Assistive technology to support people with autism spectrum disorder in their autonomy and safety: A scoping review

BACKGROUND: Autism Spectrum Disorder (ASD) is a lifelong developmental disorder with increasing prevalence rates. People affected by ASD do often need support in various activities of daily living mainly provided by formal or informal caregivers. Assistive technology can help to increase autonomy and safety of people on the autism spectrum and thus decrease the burden of care. OBJECTIVE: This study aims to assess the state of the art of assistive technology (AT) that supports autonomy, self-reliance comfort and wellbeing of people with ASD or aiming to prevent dangerous situations or shutdowns, caused by stressful (environmental) situations. Another aim is to analyze the fields of application and type of the proposed technologies and to explore the evaluations conducted. METHODS: A scoping review was carried out where the databases MEDLINE, IEEE and ACM Digital Library were searched. The identified articles were grouped according to the objective of the technology – the supported area of life that is assisted by the proposed systems. Furthermore, the conducted evaluations of the ATs in the papers were analyzed. RESULTS: A total of 40 articles were included in this review with a balanced distribution in the different fields of application (Communication & Social Life; Daily Living Assistants; Safety & Security). Eighteen studies conducted an evaluation of the proposed technology with people with ASD, mainly testing the functionality of the systems. CONCLUSION: The proposed technologies support people in the autism spectrum according to the main outcomes and symptoms of ASD. Further research is needed to determine the usefulness and acceptance of the ATs.

The potential of robotics for the development and wellbeing of children with disabilities as we see it

BACKGROUND: Rapid technological development has been opening new possibilities for children with disabilities. In particular, robots can enable and create new opportunities in therapy, rehabilitation, education, or leisure. OBJECTIVE: The aim of this article is to share experiences, challenges and learned lessons by the authors, all of them with experience conducting research in the field of robotics for children with disabilities, and to propose future directions for research and development. METHODS: The article is the result of several consensus meetings to establish future research priorities in this field. RESULTS: Robots have a huge potential to support children with disabilities: they can play the role of a play buddy, of a mediator when interacting with other children or adults, they can promote social interaction, and transfer children from the role of a spectator of the surrounding world to the role of an active participant. To fulfill their potential, robots have to be “smart”, stable and reliable, easy to use and program, and give the just-right amount of support adapted to the needs of the child. Interdisciplinary collaboration combined with user centered design is necessary to make robotic applications successful. Furthermore, real-life contexts to test and implement robotic interventions are essential to refine them according to real needs. CONCLUSIONS: This article outlines a research agenda for the future of robotics in childcare and supports the establishment of R4C – Robots for Children, a network of experts aimed at sharing ideas, promoting innovative research, and developing good practices on the use of robots for children with disabilities.

Satisfaction of visually disabled users with California educational websites

BACKGROUND: College and university websites in the United States are legally required to meet accessibility standards to promote equal opportunity in education for blind and visually disabled students. Web Content Accessibility Guidelines are the recognized standard for website accessibility. OBJECTIVE: Determine how satisfied blind and visually disabled college and university students are with college and university websites in California, and whether compliance with Web Content Accessibility Guidelines is a good predictor of that satisfaction. METHODS: A random sample of websites from California colleges and universities was evaluated for accessibility compliance. A stratified sample of six websites was taken from the initial sample. Thirty blind or visually disabled students performed a prescribed series of tasks on each of the six websites, then answered a Likert-format survey regarding their satisfaction with each website. RESULTS: Sixty-three percent of websites did not meet the first priority accessibility criteria. Participant responses showed a majority were satisfied with websites, both compliant and non-compliant, and a strong correlation between satisfaction and accessibility compliance. CONCLUSIONS: Despite legal requirements, a majority or large minority of college and university websites in California do not meet accessibility guidelines, indicating a significant opportunity to improve the accessibility of those websites.

Physical functionality of alternative communication resources on people with cerebral palsy: A systematic review

BACKGROUND: Augmentative and Alternative Communication (AAC) systems are used by people with motor disabilities, such as those with cerebral palsy (CP). The assessment of physical functional skills is crucial for appropriately choosing the computer access tool. OBJECTIVE: This study aimed to do a systematic literature review addressing the importance of the analysis of physical functional performance for the construction of specific tools to support communication. METHODS: The review followed PRISMA guidelines. We searched articles from 2009 to 2021 using three databases (PubMed, Lilacs in Portuguese, and SciELO). Three reviewers extracted the data. Registration was made to PROSPERO. The risk of bias was assessed using the Cochrane Collaboration tool. RESULTS: We found 132 articles in the databases. First, we excluded 31 articles because they did not provide evidence for the use of alternative communication in people with CP and did not use high technology resources. We also excluded 57 duplicated articles. At the end of this first step, 44 articles were left, 38 of them were excluded because they are not clinical trials. We selected 6 articles for the final analysis. CONCLUSIONS: The systematic review had a positive impact on the precise dissemination of knowledge ensuring comparisons of interventions and articles such as assistive technology programs.

Impediments to effective utilization of assistive technology for learning disabled

BACKGROUND: Assistive technology has been a boon for children with specific learning disabilities (SLDs) as it bridges the gap between them and their peers without SLDs. Despite the vast emphasis on the use of AT and speedy propagation of AT tools, yet more research is required on actual usage of AT. OBJECTIVE: The purpose of the study is to identify the most significant barriers to the usage of AT by children with specific learning disabilities and suggest various measures to deal with it. METHODS: To accomplish the study interviews were conducted with special education teachers of schools in India to find out the major barriers toward the utilisation of AT. First, Qualitative analysis was performed using CAQDAS tool QDA Miner Lite to identify the barriers towards effective utilisation of AT. Further, ISM technique and MICAMAC analysis were used to corroborate the most significant barriers. RESULTS: The results revealed the most significant barriers to implementation of AT and also that timely managing these major barriers can lower the effect on other barriers. CONCLUSION: Eliminating the significant barriers would enhance the use of AT by the special education teachers, parents, and children with SLDs. Effective use of AT can prove to be benediction in the times of pandemic.

Pandemic and disability: Challenges faced and role of technology

The pandemic has affected every facet of human life. Apart from individual’s psychological and mental health issues, the concern regarding mobility, access and communication with high risk infection is a challenging situation. People with disability are more likely vulnerable to infections. The new changes in our social lifestyle (social distancing, limiting touch) can profoundly impact the day today life of people with disability. In this paper, we will briefly discuss the situation faced by individuals with disabilities, some known remedies, and yet to be identified and curated technological remedies; the impact due to transition of special education toward online mode. Tips and tricks for better utilization of work from home concept by people with disabilities. Accessibility must be universal, accommodating all and encouraging inclusivity. As rightly said by Helen Keller, “The only thing worse than being blind is having sight but no vision”; subsequently, going by the demand of the time, we should contribute toward the universal design approach by supporting people with disabilities and commit to the changes required in disability care to reduce the impact of pandemic.

Designing virtual natural environments for older adults in residential care facilities

BACKGROUND: Spending time in natural environments is beneficial for mental health and cognitive function. Unfortunately, many elderly citizens, who would potentially gain from these beneficial effects, have limited or no access to natural environments. Virtual reality may provide the experience of being present in a natural environment without the need of transportation. OBJECTIVE: The purpose of the present study was to acquire an understanding of how residents and staff at a residential care facility may use and experience different virtual natural environments, and thus aid the design of virtual natural environments. METHODS: We used qualitative method, collecting data through interviews and observations. The data was analyzed using qualitative content analysis. RESULTS: Exposure to virtual natural environments provoked various emotional reactions, and promoted skill development and social interaction among participants. The staff perceived virtual natural environments as potentially useful for, for example, improving residents’ anxiety. We identified several user interface improvements. CONCLUSIONS: The present study discusses how various aspects of virtual natural environments work in relation to the experience of a user and how this might affect wellbeing in older adults. These aspects may be valuable to consider in the design of virtual natural environments for use at residential care facilities.

A literature review on the benefits of serious games to the literacy process of children with disabilities and learning difficulties

BACKGROUND: Many studies have been developed to explore and better understand the interaction between individuals and technological resources in the context of special education. These studies show that Information and Communication Technologies, and more specifically digital games, have the potential to improve the learning process of children with disabilities. OBJECTIVE: The main purpose of this paper was to develop a literature review in order to identify the benefits of the use of Serious Games (SG) to the literacy process of children with disabilities and learning difficulties. METHODS: Previous studies related to the use of Serious Games (SG) in the literacy process of children with disabilities and learning difficulties were identified and analyzed. Considering the expressions, keywords and criteria used to select the papers, the sample was comprised of 25 studies. RESULTS: The main results show that SG, when used as assistive technologies, contribute to the literacy process, since children usually feel motivated to play the games and learn. Moreover, we identified that to benefit the literacy process, games need to be easy to use, challenging, enjoyable and include feedback, reinforcements and interactive resources. CONCLUSIONS: The literature indicates that the use of SG can stimulate engagement and that interactive activities can contribute to the literacy process of children with disabilities and learning difficulties.

Eye gaze controlled adaptive virtual keyboard for users with SSMI

BACKGROUND: Users with Severe Speech and Motor Impairment (SSMI) often use a communication chart through their eye gaze or limited hand movement and care takers interpret their communication intent. There is already significant research conducted to automate this communication through electronic means. Developing electronic user interface and interaction techniques for users with SSMI poses significant challenges as research on their ocular parameters found that such users suffer from Nystagmus and Strabismus limiting number of elements in a computer screen. This paper presents an optimized eye gaze controlled virtual keyboard for English language with an adaptive dwell time feature for users with SSMI. OBJECTIVE: Present an optimized eye gaze controlled English virtual keyboard that follows both static and dynamic adaptation process. The virtual keyboard can automatically adapt to reduce eye gaze movement distance and dwell time for selection and help users with SSMI type better without any intervention of an assistant. METHODS: Before designing the virtual keyboard, we undertook a pilot study to optimize screen region which would be most comfortable for SSMI users to operate. We then proposed an optimized two-level English virtual keyboard layout through Genetic algorithm using static adaptation process; followed by dynamic adaptation process which tracks users’ interaction and reduces dwell time based on a Markov model-based algorithm. Further, we integrated the virtual keyboard for a web-based interactive dashboard that visualizes real-time Covid data. RESULTS: Using our proposed virtual keyboard layout for English language, the average task completion time for users with SSMI was 39.44 seconds in adaptive condition and 29.52 seconds in non-adaptive condition. Overall typing speed was 16.9 lpm (letters per minute) for able-bodied users and 6.6 lpm for users with SSMI without using any word completion or prediction features. A case study with an elderly participant with SSMI found a typing speed of 2.70 wpm (words per minute) and 14.88 lpm (letters per minute) after 6 months of practice. CONCLUSIONS: With the proposed layout for English virtual keyboard, the adaptive system increased typing speed statistically significantly for able bodied users than a non-adaptive version while for 6 users with SSMI, task completion time reduced by 8.8% in adaptive version than nonadaptive one. Additionally, the proposed layout was successfully integrated to a web-based interactive visualization dashboard thereby making it accessible for users with SSMI.

The cognitive level does not interfere with recovery after robot-assisted gait training in traumatic brain injury: A 10-year cohort study

BACKGROUND: There is still no clear evidence available on the role of robot-assisted gait training (RAGT) in severe traumatic brain injury (TBI) and on the relationship between this intervention and cognitive impairment. OBJECTIVE: This study investigates the impact of the cognitive level at admission on functional recovery in a cohort of patients with severe TBI who received RAGT training within a multidisciplinary rehabilitation setting. METHODS: We included patients with gait disturbance due to a severe TBI. Patients were grouped into three classes according to their level of cognitive functioning (LCF) at admission (LCF 2-3; LCF 4-5-6; LCF 7-8). We collected demographics (sex, age), clinical data, and a set of outcome measures at admission and discharge. RESULTS: We registered 80 patients, 19 females and 61 males, 35.3 ± 14.85 years. Patients with a low cognitive level at admission were mostly subacute (p= 0.001). Cognitive impairment despite longer length stay in the hospital (LOS) (p= 0.001) did not preclude recovery after RAGT in terms of cognition (R2= 0.68; p< 0.0001), functional independence (R2= 0.30; p< 0.0001) and overall disability (R2= 0.32; p< 0.0001). CONCLUSION: Irrespective of their level of cognition, patients with severe TBI might benefit from RAGT during a multidisciplinary program.