Transcript Current and Future Assistive Technology Linking Independent Living to Technology

Current and Future
Assistive Technology
Linking Independent Living to
Technology
Patty McDonald
Aging and Disability Services Administration
Email: [email protected]
360-725-2559
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Objective of today’s workshop
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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.
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Statistics
A Minority that includes all People
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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)
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Meaning of Disability and the Influence of
Independent Living Philosophy
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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”
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Independent Philosophy
Based on Civil Rights
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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 people’s charity.
People with disabilities are primarily seen as citizens and
only secondarily as consumers of healthcare, rehabilitation
or social services. People first.
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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.
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Four key needs
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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.
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Stephen Hawking
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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.
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Independent Living
Philosophy Supports
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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 individual’s disability,
support services such as assistive technology,
income supplements or personal assistance are
seen as necessary to achieve equal
opportunities.
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Definitions
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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.
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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.
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Principles of Universal
Design
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Equitable use
Flexibility in use
Simple and intuitive
Perceptible information
Tolerance for error
Low physical effort
Size and space for approach and use
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From the Center for Universal Design NC State University
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Universal Design Concept
Aesthetically Beautiful
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UD Design in
Environmental Design
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Applying UD to Old Technology
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Smart Homes
Home automation improves life:
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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
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Should we be afraid of
new technology?
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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?
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•Technology created for questionable purposes.
•This fully-motorized wheelchair—built from an electric golf cart and a
Marine rescue helicopter seat—is 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/flame+throwing-wheelchair-makes-me-want-tobreak-a-leg
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“After all hundreds of years ago, people
thought books were new technology.”
Joelle Brouner
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Progression of technology
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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
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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
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In the last two decades progress has accelerated
for modern wheelchairs
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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
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Recent progress
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Segway
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For commuting and recreation
More individuals are able to use it
But not all can use it
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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-wheelchairconcept-by-caspar-schmitz
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Robotics: vacuum cleaner riding vacuum
cleaner
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Care-O-Bot Can Take Good Care of You
With 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-obot 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.
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Future use for wheelchair
users?
http://www.bostondynamics.com/content/sec.php?section=BigDog
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Current lift systems
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Future systems
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Say the word "exoskeleton" and most people think of
actress Sigourney Weaver in the movie Alien.
http://www.israel21c.org/link.jsp?enDispWho=Articles^l2202&enZone=Health
• ReWalk is an Israelideveloped quasirobotic ambulation
system developed by
ARGO Medical
Technologies that
provides a viable,
upright day-to-day
alternative to
wheelchair users.
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Being able to use your body
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Low and high technology for
personal & public transportation
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Universal Design Concept for
Transport
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There was good news for parents with small children and wheelchair
users today as Translink launched Northern Ireland’s 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).
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Barriers
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Adequate funding
Information – what is out there
Living with dependence on humans and
technology and no back up plan
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Being Dependent on
Technology
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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 Times
MAINTENANCE Neal family members check the batteries, gauges and generator of their power
supply.
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Using Service Animals
Instead of Technology
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• But even animals can
benefit from
technology
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P.L. 100-407, the Technology Related
Assistance for Individuals with Disabilities
Act of 1988 (Tech Act)
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1. During the past decade there have been major advances in
technology.
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2. Technology benefits all individuals.
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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.
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Tech Act
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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.
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Funding Sources for AT &
DME
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Private Insurance
Medicare
Medicaid and Waivers
Medicare/Medicaid dual coverage
Veterans Administration
State Vocational Rehabilitation Programs
Labor & Industries
Out of Pocket
Charity
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Many of the devices, modifications, &
services discussed are not covered under
current funding sources.
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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.
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Funding of assistive technology must not be
geared toward a medical view of disability
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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 people’s
charity.
This view also has a negative effect on adequate funding for
future assistive technology.
49
Ideas for Reform
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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 doesn’t have a
wide market
Others???
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Limited Resources &
Public Policy
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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”
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Support Technology
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Patty McDonald
Aging and Disability Services Administration
Email: [email protected]
360-725-2559
52