How to Optimise Your Assistive Device?

As of 29th December 2016

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Background

Generally, assistive technology (in various forms) are deemed to enable people with different abilities.

However, there is room for improvement to result

in continuous and appropriate usage of assistive technology.

The purpose of this deck of slides is to:1. Provide insights pertaining to “non-use” of assistive technology and devices;2. Highlight the considerations in finding the appropriate assistive technology and devices; 3. Suggest possible solutions to overcome “non-use” and increase usage to result in

independence.

Information in this deck is compiled from various sources.

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What is Assistive Technology (AT)?“Assistive devices and technologies are those whose primary purpose is to

maintain or improve an individual’s functioning and independence to facilitate participation and to enhance overall well-being. They can also help prevent impairments and secondary health conditions. Examples of assistive

devices and technologies include wheelchairs, prostheses, hearings aids, visual aids, and specialized computer software and hardware that increase

mobility, hearing, vision, or communication capacities.” - WHO on Assistive devices and technologies (http://www.who.int/disabilities/technology/en/)

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Studies Show High Abandonment/Non-Use Rate of Assistive Devices

• “While assistive devices can have a profound effect on a person’s abilities, such devices have a high abandonment rate, ranging from 8% for life saving devices to 75% for hearing aides. Approximately one-third of all assistive devices are abandoned (Scherer, 1996; Scherer & Galvin, 1996). There are no studies examining the abandonment rate across all types of assistive devices (Magiera & Goetz, 2001).” - A Framework for the Adoption of Assistive Technology

• “227 adults throughout the U.S. with a variety of disabilities were surveyed about their AT [Assistive Technology] use. The overall device abandonment rate was 29.3%; most abandoned devices were mobility aids and most were abandoned either during the first year or after 5 years.” - Outcomes of Assistive Technology Use on Quality of Life

• “13 of the 35 participants who abandoned a device (37%) said they did not use the device because they do not like it; 26% said they do not need the resource anymore; 20% said they do not have physical conditions to use it and 14% said they are afraid to use the resource” - Assistive Technology Accessibility and Abandonment: Challenges for Occupational Therapists

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Some Factors Linked to Non-Use of Assistive Device (1)

1. Changes in user's needs or goals – improvement or decline in functional abilities; changes in personal goals e.g. going to work, school. Source 1,2,6

Suggestion: • Go for an assistive technology

assessment so that the therapist can prescribe a suitable (and updated) assistive technology solution for new goals or needs.

2. Ease of purchase from supplier which does not necessary ensure the device is appropriate. Source 2,3

Suggestion: • Read reviews on the device.• Consult your therapist.• Have an assistive technology

assessment first.• Try out a device at Tech Able (subjected

to availability and therapist’s recommendation).

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Some Factors Linked to Non-Use of Assistive Device (2)

3. Cost of purchase or maintenance and availability of after-sale support. Source 4, 6

Suggestion: • Check if other suppliers is cheaper.• Check if there are “substitute” products. • Apply for Assistive Technology Fund,

subject to eligibility of criteria.• Verify if there is after-sale support.• Locate 3rd party maintenance providers

such as Kampung Senang.

4. Not aware of the accessible options existed e.g. touch-screen based screen reader. Source 4, 6 Or the application of everyday-mainstream devices as assistive devices.

Suggestion: • There is a

wide range of assistive technology, including low-tech devices and everyday devices. Visit Tech Able to learn about the AT devices.

• Follow Tech Able on Facebook to learn about new AT.

• Attend courses on assistive technology.6

Some Factors Linked to Non-Use of Assistive Device (3)

5. Did not meet user's expectations for effectiveness, reliability, durability, comfort, safety and ease of use. Source 3,

4, 5,6

Suggestion: • Find out more about the device.• Consult your therapist.• Trial the AT device at Tech Able before

purchase (subjected to availability and therapist’s recommendation).

6. Lack of training on the use of device in user’s daily environments or no time to go for training. Source 3, 4,5,6

Suggestion: • Attend AT device training at

organisations such as: IC2PrepHouse (visual related), SPD-ATC (speech & mobility related), SAVH (vision rehab programme); Cerebral Palsy Alliance Singapore (AT clinic); SaDeaf (hearing care centre).

• View demonstration videos online. 7

Some Factors Linked to Non-Use of Assistive Device (4)

7. Users and/or their caregivers may fear stigmatization for using devices that identify them as being disabled.

Source 4,5

Suggestion: • Accept that it is alright to let people

around us know that assistive tech is being used.

• Personalise your assistive tech devices with an aesthetic “feel” that you will like.

• Check out communities such as Able Thrive which illustrates that persons with disabilities are ABLE!

8. Reluctant to adopt assistive device with high learning curve in fear of perpetuating the idea that persons with disabilities are less capable. Source 4,5

Suggestion: • Have a honest and open discussion with

therapists on your needs, preference and daily considerations.

• Work with therapist in the selection of the device.

• Try out the device and understand how the device can help to improve situation or achieve desired tasks.

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Some Factors Linked to Non-Use of Assistive Device (5)

9. Accessibility of public transportation and places of daily activities. Source 2,6

Suggestion: • Be involved: there are mobile apps, for

example All-go-easy, and websites providing information on accessibility. Users’ reviews and feedback are important in keeping the information updated.

10. Caregiver is not prepared for the responsibilities of programming and learning to use the device in their daily interaction with the user. Source 5,6

Suggestion: • Caregiver to participate in the device

selection and training together with the user.

• Peer support is always good; join a peer support group (for example, Special Seeds).

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Some Factors Linked to Non-Use of Assistive Device (6)

11. User's preferences are not considered during the selection process of device. Source 1,2,3,5,6

Suggestion: • Do your “homework” – read up on AT

devices prior to meeting up with your therapist.

• Communicate clearly your needs and preferences to your therapist during the assessment.

• Try out the device in an environment that you will be using the AT, and give your after-trial feedback to your therapist.

In short, finding the right tool is key to ensure continuous use of the assistive technology device, and for the user to reap the benefits of using one.

And the best approach is to undertake an assessment with your therapist.

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AT Assessment – Finding the Right Tool

“When appropriate to the user and the user's environment, assistive technology [AT] is a powerful tool to increase independence and improve

participation... It provides the means of access to and participation in educational, social and recreational opportunities; empowers greater

physical and mental function and improved self-esteem;…” -

UNICEF Assistive Technology for Children with Disabilities: Creating Opportunities for Education, Inclusion and Participation

• We would like to emphasise the usefulness and importance of first focusing on the task(s) the user wants to accomplish, his/her current abilities and his/her environment instead of looking only at the AT device.

• Therapists in Tech Able can provide speech and mobility assessment, based on the SETT framework, and training. But please email (techable@sgenable.sg) us to make an appointment as we do not accept walk-in for assessment and training.

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With the Right Tool (1)

At just 18 years old, Christopher Hills is already a YouTube sensation and master video producer and editor.Hills lives with cerebral palsy and quadriplegia, and relies on technology and software he can control with a button located at the back of his wheelchair headrest.Tapping the button with his head allows Hills to toggle through screens, surf the web, and edit video content. Source & photo credit: Brisbane Times: Apple store welcomes YouTube sensation Christopher Hills with assistive tech

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With the Right Tool (2)

Chia Yong Yong, who was diagnosed with peroneal muscular atrophy at 15, went on to become an accomplished corporate lawyer and president of Society for the Physically Disabled . Source: The Straits Times: Chia Yong Yong: A Lawyer undaunted by disability Photo credit: SPD

Stephen Hawkings, who was diagnosed with Amyotrophic Lateral Sclerosis shortly after 21yrs old, achieves brilliant success as a physicist. He received 12 honorary degrees, wrote the international bestseller, A Brief History of Time, and has three children and grandchildren. Source & photo credit: Stephen Hawking The Official Website

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Where is Tech Able?Located at the Enabling Village, Tech Able is an integrated assistive technology space that is jointly managed by SG Enable and SPD.

Some of the services we provide are:• Information and assistive technology training• Speech and mobility assessment, device modification services• Ideas for making the home and office friendly to person with disabilities

Our address:Tech Able Centre, Village Green, Enabling Village, 20 Lengkok Bahru, Singapore 159053

Our opening hours: Mon – Fri 9am - 5pm

References1. Predictors of Assistive Technology Abandonment (https://www.researchgate.net/

publication/13125783_Predictors_of_Assistive_Technology_Abandonment)2. Assistive Technology Accessibility and Abandonment: Challenges for Occupationa

l Therapists (https://www.researchgate.net/publication/289118306_Assistive_Technology_Accessibility_and_Abandonment_Challenges_for_Occupational_Therapists)

3. Predictors of assistive technology use: The importance of personal and psychological factors (https://www.researchgate.net/profile/Marcia_Scherer2/publication/7469575_Predictors_of_assistive_technology_use_The_importance_of_personal_and_psychosocial_factors/links/00463519d222741e54000000.pdf)

4. No access, no knowledge, or no interest? Examing use and non-use of assistive technologies (http://cs.rochester.edu/u/brady/non-use-assistive-tech.pdf)

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References 25. A Framework for the Adoption of Assistive Technology (http://l3d.cs.colorado.ed

u/clever/assets/pdf/ak-SWAAAC02.pdf)6. Outcomes of assistive technology use on quality of life (https://www.researchgat

e.net/publication/14330202_Outcomes_of_assistive_technology_use_on_quality_of_life)

7. Assistive Technology for Children with Disabilities: Creating Opportunities for Education, Inclusion and Participation (https://www.unicef.org/disabilities/files/Assistive-Tech-Web.pdf)

8. UNICEF Assistive Technology for Children with Disabilities: Creating Opportunities for Education, Inclusion and Participation (https://www.unicef.org/disabilities/files/Assistive-Tech-Web.pdf)

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URL• Assistive Technology Fund (

https://www.sgenable.sg/Pages/content.aspx?path=/schemes/equipment-technology-home-retrofit/assistive-technology-fund/)

• Kampong Senang (https://kampungsenang.org/wheels-of-hope/mobility-aids/)• Wide range of assistive technology (http://

www.straitstimes.com/singapore/more-people-with-disabilities-tapping-enhanced-tech-fund)• Tech Able Facebook (https://www.facebook.com/DesignTechAble/)• AT device trial (http://www.spd.org.sg/assistive-technology-loan-library.html)• IC2PrepHouse (http://ic2.com.sg/)• SPD-ATC (http://www.spd.org.sg/specialised-assistive-technology-centre.html)• Vision Rehab Programme (http://savh.org.sg/vision-rehabilitation-programme/)• AT Clinic (http://www.cpas.org.sg/our-services/therapy-clinic/assistive-technology-clinic/)• Hearing Care Centre (http://sadeaf.org.sg/services/hearing-care-centre/)• AT devices available in Tech Able (https://

www.youtube.com/playlist?list=PLHWubz8V0SHn1ITodEoR5Z46ZSF-iJof8)• Able Thrive (https://www.facebook.com/AbleThrive/)• All-Go-Easy (http://www.allgoeasy.com/)• Special Seeds (http://specialseeds.sg/SG/)• SETT Framework (http://www.slideshare.net/TechAble/tech-able-assistive-technology-e-tour-v23)