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Current approaches for generating high-quality research evidence for technology-based interventions in the field of disability and rehabilitation are inappropriate. Prevailing approaches often focus on randomized controlled trials as standard and apply clinical trial practices designed for pharmaceuticals; such approaches are unsuitable for technology-based interventions and are counterproductive to the goals of supporting people with disabilities and creating benefits for society. This communication is designed to: (1) advocate for the use of alternative approaches to generating evidence in the development and evaluation of technology-based interventions; (2) propose an alternative framework and guiding principles; and (3) stimulate action by multiple disciplines and sectors to discuss, adopt, and promote alternative approaches. Our Framework for Accelerated and Systematic Technology-based intervention development and Evaluation Research (FASTER) is informed by established innovation design processes, complex intervention development, evaluation, and implementation concepts as well as our collective experiences in technology-based interventions research and clinical rehabilitation practice. FASTER is intended to be meaningful, timely, and practical for researchers, technology developers, clinicians, and others who develop these interventions and seek evidence. We incorporate research methods and designs that better align with creating technology-based interventions and evidence for integration into practice. We propose future activities to improve the generation of research evidence, enable the selection of research methods and designs, and create standards for evidence evaluation to support rigor and applicability for technology-based interventions. With this communication we aim to improve and advance technology-based intervention integration from conception to use, thus responsibly accelerating innovation to have greater positive benefit for people and society., (Copyright © 2021 The American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.)

Developing useful and usable assistive technologies often presents complex (or "wicked") challenges that require input from multiple disciplines and sectors. Transdisciplinary collaboration can enable holistic understanding of challenges that may lead to innovative, impactful and transformative solutions. This paper presents generalised principles that are intended to foster transdisciplinary assistive technology development. The paper introduces the area of assistive technology design before discussing general aspects of transdisciplinary collaboration followed by an overview of relevant concepts, including approaches, methodologies and frameworks for conducting and evaluating transdisciplinary working and assistive technology design. The principles for transdisciplinary development of assistive technologies are presented and applied post hoc to the COACH project, an ambient-assisted living technology for guiding completion of activities of daily living by older adults with dementia as an illustrative example. Future work includes the refinement and validation of these principles through their application to real-world transdisciplinary assistive technology projects. Implications for rehabilitation Transdisciplinarity encourages a focus on real world 'wicked' problems. A transdisciplinary approach involves transcending disciplinary boundaries and collaborating with interprofessional and community partners (including the technology's intended users) on a shared problem. Transdisciplinarity fosters new ways of thinking about and doing research, development, and implementation, expanding the scope, applicability, and commercial viability of assistive technologies.

The changes in cognitive abilities that accompany dementia can make it difficult to use everyday products that are required to complete activities of daily living. Products that are inherently more usable for people with dementia could facilitate independent activity completion, thus reducing the need for caregiver assistance. The objectives of this research were to: (1) gain an understanding of how water tap design impacted tap usability and (2) create an automated computerized tool that could assess tap usability. 27 older adults, who ranged from cognitively intact to advanced dementia, completed 1309 trials on five tap designs. Data were manually analyzed to investigate tap usability as well as used to develop an automated usability analysis tool. Researchers collaborated to modify existing techniques and to create novel ones to accomplish both goals. This paper presents lessons learned through the course of this research, which could be applicable in the development of other usability studies, automated vision-based assessments and the development of assistive technologies for cognitively impaired older adults. Collaborative interdisciplinary teamwork, which included older adult with dementia participants, was key to enabling innovative advances that achieved the projects' research goals. Implications for Rehabilitation Products that are implicitly familiar and usable by older adults could foster independent activity completion, potentially reducing reliance on a caregiver. The computer-based automated tool can significantly reduce the time and effort required to perform product usability analysis, making this type of analysis more feasible. Interdisciplinary collaboration can result in a more holistic understanding of assistive technology research challenges and enable innovative solutions.

Purpose: Assistive technologies (ATs) have tremendous potential to support occupations (i.e. meaningful daily activities) impacted by changes in cognition caused by dementia. However, little is known about what or how ATs are in use in community settings. This research created and piloted guided interviews intended to capture what ATs are in use, factors that affect use and gaps in support from multiple stakeholders., Method: Family caregivers (n = 3) and occupational therapists (n = 10) were chosen as pilot respondents because of their relationship to care provision, understanding of how occupations are impacted by changes in cognition and role in AT procurement. Data were analyzed using descriptive statistics., Results: The interviews' structures enabled data to be grouped into distinct categories and organized easily. The data illustrated the types of analysis that could be done given a larger sample size. It appeared that interviews captured ATs that were in use, as well as areas of non-use and perceived difficulties. Respondents identified several unmet needs and provided suggestions for desired outcomes., Conclusions: While the interview guides must be refined and validated, they are able to capture rich and comprehensive data that could be used by multiple stakeholders, such as clinicians, engineers and caregiver education groups, to target AT development, procurement, education and policy.

Engagement in creative occupations has been shown to promote well-being for older adults with dementia. Providing access to such occupations is often difficult, as successful participation requires face-time with a person who is knowledgeable in facilitating engagement as well as access to any required resources, such as an arts studio. In response, a computer-based device, the Engaging Platform for Art Development (ePAD), was created to with the aim of enabling more independent access to art creation, ePAD is a an artificially intelligent touch-screen device that estimates a client's level of engagement and provides prompts to encourage engagement if the client becomes disengaged. ePAD is customizable such that an art therapist can choose themes and tools that they feel reflect their client's needs and preferences. This article presents a mixed-methods study that evaluated ePAD's usability by six older adult (with mild-to-moderate dementia) and art therapist dyads. Usability measures suggest that all participants found ePAD engaging but did not find prompts effective. Future development of ePAD includes improving the prompts, implementing the recommendations made by participants in this research, and long-term testing in more naturalistic art therapy contexts.

A person's ability to be independent is dependent on his or her overall health, mobility, and ability to complete activities of daily living. Intelligent assistive technologies (IATs) are devices that incorporate context into their decision-making process, which enables them to provide customised and dynamic assistance in an appropriate manner. IATs have tremendous potential to support people with cognitive impairments as they can be used to support many facets of well-being; from augmenting memory and decision making tasks to providing autonomous and early detection of possible changes in health. This paper presents IATs that are currently in development in the research community to support tasks that can be impacted by compromised cognition. While they are not yet ready for the general public, these devices showcase the capabilities of technologies one can expect to see in the consumer marketplace in the near future.