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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]

Exoskeleton can assist individuals with spinal cord injuries (SCI) with simple movements and transform their lives by enhancing strength and mobility. Nonetheless, the current utilization outside of rehabilitation contexts is limited. To promote the widespread adoption of exoskeletons, it is crucial to consider the acceptance of these devices for both rehabilitation and functional purposes. This systematic review aims to identify the barriers or facilitators of the use of lower limbs exoskeletons, thereby providing strategies to improve interventions and increase the adoption of these devices. A comprehensive search was conducted in EMBASE, Web of Science, Scopus, Cochrane, and PubMed. Studies reporting barriers and facilitators of exoskeleton use were included. The studies' quality was assessed using the Mixed Methods Appraisal Tool and undertook a thematic content analysis for papers examining the barriers and facilitators. Fifteen articles met the inclusion criteria. These revealed various factors that impact the utilization of exoskeletons. Factors like age, engagement in an active lifestyle, and motivation were identified as facilitators, while fear of falling and unfulfilled expectations were recognized as barriers. Physical aspects such as fatigue, neuropathic discomfort, and specific health conditions were found to be barriers. This systematic review provides a comprehensive overview of the barriers and facilitators to the use of exoskeleton technology. There are therefore still challenges to be faced, efforts must be made to improve its design, functionality, and accessibility. By addressing these barriers, exoskeletons can significantly improve the quality of life of people with SCI. Optimize the use of this technology to adapt as much as possible to individual needs. Offer an in-depth understanding of the challenges that can arise when adopting exoskeletons. Highlight the critical issues with the device, that prevent me from using it outside of clinical contexts. Offer useful information to therapists to select the most suitable patients for the use of the exoskeleton and to customize rehabilitation programs more effectively. [ABSTRACT FROM AUTHOR]

Functional electrical stimulation (FES) can be effective in assisting physical and psychosocial difficulties experienced by people with spinal cord injury. Perceived benefits and barriers of the current and future use of FES within the wider spinal cord injury community is currently unknown. The main objective of this research was to explore the spinal cord injury community's views of the use of FES to decrease disability in rehabilitation programmes. An online and paper questionnaire was distributed to people with spinal cord injury, health care professionals and researchers working in spinal cord injury settings in the United Kingdom. A total of 299 participants completed the survey (152 people with spinal cord injury, 141 health care professionals and 6 researchers). Common views between groups identified were: (1) FES can be beneficial in improving physical and psychosocial aspects and that (2) adequate support and training for FES application was provided to users. Barriers to FES use included a lack of staff time and training, financial cost and availability of the equipment. Sixty three percent of non-users felt they would use FES in the future if they had the opportunity. Users' views were important in identifying that FES application can be beneficial for people with spinal cord injury but also has some resourceful barriers. In order to increase use, future research should focus on reducing the cost of FES clinical service and also address implementation of awareness and training programmes within spinal units and community rehabilitation settings. Users of functional electrical stimulation think that it is beneficial for improving physical and psychosocial limitations after spinal cord injury Barriers to FES use include a lack of staff time and training, financial cost and availability of the equipment have been suggested by people with spinal cord injury and health care professionals Education and implementation programs for health care professionals and people with spinal cord injury are now necessary to increase the awareness about functional electrical stimulation application Reduction of FES cost could also increase its uptake in spinal cord injury clinical services [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]

Exercise is a safe, evidence-based approach for improving symptoms such as mobility impairment, cognitive dysfunction, and fatigue; however, persons with multiple sclerosis (MS) who use wheelchairs for mobility have been excluded from most research. This paper describes our approach for recruiting ten community advisor board (CAB) members and partnering with them on developing a novel home-based exercise training program for wheelchair users with MS. The exercise training program, which was developed based on initial qualitative research, includes a progressive exercise prescription, equipment, and one-on-one behavioural coaching based on Social Cognitive Theory. The CAB members convened in groups of five people for five meetings online, using virtual conference software. The CAB meetings each lasted approximately 1-hour and notes were transcribed into digital format for data analyses. Content analysis identified elements that aligned with meeting foci (i.e., prescription, equipment, coaching, and outcomes). Feedback was divided into categories to refine the program, specifically modifying, adding, or retaining content and/or activities. CAB member feedback was very positive and emphasised potential additions to the materials presented. The research team proposed implementing modifications based on the CAB member feedback such as adding wrist weights to the equipment options for completing resistance training exercises. The overall CAB feedback was invaluable for assessing the appropriateness of the proposed exercise training program before initiating feasibility testing. This report provides a model and guidance for researchers who seek community-engaged research approaches in creating products and interventions. Community advisory board participation was invaluable in creating and modifying a novel exercise training programmes for wheelchair users with multiple sclerosis (MS). The current study provides a framework for the creation of exercise interventions for subpopulations of persons with MS that may provide substantial rehabilitation benefits such as improved symptoms and quality of life. Health behaviour interventists targeting individuals with disabilities may consider the benefits of recruiting stakeholders from the community in creation of novel programmes. [ABSTRACT FROM AUTHOR]

Digital technologies have a great potential to improve the quality of life of people with dementia. However, this group is usually not involved in their development and dissemination. A consumer-directed role in the delivery of digital technologies could allow this group to regain autonomy and certain independence. This article aims to conceptualise the components of the Consumer Direction theory in the context of digital technologies and people with dementia. A literature review was conducted. We searched for studies within the aforementioned context in five relevant databases, covering the years 2012–2020. Identified studies were screened and assessed for inclusion. The data were categorised using two-stage qualitative content analysis. Forty articles were included. The results provide definitions of the four components of the Consumer Direction theory in the context of this study. Namely, what it means for people with dementia to be (1) in control of technology use, (2) offered a variety of technological options, (3) informed and supported regarding the use and training of digital technologies, and (4) actively participating in systems design. These can lead to the empowerment of people with dementia. The four theoretical components of the Consumer Direction theory are conceptualised differently in the context of this study. By providing new definitions, this paper contributes to research and practice. We expect the definitions to be deployed by researchers, practitioners, and policymakers for the creation of a more consumer-directed delivery of digital technologies to people with dementia. Digital technologies have a great potential to improve the quality of life of people with dementia. A consumer-directed role in the delivery of digital technologies could empower people with dementia and give them the opportunity to take control over the offered services as well as maintain a degree of independence. The Consumer Direction theory and its components should be conceptualised differently in the context of digital technologies and people with dementia than in previous contexts that used the theory. The new definitions can be utilised by researchers, practitioners and policymakers for the creation of a more consumer-directed delivery of digital technologies to people with dementia. [ABSTRACT FROM AUTHOR]

Assistive technology can provide a key tool to enabling independence, greater inclusion and participation in society for individuals with chronic conditions. This potential is currently not always realized due to barriers to accessing and using assistive technology. This review aims to identify the common barriers to acquiring and using assistive technology for users with chronic conditions through a systematic meta-synthesis. This differs from other systematic reviews by applying a transdiagnostic approach to identify if barriers are common across chronic conditions. A systematic literature search of five scientific databases (PubMed, SCOPUS, PsycINFO, CINAHL and Medline) was conducted to identify relevant qualitative studies. The search was conducted in November 2019. For the identified articles, thematic content analysis was conducted and the methodological quality was evaluated using the Critical Appraisal Skills Programme (CASP) checklist for qualitative research. Forty papers met the inclusion criteria and were included in the analysis. Fifty-one descriptive themes grouped into six overarching analytical themes were identified from the studies. The analytical themes identified were: the design and function of the assistive technology, service provision, information and awareness, psychological barriers, support network and societal barriers. The barriers are interconnected and common across different health conditions. More involvement in personalized care for developing strategies, adaptation of home technologies and provision of assistive technology could overcome the service provision and design barriers to assistive technology. Accessible information and providing greater awareness will be important to overcoming information, psychological and societal barriers to assistive technology. Individuals with chronic conditions face complex barriers to acquiring and using assistive technology as a result of the devices themselves, their individual context, the healthcare context where assistive technology is provided and wider societal barriers. The provision of assistive technology needs to change away from the traditional medical model of the "expert" clinician and instead focus on more user involvement to deliver personalised care that utilises the users lived knowledge and experiences. Assistive technology provision should be considered alongside how to adapt everyday mainstream technology to meet user needs; the provision of devices should encourage creative problem solving rather then relying on pre-defined prescription lists of assistive technology. [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]

Purpose:This pilot study investigated the possible transfer effect on reading ability in children with reading difficulties after a systematic intervention to train and compensate for reading deficiencies by using applications in smartphones and tablets. The effects of using assistive technology (AT) one year after the interventions were completely studied. School related motivation, independent learning and family relations were also considered. Method:35 pupils aged 10–12 years participated. They were assessed five times with reading tests. The participants, their parents and teachers were surveyed with questionnaires regarding their experience of using AT. The data from the assessments were analyzed with pairedt-tests and Wilcoxon signed-rank tests. The data from the questionnaires were analyzed using content analysis. Results:The paper shows that using AT can create transfer effects on reading ability one year after the interventions were finished. This means that reading impaired children may develop at the same rate as non-impaired readers. Also, increased school motivation and an increase in independent learning and family effects have been shown. Conclusions:This paper provides implications in how to facilitate reading impaired pupils’ learning process and realizes the need to challenge the concept of reading to change to fit modern means of gaining information.Implications for rehabilitationChildren with reading impairment could benefit from assistive technology in regards of their reading development process and increase their chances of not falling behind peers.Assistive technology as applications in smartphones and tablets may aid children with reading impairment to have an equal platform for learning in school as their peers without reading difficulties.Assistive technology could facilitate the information gaining process and subsequently increase motivation to learn and increase interest in reading activities.Assistive technology had wider effects on its users: stigmatizing situations when leaving the classroom for special education were avoided and positive effects on family life were noted. [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]

The purpose of this study was to identify clinician knowledge regarding manual wheelchair (MWC) training in an inpatient rehabilitation (IPR) setting, identify current MWC education provided to new manual wheelchair users (MWUs), and determine how MWC training resources can be developed or modified to promote use among IPR clinicians. Semi-structured interviews were conducted with 20 licenced IPR clinicians who work with MWUs. Using a traditional qualitative research design, researchers completed open, data-driven coding of interview transcripts. Overarching themes were determined through content analysis. Participants included 12 physical therapists, six occupational therapists, one physical therapy assistant, and one occupational therapy assistant. Five themes emerged from the interviews: (1) clinician knowledge, education, and experience (2) current training content (3) training environment, (4) desired programme components (5) barriers to implementation. Participants reported receiving minimal education in school and from their employers on training MWUs. While clinicians expressed the importance of MWU education, they used varying training approaches with little standardization. Participants identified that training protocols for IPR are beneficial if they are quick, straightforward, and flexible. While MWC training occurs during IPR stays, it appears to be inconsistent across facilities, clinicians, and patients, with varying degrees of adherence to evidence-based practices. This is likely due to limited feasibility and awareness of existing MWC training resources. Clinician input gathered from these interviews provides information for how to best integrate MWC training programmes into the rehabilitative process. Findings may inform the development and assessment of more clinically feasible MWC training protocols. New manual wheelchair users must learn numerous wheelchair-related skills in order to participate in everyday life activities. Manual wheelchair education for new users during inpatient rehabilitation is often inconsistent across facilities, clinicians, and patients, with varying degrees of adherence to existing evidence-based practices. Systematic challenges often act as a barrier to the implementation of more comprehensive, structured manual wheelchair training protocols. Manual wheelchair training resources must be concise, flexible, customisable, and easy to follow in order to promote increased implementation among inpatient rehabilitation clinicians. [ABSTRACT FROM AUTHOR]

Inadequate wheelchair provision in children can lead to delays in growth and development, poorer health, and decreased participation. Wheelchair provision for children can be challenging, especially in low-resource settings, due to limited resources. Therefore, the purpose of the scoping review was to gain an understanding of the current state of paediatric wheelchair provision in low resource settings and identify factors, strategies, and gaps that can lead to more successful wheelchair provision. This scoping review used literature published after 2010, related to paediatric wheelchair provision in low resource settings. We searched online databases and grey literature and extracted data based on categories from the World Health Organisation Guidelines to wheelchair provision in low resource settings. 34 articles were used to identify and analyse common themes and successful strategies related to wheelchair provision for children in low resource settings. Aspects of paediatric wheelchair provision were mentioned in the literature but were rarely the focus. End-user outcomes were the least represented category in the literature. Based on the currently available evidence the overall state of a wheelchair for children is inadequate. Improvements in design and production, personnel capacity, and service delivery systems are recommended to promote best practices. The lack of child-focussed wheelchair provision and end-user involvement in the research process urgently needs to be addressed. Identify best practice Identify gaps in knowledge Determine areas of need for future research [ABSTRACT FROM AUTHOR]

This study aimed to investigate: (1) the characteristics of people using, or had previously used, assistance animals within community living in Australia; (2) positive and/or negative experiences of these users; and (3) educational resources that may aid public awareness. An online survey was distributed through Australian assistance animal organisations and social media channels. Past/current assistance animal users (n = 112) responded to questions on demographic and types of animal supports used, experience of assistance animal use, community attitudes experienced, and perspectives about the need for public education. Data were analysed with descriptive and inferential statistics. Content analysis provided additional insights of the positive and/or negative experiences assistance animal users had faced. Nearly all participants used an assistance dog (n = 111), and 37 (33%) used the animal for more than one type of support. Seventy percent reported experiencing both positive and negative community attitudes/reactions. Length of time of having an assistance animal was associated with significantly higher prevalence of positive attitudes/reactions, whilst users who received medical support from the animal tended to experience more negative community attitudes/reactions than other users. The majority (90%) agreed that more public education is needed regarding assistance animal public access rights. This study is the first in Australia to undertake a large-scale survey of assistance animal users with a range of disability types. It highlights the benefits and challenges of assistance animals, which could be useful to consider when determining the most appropriate support for an individual. There are a range of possible benefits, but also challenges, in the use of assistance animals that should be considered when a person with disability or health conditions, or people advising them, are determining if an animal is the most appropriate support. Assistance animals can provide multiple types of support to one user, so could offer a potential cost-benefit beyond traditional assistive devices or other types of support. To ensure better inclusion of assistance animal users, public education is needed to promote community awareness of the types of animals that meet the definition of an 'assistance animal', and thus have public access rights. In Australia, a nationally consistent government approach to the regulation, accreditation and funding of assistance animals should be established with the aim to address the current fragmented or unfair investment approach and/or discrimination experienced by some individuals. [ABSTRACT FROM AUTHOR]

Assistive technology is the products and services used by individuals with functional limitations to enable participation in society and realisation of rights afforded by the United Nations Convention on the Rights of Persons with Disabilities. The Assistive Product List is a comprehensive list of products identified as essential for access through universal health coverage. Key stakeholders, including organisations of persons with disabilities, civil service organisations, academic organisations and government ministries are collaborating to integrate assistive technology into policy and develop a priority assistive products list for Malawi. To understand the organisational characteristics of, and assistive products provided by, key stakeholders working in AT in Malawi. Online survey of representatives from key stakeholder organisations. We surveyed representatives of key stakeholder organisations to gather information regarding assistive technology product and service provision in Malawi. Responses were analysed using counts for closed-ended questions, and conventional content analysis for open-ended questions. A total of 36 of the 50 APL products were provided by eight organisations. Related services were provided for 36 of the 50 APL products by twelve organisations. Five organisations reported providing both products and services. Products and services are largely funded by donation and provided free to those who require them. A range of organisations in Malawi play a role in assistive product delivery and related services. Coordinated AP delivery and service provision is required at a national level which is sustainable and inclusive, and is based on identified needs of the Malawian population. Policies supporting assistive product and service provision must acknowledge the contextual needs of the communities where they are implemented. Coordination is required for assistive product and service provision at the national and subnational level. Existing and potential gaps in service provision must be addressed when implementing a national assistive products list. [ABSTRACT FROM AUTHOR]

The literature review presents a conceptual participatory design through accessibility technology solutions, considering the design experience to be an essential factor in communication processes. Technologies must assess a wide range of disabilities based on characterisations that helps daily activities. This work includes collaboration concepts to assist in the development of accessible technology. Collaborative design requires the fostering of communication between actors involved in the design process. This work implemented with a protocol of guidelines developed by a group of experts in disability research. The relevant literature is included and assessed based on three categories: accessibility, assistive technologies, and participatory design. A knowledge gap can be identified: the development of assistive technology processes should enhance the voice of participants and consider their ideas, desires and needs. Multidisciplinary communication is necessary to identify problems and propose solutions, and it is essential that people with disabilities collaborate with experts from a range of disciplines to identify problem-solving patterns. A participatory design can develop a holistic understanding of the participant's motivation and rehabilitation needs. This has provided a grounded basis to offer information about the assistive technology design. A participatory work provides information about the technology design which may finally result in a better understanding of rehabilitation, other types of home-based healthcare or the gamification for rehabilitation. The rehabilitation professionals can explore requirements of a customised technology for users, which allows to transfer knowledge about disabilities and skills in rehabilitation to people with disabilities, their families and communities. The notion of a research problem in rehabilitation can be re-evaluated through a participatory design process that attempts to capture the subjective experiences of persons with disability. [ABSTRACT FROM AUTHOR]

Visual impairment (VI) problems are increasing as the global aging population grows. Mobile devices have become essential to interacting with friends and society. Because the visually impaired are no exception, it would be useful to determine the functionalities that best support the independence of people with VI. The currently available functionalities and applications were analysed to provide insight about which features the visually impaired value most. A Webropol survey with structured and open-ended questions was carried out. The participants (n = 26) were asked about their use of mobile applications and opinions regarding the usefulness of certain applications in promoting independent functioning. An instrument was developed for this study based on previous literature, and its quality was assured through an expert panel evaluation and pre-testing. The collected data were analysed statistically and by inductive content analysis. A majority of the participants were active users of mobile devices. Substantial variation was observed in the evaluations of how useful various applications are to different everyday tasks. The participants suggested numerous improvements, such as additional customization, to the current mobile devices and applications. People with VI benefit from the use of mobile devices in the same way that the population with normal vision does, and mobile devices and applications can be pivotal to supporting their independence. The participants offered innovative ideas and suggestions for how mobile devices and applications could be designed to better meet the needs of the visually impaired. [ABSTRACT FROM AUTHOR]

Functional electrical stimulation (FES), through repetitive training (FES-therapy) or continuous assistance (neuro-prosthesis), can restore motor function after paralysis due to spinal cord injury or stroke. With current technology, patients are often incapable of independently applying FES, thereby limiting its use. Novel FES-garments with embedded stimulation electrodes were developed in collaboration with Myant, Canada, to address this problem. The purpose of this study was to collect the views of future end-users to inform the refinement of the device design and to obtain insights on subsequent commercialization of this rehabilitation and assistive technology. A qualitative study was undertaken to determine the needs of potential users (patients and clinicians; n = 19). Participant took part in interviews or focus groups after a presentation of the garments. An inductive content analysis was used to generate the themes from the data and identify data saturation. The identified themes and sub-themes were: (1) User Perspectives: users' characteristics (needs, limitations), expected benefits (beliefs), and anticipated problems (fears); (2) Device Design: technical features, usability, and disadvantages of the garment, cables, stimulator, software, and interface; (3) Acquisition Process: organizational procedures (acquisition and adoption steps); and (4) Business Model: financial and strategic aspects to facilitate commercialization and support users. The insights obtained from end-users and clinicians provide guidelines to optimize the development of novel FES-garments, and strategies for bringing the device to the market. The themes identified can serve to inform other rehabilitation and assistive technology developers with processes and ideas on how to meet these groups' needs. Participants with neurological paralysis have interest and critical views on new rehabilitation and assistive technology, and the repercussions of using new technologies to address their function, health and wellbeing. The FES-garment design presented appeared acceptable to the end-users, pending resolution of certain shortcomings (wiring, operating duration, robustness, easiness to don and doff). End-users and clinicians had specific views regarding the acquisition process of new technologies (training, customization, and follow-up/support), which are important to take into consideration to ensure broad stakeholders uptake. [ABSTRACT FROM AUTHOR]

Wheelchair outcomes measures are useful to support evidence-based practice in wheelchair provision, especially in low- and middle-income countries (LMIC). The Wheelchair Interface Questionnaire (WIQ) was developed to provide a professional perspective on the quality of the interface between a wheelchair and its user. Studies conducted during the development of the WIQ indicated it has face validity and content validity. The objective of this field study was to conduct a subsequent investigation of the inter-rater reliability of the WIQ at a school for children with disabilities in Kenya. Eight practitioners with wheelchair experience from disparate cultural backgrounds participated in the study. They evaluated eight wheelchairs and the interface with their users. The interclass correlation coefficient (ICC) of the mean rating for the eight-item dataset was computed using SPSS. The ICC was found to be 0.911, indicating that the WIQ possesses inter-rater reliability. Common comment topics indicated that the qualitative data yielded by the WIQ is meaningful. Informal timing indicated that the WIQ is a brief measure. The WIQ is a reliable tool that can meet the need for a professional assessment of the wheelchair-user interface. The reliability of this questionnaire is important because the tool can be used to evaluate the interface between a wheelchair user and their wheelchair, strengthening evidence-based practice in wheelchair provision. Based on the score of a specific wheelchair interface, a rehabilitation professional could recommend more assessment, seating modification, or wheelchair replacement in order to maximize rehabilitation benefit for a client The WIQ could provide evidence-based information to support the need for wheelchair repair or replacement to funders. In large-scale studies involving many of the same wheelchair type in the same setting, the WIQ could be used to identify problems with the interface between that wheelchair type and its intended user population so that manufacturers can make responsive design changes. The WIQ could be used in a clinical setting over time to identify the most common wheelchair interface issues for that setting. [ABSTRACT FROM AUTHOR]

More than 70% of elderly people age 80 and older are experiencing problems in personal mobility. Assistive robotics can represent a concrete support providing also a support for caregivers, clinicians and nurses by reducing their burden. A total of 20 older people and 34 caregivers (formal and informal) were interviewed in Italy and the Netherlands to investigate and prioritize their needs concerning the personal mobility domains and their attitudes towards assistive robots. The data were analysed from a user point of view by means of thematic content analysis by underlying recurrent topics. The results revealed four categories of needs from the perspective of the older individuals: instrumental needs, rehabilitation needs, personal safety and indoor activities of daily life. Additionally, the results underline how personal mobility issues influence different aspects of daily life. Complementarily, three categories of caregiver needs were also distinguished: instrumental needs, rehabilitation monitoring needs and checkup needs. The highest percentage of participants showed a positive expectation towards assistive robotics. The results were clustered according to the robot abilities (i.e., motion, interaction, manipulation, decision support and perception abilities) as a list of functional and technical requirements that should be developed to address all the needs related to the personal mobility. Robotic developer teams that work in this context could take advantage of this research. Additionally, this work can be used as a basis for clinicians and nurses working in geriatric units to understand how the robots can support and enhance their work. The incidence of personal mobility limitations affects 35% of adults age 70 and older and 72% of people over 80 years of age. Assistive robots can support elderly people during daily tasks: they could promote their personal mobility acting as a supporting tool. The results of the needs analysis revealed four categories of needs from the perspective of the older individuals: instrumental needs, rehabilitation needs, personal safety, and indoor activities of daily life. Three categories of caregiver needs were also distinguished: instrumental needs, rehabilitation monitoring needs, and check-up needs. [ABSTRACT FROM AUTHOR]

Purpose: The importance of assistive technology (AT) as a pillar of universal health coverage was recognized at the 71st World Health Assembly (WHA) through the passing of Resolution 71.8 on improving access to AT (May 2018). A systematic analysis was conducted on the responses made to the Resolution by Member States and non-state actors, in order to provide a snapshot of global intent. Methods: Qualitative content analysis was conducted on over 40 written "Statements" made by Member States and non-state actors in response to Resolution 71.8. Results: The Resolution provides tangible guidance to the World Health Organisation (WHO) and its member states in order for them to meet commitments within the Convention on the Rights of Persons with Disabilities (CRPD). Statements made in response to the Resolution offer a unique plethora of multi-stakeholder views from differing global perspectives. Analysis identified a range of themes within two overarching themes: intersection of health, human rights and sustainable development; and international collaboration and support within an international agenda framework. Conclusion: The content analysis synthesises complex global data and identifies directions to positively influence national and regional AT policy and delivery. The complexity of factors demonstrates the importance of an AT systems-thinking approach; that is, the development and application of organised knowledge, skills, procedures and policies related to assistive products. AT systems thinking will be essential for AT to be effectively deployed as a pillar of universal health coverage. Assistive technology is a key facilitator of health and well-being, playing a critical role in global efforts to improve population health outcomes and strengthening health systems Access to assistive technology is a public health priority and is an essential health product to be covered under Universal Health Coverage Effective action on access to assistive technology must encompass the reality of diverse contexts yet common purposes expressed by global actors This analysis demonstrates the intersection of the health, human rights and sustainable development agendas, and the importance of international collaboration and support in achieving effective access [ABSTRACT FROM AUTHOR]

Purpose: To qualitatively describe and compare the expectations and experiences of living with a mobility or medical service dog among those with a physical disability or chronic condition. Materials and methods: A total of 64 participants living with a service dog and 27 on the waitlist to receive a service dog participated in a cross-sectional open-ended survey. Qualitative content analysis was used to identify themes and sub-themes. Results: A total of 101 codes were summarized into themes of Physical Benefits, Psychosocial Benefits, and Drawbacks to having a service dog. Psychosocial benefits included the human–animal relationship as well as emotional, quality of life, and social benefits. Drawbacks included service dog care, public access and education, lifestyle adjustments, and dog behaviour. While participants on the waitlist were more likely to anticipate physical benefits of having a service dog, those with a service dog largely described psychosocial benefits. Findings also suggest that some drawbacks, such as public discrimination, may be unanticipated by the waitlist. Conclusions: A comparison of expectations and experiences of service dog ownership highlights both the positive and negative aspects of the service dog–owner relationship and identifies potential aspects of having a service dog that may be unanticipated or overestimated by those on the waitlist. When asked about helpful and important aspects of having a service dog, 98% of service dog owners described the psychosocial benefits of their dog's assistance and companionship. The human–animal relationship was the most discussed psychosocial benefit from both current owners as well as those on the waitlist, demonstrating the unique strength of the service dog–owner bond in this population. Those on the waitlist to receive a service dog did not anticipate as many drawbacks as current owners described. In particular, difficulties with public access and education as well as dog behaviour were commonly experienced, but not expected, drawbacks to service dog ownership. Findings identify aspects of having a service dog that may be unanticipated or overestimated by those on the waitlist, providing rehabilitation professionals with a basis for preparing those who may be considering incorporating a service dog into their lives. [ABSTRACT FROM AUTHOR]

Purpose: To provide empirical evidence on learning barriers and facilitators in instructional science and engineering laboratory settings from a national survey on students with physical disabilities (SwD-P). Methods: A nationwide self-report survey, the Full Participation Science and Engineering Accessibility (FPSEA), was disseminated online via Qualtrics. Approximately 1200 organizations and universities across the United States were contacted through purposive sampling. Descriptive statistics were primarily used for the analysis of the results. Results: Survey findings reveal that students experience a wide range of limitations to full participation in the laboratory, from entering the laboratory (25%) to being given passive roles (50%). Additionally, while 66% of respondents indicated that instructors were willing to help SwD-P participate in science and engineering (S&E) laboratories, 16.8% were not willing to do so, and 47% SwD-P felt that practices were not in place to provide accommodations. The survey also reveals a range of facilitators such as elevators, ramps, accessible course materials and peer assistance. Most respondents (74%) also indicated that peers were helpful in completing laboratory tasks. Conclusion: This survey provides empirical evidence that was previously voiced through non-empirical information in the literature. Participants cited barriers such as inappropriate accommodations and instructors' negative viewpoints, as well as gaining access to facilities even after the enactment of the Americans with Disabilities Act (ADA). These findings suggest that while ADA has lessened some barriers to SwD-P, barriers remain in using the laboratory space. The FPSEA survey fills the gap in finding barriers and facilitators to using S&E laboratories from the SwD-P's perspective. Barriers students with disabilities encounter in science and engineering (S&E) laboratory environments remain unclear. The FPSEA survey fills the gap in finding barriers and facilitators to using S&E laboratories from the SwD-P's perspective. The FPSEA survey allows former and current SwD-P to share their experiences using a postsecondary S&E instructional laboratory. [ABSTRACT FROM AUTHOR]

Purpose: Reading and writing applications (with text-to-speech, TTS and speech-to-text, STT functions), used as assistive technology (AT) for students with reading difficulties are increasingly used in education, however, research has not sufficiently enough evaluated its potential. The purpose of this study was to explore how assistive reading and writing applications were perceived to function with regard to students' possibilities to assimilate (i.e., "read") and communicate (i.e., "write") text. Methods: Following a six-week app intervention, this follow-up survey contained 54 special education teachers' perceptions of how the use of apps impacted student motivation, learning, and its usability in special education. A total of 59 students with reading difficulties from Grade 4, Grade 8 and from high school, were assessed. Analyses included quantitative and qualitative analyses of teachers' responses and written material. Results: The results showed individual differences in how teachers perceived app usage for text-interaction purposes, including how app usage affected student motivation and autonomy for text-based learning. Eighty-two per cent of the younger and forty-seven per cent of older students continued to use the technology after the intervention, but in various degrees. Conclusions: Based on these findings, students with reading difficulties seem to be able to use AT in order to assimilate text (i.e., to read) and to communicate text (i.e., to write), and, thus, AT has the potential to promote participation in regular education. Future research should focus on how to customize assistive technology support in order to better utilize the potential. This study found that students with reading difficulties could use reading and writing apps (with text-to-speech, TTS and speech-to-text, STT) in portable tables to be able to gain access to, and to produce text in an applied school setting. To use TTS and STT as assistive technology efficiently may require relative extensive support and training, but even with this support, not all students in this study benefited from the potential use of the technology, as the processes of being able to gain access to and to produce text with assistive technology seem to be a difficult process for some of the students. It is proposed that in order to enable all students with reading difficulties possibilities to use assistive technology efficiently, its uses need to be customized even further than was done in this extensive intervention. [ABSTRACT FROM AUTHOR]

Purpose: Individuals with traumatic brain injury (TBI) often experience difficulties in performing kitchen-related sequencing tasks due to cognitive deficits. The primary aim of this study is to examine the feasibility of a context-aware automatic prompting system in assisting individuals with TBI in multi-step cooking tasks. Method: Sixteen individuals with TBI participated in the study. A randomized cross-over design was used to compare the automatic prompting method with a conventional user-controlled method through a tablet device. Participant performance under each prompting method was assessed using the Performance Assessment of Self-Care Skills in terms of independence, safety, and adequacy. Subjective workload and qualitative feedback were also collected. Results: The automatic method, when compared with the user-controlled method, significantly decreased the amount of external assistance required by participants, received higher ratings in user perceived ease-of-use, and was considered less stressful for participants. However, the user-controlled method showed strengths in offering participants more flexibility in terms of controlling on the timing of prompts. Conclusions: The results provided insight into the potential benefits and user perceptions of a context-aware prompting system. The information could contribute to the future development of advanced prompting technology for people with cognitive impairments in completing sequential tasks. For people with traumatic brain injury, the context-aware prompting method showed advantages in improving user performance, receiving better ratings on ease-of-use, and decreasing stress levels, compared to the user-controlled prompting method in completing multi-step cooking tasks. Future prompting systems for people with cognitive impairments may allow users to control the pace of prompting and use sensing information as back-up assistance in critical situations. In this way, the system may help users monitor their actions and offer confirmations, especially at steps with safety concerns, thus enhancing the sense of security and reducing the stress from self-monitoring. [ABSTRACT FROM AUTHOR]

Purpose: This study examined speech and language pathologists' (SLPs') perceptions and practices of communication partner training with high-tech speech generating devices (SGDs). Method: Fifteen SLPs were recruited throughout Sweden. The SLPs answered a study-specific questionnaire on communication partner training in relation to communication partners to children with severe cerebral palsy and intellectual disability. The results were analysed with descriptive statistics (closed-ended questions, responses on Likert scales) and content analysis (open-ended question) using ICF-CY. Results: Twelve SLPs completed the survey. Half had no or one training session with communication partners in the last year. One-third never used documents for goal-setting. Half seldom or never taught communication partner strategies. Three quarters only used verbal instructions. The main obstacles were environmental factors. Conclusions: This study contributes valuable knowledge about high-tech SGD interventions targeting communication partners. The high-tech SGD intervention may benefit from goal-setting, extended number of training sessions and a range of instructional approaches. Speech and language pathologist (SLPs) reported that children with severe cerebral palsy and intellectual disability (SSPI) can benefit from speech generating device (SGD) communication. Communication partner strategies and goal-setting supports the development of communication with SGD. SLPs seldom taught stakeholder communication partner strategies and instruments for goal-setting. Because stakeholders may vary in their way of learning SLPs need to use a variety of instructional approaches. SLPs used few instructional approaches, typically verbal information. [ABSTRACT FROM AUTHOR]

Purpose: Improving access to education and training for those providing wheelchair and seating assistive technology to meet personal posture and mobility requirements, as a basic human right, is a priority. This review considers education and training available to personnel within low and lower middle income countries (LLMIC), to ascertain where gaps in knowledge exist and identify human resource education priorities. Method: A scoping review, mapping out existing scientific and grey literature within the field between 1993 and 2017 was conducted. The search strategy included use of online databases, manual analogue searches and key stakeholder informant advice. A content analysis process was applied to organize the literature retrieved and extract key themes. Results: Education and training in LLMIC appears ad hoc and limited, however, there is growing recognition as to its importance, notably by the World Health Organization and nongovernmental organizations, delivering education initiatives to a number of countries, along with the development of a credentialing test. Inconsistency exists regarding personnel responsible for wheelchair provision, with no specific professional clearly recognized to oversee the system within many LLMIC. Conclusions: Education and training is required for all stakeholders involved in wheelchair provision. Advocating for programme development to enhance personnel skills, build capacity and ensure best practice is a priority. Pilot sites, delivering and credentialing appropriate wheelchair provision education and training within context should be considered. Measuring outcomes and transferable skills should be part of education programme delivery structures. Considering a new discipline responsible for oversight of wheelchair provision should be investigated. Implications for rehabilitation: Education and training is an essential step in the wheelchair provision process in the bid to obtain an appropriate wheelchair via appropriate provision services. However, it is more than education and training; its a human rights issue. Mandatory education and training needs to be a requirement for all stakeholders involved in wheelchair provision. Key wheelchair personnel need to establish their central role in this arena. The study raises awareness as to the importance of working with governments to commit to building sustainable wheelchair provision infrastructures. [ABSTRACT FROM AUTHOR]

Purpose: This article illustrates user-centred design of a novel sensor access system for environmental control in the concept stage of development.Methods: Focus groups of individuals with disabilities and rehabilitation healthcare professionals were provided with video illustration of the technology and asked to provide quantitative and qualitative feedback through a semistructured interview process. Qualitative methods were employed to analyse transcribed comments to develop themes supporting ongoing development of the technology.Results: Both end-user streams rated the original design features of the sensor access system (alternative interface to assistive technologies, having wireless capabilities and not requiring batteries) as having high potential value. Both groups identified a need for the future design of the sensor technology to be able to capture minimal/reduced movements for those with severe physical impairments. Themes included (1) the sensor technology could be individualized/customized to accommodate the user, (2) minimal positioning and set-up requirement and (3) technology that alleviated problems encountered with touch-based solutions.Conclusions: Inclusion of end-user feedback provided the research team with valuable information that supported the initial conceptualization of the design features of the technology and provided valuable data to support development of a new prototype that can capture more reduced/minimal movements. Implication for Rehabilitation User-centered design of assistive technology is essential to the development of technology that can meet the unique needs of those with the most severe physical impairments.New sensor technology may alleviate some of the access challenges faced by individuals with severe physical impairments.Collaboration between all key stakeholders (individuals with disabilities, rehabilitation professionals, researchers, and developers) is an essential component in the iterative assistive technology design process. [ABSTRACT FROM AUTHOR]

The goal of this study was (1) to determine whether and how nursing home residents with dementia respond to the interactive art installation in general and (2) to identify whether responses change when the content type and, therefore, the nature of the interaction with the artwork changes. The interactive art installation ‘VENSTER’ evokes responses in nursing home residents with dementia, illustrating the potential of interactive artworks in the nursing home environment. Frequently observed responses were naming, recognizing or asking questions about depicted content and how the installation worked, physically gesturing towards or tapping on the screen and tapping or singing along to the music. It seemed content matters a lot. When VENSTER is to be used in routine care, the choice of a type of content is critical to the intended experience/usage in practice. In this study, recognition seemed to trigger memory and (in most cases) a verbal reaction, while indistinctness led to asking for more information. When (initially) coached by a care provider, residents actively engaged physically with the screen. Responses differed between content types, which makes it important to further explore different types of content and content as an interface to provide meaningful experiences for nursing home residents.Implications for rehabilitationVENSTER can facilitate different types of responses ranging from verbal reactions to active physical engagement. The choice of a type of content is critical to the intended experience/usage in practice.Activating content seems suitable for use as a meaningful experience during the spare time in between existing activities or therapy.Sessions with interactive content are short (avg. 30 mins) and intense and can therefore potentially be used as an activating therapy, activity or exercise.In order to actively engage residents with dementia, the role of the care provider seems very important. [ABSTRACT FROM PUBLISHER]

Summative content analysis was used to define methods and heuristics from each case study. The review process was in two parts: (1) A literature review to identify conventional research methods and (2) a summative content analysis of published case studies, based on the identified methods and heuristics to suggest an order and priority of where and when were used. Over 200 research and design methods and design heuristics were identified. From the review of the 20 case studies 42 were identified as being applied. The majority of methods and heuristics were applied in phase two, market choice. There appeared a disparity between the limited numbers of methods frequently used, under 10 within the 20 case studies, when hundreds were available.Implications for RehabilitationThe communication highlights a number of issues that have implication for those involved in assistive technology new product development:•The study defined over 200 well-established research and design methods and design heuristics that are available for use by those who specify and design assistive technology products, which provide a comprehensive reference list for practitioners in the field;•The review within the study suggests only a limited number of research and design methods are regularly used by industrial design focused assistive technology new product developers; and,•Debate is required within the practitioners working in this field to reflect on how a wider range of potentially more effective methods and heuristics may be incorporated into daily working practice. [ABSTRACT FROM PUBLISHER]

Background: Adults with cognitive disabilities often have difficulties in dealing with the complexity of everyday life. With cognitive assistive technology (e.g. electronic planning devices [EPDs] and individual support), they can bring order to their often chaotic life. Assumptions are that environmental factors influence with non-use of EPDs.Objective: To explore how adults with cognitive disabilities perceive the influence of environmental factors in the use of EPDs.Methods: A reference group with experience of use of EPDs assisted the researchers. Twelve adults with cognitive disabilities and experience of using EPDs participated. An interview guide was implemented covering environmental factors according to the International Classification of Functioning, Disability and Health. Qualitative content analysis was applied in the analyses.Results: Five categories and two themes emerged, which were integrated into a model of facilitating factors influencing the use of EPDs. Measures to prevent or eliminate negative influences of the device use are important to be taken.Conclusions: Professionals need more knowledge about EPDs, while users need individual adaption of the EPDs. EPDs need to be user-friendly, manageable and work in any seasons.Implications for RehabilitationThe users should have access to specially trained prescribers.There is a need for development of user-friendly and manageable products to function in any climate.Knowledge is lacking on how to implement the users in all stages of the prescribing process.Prescribers should increase knowledge in the use of EPDs to influence the attitudes of the social environment. [ABSTRACT FROM PUBLISHER]