What is assistive technology?
Assistive technology is any equipment, product, software program, that is used to maintain, or improve the functional capabilities of persons with disabilities. Assistive technology creates opportunities for people with disabilities to participate more fully in all aspects of life, increases independence, security, and control at home, work, leisure, and community environments.
Assistive technology can include tools that aid in communication, activities of daily living (ADLs) like toileting, ambulation, eating, and grooming, and also includes electronic aids to daily living (EADLs) for means of controlling appliances and technology.
In this article, we will focus on assistive technology as it relates to augmentative and alternative communication devices, computer access, mobile device access, and environmental control.
WHAT DO I NEED TO KNOW?
Assistive Technology Categories
Augmentative and Alternative Communication
For those who have difficulties using speech to communicate, there are a variety of other strategies and tools available to express ideas and to understand others. This toolset is called augmentative and alternative communication.
Unaided Systems – Communication strategies that do not involve technology aids (ie. .gestures, body language, facial expressions and sign language.
Aided Systems: Low Tech – Simple technology that utilizes basic tools or devices (e.g. writing with pen and paper, pointing to letters, words or pictures on a board)
Aided Systems: High Tech – Communication tools or devices that use computers to assist with communication (e.g. touching letters or pictures on a computer screen that result in audible language output)
Computers have evolved from traditional desktop Personal Computers and Apple Computers to laptops, hybrids (laptops with touchscreens, or tablets with keyboards), and tablets. Powerful mobile devices are convenient and their apps have a lot of functionality. But laptops and desktop computers often have more fully featured operating systems and software applications. At this time of writing, there are three main desktop operating systems: Windows, Mac, and Linux.
Computers set up to be stationary have the advantage of being more reliable. Once equipment is configured and positioned to an individual’s needs, they do not have to be set up again.
A category of technology including smartphones and tablets, which typically have a touchscreen interface and can perform a huge range of functions from communicating via text and audio or video calls, to browsing the internet, playing games, and creating media. At this time of writing, mobile devices run on one of two major operating systems: Android (ie. Samsung, Google) and iOS (ie. iPhone, iPad).
Android (Samsung, Google devices)
- less restrictive use as compared to iOS
- large range of phones at different price points with different “flavours” of Android
- can use external USB/Bluetooth cursor control
- lots of personalization and flexibility in the way the device is used
- overwhelming number of device choices, including some not- so-great options
- operating system updates and feature choices are less consistent and predictable
Apple iOS (iPhone and iPad)
- streamlined operating system among all devices (iPhones and iPads)
- many people find iOS more intuitive and simpler to use
- less likely to be affected by viruses, bloatware, ads
- on average devices are supported for longer
- typically more expensive than devices with similar specifications/features on Android
- more restricted use as compared to Android
Home automation equipment is becoming commonly used for security, entertainment, convenience, and energy conservation purposes. This technology, which is an alternate method of controlling the environment, potentially allows older adults and people with disabilities to remain at home rather than move to healthcare facilities.
Security Systems – Smart video cameras, doorbells, door locks can be used by homeowners to monitor entrances remotely. For example, a homeowner can view live video feed of their entrance to identify who rang their doorbell, and unlock the door remotely.
Emergency Systems – GPS trackers, bed alarms, and call bells can be used to contact staff or emergency personnel when needed.
Technology Control Systems – At this time of writing, more and more electrical appliances have built-in “smart” functionality, which allows them to be controlled remotely, scheduled, and via triggers.
For example, a user can use a smart thermostat to control the temperature in their homes
- Remotely through an app on their mobile device
- Automatically through scheduled activation times
- Triggered when the user’s mobile device enters or leaves a vicinity.
“Recipes” can be created to do multiple actions in sequence. For example, a recipe can be set turn on all the lights, radio, reduce the temperature, and unlock the door with one command.
Alternative Access Methods:
Typical “QWERTY” keyboards come in many shapes and sizes. Some offer bigger or smaller keys, higher or lower action, and different tactile feedback. The keyboards themselves can also have different layouts, ergonomics, spacing between keys, or keyguards to help with accuracy.
Alternate Cursor Control
Typical cursor control on computers or Android tablets involve the use of computer mice. Alternative ways of controlling the cursor on the screen include various configurations of trackballs and joysticks. There are joysticks that are controlled using the tongue or lips!
Special cameras can also be used to detect head or eye movements to direct the cursor.
Eye gaze technology involves using eye movements to select onscreen choices. The user rests on an area of the screen they want to make a selection (ie. a letter on the onscreen keyboard, or an icon) and after a predetermined length of time the device automatically selects the item.
Voice dictation is a feature found on contemporary mobile devices and computers, which reduce the amount of effort needed to type by converting speech to text. The current gold standard for voice dictation software on computers is Dragon Naturally Speaking.
Voice recognition is often integrated with “smart assistants” so that verbal commands can be given to control appliances in the environment, retrieve information from the internet, set reminders, or dial phone numbers.
Direct selection is an access method that involves touching a touchscreen device with finger, stylus, or any conductive body part.
There are switches that are used as an access method for just about any type of voluntary, reliable, and repeatable action. These include switches that are activated by button presses, lever pulls, sound, eye-blink, and sip/puff into a straw. Physical access switches can come in all shapes and sizes, amount of activation pressure, deflection, resistance, and can give a user different access depending on their placement location. Oftentimes, the way a switch is oriented and positioned is just as important as the selection of the switch.
Device scans through onscreen options automatically with a pre-determined time delay, and user makes the selection via a switch. With scanning, a single switch can be used to select multiple options.
Oftentimes, routine tasks can be performed without the need for human interaction. For example, sprinklers can be set to turn on 3 times per week at a specific time, or the goldfish feeder can deposit food into the tank every 12 hours. Even tasks like making dinner reservations or buying gifts online can be automated!
Similar to scheduled automation, sensors can be used to trigger actions without the need for direct human input. A common everyday example is automatic sliding doors which trigger open when the motion sensor is activated.
Wheelchair Drive Controls
Power wheelchairs can be outfitted with special electronics that enables drive controls to be used as access methods for other technology. For example, the joystick, head array, or sip/puff, which traditionally is only used to drive the chair, can also be used to navigate through computers, mobile devices, or even directly control appliances in the environment via Bluetooth or infrared transmitters.
Multiple assistive technologies and access methods can be combined to maximize efficiency and independent activity. For example, wheelchair joystick to control mouse cursor movement, an external switch to click, and a microphone paired with voice recognition software can all be used together to encompass all aspects of computer access.
Whether it is a device that is mounted to a wheelchair for mobile access and viewing, or a call bell that is mounted to the bed rail for access while lying down, various mounting systems – either commercially available or custom built, can help to make technology more accessible.
There are times when no commercially available devices or applications are suitable for an individual’s needs. In those instances, custom hardware or software adaptations need to be made.
Traditional methods using machine shop tools and metals/wood/plastic can be used to create custom mounts, or modify existing technology to be more accessible. 3D printing is another method of creating various grips, guards, and adaptors for an individual’s needs. An advantage of 3D printing is that once the design is created, it can be easily shared and reproduced!
Sometimes custom software needs to be written to change the way software responds to user input, but most of the time just some simple adjustments to accessibility settings can make using computers or mobile devices much easier.
Future of Assistive Technology
Assistive technology is becoming more functional, readily available, and cheaper. The use of this technology enables those with disabilities not only to be more independent than ever, but also pursue career and recreational goals, and participate in the community.
WHAT CAN I DO?
How do I choose the right technology for me?
Consumer Electronics VS Dedicated Devices
Consumer electronics may not have the extra accessibility features, or customizability that comes with dedicated assistive technology devices.
With consumer electronics options available, it can also be difficult to choose the right combination of technology that will work well with each other, in particular environments, and that are suited to an individual’s needs.
In either case, it is recommended to consult with professionals who can help with selection, setup, and equipment trials.
WHO CAN HELP ME?
Assistive Technology/Rehabilitation professionals
These professionals keep up with the ever-changing technology. They know the trade-offs between different devices and software, take into consideration the client’s needs and goals, environmental factors, and how the addition of, or change in technology can impact day to day activities.
Local “makers”, like the volunteers from Tetra Society (see below), are great at building modifications to make devices, mounts, or furniture more accessible. They are a great resource when commercially available products do not exist, are not suitable, or are cost prohibitive.
Family and caregivers who are familiar with assistive technology can help setup, troubleshoot and adapt this equipment to the needs of the patient and their environment.
Online Resources and Tutorials
Educational resources are readily available on the internet via web articles, tutorials, and youtube videos.
Local Tech Support
Many brick and mortar stores or wireless carriers that sell consumer electronics offer some level of tech support for customers. Some also have display units and generous return policies, so that customers can try technology out for themselves before making purchases. Depending on the device brand or vendor, they may also provide troubleshooting and repair services.
For example Apple products, (iPhone, iPad, Mac computer) are well supported at Apple Stores. They provide drop in and appointment only device troubleshooting, education, and guided group sessions.
Technology can do incredible things to keep people connected, make everyday tasks easier, and provide entertainment. Choosing the suitable systems of technology and identifying appropriate access methods can be an overwhelming task. Professionals and community experts can help select equipment, make adaptations when needed, and provide tech support.
Connect with one of the following groups to see what they can do for you. Programs and services offered by each of these organizations may change from time to time, so be sure to visit the links below for the most up-to-date information.
LOCAL ASSISTIVE TECHNOLOGY ORGANIZATIONS AND SERVICES
GF Strong Assistive Technology – Assistive technology service based in GF Strong Rehabilitation Centre that provides consultation services to clinicians and their clients with disabilities in the public health system of British Columbia and Yukon. The service consults with and supports a client team in the assessment, selection, and application of technology to further an individual’s goals related to communication, vocation, education, leisure, and independent living. Focus is on physical access to technology in the areas of computers, mobile devices, environmental control, and communication.
Referral to the service and equipment trial is by clinician only.
GF Strong Assistive Technology also supports the access technology needs of inpatients at GF Strong, and maintains a resource centre with adapted computer stations and equipment.
Technology for Independent Living (TIL) – Services include assessment, installation, and repairs for environmental control systems that assist people with high level physical disabilities to control devices in their home and on the go.
- Environmental Control (Smart Home Access): Device provisions include smart home speakers, lights, switches, and plugs, TV control devices, attention getters, and mobile device access equipment.
- Door Opener Systems: Automatic door openers for individuals who cannot independently open doors to their suite or single family homes.
Neil Squire Society – The Neil Squire Society is the only national not-for-profit organization in Canada that has for over thirty years empowered Canadians with disabilities through the use of computer-based assistive technologies, research and development, and various employment programs. Neil Squire Society helps to remove barriers so that clients can live independent lives and become active members of the workplace and society.
- Computer Comfort: No cost service providing one-on-one computer tutoring for adults with disabilities.
- Makers Making Change: Initiative connecting “makers” to people with disabilities who need assistive technologies. Projects are all open-source with complete parts lists, and assembly instructions. Users can also find or request 3D printing schematics for assistive equipment.
- LipSync, one of the projects, is a mouth operated joystick mouse cursor control solution for Android tablets, Windows tablets, and PC/Mac computers.
- Solutions: Fee-for-service program utilizing a team of occupational therapists and assistive technology specialists to provide a range of related services to meet individual ergonomic and assistive technology needs, in a variety of settings including workplace, home, and classroom.
CanAssist – CanAssist at the University of Victoria is dedicated to helping people with disabilities improve their quality of life, with a focus on promoting independence and inclusion. The team of software developers and engineers develop customized technologies and programs where there are no commercially available solutions and funding can be secured.
Assistive Technology British Columbia (ATBC) – ATBC provides assistive technology resources to make learning and working environments usable for people with disabilities throughout British Columbia. Services include assistive technology assessments, equipment loans, training, and consultation for those seeking or in Post-Secondary Educational Institutions. Also provides transition services from Post-Secondary Education to employment.
Communication Assistance for Youth and Adults (CAYA) – CAYA is a province wide service that supports adults aged 19 years and older who require an augmentative/alternative communication system due to a severe communication disability ie. speech that is not functional for daily communication.
Additional assistive technology information and resources
Ability411 – Question and answer website written by professionals about assistive technology and equipment
AbleGamers – Custom Gaming Setups and Information
Can I Play That – Accessibility focused game reviews and news.
Craig Hospital Assistive Technology – Rehabilitation Hospital in Denver, Colorado with an excellent selection of online resources
Lifewire – Helpful technology reviews, tutorials, and troubleshooting tips
OneSwitch – Switch users and Game Accessibility Solutions
Smart Homes Made Simple – Articles, tips and resources about environmental control using generic smart home technology
This website contains general information about medical conditions and treatments. All information, content, and material of this website is for informational purposes only and are not intended to serve as a substitute for the consultation, diagnosis, and/or medical treatment of a qualified physician or healthcare provider. (c) 2019 Spinal Cord Injury BC