Ebook: Harnessing the Power of Technology to Improve Lives

On behalf of the Association for the Advancement of Assistive Technology in Europe (AAATE), the Centre for Assistive Technology and Connected Healthcare (CATCH) at the University of Sheffield and congress committees and staff, we are honoured to present the rich tapestry of articles accepted for the 14th AAATE Conference in Sheffield 2017. 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, and Budapest 2015 we are proud to host this conference for the first time in the UK.

Now that the World Health Organization's International Classification of Function includes long-term conditions there is a less stigmatising environment in which innovation can occur. While applauding this, care is needed that the massive investment in interventions for those with common long-term conditions does not obscure the important work for other groups. Increasingly international policies and agreements such as the UN Convention on the Rights of People with Disabilities are helping to drive equality, inclusion and independence forward. Legislation make changes happen. The AAATE conferences highlight innovations that are within this movement and can contribute to it. Knowledge sharing about and spreading awareness of innovations in technology, services and understanding are actions that the AAATE pursues to improve the quality of life of people with disabilities.

The 14th AAATE conference, with its theme of ‘Harnessing the power of technology to improve lives’, is intended to refresh how we approach the event. The AAATE board has taken a greater role in developing the conference, attempting to broaden its appeal and strongly encouraging experts in our field to show leadership in their specialisms. This has led to many successful engagements with project and centre teams from around the world. We would especially like to thank all those who proposed themed sessions and indeed in many cases have also become session chairs. Thanks are also due to those organisations that signed up to become ‘Conference Approved’ partners and promoted our conference to their members and networks.

We would really like to resoundingly thank the authors for submitting their work and the reviewers in volunteering to review them. There are well over 200 papers in the Congress; in the Conference there are two plenary talks, 3 platform sessions and 30 multiple presentation and workshop sessions. All presentations and posters have double-blind reviewed contributions in these 1100 plus page proceedings (barring a handful which have open-access online short communications instead). Authors can freely share electronically their pre-review original draft submissions, provided the document also quotes the reference for their final article here.

The breadth of the articles encompassed by ‘Harnessing the power of technology to improve lives’ affirms that the lives of people are complex with many situations where technology – assistive technology – might, can or does already make a real difference. It highlights the AAATE interest not only in innovating in matters of technology but also around services and service provision. It is clear that the smartphone and tablet computer, through apps, continue to increase the independence and quality of life of their users. However, it is also clear that further innovation of ICT and other forms of technology for use in people's lives is as necessary as ever: some people need a better rollator, white cane or wheelchair as much, or even more, than they do a digital device. In 2017 robotics has really been brought to the fore with a global – especially Japanese and European – collaboration to offer three whole sessions discussing their uses for providing independence and care. These sessions raise many complex issues, not least around the ethics of their use, issues which are bound to be the subject of debate and discussion in AAATE conferences for years to come.

Peter Cudd

Luc de Witte

Evert-Jan Hoogerwerf

Conclusions were synthesised from recent reviews on (touchscreen)technologies and people with dementia and lessons learnt, using these devices in projects in the UK, the Netherlands and Canada. The combined findings provide a strong basis for defining new strategies for exploiting touchscreen technology for people with dementia.

Cognitive impairment may cause difficulties in planning and initiating daily activities, as well as remembering to do what is scheduled. This study investigates the effectiveness of an interactive web-based mobile reminder calendar that sends text messages to the users mobile phone as support in everyday life, for persons with cognitive impairment due to neurological injury/diagnoses. The study has a randomised controlled trail design with data collection at baseline and at follow-up sessions after two and four months. Data collection started in August 2016 and continues until December 2017. The interactive web-based mobile reminder calendar may give the needed support to remind the person and thus increase the ability to perform activities and to be independence in everyday life. Preliminary results will be presented regarding what effect the interactive web-based mobile reminder calendar have for the participants performance of everyday life activities as well as perceived quality of life.

Dementia is a progressive brain disease with a decline in functioning over time. CRDL (pronounced as Cradle) is an interactive instrument, developed to stimulate communication between users through sound and touch. It recognises the intention of the touch (tickle, holding, grabbing, fondling, kneading, and tapping) and will adjust the sound accordingly. This qualitative observational study explores whether this innovative product has the potential to be used in elderly care to create a moment of interaction between the person with dementia and someone else or multiple others. In a nursing home facility in the south of the Netherlands CRDL has been studied in one-to-one interaction between a person with dementia and a member of their family, a healthcare professional or a recreational therapist (n = 7), and group interaction between several people with dementia and a healthcare professional or a recreational therapist (n = 5). In the one-to-one interaction study professionals and family members reported that the interaction with CRDL and the person with dementia was a pleasant experience. They also mentioned that it felt familiar and they had the feeling that they were in better contact with the person with dementia. The exit interviews with the professionals and family members indicate that CRDL has the potential to encourage the interaction between the healthcare professional, recreational therapist or family member and the person with dementia. Healthcare professionals and recreational therapists who used CRDL in a group interaction session reported participants were generally fascinated by the object itself, but needed active encouragement to interact. The role of the healthcare professional, recreational therapist or family member seems very important.

Independent Living Functions for the Elderly (IN-LIFE) is a 3 year multidisciplinary, multisite European project that aims to prolong and support independent living for people with cognitive impairments, through (ICT) services. Sheffield is one of six research sites and is focused on enhancing communication and conversations using touch screen computers.

As the demographic change progresses, dementia is going to become a prevalent condition in many countries. In order to keep the Quality of Life (QoL) of People with Dementia (PwD) on a steady level, Assistive Technologies (AT) implemented on table-sized Surface Computers (SC) that promote playful and/or reminiscence-triggering activities turn out to be valuable tools for dementia care. This article gives an overview over two similar multimedia-based AT systems implemented on Microsoft PixelSense SCs and field-tested in dementia care institutions. The observations indicate that both systems can trigger positive emotions and activities as well as memories.

This technology evaluation study assessed a personalised digital prompter designed for people with dementia, by trialling its use in the home by people with dementia and their carers.

Technology based prompting may be used to support people with dementia to complete multi-step tasks in the home, provided that suitable tasks can be chosen and that a carer is able to load appropriate task steps onto the prompter. A prompter was developed specifically for this purpose, along with a detailed guidance manual.

Twelve participants with mild or moderate dementia carried out cognitive tests and their carers completed carer burden and carer competence scales. Each pair attended a training session with a researcher and were provided with the prompter and instruction manual.

The prompter was trialled at home for four weeks after a one-week familiarisation period, for use with a simple set task and one or two tasks chosen by the participants. Semi-structured interviews were used to capture the views of the participants at the start and end of the home testing, and to set and evaluate goals.

Chosen tasks included preparing simple food and drinks, and using home appliances including coffee machines and television remote controls. There was a weak correlation between greater goal success for the participants and the carer goal success, number letter switching within the D-KEFS and ACE-III score.

A thematic analysis of the interviews revealed three core themes relating to familiarity with technology, utility of the prompter and the cost versus benefit in terms of the effort required to set up the prompter.

Factors influencing success could be grouped into: participants' motivation and capability; the design of the prompter; and the details of the task being carried out. Barriers to success included the difficulty of choosing a suitable task and the effort required to break down a task in to appropriate steps.

All of the participants with dementia could follow the steps on the prompter, and all of the carers were able to choose, breakdown and load at least one task onto the prompter during the training session, but successful use in the home was varied because of the increased complexity of the home context. Changes to the hardware, software and manual were made in response to the data gathered during the study, in readiness for the planned further testing.

The design of a smartphone application (app) for promoting healthy lifestyle choices has been investigated for people with mild cognitive impairment. The app was designed to provide health-related messages and assist users to keep track of activities such as walking, eating and drinking water. A reward scheme with gold, silver and bronze awards was incorporated as a means of assisting user motivation. Responses to the app and user feedback were gathered for purposes of evaluation and improvement. Outcomes indicate that the approach has some potential and could have good implications for encouraging positive health-related behaviour change in this population, hence prompting further investigation and development of the concept.

MARIO is a companion robot that aims to help people with dementia (PWD) to battle isolation and loneliness by enabling them to stay socially active by providing a number of applications focused on hobbies (music, movies, etc), staying engaged with communities (reading headlines, reading local twitter feeds etc.) and staying connected with family and friends (telephoning them, reading their news from twitter, etc.). This paper presents the results from the initial trials of MARIO interacting with PWD involving a limited set of applications. It confirms some of the challenges hypothesized at the outset of the study and provides guidelines for future development work.

Assistive technologies play an important role in promoting healthy aging, independent living and aging-in-place, yet many experience unmet needs. This project reports on three citizen panels and a stakeholder dialogue convened in Canada to spark action towards enhancing equitable access to assistive technologies for older adults.

Older adults may benefit from decision support systems for the selection of assistive technologies. We present a case study cross-cultural adaptation in Canada of a system developed in the United Kingdom. We describe a conceptual framework for examining challenges with cultural and literacy issues and ways to address them.

Ethical issues arise when the risks and benefits of technology use are unclear or controversial, or their access inequitable. This paper presents a preliminary framework for understanding ethical issues related to IT development and adoption by elderly persons with cognitive impairments and their caregivers. The development of the framework relied on a hybrid qualitative approach that draws on several data sources: 1) systematic literature review, 2) focus groups with IT users, and 3) a reflexive researcher-learning diary.Preliminary findings were synthesized into a coherent model that views IT adoption as the outcome of complex interactions between different factors: 1) Personal factors that include the cognitive abilities of the users, as well as their physical and sensory limitations, and 2) Environmental factors that are related to the technology, the caregivers, and the support networks of the user with cognitive impairment. Findings from this project will help better understand, balance, and responsibly address the competing ethical issues at play in technology development and adoption by elderly persons with cognitive impairments and their caregivers.

This paper presents the theoretical and methodological framework underpinning the advancement of new technology enabling seniors domicile in residential homes to live with independence, quality of life and dignity. In addition, it presents the preliminary findings of this research including the emerging user interface design solution.

This paper presents the findings of the first end-user research study with seniors who are not familiar with operating ICT devices, executed as part of the EU-Active and Assisted Living research project Kith & Kin. This project aims at developing an ICT device for these seniors by building on their needs and real capabilities, encouraging communication and fostering social inclusion.

The service delivery of Assistive Technology for access to information and communications technology is frequently fragmented and inconsistent as evidenced by experience in the US and much of Europe (AAATE 2012). AT users can experience hiatuses in their access to appropriate assistive technologies as they transition from home to education, to employment and in the community. An AT Passport can provide a record of Assistive Technology requirement and use across the lifespan.

This paper overviews new and emerging wireless technologies that could positively impact on the lives of the elderly or disabled, as Social Care users of Assistive Technology (AT) for ‘independent living’. Novel Internet of Things (IoT) radio systems and wireless locating systems being researched at The University of Sheffield are discussed in the context of Social Care technology use-cases.

The study reported in this paper developed criteria and guidelines for writing up a good-quality AT Assessment Report - a document which is often required to activate an assistive technology intervention for an individual client. The Report should provide precise recommendations about the assistive solutions that best meet the client's needs, explain the underlying reasoning, provide evidence of appropriateness for the funding agency and set the baseline for later measurement of the outcomes of the intervention. Within this study, forty-eight clients with severe disability conditions were recruited in nine rehabilitation Centers in various regions of Italy. They were assessed for assistive solutions by their rehabilitation teams according to a common protocol; assessment Reports were produced for each client according to the same template, and individual AT interventions were activated following the recommendations. Then the Reports underwent a blind peer-review exercise involving over fifty professionals, who evaluated their quality against ten criteria; based on the findings, the template of the AT Assessment Report was revised and good-practice guidelines were inferred for the contents of each field. Now the final version is freely downloadable and is being used routinely in the Centers that participated in the study.

A lack of widely accepted guidelines/protocols for remote prescription of assistive technology is noted. This paper reports observations from attempts to use web based videoconferencing with embedded tools for the provision of assistive technology to children with complex needs.

Central Hospital Districts (CHD) in Finland provide most of the Assistive Technology Device Services (ATDS). ATDSs have been developing their work and unifying their practices regionally. Each of these 20 CHDs have their own guidelines for the ground rules for lending assistive technology devices. These ground rules include principles of ATD Services and lending rules for different device groups classified by ISO 9999 standard. There has been a growing pressure to unify the practices of ATDS nationally, because of a growing need for devices and economy. A project to unify National Guidelines was set up in spring 2016. There were four different review rounds among CHD ATD services and patient organizations. The Ground Rules will be published in 2017.

An online video communication system is presented that enables Occupational Therapists (OTs) assess patient homes for assistive technology needs before acute care discharge to ensure appropriate independence and recovery conditions. Explorations under multiple conditions revealed perspectives from OTs and volunteer facilitators. Preliminary key findings and insights are reported.

The present study was based on a systematic review of reviews and meta-analyses and aimed to identify technologies being used to provide home monitoring to support older adults with chronic diseases and to promote their empowerment, as well as to identify how these technologies impact health related outcomes.

Recent investigations in several EU-projects, incl. IN LIFE revealed that experts in the field of eAccessibility & eInclusion (eAcc&eIncl) – but also general ICT developers, decision makers in industry and administration – are quite unaware of the importance of standards for interoperability and sustainability of ICT solutions. Especially, if persons with disabilities (PwD) are concerned, system development and the design of services can become unnecessarily costly. For accessibility in general and eAcc&eIncl in particular, knowing about pertinent standards is becoming an asset of personal competencies of experts and decision makers, and particularly benefit small enterprises. Given the complex world of standardization and the multitude of standards developing organizations (SDOs) easy access to information on standards is critical.

Kwazo instrument was designed to assess the customer's satisfaction with prescription and attribution services of assistive technology. This paper presents the cross-cultural translation and validation of the European Portuguese version of the Kwazo, whose psychometric proprieties were assessed by customers of rehabilitation facilities of North and Centre of Portugal.

Limited scientific evidence on the effectiveness of psychiatric service dogs used by Veterans with post-traumatic stress disorder (PTSD) is available. This study investigated their short-term effectiveness among 15 Canadian veterans who received a first psychiatric service dog. Preliminary results suggest potential beneficial effects at 3 months on the psychiatric symptoms.

The modified System Usability Scale (SUS) is a widely used generic measure of product usability. This study concerns the usability of mobile shower commodes using correlations between the SUS and AT device-specific measures. Results suggest the modified SUS, and corresponding adjective-anchored rating scale, are appropriate for measuring MSC usability, and have potential for use with other AT devices.