions including Child, Content, Context and Format. It is used as a vehicle to analyse and code 130 "Dream Wheelchair" designs by children. The children's "Dream Wheelchair" designs reference a range of features and priorities, which are gathered into themes through the framework, providing insights into children's individual and collective mobility narratives, values and requirements. Themes are explored through a qualitative interdisciplinary lens to understand the nature of children's lived experiences. The framework promotes child-centred framing through extracting meaning from children's own designs. It is suggested that child-centred framing and a rights-respecting approach to assistive technology design research can lead to more appropriate design outcomes and improved user experiences for children with disabilities. The design analysis framework developed and presented in this paper facilitates child-centred framing to elevate children's voice in a design process. Analysis of 130 children's visual and textual designs elicited narratives, values, and requirements around their "Dream Wheelchairs"; these findings contribute insights which can be used for designing inclusive paediatric mobility interventions. This paper invites industry practitioners and design researchers to use a child-centred and rights-respecting approach when designing with or for children. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to analyse and critically reflect on access to Assistive Technology (AT) for persons with disabilities (PWD) in Nepal, India and Bangladesh. This analysis aims to guide the development of a contextualised generic AT service delivery model suitable for these countries, based on the best practices identified. This paper is based on a comprehensive study conducted in Nepal, India and Bangladesh, observing mobility and hearing-related AT service delivery centres run by the government, as well as private and nongovernmental organisations, and interviews with key informants: policymakers (5), AT service providers (20) and AT service users (20) between December 2019 to February 2020. A descriptive, qualitative exploratory study design was followed. A quality assessment framework was used to structure the analysis and interpret the findings. AT service provisions are poorly developed in all three countries. On all quality indicators assessed, the systems show major weaknesses. AT users have very limited awareness about their rights to these services and the availability of AT services, the range of services available is very limited, and eligibility is dependent on medical criteria related to visible and severe disabilities. Lack of accessibility, eligibility, reachability and affordability are the main barriers to access AT services for PWD in Nepal, India and Bangladesh. Increased community level awareness, increased Government funding and a community based, medically informed flexible social model of AT services is a way forward to ensure access to AT services for PWD in these countries. Increased community awareness is necessary to increase access to Assistive Technology Services for Persons with Disabilities. Increased and flexible funding from the Government and philanthropists will improve rehabilitation. Establishment of community based Assistive Technology Services centres will increase access and improve rehabilitation. [ABSTRACT FROM AUTHOR]

There is limited evidence on the strategies, resources, and tools shown to improve winter mobility and community participation. This paper describes a multifaceted approach taken to develop an mHealth application that provides information, resources, and strategies to facilitate winter mobility for mobility device users, service providers, community organisations, and researchers. The study was conducted in three phases: (1) A scoping review of peer-reviewed and grey literature was completed to identify literature that reported on tools, strategies, resources, and recommendations used to promote winter mobility; (2) Online asynchronous focus groups were conducted to identify the type of content that mobility device users wanted to include in the web-based application; and (3) A prototype mHealth application was developed based on the findings from the previous phases. Using a rapid prototyping process that included stakeholder review through an online survey, four cycles of application design and development were undertaken. The scoping review identified 23 peer-reviewed studies and limited grey literature on winter mobility strategies, resources and recommendations. Twenty-four participants from across Canada engaged in one of five focus groups. Focus group analysis led to the development of the content categories for the mHealth application. The initial prototype application developed was reviewed by; 27 mobility device users, 16 health care providers, and seven consumer organisation representatives identified areas of strength and further refinement in regard to application design. The approach used in this study provided a method to develop an application based on the ideas, needs, and interests of a variety of stakeholders. Once fully developed, the application has the potential to fill the gaps related to the lack of a unified collection of winter mobility strategies and resources, and open the dialogue on methods to improve winter participation among mobility device users. Despite winter conditions being a common challenge among mobility device users, there is an absence of an organised approach towards helping individuals manage their winter mobility needs. As the development and usage of mHealth applications continues to increase, it is valuable to use methods of designing applications based on the ideas, needs, and interests of a variety of stakeholders. Development of a framework for collating information on winter mobility strategies and resources is the first step towards launching an mHealth application. [ABSTRACT FROM AUTHOR]

This study explores the usability, usefulness and user experience of the Forward with Dementia website for people with dementia and family carers, and identifies strategies to improve web design for this population. The website was iteratively user-tested by 12 participants (five people with dementia, seven carers) using the Zoom platform. Data collection involved observations, semi-structured interviews and questionnaires. Integrative mixed-method data analysis was used, informed by inductive thematic qualitative analysis. Users of Version 1 of the website experienced web functionality, navigation and legibility issues. Strategies for desirable web design were identified as simplifying functions, streamlining navigation and decluttering page layouts. Implementation of strategies produced improvements in usability, user experience and usefulness in Version 2, with mean System Usability Scale scores improving from 15 to 84, and mean task completion improving from 55% to 89%. The user journey for people with dementia and carers overlapped, but each group had their own unique needs in the context of web design. The interplay between a website's content, functionality, navigation and legibility can profoundly influence user perceptions of a website. Dementia-related websites play an important role in informing audiences of management strategies, service availability and planning for the progression of dementia. Findings of this study may assist in guiding future web development targeting this population. People with cognitive impairment can provide useful feedback on design and accessibility of websites, and their input should be obtained when developing digital applications for this group. This paper provides practical suggestions for website design features to improve function, legibility and navigation of websites for older people and people living with dementia. [ABSTRACT FROM AUTHOR]

People with physical disabilities often require lifetime support and experience challenges to maintain or (re)define their level of independence. Assistive living technologies (ALT) are promising to increase independent living and execution of activities of daily living (ADL). This paper provides a systematic literature review that aims to analyse the present state of the literature about the impact of ALT on perceived independence of people with a physical disability receiving long-term care. Databases Embase, Medline, and Web of Science were searched for eligible studies from 2010 or later. Nine studies were included, of which seven qualitative, one quantitative, and one mixed methods. Quality was generally high. ALT enabled participants to execute ADL. We found six themes for the impact of ALT on perceived independence: feeling enabled, choice and control, feeling secure, time alone, feeling less needy, and participation. ALT appears to impact perceived independence in many ways, exceeding merely the executional aspect of independence. Existing research is limited and quite one-sided. More large-scale studies are needed in order to inform care organisations how to implement ALT, especially considering societal developments and challenges impacting long-term care. People with a physical disability receiving long-term care experience that assistive living technology impacted their independence. Their independence is increased by making them feel enabled, secure, and less needy and increasing their choice and control, time alone, and participation. Most studies focused on the use of environmental control systems by people with spinal cord injury. More research is needed to evaluate long-term effects of diverse assistive living technologies used by people with a physical disability receiving long-term care. [ABSTRACT FROM AUTHOR]

The purpose of this paper is to describe non-participation during the outcome measurement step of the wheeled mobility service delivery process (WMSDP) based on the Functional Mobility Assessment (FMA)-Uniform Dataset (UDS) Registry. The WMSDP is a standard framework for the provision of wheeled mobility devices, and several factors influence the client's experience throughout the process. Patient-reported outcomes are one way to measure the client's experience as part of a quality improvement program. A retrospective descriptive study was conducted on the FMA-UDS Registry to measure the response rate during the outcome measurement step of the WMSDP and describe the reasons an individual did not complete the FMA-UDS. The FMA-UDS was examined at two time points: pre-delivery and post-delivery of the wheeled mobility device. As of September 2, 2021, 10,253 cases have been entered into the FMA-UDS Registry. 2,247 cases were no longer participating pre-delivery, and an additional 3,905 cases were no longer participating post-delivery. The most common reasons for non-participation in the FMA-UDS pre-delivery and post-delivery included: equipment not delivered; provider no longer participating in the FMA-UDS; funding issues; no new equipment; client opted out; loss in contact; deceased; returned equipment; and other. The type and frequency of non-participation in the outcome measurement step of the WMSDP is critical to understanding why individuals participate in outcome measures and provides insight into the barriers and facilitators for the implementation of quality improvement programs. The outcome measurement system provides a structured mechanism for consistent communication between the client and the professionals providing the service, thereby identifying issues earlier in the process and mitigating frustration throughout the wheeled mobility service delivery process. The role of a credentialed professional, specifically an Assistive Technology Professional, in the wheeled mobility service delivery process could emphasize the importance of the follow-up and outcome measurement steps, which may increase the consumers' participation rate and demonstrate the effectiveness of devices and services. Clients who no longer participate in the outcome measurement process do not have the sustained support of the interprofessional team, and possess an increased chance that they will not get their mobility needs met through the health care system. [ABSTRACT FROM AUTHOR]

To identify and describe the aims, methodological approaches, and major findings of studies on the use of STT among secondary pupils (age 12–18) with learning difficulties published from January 2000 to April 2022. This scoping review includes empirical studies published in peer-reviewed journals and grey literature between January 2000 and April 2022. Searches were conducted in April 2022 in three databases: ERIC, PsycINFO and Scopus. In addition, related reviews were manually screened for relevant papers. Eight peer-revied studies and five publications of grey literature were found to meet the inclusion criteria; two studies employed experimental designs, four employed quasi-experimental designs and seven employed explorative designs. Six studies described STT as an assistive technology (a compensatory aid for poor writing performance); two assessed STT as an instructional technology to determine whether it improves overall writing and related skills (e.g., reading). Results suggest that STT may increase pupils' abilities to produce texts with fewer errors, provide help with spelling and improve reading comprehension and word recognition. To date, there is a paucity of high-quality research on the use of STT among adolescents with LD. The scoping review shows that very little research has been conducted on the use of STT for adolescents with learning difficulties in secondary education. Findings from the studies identified five areas of interest: writing related skills, text assessment, writing processes, accuracy of the technology, and participants' experiences. Findings indicate that writing performance among students with learning difficulties improves when using STT. Parents, teachers, and pupils report positive experiences with the technology, particularly for students with severe reading and writing difficulties. There is a great need for more robust research on the use of speech-to-text technology (STT) in educational settings, especially on its effect on writing skills Studies describe STT as either an assistive (a compensatory aid for poor writing performance) or instructional technology (aiming to improve learning in general). It is important that practitioners are aware of the different aims and possible consequences of introducing STT to learners with writing difficulties. STT provides both opportunities and challenges for writers with learning difficulties in secondary education. Findings indicate that writing performance among students with learning difficulties improves when using STT, yet inaccuracy of the technology was presented as one of the main challenges. Parents, teachers, and pupils report positive experiences with the technology, particularly for students with severe reading and writing difficulties. [ABSTRACT FROM AUTHOR]

To offer guidance for future welfare technology research, this review provides an overview of current knowledge gaps and research needs as reported in primary scientific studies addressing the implementation of welfare technology for older people, people with disabilities and informal caregivers. This paper conducted a state-of-the-art review based on systematic searches in 11 databases followed by a descriptive qualitative analysis of 21 selected articles. Knowledge gaps and research needs were identified concerning two categories: research designs and populations and focus of research. The articles reported needs for comparative studies, longitudinal studies, and demonstration trials as well as the development of co-design processes involving technology users. They also called for studies applying a social system theory approach, involving healthy and frail older adults, representative samples of users within and across countries, informal and formal caregivers, inter-and multidisciplinary teams, and care organizations. Moreover, there are reported needs for studies of acquirement, adoption and acceptance of welfare technology, attitudes, beliefs, and context related to welfare technology, caregiver perspectives on welfare technology, services to provide welfare technology and welfare technology itself. There are considerable knowledge gaps and research needs concerning the implementation of welfare technology. They relate not only to the research focus but also to research designs, a social system theory approach and study populations. When planning for the implementation of welfare technology for older people and persons with disabilities, it is important to be aware that necessary evidence and guidance may not always be available in peer-reviewed scientific literature but considerable knowledge gaps and research needs remain. Actors implementing welfare technology are encouraged to include researchers in their projects to study, document and report experiences made, and thereby contribute to building the evidence base and supporting evidence-based implementation. [ABSTRACT FROM AUTHOR]

This paper critically reviews and reflects on the processes for providing Assistive Technology (AT) services to Persons with Disabilities (PWD) in Bangladesh, India and Nepal. The aim is to investigate the AT service delivery systems in these countries and suggest improvements where weaknesses are identified. We carried out a descriptive qualitative exploratory study in Bangladesh, India and Nepal by conducting key informant interviews with policymakers (5), AT service providers (22) and mobility and hearing related AT service users (21). We used a directed content analysis approach guided by a seven-point AT service delivery process model to thematically analyse the existing processes for AT service delivery, from first contact through to follow-up and maintenance. AT service delivery processes are sub-optimal in all three countries, and improvements are needed. No common AT service delivery process was found, although there are common features. In general, it is easier for PWDs in India and Nepal to access AT than for those in Bangladesh, but all three countries are failing to live up to their commitments to uphold the human rights of PWDs. Although good elements of AT service delivery processes can be identified, the systems in all three countries are fragmented and generally weak. A more holistic approach of looking at the process of AT service delivery, from first contact right through to follow-up and device maintenance, with a single door service delivery system, free of cost at the point of service is recommended in these countries. Although we found significant weaknesses in AT delivery in all three countries, there are some good AT service delivery practices and opportunities for these countries to learn from one another. A systematic and stepwise approach to assessing current AT service delivery processes in the three countries – examining the delivery system as a whole, from initiation to repair and management – can help identify opportunities to improve the process for (prospective) AT users. A more coherent single door system of AT service delivery will increase the quality and efficiency of the fragmented AT service delivery practices in Bangladesh, India and Nepal. [ABSTRACT FROM AUTHOR]

This paper presents a novel application of an assistive robotic system with virtual assistance to enhance manual performance of individuals with cerebral palsy. Cerebral palsy affects one’s voluntary motor movements resulting in limited opportunities to actively engage in physical manipulative activities that require fine motor movements and coordination. Lack of object manipulation and environmental exploration can result in further impairments such as cognitive and social delays. The proposed assistive robotic system has been developed to enhance hand movements of people with disabilities when performing a functional task colouring. This paper presents the usability testing of the effectiveness of the developed system with an individual with cerebral palsy in a set of colouring tasks. Assisted and unassisted approaches were compared and analysed through quantitative and qualitative measures. The robotic-based approach was further compared with the participant’s typical alternate access method to perform the same proposed tasks. The robotic system with virtual assistance was clinically validated to be significantly more effective, compared to both unassisted and typical approaches, by increasing the hand controllability, reducing the physical load and increasing the easiness of maintaining movements within the lines. Future studies will inform the use of the system for children with disabilities to provide them with assisted play for functional and playful activities. Implications for rehabilitation: Robotic system can enhance manual performance in individuals with disabilities. Participating in a robot-mediated play activity could increase children’s motivation and engagement. The developed robotic system can contribute to a basis for clinical and home-based implementation of the technology to promote manual play activities for children with disabilities. [ABSTRACT FROM AUTHOR]

The present study seeks to survey information and training needs of informal caregivers related to the use of assistive technologies at home, so as to, in the near future, try to meet them. Therefore, the full aim of this study is to contribute to reducing technology abandonment and to enhancing its use in the family setting by children with cognitive and/or motor limitations. Content analysis of a set of ten interviews with informal caregivers of children and youngsters with cognitive and/or motor disabilities. Assistive technologies open a wide range of opportunities, mostly to students whose learning skills diverge from standard development. They promote communication, independence as well as inclusion of children with cognitive and/or motor disabilities. Despite the human and material resources available, the implementation of assistive technologies in many family settings is still a struggling task. The results reveal a perspective on (i) the interaction between those caregivers and their children, (ii) children's skills in using assistive technology, (iii) caregivers' digital literacy and (iv) their training needs. The present paper highlights the fact that carrying out interviews with informal caregivers leads to obtaining significant data for a diagnosis of the use of assistive technologies in the family setting and to assess the needs of informal caregivers. From this study, the need to provide caregivers with further training on assistive technologies emerges as preponderant, and to improve caregivers' skills in the search for and access to practical information. Cognitive and/or motor disabilities impact on communication, independence and also on the full inclusion of children, especially when efforts developed at school do not have any follow up at home. Endowing informal caregivers with the knowledge and skills to use assistive devices with their children is a step forward to their full development. Interviews conducted with informal caregivers are a means to gaining insights into understanding the reasons behind assistive technology abandonment at home. [ABSTRACT FROM AUTHOR]

Background: The smartphone app "My Wheelchair Guide" is designed to provide essential information about wheelchair use and service delivery for new wheelchair users. It aims to empower wheelchair users in taking ownership in acquiring appropriate wheelchairs, and guiding them to use their wheelchairs in a safe and effective manner. Objective: This paper describes the development of the "My Wheelchair Guide" app and the usability evaluation of one of the app sections "Use a Wheelchair". Method: Ten manual wheelchair users and four seating/mobility professionals completed a survey on the ease of use and perceived usefulness of the app, and a semi-structured interview. Wheelchair users used checklists in the app to self-assess their wheelchairs' fit and set-up, and their wheelchair skills. Two investigators independently conducted content analysis of the interview transcripts and identified salient themes. Results: All participants perceived the app to be easy to use. Both wheelchair users and wheelchair seating professionals recognized that the "Use a Wheelchair" section would be very beneficial for new wheelchair users. Self-assessment checklists facilitated participants to review their wheelchair set-up and skills. Participants also provided several suggestions and recommendations to revise and refine the app section. Conclusion: The app section was perceived to be a useful and easy-to-use educational tool by most of the study participants. Participants' feedback will be used to guide the app revision for a better user experience. Further studies could be conducted to assess the app effectiveness on improving wheelchair users' knowledge and facilitating self-advocacy for appropriate wheelchairs. Smartphone apps designed to support patient education and self-management regarding wheelchair use are perceived beneficial by both wheelchair users and clinical professionals. Smartphone apps support multimedia information presentation and user interaction, and can potentially create an effective learning environment for wheelchair users and their families to learn about their everyday devices. Users of educational apps prefer reduced text-based content and care about app aesthetics. [ABSTRACT FROM AUTHOR]

Background: Achieving appropriate wheelchair provision at a national level is complex, requiring regulations, funding and policies established through governments. Understanding wheelchair provision within different countries is key. This paper describes the process used to support the development of wheelchair service strategic plans in Romania and the Philippines. It considers the influences, meaning, challenges and developments when producing strategic priorities within two different contexts. Methods: The International Society of Wheelchair Professionals (ISWP) sponsored affiliates Motivation Foundation Romania and the Philippine Society of Wheelchair Philippine Society of Wheelchair Professionals (PSWP), to conduct organizational ethnographic mixed method stakeholder centred studies, to develop robust strategic plans. An affiliate coordinator for wheelchair provision in less resourced settings supported this process. Results: Diversity between the two-affiliate sites was evident, influencing value placed within both societies towards equality and participation. Common components to address included: advocacy; wheelchair service infrastructure; capacity building; education; training and research. Research process facilitation supported by affiliate coordinator is important. Conclusion: Understanding contextual dimensions, which sharp a countries wheelchair service, is essential. Member states should take action by conducting in-country wheelchair sector analysis, to create wheelchair provision strategies for sustainable development, to meet personal posture and mobility needs, primary for daily living, as a basic human right. Understanding the complexity of providing appropriate wheelchairs within different countries is essential to meet the diverse needs of citizens. Conducting situational analysis of the wheelchair sector involving key stakeholders in the process is important to understand different perspectives and develop strategic priorities towards sustainable development. Producing context specific wheelchair sector reports and strategic plans strengthens the evidence base when informing governments regarding the importance of developing sustainable wheelchair provision infrastructures. The affiliate coordinator role is important to support affiliates to produce robust documentation that clearly and objectively outlines the wheelchair sector issues and plans, to provide solutions. [ABSTRACT FROM AUTHOR]

Purpose: Older adults with low vision are a growing population with rehabilitation needs including support with community mobility to enable community participation. Some older adults with low vision choose to use mobility scooters to mobilize within their community, but there is limited research about the use by people with low vision. This paper describes a pilot study and asks the question: what are the experiences of persons with low vision who use mobility scooters? Methods: This study gathered the experiences of four participants with low vision, aged 51 and over, who regularly use mobility scooters. Diverse methods were used including a go-along, a semi-structured interview and a new measure of functional vision for mobility called the vision-related outcomes in orientation and mobility (VROOM). Findings: Four themes were found to describe experiences: autonomy and well-being, accessibility, community interactions and self-regulation. Discussion and implications: This study was a pilot for a larger study examining self-regulation in scooter users. However, as roles emerge for health professionals and scooters, the findings also provide evidence to inform practice, because it demonstrates the complex meaning and influences on performance involved in low vision mobility scooter use. Scooter use supports autonomy and well-being and community connections for individuals with both mobility and visual impairments. Low vision scooter users demonstrate self-regulation of their scooter use to manage both their visual and environmental limitations. Issues of accessibility experienced by this sample affect a wider community of footpath users, emphasizing the need for councils to address inadequate infrastructure. Rehabilitators can support their low vision clients' scooter use by acknowledging issues of accessibility and promoting self-regulation strategies to manage risks and barriers. [ABSTRACT FROM AUTHOR]

A "kneeling" ultralight wheelchair prototype has been developed that allows users to adjust seat position "on the fly" for different activities throughout the day. The wheelchair includes independent adjustment functions for rear seat height, front seat height ("kneeling") and backrest angle. Aim: This work aimed to gather feedback about the wheelchair's functionality and performance through end user evaluation trials. Methods: Eight manual wheelchair users evaluated the prototype Kneeling Wheelchair for a range of activities. User perspectives on parameters such as usability, comfort, stability and effectiveness were obtained through both open-ended and Likert-scale rating questions. Results: Results indicate several potential benefits of the adjustment functions of the Kneeling Wheelchair. Rear seat height adjustment may facilitate a number of activities of daily living, as well as provide benefits for comfort and social interactions. Back rest adjustment may increase comfort and stability on slopes. Front seat height adjustment may be beneficial for transfers and conducting sustained low-to-the-ground activities. While benefits of this adjustment function were described by many participants, some struggled with usability of the kneeling mechanism and rated this function less favourably than the other two. Conclusion: The findings of this study will inform future iterations of the Kneeling Wheelchair design and may spur future developments in wheeled mobility. In the long-term, it is anticipated that novel wheelchair solutions, such as the one described in this paper, may support improved health, quality of life and community participation for people with mobility impairments. Wheelchairs that allow users to easily adjust seat and backrest position "on the fly" to better suit different tasks throughout the day may provide benefits such as facilitating activities of daily living. A front seat height adjustment feature on a new wheelchair prototype may be beneficial for transfers and conducting sustained low-to-the ground activities. End user evaluations can provide valuable insight to direct future design modifications and innovation. [ABSTRACT FROM AUTHOR]

Purpose: The telehealthcare sector has been expanding steadily in the UK. However, confusing, complex and unwieldy designs of telehealthcare devices are at best, less effective than they could be, at worst, they are potentially dangerous to the users. Method: This study investigated the factors within the new product development process that hindered satisfactory product design outcomes, through working collaboratively with a leading provider based in the UK. Results: This study identified that there are too many costly late-stage design changes; a critical and persistent problem area ripe for improvement. The findings from analyzing 30 recent devices, interviewing key stakeholders and observing on-going projects further revealed that one major cause of the issue was poor practice in defining and communicating the product design criteria and requirements. Conclusions: Addressing the characteristics of the telehealthcare industry, such as multiple design commissioners and frequent deployment of design subcontracts, this paper argues that undertaking a robust process of creating the product design brief is the key to improving the outcomes of telehealthcare device design, particularly for the small and medium-sized enterprises dominating the sector. Implications for rehabilitation: Product design criteria and requirements are frequently ill-defined and ineffectively communicated to the designers within the processes of developing new telehealthcare devices. The absence of a (robust) process of creating the design brief is the root cause of the identified issues in defining and communicating the design task. Deploying a formal process of creating the product design brief is particularly important for the telehealthcare sector. [ABSTRACT FROM AUTHOR]

Purpose: The potential of service robots for seniors is given increasing attention as the ageing population in Western countries will continue to grow as well as the demand for home care. In order to capture the experience of living with a robot at home, a multi-perspective evaluation was conducted. Methods: Older adults (n = 10) were invited to execute an actual interaction scenario with the Care-O-bot® robot in a home-like environment and were questioned about their experiences. Additionally, interviews were conducted with the elderly participants, informal carers (n = 7) and professional caregivers (n = 11). Results: Seniors showed to be more keen to accept the robot than their caregivers and relatives. However, the robot in its current form was found to be too limited and participants wished the robot could perform more complex tasks. In order to be acceptable a future robot should execute these complex tasks based on the personal preferences of the user which would require the robot to be flexible and extremely smart, comparable to the care that is delivered by a human carer. Conclusions: Developing the functional features to perform activities is not the only challenge in robot development that deserves the attention of robot developers. The development of social behaviour and skills should be addressed as well. This is possible adopting a person-centred design approach, which relies on validation activities with actual users in realistic environments, similar to those described in this paper. Implications for rehabilitation: Attitude of older adults towards service robots Potential of service robotsfor older adults [ABSTRACT FROM AUTHOR]

Purpose:The purpose of this study is to identify the objective physical activity (PA) measurement tools and outputs that are used within Multiple Sclerosis (MS) literature. Methods:A systematic search strategy on eight databases (2000–2016) using keywords associated with MS and PA. Results:This review includes 32 papers. Uni-axial accelerometers were the most popular objective PA tool in this review (68%). Pedometers (14%) and multi-sensor systems (3%) were the second and third most common. PA outputs included activity counts per day, steps per day, energy expenditure per day, minutes of moderate-vigorous PA (MVPA), minutes of light PA and daily dynamic activity. Both activity counts per day (n = 21 studies), and steps per day (n = 11 studies) were most commonly used representing 78%. Conclusion:Uni-axial accelerometers and pedometers are the most popular PA measurement tools used in MS literature. However, developments in the field mean that most new sensors are tri-axial, and multi-sensor systems are also available. Researchers should use devices with published validation information, and should utilize the detail on activity patterns available from accelerometer measurement instead of expressing a single unit such as activity counts or step counts per day. Attention to capturing the duration, frequency, intensity and energy expended during daily PA is warranted. Implications for RehabilitationThe review reports that accelerometers were the research tool most frequently reported in the literature, though there were differences in device type and in how activity data was extracted from the stored information.The majority of research studies of physical activity levels in Multiple Sclerosis fail to provide an adequate range of activity outcomes, frequently using outcomes which do not allow simple cross-comparisons with other populations. [ABSTRACT FROM PUBLISHER]

Lower-limb amputees typically require some form of prosthetic limb to ride a bicycle for recreation or when competing. At elite-level racing speeds, aerodynamic drag can represent the majority of the resistance acting against a cyclists’ forward motion. As a result, the reduction of such resistance is beneficial to an amputee whereby the form and function of the prosthetic limb can be optimized through engineering. To measure the performance of such limbs, field testing provides a cost-effective and context-specific method of aerodynamic drag measurement. However, few methods have been formally validated and none have been applied to amputees with lower-limb amputations. In this paper, an elite level para-cyclist wore two different prosthetic limb designs and had their total aerodynamic drag of a wind tunnel reference method statistically correlated against a velodrome-based virtual elevation field test method. The calculated coefficient of variation was in the range of 0.7–0.9% for the wind tunnel method and 2–3% for the virtual elevation method. A 0.03 m2difference was identified in the absolute values recorded between the two methods. Ultimately, both methods exhibited high levels of precision, yet relative results to each other. The virtual elevation method is proposed as a suitable technique to assess the aerodynamic drag of amputee para-cyclists.Implications for rehabilitationThis assessment method will provide practitioners a reliable means of assessing the impact of changes made to prosthetics design for cyclists with limb absence.The proposed method offers a low cost and geographically accessible solution compared to others proposed in the past.This assessment method has significant potential for impact among prosthetic limb users looking to improve their cycling performance whereas previous attention in this field has been extremely limited. [ABSTRACT FROM PUBLISHER]

Purpose:This paper outlines the development and content validation of the power mobility training tool (PMTT), an observational tool designed to assist therapists in developing power mobility training programs for children who have multiple, severe impairments. Methods:Initial items on the PMTT were developed based on a literature review and in consultation with therapists experienced in the use of power mobility. Items were trialled in clinical settings, reviewed, and refined. Items were then operationalized and an administration manual detailing scoring for each item was created. Qualitative and quantitative methods were used to establish content validity via a 15 member, international expert panel. The content validity ratio (CVR) was determined for each possible item. Results:Of the 19 original items, 10 achieved minimum required CVR values and were included in the final version of the PMTT. Items related to manoeuvring a power mobility device were merged and an item related to the number of switches used concurrently to operate a power mobility device were added to the PMTT. Conclusions:The PMTT may assist therapists in developing training programs that facilitate the acquisition of beginning power mobility skills in children who have multiple, severe impairments.Implications for RehabilitationThe Power Mobility Training Tool (PMTT) was developed to help guide the development of power mobility intervention programs for children who have multiple, severe impairments.The PMTT can be used with children who access a power mobility device using either a joystick or a switch.Therapists who have limited experience with power mobility may find the PMTT to be helpful in setting up and conducting power mobility training interventions as a feasible aspect of a plan of care for children who have multiple, severe impairments. [ABSTRACT FROM PUBLISHER]

Purpose: To examine the Assistive Technology Device Predisposition Assessment scale and provide evidence of validity and reliability of the Greek version.Methods: We translated and adapted the original instrument in Greek according to the most well-known guidelines recommendations. Field test studies were conducted in a rehabilitation hospital to validate the appropriateness of the final results. Ratings of the different items were statistically analyzed. We recruited 115 subjects who were administered the Form E of the original questionnaire.Results: The experimental analysis conducted revealed a three subscales structure: (i) Adaptability, (ii) Fit to Use, and (iii) Socializing. According to the results of our study the three subscales measure different constructs. Reliability measures (ICC = 0.981, Pearson's correlation = 0.963, Cronbach's α = 0.701) yielded high values. Test-retest outcome showed great stability.Conclusions: This is the first study, at least to the knowledge of the authors, which focuses merely on measuring the satisfaction of the users from the used assistive device, while exploring the Assistive Technology Device Predisposition Assessment - Device Form in such depth. According to the results, it is a stable, valid and reliable instrument and applicable to the Greek population. Thus, it can be used to measure the satisfaction of patients with assistive devices.Implications for RehabilitationThe paper explores the cultural adaptability and applicability of ATD PA – Device Form.ATD PA – Device Form can be used to assess user satisfaction by the selected assistive device.ATD PA – Device Form is a valid and reliable instrument in measuring users’ satisfaction in Greekreality. [ABSTRACT FROM PUBLISHER]

Purpose: This paper describes the development and test of physical and virtual integrated augmentative manipulation and communication assistive technologies (IAMCATs) that enable children with motor and speech impairments to manipulate educational items by controlling a robot with a gripper, while communicating through a speech generating device. Method: Nine children with disabilities, nine regular and nine special education teachers participated in the study. Teachers adapted academic activities so they could also be performed by the children with disabilities using the IAMCAT. An inductive content analysis of the teachers’ interviews before and after the intervention was performed. Results: Teachers considered the IAMCAT to be a useful resource that can be integrated into the regular class dynamics respecting their curricular planning. It had a positive impact on children with disabilities and on the educational community. However, teachers pointed out the difficulties in managing the class, even with another adult present, due to the extra time required by children with disabilities to complete the activities. Conclusions: The developed assistive technologies enable children with disabilities to participate in academic activities but full inclusion would require another adult in class and strategies to deal with the additional time required by children to complete the activities. Implications for RehabilitationIntegrated augmentative manipulation and communication assistive technologies are useful resources to promote the participation of children with motor and speech impairments in classroom activities.Virtual tools, running on a computer screen, may be easier to use but further research is needed in order to evaluate its effectiveness when compared to physical tools.Full participation of children with motor and speech impairments in academic activities using these technologies requires another adult in class and adequate strategies to manage the extra time the child with disabilities may require to complete the activities. [ABSTRACT FROM PUBLISHER]

Purpose: The WheelSense project aims to develop a system for assessing the stability and performance of wheelchairs through a user-centred design process. This study sought to capture user needs and define the specification for the system.Method: A mixed methods approach was adopted. An online survey was completed by 98 participants working in wheelchair provision. The results were built upon through 10 semi-structured interviews and one focus group (n = 5) with professionals working in wheelchair provision in three NHS Trusts in the UK.Results: The results provided a picture of the current UK practice in stability testing. Issues with the reliability and usefulness of the existing methods used to assess the stability and performance of wheelchairs were highlighted. Requirements for a new system were ascertained. These included improved accuracy of tipping angles, features to support record keeping, improved client/carer education support and ability to model or predict client–wheelchair system performance in different configurations. Conclusions: The paper concludes that there is a need for improved tools to determine the stability of the client–wheelchair system and support the prescription process, to ensure client safety and optimum equipment performance. A list of requirements has been produced to guide the future development of WheelSense.Implications for RehabilitationThe results of this survey and interview-based study present a picture of wheelchair stability testing practices in the UK, and highlight the need for new, more informative methods for guiding wheelchair prescription.The requirements for the design of a new system, or further development of existing tools to support the stability testing and prescription of wheelchairs have been established. [ABSTRACT FROM PUBLISHER]

Objective: Some adults with acquired communication disorders are faced with an inability to communicate coherently through verbal speech with their communication partners. Despite the fact that a variety of augmentative and alternative communication (AAC) aided systems is available to assist them in communicating, not all adults accept them. In Cyprus, there is scant research focusing on the factors that are linked to AAC system acceptance and abandonment. Methods: To address this gap, this research involves exploring the experiences of six speech and language therapists supporting adults with acquired communication disorders, who could benefit from the use of AAC systems. The main research question is: What are the factors that influence AAC system acceptance or abandonment? The method used for data collection, was semi-structured interviews and the transcripts were analyzed thematically. Results: The findings show that a number of factors influence the acceptance of AAC systems. These include the time since onset and acceptance of disability, the person's attitude towards communication facilitators, and the perceptions about AAC systems. These findings indicate that the process of accepting an AAC system is multi-layered and these layers are interrelated. Conclusions: More research is warranted focusing directly on the experiences of people with acquired communication disorders and their communication partners. The different myths about AAC systems need to be challenged such that awareness about their usefulness is raised. AAC specialists need to find ways to spread the message that AAC systems can actually support language, speech and communication through different dissemination avenues, such as articles in newspapers and talks through the media. [ABSTRACT FROM AUTHOR]

Purpose: College students with mild traumatic brain injury (mTBI) may experience chronic cognitive deficits necessitating use of external supports for daily task completion. The purpose of this study was to explore cognitive support system selection and use by students with histories of mTBI when completing novel prospective memory tasks. Materials and methods: We implemented a multiple case study, sequential explanatory mixed-methods design with three participants. Participants completed four experimental phases: (1) background history collection, cognitive assessment completion, pre-trial interview, and selection of two external supports for trial phase use; (2) trial Phase 1 (i.e., 10-days); (3) trial Phase 2 (i.e., 10 days); and (4) post-trial exit interview. We examined participants' support type and characteristic preferences and evaluated task execution accuracy when implementing differing supports. Results: Participants expressed both collective and unique cognitive aid preferences before trial completion. Trial phase results revealed that task completion accuracy did not alter substantially between trials; however, personal preferences and perceived usefulness of trialled cognitive aid systems appeared to impact support implementation and effectiveness. Themes emerged from post-trial interview relating to the (a) necessity for differing functions of individual systems and (b) importance of trialling devices prior to selection. Conclusions: Results emphasize the necessity of person-centred approaches to treatment due to the variability of performance accuracy and system preferences. The cognitive aid selection and implementation intervention protocol piloted in this study appears beneficial for understanding unique strengths and challenges for college students following mTBI and may be useful for clinicians working with individuals with mTBI. College-aged students with mild traumatic brain injury report unique preferences for no- and high-tech cognitive aids; however, similar patterns emerge relating to preferred system characteristics. Facilitating several trial periods prior to selection and implementation of external cognitive supports for individuals with mild traumatic brain injury is essential given the preference changes that occur post-trial. Implementing a three-phase external cognitive aid selection process appears beneficial for young adults with mild brain injuries. [ABSTRACT FROM AUTHOR]

This study explored the impact of assistive technology on the well-being of legally blind adults. In this mixed-method study, a convenience sample of 86 legally blind adults took an electronic survey. The questionnaire was comprised of demographics, use patterns, and an instrument called TENS-Interface that measured the impact of technology on well-being categories of autonomy, competence, and relatedness. Descriptive statistics, reliability, power analysis and bivariate correlations were calculated using SPSS statistical software. Three participants completed follow up semi-structured interviews, which were analysed for themes of technological mediation using NVivo 12 software. The TENS-Interface was validated for use with a legally blind population. Descriptive statistics showed a higher mean for autonomy than competence or relatedness. Braille was positively correlated to both autonomy and competence, while screen reader proficiency was related to competence. Daily use of social media, email, instant messaging, and video calls were correlated to relatedness. The technological devices used by interview participants were analysed for technological mediation. Training was identified as an additional theme. Recommendations for practice include providing training to legally blind adults in screen reader use and braille use to support well-being via competence and autonomy. Training is also recommended for this population in the use of social media, email, and video calls to promote well-being through opportunities for relatedness. Further research is recommended to explore instructional methods that are not only efficient, but also meaningful for older adults in the position of losing their vision. Providing access to braille instruction and braille assistive technology equipment can promote legally blind adults' well-being by supporting their basic needs for both competence and autonomy. Providing training in screen reader use can promote legally blind adults' well-being by supporting their basic need for competence. Providing training in use of email, social media, video calls, and instant messaging can promote legally blind adults' well-being by supporting their basic need for relatedness. A consideration of technological mediation can allow practitioners to make recommendations that take into account not only efficient task completion, but issues related to meaning and social context. Instruction for adults losing their vision adventitiously needs to address not only efficient task performance, but also meaning and social context. [ABSTRACT FROM AUTHOR]

Assistive technology (AT) enables and promotes inclusion and participation, especially for persons with a disability, ageing populations, and those with non-communicable diseases. AT is essential for generating collaborative learning environments, inclusive of students with a range of specific needs and required supports. However, many teachers lack the training, resources, and skills to use AT in the class. This study uses a systems thinking approach to consider teachers AT needs in the Irish classroom. Three hundred and five teachers completed an online survey, and 10 took part in semi-structured focus groups. The survey examined teachers experiences with AT, their training needs, and the context within which they need support. Teachers reported low levels of AT knowledge, skills, and confidence. Many described limited access to training and support for AT use. Results also reveal non-systems thinking, whereby there is no meaningful linking across the main strategic drivers of AT - policy, products, provision, and personnel, to support the people at the centre of the AT system – between these and the contextual factors that influence their effectiveness. An AT system which is easy to navigate, which has policies and provision that supports educators, and has expert personnel on hand to support teachers, is crucial if AT is to become embedded in Irish classrooms. This research shows that a comprehensive AT system in education should include policies, practices, personnel, and products that interact to support people to engage easily and successfully with AT in the classroom. Describes current trends in how teachers are engaging with Assistive Technology. Describes the current trends in disabilities in Irish classroom and teachers requirements for support. Understand the system challenges facing teachers attempting to use Assistive Technology. Support the development of Assistive Technology training for teachers which are informed by teachers needs. Inform the development and improving policies and processes for common situations. [ABSTRACT FROM AUTHOR]

Powered wheelchairs promote participation for people with mobility limitations. For older adults with cognitive impairment, existing training methods may not address learning needs, leading to difficulty with powered wheelchair skills. Error-minimized training, facilitated by shared control technology, may provide learning opportunities more suited to this population. The objective of this study was to evaluate the feasibility of an error-minimized approach to powered wheelchair skills training using shared control in residential care. Feasibility indicators were hypothesized a priori to be feasible for use in a definitive RCT. A 2 × 2 factorial RCT compared an error-minimized powered wheelchair skills training program (Co-pilot) to a control intervention at two doses (6 sessions vs. 12 sessions). Data were collected on the feasibility of study processes (e.g., recruitment), resources (e.g., participant time), management (e.g., technology reliability), and training outcomes (e.g., adverse events, clinical outcomes). Twenty-five older adults with cognitive impairment participated in the study. Technical issues were encountered in 14.5% of training sessions. Participants receiving 6 sessions of training adhered better to the treatment than those receiving 12 sessions. All participants learned the skills required for PWC use with minor errors, regardless of the training method or dose. Co-pilot participants and trainers reported feelings of safety and training benefits with the use of shared control technology. Individuals with mild to moderate cognitive impairment are able to learn the skills required to drive a powered wheelchair in as few as six training sessions. Further evaluation of the Co-pilot training program is required. Shared control teleoperation technology may be used to augment learning in older adults with cognitive impairments. Evaluation of the feasibility of use of novel rehabilitation technologies is critical prior to engaging in large-scale clinical research. Individuals with cognitive impairment are able to learn the required skills for operation of a powered wheelchair. [ABSTRACT FROM AUTHOR]

Converging visual behavioural and attentional allocation studies within neuroscience have shown culture influences the processing of visual information obtained from the visual field. While attending (reviewing) a visual scene, individuals from a collectivist culture attend more to the context (background) compared to those from an individualist culture who view more the focal object. This highlights the effect of cultural conditioning in terms of holistic and analytical processing of visual information. This study aimed to demonstrate these principles in the context of an assistive product, a wheelchair, highlighting the key visual elements of the form; and, how a congruent background (hospital room) or incongruent (athletics track) influenced cultural bias during visual processing and assigned meaning. A combination of research methods (Semantic Differential Scale and eye-tracking) was used to triangulate the results. A total of 126 adult student participants, (Pakistani/collectivist, n = 57) and the (UK/individualist, n = 69), viewed a visual presentation of a wheelchair with semantically congruent and then an incongruent background and responded via an online questionnaire. A sub-sample completed the survey whilst monitored via eye-tracking. Pakistani respondents used shorter and less frequent fixations on the foreground compared to the responses of their counterparts (UK respondents). The wheel of the wheelchair was highlighted as the prominent form by both groups. Results demonstrate a culture-influenced pattern of visual processing even when the product was displayed against a semantically incongruent background. The findings from this study also validate and extend the outcomes of similar studies revealing a more specific, yet consistent, cultural effect on individuals' visual perception. Finally, the efficacy of triangulated research methods in their relationship to exploring the AT product's semantics was discussed. The knowledge of AT products' semantics will be significant to investigate, for their improved social acceptance, particularly when considered from a diverse cultural standpoint. A model of best practice, focussing on semantics manipulation, will provide AT product designers, practitioners, and those involved in their marketing, Internationally, with a suitable process/tool to positively reframe the perception of these devices. Finally, this research will help product and industrial designers to consider cultural cognitive styles in the design of products for the better adoption of products within the global marketplace. [ABSTRACT FROM AUTHOR]

The study aim was to develop and assess the measurement properties of the Functional Impact of Augmentative and Alternative Communication – Educator (FIAAC-E) scale – an educator-reported measure designed to detect change in factors associated with communicative participation in students who use augmentative and alternative communication (AAC). The study had three phases. In phase 1 (content validity), 22 content specialists independently rated the relevancy of 22 dimensions proposed for the new scale. In phase 2 (item generation, face validity), 8 educators independently completed a preliminary version of the FIAAC-E scale and flagged items that were unclear. Next, these educators adjusted the wording of unclear items during consensus-building sessions. In phase 3 (item reduction, reliability, convergent validity), 62 educators completed an online survey that included the revised FIAAC-E scale. Survey data were used to shorten the scale, estimate its reliability, and evaluate support for its convergent validity. In phase 1, the 11 dimensions ranked most highly by content specialists were selected for inclusion in the preliminary scale. In phase 2, educators reviewed 113 items and revised 33 to improve clarity. In phase 3, correlational statistics informed the selection of 77 items for the shortened scale. Subsequent data analyses indicated acceptable levels of internal consistency and test-retest reliability and support for convergent validity of the preliminary measure. The study provides emerging evidence that supports the FIAAC-E scale as a reliable way to evaluate communicative participation in children and youth who use AAC systems at school. Using a reliable means to measure the effectiveness of AAC for children and youth at school may reveal important factors that influence successful communicative, academic, and social participation in school. The FIAAC-E scale is a promising educator-reported questionnaire to inform the development of communication goals and monitor progress towards meeting these goals for students with complex communication needs. [ABSTRACT FROM AUTHOR]

Power wheelchairs (PWCs) can enhance independent mobility. The World Health Organization recommends training PWC users. However, current PWC training approaches do not always meet the needs of PWC users with complex mobility and cognitive impairment. The aim was to co-develop an innovative approach to PWC training for individuals with complex mobility and cognitive impairments. A two-phase mixed method research, involving PWC users, clinicians and researchers throughout all aspects of the research, was realized. (1) Interviews and focus groups were used. (2) The Delphi method was followed to refine the PWC training approach. Phase 1: Twenty-six stakeholders indicated that PWC training should consider the client as a partner, the learning environment, the proposed activities, interactions with the trainer and intervention format. Phase 2: two hundred and seven participants agreed that the PWC training should be goal directed, should be client-centred and occupation-based, should enhance client–therapist relationships and should be realized in a safe and adapted environment. Stakeholders on PWC use came to agreement on key components that should be applied when training people with cognitive impairments. Stakeholders on power wheelchair (PWC) use came to agreement on key components that should be applied when training people with cognitive impairments. Power wheelchair training should be goal directed, should be client-centred and occupation-based, should enhance client–therapist relationships and should be realized in a safe and adapted environment. Results of this study may contribute to best practices for PWC training and may empower occupational therapists providing PWC in their clinical decision-making. [ABSTRACT FROM AUTHOR]

To explore the experiences of new motorised mobility scooter users from the perspectives of the assessment and training of scooter skills. Descriptive secondary analysis of qualitative data. Community. 20 New users of motorised mobility scooters. Not applicable. Directed qualitative analysis of up to four semi-structured interviews over the course of the first year of scooter use, to identify themes and sub-themes that could inform recommendations regarding assessment and training protocols. We identified two themes. The first related to potential new content. As one example of the sub-themes, there were many excerpts that dealt with the use of skills in various combinations and permutations that were used to carry out activities during everyday life and participate in society. These excerpts suggested the importance of training skills in combination to facilitate skill transfer (or generalizability). The second theme is related to enhancements of existing content. As one example of the sub-themes, there were several excerpts that dealt with scooter security. These excerpts led to the recommendation that removing and inserting the scooter key should be added to the assessment criteria for the "turns power on and off" skill of the Wheelchair Skills Test (WST) and its questionnaire version (WST-Q). The experiences of scooter users over the first year of receiving a scooter appear to be relevant to the assessment and training of scooter skills and suggest themes for further study. Clinical trial registration number: NCT02696213 The experiences of new scooter users are highly relevant to the assessment and training of scooter skills. These experiences suggest both potential new content and enhancements of existing content to the Wheelchair Skills Program Manual. [ABSTRACT FROM AUTHOR]

Complex rehabilitation technologies (CRT) support independence for individuals with disabilities by enabling mobility for function, employment, education, and independent living. CRT service delivery is evolving, with changes to funding, provider qualifications, consumer needs, and technological advances. This scoping review investigated service delivery processes for individuals with disabilities who have a mobility impairment, while specifically identifying best practices, barriers, and unique features of health delivery policies and practices. We used a framework described by Colquhoun et. al. for conducting scoping reviews, a six-step process that includes: 1) identifying the research question, 2) identifying studies, 3) selecting studies 4) data charting, 5) reporting results and 6) consultation. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) was also used for reporting results of the review. Common categories were identified and organised into a hierarchical structure of four categories and 16 sub-categories. The primary categories included "policy", "consumer", "service delivery", and "wheeled mobility devices". The sub-categories described funding sources, consumer and professional populations, service delivery guidelines, and types of mobility devices. Analysis indicated the data were from 21 countries and 14 combinations of funding sources, and the articles were primarily descriptive studies. This scoping review identified evidence from various countries, health systems, and stakeholder. Currently, this process does not proactively address the needs of individuals with mobility disabilities. The scoping review provides the foundation for the development of a novel policy on the provision of CRT services and devices to address these needs. Examination of national and international service delivery practices in diverse clinical and funding environments indicate various challenges and opportunities for improvement. CRT consumers are negatively impacted by current service delivery practices, including long wait times, lack of specialised clinical expertise, and limited consumer education opportunities. More consistent and widespread research is needed within the CRT provision industry to grow evidence-based practice related to complex rehabilitation technology and individuals with disabilities. [ABSTRACT FROM AUTHOR]

Reading is one of the main complaints of low vision patients referred for visual rehabilitation, since it is fundamental for full participation in modern society. The purpose of this study was to analyse the usability of free smartphone apps with magnification tools as digital aids for reading visual rehabilitation in low vision patients. Low vision adult patients were included regarding the following criteria: best-corrected visual acuity in the better-seeing eye from 0.6 to 1.3logMAR, previous habit of smartphone use, without former aid adaptation. Android system was used for the selection of three applications (apps) to be tested as digital reading aids. Visual acuity (VA) for near, reading acuity (RA) and reading speed (RS) using each app were measured. The participants were also asked about apps usability concerning accessibility, focus adjustment and text tracking. Seventeen participants (10 females – 58.8%) with ages ranging from 26 to 73 years (mean = 45.2 ± 13.1 years) were included. Mean binocular VA, RA and RS without the apps were respectively 1.00 ± 0.22 logMAR, 1.01 ± 0.28 logMAR and 41.7 ± 28.6 words/minute. Statistically better visual and RA results through the apps were found with a mean ≥9-line gain for both, and no significant difference for RS was found. All apps achieved good usability scores (means > 7). All tested apps provided improvement in VA and reading performance, with proven usability. Free smartphone apps for magnification should be considered in reading rehabilitation programmes for low vision patients. Reading is essential for performing productive daily activities and for full participation in modern society, being a clinical indicator of visual function and quality of life. Difficulty in reading is one of the main complaints of low vision patients referred for visual rehabilitation. Smartphone apps for magnification and readability optimization of printed texts may provide improvement in visual acuity and reading performance of low vision patients. Digital technologies should be considered in the low vision reading rehabilitation programme since they provide additional advantages such as accessibility, cost, portability and social acceptance. Usability is the user's experience when interacting with a software application and associated with pleasantness, usefulness, ease of use, safety and efficiency. Low vision patient's feedback on the usability of assistive technologies is important for a successful visual rehabilitation which meets his/her needs and expectations. [ABSTRACT FROM AUTHOR]

This study explored and interpreted insights expressed by a cohort of older adults related to their life experience, their experiences using or assisting someone with assistive devices, and their perceptions of robots and robotic assistive devices, including lower limb exoskeletons. A grounded theory study was undertaken with 24 older adult participants over five months. Each participant participated in a structured interviewed regarding their experiences with technologies and in particular their perceptions of assistive technologies. Themes from the interviews were coded using Nvivo software. Five main themes emerged from this study – (1) Aging & life stage experiences, (2) Quality of Life, (3) Assistive Technologies, (4) Health Conditions & Care, (5) Products & Service Systems. These have influenced new constructs for a hybrid design tool that incorporates stages of Usability and TAMs (Technology Acceptance Models) to gauge (a) Perception, (b) Experience and (c) Perceived Impact by older adults of lower limb exoskeletons. Conclusions: Emerging technologies such as robotic assistive devices require a specific enquiry to understand how best to optimise acceptance by older adults and avoid feelings by them of frustration, embarrassment and ultimately abandonment of these devices. Older adults frequently require rehabilitation and assistance with ambulation Exoskeletons are forms of assistive technologies for rehabilitation, and they are moving from clinical use to more day care use, including as part of daily living These results help explain factors related to the perception of exoskeletons by older adults, which if considered during exoskeleton design, could improve the technology uptake and compliance with this technology use by these users [ABSTRACT FROM AUTHOR]

Purpose: To explore ways in which social and economic interactions are changed by access to mobile telephony. Method: This is a mixed-methods study of mobile phone use among 52 urban professionals with vision impairments in Bangalore, India. Results: Interviews and survey results indicated that mobile devices, specifically those with adaptive technology software, play a vital role as multi-purpose devices that enable people with disabilities to navigate economically and socially in an environment where accessibility remains a significant challenge. Conclusions: We found that mobile devices play a central role in enabling and sustaining weak ties, but also that these weak ties have important gender-specific implications. We found that women have less access to weak ties than men, which impacts women's access to assistive technology (AT). This has potential implications for women's sense of safety and independence, both of which are strongly related to AT access. [ABSTRACT FROM AUTHOR]

Assistive technology users may encounter challenges and inequality in having an access to health information and care during the emergency or in a crisis time. This issue seems to be understudied in most developing countries. The aim of this study was to explore the challenges faced by Iranian people with disabilities faced during the COVID-19 pandemic as far as the use of assistive technology is concerned. A thematic analysis approach was employed to collect and analyse the data. We interviewed 10, 12 and 20 participants with physical, visual, and hearing disability, respectively during the pandemic between May to July 2020. A six-step thematic analysis method was used to identify categories and main themes. The results revealed that people with disability were faced with some challenges in accessing information or receiving it on time during the emergency time. The lack of clear information may increase uncertainty about providing, using or maintaining assistive products. With no clear information or instruction, increased fear of infection, as well as the lack of necessary infrastructure for using available online applications, people with a disability had to rely more on others and seemed to feel disempowered. Assistive technology (AT) users may not receive enough care and attention during health crisis, nor may be included in crisis management programs. Actions to create preparedness plans to meet the needs of AT users in possible future crisis seem to be necessary. Assistive technology users' voice and needs should be given priority in crisis management programs. Web accessibility barriers and information accessibility challenges need more research attention in order to create effective and timely information dissemination programs. There seems to be a research gap about AT users during health crisis, and more research in this area is needed. [ABSTRACT FROM AUTHOR]

Coronavirus 2019 (COVID-19) was first identified in December 2019 with millions of cases reported globally in the succeeding months. Initial hospitalisation strives to minimise multisystem organ failure and of those that survive, individuals can present with profound rehabilitation needs. The purpose of this case series is to describe occupational therapy (OT) and special technology considerations for three male Veteran patients hospitalised with suspected or confirmed COVID-19. This is a descriptive case series using a retrospective electronic health record review at a Veterans Administration hospital. The case series includes three male Veterans with confirmed or suspected COVID-19 (ages 69–78) who were referred to OT. The cases were selected to demonstrate the novel use of technology and strategies to reduce the risk of transmission. In two of three of our cases, we describe acute rehabilitation with a focus on activity tolerance, participation in occupations, and discharge planning. In all cases, we measured vital signs and activity tolerance as primary outcomes. The findings suggest that outcome measures focussing on activity tolerance to maintain stable vital signs during the recovery phase is central to the progression of activities. We observed in our cases that the Person-Environment-Occupation-Performance (PEOP) model can guide practice and complement the medical model in management of these patients. We utilised technology to engage family members in the rehabilitation care and minimise exposure risks. Acute occupational therapy for rehabilitation early in the recovery of Cornavirus-2019 can be guided by the Person-Occupation-Environment-Performance model as seen in this case series of three Veteran patients. Assistive technology can serve dual roles in supporting the rehabilitation of individuals with Cornavirus-2019 and lowering the risk of virus transmission to staff. [ABSTRACT FROM AUTHOR]

To explore parental experiences on the role of wheelchairs in the lives of their children with mobility impairments in Dubai. Seven participants were recruited through purposive sampling and their experiences were explored by conducting semi-structured interviews. The audio recordings were transcribed and thematically analysed. The findings showed that wheelchairs were an essential part of the children's lives, which enabled their participation in the home, the school and the community. Procurement processes were difficult owing to a lack of assessment and prescription processes as well as insurance companies providing little assistance with payment. The participants described Dubai as a wheelchair friendly city and two overarching themes emerged; firstly, The wheelchair: "It is her life", and, secondly, Participation: Isolation versus inclusion. The study is the first of its kind in Dubai and indicated that the wheelchair played an important role in the children's lives and allowed participation in life roles that brought joy and fulfilment. Without wheelchairs, children would be isolated and frustrated. However, some of the participants were not satisfied with their child's current wheelchair and felt the chair was not appropriate. Recommendations to specific stakeholders included: the development of policies to guide wheelchair service provision by government. In addition, insurance providers could collaborate with the government to adhere to the policy to ensure healthy lives and promote well-being for all. The wheelchair provided children the mobility to participate in life roles instead of being isolated. Not all children had appropriate wheelchairs. Service providers and medical insurance did not give sufficient support during wheelchair selection and procurement. [ABSTRACT FROM AUTHOR]

Care robots are machines, operating partly or completely autonomously, that are intended to assist older people and their caregivers. Care robots are seen as one part of the solution to the aging population, allowing fewer professional caregivers to provide the necessary assistance and care. Despite the potential benefits, the dissemination of care robots, and welfare technology in general, is limited in Swedish elder care. To explore the challenges of introducing welfare technology, particularly care robots, in elder care. Twenty-one individual interviews with key actors at the societal level, analysed by thematic analysis. The challenges, from the societal actors' perspectives, were related to; the beliefs in technology, attitudes, ethics, collaboration, and the need for knowledge and skills regarding care robots (individual and group challenges). Challenges of a national character were: national governance, infrastructure, laws and regulations, economics, and procurement (systemic and societal challenges). In addition, the necessary preconditions for successful introduction were revealed as: the utility of the technology, implementation, evaluation and safety, security, and integrity (preconditional challenges). The introduction of care robots in elder care services seems to be more challenging than that of welfare technology in general, given the context and prevailing attitudes and preconceptions about robotics. Significant challenges need to be managed, at all levels of the society, before care robots can become an integral part of daily care and assist older people and their caregivers in activities and rehabilitation. The challenges described by the societal actors', are partly similar to those of the end users', in terms of attitudes, ethics, knowledge and skills, and collaboration. This consensus should provide a solid foundation for the conceptualization and introduction of care robots in elderly care. The challenges follow the pattern of an ecosystem involving all sections of society, which are intertwined and require consideration before the expected benefits can be realised. A user-centred approach is necessary to support the design, implementation, and usefulness of care robots and their suitability for meeting the real needs of older persons and professional caregivers. [ABSTRACT FROM AUTHOR]

The aim of this study was to identify factors that influence the perceived stigma of two assistive devices for visual impairment, namely the white cane and smart glasses. Face-to-face semi-structured interviews with eight European students were conducted to probe their experiences and knowledge related to disability, assistive technology, visual impairment, as well as handheld and wearable devices. Close relationships with disabled people seems to have a positive influence on participants perceptions about stigma, disability, and assistive technology. Academic background seems to not have any influence. The aesthetics of assistive devices was observed as an important factor that influences the adoption or abandonment of the device. Device without negative symbolism but with modern aesthetics (smart glasses) were positively accepted by the participants than the device with traditional aesthetics and symbolisms of visual impairment (white cane). Designers should, therefore, consider aesthetics in addition to functionality in order to avoid the perceived stigma, thereby reducing the chances of device abandonment. Understanding the factors that influence the perceived stigma associated with assistive technology can help designers and developers to reduce assistive technology abandonment and perceived stigma. Designers need to consider both functionality and aesthetics. While functionality is crucial for the users' adaptation, aesthetics is important for the users' positive perceptions. [ABSTRACT FROM AUTHOR]

Manual wheelchair users are more vulnerable, in situations such as road crossings, hazardous sidewalks or curbs and crossing of buildings and facilities threshold. Geospatial assistive technology (GAT) can help with route planning. However, it is important to ensure the usability of such products, as well as the satisfaction of persons with reduced mobility. The study's aim was (1) to develop and validate a questionnaire on the satisfaction of GAT, in English and French, and to (2) assess satisfaction, efficacy and efficiency of a GAT with manual wheelchair users following a filmed trial in a dense urban area. A methodological study was conducted (development of the questionnaire, assessment of its content validity, feasibility and practicability) followed by a trial and post-observations with the videos. Two questionnaires (English, French) were concurrently validated by two groups of experts (n = 8), and then field-tested by wheelchair users (n = 8), using Google Maps Pedestrian routeing tool. The Evaluation of satisfaction with geospatial assistive technology (ESGAT) consists in a user profile and their experience with the technology, followed by 12 satisfaction criteria rated from 1-not satisfied to 5-very satisfied. Both questionnaires were rated as feasible and practicable to complete. The usability of Google Maps Pedestrian routeing tool was measured as "moderate" by manual wheelchairs since the total satisfaction score at the ESGAT was 3.9/5 (quite satisfied). The items with the lowest score were navigation assistance, hands-free function and security. The GAT was effective (87.5% have completed their destination) but not efficient (37.5% needed help). For manual wheelchair users paired with geospatial assistive technology: • A 10 minutes questionnaire was developed and validated to assess their satisfaction after testing aid in an urban area. • Satisfaction criteria to address are ease of access (service), learnability, hands-free function, ease of use for planning as well for navigating, transportability/ appearance, content, geographic information, effectiveness, efficiency, navigation assistance and security • A field test is necessary to ensure the effectiveness of the technology in avoiding or announcing potential obstacles such as sidewalk crossing ramp, damaged and congested sidewalk; sidewalk tilt (side slopes); thresholds at destination; verbal indication too soon or too late; incorrect indication; the arrow does not indicate the right direction; readjustment of the route needed; a lack of indication; and human intervention needed. [ABSTRACT FROM AUTHOR]

Motorized shopping carts found at grocery and retail stores provide mobility for those who have difficulty walking through the store or pushing a regular cart. The purpose of this study was to understand the usage of motorized carts in grocery stores and pilot test an air-powered cart to determine its feasibility as a replacement for electric-powered carts as well as identify areas for improvement and preferred users. Users were asked to complete an online survey that assessed their shopping characteristics and experience using the motorized cart. K-Means clustering determined user demographics who chose to use the air-powered carts versus the electric-powered carts. Open-ended comments for improvements were also collected. A total of 65 participants were provided informed consent, 60 participants met inclusion criteria and completed the survey. A majority of the air-powered (N = 29, 91%) and electric-powered (N = 11, 73%) cart users had a positive experience. Clustering found age and type of mobility device owned were significant whether participants chose the air-powered or electric-powered carts. Most suggested improvements for the air-powered carts were better braking, higher speed and a bigger basket while a longer battery life was most suggested for electric-powered carts. Motorized shopping carts are used by a wide variety of individuals. Individuals aged 54 or younger and do not own a mobility device chose to use air-powered more than electric-powered carts. The functional capabilities of the air-powered carts demonstrated their potential to serve as practical replacements for electric-powered carts found in grocery and retail stores. The availability and reliability of motorized shopping carts at retail stores are integral for individuals with physical impairments to complete their shopping needs. The development of novel assistive devices such as air-powered carts provides improved experiences and quality of life. Integrating end-user feedback during the design of assistive technologies is paramount for meeting actual needs. [ABSTRACT FROM AUTHOR]

We tested the feasibility, implementation strategy and mechanism of impact of FindMyApps. FindMyApps is a tablet intervention consisting of a selection tool to help people with dementia find usable apps for self-management and meaningful activities, including training to support informal carers in employing errorless learning principles to help people with dementia learn tablet and tool usage. We conducted an exploratory, pilot randomized controlled trial with a mixed-methods design. Twenty persons with mild dementia and carer dyads were randomly assigned to the FindMyApps group (n = 10), receiving either the FindMyApps training and selection tool, or a control condition (n = 10), receiving only a short tablet training. Pre- and post-test measurements at a three month follow-up, consisted of questionnaires and post-test semi-structured interviews. The FindMyApps tool was mostly perceived as useful and easy to use. Persons with dementia were generally able to learn how to use the tool, though they regularly needed support from informal carers. Persons with dementia found apps through the tool, which they used regularly. Persons with dementia and informal carers were positive about the training and support they received. No significant differences were found on outcome measures of persons with dementia, but based on effect sizes FindMyApps is a promising intervention. Qualitative results indicate that the FindMyApps intervention has the potential to positively influence the self-management abilities and engagement in meaningful activities of people with dementia. Remarks are made to improve the intervention and recommendations are given for future effectiveness studies. The person-centred tablet intervention FindMyApps has the potential to positively influence the self-management and engagement in meaningful activities in people with dementia. Based on the input of persons with dementia and informal carers, the FindMyApps intervention and study procedure will be further improved and evaluated in terms of effectiveness in an RCT. [ABSTRACT FROM AUTHOR]

Unmet needs for assistive technologies (ATs) exist and the need for ATs is growing owing to demographic changes worldwide. Little comprehensive research has examined equity of access to ATs in Canada. Our study elucidates perspectives of policymakers and stakeholders on challenges and solutions for enhancing equitable access to ATs to advance policy discussions. We conducted a qualitative interview study with a purposive sample of policymakers and stakeholders. Stakeholders were from non-profit organisations; private insurance companies; ageing or technology industries; and advocacy, consumer, and support groups. We used thematic analysis to develop themes that summarised and facilitated data interpretation. We conducted 24 interviews involving 32 participants. We present three themes: (1) User experiences, detailing challenges experienced by AT system users; (2) System characteristics: Challenges and solutions, outlining governance, financial, and delivery arrangements that create challenges for accessing AT, as well as participants' proposed solutions; and (3) Shifts in models and principles, for approaches that may foster equitable access to ATs. We consolidate results into a set of valued qualities of a system that can enhance equitable AT access, and relate results to relevant national and international activities. This is the most comprehensive study of Canadian policymaker and stakeholder views on AT access to date. Identified challenges and solutions point to opportunities for policy action and to support work to create a national vision for AT access that strengthens the potential for ATs to enable daily activity participation, independence, and societal inclusion of seniors and people with disabilities. AT use supports daily activity participation, independence, and societal inclusion of seniors and people with disabilities. There is an urgent need to ensure that those who need ATs have access to them, considering the benefits of their use, current unmet needs for ATs, and the anticipated demand for ATs because of the ageing population and increased prevalence of chronic disease and disability. A comprehensive understanding of policymakers' and stakeholders' perspectives on challenges and potential solutions for enhancing equitable access to ATs is critical to support development of evidence- and values-informed policies. Understanding challenges and solutions identified by diverse policymakers and stakeholders can lead to national and local opportunities for policy action and support work to create a national vision for enhancing equitable access to AT. [ABSTRACT FROM AUTHOR]

This pilot study examined whether two different types of non-powered mobile arm supports (MAS) enhanced upper limb function and independence with activities of daily living (ADLs) in people with Duchenne muscular dystrophy (DMD). A mixed methods cross-sectional design was used. Participants were four males with DMD, aged 16 to 20 years (M = 18.25 years). Two participants were current MAS users, and two had previously used MAS. To explore experiences of MAS use, semi-structured interviews were undertaken, then transcribed verbatim and analysed thematically. To measure the impact of MAS on arm function and ADLs, participants using MAS completed the Performance of the Upper Limb (PUL) and the DMD Upper Limb Patient Reported Outcome Measure with and without MAS. Participants no longer using MAS only completed the PUL without MAS. MAS enhanced upper limb function and independence with ADLs in three of four participants. Eating and drinking was most often positively impacted by MAS. Access to informal support for MAS set-up, and ongoing input from a clinician or assistive technology (AT) supplier with MAS expertise, were important enablers to successful MAS use. Barriers to use included inadequate upper limb strength, interference of MAS with wheelchair controls, and AT funding delays. MAS should be considered by individuals with DMD and clinicians working with them as the disease progresses and strength declines. Potential barriers to MAS use need to be addressed to ensure maximum utility. AT funding delays must also be minimized to avoid impact on outcomes of people with DMD. Individuals with DMD, and clinicians working with them, may consider MAS to aid achievement of functional goals as the disease progresses and upper limb function declines. Both objective and subjective outcome measures should be used when evaluating the effectiveness of MAS. Consideration should be given to the potential interference of MAS with wheelchair controls and the availability of informal or paid supports (e.g., family, support workers, teachers) to aid MAS use. Efficient and timely funding of MAS is required, as delays may negatively impact outcomes for people with progressive neurological conditions, such as DMD. [ABSTRACT FROM AUTHOR]

This article critically examines user-involvement in the service delivery process for assistive activity technology. Data were collected in semi-structured interviews with 44 end users of assistive activity technology and in focus group interviews with 11 professionals at Norway's Assistive Technology Centre. Data was analysed according to a stepwise deductive–inductive approach. Flawed organisational principles like division of responsibility, unclear regulations, and a lack of competence with assistive activity technology among service professionals have hindered user involvement in the service delivery process. A missing knowledge of assistive activity technology among professionals and the current organisation of services creates barriers for a positive collaboration with users in the service delivery process of assistive activity technology. The spread of information among users and courses for professionals should be expanded to ensure the necessary competence with assistive activity technology within the service delivery process. In developing the service delivery process for assistive activity technology, professionals should act less as guardians of traditional functional requirements and more as active providers of different technological solutions. The service delivery process for assistive activity technology should allow long-term testing to identify relevant social and physical factors affecting the use of this type of technology, before delivery. Guarantees and complaint systems should be established in the service delivery process for assistive activity technology. [ABSTRACT FROM AUTHOR]