Search

Information on available assistive technology products and services plays a key role in improving effective access to assistive solutions to those who need it. To address their information need, public databases have been established in several countries over the years.The Global Assistive Technology Information Network (EASTIN) was initiated in 2005 to aggregate the contents of the major databases; now it involves 28 countries and provides a unique picture of the range of AT products available on the market worldwide. The paper describes the EASTIN approach, the technology used, the results achieved and its contribution to fulfill the people right to assistive technology information.

Robots have the potential to support care and independence of older adults. The ENRICHME project is developing an integrated system composed of a robot, sensors and a networking care platform, aiming at assisting older adults with MCI in their home environment. This paper reports findings of the tests performed on a sample of MCI users and their caregivers, with the first version of the ENRICHME system, in a controlled environment.

The study reported in this paper developed criteria and guidelines for writing up a good-quality AT Assessment Report - a document which is often required to activate an assistive technology intervention for an individual client. The Report should provide precise recommendations about the assistive solutions that best meet the client's needs, explain the underlying reasoning, provide evidence of appropriateness for the funding agency and set the baseline for later measurement of the outcomes of the intervention. Within this study, forty-eight clients with severe disability conditions were recruited in nine rehabilitation Centers in various regions of Italy. They were assessed for assistive solutions by their rehabilitation teams according to a common protocol; assessment Reports were produced for each client according to the same template, and individual AT interventions were activated following the recommendations. Then the Reports underwent a blind peer-review exercise involving over fifty professionals, who evaluated their quality against ten criteria; based on the findings, the template of the AT Assessment Report was revised and good-practice guidelines were inferred for the contents of each field. Now the final version is freely downloadable and is being used routinely in the Centers that participated in the study.

BACKGROUND: The importance of providing accessible and accurate information on Assistive Technology products to all the stakeholders needing it is widely acknowledged. A standardization in the description of assistive products can facilitate the selection of the products that best match the individual needs. Furthermore the definition of a standard for describing product technical details is needed for building up the knowledge base for Decision Support Systems. OBJECTIVE: The aim of our work was the development of a Taxonomy that can be used to standardize the description of ICT-Based assistive products. METHODS: The taxonomy described in this paper has been developed by the ETNA project – a EU-funded Thematic Network that has been carried out within the framework of the European Assistive Technology Information Network (EASTIN). The taxonomy has been built trough a consensus procedure within the ETNA consortium. RESULTS: The taxonomy is based on a two-level hierarchy of Clusters and Features, and has been connected to the thirdlevel categories of the ISO 9999 standard “Assistive Products for Persons with Disability – Classification and terminology”. A procedure has also been defined to manage the continuous update of the taxonomy. CONCLUSIONS: The taxonomy has been implemented on the EASTIN information system, the web portal of the European Assistive Technology Information Network.

Background: Service robots may offer an innovative assistive solution to improve the quality of life of frail elderly people, by assisting them in specific situations identified as relevant to maintain independence. Objective: This paper describes the results of a qualitative and quantitative research based on a user-centered methodology carried out within the EU-funded project "Multi-Role Shadow Robotic System for Independent Living" (SRS), aiming to generate user requirements and realistic usage scenarios maximizing the alignment with users' needs, perceptions, feelings and rights. Methods: A qualitative and quantitative research - based on focus groups (59 participants) and questionnaires (129 respondents) - was carried out in three countries: Italy, Spain and Germany. The survey involved prospective end-users (elderly people and family members who care for them), caregivers, and geriatric experts. Results: Results show that despite elderly people encounter difficulties in many activities of daily life, a semi-autonomous remotely-controlled and self-learning service robot has been judged an interesting solution only in some circumstances. Moni- toring and managing emergency situations, helping with reaching, fetching and carrying objects that are too heavy or positioned in unreachable places: these are tasks for which robotic support has been widely accepted, while tasks involving direct physical contact between the person and the robot are not appreciated instead. Relatives of the elderly could act as remote operators; however, family psychological burden and time restrictions should be considered too. Conclusions: A tele-operated robotic system may be of help for frailelderly people. In certain cases this solution may be effective only in conjunction with a 24-hour professional Service Centre able to manage tele-operation when relatives are not available. This survey adds further tokens of knowledge to previous literature studies on this subject; it compares the potential users' and the professionals' views; it helps identifying potentially successful applications of tele-operated robots in the care of elderly people living at home. The results obtained by the present study, generated specific requirements and the first versions of concrete usage scenarios, enabling designers and technologists to start with a first development phase of the SRS concept.

The World Health Organization Disability Assessment Schedule II (WHO-DAS II) is a non-disease-specific International Classification of Functioning, Disability, and Health-based disability assessment instrument developed to measure activity limitations and restrictions to participation. The aim of this pilot study is to evaluate WHO-DAS II responsiveness in detecting short-time changes following the provision of an Assistive Technology,which is important to define its utility in performing daily activities. Adult inpatients with a diagnosis of Disease of the Nervous System (included in Chapter VI of the ICD-10),who were prescribed an Assistive Technology to be used in the household settings, were enrolled. The WHO-DAS II was administered in individual interview at baseline and at a 2 months follow-up: in this period patients were transitioning from the hospital to home. Changes in disability profiles were detected by calculating the effect size (ES) for each WHO-DAS II domain. Ten patients with different neurological diseases were enrolled. Few longitudinal changes in disability level are reported: mild improvement is observed in the household activities (ES0.28), whereas mild worsening is reported in self-care and participation in society domains (ES – 0.27 and – 0.26,respectively). Our study shows that the WHO-DAS II is responsive in detecting domain-specific changes over a short-term period and provides preliminary encouraging evidence for the utility of its utilization in clinical settings.However, changes in setting between baseline and follow up could have an impact on the findings and interpretation of this study.

If working tasks are carried out in inadequate conditions, workers with functional limitations may, over time, risk developing further disabilities. While several validated risk assessment methods exist for able-bodied workers, few studies have been carried out for workers with disabilities. This article, which reports the findings of a Study funded by the Italian Ministry of Labour, proposes a general methodology for the technical and organisational re-design of a worksite, based on risk assessment and irrespective of any worker disability. To this end, a sample of 16 disabled workers, composed of people with either mild or severe motor disabilities, was recruited. Their jobs include business administration (5), computer programmer (1), housewife (1), mechanical worker (2), textile worker (1), bus driver (1), nurse (2), electrical worker (1), teacher (1), warehouseman (1). By using a mix of risk assessment methods and the International Classification of Functioning (ICF) taxonomy, their worksites were re-designed in view of a reasonable accommodation, and prospective evaluation was carried out to check whether the new design would eliminate the risks. In one case - a man with congenital malformations who works as a help-desk operator for technical assistance in the Information and Communication Technology (ICT) department of a big organisation - the accommodation was actually carried out within the time span of the study, thus making it possible to confirm the hypotheses raised in the prospective assessment.

Powered wheelchairs are complex and expensive assistive devices that must be selected and configured on the basis of individual user needs, lifestyle, motivation, driving ability, and environment. Providing agencies often require evidence that their financial investment will lead to a successful outcome. The authors surveyed a sample of 79 users who had obtained powered wheelchairs from a Regional Health Service in Italy in the period 2008-2013. Follow-up interviews were conducted at the users' homes in order to collect information about wheelchair use, and its effectiveness, usefulness, and economic impact. The instruments used in the interviews included an introductory questionnaire, QUEST (Quebec User Evaluation of Satisfaction with Assistive Technology), PIADS (Psychosocial Impact of Assistive Devices Scale), FABS/M (Facilitators and Barriers Survey/Mobility), and SCAI (Siva Cost Analysis Instrument). The results indicated positive outcomes, especially in relation to user satisfaction and psychosocial impact. A number of barriers were identified in various settings that sometimes restrict user mobility, and suggest corrective actions. The provision of a powered wheelchair generated considerable savings in social costs for most users: an average of about $38,000 per person over a projected 5-year period was estimated by comparing the cost of the intervention with that of non-intervention.

This study surveyed a sample of 79 wheelchair users who had obtained powered wheelchairs from the National Health Service in an Italian Region in the period 2008-2013. The wheelchair prescriptions had been done on the basis of an assessment protocol agreed with the Local Health Authority. Follow-up interviews were carried out at the users' homes, in order to collect information about the wheelchair use and its effectiveness, usefulness and economic impact. The instruments used in the interviews included an introductory questionnaire (describing the wheelchair use), the QUEST (measuring the user's satisfaction), the PIADS (measuring the psychosocial impact, in terms of perceived changes in ability, adaptability and self-esteem), the FABS/M (detecting environmental facilitators and barriers) and the SCAI (estimating the economic impact). Overall, positive outcomes were detected for most users, especially in relation to their satisfaction and the psychosocial impact. A number of barriers were identified in various settings (at home, in public places, in natural spaces, in public transportation) that sometimes restrict the user mobility and thus may claim for corrective actions. Several environmental factors acting as facilitators were also identified. In relation to the economic impact, the provision of a powered wheelchair generated remarkable savings in social costs for most of the users, on average about 36.000 Euros per person on a projected 5-years span. This estimate results from the comparison between the social cost of the intervention (sum of the costs of all material and human resources involved in the provision and usage of the wheelchair) and the cost of non-intervention (the presumed social cost incurred in case no powered wheelchair had been provided and the user had to carry on with just a manual wheelchair). The study was also an opportunity to develop and try out a follow-up method that proved applicable within service delivery practice.

The European Assistive Technology Information Network (EASTIN), launched in 2005 as the result of a collaborative EU project, provides information on Assistive Technology products and related material through the website www.eastin.eu. In the past few years several advancements have been implemented on the EASTIN website thanks to the contribution of EU funded projects, including a multilingual query processing component for supporting non expert users, a user rating and comment facility, and a detailed taxonomy for the description of ICT based assistive products. Recently, within the framework of the EU funded project Cloud4All, the EASTIN information system has also been federated with the Unified Listing of assistive products, one of the building blocks of the Global Public Inclusive Infrastructure initiative.

A new method for assessing preference based outcome measures in rehabilitation with assistive devices is reported. The method uses a standard utility instrument, the EuroQol, with complementary items on mobility and social relationships. In addition, a problem solving scale (PIRS) is introduced. Validation has been carried out in a multicenter study of mobility, hearing and communication devices. Utilities and problem solving scores covary strongly for mobility interventions but not for those dealing with communication. So far it is not explained whether the investigated communication interventions result in moderate utility gain only, or whether there is a bias in the corresponding utility scores. Further research on this has been started. The issue of deriving utility weights for the PIRS has also been started. We recommend the described method to be used for cost-utility analyses of rehabilitation measures for disabled persons.

IPPA (Individually Prioritised Problem Assessment) is a new instrument to assess the effectiveness of assistive technology provision. It assesses the impact that problems have on daily life as perceived by the end-user. In an international trial, 248 clients of service delivery centres were interviewed using the instrument, of whom 188 also participated in a follow-up interview. Respondents had problems in mobility, hearing, speech-related communication or self-care. In addition to IPPA, SIP68 and EuroQol were administered for validation purposes. The instrument fits well into the process of service delivery (and even facilitates the actual assessment). The direction of changes measured by IPPA is consistent with the direction of changes measured by SIP68 and EuroQol, supporting construct validity. Changes measured by IPPA are considerably larger, supporting our view that solving problems is a key outcome in provision of assistive devices. Results support the ideas behind the instrument and are promising enough to continue.

The state-of-the-art in cost-outcome analysis of assistive technology (AT) is first reviewed, and then the article focuses particularly on the cost aspects of such technology. It elaborates on the concept of 'social cost' as the main indicator of AT economic impact, and proposes methods to compare alternative AT solutions in terms of social cost. A specific instrument for social cost analysis--Siva Cost Assessment Instrument (SCAI)--was designed to help clinicians estimate the economic aspects of providing individual users with AT solutions. The use of the instrument involves: (1) a description of the objectives of the individual AT programme, (2) the establishment of the sequence and timing of all the interventions forming the programme, and (3) the compiling of a cost calculation table for each AT solution. Such a table distinguishes social costs (the sum of all material and human resources mobilised by the intervention) from the financial plan (the actual disbursement of money over time by involved actors). The SCAI tool is not intended as a decision-maker, it is just an informative instrument that, used during clinical assessment, makes clinicians and users aware of the economic consequences of their decisions. The article also explores the possibility of using SCAI to compare different individual AT programmes. Based on a survey of 31 individual AT programmes carried out over a number of years, a first attempt has been made to infer social cost indicators for various categories of AT equipment. The first clear finding is that--not surprisingly--most AT solutions, though very expensive in terms of initial purchase price, lead to considerable savings in social costs due to the reduced assistance burden. In some cases, the savings detected in social costs were in the range 150,000 euros over 5 years. The second major finding is the marked variation in the social costs of different individual cases where similar AT solutions were implemented, suggesting difficulty in establishing repeatable social cost figures for a given device: such figures also depend on the individual context of the implemented AT solution, and on its inter-relationship with the other AT solutions composing the whole programme.

Awareness and knowledge of Assistive Technology (AT) are key factors in supporting empowerment of people with disabilities. They also greatly contribute to the success of AT solutions. Based on the findings of the EUSTAT study--an international project within the Telematics Application Programme of the European Commission--this paper offers a synthesis of the guidelines developed for those who organize educational activities on AT addressed towards end-users.The educational process is looked at within an empowerment perspective rather that as a mere transmission of notions. The effectiveness of education should be evaluated in relation to the increased ability of end users to make use of AT knowledge for improving their quality of life, and becoming informed, demanding and responsible consumers of AT products and services.To such end a number of critical factors are identified, and ways to address them are discussed. Finally, a case study is reported as an example of an effective AT educational curriculum for end-users.

During the CERTAIN study (research carried out in 1994-96 within the Technology Initiative for Disabled and Elderly (TIDE) programme of the European Union), a number of real life case studies of provision of assistive technology to disabled persons were investigated in order to assess the applicability of socio-economic principles, methods and techniques already available from Health Care Technology Assessment studies. A retrospective study on cost, effectiveness and utility resulting from the implementation of assistive technology was carried out over a sample of disabled persons who had adopted technical aids before the start of the project. The sample was selected in such a way to include different pathologies (steady or progressive), impairments, ages, technology and social environment. Each case was described by considering all clinical, technical and social aspects; a common structure for case reporting was developed and tested; attempts were carried out to apply and refine concept and tools derived from health technology assessment studies; on the grounds of such experience a decision support model was elaborated for the choice between different alternatives in order to maximize the client's quality of life while making efficient use of scarce resources. A computer implementation of such a model was also developed, along with a mathematical structure of cost analysis. Within a national research programme such findings were further exploited, leading to the development of a prototype cost-outcome instrument designed for use in clinical practice in the provision of assistive technology to individual cases.

The principal objective of the research project is to create inclusive and accessible environments on the Web, using technologies in an innovative manner in terms of their pedagogical and didactic aspects, and to enable people with disabilities or special needs to enjoy equal opportunities and participate in university matters. Diversity is viewed as an asset in the field of relationships and learning for all. The project also aims to demonstrate the possibilities of learning and knowledge-building in the transition from informal to formal learning. The experimental research was carried out in an academic context involving students, professors and tutors (2297 students, 56 professors and 33 e-tutors). The e-tutors, who aimed to become “inclusive e-tutors”, took part in a research-action program and received field training during their mentoring activities. Their ultimate goal, in collaboration with professors and students, was to create an environment both inclusive and accessible for everyone. During the research, participants built models of interactive training. Development of the use of ICT through an interactive and inclusive approach that deals with issues relating to pedagogical and technological accessibility, confirmed the working hypothesis. Another key result was the discovery that relationships and interactions can modify the methods of teaching to make curricula more flexible and accessible.

Individually Prioritised Problem Assessment (IPPA) is an instrument to assess the effectiveness of assistive technology provision. It is a generic instrument that can be used to assess the extent to which problems identified by an individual assistive technology user have been diminished. IPPA was developed because existing instruments in the field of Health Technology Assessment are not sufficient for assessing effectiveness of assistive technology. IPPA assesses effectiveness in relation to those activities that the individual respondent considers relevant. At the start of the service delivery process, the client is asked to identify and rate the activities that he or she has problems with in everyday life. The same activities are rated again, a few months after receiving a new assistive technology. IPPA has been used in several studies and has proven to be a usable and valid instrument. 1. Purpose Individually Prioritised Problem Assessment (IPPA) was conceived as an instrument to assess the effective- ness of assistive technology provision. It assesses the extent to which problems identified by an individual assistive technology user in his or her daily activities have been diminished as a result of the provision of assistive technology (5). IPPA is primarily meant to be used in outcome stud- ies. Results can be used to support policy decisions related to provision of assistive technology. IPPA can also be used to structure and evaluate an individual service delivery process. IPPA is a generic effectiveness measure. Basically, it can be used to assess the effectiveness of any kind of assistive technology provision. So far, IPPA has been applied in outcome studies to assess the effectiveness of provision of mobility aids (2,5), transportation ser- vices (2), hearing aids (5), communication devices (5), home adaptations (5), telephone relay services (1) and a robot manipulator (8). In Norway it has been used

Nel contributo vengono affronatate le questioni della disabilità da un punto di vista pedagogico-educativo, ma inserendovi il contributo imprescindibile della Classificazione internazionale del funzionamento (ICF) dell'Organizzazione mondial della sanità