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Title: Current and Future Assistive Technology


1
Current and Future Assistive Technology
  • Linking Independent Living to Technology
  • Patty McDonald
  • Aging and Disability Services Administration
  • Email mcdonpm_at_dshs.wa.gov
  • 360-725-2559

2
Objective of todays workshop
  • Promoting the concepts of independent living
    philosophy and universal design and the need for
    adequate funding aid people with disabilities
    achieve success and live with dignity in their
    own homes and community.

3
StatisticsA Minority that includes all People
  • There are an estimated 54 million people with
    disabilities living in the United States. (U.S.
    Census Bureau)
  • There are nearly 7 million school-aged children
    with disabilities in the U.S. (Congressional
    Research Service)
  • Nearly 70 percent of working-age adults with
    disabilities are unemployed. (U.S. Census Bureau,
    Population Division and Housing and Household
    Economic Statistics Division)
  • Almost 40 percent of working-age Americans with
    disabilities live in poverty. (World Institute on
    Disability)
  • Fewer than 25 percent of people with disabilities
    who could be helped by assistive technology are
    using it. (Alliance for Technology Access)

4
Meaning of Disability and the Influence of
Independent Living Philosophy
  • General definition - lack of adequate power,
    strength, or physical or mental ability
    incapacity.
  • The Independent Living Philosophy asserts that
    people with disabilities are the best experts on
    their needs, and therefore they must take the
    initiative, individually and collectively, in
    designing and promoting better solutions and must
    organize themselves for political power.
    Wikipedia

5
Independent PhilosophyBased on Civil Rights
  • Persons with disabilities have the same right to
    participation, to the same range of options,
    degree of freedom, control and self-determination
    in every day life and life projects that other
    citizens take for granted.
  • The disability rights movement aims to improve
    the quality of life of people with disabilities
    and started in the 1970s.
  • In most countries, proponents of the disability
    rights movement argue preconceived notions and a
    predominantly medical view of disability
    contribute to negative attitudes towards people
    with disabilities, portraying them as sick,
    defective and deviant persons, as objects of
    professional intervention, as a burden for
    themselves and their families, dependent on other
    peoples charity.
  • People with disabilities are primarily seen as
    citizens and only secondarily as consumers of
    healthcare, rehabilitation or social services.
    People first.

6
The ADA
  • 1990's landmark Americans with Disabilities Act,
    mandated equal access to education, employment,
    and other essential activities and services for
    the country's largest minority group. The
    benefits of new technology, new laws, and new
    design concepts do not have adequate funding due
    to the lack of information, and political will.
    As a result, society as a whole misses the chance
    to maximize human potential and productivity.

7
Four key needs
  • Accessible housing
  • Accessible transportation
  • Access to assistive technology devices and
    services
  • Access to personal assistance services
  • Without these being available, can lead to
    unneeded institutionalization and dependence.

8
Stephen Hawking
  • For a time, the only way I could communicate was
    to spell out words letter by letter, by raising
    my eyebrows when someone pointed to the right
    letter on a spelling card. It is pretty difficult
    to carry on a conversation like that, let alone
    write a scientific paper. However, a computer
    expert in California, called Walt Woltosz, heard
    of my plight. He sent me a computer program he
    had written, called Equalizer. This allowed me to
    select words from a series of menus on the
    screen, by pressing a switch in my hand. The
    program could also be controlled by a switch,
    operated by head or eye movement.
  • David Mason, of Cambridge Adaptive Communication,
    fitted a small portable computer and a speech
    synthesizer to my wheel chair. This system
    allowed me to communicate much better than I
    could before. I can manage up to 15 words a
    minute. I can either speak what I have written,
    or save it to disk. I can then print it out, or
    call it back and speak it sentence by sentence.
    Using this system, I have written a book, and
    dozens of scientific papers. I have also given
    many scientific and popular talks. They have all
    been well received. I think that is in a large
    part due to the quality of the speech
    synthesizer, which is made by Speech Plus. One's
    voice is very important. If you have a slurred
    voice, people are likely to treat you as mentally
    deficient Does he take sugar? This synthesizer
    is by far the best I have heard, because it
    varies the intonation, and doesn't speak like a
    Dalek. The only trouble is that it gives me an
    American accent.

9
Independent Living Philosophy Supports
  • The removal of infrastructural, institutional and
    attitudinal barriers and the adoption of the
    Universal Design principle is critical for people
    with disabilities to achieve success and live
    with dignity in the community.
  • Depending on the individuals disability, support
    services such as assistive technology, income
    supplements or personal assistance are seen as
    necessary to achieve equal opportunities.

10
Definitions
  • Assistive Technology - maximizes functional
    opportunities for individuals with disabilities
    in all environments through devices,
    modifications and services.
  • Durable Medical Equipment (DME) - equipment which
    can withstand repeated use and which is used to
    serve a medical purpose when supplied to
    individuals with an illness, injury or
    disability. DME includes, but is not limited to
    wheelchairs, walkers, specialty beds, and
    mattresses.

11
Universal Design (UD)
  • Universal design is a relatively new paradigm
    that emerged from "barrier-free" or "accessible
    design" and "assistive technology.
  • " Barrier free design and assistive technology
    provide a level of accessibility for people with
    disabilities but they also often result in
    separate and stigmatizing solutions, for example,
    a ramp that leads to a different entry to a
    building than a main stairway.
  • Universal design strives to be a broad-spectrum
    solution that helps everyone, not just people
    with disabilities. Moreover, it recognizes the
    importance of how things look. For example, while
    built up handles are a way to make utensils more
    usable for people with gripping limitations, some
    companies introduced larger, easy to grip and
    attractive handles as feature of mass produced
    utensils. They appeal to a wide range of
    consumers.

12
Principles of Universal Design
  • Equitable use
  • Flexibility in use
  • Simple and intuitive
  • Perceptible information
  • Tolerance for error
  • Low physical effort
  • Size and space for approach and use
  • From the Center for Universal Design NC State
    University

13
Universal Design ConceptAesthetically Beautiful
14
UD Design in Environmental Design
15
Applying UD to Old Technology
16
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17
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18
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19
Smart HomesHome automation improves life
  • Security while you are there or remotely using
    your phone
  • Control lighting and audio with touch panels
  • Lights dim, the shades close, the plasma TV turns
    on and your favorite movie begins
  • Window treatments are programmed to adjust at
    pre-set times to reduce glare and protect from
    harmful direct sunlight
  • At night the hallway lights automatically
    illuminate as you walk by
  • Monitor indoor and outdoor temperature for
    comfort and energy savings
  • Vehicle detection outside home

20
Should we be afraid of new technology?
  • New technology can reduce jobs or supplement
    workforce shortages?
  • Create the illusion that physical access is no
    longer needed or enhance universal design
    concept?
  • What will information from smart homes be used
    for?
  • Create moral and legal dilemmas or solve them?

21
  • Technology created for questionable purposes.
  • This fully-motorized wheelchairbuilt from an
    electric golf cart and a Marine rescue helicopter
    seatis equipped with a flamethrower capable of
    firing 15-foot flames.
  • Capable of hitting 20 miles per hour and a
    perfect opportunity for disabled people of the
    world to get even-Steven with all those punks who
    always park in the wrong spots.
  • http//gizmodo.com/393927/flamethrowing-wheelchai
    r-makes-me-want-to-break-a-leg

22
After all hundreds of years ago, people thought
books were new technology. Joelle Brouner
23
Progression of technology
  • Technology started to make care easier for
    providing the care
  • Then it progressed to allow the person with the
    disability to be more independent
  • And is now progressing to allow anyone with or
    without a disability to use it and to benefit
    from it, which allows for more affordability

24
Example Wheelchairs
  • One of the first wheelchairs was invented by King
    Phillip II of Spain. The drawing below shows the
    King dated 1595 in a chair with wheels, armrests
    and footrests.
  • Not usable independently.
  • High costs

25
In the last two decades progress has accelerated
for modern wheelchairs
  • They are lighter and perform better than ever
    before. There are now many possibilities
    available to improve the ride, from suspension
    systems which help to remove vibrations and
    jolts, to ultra-light weight frames which enable
    better performance, to special designs for every
    individualized need and taste.
  • Much easier for individuals to use
  • Still high costs

26
Recent progress
27
Segway
  • For commuting and recreation
  • More individuals are able to use it
  • But not all can use it

28
  • Transformable Wheelchair Concept by Caspar
    Schmitz
  • This wheelchair is made of an elastic as well as
    strong plastic, for example Polyurethane. The
    vehicle becomes adapted to contact face and the
    center of gravity to the situation. Through
    vertical pressure on the handle bar the round
    wheel converts to ellipsoid. As a result of which
    steps and barriers can be taken care of easily.
    This transformable wheel will surely abolish lots
    of barriers and assist people with disabilities
    to carry on their life easily.
  • http//www.tuvie.com/transformable-wheelchair-conc
    ept-by-caspar-schmitz

29
Robotics vacuum cleaner riding vacuum
cleaner
30
Care-O-Bot Can Take Good Care of YouWith rising
spending power and better lifestyle, the need for
providing care services is on the rise. To cater
to these care needs Fraunhofer IPA has developed
the mobile robot assistant to take care of
humans. It is designed to take care of day to day
needs for everyone. The first Care-o-bot was
developed in 1998 with its ability to move around
safely in the human environment. The subsequent
developments have given it the ability to
manipulate regular household tasks.
31
Future use for wheelchair users?
http//www.bostondynamics.com/content/sec.php?sect
ionBigDog
32
Current lift systems
33
Future systems
34
Say the word "exoskeleton" and most people think
of actress Sigourney Weaver in the movie Alien.
http//www.israel21c.org/link.jsp?enDispWhoArtic
lesl2202enZoneHealth
  • ReWalk is an Israeli-developed quasi-robotic
    ambulation system developed by ARGO Medical
    Technologies that provides a viable, upright
    day-to-day alternative to wheelchair users.

35
Being able to use your body
36
Low and high technology for personal public
transportation
37
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38
Universal Design Concept for Transport
  • There was good news for parents with small
    children and wheelchair users today as Translink
    launched Northern Irelands first fully
    accessible, low floor Goldline coach,  the first
    vehicle of its kind in the UK and Ireland. Fitted
    with an electronic ramp and a wide opening door,
    it is the first of 25 fully accessible double
    deck Goldline coaches ordered by Translink as
    part of the overall 50 million investment in
    buses announced in December 2004.  Three-year-old
    Alex Beggs is pictured with mum Helen. Looking on
    is Deirdre Brady, Chief Executive of NIMBA
    (Northern Ireland Mother Baby Action).

39
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40
Barriers
  • Adequate funding
  • Information what is out there
  • Living with dependence on humans and technology
    and no back up plan

41
Being Dependent on Technology
  • Need for back-up technologically
  • Need for human back-up
  • Service animals are great back-up
  • Use alternatives
  • Build an emergency kit
  • Create emergency plan

Julie Keefe for The New York TimesMAINTENANCE
Neal family members check the batteries, gauges
and generator of their power supply.
42
Using Service Animals Instead of Technology
43
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44
  • But even animals can benefit from technology

45
P.L. 100-407, the Technology Related Assistance
for Individuals with Disabilities Act of 1988
(Tech Act)
  • 1. During the past decade there have been major
    advances in technology.
  • 2. Technology benefits all individuals.
  • 3. For some individuals with disabilities,
    assistive technology is a necessity that enables
    them to engage in or perform many tasks. Tasks
    listed include those at home, school, work, and
    in the community.
  • 4. There already exists a substantial number of
    assistive technology devices that could be used
    in early intervention and education,
    rehabilitation and training, employment,
    residential living, independent living,
    recreation, and other aspects of daily living.

46
Tech Act
  • 5. The use of assistive technology devices and
    services by individuals with disabilities can
    reduce the costs of disabilities.
  • 6. Many individuals with disabilities do not have
    access to the assistive technology devices and
    services needed to allow such individuals to
    function in society commensurate with their
    ability.
  • 7. There are insufficient incentives for
    commercial pursuit of the application of
    technology devices because of limited markets.
  • 8. At the federal level, there is a lack of
    coordination among agencies that provide or pay
    for the provision of assistive technology.

47
Funding Sources for AT DME
  • Private Insurance
  • Medicare
  • Medicaid and Waivers
  • Medicare/Medicaid dual coverage
  • Veterans Administration
  • State Vocational Rehabilitation Programs
  • Labor Industries
  • Out of Pocket
  • Charity

48
Many of the devices, modifications, services
discussed are not covered under current funding
sources.
  • Private Insurance, Medicare and Medicaid cover
    DME that is deemed medically necessary
  • Increase in physical independence, being able to
    access your community, education and employment
    may not meet the medical necessity definition.

49
Funding of assistive technology must not be
geared toward a medical view of disability
  • Independent Living Philosophy - Persons with
    disabilities have the same right to
    participation, to the same range of options,
    degree of freedom, control and self-determination
    in every day life and life projects that other
    citizens take for granted.
  • The disability rights movement argue preconceived
    notions and a predominantly medical view of
    disability contribute to negative attitudes
    towards people with disabilities, portraying them
    as sick, defective and deviant persons, as
    objects of professional intervention, as a burden
    for themselves and their families, dependent on
    other peoples charity.
  • This view also has a negative effect on adequate
    funding for future assistive technology.

50
Ideas for Reform
  • Reforming insurance coverage (private
    Medicaid/Medicare
  • Providing Services in the Cash and Counseling
    Model
  • Legislation that supports universal design in
    products and architecture
  • Provide incentives to businesses to create
    technology that doesnt have a wide market
  • Others???

51
Limited Resources Public Policy
  • The access to assistive technologies is properly
    set in the context of civil rights and public
    policy rather than limited to the realm of
    charity or good will. Freedom Machines 2004

52
Support Technology
  • Patty McDonald
  • Aging and Disability Services Administration
  • Email mcdonpm_at_dshs.wa.gov
  • 360-725-2559
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