Technology and Disability

While it is generally acknowledged that people with mental retardation do not utilize assistive technology to the degree warranted, there has been little empirical evidence to support this assumption. This article reports findings from a pilot study that evaluated the use of assistive technology by people with mental retardation and examined barriers to this outcome. A national survey found that people with mental retardation under-utilized assistive devices. The survey identified several barriers to technology use, including cost, a lack of information, device complexity and a lack of training and support.

The advanced technology of today's society is challenging for persons with disabilities. One way to handle these challenges is assistive technology, such as powered wheelchairs for persons with motor disability or synthetic speech for persons with communication disability. The use of assistive technology has been minimal for a large group of persons with disabilities, namely persons with cognitive disability. This is probably due to the fact that cognitive disability is more difficult to observe and measure than other disabilities, like motor disability. The handicapping consequences of the disability on the person-environment interaction cannot be directly observed and therefore must be deduced from behavior in task-analysis. Thus, unlike observable disabilities, the need for assistive technology is not self-evident in persons with cognitive disabilities. This paper describes a model for developing assistive technology for cognitive disability, illustrated by a case study. The model was developed in the MENTEK project, sponsored by the Swedish Handicap Institute. The model is based on the international classification of impairments, disabilities, and handicaps (ICIDH) and stresses the importance of differentiating between cognitive impairment, cognitive disability and cognitive handicap. Assistive technology can be used either to minimize the disability with the help of a cognitive aid, like a device for understanding the passage of time, or to minimize the handicapping consequences of the disability in a specific context, like a computerized cash-register helping a person to handle money in a coffee-shop.

An increasing number of young children with disabilities and their families are being provided with augmentative and alternative communication (AAC) devices. Early intervention professionals involved in making decisions about AAC devices typically consider a variety of child characteristics, technology features, and service system issues to identify appropriate devices to be used by children and families. Family issues may not be considered as frequently in AAC assessment processes. This article describes a preliminary study designed to explore current AAC assessment and prescriptive practices nationally. Findings of the study suggest that family issues may be considered less frequently in AAC decision-making. Implications are discussed, including the possibility of increased stress for families, technology abandonment by young children and family members, and inefficient use of scarce fiscal resources in service systems.

Project FACTT (Facilitating Augmentative Communication Through Technology) is a model school-based program for the delivery of augmented language development services to children with mental retardation. As an outgrowth of a longitudinal study of augmented language development, Project FACTT has translated scientific principles into practice. FACTT's philosophy is that technology, coupled with innovative instructional strategies, can enhance the quality of a child's life by promoting increased communicative independence across a variety of environments. This article illustrates Project FACTT's successful components and service delivery practices. Project outcomes, in terms of student achievements, and future directions are also presented.

The passage of the Americans with Disabilities Act (ADA) was hailed as a milestone event that insured persons with disabilities can achieve gainful employment. Although recognized as a momentous piece of civil rights legislation, it has, unfortunately, not fulfilled the promise of providing a significant number of jobs for persons with disabilities. This paper examines the complexities inherent in the process of placing persons with disabilities into productive employment through the usage of assistive technology. Simply stating that individuals with disabilities can be cost effective members of the American work force does not necessarily make it so. A cohesive team of persons with disabilities, their significant others, rehabilitation technologists, rehabilitation engineers, physical therapists, social workers, etc. is necessary to open doors for persons with developmental disabilities as they seek to gain their rightful place in American business and industry. This paper examines, from a pragmatic point of view, elements to be considered by persons with disabilities as they take advantage of the Americans with Disabilities Act from both the spirit and the letter of the law.

The Americans with Disabilities Act, the ADA, requires employers to make reasonable accommodations for persons with disabilities who are otherwise qualified for a given job. Being ‘qualified’ for a job simply means that the person possesses sufficient knowledge and the skills required for the job. The provision of reasonable accommodations for persons with physical disabilities is largely a requirement to make the job physically accessible to the individual. In other words, a person with a disability who is otherwise qualified for a job must receive equal opportunity to get the job, regardless of whether reasonable accommodations are required to perform job-associated tasks. Confusion has risen over the definition of ‘reasonable’. An employer is not required to undergo ‘undue hardship’ when considering the hiring, or retention, of a person with a disability. The burden of proof in this case is on the employer. The establishment of what is ‘reasonable’ seems to cause concern when making an accommodation. Information from the ADA is presented in this article along with six case studies which include discussions of cost and ‘reasonable accommodations’.

Most people with developmental disabilities are limited in their daily activities by functional or cognitive deficits. Until recently, these limitations restricted independent living. With the passage of community integration legislation and improved access to assistive technology, many people can now live in supported living situations in the community. This study assessed 268 nursing home residents with developmental disabilities to determine both the functional limitations that restricted residential options and the types of assistive devices needed. Results of this study showed that the greater the prevalence of functional limitations, the less likely people were to move out of nursing homes. The types of equipment most needed by residents of nursing homes were wheelchairs and seating systems. With the expansion of opportunities in community residences, additional assistive technology is needed to optimize functional abilities and community integration.

This article discusses a program of providing evaluation, recommendation, fitting, and final provision of wheelchair seating for individuals living in skilled nursing facilities who are diagnosed with developmental disabilities and are also demonstrating signs of the aging process.

The proportion of the population over the age of 65 is increasing, and this includes persons with developmental disabilities, For this population, impaired mobility is often the result of the combined effects of the aging process, chronic diseases, and developmental disability. Unfortunately, there has been virtually no research on the interaction of these factors on mobility. Neither has there been a focus on mobility related assistive devices that might increase independence and safety, and improve quality of life for older persons with developmental disabilities. This study investigated the types of ambulation problems experienced by older persons with developmental disabilities and their use of mobility devices. The sample included 27 participants over the age of 60 with developmental disabilities living in community residences in Western New York. All but one participant used a walker and all had difficulty in walking. Participants and their caregivers were interviewed. Videotapes of participants' performance using their walkers were reviewed by an occupational therapist and a physical therapist. The assistive device most used by participants was the walker and 92.59% of participants reported satisfaction with their walker. Reasons for using a walker included skeletal problems, muscle weakness, balance problems and prevention of injuries to lower extremities. In most cases the physical therapist recommended the device, and provided training and follow-up. Caregivers in both the home and day program played important roles in ensuring correct use of the device. No accessibility problems were found in the community residences. These residences provided a social environment that fostered the use of walkers. The high level of consumer satisfaction with the walkers suggests effective service delivery for this population.

This paper demonstrates the implementation of adaptive technology to assist a 26 year-old woman (WR) with severe developmental disabilities in her daily life activities. A multidisciplinary team of University-affiliated professionals and staff at a Center for persons with developmental disabilities worked together in evaluating WR and interfacing her with a specially adapted remote control for a TV/VCR. This paper delineates the process of identifying WR's specific needs to determine attributes of technology most conducive to her functioning.

To meet the assistive device needs of individuals with developmental disabilities in Western New York State, the Center for Assistive Technology offers a program called Applied Studies. This program was described in more detail in a previous issue of Technology and Disability (Mann, 1992). Graduate students in engineering, architecture, the therapies, and rehabilitation counseling work in teams with faculty in identifying appropriate assistive devices for each individual referred to the program. When there is a need for a device but the device is not commercially available, the team designs and fabricates one copy for the client's issue. For those devices that might serve other individuals with disabilities, the Center for Assistive Technology develops and prints Technical Reports. Each Technical Report provides a description of the functional need addressed, and directions for fabricating copies of the device. Below are descriptions of the eight Applied Studies devices: Supine Positioner Mold, VCR Tape Guide, Adapted Camera, Horseback Riding Trunk Support, Cassette Tape Guide, Labeling Jig, Portable Paraffin Wax Stand, Assessment Walker.