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Computer Assistive Technologies for Physically and Cognitively Challenged Users focuses on the technologies and devices that assist individuals with physical and cognitive disabilities. These technologies facilitate independent activity and participation, serving to improve daily functional capabilities.
The book features nine chapters that cover a wide range of computer assistive technologies that give readers an in-depth understanding of the available resources to help the elderly or individuals with disabilities. The topics covered in the book include 1) The category and ontology of assistive devices, 2) Web accessibility and ICT accessibility for persons with disability (PWD), 3) Assistive technologies for blind and visually impaired people, 4) Assistive technologies for home comfort and care, 5) Assistive technologies for hearing impaired people using Indian sign language synthetic animations, 6) Augmentative and alternative communication/hearing impairments, 7) Accessibility innovations to help physically disabled users, 8) Adhesive tactile walking surface indicators for elderly and visually impaired people mobility, 9) future of assistive technologies.
This book serves as a textbook resource for students undertaking modular courses that require learning material on computer assistive technology. It also serves as a reference for graduate level courses in disability studies, human-computer interaction, gerontology and rehabilitation engineering. Researchers working in the allied fields intersecting computer science, medicine and psychology will also benefit from the information provided in the book.
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This book aims to collate the methods and literature related to techniques that will aid the life of cognitively challenged individuals. A cognitive impairment (also known as an intellectual disability) is a term used when a person has certain mental functioning limitations and skills, such as communication, self-help, and social skills.
The content presented in this book discusses the range of methods/techniques that will improve the life of a person with cognition problems. The range of topics like the ontology of cognitive devices, accessibility hardware and software, assistive technologies for Vision impairment, hearing impairment and communication impairment has been detailed extensively. This edited book also sheds light on upcoming trends, challenges, and future research directions in assistive technologies for cognitively challenged users. We editors believe this book will help researchers, students, academicians and medical practitioners know and adopt state-of-the-art technologies in cognitive disability. We extend our heartfelt thanks to our reviewers, who have extended their support despite their busy schedules. A special thanks to all our authors for submitting the work. Our sincere thanks to Bentham Science publishers for accepting our proposal for editing this book and supporting us extensively during the editing process. Our thanks to one and all who have directly or indirectly rendered support for completing this edited book.
We believe the efforts we rendered for editing the book are worthwhile only if this book is of any use to the ordinary end-users of our society. This satisfaction will fuel us to come up with more edited books that will be useful for society at large.
The majority of physically challenged and elderly people demand a lot of care when it comes to assistive technologies that can provide tailored services to their needs. The primary concern of advancement in Assistive technology is to address a wide variety of disabilities and intellectual impairments for societal benefits by reducing welfare costs and allowing for an efficient workforce. To better respond to changes brought on by modernity, it is necessary to understand how assistive technology interacts in that group. The broad range of assistive devices in the continuum of assistive technology can help people with various impairments. Based on the underlying technology, the Categorization of assistive devices has important implications for clinical usage when examined through the perspective of social phenomenon. In the realm of Assistive Technology, a consistent focus on the relationship between the individual and the supported activity within certain contexts is essential. Assistive technology can be viewed from the perspective of various performance areas. The Ontology-based Assistive Devices that are among the finest within common, everyday contexts for more relevant applications are interesting. This chapter explores all those essential elementary and general considerations of assistive devices that form the bases of Assistive technology and brings out the categories of assistive devices and the various application domains where assistive devices can be served as a derivative of a particular ontology. The chapter focuses on the various performance areas by addressing the issues associated with Assistive technology Practice.
The population of aging adults is expected to reach more than two billion by 2050. In a society where the life expectancy and increasing need for assistance are
advancing, it is becoming more likely that elderly people will need the technology to accomplish critical and necessary tasks. Assistive technology is the most prominent and prime solution that exemplifies how technologies can be used to meet the requirements of the elderly. People with disabilities, those who live longer, those with non-communicable disorders, and those needing recovery are all potential beneficiaries of assistive technologies, which help them live independently and enable them to maintain their dignity. In a broader sense, assistive technology is needed for all people with cognitive/physical disabilities, mental health disorders, progressive functional impairment, non-communicable diseases, etc. Assistive technology aims to ensure that any artificial aid a patient takes, requires no external dependence. For the moral well-being of the patients, it is important that they feel independent and can manage the majority of their tasks on their own.
Assistive Technology (AT) is either an element or a piece of equipment used to enhance, preserve, or expand the associated support of an impaired individual's life. Reasonable assistive technology may also help individuals accommodate a disability, at least partially. Traditionally, the word “assistive technology” has been used to refer to computer software and hardware, as well as digital equipment.
Assistive Technology is a broad term that refers to a range of low- to high-tech devices whose major intention is to enhance a person's individual functioning and mobility in order to maximize involvement and greatly improve quality of life. Mobility aids, such as prosthetic devices and orthotic devices, cognitive aids, such as electronic or electrical assistive devices, and high-performance mobile devices that enable people with disabilities to participate in sports and be physically active are some of the examples. They can also help avoid impairments and secondary health problems by encouraging independence and autonomy in the person and those around them.
Assistive technology offers opportunities for every individual with a disability by providing the most appropriate technologies and removing environmental barriers to functioning. Computers are the entities most widely associated with Assistive Technology. However, a broad spectrum of Assistive Technology ranges from mainstream gadgets to exoskeletons and robotics, sophisticated automated systems, intelligent houses, etc. The technology support includes ergonomics and telerehabilitation with the aid of environmental accommodations and service delivery systems.
People with learning difficulties are increasingly turning to assistive technologies for help. Nevertheless, general computer use is a relatively widespread phenomenon, as seen by the availability of computers for a wide range of applications. The potential advancement in the computer environment has changed the nature of technology support. First, in the last decade, technology has emerged as a platform where powerful yet cheaper modern equipment can be afforded. Second, a lot of new technologies have developed. Third, the sophistication of technology has improved significantly, especially in the realm of computer software. Traditional technology has little in common with modern technology, which features realistic sound, spectacular images, and on-screen videos. According to the current consensus, computer technology and other innovations have a great deal of potential for improving the capacities of children, teens, and adults with learning difficulties.
Equal opportunities are everyone's rights, but people with disabilities are often ostracised, marginalized, and driven into poverty, which intensifies the impact of psychological distress on a person's social environment and makes it critical to provide helpful services to individuals with a diverse range of impairments. Self-management skills refer to the capabilities to govern one's beliefs and actions. A self-motivated, physically challenged individual can strengthen confidence to manage potential tasks with significant and precise technology-driven assistance. An assistive device-based task accomplishment paradigm can enhance an individual's self-management ability by solving ongoing issues and assignments. There are two main goals of assistive technology. First, it can enhance an individual's strengths so that personal abilities can compensate for any impairments. Second, technologies can provide an alternative means of executing a task, allowing for compensation or eliminating limitations.
The typical assistive technology user has an impairment that necessitates using a compensatory solution in an attempt to gain more independence. The user's ability or disability can vary. It might range from someone who has a spinal cord injury and can only move their head to someone who suffers from carpal tunnel syndrome and has pain when opening their mouth. Technology can be beneficial to both adults and children. Individuals with a short illness, a long-standing impairment, or a neurologic condition in which the individual's functional abilities will continue to deteriorate are almost all illustrations of AT users.
The Foundation Period - AT started when the population of people with disabilities, injuries, and troops who survived the wars increased in the early 1990s. As disability disciplines were established during this foundation period to motivate independence and productivity, social perception towards individuals with disabilities changed positively. As more people began to live independently, the use of AT increased. Different acts were passed to help and give rights to individuals with disabilities.
Many things that were invented in the past are still being used today. The ear trumpet, which emerged during the 17th century, remained widely accepted in various sizes and shapes. In 1800, various educational fraternities adopted a systematic approach to the blind invented by Louis Braille. Most sign languages are legally recognized. With the aid of a microphone and telephony, hearing aids were developed in the 19th century. While wheelchairs have been used for generations, the first lightweight, foldable wheelchair, which employed an X-joint to allow it to be flattened, was designed in the 19th century.
Empowerment Period - The empowerment period is when individuals with disabilities are given the right to pursue their life goals. Many legislations passed to improve the rights of individuals with disabilities, such as the rehabilitation act 1973 and the individuals with disability education act 1997. Most notable AT technologies, such as Closed Caption Television (CCTV), talking calculators, and the very first prototype of a voice synthesizer, were developed during the empowering period. Most ATs were invented during this period to improve independence and achieve goals for individuals with visual and hearing impairments [1]. People realized the “desire to accomplish” during this empowerment period.
Many innovative thinkers and scientists have looked for the technical possibilities to indulge the lives of people with physical disabilities and other associated problems. Every technological advancement, from modest prosthetics in the middle ages to complex electronic systems, aims to improve the quality of a person's life as much as possible.
Assistive technology encompasses selecting, locating, and using assistive and rehabilitative devices for persons with impairments. It's important to realize that this sector has much fragmentary development despite its enormous potential and reach. The domain is fiercely competitive, but it needs the right assistive technology solutions to achieve it. However, the following organizations which create and pay for administrative assistance devices and workplace technologies primarily employ them:
Private-Health-Insurance- When a medical practitioner suggests assistive technology as a vital rehabilitative aid, healthcare entities can employ various assistive technologies that make it easier for nurses to provide quality care to their patients.
Business Employers- In a business organization, Assistive technology can be used to provide fair compensation for employees to complete vital activities assigned to them at work.
Job Training Programs and Rehabilitation - They use this technology to assist individuals in finding jobs. With ease in the training process and more skills added with the help of AI and ML solutions in everyday life, it becomes quite easier for new people to join interesting professions.
School System- They use it for conventional school educational resources as well as technology that is part of Individualized Education Programs (IEP).
AI and ML have transformed the Healthcare, Business, Education, and other sectors and welcome the new technology for efficient services. Over the years, we have transformed how things could be better worked on and what solutions can make it easier for the patients to meet their needs.
When exploring various impairments that might be addressed with assistive technology, it's crucial to understand how each impairment is actually dealt with and what the response might be to treating such concerns in everyday life.
Assistive technology aims to make sure that any artificial aid that a patient takes requires no external dependence. For the moral well-being of the patients, it is important that they feel independent and can manage the majority of their tasks on their own. It is here that Assistive Technology comes into the picture. Numerous IT service companies worldwide are constantly improving Assistive Technology and its associated solutions. Various supplemental technological innovations and strategic initiatives have been devised, all of which are uncomplicated to use, precise, and approachable.
Hearing: There is a variety of approaches to present sound visualization for people with hearing impairment to provide a fresh experience. Users can use options like Mono Audio, Adapt Sound, Flash Notification, Turn Off All Sounds, Sound Balance, and Create Vibration after the hearing aid keeps track of incoming messages and guarantees they won't miss sound notifications.
Vision: The device's revolutionary and innovative features allow users to view it with ease and get the most out of it in practically any environment, even if the screen isn't visible.
Dexterity: When using several gestures the device requires is difficult, a user can control them with an intuitive interface. A User-friendly and streamlined user interface makes it simple to access the options with Assistant Menu.
Interaction: Users frequently make unintentional touches on their smartphone screens; the service allows them to adjust the harsh response from the target area. As a result, the device's touch control is more precise, and the operator may accomplish quite well with the gadget by simply touching it just once.
Based on the function being performed by the Assistive Technology within the intervention, the AT devices can be categorized into two broad classes: those that are involved in the action prioritization and those that impact self-awareness. The chapter initially focuses on the categories which include the most commonly used assistive technology devices, such as self-care, communication, and safety devices, independent living aids, medication aids, incontinence supplies/aids, reading, and vision aids, home modifications, vehicle modifications, accessible vans, etc. Under this section, a focus has been made on design considerations, evaluation of functional capabilities, and possible outcomes of assistive devices. In Section 3, the ontology of assistive devices has been explored in which the mechanism of usage of technology concepts and relationships to enable standards for a community of humans with various impairments are discussed. A deal with performance areas has been made in Section 4, which includes Assistive Technology for Cognitive Augmentation, AT for Enabling Mobility and Transportation, Assistive technology for home comfort, Controlling the Environment, AT Consideration for Emergency Situations. Further, Assistive Technology Applications have been discussed in various contexts, such as Workplace, Healthcare Industry, etc. The issues and challenges of professional practice and efforts to make Assistive Technology Practice more affordable and accessible have been reviewed.
The objective of the chapter is to emphasize the exploration of assistive devices and fundamental performance areas, where assistive devices can meet the purpose of employment. The general considerations and elementary features have been described to provide an understanding of various assistive devices. The organization of the chapter is as follows. The initial part deals with the categories of assistive devices based on the underlying technology involvement. Next, as a part of framing the categories, the design considerations, evaluation of functional capabilities, and possible outcomes of Assistive devices are discussed. Further, performance areas have been made focusing on ontology and general-purpose assistive technologies. Various issues associated with assistive technology practice and attempts to maximize the accessibility and affordability of Assistive technology are also discussed.
Most assistive devices exhibit a multifunctional nature, which makes it difficult to find a proper categorization framework. However, there are certain ways to categorize Assistive Technology Devices. Based on the characteristics, the devices can be classified into two groups: those that influenced self-awareness and those that required action prioritization [2]. Nevertheless, it is unsurprising that Assistive Devices may fall into more than one category, depending on the individual's needs and how and where the person uses the AT. As a result, grouping Assistive Devices based on the underlying technology, nature of the operation, acquisition ability, and associated cost will be a better practice. As a result, it can be seen that assistive technology can range from no and low-tech to high-tech solutions (Fig. 1).
Fig. (1)) Categories of Assistive technology.The use of Assistive devices moves along the Continuum of Assistive technology from no and low-tech to high-tech, based upon the needs of the individual [3]. And hence, Assistive technology tools fall into one of these categories: No-technology devices, Low Technology devices, Mid-Technology devices, and High Technology devices. Fig. (2) shows most of the AT devices that are categorized based on the underlying technology support.
Fig. (2)) Infographic of Assistive technology category.No-tech AT devices require absolutely no machinery and can be as incredibly easy to make as one desires. These are services that rely on procedures and services already in existence in the environment rather than relying on devices or technology. Simple, non-electronic solutions that provide access and improve functional capacity are referred to as No-tech AT. Devices like modified spoon handles, custom-designed pencil grips, and picture communication displays are examples of AT solutions that can be made or purchased commercially at a cheap cost. The most common No Tech Solution involves Changing the environment, rules, or practices to reduce obstacles without bringing additional items or equipment. In lieu of overhead lighting, using the lights, modifying seating arrangements to provide a comfortable space for someone to work, using three-ring binders instead of binder clips to hold papers together, and visible work schedule in the classroom environment, Post-it-Notes during reading instruction and a number line during numeracy instruction are the most common illustrations of employing the No technology devices.
Low Tech Assistive Technology involves adaptations of very few or limited electronic components. They are relatively cheaper than electronic and digital tools and are often repurposed tools and items that were not originally intended to be assistive technology. Low-tech tools tend to be more readily attainable and easier for the user to learn. These are usually low-priced/affordable or easy to make by using disposable or inexpensive materials. Low-tech devices can be used and manipulated by the individual independently.
Low tech is a word that refers to out-of-date technology that is intended to be as minimal as possible. Low-tech does not necessitate the use of a power source. This is sometimes the simplest and most practical assistive technology solution. An individual can have the best support of high-tech assistive technology if he always has a low-tech “backup”. Technology can malfunction, batteries can drain, and disasters can strike, and in such cases, using their low-tech equipment, people can continue to meet their needs. Low-tech devices may also be all that a user requires. For some people, high-tech is not the best option.
In a regular school supply store, there are numerous low-tech reading and writing Assistive Technologies. Individuals with low manual dexterity can utilize writing gadgets like Pencil grips or Oversized Pencils to assist them in acquiring a better grasp on writing instruments. Slant & Clipboards help handle documents in position at an inclination, making it convenient for those individuals who cannot turn their wrists to try writing on a flat plane or anyone who has difficulties holding their paper in position during writing. Note-taking assistance, including such enhanced line papers or signature cards, makes it easier to write on a slip of paper. When used with learning methodologies, reading gadgets such as Highlighters and Sticky Notes provide structured learning help and reminders of essential concepts. Reading Aids makes it easier to read by moving over the pages and only obeying one piece of text at a time. Page Magnifiers enlarge the text on a printed page, making it simpler to read.
The term “mid-tech” refers to a relatively new technology platform that combines certain advanced features. Consequently, it is widely considered that both mid and high technologies are always superior to low technology. Conversely, as mid-and high-tech solutions become more common, their intrinsic complexity is increasingly perceived as a major inconvenience, inefficient, overpriced, or inconvenient trait. Mid-tech assistive devices are electronic gadgets that require batteries to work and may or may not require training to use.
Mid-tech Assistive devices used for learning include audiobooks, MP3 players, and other audio playback devices. Audiobooks and sound files may be useful if a person has difficulty reading printed materials. Individuals can utilize digital recorders as a mid-tech tool to take notes and enable the collection of audio to guarantee that no data is missing because of writing complications.
Wheel-chair, Screen magnifiers, Gait trainers, Laser pointers, Voice amplifiers, Beep boxes, scooters, Braille translation software, Talking pedometer/watch, Switch adapted toys, Adapted seating, keyboards, Calculator, Electronic speller, etc., are the most well-known Mid Technology devices. Augmentative and Alternative Communication (AAC) devices rely on Mid technology, generally called speech-generating Devices (SGDs), which are typical battery-operated electronic devices and have simpler functions, whereas “high tech” AAC devices are electronic devices with highly advanced processors.
High-tech AT devices, such as computers and specialised software, are more complex electrical devices that often include both hardware and software and include numerous functionalities to satisfy a variety of needs. High-tech AT is frequently used in conjunction with low-tech systems that can be employed in specific scenarios or as a backup in the event of a malfunction. Individuals with major functional impairments are the most common users of high technology, which is connected with almost necessary features but steep learning curves, complex restrictions and unpredictable results make it difficult to acquire, use, and maintain.
High-tech assistive technology aids for writing include software, apps, and hardware devices. Text-to-speech, highlighting and notes, digital reading aids, idea mapping, word prediction, and a variety of other capabilities are all available in various literacy software packages. Evernote and Notability are note-taking apps that let users create an electronic notebook that can be shared and linked to reminders. The speech recognition software can transcribe an audio file into a text document when used in conjunction with a digital recorder. Smart pens, like the Livescribe pens, employ software combined with hardware to capture audio and sync it with notes on specific paper and note-taking apps like Evernote.
The design of the assistive device system looked to be tough even after several years of feedback. Although most assistive devices for the disabled appear to be easy, the technology that underpins their design and execution is usually fraught with complications. One of these challenges is that designers cannot depend on their own user experience since their capabilities vary markedly from those of disabled people. Development and Engineering for disabled individuals is a highly specialised object of research that examines how to establish a design strategy while working with impaired persons. There is no consensus in the scientific literature about which design technique is the most efficient when designing for impaired people or what aspects should be considered when picking the best acceptable design method.
For designing assistive devices, the most extensively utilised techniques and tools are User-Centred Design (UCD) techniques and tools (modular elements of one distinct design method) [4, 5]. User-centered design (UCD) is a design strategy that stresses product adaptability to the user by involving the user throughout the design process [5, 6].
Many alternative approaches to AT design, such as iterative process, participatory design, emotion-driven design, USERfit & AD-SWOT & AD-TOWS, follow a UCD approach in some ways (such as involving users in various design stages), though the other design methodology is claimed.
Assistive technology (AT) has a range or continuum of “low tech” to “high tech”. Both, the amount of technology as well as training required for the person who will be using it, decides whether the AT is low-tech or high-tech. Each piece of AT is tailored to the individual's needs and ability. The following steps are commonly involved in providing an AT evaluation after you and the individual determine the evaluation is necessary.
Referral: As a service provider, we might request that an AT professional become involved in providing services. This typically involves the completion of a referral form, an in-person or telephone conversation about the person's needs and the determination of the funding source.
Scheduling and Evaluation: An evaluation often takes place on the job or in an educational setting. Evaluations can range in time from an hour or less in a single visit up to several visits over several hours.
Report: The evaluator(s) generate a written list of their recommendations that typically includes specific equipment and services. In many cases, the individual can borrow trial equipment during and/or following the evaluation before the evaluator makes a final recommendation.
Implementation: Once VR approves the recommendations and authorizes the funding for the equipment and any related costs, you will collaborate with the individual receiving services and your team to schedule and provide training and other services. You may need to arrange for ongoing technical support for a prescribed time.
People's attitudes regarding today's technology range from those who use it frequently and frequently and comfortably to those who use it rarely and with unease. Despite the fact that there are presumed positive correlations between AT utilization and living standard, non-use may not rule out obtaining a significant level of life expectancy. Those who believe capability enhancement in the context of a comprehensive assessment of a person's interests, needs, and life experience presume it is truly essential and cost-effective to improve a person's life quality, not just to restore functionality; to confront a person's emancipation necessities. Furthermore, the dynamic interplay between functional capacities, technological utilisation, and quality of life evolves with time. As a result, this complex of issues must be handled on a regular basis.
The outcomes of an Assistive Technology Device framework begin when the device is purchased or placed in the consumer's hands [7, 8]. It progresses from short-term to longer-term outcomes such as Device Satisfaction, Effectiveness, Psychological Functioning, Efficiency, and Subjective, along with the influence of moderating factors such as personal and contextual factors. Environmental and Personal Factors are used by the AT components of Participation and Activities. All of these constructions are dynamic and recursive, which is crucial for the examination of ATDs. That is, they can modify and impact one another over time as a result of ATD use. As a result, they must be re-evaluated on a regular basis when looking at both short- and long-term outcomes.
When it comes to matching a person with assistive equipment, there are numerous aspects to consider (Fig. 3). Irrespective of a category, a person is either a user or a non-user of the product under review. People, on the other hand, may differ within the classifications of use or non-use: use could be full-time and voluntary, or partial and hesitant; non-use can be due to completely avoiding or abandoning a gadget.
Fig. (3)) Feature Matching for the Assistance.An individual can simultaneously utilize any number of appliances that may belong to any number of categories. The introduction of any new device may replace the existing one, but this can create a situation where a user can find it more difficult to operate and adjust to the new features. Since it is known that a system made of many elementary supports might have an additive effect, resulting in a condition of overwhelmingly advanced for an individual, device configurability is expected to become a significant topic of concern as time goes on. The formal and informal process of determining the attributes of Assistive Technology are needed and desired as part of the AT Assessment Process.
The concept of ontologies is critical for facilitating knowledge sharing and reuse. An ontology [9-11] is a formal description of concepts and relationships that really can emerge for a community of human and/or computer entities. An ontology is a characterization of a set of ideas in a shared domain [5] to facilitate the dissemination of information about technological products and best knowledge sharing, as well as set the way for a completely standardized evaluation procedure.
There have been no specific ontological matching initiatives for individualised preference portability across different programmes, platforms, and devices in the realm of assistive technology. However, the most important factor to consider when explaining the ontology of assistive technology is 'accessibility,' which ensures that people of various capabilities can interact with information and communication technologies (ICTs) [12]. Generally, the Ontology of the assistive devices can be formed on the basis of either the Matching Person and Technology (MPT) [4, 6] or Human-activity-assistive technology (HAAT [13-15]) models. The Human Activity Assistive Technology (HAAT) paradigm, which focuses on the relationship between the disabled observer and the facilitated activity in specific situations, is the most extensively used approach in the field of assistive technology. The Matching Person and Technology model [16] is quantified through a set of well-grounded and reasonable measurements which allow for a customized person-centered strategy to match people with the best solutions for particular needs.
The Human Activity Assistive Technology (HAAT) paradigm represents any individual engaged in a certain activity while using assistive technology in a specific situation. The model's emphasis may be on an individual performing a task in a specific environment. As a consequence, any application of the framework begins with someone doing something in context, followed by the AT. The exercise, the individual, the Assistive Technology, and the context are the 4 elements of the HAAT model. The model's transactional aspect is supposed to portray an individual's experience when participating in activities, which contributes to AT by stressing the potential influence of the person's experience in a situation as he interacts with others and nonhuman elements. Situated knowledge is a notion that describes how a user's perceptions and interpretations of his current experience influence the current circumstance.