Assistive/rehabilitation technology,disability, and service delivery models

The United Nation’s Millennium Development Goals do not explicitly articulate a focus on disability; similar failures in the past resulted in research, policy, and practice that are not generalizable and did not meet the needs of persons with disabilities since they were developed for an “average” population. Academics and professionals in health and other disciplines should have a knowledge base in evidence-based practices that improve well-being and participation of people with disabilities through effective service delivery of assistive technology. Grounded by a theoretical framework that incorporates a multivariate perspective of disability that is acknowledged in the convention on the rights of persons with disabilities and the World Health Organization’s International Classification of Functioning, Disability and Health, we present a review of models of assistive technology service delivery and call for future syntheses of the fragmented evidence base that would permit a comparative effectiveness approach to evaluation.     

The social utility of disability and rehabilitation

This article suggests that a disabled class is useful to society in maintaining certain social arrangements. Consequently, the rehabilitation counselor may unwittingly play unexpected roles that facilitate the social utility of the disabled. As totem, he wards off the evil associated with disability; as scapegoat, he assumes society's guilt unobtrusively; and as lightning rod, he draws off and grounds the anger of the disabled toward society. If the rehabilitation counselor persistently or willfully plays these roles, he risks being perceived as a “rat fink” who is unworthy of respect or rewards. The authors suggest possibilities for altering these roles.     

Assistive technology patenting trends and the Americans with Disabilities Act

This article examines the ways in which the growing economic market for assistive technology (AT) may be analyzed in the context of effective implementation of the Americans with Disabilities Act (ADA). It summarizes the results of an ongoing study of patent data from the United States Patent and Trademark Office (PTO). The purpose of the study is to examine how the ADA is fostering innovation and economic opportunity for AT developers, manufacturers, and retailers. The findings suggest that evaluations of the ADA based on its perceived costs to society need to be balanced by the range of societal benefits accruing from the law, including those unanticipated economic benefits found in the present study.     

Health Care,Capabilities, and AI Assistive Technologies

Scenarios involving the introduction of artificially intelligent (AI) assistive technologies in health care practices raise several ethical issues. In this paper, I discuss four objections to introducing AI assistive technologies in health care practices as replacements of human care. I analyse them as demands for felt care, good care, private care, and real care. I argue that although these objections cannot stand as good reasons for a general and a priori rejection of AI assistive technologies as such or as replacements of human care, they demand us to clarify what is at stake, to develop more comprehensive criteria for good care, and to rethink existing practices of care. In response to these challenges, I propose a (modified) capabilities approach to care and emphasize the inherent social dimension of care. I also discuss the demand for real care by introducing the ‘Care Experience Machine’ thought experiment. I conclude that if we set the standards of care too high when evaluating the introduction of AI assistive technologies in health care, we have to reject many of our existing, low-tech health care practices.     

Reading disability in adjudicated youth: Prevalence rates,current models,traditional and innovative treatments

This paper reviews current literature from two distinct but overlapping domains: juvenile delinquency (JD) and reading disability (RD). In light of the substantial evidence that RD is both associated with, and causally involved in JD, it is alarming how little extant research has systematically investigated remediation strategies for use in the juvenile corrections system. The paper begins with a definition and a review of approaches for conceptualizing JD. RD is placed within the context of a large domain of risk factors for JD. We then define RD and introduce studies that establish the link between RD and JD, and give estimates of its prevalence within the JD population. We discuss briefly the role of attentional problems in mediating the relationship between RD and JD, before exploring the tenets and some limitations of common theories of RD. This is followed by a brief review of the literature that has begun to investigate the efficacy of various reading remediation approaches within the juvenile detention setting. We conclude by previewing some promising new research employing computer-based training and highlight recommendations for future research on RD in the JD population.     

Level of service delivery of public transport and mode choice in Accra,Ghana

Worsening traffic congestion and air quality has been associated with the proliferation of informal operation of private microbus and minibus in African cities. It is recognised that large buses hold the promise of relieving the growing congestion of African cities if they are managed efficiently and sustainably.It is in line with this that this study seeks to explore the reasons behind commuters’ non-preference of Metro Mass Transit (MMT) for intra-city commuting in Accra, Ghana. A revealed preference survey was administered to 134 commuters to find out the reasons behind their non-preference and their perception of the level of service (LOS) delivery of the Metro Mass Transit.The Study revealed that though Metro Mass Transit was 20% cheaper in terms of price, commuters perceived its service delivery as poor. Over-crowding of buses, non-adherence to time schedule, long in-vehicle time, perception of not getting access to seats, non-availability of bus at respondents’ origins and destinations, accessibility of alternative modes and long waiting times for buses accounted for the major reasons for non-preference.Metro Mass Transit Limited’s improvement in its service attributes especially in-vehicle time, waiting time, comfort, reliability and accessibility is a means of increasing its modal share. Adherence to these is the surest way to achieving the objective of promoting mass transit in Accra by shifting people from the use of unsustainable modes such as mini-buses and taxis to the use of efficient high capacity systems as Metro Mass Transit.     

Guidelines for planning and evaluating school psychology service delivery systems

Contemporary standards of professional practice (e.g., American Psychological Association, 1977) and recent educational compliance legislation (e.g., PL 94–142) emphasize the delivery of appropriate school psychological services geared to a range of school-age children with special needs. Thus, school psychologists must pay increased attention to the development of school psychology service delivery systems. Toward this end, guidelines are presented for planning and evaluating school psychology service delivery systems. The guidelines are set forth in order that school psychologists might consider them and adapt them to local circumstances. The eight principles which comprise the guidelines have been used by the author in planning and evaluating school psychology service delivery systems in several public school districts. One particular school district will serve to illustrate the utilization of the guidelines.     

The next exclusion debate: assessing technology, ethics, and intellectual disability after the Human Genome Project

Recent scientific discoveries have made it much easier to test prenatally for various genetic disabilities, such as Down syndrome. However, while many observers have heralded such "advances" for their effectiveness in detecting certain conditions, others have argued that they perpetuate discrimination by preventing the birth of children with disabilities. This article examines the ethical and social implications of the Human Genome Project for individuals with intellectual disabilities and their families. It details the critique of prenatal testing articulated by many disability rights activists as well as scholarly and professional responses to that critique. A review of the pertinent research literature includes perspectives of genetic professionals, ethicists, disability studies scholars, parents of children with disabilities, and disabled individuals themselves. Finally, the article explores how future research endeavors, policies, and practices may more effectively integrate and respect the positions of these various stakeholders.     

Applications of gene targeting technology to mental retardation and developmental disability research

The human and mouse genome projects elucidated the sequence and position map of innumerous genes expressed in the central nervous system (CNS), advancing our ability to manipulate these sequences and create models to investigate regulation of gene expression and function. In this article, we reviewed gene targeting methodologies with emphasis on applications to CNS development and neurodevelopmental disorders.     

Prenatal diagnosis, personal identity, and disability

A fascinating criticism of abortion occasioned by prenatal diagnosis of potentially disabling traits is that the complex test-and-abortion sends a morally disparaging message to people living with disabilities. I have argued that available versions of this "expressivist" argument are inadequate on two grounds. The most fundamental is that, considered as a practice, abortions prompted by prenatal testing are not semantically well-behaved enough to send any particular message; they do not function as signs in a rule-governed symbol system. Further, even granting, for the sake of argument, the expressive power of testing and aborting, it would not be possible, contra the argument's proponents, to distinguish between abortions undertaken because of beliefs about the disabling conditions the fetus might face as a child and abortions undertaken for many other possible reasons -- e.g., because of the poverty the fetus would face or the increase in family size that the birth of a new child would occasion. Here, I respond to criticisms of those arguments, and propose and defend another: the expressivist argument cannot, in general, distinguish successfully between abortion and therapy as modalities for responding to disabilities.     

The use of qualitative strategies in participant and emancipatory research to evaluate disability service organizations

Disability research has taken two distinct directions-participant and emancipatory. These have been described as complementary approaches. Experiences in the use of qualitative strategies are discussed in the context of a participative evaluation of a network of work-related services for people with mental health problems undertaken by a team comprising practitioners, academic researchers, and co-researchers who were also users of the services being evaluated. Strengths and limitations of the approach are considered and recommendations made. The relationship between participant and emancipatory research approaches is discussed in the light of these experiences.     

Bio-Inspired Design of Soft Robotic Assistive Devices: The Interface of Physics,Biology, and Behavior

Wearable assistive robotic devices are characterized by an interface, a meeting place of living tissue and mechanical forces, at which potential and kinetic energy are converted to one or the other form. Ecological scientists may make important contributions to the design of device interfaces because of a functional perspective on energy and information exchange. For ecological scientists, (a) behavioral forms are an assembly of whole functional systems from available parts, emerging in energy flows, and (b) nature explores for informationally based adaptive solutions to assemble behavioral forms by generating spontaneous patterns containing fluctuations. We present data from ongoing studies with infants that demonstrate how infants may explore for adaptive kicking solutions. Inspired by the ecological perspective and data from developing humans, ecological scientists may design interfaces to assist individuals with medical conditions that result in physical and/or mental impairment. We present one such device, what is called the “second skin,” to illustrate how a soft, prestressed material, worn on the skin surface, may be used synergistically with synthetic and biological muscles for assisting action. Our work on the second skin, thus far, suggests a set of ecologically inspired principles for design of wearable assistive robotic devices.