Facilitators and Barriers of Assistive Technology and Learning Environment for Children with Special Needs

Starting from the needs: what are the appropriate sources to co-create innovative solutions for persons with disabilities?

PURPOSE

Technical solutions could facilitate activities and participation in individuals with disabilities. For the development of solutions, hackathons are a method of interdisciplinary collaboration. For hackathon, the definition of pain points that require solutions is crucial. We aimed to determine engineers' preferences and expectations regarding pain point qualities.

METHODS

We used a collaborative approach involving individuals with disability, families, and healthcare professionals to determine pain points for use by engineering students during a disability Hackathon. A pain point bank was built using 3 upstream sources: a survey (350 responses, 20 pain points selected), interviews (8 children, 13 pain points), and a multidisciplinary workshop based on design thinking methods (45 people, 32 pain points). A fourth source was 20 adults with disabilities present during the Hackathon. Engineering students rated pain point qualities from each source in a questionnaire that included closed questions relating to predefined criteria: achievability, specificity, relevance and attractiveness and open questions to collect non-predefined quality criteria.

RESULTS

Pain points from the workshop were most frequently used (48%); followed by on-site discussions with mentors (43%), the survey (38%), and interviews (31%). On-site discussions received the highest quality ratings followed by the workshop, survey, and interviews. Three quality criteria emerged from the responses to open questions: "representative", "empathy", and "real-need".

CONCLUSIONS

To be actionable by engineers, pain points must relate to real needs, be achievable, specific, relevant and attractive but also representative and arouse empathy. We devised a checklist of qualities along with a toolbox of methods to achieve each.

Implications For RehabilitationThe first step of the development of technical solutions for children and individuals with disabilities is the identification of their needs and their adequate formulation to be submitted to technical solutions providers.Daily life needs of individuals with disability were gathered for an engineering hackathon and proposed as pain points to 400 engineering students.To facilitate the development of solutions by engineers, pain points must relate to real needs, be specific, relevant, achievable and attractive; be representative and arouse empathy; a toolbox of needs collection methods is proposed to achieve each of those qualities.Discussions with individuals with disability and health professionals should be provided.

Barriers to, and facilitators of, education for children with disabilities worldwide: a descriptive review

Background

Inclusionary ideals regarding the education of children with disabilities (CWD) are articulated in various international human rights treaties and instruments such as the United Nations Convention on the Rights (2006), the Salamanca Statement (1994), and the 2030 agenda of the UN's Sustainable Development Goals (SDGs). In the latter, the fourth goal explicitly focuses on the removal of barriers to education and supporting access to quality, equity, and inclusion for people with disabilities. Although data regarding access to education among CWD remains scarce, it is well known that rates of their participation in education remain low, particularly among those in LMICs. The research question of this descriptive review is what are the barriers to and facilitators of education for children with disabilities worldwide aged between 6 and 18 years old?

Methods

A descriptive review of literature published in English between 2013 and 2021 was conducted following the Joanna Briggs Institute (JBI) guidelines for a scoping review using the following databases: EBSCO, SocINDEX with full text (EBSCO), and ERIC (EBSCO). The search resulted in 7,072 titles and abstracts, which were narrowed down to 1,335 papers for full text review. After data extraction, 54 papers were included in the analysis, with 34 being qualitative, 10 quantitative, and 10 mixed-methods studies. The findings on the facilitators and barriers to education for children with disabilities were analyzed using the International Classification of Function, Disability and Health (ICF) and Urie Bronfenbrenner's Ecological Framework (1979).

Results

Out of the eligible studies included in our research, 40 were conducted in developing countries, while 14 studies conducted on LMICs. Of the five environmental domains in the ICF, the most significant barriers were found to be that of attitudes and services, while technology and effective communication with school staff were found to play a crucial role in facilitating the education process. Applying Bronfenbrenner's framework, barriers occurred at the micro-system (school level), meso-system (parent and teacher communication), exo-system (services), and macro-system (education policy). Only 3 out of the 54 studies included the voices of CWD.

Conclusion

Despite documented barriers, facilitators of education for CWD are underexplored, lacking research on their voices. Further investigation is needed.

Assistive Products and Technology to Facilitate Activities and Participation for Children with Disabilities

We aimed to identify activity limitations and participation restrictions encountered by children and youth with disabilities for which assistive products and technology could be helpful. We used a convergent, parallel, mixed-methods design involving a nationwide, French survey composed of closed questions (quantitative) and open questions (qualitative) that enlightened the quantitative data. A total of 1055 responses were received, and 962 included: 92 from children and youth with disabilities, 493 from relatives and 377 from professionals. Difficulties frequently checked and described in detail were participation in recreational activities, leaving the house and traveling, participating in a group, and getting ready. Transversal explanations for difficulties were spontaneously provided (e.g., lack of accessibility and mobility). Solutions proposed included personal assistive devices to facilitate home life, high-tech devices, devices to compensate for impaired body functions, and adaptation of the familiar environment and daily activities. Few public solutions were proposed. The necessity of human assistance was emphasized. The mixed-methods design and involvement of different stakeholders identified common, macroscopic trends in difficulties encountered and desired solutions. Products and technology are required in the following domains: the familiar environment, accessibility and mobility, sports and leisure, high-technology, and family support. We provide suggestions to facilitate the development of innovative solutions.

Children and adolescents with physical disabilities: describing characteristics and disability-related needs in the Kilimanjaro region, north-eastern Tanzania - a cross-sectional survey

OBJECTIVES

To describe the characteristics and disability-related needs of children and adolescents with physical disabilities in the Kilimanjaro region, North-Eastern Tanzania.

DESIGN

A cross-sectional community survey was conducted from November 2020 to June 2021. Trained research assistants interviewed primary children's carers using a questionnaire based on the International Classification of Functioning, Disability and Health-Children and Youth Framework. Data were analysed using IBM SPSS Statistics V.27. The Pearson χ² test was used to examine differences between age, gender and self-reported needs. The independent t-test assessed difference in needs according to age and gender.

SETTING

Kilimanjaro region, Tanzania.

PARTICIPANTS

Children and adolescents, aged 2-18 years, with physical disabilities (n=212).

RESULTS

Almost 40% had severe speech (n=84) and joint mobility (n=79) impairments, and more than half (n=124) had severe or complete difficulties walking. In aspects of self-care (caring for body parts, toileting, dressing, eating and drinking), most had severe and complete difficulties. Almost 70% (n=135) of households were located near health facilities without rehabilitation services. About one-quarter (n=51) had never received rehabilitation services. More than 90% (n=196) needed assistive devices, and therapeutic exercises (n=193). Over three-quarters needed nutritional supplements (n=162).

CONCLUSION

Children and adolescents with physical disabilities in North-Eastern Tanzania have impaired speech and joint mobility, and difficulties in communication, self-care and walking. Rehabilitation services essential for addressing these impairments and activity limitations are either scarce or inaccessible. Action is needed to facilitate urban and rural access to rehabilitation services in order to improve the well-being of children and adolescents with physical disabilities.

The Quest for Ecological Validity in Hearing Science: What It Is, Why It Matters, and How to Advance It

Ecological validity is a relatively new concept in hearing science. It has been cited as relevant with increasing frequency in publications over the past 20 years, but without any formal conceptual basis or clear motive. The sixth Eriksholm Workshop was convened to develop a deeper understanding of the concept for the purpose of applying it in hearing research in a consistent and productive manner. Inspired by relevant debate within the field of psychology, and taking into account the World Health Organization's International Classification of Functioning, Disability, and Health framework, the attendees at the workshop reached a consensus on the following definition: "In hearing science, ecological validity refers to the degree to which research findings reflect real-life hearing-related function, activity, or participation." Four broad purposes for striving for greater ecological validity in hearing research were determined: A (Understanding) better understanding the role of hearing in everyday life; B (Development) supporting the development of improved procedures and interventions; C (Assessment) facilitating improved methods for assessing and predicting ability to accomplish real-world tasks; and D (Integration and Individualization) enabling more integrated and individualized care. Discussions considered the effects of variables and phenomena commonly present in hearing-related research on the level of ecological validity of outcomes, supported by examples from a few selected outcome domains and for different types of studies. Illustrated with examples, potential strategies were offered for promoting a high level of ecological validity in a study and for how to evaluate the level of ecological validity of a study. Areas in particular that could benefit from more research to advance ecological validity in hearing science include: (1) understanding the processes of hearing and communication in everyday listening situations, and specifically the factors that make listening difficult in everyday situations; (2) developing new test paradigms that include more than one person (e.g., to encompass the interactive nature of everyday communication) and that are integrative of other factors that interact with hearing in real-life function; (3) integrating new and emerging technologies (e.g., virtual reality) with established test methods; and (4) identifying the key variables and phenomena affecting the level of ecological validity to develop verifiable ways to increase ecological validity and derive a set of benchmarks to strive for.

A Low-Cost Assistive Robot for Children with Neurodevelopmental Disorders to Aid in Daily Living Activities

In this paper, we present a new low-cost robotic platform that has been explicitly developed to increase children with neurodevelopmental disorders’ involvement in the environment during everyday living activities. In order to support the children and youth with both the sequencing and learning of everyday living tasks, our robotic platform incorporates a sophisticated online action detection module that is capable of monitoring the acts performed by users. We explain all the technical details that allow many applications to be introduced to support individuals with functional diversity. We present this work as a proof of concept, which will enable an assessment of the impact that the developed technology may have on the collective of children and youth with neurodevelopmental disorders in the near future.

Socio-Demographic Factors Influencing the Use of Assistive Technology among Children with Disabilities in Malawi

This paper aims to address the information gap on the influence of socio-demographic factors on access and utilization of Assistive Technology (AT) among children with disabilities in Malawi. Thus, it contributes towards the realization of the recommendations of the UN Convention on the Rights of Persons with disabilities and the development of a framework for creating an effective national AT policy. The paper used two statistically matched datasets, namely, the 2017 survey on Living conditions among persons with disabilities in Malawi and the 2015-16 Malawi Demographic and Health survey. Logistic regression and structural equation modeling techniques were utilized to assess the influence of socio-demographic factors on the use of AT among children with disabilities. The results indicate that there is a high level of unmet need for AT among young children aged 2 to 9 and those living in urban areas. The results further indicate that children with multiple disabilities have lower odds (OR = 0.924) of using AT for personal mobility compared to children with a single functional difficulty. These results entail that AT needs for children with multiple disabilities are not adequately addressed. Therefore, when developing policies on AT, younger children and those with multiple disabilities need to be specifically targeted.

Development and Usability Testing of an Emergency Alert Device for Elderly People and People with Disabilities

The objectives of this study were to develop and evaluate the effectiveness of an emergency alert device for elderly people and people with disabilities by usability testing. There were two phases in this study: (1) development of a prototype for an emergency alert device and (2) usability testing of the device. Results presented development of the prototype, which comprised parts for sending and receiving signals. There were two kinds of alarms for emergency calls known as conscious and unconscious alerts. Participants in the usability testing phase included 12 specialists and 161 users that comprised 146 elderly people or people with disabilities and 15 caregivers or community health volunteers. The instruments used were a rating scale, usability checklist, and individual interviews regarding the usability, general appearance, and use of the device. The users agreed with the overall aspects regarding usability of the device, its general appearance, and use (X¯ ± SD = 4.24 ± 0.88, 4.11 ± 0.90, and 4.37 ± 0.83, respectively). Most of the participants, both specialists and users, gave their perspectives on improving the size, color of the letters displayed, type of wristband, and method for sending signals.