Ebook: Assistive Technology from Adapted Equipment to Inclusive Environments

On behalf of the Association for the Advancement of Assistive Technology in Europe (AAATE) we are honoured to publish the proceedings of the 10th European Conference for the Advancement of Assistive Technology. After The Netherlands, Sweden, Greece, Portugal, Germany, Slovenia, Ireland, France and Spain we are proud to host this conference so that we can all share and benefit from each others' knowledge.

The “Association for the Advancement of Assistive Technology in Europe” (http://www.aaate.net) is the interdisciplinary pan-European association that devotes itself to all aspects of assistive technology, such as use, research, development, manufacture, supply, provision and policy. Its mission is to stimulate the advancement of assistive technology for the benefit of people with disabilities, including elderly people, through the following main areas of action:

• the creation of an awareness of assistive technology;

• the promotion of research and development of assistive technology;

• the facilitation of an exchange of knowledge within the field;

• the dissemination of information regarding assistive technology and related issues.

As technology develops rapidly and an Information Society is approaching, the concept of Assistive Technology seems to be moving away from adopting the most appropriate device(s) for each user in order to overcome the limitations to her/his activity to the design and set up of the total environment in which people live, supported by suitable functionalities (services) and, when necessary, by additional support devices integrated within the environment. At present, these two perspectives are deeply intertwined, from both a technological and a social point of view. The relationship, coexistence and transition between them currently represent the first challenges for the world of Assistive Technology.

This is coherent with the WHO-ICF modelwhich describes disability as resulting not only from a person's intrinsic attributes but also from the context. Therefore, according to the emerging technological perspectives, inclusion of all citizens can be pursued by the creation of inclusive living environments in which the abilities to carry out necessary tasks are redefined, particularly with reference to the accessing of information, interpersonal communications, and environmental control. From this perspective, this approach is also coherent with the definition of eInclusion, as approved in the 2006 Riga Ministerial Declaration: “e-Inclusion means both inclusive ICT and the use of ICT to achieve wider inclusion objectives”.

The main aim of the 10th European Conference for the Advancement of Assistive Technology is to bridge the gap between these two complementary approaches, by providing an opportunity to clarify the differences and the common points between them and to better define a way for the future.

A non-exhaustive list of relevant discussion topics related to the above transition and covered in the proceedings includes:

• Technological innovation in Assistive Technology;

• The need for interdisciplinary/multidisciplinary approaches to the development of integrated solutions;

• The contribution of Assistive Technology and Design for All towards inclusion;

• Equipment interconnectivity and compatibility, covering hardware, software and wireless, to favour integrated solutions to inclusion;

• The need for standardization (formal, informal and de facto);

• Cultural aspects: e.g. acceptance of different approaches, design and aesthetics of AT devices and inclusive living environments, high tech versus low tech, creative solutions for complex problems;

• Social aspects: penetration of AT and integrated approaches, the role of Europe in building up inclusion competence in emerging and developing countries, etc.;

• Technology transfer, towards not only AT industry, but also mainstream industry.

Pier Luigi Emiliani, General Chairman

Anna-Liisa Salminen, AAATE President

Can alternative communication devices impact on the quality of life of people with Amyotrophic Lateral Sclerosis? Without pretending to be exhaustive, this paper aims to answer that question through a literature review and a case report. Aspects of service delivery are highlighted and discussed.

This paper describes a systematized approach to assess and provide Assistive Technological equipments that help ALS patients to overtake some the severe limitations posed by this disease, with an emphasis in the area of Augmentative Communication. Thanks to a cooperation between the Department of Rehabilitation of a State Hospital and a team of professionals (rehab engineers) working for a Company specialized in AT, patients with ALS of that hospital are referred to those professionals that assess them and suggest to the clinicians the AT devices for AAC they consider to be the most adequate to the patients. The authors developed an “AT Integrated System for AAC” based on a tablet computer with specific software and a multimodal system of interfaces that will be “adaptable” to the end-user and adequate to be used by the patients, taking into account the progression of the disease. As at the time of the writing of this paper not all the data considered as crucial was available, what follows is a summary of the work done with preliminary conclusions. Full data will be available by the time of the AAATE 2009 Conference, a complete paper will then be presented by the authors.

Progressive neurological disorders, such as Amyotrophic Lateral Sclerosis (ALS), pose a great challenge to Assistive Technology (AT) selection. In fact, as the disease progresses, the patient needs for AT support change and assistive technology devices can soon become of no use to the patient. To assist professionals in the selection of AT devices for Communication, a table that suggests commercially available technologies appropriate to each stage of ALS is presented. This instrument provides a guideline for technology selection, taking into consideration the disease progression. However, it does not substitute a thorough patient assessment, and it does not consider user preferences. The main purpose of developing such a table is to bring into the assistive technology selection process not only the ALS patient present needs but also the envisioned future needs. Prescribing AT with these concerns has the potential to reduce the need to substitute devices as the disease progresses, releasing the patient from the effort to adapt to a different technology and avoiding the usually long time interval before getting a new device, during which the person stays with no useful AT support.

To gain understanding in the current status of Robotics in healthcare the European Commission issued a roadmap study into this domain. This paper reports on the main characteristics and results of this study. The study covered the wide domain of Healthcare and in this paper the domains relevant for Assistive Technology are highlighted. The study ultimately resulted in a range of required or foreseen developments foreseen in six areas of Healthcare Robotics regarding societal needs, innovations and technology. These developments were positioned along a timescale running till 2025. This study will guide the policy development regarding Robotics for Healthcare of the 7^th and 8^th framework of the EC.

Although many assistive technologies have been developed, users in Japan often do not use such developed devices. One reason is that gaps exist between user needs and engineers' design concepts. Therefore, a methodology based on user-centered design is indispensable for developing assistive technologies. This study proposes a framework for development by collaboration with users, including a group interview method of qualitative research. An original point in this study was to have a group containing users with different disabilities in order to make the variety of users, needs, and their background factors tangible. A group interview of powered-wheelchair users was held, and remarks from users were categorized as “needs,” “situations,” and “suppositions.” To analyze the relationship among these categories, a structural diagram from graph theory was applied. This methodology demonstrated that a variety of users with different needs and disabilities could be grasped systematically and visually.

This paper proposes new assistive functions for the joystick of electric wheelchairs in order to reduce some difficulties in the early stage of training. The functions are implemented as three modes, and each mode restricts driving duration or directions of the electric wheelchair. These functions prevent the wheelchair from running out of control, and ensure the safety of the user. Three children who have multiple disabilities without any experience of driving an electric wheelchair were asked to drive the electric wheelchair at their schools. As a result, the assistive functions are effective to the improvement of driving abilities. Additionally, it is found that the electric wheelchair is useful for the teachers because the restriction of driving duration enables to drive it at narrow space. Furthermore, the results give suggestions that the electric wheelchair is available as educational aids of sensory integrations of multiple disabled children.

Persons with severe physical disabilities (limited or no hand control) often use mouth- or headsticks to handle things (pressing buttons, pushing things, etc.) in the nearer environment including computers. Standard mouthsticks do not allow the grabbing of objects. Such a functionality would considerably improve the benefit of sticks and enhance abilities and independence of users.

This paper introduces the prototype of an EMG signal controlled pneumatic gripper for mouthsticks. It shows the assembly of the prototype, discusses two approaches to control the gripper and finally points out some user experiments.

In developing new assistive technologies, we need to evaluate their clinical efficacy. The purpose of this study was to evaluate a protocol devised for evaluating the efficacy of new assistive devices. This paper describes the short-term evaluation of a new, simple, failsafe brake for wheelchairs that reduces the risk of falls during patient transfer, as a case study. The evaluation confirmed the activation of the brake during patient transfer and deactivation during travel. This short-term evaluation confirms the effectiveness of the protocol and informs our plan for a long-term evaluation.

This paper reports on a pre-post study on outcomes of rollator interventions in terms of mobility-related participation frequency and ease, and of users perceptions of the importance of the device. Data were collected in two municipalities with 37 and 38 respondents, in average 77 and 82 years of age. Taking walks became more frequent and easier, and in one of the municipalities it also became easier to go to the pharmacy, the post office and the library, to do shopping and to visit families and friends. Most users considered their device to be important, but there was an increased risk that the oldest users would not rate the device as important. Reasons for modest outcomes and for municipality differences are discussed.

This paper describes a case study in designing a compliant seat for a child with severe whole body extensor spasms and epilepsy who was previously unseatable. A seat was designed for the child based on a saddle seat design using dynamic foot and back rests. When using the seat, the child showed reduced muscle tone and improved head and hand control.

When the person with visual impairment try to cross the road, there is some deviation from center line of crossing zone at the time of he/she arrived to the opposite end. This paper shows that the reason of this phenomenon is caused by two reasons. One is the misdirection at the time of the first step forward and the other is the veering tendency when walking on the crossing zone. And also this paper shows that the deviation from the centerline of crossing zone will be reduced by reducing initial misdirection at the time of the first step forward.

This paper presents a research project that consists in the analysis, design, development and demonstration of a mobility aid for partially sighted/blind people, intended to allow them a safe and autonomous mobility in urban scenarios. Some mobility aids exist, mostly based on consumer GPS receivers, but they are not completely suitable or present some limitations. To overcome these limitations, we propose a system in which the user may move on a ground-level virtual path, which may be followed through the use of an electronic device mounted on a traditional white cane (smart cane). The device is able to detect the virtual path and to signal to the users, by means of vibration, that they are moving on a safe path. The smart cane also interacts through a Bluetooth link with a mobile device, which manages different navigation functionalities. Vocal information are sent by the mobile device through a wireless link to an earpiece worn by the user. The stick is equipped with a basic input interface (mini-joystick and slider) which allows the control of the main and frequently used functions of the system. The project, still in progress, plans the final installation of a demonstrator on the Walls of Lucca city, for a final validation by the users.

Traffic intersections are among the most dangerous parts of a blind or visually impaired person's travel. Our “Crosswatch” device [4] is a handheld (mobile phone) computer vision system for orienting visually impaired pedestrians to crosswalks, to help users avoid entering the crosswalk in the wrong direction and straying outside of it. This paper describes two new developments in the Crosswatch project: (a) a new computer vision algorithm to locate the more common – but less highly visible – standard “two-stripe” crosswalk pattern marked by two narrow stripes along the borders of the crosswalk; and (b) 3D analysis to estimate crosswalk location relative to the user, to help him/her stay inside the crosswalk (not merely pointing in the correct direction). Experiments with blind subjects using the system demonstrate the feasibility of the approach.

Mobile Wireless Accessibility is a project designed by IBM Italy, together with Cisco and Nokia. In this paper, the authors describe involvement of CATTID (research Centre for the Applications of Television and Distance Learning Techniques) in the project, which consists in the several steps that lead at the creation of a location based service (LBS) specifically for visually impaired people. First, the authors speak about the advantages for impaired people in using mobile devices and about the state of the art of these devices. After a brief introduction of the MWA platform, the authors report on the development process of MWA Guide, explaining the features created, the technical solutions adopted and the interface designed. Finally a vision of the main problems retrieved in the first version of the application is shown, together with possible solutions to implement in future development.

Large groups of the population in Europe encounter significant difficulties in taking part in everyday life due to their functional limitations. The NADIA (NAvigation for DIsability Applications) Project, funded and promoted by the Italian Space Agency (ASI) and implemented by Thales Alenia Space Italia with the collaboration of a mixed team of companies, university and user associations, has made concrete steps forward in demonstrating that satellite navigation applications can have an important role in facilitating the mobility of people with disabilities. This paper describes not only some basic features of the system, but looks at how they are related to the process of defining user needs and requirements, highlighting the role of end users and of professional users of Assistive Technology (AT).

The paper presents main objectives and challenges of the Health @ Home project (http://www.health-at-home.eu/). The project aims to propose and implement a new model for delivering healthcare services at home for elderly citizens affected by Chronic Heart Failure (CHF). The two years project started on 1st February 2009 it is partly co-funded by the European Ambient Assisted Living Programme (AAL) http://www.aal-europe.eu/.

Nowadays employment of new technologies has been established as an acceptable means to support daily living for different segment of young population, elderly or people with disabilities. In this context, new technological tools for telecare and Ambient Assisted Living can support people in their daily life activities. Several solutions have been demonstrated to support different level of services through seamless data acquisition or specific users interaction modalities. In such approach, services usability and accessibility are handled in design process itself and validated with small users' groups. Moreover, while service design and systems development have been extensively described in literature, the service deployment methodologies are not properly addressed and documented and proper reference guidelines are missing.

The most common methodologies like Unified Process (UP) or ICONX can cover only the design and the development of telecare service without describing clearly the following phases of deployment and distribution: such phases have quite often very high risks witch have to be considered in advance. So, in this paper, we focus on the development of a methodology and structured approach to deploy telecare services. Based on the experience and outcome collected in the deployment of service in different European countries, this paper outline at methodological level the main criticism and issues encountered in telecare services deployment, tailoring and adapting the UP framework, in particular the “Transition phase”, for such services.

The aim of this study was to evaluate the quality of existing research in the area of lower limb prostheses targeting adults in terms activity, participation and quality of life in real life contexts. Out of initially 435 articles, only three studies fulfilled the inclusion criterias. No general conclusions could be drawn from theese few studies. There is an abvious need for more well-designed research in this area.

Mainstream technology development and application development focused on the domain of long-term care are expected to have a large potential for long-term care provision. If we know which care technology is underway, it is better possible to anticipate and adjust the technology under development to care demands.

A new, non-invasive, sensor technology is applied to the acquisition of surface electromyogram signals. High quality data is presented using this dry electrode technique which is suitable for long term monitoring or motor control applications. No skin or surface preparation techniques are required. Independent two degree of freedom control signals are derived from a three electrode measurement without the use of post processing. In addition, measurements are made using high resolution surface micro-electrodes.