Previous |
Contents |
Next |
|---|
[117] MUSICAL INSTRUMENT DIGITAL INTERFACE FOR CHILDREN WITH PHYSICAL DISABILITIES
Isaac Kurtz, MHSc; Roger Knox, PhD; Gilbert Chau,
EEngT
Bloorview MacMillan Centre, Toronto, ON Canada M3H 2B3;
email: ortcik@oise.utoronto.ca
Sponsor: Bloorview MacMillan Children's Foundation
PURPOSE--The project aims to broaden the scope of possibilities for recreation and social interaction for children and adults with severe physical impairments through the creation of a single switch interface to a Musical Instrument Digital Interface (MIDI) keyboard and exploring how to best integrate music into education, therapy, and play. MIDI is a universal standard that allows musical keyboards and instruments to communicate electronically.
PROGRESS--MIDImate is a device that allows people with physical disabilities to play music independently with a single switch. The device consists of an LCD display, adapted switch inputs, a MIDI connection for electronic keyboards and a removable cartridge containing a microprocessor with software to play music. Two types of cartridges have been produced. One allows users to play individual notes, chords, and arpeggiated chords from one, two, or three switches, with a fourth switch for the control of tempo and the fundamental note being played. This cartridge allows individuals or groups to play harmony and accompany virtually any song or melody. Virtually any instrument, or even choral music can be played. The second type of cartridge is a melody cartridge that allows using single switches to play from a choice of approximately 10 melodies. A second switch can be used for chord accompaniment. The tempo and timing of the music are controllable by the user. Melody cartridges for children, teens, and seniors have been produced. Custom melody cartridges with musical choices of individual clients have also been produced. Pilot testing of MIDImate at the Bloorview MacMillan Centre school has begun. The goal is to develop age and ability appropriate group and individual musical activities for musical education and recreation.
FUTURE PLANS--A manual for Occupational, Physical, and Music therapists outlining the activities developed in this project will be produced. The development of a modified music education curriculum for children with physical disabilities is a long-term goal of this project.
[118] EFFECTIVENESS OF ENVIRONMENTAL CONTROL UNITS
Rob Garrett, BTech, Grad Dip Maths; Ruth Croser, BAppSc
(OT); Barry Seeger, BE, PhD; Paul Davies, BEng
Regency Park Rehabilitation Engineering, Regency Park,
South Australia 5942; email:
rgarrett@eol.ieaust.org.au
Sponsor: The Crippled Children's Association of South Australia Inc., Regency Park, South Australia 5942
PURPOSE--The aim of this study was to determine the impact of a short-term trial of environmental control technology on people's perceived levels of independence and frustration when using mains-powered or infra-red controlled appliances.
METHODOLOGY--Eight subjects tested various environmental control options over a 2-wk period to assist them in accessing appliances they considered to be a high priority. Subjects used no environmental control technology for 2 wk, a useful environmental control solution for an additional 2 wk, and then returned to using no environmental control technology for a final 2 wk. Subjects rated their independence, frustration level, and average time taken to complete the task before, during, and after the equipment trial. Results were analyzed as single case study designs run in parallel.
PROGRESS--All participants indicated the use of environmental control technology increased independence, decreased frustration, and decreased time taken to complete the task
FUTURE PLANS--As a result of these positive findings, we may undertake further research in this area. Initially we are setting up a demonstration centre at the Independent Living Centre of SA for clients to try new home automation technologies.
[119] COMPUTER ACCESS SELECTOR AND VOCASELECT
Rob Garrett, BTech, Grad Dip Maths; Duane Stapleton,
BEng; Paul Davies, BEng
Regency Park Rehabilitation Engineering, Regency Park,
South Australia 5942; email: rgarrett@eol.ieaust.org.au;
duanes@eol.ieaust.org.au
Sponsor: The Crippled Children's Association of South Australia Inc., Regency Park, South Australia 5942
PURPOSE--Computer Access Selector (CAS) and VOCAselect are computer programs that aim to assist in the selection of alternative computer access and voice output communication devices respectively, processes which, for an individual with a disability, involve a compromise of many different parameters. Professional assessment is generally required to determine the needs and abilities of such a person who wishes to access a computer or communicate via a device. Even when their capabilities are understood, selection of specific products is not necessarily straightforward, due to the number of products available. CAS and VOCAselect narrow down the large number of products, based on feature selections made by the user.
METHODOLOGY--The programs give the user an opportunity to specify the requirements of the system or device they are looking for by selecting from a series of parameters. They then use expert knowledge to suggest potentially suitable products. The suggestions are dynamically adjusted as selections are changed, enabling the user to explore different possibilities and trade-offs, viewing details about a product and seeing a picture of it on-screen with a mouse-click. Manufacturer and Australian supplier contact information is provided in the product details. The software can be instructed to generate a report of the findings for printing or inclusion in a word processing document.
PROGRESS--CAS version 1.0, a Windows-compatible program, was released in 1995 and subsequently offered free for evaluation purposes. It has now been distributed to a large number of interested individuals, professionals, and organizations. In late 1997, versions 2.0 of VOCAselect for Windows and Macintosh and CAS for Windows were released. All programs underwent alpha- and beta-testing prior to release, and are now available for A$29.00. A demonstration version of the software is available on our web page http://regencyrehab.cca.org.au/
RESULTS--Feedback and responses have been sought from users, primarily via survey questionnaires sent with the software. The survey results have been used to assist in the development of the next versions of the programs.
FUTURE PLANS--The product information contained in both software packages is expected to be updated annually.
[120] CHARACTERISTICS OF GENITAL SKIN FLORA IN PERSONS WITH SCI AND THEIR EFFECT ON DEVELOPMENT OF URINARY TRACT INFECTION
Ken B. Waites, MD
University of Alabama at Birmingham, Department of
Pathology, Birmingham, AL 35233; email:
waites@wp.path.uab.edu
Sponsor: National Institute on Disability and Rehabilitation Research, US Department of Education, Washington, DC 20202-2646
PURPOSE--The nature of changes occurring in microbial ecology of the skin and urinary tract after SCI, resulting in the establishment of diverse, antibiotic-resistant flora are complex and poorly defined. Increased understanding of these changes through data provided by this study may lead to ways of preventing or eliminating skin colonization by urinary pathogens following SCI, and ultimately lead to reduced occurrence of complications resulting from urinary tract infections (UTI).
This study will determine whether there is a significant difference in skin colonization by urinary pathogens in those persons with SCI who retain normal bacterial flora of the genital skin long after injury in comparison to those who have chronic or recurrent bacteriuria. Whether the nature and degree of surface colonization and development of bacteriuria are affected by bladder management method will also be assessed.
The study will also evaluate the natural history of skin colonization in hospitalized persons with SCI, and determine whether and how administration of systemic antibiotics affects skin colonization and development of bacteriuria.
This study differs from prior investigations in that it includes persons injured many years ago, evaluates larger numbers of persons using different bladder management methods, and includes quantitative microbiologic procedures sufficient to detect all pertinent bacterial species and determine antibiotic susceptibility patterns.
Our specific objectives are first to determine relationships among urethral and perineal bacterial flora, bladder management method, and bacteriuria in males with long-standing SCI, and second to determine the effect of systemic antibiotics on bacterial flora of the urethra and perineum in men with SCI currently hospitalized and undergoing treatment for UTI.
METHODOLOGY--A cross-sectional study will examine cultures of the perineum and urethra obtained simultaneously with urine cultures and urinalysis on eligible persons who return to the UAB-SCICS clinic for routine annual evaluation. If antibiotics are being taken for any reason, these data are recorded. Also recorded are any positive urine cultures greater than 100,000 colonies/ml since their last annual and for which antibiotics were given. Persons whose urine culture is negative will be cultured again at their next annual evaluation to determine whether the characteristics of skin flora and freedom from bacteriuria persist. Only men are being included in this investigation because of the nature of the study.
The data analysis will compare the percentage of persons with each degree of bacteriuria by the method of bladder management. Next the percentage of persons with each type of bladder management who have abnormal skin flora will be compared. The results of the urethral, perineal, and urine cultures will then be used to determine whether persons with negative urine cultures are less likely to have pathogenic bacteria on the skin.
For those persons who have negative urine cultures initially, the percentage who remain negative at the next annual evaluation will be compared for each type of bladder management.
A prospective follow-up study will be performed on hospitalized persons with SCI who develop UTI requiring treatment. Urethral and perineal cultures will be obtained just before initiation of systemic antibiotic treatment, during treatment, and 7 days after treatment. This will allow determination of the effect of systemic antibiotics on skin flora.
PROGRESS--This project began fall 1996. The first patient was enrolled March 1997. We have developed a syllabus and data collection instruments, finalized project entry criteria and trained data collector. To date, 42 subjects have been enrolled in the study, none of whom experienced any adverse effects.
[121] ASSESSING INDIVIDUALS' PREDISPOSITIONS TO THE USE, AVOIDANCE, OR ABANDONMENT OF ASSISTIVE TECHNOLOGIES
Marcia J. Scherer, PhD, MPH
The Institute for Matching Person & Technology, Inc.,
486 Lake Road, Webster, New York 14580; email:
IMPT97@aol.com
Sponsor: National Science Foundation, Ethics and Values in Science and Technology, and Program for Persons with Disabilities, Arlington VA 22230
PURPOSE--Predispositions to assistive technology (AT) use depend upon characteristics in four major areas: a) the features and functions of the particular technology, b) the preferences and needs of the user, c) the nature of the need for the technology (i.e., disability type and severity), and d) both resources and disincentives in the person's physical and psychosocial environments.
METHODOLOGY--The Assistive Technology Device Predisposition Assessment (ATD PA) was created from the revealed differences between known technology users and nonusers. It has subscales to separately assess characteristics in each of the following four areas: a) the particular technology (e.g., perceived benefit from use); b) the person's capabilities and personality (e.g., aptitudes, outlook, expectations); c) the nature of the disability (e.g., type, severity); and d) the person's psychosocial environment (e.g., support from family and friends, life experiences, education). It is a consumer self-report checklist with 63 items of varied format, including 5-point Likert scales, developed to identify potential sources of person and technology mismatches for targeted intervention. Side One of the consumer form consists of 53 questions on preferences, psychosocial resources, and inquires into subjective satisfaction with current functioning in many areas and where the person wants the most improvement to occur. Side Two contains 10 questions addressing technology with regard to their views of and expectations for that particular AT. A companion professional form is similarly constructed and allows the assessment of shared perspectives between consumer and professional.
The ATD PA is one set of assessment instruments in the Matching Person and Technology (MPT) process. Other instruments are the Worksheet for the Matching Person & Technology Model, Survey of Technology Use (SOTU) and the Educational Technology Predisposition Assessment (ET PA).
PROGRESS--The MPT manual was updated in 1998. One addition is a list of validation studies in the Bibliography. Our study on predispositions to hearing aid use to be published in JRRD describes the results of the ATD PA obtained from persons with marginal hearing loss.
Peer mentors at the Rochester Center for Independent Living use the MPT process to help consumers identify the best technologies and other resources for their use. Additionally, an occupational therapist has adapted the MPT assessments for use in matching person and service animal. Workshops on the MPT Process have been conducted in Ireland, Italy and the Netherlands, and this year we shall complete the data analyses on the project, Facilitating Optimal Outcomes of Persons with SCI Through Assessment of Perceived Needs and Person-Technology Fit.
FUTURE PLANS--A project is underway to further study differences in predispositions to hearing aid and ALD use by persons with varying degrees of hearing loss.
[122] DEVELOPMENT OF AN ASSISTIVE ROBOT FOR EFFECTIVE HEALTH CARE DELIVERY
H.F. Machiel Van der Loos, PhD; Charles G. Burgar,
MD
Rehabilitation R&D Center VA Palo Alto Healthcare System
Palo Alto, CA 94304-1200; email:
vdl@roses.stanford.edu
Sponsor: Department of Veterans Affairs, VA
Rehabilitation Research and Development Service, Washington,
DC 20420
(Project #B899-2DA)
PURPOSE--Over the past 7 years, veterans with high level quadriplegia have been testing the ability of the DeVAR robotic workstation to replace an attendant for independent execution of vocational tasks. These tests have proven feasibility, and along with the recent VA Technology Transfer Section (TTS) evaluation, have clarified the next necessary phase of development that will advance the workstation to successful commercialization. The primary goals for this new phase, called ProVAR, are more functionality per dollar, easier operator control, and higher system reliability.
METHODOLOGY--The research plan involves 1 year of intensive design and low-level development, including evaluation methods and materials, 1 year of iterative development and evaluation cycles of subsystems, and a third year of full system evaluation in collaboration with this VA facility's Spinal Cord Injury Center.
Increased functionality is being achieved by refining the previous DeVAR interface so that users can design their own robot tasks without having to become robot programmers to do so. Adding force and touch sensors that detect surfaces and objects allows the robot to make adjustments, when needed, and verify that tasks are done correctly and safely. The combination of the new interface and the sensors is the key to a successful implementation, since neither advance alone will meet the challenge of providing effective user control of robot programming.
PROGRESS--The reliability of the robot is increased by use of a commercial control system that integrates motion, sensing, and communication functions. The controller has a dedicated link to the interface computer, which has a separate link to the Internet. This modular approach enhances reliability, and provides a rich, multimedia communication path for troubleshooting, training, and information exchange between the user, the robot manufacturer, therapists, and other users. The TTS evaluation demonstrated the tremendous importance of communication for system maintenance and downtime reduction. We are developing customized, network-based software for remote diagnostics and troubleshooting that will allow fast response to problems that arise in the field.
RESULTS--The start-up and preliminary development phases are complete. We have procured the necessary hardware and software for robot controller, user interface, networking, and sensor subsystems. We have specified and implemented critical, low-level communication protocols. Interface and controller programming and evaluation are ongoing. Evaluation methods and materials from previous DeVAR evaluations are being used to develop augmented data instruments. Collaboration with Spinal Cord Injury Center clinical staff is ongoing to develop task lists, user profiles and staff needs.
Adaptive access equipment for a Windows environment allows operators to use head motion, speech, and residual arm motion to operate a keyboard, pointing device, and other equipment. The interface design is based on WWW standards, including VRML and JAVA, for modeling and communication. A graphical user interface has been developed to send commands to the controller. QNX-based controller software for full dynamic control of a PUMA robot has been implemented.
FUTURE PLANS--The last year of the project will be devoted to final development work, intensive user testing, and publication of project results.
[123] DEVELOPMENT OF AN ASSISTIVE MEMORY DEVICE FOR PATIENTS WITH SEVERE AMNESIA
Gerald Goldstein
VA Pittsburgh Healthcare System, Highland Drive
Division, Pittsburgh, PA 15206
Sponsor: Department of Veterans Affairs, VA
Rehabilitation Research and Development Service, Washington,
DC 20420
(Project #F471-5PA)
PURPOSE--The specific purpose of this pilot investigation was to evaluate whether an assistive device shown to be effective with patients with pure amnesic disorders (Korsakoff's syndrome) can be productively applied to brain-damaged patients with multiple deficits including, but not restricted to, memory. The study planned was concerned with densely amnesic patients, and with the evaluation of a small, portable device that subjects can use to access ADL-relevant information. Training to use the device involved a conditioning procedure shown to be effective in previous research. The major goal of the study was that of determining whether subjects could be successfully trained to use the device, and whether such training substantially improved memory function in everyday life.
METHODOLOGY--Subjects were recruited on the basis of presence of severe memory disorder associated with Alzheimer's disease, or other neurological illness associated with severe dementia and amnesia. A neuropsychological assessment was used to determine eligibility for the study. Subjects meeting the criteria were to be introduced to the training device and to engage in the conditioning program. The goal of the program was to teach the subject to independently use the device upon a verbal request for information that the device contained. Learning curve data would be accumulated, and various measures administered before and after training were to be used to assess outcome.
PROGRESS--Substantial effort has been made to recruit subjects for this study. Of 13 patients approached who met the criteria of severe aninesia and other cognitive deficits, who were mainly patients with Alzheimer's disease, they all either did not meet psychometric inclusion criteria, could not cooperate for psychometric testing, or could not understand the requirements of the training. We were unable to enter any subjects with diagnosed Alzheimer's disease who could cooperate for the program. Our conclusion from this pilot work is that training to use an assistive memory device, while effective with patients with severe but pure amnesic disorders, is unlikely to be effective for patients with progressive dementia.
FUTURE PLANS--We remain committed to finding effective methods for improving functional capacity and quality of life for brain-damaged patients. However, we appear to have convincing evidence that a method shown to be remarkably effective for patients with a neurobehavioral disorder that involves a single domain, in this case memory, was not found to be effective in patients with more generalized cognitive dysfunction. Perhaps usage of "smart" technologies in the environments of these patients would be more productive.
[124] CREATION OF A SINGLE SWITCH INTERFACE TO A MIDI KEYBOARD
Isaac Kurtz, MHSc, PEng; Roger Knox, PhD
Bloorview MacMillan Centre, Toronto, ON, Canada M4G
1R8
Sponsor: Bloorview MacMillan Children's Foundation, Bloorview MacMillan Centre, Toronto, ON, Canada M4G 1R8
PURPOSE--This project aims to fill a gap in currently available access to music-making by persons with significant motor impairments. It is an affordable, portable, easy-to-use device intended to allow persons with cerebral palsy and other disabilities to play sounds and music on a Musical Instrument Digital Interface (MIDI) synthesizer or keyboard. The primary target group is children with spastic quadriplegia who are already using switches to access computers, communication devices, and powered wheelchairs.
METHODOLOGY--MidiMate is a prototype switch interface and controller which connects standard ability switches to any MIDI-compatible synthesizer, sound module, or computer. It includes an LCD display, adapted switch inputs, a MIDI connection to electronic keyboards, and removable cartridges containing microprocessors with software to play music. One type of cartridge allows one switch to play melodies while a second switch can add accompanying chords. A series of cartridges includes music for people of various ages and backgrounds. Another type of cartridge allows notes, chords, and arpeggiated patterns to be assigned to three different switches.
PROGRESS--During 1997, activities were developed and the device was tested extensively in a number of settings including Cyberkids, a summer recreation program at the Bloorview MacMillan Centre, and the Community Music Therapy Clinic of Wilfrid Laurier University. Further testing was planned for "Composing in the Classroom," a series of 20 sessions for children with and without disabilities at the Bloorview MacMillan Centre School during January-April, 1998. A questionnaire was developed and extensive user feedback, video, and ideas for refining the prototype were gained from these programs.
FUTURE PLANS--From April 1998 through March 1999, an upgraded version of the device, user manual, and curriculum will be developed and tested. A research proposal for incorporating the device into group music-making and investigating benefits in the areas of learning, self-esteem, and independence has been prepared and a commercial partner for the device is being sought.
[125] PERSONAL PORTABLE COMMUNICATIONS THROUGH CELLULAR TELEPHONE INTERFACES
Ed Snell, CET; Paul O'Brien, BTech
Bloorview MacMillan Centre, Toronto, ON, Canada M4G
1R8
Sponsor: Bell Mobility, Bloorview Childrens Hospital Foundation, OKI Telecom
PURPOSE--Many commercial telephones do not address the needs of personal communication for persons with disabilities when used outside of the home environment. Persons with more severe disabilities could have their personal communication needs met through wheelchair-mounted cellular telephones requiring minimal input to operate. This would increase access to the community and enhance vocational and recreational activities by facilitating personal safety and security.
METHODOLOGY--A consumer focus group was established to identify important adapted telephone features and, later, to perform the field evaluation of a cellular telephone interface called CELLINK. All consumers used powered wheelchairs and had normal visual acuity and hearing.
Consumers have used the CELLINK units in the community for approximately 2 yrs. There were no reports of electromagnetic interference with any of their assistive technology, although one reported that he thought operation of the cellular telephone increased muscle spasms. All felt that the CELLINK increased their independence, particularly for getting help in a timely manner, personal safety, and acquiring transportation. Some felt that having the CELLINK gave them the security to go places spontaneously in their wheelchairs where they normally would only have gone with organized transportation. They were less concerned with becoming stranded in the community, which promoted more outings.
PROGRESS--Developments in the area of personal communications continue in measuring the quality of life impact provision of accessible cellular telephone has on persons with severe disabilities. The CELLINK interface is being provided to 20 additional consumers in the metropolitan Toronto area. CELLINK can now be interfaced to a broader range of cellular telephone models. Also the CELLINK system has been prototyped in a graphical user interface (GUI) based on the Windows CE platform. Access is provided through direct touch screen contact, keyboard, or external switch-controlled scanning methodologies. Work continues on integrating the cellular telephone functions with existing Windows CE capabilities.
FUTURE PLANS--Infrared capabilities are being incorporated into the CELLINK design to provide access to land-line telephones through the same user interface. Similar work will be performed with the Windows CE platforms but will also explore GUI systems for operating other infrared devices including environmental control.
[126] INTERNET-BASED INTERACTIVE VIDEO IN REHABILITATION
Edmund Biden, DPhil; Alden Parker; Kathryn
LeBlanc
Institute of Biomedical Engineering, University of New
Brunswick, Fredericton, NB CANADA E3B 5A3; NB Tel
Interactive, Saint John NB; Stan Cassidy Centre for
Rehabilitation, Fredericton, NB E3B 4R3; email:
biomed@unb.ca
Sponsor: Canadian Network for the Advancement of Research, Industry and Education (CANARIE Inc.), Ottawa, ON, K1P 6H5
PURPOSE--This project will develop and test the use of interactive video over the Internet to provide follow-up for clients using high technology prosthetic arms, seating systems, or communications devices. The program draws on the technical and clinical expertise of NB Tel Interactive (NBTeI), The University of New Brunswick Institute of Biomedical Engineering (IBME), and the Stan Cassidy Centre for Rehabilitation (SCCR), and involves testing of the systems to be developed with clients from the IBME Prosthetics Service and the Adaptive Seating and Augmentative Communications Programs at SCCR.
METHODOLOGY--The project will of integrate commercially available Internet-based video technology to produce an easy-to-use system for communication between the clinic and the client at home. The development portion of the project involves preparing an Internet-ready video link that will make use of the existing Wellness Network provided by NBTel. Currently available computer and video camera combinations will be evaluated by computer and communications specialists from NBTel and IBME, and by the clinical teams at IBME and SCCR.
We shall develop a user-friendly interface to the Internet using a computer, video camera, and related software. Commercially available technology will be bundled to produce a robust package. We shall also design user protocols and guidelines, so that any subsequent marketing of the system can recommend not only hardware and software, but also the methods of application.
PROGRESS--Systems to perform the above functions are in development and are expected to be tested in the field as part of a pilot program beginning fall 1998. Preliminary results are expected by spring 1999.
IMPLICATIONS--The Atlantic Provinces in general and New Brunswick in particular are relatively rural and even the cities are small. On the other hand, the level of telecommunications service is very high and NB Tel provides a private and secure intranet for the New Brunswick Health Care Community.
Both SCCR and IBME face the same problem. When clients who have recently been fitted with prostheses, or have been supplied with assistive technology, return home, they are remote from the centers. Problems with fit or technology function which cannot be described well over the telephone then require a trip to the center for evaluation. Making use of this technology will reduce client travel and will make more effective use of the time of rehabilitation professionals.
[127] VOCABULARY ORGANISER: FORMERLY THE AUSMAP DATABASE
Duane A. Stapleton, BEng; Jenny Faulks, BAppSc (SpPath);
Bronwyn Timko, BAppSc (SpPath); Rob Garrett, B.Tech, Grad
Dip Maths
Regency Park Rehabilitation Engineering, Regency Park,
South Australia 5942; email: duanes@eol.ieaust.org.au; web:
http://regencyrehab.cca.org.au/
Sponsor: The Crippled Children's Association of South Australia Inc., Regency Park, South Australia 5942
PURPOSE--The Vocabulary Organiser (VO) is a computer-based tool for storing, organizing, and printing vocabulary for users of communication devices that employ symbol sequencing. Alternative Augmentative Communication Devices that can use key sequencing for encoding vocabulary have been used extensively with clients of the Crippled Children's Association of South Australia (CCA) since 1993. During the past 4 years, therapists in CCA have produced customized symbol-sequenced vocabulary to suit the specific needs of users. There was great success in using key linking or symbol sequencing with a broad range of clients within various settings to them to have access to wider vocabulary than by simply using single message systems or the use of multiple vocabulary displays as in a levels-based system. As a result of the success clients were having, it became necessary to investigate options for quick and easy methods for recording the vocabulary and organizing individual dictionaries and support materials. VO is the software developed to address this need.
METHODOLOGY--A formal specification was developed that included the following key features: complete, user-friendly recording system for sequence encoded vocabulary; the ability to selectively choose and print vocabulary and icon sequences in a range of sizes and layouts; the ability to store vocabulary specific to certain users; and the ability to add, delete, and edit the vocabulary.
PROGRESS--We produced and tested an initial version of the software (AusMAP), and released it commercially in early 1998 under the name Vocabulary Organiser. The software is centered around a large table of words/phrases and their corresponding symbol sequences. Each entry also allows storage of one or more descriptions, one or more theme tags, and one or more user tags. A theme tag is any word or short phrase denoting a distinguishing characteristic of a group of dictionary entries, such as "food" or "sport." A user tag is a name identifying a certain device user or group of users. Besides the core dictionary, the software includes extensive facilities for extracting and printing subsets of the dictionary in the form of reports, dictionary listings, or therapy worksheets.
RESULTS--VO has been received by speech therapists and assistants with enthusiasm as a vast improvement over previous means of recording and organizing sequence-encoded vocabulary of widely varying types.
FUTURE PLANS--Version 2.0 is now being planned to incorporate feedback received from users of version 1.0. The software will continue to be used by the CCA Speech Pathology Department, including both therapists and assistants. It will also be used by educators and families for the development of customized dictionaries, and the production of therapy and educational material.
[128] EFFECTIVENESS OF USING VOICE RECOGNITION SYSTEMS
Ava-Lee Kotler, MS; Cynthia Tam, BSc
Bloorview MacMillan Centre, Toronto, ON M4G 1R8
Sponsor: Ontario Ministry of Health, Neurodevelopmental Clinical Research Unit McMaster University, Faculty of Health Sciences, Hamilton, ON L8S 4K1
PURPOSE--The purpose of this pilot study was to evaluate the use of voice recognition systems (VRS) to create text and the effects of discrete utterance speech on participants' voices.
METHODOLOGY--Participants were clients who have been prescribed VRSs to use as writing aids; six were recruited for this preliminary study and asked to complete various typing tasks and to answer questions regarding the use of their system. Speed and accuracy of text generation, and the VRS' accuracy were calculated. Tape recordings of each participant's speech were obtained in order to evaluate voice quality. Responses to interview questions were analyzed descriptively.
PROGRESS--Six persons between the ages of 19 to 35 years have completed the above protocol. Each has a different diagnosis (e.g., muscular dystrophy, upper motor neuron disease, scleroderma, and thoracic output syndrome).
RESULTS--Speed of text generation and accuracy were not calculated for one of the participants because she was no longer using her computer and was not familiar with the correction procedures to use her software. The average speed for all dictation tasks was 12.7 wpm. Speed of dictation for all tasks ranged from 4.0 to 29.6 wpm. Recognition accuracy was rarely above 90 percent (range 52.6 to 100 percent). The number of utterances (dictation words, formatting words, and words used to correct misrecognitions) required to produce a specified amount of text was, on average, twice the number contained in the actual text. Participants found that their VRSs were appropriate for use with word processors, but very limited for use with other applications. In addition, participants reported that the use of VRSs affected their voices and related areas (i.e., mouth and throat).
IMPLICATIONS--The finding of low speeds of text generation suggest that people who can use their keyboard to some extent (e.g., slow typists), may not be able to increase their speed by using VRSs. Voice recognition can be effective for people relying on alternative access methods to write; however, users need to balance the benefits of voice recognition with its limitations.
[129] TOWARD TASK TRANSPARENCY: SELECTION OF TEXT THROUGH SWITCH-BASED SCANNING
Fraser Shein, PhD, PEng; Mark Chignell, PhD
Bloorview MacMillan Centre, Toronto, Ontario, M4G 1R78
Canada; University of Toronto, Toronto, Ontario, M4S 1A1
Canada; email: fshein@bloorviewmacillan.on.ca; web:
http://www.wivik.com
Sponsor: Ontario Rehabilitation Technology Consortium (funded by the Ontario Ministry of Health); National Health Research and Development Program, Health and Welfare Canada
PURPOSE--This research explored a new view of transparent computer access, called task transparency, for people who use switch-based scanning. Task transparent design involves allowing the user to access the underlying tasks and information directly without requiring him or her to perform equivalent functions to the standard input devices. With this view, scanning can be applied directly to the user task rather than higher-level mouse-pointing task. This research sought new knowledge and understanding of the interactions that arise with a number of switch-based scanning strategies in a task transparent fashion. These strategies target the basic task of selecting text.
METHODOLOGY--Text scanning was implemented using repeating keys injected by an on-screen keyboard in a manner such that the user perceived scanning in the text area. Two test applications were developed and used to evaluate a number of proposed text scanning strategies. In addition, predictive performance models were derived to predict performance measures under error-free conditions. Three new strategies for positioning the insertion point by text scanning were evaluated through predictive analyses and experimentation. They were compared with each other and with a standard keystroke strategy. These strategies offered significant improvements in reducing key selections and switch activations.
PROGRESS--This research demonstrated that, in the case of selecting text, directness to the task could be achieved with minimal effort by applying scanning within the text area itself. Design guidelines for scanning in a task transparent fashion have been formulated. Although further work is required, these provide a foundation to build upon.
FUTURE PLANS--Future research will extend the concept of task transparency in new ways with scanning and other access methods across other GUI objects including menus, buttons, and window controls. Studies are planned to determine whether such strategies would allow people with physical disabilities to control computer systems with greater speed and accuracy while reducing complexity of control.
[130] WIVIK ON-SCREEN ACCESS TO COMPUTERS
Fraser Shein, PhD, PEng; Gil Hamann, MASc, PEng; Paul
Marshall; Tom Nantais, BSc; Rose Nishiyama, BSc; Pat
Stoddart, BA; Cynthia Tam, BScOT
Bloorview MacMillan Centre, Toronto, Ontario, M4G 1R78
Canada; email: fshein@bloorviewmacillan.on.ca; web:
http://www.wivik.com
Sponsor: Microslate, Microsoft Corporation; Ontario Rehabilitation Technology Consortium (funded by the Ontario Ministry of Health); Prentke Romich Company, Wooster, OH 44691
PURPOSE--WiViK ON-SCREEN includes several software modules based on our WIViK on-screen keyboard products that enable users with physical disabilities to use any Microsoft Windows application. These modules can be combined in various ways to meet specific user needs. WiViK displays a customizable keyboard on the computer screen. Users type with any pointing device including a mouse, trackball, joystick, pointing pad, touchscreen, pen, or advanced devices such as headpointers and eye-gaze. Simply clicking or dwelling on the desired key's image activates that key's function. Those with greater physical limitations may use a single switch.
METHODOLOGY--New research and development related to access methods is being conducted and new object-oriented functional modules are being designed and programmed. Rather than viewing WiViK as just accessible keyboard input, WiViK will provide the methods by which any computer object can be accessed and manipulated. The user interface for customizing the functions and layout of WiViK is being enhanced. New modules to provide dwelling and scanning access over the entire Windows environment are being developed. This work extends research conducted by Shein into applying the concept task transparency in access systems. A speech output module will be used to augment access. Current WiViK products are being translated into several international languages, including German, French, Swedish, and Dutch in response to new European laws requiring native language products.
PROGRESS--WiViK, WiViK REP, and WiViK Scan were updated with new installation software, bug fixes, and modifications to support new 32-bit applications. Translations of WiViK into several international languages are underway with releases planned in 1998. Designs are underway for a new-style access environment including but not limited to an on-screen keyboard. A design of an API (application programming interface) to enable switches to work with access software within Windows was completed.
FUTURE PLANS--Much research remains to be done to allow people to productively use computer technology at a level where their disability disappears. Outstanding concerns to be tackled in future research include increasing the speed of interaction, reducing fatigue, and minimizing and balancing user demands.
[131] WIVIK TOOLS FOR STUDENTS WHO ARE LEARNING TO WRITE
Fraser Shein, PhD, PEng; Gil Hamann, MASc, PEng; Paul
Marshall; Tom Nantais, BSc; Rose Nishiyama, BSc; Pat
Stoddart, BA; Cynthia Tam, BScOT
Bloorview MacMillan Centre, Toronto, ON, M4G 1R78
Canada; email: fshein@bloorviewmacillan.on.ca; web:
http://www.wivik.com
Sponsors: Ontario Rehabilitation Technology Consortium (funded by the Ontario Ministry of Health); Prentke Romich Company, Wooster, OH 44691
PURPOSE--This research and development is in response to needs identified by clinicians working with students with disabilities using computer technology and who are learning to write. New WiViK writing tools are being developed for such users that combine the functions of our current WiViK, KeyREP, and WiVox products along with added functionality.
METHODOLOGY--Research and development of methods to appropriately provide auditory prompting, cueing of writing and sentence construction, context-sensitive age- and topic-related dictionaries, and next word prediction will be carried out. While these are available as features within a variety of products, including KeyREP and WiVox, they are not available as a unit. New rate enhancement and speech modules are in development to replace current KeyREP and WiVox products. Also, the efficacy of specific features such as next word prediction is still in dispute. Therefore, evaluations and experiments will be conducted to gain further insights in order to improve the effectiveness of such features. In addition, the team will explore applications of computational linguistics to facilitate the writing process jointly with the artificial intelligence group at the University of Toronto.
PROGRESS--KeyREP was significantly updated to include auditory feedback in conjunction with WiVox, new installation software, and to support new 32-bit applications. WiVox was also updated with soundcard text-to-speech, new installation software, and a link to KeyREP. New techniques of next word prediction have been researched and prototyped. Text sources across the Internet have been used to generate several word prediction dictionaries that have been released with KeyREP. A new link with the artificial intelligence group at the University of Toronto to carry out joint research in applications of computational linguistics was also established.
FUTURE PLANS--Future research will consider learning paradigms and educational strategies in the application of tools such as word prediction in the writing process. Methods of adding sophistication of word prediction to improve its efficacy will be studied.
[132] WIVIK COMPUTER-BASED COMMUNICATION
Fraser Shein, PhD, PEng; Gil Hamann, MASc, PEng; Paul
Marshall; Tom Nantais, BSc; Rose Nishiyama, BSc; Pat
Stoddart, BA; Cynthia Tam, BScOT
Bloorview MacMillan Centre, Toronto, Ontario, M4G 1R78
Canada; email: fshein@bloorviewmacillan.on.ca; web:
http://www.wivik.com
Sponsors: Ontario Rehabilitation Technology Consortium (funded by the Ontario Ministry of Health); Prentke Romich Company, Wooster, OH 44691
PURPOSE--This research and development focuses on the application of computer access and writing tools as they are applied to communication for persons who are non-speaking and use traditional orthography. New WiViK communication solutions will include a new application for quick chatting through text-to-speech output, on-screen keyboard layouts for communication, and conversation-oriented word prediction dictionaries and abbreviation-expansion sets.
METHODOLOGY--WiViK communication solutions will use the same rate enhancement and speech output modules as in the WiViK writing tools. In addition, a new product will be developed that allows the user to chat more quickly. Designs will be derived from the experiences gained by consumers for new specialized on-screen keyboard layouts, word prediction dictionaries and abbreviation-expansion sets for communication purposes. The research team will contact their current customers who have been customizing the products for communication for samples of their designs. These will be reviewed, edited as necessary and posted for distribution on the web site.
PROGRESS--WIViK, KeyREP, and WiVox software have been used for this application area for some time with end-users customizing their WiViK on-screen keyboard, word prediction dictionary, and abbreviation-expansion set as needed. Typically, a standard word processing application is used for editing text that is then spoken through WiVox text-to-speech software.
[133] VIOLENCE AGAINST WOMEN WITH PHYSICAL DISABILITIES
Margaret A. Nosek, PhD; Rosemary B. Hughes, PhD; Carol A.
Howland, MPH(c); Laurie J. Walter, PhD
Center for Research on Women with Disabilities,
Department of Physical Medicine and Rehabilitation, Baylor
College of Medicine, Houston, TX 77046
Sponsor: Centers for Disease Control, Atlanta, GA 30333
PURPOSE--The purpose of this study is to identify and measure risk factors for secondary conditions brought on by violence in the lives of women with physical disabilities and to develop an intervention to reduce violence in their lives. The specific aims of this study are to evaluate the dynamics of violence against such women to determine risks and protective factors, barriers to seeking help, and the effectiveness of available interventions; develop and test the validity of an abuse assessment instrument designed specifically for these women, in comparison to standard abuse assessments; develop and pilot test an intervention for these persons that will decrease their risk of abuse; and disseminate information about this violence and our study to women with disabilities, programs for battered women, disability service providers, medical practitioners, and researchers.
METHODOLOGY--Through interviews of a sample of 15 women with physical disabilities who have successfully resolved physical or sexual abuse in their lives we shall identify the determinants of behaviors effective in resolving abusive relationships and the helpfulness of available community resources. Then we shall develop and test an abuse intervention with a systematic process called Intervention Mapping. Through this process, we will develop a screening tool to identify abused women with disabilities that is based on existing instruments. We shall test this tool for reliability and validity on a sample of 438 women with disabilities recruited through the chronic care clinics of the Harris County Hospital District and Baylor College of Medicine.
PROGRESS--During the first year of this 3-year study, we are completing the in-depth interviews with the 15 women, and thematic analysis of interview data is underway in an attempt to identify disability-specific vulnerabilities and barriers to receiving assistance. We are preparing to initiate the pilot testing of an abuse assessment screening instrument for such women.
[134] BREAST CANCER SCREENING AMONG WOMEN WITH DISABILITIES
Margaret A. Nosek, PhD; Mary Ellen Young, PhD; Carol A.
Howland, MPH(c); Laurie J. Walter, PhD; Ellen W. Grabois,
JD, LLM
Center for Research on Women with Disabilities,
Department of Physical Medicine and Rehabilitation, Baylor
College of Medicine, Houston, TX 77046
Sponsor: Centers for Disease Control, Atlanta, GA 30333
PURPOSE--The purpose of this project is to explore the nature of perceived risk for breast cancer, concerns associated with mammography screening, preventive orientation, and environmental barriers to participation in mammography screening among women with disabilities aged 40 and older. This will be done through a series of focus groups. The information gleaned from the focus groups will be used to develop a model for predicating screening among disabled women and suggest innovative strategies for future preventive interventions.
METHODOLOGY--Women with a variety of physical disabilities will be recruited for focus group participation. They will discuss topics such as concerns associated with mammography screening, including environmental barriers they have encountered.
PROGRESS--Using data from the National Center for Disease Statistics, we have examined the extent of breast cancer epidemiological studies with respect to geographical area, and determined which independent living centers have the means, personnel, and interest in pursuing focus-group studies in women's issues.
FUTURE PLANS--We shall coordinate the logistics and planning for 24 focus groups that will generate the data for this study, developing special outreach strategies to insure the involvement of women with low incomes and disabilities. Personal interviews will be used, where necessary, to get their supplemental input. We will determine recruitment strategies and interview protocols for use in conducting the focus groups.
[135] INCREASING THE CAPACITY OF INDEPENDENT LIVING CENTERS TO SERVE MINORITY POPULATIONS
Margaret A. Nosek, PhD; Kym King; Graciela C.
Wright
Center for Research on Women with Disabilities,
Department of Physical Medicine and Rehabilitation, Baylor
College of Medicine, Houston, TX 77046
Sponsor: National Institute on Disability and Rehabilitation Research, Bethesda, MD 20892
PURPOSE--We are seeking to find out how independent living centers could improve the effectiveness of their services for minorities with disabilities.
METHODOLOGY--We focus on a different minority group each year of this 5-year study, beginning each year with focus groups of consumers to help us identify the factors that affect their independence. Last year, we conducted four African-American focus groups. Data analysis regarding issues facing African-Americans is in progress. This year, we will be conducting focus groups and analyzing issues facing Hispanics.
PROGRESS--Hispanic men and women with a variety of physical disabilities have been recruited, and two focus groups have been conducted.
FUTURE PLANS--The information gathered will be presented to the centers for use in addressing the needs and barriers facing this population.
[136] RELATIONSHIPS AMONG AGE AT ONSET, ADEQUACY OF PERSONAL ASSISTANCE, NEGATIVE HEALTH INCIDENTS, AND HEALTH CARE UTILIZATION FOR PERSONS WITH PHYSICAL DISABILITIES
Carol A. Howland, MPH(c); Margaret A. Nosek, PhD; C. Don
Rossi, MS; James Song, MS; Kathy L. Meroney, BA
Center for Research on Women with Disabilities,
Department of Physical Medicine and Rehabilitation, Baylor
College of Medicine, Houston, TX 77046
Sponsor: National Institute on Disability and Rehabilitation Research, Washington, DC 22202
PURPOSE--The purpose of this longitudinal study is to determine the strength of relationships among users of personal assistance (PA) services for activities of daily living, health status, and the use of health care services by persons with a variety of severe physical disabilities.
METHODOLOGY--Survey packets were mailed to 120 subjects with the objective of having at least 100 complete the study. Data were used to construct a profile on each participant and his/her health service use and health conditions over a 12-mo period. These profiles were used to identify differences between participants based upon whether PA services are provided by family members or by professional providers, alone or with supplementary family assistance.
In the second year, open-ended, qualitative interviews were conducted with 20 participants representing two subsets, the 5 subjects each in the top and bottom quartile of scores on the PA Satisfaction Index (PASI) and 5 each in the top and bottom quartile in negative health incidents (HI).
PROGRESS--All survey instruments were developed and pilot-tested on 10 subjects, and distributed to 100 subjects aged 18 to 65, living independently in the community, who use at least 1 hr of PA daily. They completed weekly checklists for 1 yr to record: any changes in PA or health status; visits to hospitals, emergency rooms, or physicians; and, when HIs occurred, effects on productivity and levels of distress. Data analysis has been completed on the initial PAS and Health Study questionnaire, as well as the monthly health and PA incident checklists. Hypothesis testing is ongoing.
RESULTS--Participants were generally satisfied with the quality of their PA services, possibly because most had many years of experience to find an arrangement that best met their needs. However, they were less satisfied with the availability of attendants and costs of services. Overall, participants were in very good health, with few or no acute illnesses in the year (>33 percent reported no acute HIs; another 33 percent had 20 or fewer sick days). In the third year, the total number of health and PA incidents that occurred over the 12-mo reporting period was analyzed. The top five PA incidents were: assistant did not perform a task (299), assistant did not perform a task in the manner requested (263), assistant did not show up/had to find a back-up (186), assistant arrived late (141), and assistant was verbally abusive (131). The top five HIs were: pressure sores (1147), urinary tract infections (832), joint contractures (217), fractures (189), and colds or flu (115). Same day occurrences of health and PA incidents were counted in order to provide a frequency of paired incidents, and the kinds of paired incidents noted. Overall, quality of PA had an impact on the health status of subjects in maintaining mobility and nutritional status. There was a correlation between the mean number of monthly health and PA incidents. However, the majority of HIs were not associated with PA incidents: only 4.5 percent of HIs occurred within a week of a PA incident. A small subset of participants had a large occurrence of HIs, PA incidents, and HIs that could be attributed to inadequate PA services. The impact of HIs and how they relate to age at onset of disability and levels of satisfaction with PA services is currently being analyzed.
[137] HEALTH PROMOTION FOR WOMEN WITH PHYSICAL DISABILITIES
Margaret A. Nosek, PhD; Carol A. Howland, MPH(c);
Rosemary B. Hughes, PhD; Catherine Clubb Foley, PhD; Laurie
J. Walter, PhD
Center for Research on Women with Disabilities,
Department of Physical Medicine and Rehabilitation, and the
Southwest Regional Brain Injury Rehabilitation & Prevention
Center, The Institute for Rehabilitation and Research,
Baylor College of Medicine, Houston, TX 77046
Sponsor: National Institutes of Health, Bethesda, MD 20892
PURPOSE--The concept of wellness in the context of physical disability among women has only recently been introduced into the field of health promotion. The purpose of this project is to develop an intervention to enhance wellness among such women, based on expanded theoretical models and measures of health-promoting (HP) behaviors that accommodate some of their unique life circumstances. The specific aims of this study are 1) to identify the psychological, physical, social, and environmental factors that contribute to HP behaviors of such women; 2) to develop and test methods for measuring their HP behaviors and their attitudes toward improving those behaviors; 3) to develop and pilot-test an intervention to inform and motivate such women to take action to improve their psychological, social, and physical health; and 4) to develop and pilot-test a theory-driven, multicomponent program to promote wellness among such women, targeting increased self-efficacy related to HP behaviors. This research will be grounded in the Transtheoretical Model that identifies five stages of an individual's willingness to change a given behavior: 1) precontemplation, 2) contemplation, 3) preparation, 4) action, and 5) maintenance.
METHODOLOGY--To accomplish these aims, we began with qualitative focus groups and individual interviews to understand how women with physical disabilities define wellness and practice HP behaviors.
PROGRESS--Findings from our recently completed national survey indicate that segments of the population of women with physical disabilities are at a higher risk for 1) certain acute and chronic conditions, 2) limited access to preventive health services, 3) negative social attitudes toward their potential for fitness and wellness, and 4) reduced motivational factors affecting HP behaviors, such as self-esteem, self-efficacy, and body image. Results have been analyzed from the focus groups and individual interviews and, based on these findings, a health promotion model has been developed that is guiding construction of the questionnaire.
[138] REDUCING RISK FACTORS FOR ABUSE AMONG LOW-INCOME, MINORITY WOMEN WITH DISABILITIES
Margaret A. Nosek, PhD; Rosemary B. Hughes, PhD; Carol A.
Howland, MPH(c); Laurie J. Walter, PhD
Center for Research on Women with Disabilities,
Department of Physical Medicine and Rehabilitation, Baylor
College of Medicine, Houston, TX 77046
Sponsor: National Institute on Disability and Rehabilitation Research, Bethesda, MD 20892
PURPOSE--In the past two decades, sociologists and psychologists have turned more of their attention to studying the experiences of women who have been abused and assaulted. Little has been done, however, to examine the abuse experiences of women with disabilities or society's response to that abuse. We are in the final phase of a 4-year national study of women with physical disabilities.
The purpose of this project is to identify risk factors for emotional, physical, and sexual abuse experienced by such women and to develop and test strategies for reducing those risk factors, particularly among those from low-income, minority backgrounds where the incidence of abuse is the highest. In developing program models in this area, it is important to consider cultural attitudes toward violent behaviors and family values. Another critical issue is the woman's perception of her situation and her readiness to seek help. In this research and demonstration project, we will pursue strategies to reach women with disabilities at all stages of change in resolving abusive situations, working not only with programs that help battered women, but also with those dealing with disabled women in various community contexts to:
METHODOLOGY--We will target community-based organizations, disability service programs, and the media to reach women with disabilities who may not realize that they are in abusive situations or who may never have contact with battered women's programs. By offering training to disability-related service providers on how to recognize and assist women in abusive situations, and to battered women's programs on how to meet the needs of their participants with disabilities, we hope to expand the resources available to women who are trapped in abusive situations.
PROGRESS--A written survey on abuse and women with disabilities was developed and sent to vocational rehabilitation and independent living service providers across the country. More than 600 service providers responded to the survey, and the data have been analyzed. A written survey of programs delivering abuse intervention services to women with disabilities has also been developed and will be sent to programs specializing in abuse intervention across the country. Questions included the following:
FUTURE PLANS--Results of the survey of programs delivering abuse intervention services to women with disabilities will be analyzed and disseminated nationally, and a directory of programs delivering abuse intervention services to women with disabilities developed.
Go to top.
|
Previous |
Contents |
Next |
|---|