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A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Behavior, Chronic Disease and Health Promotion".

Deadline for manuscript submissions: closed (15 September 2020) | Viewed by 38261

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Prof. Dr. Helena Hemmingsson

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Guest Editor

1. Department of Special Education, Stockholm University, 106 91 Stockholm, Sweden.
2. Division of Occupational Therapy, Linköping University, 581 83 Linköping, Sweden
Interests: ICT; eye gaze controlled computer; children with disabilities; digital equality

Special Issue Information

Dear colleagues,

We are organizing a Special Issue on Assistive Technologies for Children, Young People, and Adults in Environmental Research and Public Health. The venue is a peer-reviewed scientific journal that publishes articles and communications in the interdisciplinary area of environmental health sciences and public health. For detailed information on the journal, we refer you to https://www.mdpi.com/journal/ijerph.

Assistive technologies’ relationship with public health is recognized, since they enable people to stay active and independent and facilitate participation in education, work, and civic life. They also have the potential to reduce institutional care and care-giver burden. In spite of this, the link between assistive technology and health on a national level is weak in most countries, and few, including high -income countries, have a national assistive technology policy or program. The World Health Organisation (WHO) reports that only 1 in 10 people globally have access to needed assistive products. The problem is more acute in low- and middle-income countries, having a great impact on people’s opportunities regarding work, education, and well-being. To address these problems, the WHO launched the program Global cooperation on Assistive Technology (GATE), emphasizing that access to assistive technology offers a public health solution to meet the needs of 21st century populations.

Assistive technology is an umbrella term for technologies that are used to maintain, increase, or improve the functional capabilities of people with disabilities, including people whose abilities decline because of age. Related concepts and areas include, for example, accessibility, universal design, information and communication technologies (ICT), and smart environments. The digitalization of nearly all parts of society has not only changed the technical landscape but also our habits and how we perform everyday activities, and, increasingly, accessibility features are being built into mainstream products.

Considering the huge potential assistive technologies have on people’s health, well-being, and participation in society, the body of research that links assistive technologies to people’s opportunities for a healthy and active life is incomprehensively scare. Research is needed on the design and development of accessible products; the usability of assistive technologies for intended groups, services, and regulations related to assistive technologies; standardization in the area; the usability of products; and most urgent intervention studies in which the effect of assistive technologies for people’s everyday lives and participation is researched. Thus, we are inviting research on all aspects of assistive technologies; we provide some keywords below that suggest just a few of the many possibilities.

Prof. Dr. Helena Hemmingsson
Guest Editor

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Keywords

Self-help devices
Information and communication technologies
Universal design
Policies, legalization, and guidelines
Services;
Intervention studies
Human rights
Augmentative and alternative communication
Hearing aids
Assistive technology for cognition
Digital accessibility
Smart environments
Robotics
Technologies for aging
Assistive technology provision
Assistive technology standards
Assistive technology for inclusive education

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Published Papers (9 papers)

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14 pages, 397 KiB

Open AccessArticle

How Loan Bank of Assistive Technology Impacts on Life of Persons with Amyotrophic Lateral Sclerosis and Neuromuscular Diseases: A Collaborative Initiative

by Thais Pousada, Jessica Garabal-Barbeira, Cristina Martínez, Betania Groba, Laura Nieto-Riveiro and Javier Pereira

Int. J. Environ. Res. Public Health 2021, 18(2), 763; https://doi.org/10.3390/ijerph18020763 - 18 Jan 2021

Cited by 11 | Viewed by 2998

Abstract

(1) Background: The study is focused on the implementation of outcome measurement tools to assess the impact of an assistive device from a loan bank in the lives of people with Amyotrophic Lateral Sclerosis and Neuromuscular Diseases. The secondary purpose is to analyse the correct matching between the person and technology, derived from the counselling of an occupational therapist. (2) Methods: Cross-sectional study. The sample was formed by 28 people with rare neurodegenerative disorders. A specific questionnaire, the Psychosocial Impact of Assistive Device Scale (PIADS), and the Matching Person and Technology (MPT) tool were applied to collect the data. (3) Results: The dimension of the PIADS with the best score was competence, and the variations according to gender were not remarkable. The three dimensions of the PIADS (competence, adaptability, and self-esteem) were correlated positively between them and with the mean score of the MPT tool (p < 0.01). The type of assistive technology (AT), diagnosis, and correct match between person–technology are the main factors that condition a positive impact. (4) Conclusions: The results noted the importance of assessing the needs, demands, and contexts of people with rare neurodegenerative diseases to prescribe the best AT. Loan banks of AT have to be considered a valid service that complements their lack in public health services. Full article

(This article belongs to the Special Issue Assistive Technologies for Children, Young People and Adults)

17 pages, 3316 KiB

Open AccessArticle

Deep Learning-Based Object Detection, Localisation and Tracking for Smart Wheelchair Healthcare Mobility

by Louis Lecrosnier, Redouane Khemmar, Nicolas Ragot, Benoit Decoux, Romain Rossi, Naceur Kefi and Jean-Yves Ertaud

Int. J. Environ. Res. Public Health 2021, 18(1), 91; https://doi.org/10.3390/ijerph18010091 - 24 Dec 2020

Cited by 27 | Viewed by 4664

Abstract

This paper deals with the development of an Advanced Driver Assistance System (ADAS) for a smart electric wheelchair in order to improve the autonomy of disabled people. Our use case, built from a formal clinical study, is based on the detection, depth estimation, localization and tracking of objects in wheelchair’s indoor environment, namely: door and door handles. The aim of this work is to provide a perception layer to the wheelchair, enabling this way the detection of these keypoints in its immediate surrounding, and constructing of a short lifespan semantic map. Firstly, we present an adaptation of the YOLOv3 object detection algorithm to our use case. Then, we present our depth estimation approach using an Intel RealSense camera. Finally, as a third and last step of our approach, we present our 3D object tracking approach based on the SORT algorithm. In order to validate all the developments, we have carried out different experiments in a controlled indoor environment. Detection, distance estimation and object tracking are experimented using our own dataset, which includes doors and door handles. Full article

(This article belongs to the Special Issue Assistive Technologies for Children, Young People and Adults)

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22 pages, 5444 KiB

Open AccessArticle

Octopus Watch Fosters Family Resilience by Enhancing Occupational Engagement for Children with Spina Bifida and/or Hydrocephalus: Pilot Study

by Mark Jennings, Aoife Guilfoyle, James Green, Yvonne Cleary and Rosemary Joan Gowran

Int. J. Environ. Res. Public Health 2020, 17(22), 8316; https://doi.org/10.3390/ijerph17228316 - 10 Nov 2020

Cited by 2 | Viewed by 4884

Abstract

Background: Children with spina bifida and/or hydrocephalus (SB&/H) often experience difficulties with activities of daily living (ADLs) due to impaired executive functioning, increasing sedentary behaviours. The HeyJoy Octopus watch, a child-friendly icon-based smartwatch could be used as an enabler to promote purposeful ADLs (i.e., goal-orientated ADLs). Objective: to investigate the effectiveness of the Octopus watch in promoting purposeful ADLs for children living with SB&/H (<8 years). Methods: Mixed-methods engaging parents and children in four phases: (1) Administered demographic questionnaire, semi-structured interview, childhood executive functioning inventory (CHEXI) and the Canadian occupational performance measure (COPM); focus group one introducing the study, information pack using smartwatch and photovoice data collection methods. (2) Measured baseline movement for four days with smartwatch without using functions. (3) Measured activity for 16-days while using the smartwatch. (4) Re-administered assessments and conducted a second focus group based on photovoice narratives. Results: movement data recorded for four participants, three of four showed mean activity increase (36%). N-of-1 analyses found one participant showed clear improvement (p = 0.021, r² = 0.28). Mean inhibition decreased by 16.4%, and mean change in COPM performance and satisfaction scores were 2.1 and 2.4, respectively. The photovoice narrative focus group supports findings evidenced with improved daily routines. Conclusions: The Octopus watch is an innovative early intervention that can promote purposeful ADLs, fostering family resilience by enhancing occupational engagement. Further research is required. Full article

(This article belongs to the Special Issue Assistive Technologies for Children, Young People and Adults)

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13 pages, 4259 KiB

Open AccessArticle

Ciranda—An Inclusive Floor Seating Positioning System and Social Enterprise

by Tulio Maximo, Erika Foureaux, Xiao Lu Wang and Kenneth N. K. Fong

Int. J. Environ. Res. Public Health 2020, 17(21), 7942; https://doi.org/10.3390/ijerph17217942 - 29 Oct 2020

Cited by 2 | Viewed by 2508

Abstract

One of the first challenges for many children with physical disabilities is to sit independently. A floor seating positioning system enables this milestone, helping a child to maintain eye level with other children, play and learn on the floor, rectify his or her posture, and, therefore, helps to include the child within his or her social spectrum. Ciranda is the first comprehensive floor seat solution in Brazil to attend to those needs. The project collected anthropometric data from 370 children who were unable to sit without support. A sample of 37 families of these children was visited, observed, and interviewed. A project requirement compiled key insights from the field data to support a multidisciplinary team of collaborators to co-design solutions. The project resulted in two floor seating positioning systems to attend to different needs. One is a social enterprise where the children’s parents and the community build the seat while the child in need and his or her friends engage in entertainment. The other is a salable seat that helps to raise funds for the social enterprise. The model also unravels other challenges common to assistive technologies, such as access to a device and training for the use and maintenance of the device. Full article

(This article belongs to the Special Issue Assistive Technologies for Children, Young People and Adults)

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19 pages, 6382 KiB

Open AccessArticle

Shared Control of an Electric Wheelchair Considering Physical Functions and Driving Motivation

by Lele Xi and Motoki Shino

Int. J. Environ. Res. Public Health 2020, 17(15), 5502; https://doi.org/10.3390/ijerph17155502 - 30 Jul 2020

Cited by 5 | Viewed by 3005

Abstract

Individuals with severe physical impairments have difficulties operating electric wheelchairs (EWs), especially in situations where fine steering abilities are required. Automatic driving partly solves the problem, although excessive reliance on automatic driving is not conducive to maintaining their residual physical functions and may cause more serious diseases in the future. The objective of this study was to develop a shared control system that can be adapted to different environments by completely utilizing the operating ability of the user while maintaining the motivation of the user to drive. The operating characteristics of individuals with severe physical impairments were first analyzed to understand their difficulties when operating EWs. Subsequently, a novel reinforcement learning-based shared control method was proposed to adjust the control weight between the user and the machine to meet the requirements of fully exploiting the operating abilities of the users while assisting them when necessary. Experimental results showed that the proposed shared control system gradually adjusted the control weights between the user and the machine, providing safe operation of the EW while ensuring full use of the control signals from the user. It was also found that the shared control results were deeply affected by the types of users. Full article

(This article belongs to the Special Issue Assistive Technologies for Children, Young People and Adults)

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19 pages, 1792 KiB

Open AccessArticle

Social Participation in Relation to Technology Use and Social Deprivation: A Mixed Methods Study Among Older People with and without Dementia

by Sophie N. Gaber, Louise Nygård, Anna Brorsson, Anders Kottorp, Georgina Charlesworth, Sarah Wallcook and Camilla Malinowsky

Int. J. Environ. Res. Public Health 2020, 17(11), 4022; https://doi.org/10.3390/ijerph17114022 - 5 Jun 2020

Cited by 18 | Viewed by 4667

Abstract

Social participation is a modifiable determinant for health and wellbeing among older people; however, social participation is increasingly dependent on technology use. This study investigated social participation in relation to Everyday Technology use and social deprivation of the living environment, among older people with and without dementia in the United Kingdom. Sixty-four people with dementia and sixty-four people without dementia were interviewed using standardized questionnaires: The Participation in ACTivities and Places OUTside Home Questionnaire and Everyday Technology Use Questionnaire. A mixed methods approach integrated statistical analyses and content analysis of free-text responses, through data visualizations. Small, statistically significant associations were found between social participation and Everyday Technology use outside home, for participants with dementia (R_s = 0.247; p = 0.049) and without dementia (R_s = 0.343; p = 0.006). A small, statistically significant association was identified between social participation and social deprivation in the living environment, among only participants with dementia (R_s = 0.267, p = 0.033). The content analysis and graphical joint display revealed motivators, considerations that require extra attention, and strategies for managing social participation. The results underline how Everyday Technology use can be assistive to social participation but also the need to consider social deprivation of the living environment, especially among people with dementia. Full article

(This article belongs to the Special Issue Assistive Technologies for Children, Young People and Adults)

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14 pages, 512 KiB

Open AccessArticle

Feasibility of an Intervention for Patients with Cognitive Impairment Using an Interactive Digital Calendar with Mobile Phone Reminders (RemindMe) to Improve the Performance of Activities in Everyday Life

by Maria Andreassen, Helena Hemmingsson, Inga-Lill Boman, Henrik Danielsson and Tiny Jaarsma

Int. J. Environ. Res. Public Health 2020, 17(7), 2222; https://doi.org/10.3390/ijerph17072222 - 26 Mar 2020

Cited by 13 | Viewed by 4545

Abstract

The aim of this study is to increase evidence-based interventions by investigating the feasibility of an intervention using an interactive digital calendar with mobile phone reminders (RemindMe) as support in everyday life. Qualitative and quantitative data were collected from participating patients (n = 8) and occupational therapists (n = 7) from three rehabilitation clinics in Sweden. The intervention consisted of delivering the interactive digital calendar RemindMe, receiving an individualized introduction, a written manual, and individual weekly conversations for two months with follow-up assessments after two and four months. Feasibility areas of acceptability, demand, implementation, practicality, and integration were examined. Patients expressed their interest and intention to use RemindMe and reported a need for reminders and individualized support. By using reminders in activities in everyday life their autonomy was supported. The study also demonstrated the importance of confirming reminders and the possible role of habit-forming. Occupational therapists perceived the intervention to be useful at the rehabilitation clinics and the weekly support conversations enabled successful implementation. This study confirmed the importance of basing and tailoring the intervention to patients’ needs and thus being person-centered. Full article

(This article belongs to the Special Issue Assistive Technologies for Children, Young People and Adults)

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13 pages, 684 KiB

Open AccessArticle

Usability of Eye-Gaze Controlled Computers in Sweden: A Total Population Survey

by Helena Hemmingsson and Maria Borgestig

Int. J. Environ. Res. Public Health 2020, 17(5), 1639; https://doi.org/10.3390/ijerph17051639 - 3 Mar 2020

Cited by 15 | Viewed by 3847

Abstract

Eye-gaze technology allows individuals with severe physical disabilities and complex communication needs to control a computer or other devices with eye-gaze, thereby enabling them to communicate and participate in society. To date, most research on eye-gaze controlled devices related to persons with disabilities has focused on a single diagnosis in either adults or children and has included only a few participants. This current study utilized a total population survey to identify the prevalence and perceived usability of eye-gaze technology among adults and children in Sweden. Participants were 171 eye-gaze technology users with severe physical and communication impairments, ranging between 4 and 81 years. Cerebral palsy was the most common diagnosis. Daily usage was found in 63%, while 33% had weekly, and 4% had less frequent usage. Adults, compared with children, reported using their computers more frequently (65%/38%; p < 0.01), and for the activities they needed to perform (59%/31%; p < 0.01) and were more satisfied with services, indicating that service providers should prioritize and develop more effective services for children and their parents. Full article

(This article belongs to the Special Issue Assistive Technologies for Children, Young People and Adults)

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14 pages, 378 KiB

Open AccessCommentary

Understanding the Global Challenges to Accessing Appropriate Wheelchairs: Position Paper

by Rosemary Joan Gowran, Nathan Bray, Mary Goldberg, Paula Rushton, Marie Barhouche Abou Saab, David Constantine, Ritu Ghosh and Jonathan Pearlman

Int. J. Environ. Res. Public Health 2021, 18(7), 3338; https://doi.org/10.3390/ijerph18073338 - 24 Mar 2021

Cited by 14 | Viewed by 5669

Abstract

Introduction: Appropriate wheelchairs are often essential for the health and wellbeing of people with mobility impairments to enhance fundamental freedoms and equal opportunity. To date, provision has mainly focused on just delivering the wheelchair instead of following an evidence-based wheelchair service delivery process. In addition, many governments have not committed to a national wheelchair provision policy. Approach: To prepare this position paper, a systemic development model, founded on the sustainable human security paradigm, was employed to explore the global challenges to accessing appropriate wheelchairs. Positions: I: Consideration of key perspectives of wheelchair provision across the life course is essential to meet the needs to children, adults, older people and their families; II: Comprehensive wheelchair service delivery processes and a competent workforce are essential to ensure appropriate wheelchair service provision; III: Evaluations on wheelchair product quality development, performance and procurement standards are key as wheelchair product quality is generally poor; IV: Understanding the economic landscape when providing wheelchairs is critical. Wheelchair funding systems vary across jurisdictions; V: Establishing wheelchair provision policy is a key priority, as specific policy is limited globally. Conclusion: The vision is to take positive action to develop appropriate and sustainable wheelchair service provision systems globally, for me, for you, for us. Full article

(This article belongs to the Special Issue Assistive Technologies for Children, Young People and Adults)

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