Ebook: Assistive Technology

On behalf of the Association for the Advancement of Assistive Technology in Europe (AAATE), the University of Pannonia and the team of local organisers, we are honoured to present the proceedings and the program of the 13th European Conference on the Advancement of Assistive Technology. After Maastricht 1990, Stockholm 1993, Lisbon 1995, Porto 1997, Düsseldorf 1999, Ljubjana 2001, Dublin 2003, Lille 2005, San Sebastian 2007, Florence 2009, Maastricht 2011, Vilamoura 2013, we are proud to host this conference in Budapest with the main patronage of President János Áder, President of the Republic. Zoltán Balog, the Minister of Human Capacities and István Tarlós, the Mayor of Budapest are also our patrons.

The slogan of the AAATE 2015 conference, “Attracting new areas and building bridges” reflects both the intention to reach out to Eastern-Europe and to target a wider audience of professionals interested in the relationship between technology and disability, in particular those involved in partially overlapping fields, such as e.g. Ambient Assisted Living, Universal Design, e-Accessibility, Technology in Social Care and Person-Centred Technology. Colleagues responsible for the training of future specialists in the field are also an important target group we invite to get involved. A particular focus in this year's conference is on connecting with stakeholders from industry to establish a sustainable exchange amongst all stakeholders in the value chain of Assistive Technology and service provision for people with disabilities.

Every two years the AAATE conference provides a unique platform to reflect and review progress and challenges in the implementation of equal opportunities as best expressed in the UN Convention on the Rights of People with Disabilities. Contributions to the advancement of Assistive Technology, not only in technological areas, but in all the fields closely related to this domain – Education and Training, Service Delivery, Research, Industry, Legislation – are welcome at this conference. The conference covers thematic areas as:

• Assistive Technology

• Aging, disability and technology

• Ambient Assisted Living

• AT and Accessibility for people with dementia and cognitive disabilities

• AT and social/health care

• AT for Blind and low vision people

• AT for people with motor and physical disability

• AT outcome, transfer and policy

• Augmented and Alternative Communication

• (e)Accessibility

• Education and training in AT

• Mobility: AT, accessibility and usability

Several Special Thematic Sessions have been organised:

• Universal teaching and learning

• Technology and human assistance for people with cognitive disabilities

• Aging, disability and technology: creating healthy environments to support ageing and disabled persons

• AT service provision, organisation and impact

The conference and the proceedings in your hands cover 138 reviewed papers, grouped into 28 sessions, and contains 28 accepted poster presentations. We expect participation of experts and delegates from 32 countries. Program building and organising the conference requires the dedicated effort of many people. First, we thank all authors for submitting their work and results in research, development and evaluation of practice for presentation and publication in the proceedings. Second, we thank all organisers of session and other program parts for their engagement. Third, we thank all members of the International Programme Committee for their support in the scientific review process. Fourth, our special thanks go to the keynote speakers for their outstanding contributions:

• Sofia L. Kalman: “What makes it tick? Components of the effective use of AAC.

• Penny Standen: Designing dedicated assistive technology or adapting mainstream technology? Examples from intellectual disabilities.

• Mike Paciello: E-Accessibility: Achieving Pervasive Inclusion.

• Laura Evans and Sally Fowler Davis: Assistive technology in rehabilitation; Have we lost the plot?

Finally, special thanks go to the Laboratory of Virtual Environments and Imaging Technologies Research Laboratory at the University of Pannonia, the Diamond Congress Ltd. and John von Neumann Computer Society, the board and the secretariat of AAATE for hosting and organising the conference. Only due to all their joint efforts could the conference be put in place and will contribute to the mission of AAATE: to advance Assistive Technology in Europe and around the globe for better quality of life for people with disabilities.

Cecilia Sik-Lányi

Evert-Jan Hoogerwerf

Klaus Miesenberger

Peter Cudd

Digital textbooks have been expected for providing multimedia information that the print textbooks could not handle. The original digital textbook can be fabricated relatively easily by using Epub or DAISY. Print textbooks are, however, employed as textbooks in the most of lectures in universities. Therefore, it is considered necessary to convert the content of the print textbook to the digital textbook simply and in a short time. In this paper, the digital textbook using PDF files of the print textbook was suggested as one of simple and practical solution to provide an alternative textbook for the physically disabled university student who has difficulty handling the print textbook. Then usability of the suggested method was evaluated experimentally from the point of workload. Result of the experiment indicates that the digital textbook fabricated as the alternative one for the print textbook by the suggested method has a potential to reduce workload for the physically disabled university students. In addition, the digital textbook with larger LCD display needs less workload than the print textbook. Then, there are not so much difference in the workload between the print book which is smaller than the print textbook and the digital book made from the print book.

Utilizing invisible 2-dimensional codes and digital audio players with a 2-dimensional code scanner, we developed paper-based textbooks with audio support for students with print disabilities, called “multimodal textbooks.” Multimodal textbooks can be read with the combination of the two modes: “reading printed text” and “listening to the speech of the text from a digital audio player with a 2-dimensional code scanner.” Since multimodal textbooks look the same as regular textbooks and the price of a digital audio player is reasonable (about 30 euro), we think multimodal textbooks are suitable for students with print disabilities in ordinary classrooms.

The use of ICT in education is becoming increasingly important and has potential advantages to disabled learners if the technologies are appropriately designed, including for accessibility and usability, and used. This paper presents the first sets of recommendations for learning technologies for disabled people aimed at disabled learners, teachers, developers and educational institutions respectively. They were developed as part of the work of the Enable Network for ICT Learning for Disabled People and involved input from both experts and end-users. The concise format facilitates production in a variety of formats and languages for accessibility and wide distribution. The paper discusses the recommendations and their relationship to existing guidelines.

Equal access to education will foster a knowledge society for all. In particular for the ICT based information society a benchmark has been set to raise the numbers of graduates in science, technology, engineering and mathematics (STEM) study courses by 15% (748.000) per year, asking for increased efforts in Europe (http://ec.europa.eu/education/policy/strategic-framework/index_en.htm). This holds even more true for people with disabilities who a) participate in and graduate from STEM at a much lower number and b) face a much higher unemployment rate, in particular in STEM related fields. This asks for sound and well-founded education – first and foremost in math – for people with disability and here especially for blind people.

Grounded on new research in neuroscience and the Design for All principles, Universal Design for Learning (UDL) constitutes an educational approach that promotes access, participation and progress in the general curriculum for all learners. The difficulty is in all cases translating the UDL principles and guidelines into practice. Though the UDL policy context supports a shift to inclusion, professionals need more support to develop their practice. In order to bridge the gap between policies and practice the UDLnet network aspires to address this necessity collecting and creating good practices under the framework of Universal Design for Learning. This paper presents the UDLnet project, its aims, the methodological framework, as well as the envisaged themes. UDLnet is a European network that aims to contribute to the improvement of teachers' practice in all areas of their work, combining ICT skills with UDL-based innovations in pedagogy, curriculum, and institutional organization.

Autonomy of mid-seriously and seriously intellectually disabled persons is encouraged both by legislations on human rights and the modern social care and services. The process leading to the maximum possible autonomy is illustrated by a developmental spiral in our model. Specialty of the development is that the personal educational projects are realized during everyday activities. The process requires conscious professionals with an empowering and motivating attitude, with adult relationship to the intellectually disabled persons and versatile skills and tools. In this educational relationship the social professional and the supported person are equal partners moving together along the spiral of human development. An innovative tool-battery has been developed aiding support-staff in the ‘pedagogical’ task embedded into everyday social services. The tool-battery and its first application in supported living services of the Hungarian Down Foundation are introduced in this paper.

At current, screening for, and diagnosis of, autism spectrum disorders (ASD) are based on purely behavioral data; established screening tools rely on human observation and ratings of relevant behaviors. The research and development project in the focus of this paper is aimed at designing, creating and evaluating a social serious game based multi-modal, interactive software system for screening for high functioning cases of ASD at kindergarten age. The aims of this paper are (1) to summarize the evidence-based design process and (2) to present results from the first usability test of the system. Game topic, candidate responses, and candidate game contents were identified via an iterative literature review. On this basis, the 1^st partial prototype of the fully playable game has been created, with complete data recording functionality but without the decision making component. A first usability test was carried out on this prototype (n=13). Overall results were unambiguously promising. Although sporadic difficulties in, and slightly negative attitudes towards, using the game occasionally arose, these were confined to non-target-group children only. The next steps of development include (1) completing the game design; (2) carrying out first large-n field test; (3) creating the first prototype of the decision making component.

A growing body of evidence confirms that mobile digital devices have key potentials as assistive/educational tools for people with autism spectrum disorders. The aim of this paper is to outline key aspects of development and evaluation methodologies that build on, and provide systematic evidence on effects of using such apps. We rely on the results of two R+D projects, both using quantitative and qualitative methods to support development and to evaluate developed apps (n=54 and n=22). Analyzing methodological conclusions from these studies we outline some guidelines for an ‘ideal’ R+D methodology but we also point to important trade-offs between the need for best systematic evidence and the limitations on development time and costs. We see these trade-offs as a key issue to be resolved in this field.

Although considerable amount of evidence suggest that info-communication technologies have important potential to promote higher level of adaptive functioning and more efficient learning in people with intellectual disability (ID), very little is known about how people with ID scan visually the visual user interfaces of digital tools. Eye-tracking technique is widely used to study visual scanning processes and is used more and more extensively in assistive and educational technologies, too. Therefore, it is important to explore and understand the limitations and potentials of applying eye-tracking technique in people with ID. The present paper aims this by analyzing data from 4 studies (n=38/38 and n=15/30), via contrasting data from people with ID with data from neurotypical (NT) control subjects along 3 variables, indicative of the applicability of eye-tracking technique. Results strongly suggest that there are specific difficulties in using eye-tracking in people with ID, showing considerable individual variability but depending also on the nature of the actual task. Consequentially, using eye-tracking in this group expectedly requires special considerations and specific solutions.

Down syndrome is caused by trisomy of all or part of human chromosome 21 (HSA21) and is the most common genetic cause of significant intellectual disability. It is the most common chromosome abnormality in humans, occurring in about one per 1000 babies born each year. It is typically associated with physical growth delays, characteristic facial features, and mild to moderate intellectual disability [1]. The average IQ of a young adult with Down syndrome is 50, equivalent to the mental age of an 8- or 9-year-old child, but this varies widely [2]. The purpose of this study is to create a tool in the virtual world Second Life [3] to develop basic counting skills for young adults with Down syndrome. Following an international literature review, our project explored and used pre-programmed equipment, Linden Scripting Language, tables and intellectual interfaces with educational intentions. The study suggests that the product will not only aid the development of counting skills for young adults with Down syndrome, but will also create an entertaining environment for all visitors, furthermore promoting imagination and motivation within a virtual community.

Society typically relies on the industrial sector to supply product and service innovations through the free market system. In some areas of free market failure deemed important to society – such as Assistive Technology – governments intervene by applying alternative innovation systems. This paper contends that governments consistently and inappropriately support an exploratory grant approach led by academia which generates knowledge in conceptual and prototype states, and instead should shift to a procurement contract approach led by industry which designs, tests and deploys commercial products and services.

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.

This paper describes a series of three randomized controlled case studies comparing the effectiveness of three strategies for communicating new research-based knowledge (Diffusion, Dissemination, Translation), to different Assistive Technology (AT) stakeholder groups. Pre and post intervention measures for level of knowledge use (unaware, aware, interested, using) via the LOKUS instrument, assessed the relative effectiveness of the three strategies. The latter two approaches were both more effective than diffusion but also equally effective. The results question the value added by tailoring research findings to specific audiences, and instead supports the critical yet neglected role for relevance in determining knowledge use by stakeholders.

This paper provides an overview of research to develop a new questionnaire testing mobile shower commode usability. It describes the methodology used to develop the questionnaire, and reports significant findings that have been published in peer-reviewed journals. Implications of the research and recommendations for further research on mobile shower commode usability are discussed.

Researchers working in fields intending to generate beneficial socio-economic impacts are increasingly challenged to demonstrate evidence that the findings from their studies have value to audiences beyond the peer academic community. These diverse and diffuse target audiences may include clinicians, consumers, manufacturers and information brokers. This paper summarizes a project that designed, constructed and validated a web-based instrument for collecting and analyzing self-reported data on knowledge use. The Level Of Knowledge Use Survey instrument is valid and reliable for measuring uptake of new knowledge and for tracking changes in level of knowledge use over time.

Versatile description languages such as the Unified Modeling Language (UML) are commonly used in software engineering across different application domains in theory and practice. They often use graphical notations and leverage visual memory for expressing complex relations. Those notations are hard to access for people with visual impairment and impede their smooth inclusion in an engineering team. Existing approaches provide textual notations but require manual synchronization between the notations. This paper presents requirements for an accessible and language-aware team work environment as well as our plan for the assistive implementation of Cooperate. An industrial software engineering team consisting of people with and without visual impairment will evaluate the implementation.

The market of mobile technologies has considerably increased in the past few years and the costs have consequently decreased. This rapid technological evolution can be seen in two different ways from the perspective of people with disability: on the one side it represents a great opportunity to create new solutions for improving independence; on the other it may represent a source of social exclusion if appropriate assistive solutions are not available to make technology usable by people with disability. This paper describe three case studies of persons with disabilities that have undergone an Assistive Technology assessment at the DAT service of Fondazione Don Gnocchi (Milan, Italy) involving the use of mobile ICT based Assistive Technologies. In all the three cases the appropriate solution for performing the desired activities is represented by a combination of mainstream products and assistive products. The three use cases described support the idea that mobile technologies can be powerful and versatile instruments to create assistive solutions for improving independence in daily life.

This paper reports on an innovative approach to facilitating the expedient reporting of web accessibility issues using volunteers. The aim of the Fix the Web website and project is not to replace existing formal methods of reporting inaccessible websites, but to provide an easy, informal way by which users with disabilities can report inaccessible websites quickly and can be assured that a volunteer on their behalf will take the issue up with the website owner or administrator. Fix the Web was launched in 2010 and from a small start has gone onto success in dealing with nearly 150 inaccessible websites. The results of an analysis of reports of inaccessible websites received by the Fix the Web are also presented and the practical benefits and limitations of using an informal approach to achieve accessibility are discussed.

Large scale benchmarking of web accessibility can benefit from human input to complement results produced by automatic evaluation tools. This paper presents a novel method that enables non-experts to provide input on web accessibility. The semi-automatic approach guides the evaluators through a structured process with clear instructions. We present a template to describe different types of user input and an outline of the empirical validation.

The aim of this paper is to describe ongoing research being carried out to enable people with visual impairments to communicate directly with designers and specifiers of hobby and community web sites to maximise the accessibility of their sites. The research started with an investigation of the accessibility of community and hobby web sites as perceived by a group of visually impaired end users. It is continuing with an investigation into how to best to communicate with web designers who are not experts in web accessibility. The research is making use of communication theory to investigate how terminology describing personal experience can be used in the most effective and powerful way. By working with the users using a Delphi study the research has ensured that the views of the visually impaired end users is successfully transmitted.

In order for smart houses to achieve acceptance from potential beneficiaries they will need to match the users' expectation that their house is also their home, with the sense of privacy and control that this implies. Designers of this technology will need to be aware of findings in this regard from fields such as architecture and design ethnography.

We present a complete BCI-enabled (Brain Computer Interface) solution for Ambient Assisted Living system control. BCI are alternative, augmentative communication means capable of exploiting just the brain waveforms to infer intent, thus potentially posing as a technological bridge capable of overcoming limitations in the usual neuromuscular pathways. The module was completely developed in a customized way, encompassing hardware and software components. We demonstrate the effectiveness of the approach on a practical control scenario in which the user can issue 4 different commands, at his own pace and will, in real-time. No initial calibration is necessary, in line with the aimed plug&play approach. Results are very promising, especially in false positives rejection, well improving over literature.

The present impact of ambient intelligence concepts in eInclusion is first briefly reviewed. Suggestions and examples of how ambient intelligent environments should be specified, designed and used to favour independent living of people with activity limitations are presented.