Lecture 8

1. Lecture 8 AT systems

2. ‘Environmental factors make up the physical, social and attitudinal environment in which people live and conduct their lives’ Health. P.171 ICF. Geneva: World Health Organization; 2001. • Included in environmental factors is Products and Technology, closely aligned to the International Standards • Organizations classification of ‘Technical Aids for Disabled Persons’ or ISO 9999 which is focused • on ATDs [ibid p173] and is called ‘‘Assistive Products for Persons with Disability’’ in ISO 9999:2007

3. Personal Factors • Although not classified in the ICF, personal factors have been broadly described as follows: “Personal factors are the particular background of an individual’s life and living, and comprise features of the individual that are not part of a health condition or health states.” • p.17 World Health Organization. International classification of • functioning, disability and health (ICF). Geneva: WHO 2001

4. These factors may include • gender, race, age, other health conditions, • fitness, lifestyle, habits, upbringing, coping styles, social background, • education, profession, past and current experiences, overall behaviour pattern and character style, • individual psychological assets and other characteristics, all or any of which may play a role in disability at any level • World Health Organization. International classification of functioning, disability and health (ICF). Geneva: World Health Organization; 2001.

5. Negative impact: Barriers • The terms barriers/hindrances apply to factors that have a negative impact. For example, barriers within the social environment exist when trained personnel to assist in selecting and obtaining AT devices are not available. • Another barrier can be the failure to conduct a comprehensive assessment of an individual’s needs, priorities and AT preferences at the beginning of the AT and support-selection process. • Barriers also occur when some professionals do not acknowledge that a person with a disability develops and changes perspectives over time. • Additional examples of environmental barriers to ATD use include the lack of funds to purchase an ATD and non-supportive attitudes of family members, teachers or employers toward ATD use. • Scherer M, Jutai J, Fuhrer M, Demers L, DeRuyter F. A framework for modelling the selection of assistive technology devices (ATDs). Disabil Rehabil: Assist Technol 2007;2:1–8.

6. Predispositions • People’s predispositions to, expectations for, and reactions to assistive technology use are highly individualised and personal. • These predispositions, expectations and reactions emerge from such influences as varying needs, abilities, preferences and past experiences with and exposures to technologies • Scherer, M, Craddock G & Tmackeogh (2011)The relationship of personal factors and subjective well-being to the use of assistive technology devices Disability and Rehabilitation, 2011; 33(10): 811–817

7. IMPT The following seven factors were found to impact on the QOL of the students • The Benefits of the Statement of Need and a collaborative approach • What type of technology was utilised whether high or low technology or a combination of both • What strategies or supports were used to access the curriculum, note taking or personal assistant, copies of notes • Whether the students received all or any of their technology • Work ethic of the student • Length of study • Availability of Transport to college • Craddock G. The AT continuum in education: novice to power user. Disabil Rehabil: Assist Technol 2006;1:17–27.

8. AT & students with disabilities • The research clearly showed that a collaborative/partnership approach between service provider and the student with a disability was a key factor in the successful selection, acquisition and long-term use of the specific AT. • The students’ quality of life was improved by reducing the length of time they had to spend studying. • The technology made life easier by allowing them to concentrate on learning rather than struggling to read, write and understand what was said or written. • This also provided time to do other things outside of education that had not been possible before. • Both formal (Disability Liaison Officers, technology support) and informal (parents, friends) support networks were also critical to the successful and continued use of the AT

9. AT & students with disabilities • The strategies learned and used by the students in accessing the curriculum were further factors • however a critical element to emerge in the change process was the importance of both time and timing, • particularly in respect of the timing of the intervention in relation to the person’s life development, timing of receipt of AT within the educational continuum and the length of time that the students were using the technology and the duration of the evaluation process

10. AT & students with disabilities • Two discernable groups of students emerged from the study distinguishable by the type of technology they used, how successful they were using the technology and its impact on their quality of life, how they used it, and how satisfied and comfortable they were with the technology. • The novice and power users with students progressing between the two stages characterized as transition users.

11. AT & students with disabilities • The study clearly demonstrated that many students became ‘power users’ of AT. For these students’, the factors relating to the three domains are coalesced providing the necessary support and space for the assimilation of AT resulting in the changes within their self-esteem. • It was found that positive changes occurred within family relationships and the students’ ‘connective’ social relations. • The students had a positive perception of themselves as equal participants within their relationships and society and found they excelled with this added support. • AT became a positive factor in their lives; • they were both confident in the assimilation of AT

14. ATD PA • The Assistive Technology Device Predisposition Assessment (ATD PA) is a measure of an individual’s predisposition to and readiness for ATD use. • The follow-up version assesses realisation of benefit from the selected ATD and reasons for situations of nonuse. • The ATD PA was developed to help reduce inappropriate ATD recommendations and the frustration that often accompanies a poor match of person and device.

15. MPT • Section A (9 items): consumer ratings of functional capabilities (5-point Likert scale), . • Section B (12 items): quality of life/ SWB in the context of the ICF, Disability and Health (ICF)28 domains of activity and participation (5-point Likert scale), • Section C (33 items): consumer personal and psychosocial characteristics (yes/no) . This section is comprised of eight subscales as follows: Mood, temperament, self-esteem, self-determination and autonomy, family support, friend support and readiness and motivation to use support.

16. Assistive Technology Device Predisposition Assessment 16

17. ATD PA Personal Factors mapped on the ICF ATDPA Section C: Personal Factors Scales ICF Classification: Contextual Factors ______________________________________________________________________ Perceived support from family, Support from family (e310, 410), friendsSupport from friends (e320,420) Temperament Personal, Temperament & personality (b126) Mood Emotional functions (b152) Autonomy and self-determination Making decisions(d177), Higher cognitive functions (b164), Attitudes (e4) Self-esteem Personal, Emotional functions (b152) Readiness for technology use Incentive to act (b1301), Forming an opinion (b1645)

18. Activities and Participation

19. The guidelines are very specific about the elements that should be included in the AT assessment framework. • The framework represents a bio-psychosocial approach in that it focuses on the learner in terms of his or her history, interests, abilities, learning, attitude and academic and physical skills. • The environment is considered in terms of the physical context at school and home and social factors such as the role and attitudes of peers, teachers and family. • The guidelines also describe the tasks, goals and tools for assessment.

20. Students of AT • Female, aged 19, with a visual impairment, who wanted to take social studies in her local Institute of Technology. She has difficulty reading the blackboards and experiences eye fatigue reading books. • She has a laptop and uses Lunar ’95 as well as Telescopic lens. She received the laptop in the middle of her second last year in secondary school. • A separate room to sit the Leaving Certificate, with laptop, large print and extra time, though they forgot english paper! • After the leaving certificate, the school took her laptop back, no system for third-level so she went back to her secondary school and asked could she borrow her laptop, they said “no way”. She since found out that the vice principal was using the laptop. • Had to reapply for the technology again, for third-level use. This took another year, she eventually received another laptop two weeks before her 1st year college exams, and was told to use it by the college. She told them there was no way she could use it, having not had it for over a year, it also had a totally different software package. The exam authorities enlarged the paper for her 1st year exams • She had a very good second year with her laptop until her final exams. In her final exams, the papers were not enlarged. She wrote to the Department of Education and the Minister of Education, but she got no reply. She also wrote to the head of exams and the president of the college, but they did not reply either. She was looking for extra marks for the subjects.

21. Students of AT • Student four is Female, aged 20 years, with dyslexia, this is her account taken at the post-leaving certificate stage, two years after the project. She had no access to any assistive technology in school; she used school computers as part of the curriculum • recommended that she needed a high-spec computer with Dragon Naturally Speaking, Quicktionary Pen, Kurzweil 3000 and a Franklin Spellmaster with Thesaurus with copies of lecture notes in digital form, access to photocopying and one-to-one tutoring • The school alerted examiners to issues of readability of the exam scripts. She sat the applied Leaving Certificate and was awarded 93%, the second highest in her year.

22. Students of AT • Student three is a male who is twenty-two years of age. He has poor hand and lower limb capabilities which means he has great difficulty writing and walking. • In secondary school he studied English, History, Business Organisation, German and Biology at honours level and Irish and maths at lower level in the leaving certificate. He wanted to get 430 points in the leaving certificate to go onto University.

23. Students of AT • The student is male, twenty-one years of age and has a severe disorder of the skin. This results in the constant breakdown of the skin and the dexterity of his hands is poor, making writing difficult if not impossible. • unable to sustain legible writing for long periods. • Dragon Dictate Systems products. • “the headmaster always kept me informed of assistive technology demonstrations and assessment schemes” Student • A computer company sponsored him for the Leaving Cert, and provided him with a new laptop computer