Ebook: Assistive Technology: From Research to Practice

AAATE 2013 – From Research to Practice

This volume contains the proceedings of the AAATE 2013 conference, the 12^th biennial European conference of the Association for the Advancement of Assistive Technology in Europe (www.aaate.net). AAATE's mission is “to stimulate the advancement of assistive technology for the benefit of people with disabilities, including elderly people”. Assistive Technology (AT) is an umbrella term indicating any product or technology-based service that enables people of all ages with activity limitations in their daily life, education, work or leisure.

Those that have been associated to the area of AT in Europe for the last two decades might remember that the last of the ECART Conferences – the precursor of the AAATE Conferences - took place in Lisbon, Portugal in 1995. And it was during this ECART Conference that AAATE was officially created. In 2013, commemorating AAATE's 18th anniversary, the AAATE biennial conference is again being held in Portugal, this time at Algarve.

The scientific field of AT is highly interdisciplinary, encompassing all aspects of assistive technology, such as use, research, development, manufacture, supply, provision and policy. One of the main objectives of the AAATE 2013 Conference is to bring together researchers, professionals, manufacturers, end users and their families, and combine their knowledge, expertise, needs and expectations, contributing in a multidisciplinary way to the advancement of Assistive Technology in Europe, from research to practice. With the goal of attracting all AT players to the conference, a Special Session Call for proposals was issued. As a result, 10 Special Sessions were organized parallel to the conference regular sessions:

• Alternative Human Computer Interfaces for People with Motor Disorders

• AT Centres and Service Delivery Issues

• Design for All and Mainstreaming in Ambient Assisted Living - The Role of Networking

• ICT-Based Learning Technologies for Disabled People

• Power Mobility: User experiences and Outcomes

• Predictors, Acceptance and Use of E-health Technology by Older Adults and Professionals

• (Semi-automatic) User Interface Generation

• Standardization within the Assistive Technology Field

• The Development and Implementation of “Remote Care”

• Using the Cloud to Enhance AT

High profile speakers were invited to give plenary talks sharing their knowledge, expertise and experience in different facets of Assistive Technology:

• Al Cook (University of Alberta, Canada) and Alan Newell (University of Dundee, UK) discussed and debated the impact of the increasing percentage of older people on AT development and service delivery;

• Fraser Bathgate (Disabled Divers International) addressed the role of scuba diving in the rehabilitation of persons with disabilities, sharing recent research projects findings and his personal experience;

• Inmaculada Placencia Porrero (DG Justice, European Commission) addressed the important subject of “Acessibility in Europe” focusing on European policies for persons with disabilities, namely the European Disability Strategy 2010-2020, the implementation of the UN Convention on the rights of persons with disabilities at EU level, and the preparation of the European Accessibility Act;

• Karin Astegger (EASPD - European Association of Service Providers for Persons with Disabilities) presented the concept of Person Centered Technology as a mean to empower technology users and to achieve effective, high quality, available, and affordable solutions to real needs;

• Sarah Blackstone (Augmentative Communication Inc., USA) proposed to reverse the acronym AAC - Augmentative and Alternative Communication yielding CAA - Communication Access for All to change the field perspective in the face of a time where many individuals, with or without disabilities, are dripping with devices that enable them to communicate easily and effectively almost anywhere, anytime, and with anyone.

Additionally, a session on Global Challenges in AT was organized where representatives from the United Nations, World Health Organization, European Union, AAATE and sister organizations RESNA, RESJA and ARATA, EASPD and from persons with disabilities organizations discussed existing global co-operation initiatives to further AT, and reflected on the needs and challenges, opportunities and difficulties of global co-operation in this field.

The AAATE 2013 conference has received 280 paper submissions from 39 countries in all continents. These papers were all reviewed by at least two of the 135 members of the conference Scientific Board. 182 papers (65%) were accepted and presented for oral presentation, 37 (13%) for poster presentation and 50 (18%) were rejected.

The program for this conference required the dedicated effort of many people. Firstly, we must thank the authors, whose research and development efforts are recorded here. Secondly, we thank the members of the Scientific Committee and the additional reviewers for their diligence and expert reviewing. Thirdly, we thank the keynote speakers for their invaluable contribution and for taking the time to synthesise and prepare their talks, and also the Special Sessions chairs that accepted our challenge to organize a Special Session in their field of expertise. Finally, special thanks to INSTICC - Institute for Systems and Technologies of Information, Control and Communication (www.insticc.org) for accepting the challenge of organizing with us this conference and for their professionalism and competence that allowed us to concentrate only on the scientific aspects of the conference.

Pedro Encarnação

Luís Azevedo

Studies have shown that about a third of all persons over 65 years who live at home fall at least once a year. Development of a lifting device that can help people raise themselves up entirely on their own, or with minimal assistance, would be a revolutionary step for the individual as compared with the lifting devices in use today. A prototype has been developed and the prototype has been tested to verify the approach. Studies have been conducted with nursing staff in a nursing home to find out the conditions for how a walker equipped with a lifting beam could facilitate the work. For caregivers dealing frequently with people who fall, this assistive device can contribute to decreasing occupational injuries.

The main objective of E-MOSION is to provide mobility services for older adults with age-related impairments. The idea is to help older adults in their daily routine activities far from home. The development and innovation process follows an iterative method where older adults are involved in the project from the beginning till the end. In the initial stage end-users were involved by means of a questionnaire and in focus groups. A result from the questionnaire was as expected that the reasons for getting around are manifold. Most of the participants mention shopping as the main reason for frequent mobility followed by visiting friends and cultural activities. Regarding the ways how people get around outside the responses show a broad spectrum. Walking, by car and by public transport services are the most prominent means. All in all the results highlighted the usefulness of the intended solution and revealed interesting insights which will be envisaged in the course of the project.

Background: Although much is known about communication patterns of young people, communication habits of older people still seem to be to be a neglected area of research. This seems surprising considering the great importance of information exchange, especially for this age group. Communication enables older people to participate in social life and thus can prevent loneliness and isolation.

Methods: After conducting a systematic literature search a questionnaire was designed to assess possible factors influencing the use of the internet for communication reasons. 150 persons aged 60 years and older were asked about socio-demographic information, conversation durations and dialogue partners. Additionally, participants were asked about subjective advantages and disadvantages of internet communication.

Results: Almost 50 % of the participants reported using the internet for communication (mainly e-mail). In particular, the socio-demographic factors age, gender and education influenced the use of internet for communication. Besides socio-demographic factors, we demonstrated that daily telephone use influences the use of the internet for communication. Contrary to our expectations, family situation, mobility and size of living area had no impact in this study-sample.

Conclusion: Using the internet for communication can be a possible solution to some of the problems many older people have to face, such as loneliness and isolation. Currently, the internet is used by only a small part of older adults. In order to strengthen internet communication in older people, it is necessary to know about factors influencing the use of internet for communication.

The aim of this study is to explore the use and perceived unfilled need for assistive technology (AT) for everyday life in three age-groups during the ageing process. Data on use and perceived unfilled need for AT from three age-groups were used; the very old age-group; 81-90, n=314, the oldest old age-group; 85-94, n=154 and younger agegroup, 67-71. The results show that the proportion of users highly increased between the youngest age-group and the very old age-group. An increase of use was also seen between the very old and oldest old age-groups, however not so prominent. In most respects the perceived unfilled need followed the same pattern. The result of this study can contribute to increased effectiveness of the supply of AT.

Accessibility for all is an overall goal in many communities around the world. The UN has the Convention on the Rights of Persons with Disabilities which Sweden along with many other countries has agreed to follow. The aim with this project was to analyse which environmental difficulties elderly people over 65 years of age experience in their daily life when walking with a four-wheeled walker. The focus area was the surroundings close to their home. It is necessary to learn more about the difficulties for people with disabilities as a base for future development of the built environment. The group of elderly is increasing daily. In Sweden the four-wheeled walker is a commonly used assistive device by the elderly when, for example, their balance decreases; this is why we chose to focus on this specific assistive device.

With the goal to design a mobile navigation solution for older users, we performed a user requirements analysis study with 49 participants in four different cities: Zaragoza (Spain), Paris (France), Oslo (Norway) and Vienna (Austria). The study focused on older users' mobility and interaction with mobile technology and it included focus group discussions, brainstorming, questionnaires, observations and interviews with tourism organizations for older adults. Our findings suggest that older users “need to know” information that will make their routes accessible and predictable; they often “cannot” properly use gestures, speech interfaces or read from the screen and in many instances they “do not understand” common navigation interfaces and their symbols.

Older persons turn directly to the branch for accessing to banking services because they feel safer and they have problems when they interact with bank interfaces. These interfaces are not adapted to older people needs and capabilities. Bank4Elder project aims to develop innovative web and Automatic Teller Machine (ATM) interfaces involving older persons along all the design and development process. The results showed high levels of satisfaction of older persons with the new interfaces, which combine age-friendly and aesthetic characteristics. Moreover, designers and developers have become aware of the older persons profiles and their real needs.

To meet the needs of an ever ageing population it has been proposed that assitive technology might provide aid and support for elderly people and allow them to reside for longer in their own homes. Such proposals face many social, ethical and technical challenges. In the research presented in this paper we study how a commercially available robot situated in a fully sensorised, although in all other ways typical home, can meet some of these challenges. We focus especially on the technical integration of the robot, the home and the actions of the house residents especially in relation to the learning and control architectures. We envisage that such a software architecture would not only be useful as a physical and memory prosthetic but would also provides active support for re-ablement and co-learning.

The development of an in-home fall risk assessment tool is under investigation. Several fall risk screening tests such as the Timed-Get-Up-and-Go-test (TGUG) only provide a snapshot taken at a given time and place, where automated in-home fall risk assessment tools can assess the fall risk of a person on a continuous basis. During this study we monitored four older people in their own home for a period of three months and automatically assessed fall risk parameters. We selected a subset of fixed walking sequences from the resulting real-life video for analysis of the time needed to perform these sequences. The results show a significant diurnal and health-related variance in the time needed to cross the same distance. These results also suggest that trends in the transfer time can be detected with the presented system.

This paper reports the process of developing an assistive technology transitional living service for brain injury rehabilitation. The aim of the service is to take advantage of smart home technology to assess, rehabilitate and promote independence in individuals with acquired brain injury who wish to live on their own in the community.

Fall is a major risk for elderly people. This paper is an outline of the research work that we are conducting in our group concerning the development of new technologies for fall detection and prevention at home. Our aim is to propose new affordable devices at home which: (1) automatically detect falls, and then alert whom is concern when a fall has been detected, (2) proceed with some measure in order to define an indicator associated with the risk of fall. Such devices could reassure persons affected by mobility problems or being recently injured in a fall, thus permitting them to stay at home longer. We are currently examining how low-cost RGB-D cameras could be used to track continuously a person at home. We show that we can easily extract, from depth images, the body center of mass of a person and some other simple parameters from which we can detect and prevent falls. Preliminary results are presented based on two real experimentations with young people, within an experimental smart home. 208 sequences were recorded for the first experimentation concerning fall detection and 106 strides were analyzed for gait parameters measurement.

The society and health systems have to face new challenges due to the increasing proportion of older people in the total population. The demographic change leads to an increase of the imbalance between beneficiaries and providers. According to forecasts, the proportion of over 60 year olds especially in rural areas will grow up to 45 percent by 2025. Concepts must be developed especially for person with a low family support potential. These have to consider the individual health state and have to enable an independently, self-determined life. Furthermore, under the inclusion of the latest technologies, their daily life should be assisted by a system based environment (in the private and public sector) with the intention to preserve their mobility. Therefore, the main target of the service provider and the service recipient should allow the older people, despite their individual health restrictions, independence but also supported and medical controlled life in their familiar home environment. This ensures in a holistic and integrated way that the gap between the domestic private sphere and the healthcare system can be closed. The requirements of this conceptual gap lead to the subject of the research project A²LICE composed of the University of Applied Sciences Zwickau and Chemnitz University of Technology and will be presented in the paper.

This paper describes a system able to detect footstep locations. Through acoustic information retrieved from a wireless sensor network with small and relatively cheap microphone arrays. A dataset was recorded in order to validate the accuracy of the detection. Results on this dataset show that a best median of errors of 31cm per time moment are achievable, but results heavily depend on the positions of the microphones relative to the footsteps.

Falls are the most frequent external cause of death for older adults, where bathrooms are a particulary dangerous environment. We propose an autonomous, ubiquitous, low-cost fall detection system based on ultrasonic and piezoelectric sensors, which takes into account privacy concerns as well as bathroom-specific hazardous environmental influences to technology. The system was implemented and tested in a real-world scenario.

MuSA, Multi Sensor Assistant, is a wearable device designed for elderly people monitoring. The system provides healthcare services as a fall detector, a user alarm button, heartbeat, breathing rate and body temperature measurement. The full integration of MuSA in the ambient-assisted living framework CARDEA allows to provide the user with remote health monitoring, supporting independent and autonomous life at home. The paper illustrates the main concepts behind the MuSA device and presents details of single functionalities. Field tests have been carried out to ensure that the low-cost approach provides adequate quality of the system response.

Aside from the recent progresses in robotics, autonomous robots are still limited in assisting disabled people. On the contrary, the animal, especially dogs, have demonstrated real skills to support the human being in many everyday life situations, such as rescue (avalanches, earthquakes...), smell detection (drugs, explosives or even cancers), handicap assistance (blind, deaf, motor or cognitive disabled people)... However, each system, the robot or the dog, has its own limitations: a step or a hole can fatally immobilize the machine and a cat may easily distract the animal. Due to the limitations and complementarities between a service dog and an assistive robot, the idea of the Cochise project is to develop a hybrid system animal/robot that will take advantage of both to be more efficient. In the present study, this approach is applied to assist people with motor disabilities. The robot is used to “augment” the service dog by increasing its control from the human being. This machine is a mediator that translates and transmits the dog state to the human user, on one hand, and enables the person to trigger predetermined behaviors of the animal, on the other hand.

This exploratory study examined nurses' perceptions of using the robot “Giraff” in their work in brain injury rehabilitation. The robot is a mobile robotic that is driven remotely via a computer and pc-mouse. All nurses at a rehabilitation clinic in Stockholm, Sweden received training in how to handle the “Giraff”. After the training session they were asked to answer a questionnaire regarding their perceptions of using the robot in their work. The results indicated that the robot “Giraff” could be useful to check on the patient, handle alarms and unforeseen situations and be funny to use. The potentials of the robot reported prompt for further research into the use of mobile telepresence robotics in brain injury rehabilitation. In a forthcoming study we are going to interview patients, occupational therapists and nurses' to assess their experiences in using the “Giraff”.

The goal of home care robots is to help elderly people to age in their own homes. Ageing people who are otherwise quite healthy may suffer from memory loss and consequently decrease their independence because the memory loss might endanger their health and safety. For example they may not remember if they have taken their medicine or what task they were currently engaged in. Equipping a robotic companion with a visualization tool for episodic memory is an excellent opportunity to have a robot provide memory prosthesis. In the EU project ACCOMPANY we study how memory visualization can support the user in remembering past events from the human-robot interaction history. Potentially, this ability to explore interaction histories could enable elderly persons as well as third parties (e.g. technicians, carers, family and friends) to monitor, maintain and improve the robot's abilities, services and ultimately its usefulness as a care robot.

Walking rehabilitation exercise using a robotic dog is proposed. Using a robot instead of an animal in animal assisted therapy overcomes the problems of infection, feeding and excretion, animal abuse, and the like. Patients operate the robotic dog AIBO using an acceleration force sensor, a touch panel, or a center of gravity sensor. Use of these human interface devices allows new functions such as sensing, recording, and processing of human conditions to be easily achieved using information communications technology. One of the key aspects of this proposal is the reversal of the roles of actor and object in assistive technology such as rehabilitation exercises. Patients operate the robot by themselves and the consequent feeling of self-efficacy should help to prolong the rehabilitation exercise. Preliminary experiments conducted at a nursing home and hospital supported this prediction and show the effectiveness of the proposal.

Our previous research has shown that children respond to a robotic interviewer very similar compared to a human interviewer, pointing towards the prospect of using robot-mediated interviews in situations where human interviewers face certain challenges. This follow-up study investigated how 20 children (aged between 7 and 9) respond to questions of varying difficulty from a robotic interviewer compared to a human interviewer. Each child participated in two interviews, one with an adult and one with a humanoid robot called KASPAR, the main questions in these interviews focused on the theme of pets and animals. After each interview the children were asked to rate the difficulty of the questions and particular aspects of the experience. Measures include the behavioural coding of the children's behaviour during the interviews, the transcripts of what the children said and questionnaire data. The results from quantitative data analysis reveal that the children interacted with KASPAR in a very similar manner to how they interacted with the human interviewer, and provided both interviewers with similar information and amounts of information regardless of question difficulty.