An enthusiastic welcome to Volume 12 of Disability and Rehabilitation: Assistive Technology. In recognition of this achievement, we have made available no-cost online downloads of the top 20 most read articles published in the first eleven volumes. You can access them through 31 March 2017 at this URL: http://explore. tandfonline.com/content/med/drat-hit-parade-top-20. Popular articles were found in each of the journal’s major categories: Review articles, original research, products and devices and case studies. I wrote by way of introduction to these 20 featured articles that, “It is interesting to note the themes that have emerged as being important to readers: Consumer involvement, user perspectives and needs, the importance of culture, device use and impact, and service delivery challenges.” As I look again through the table of contents of the issues published since volume 1, number 1, it is clear the field of assistive technology (AT) has experienced many changes and much growth, as have the areas of disability and rehabilitation. Evolving systems of healthcare, education and services for community living and participation have produced new efforts and emphases. AT has expanded for people with disabilities and chronic illnesses and those with changing needs due to aging. The term AT embraces universally designed and everyday/mainstream products, mobile and remote technologies, monitoring and sensing devices, a variety of information and telecommunication technologies, while maintaining a strong focus on new and innovative, specialized, technologies as well as modified everyday technologies.
Technology complexity and choice
Devices that are complex with multiple options and steps to follow can be so exasperating to use that they are abandoned or discarded. But device oversimplification can be just as frustrating and lead to the same outcome. People are clear that they want choice and control over what they use. For example, in a smartphone they want the capability to choose the access features appropriate for them and to be able to turn them on and off as desired. Yet many built-in features cannot easily be altered. Additionally, many products and systems contain showy and nice, but unnecessary features that consume bandwidth and battery power and tax the patience of the user. It has also resulted in what some people consider to be a choice overload.
Technology’s growth and advancement has led to the existence of a considerable amount of literature devoted to technology adoption, technology acceptance and technology diffusion, with a lesser amount on technology avoidance and rejection, and still less on technology underutilization (such is experienced in areas of poverty and low resource countries) and the contrary situations of overutilization and overreliance.
Fortunately, the field of AT has from its beginning emphasized interdisciplinary collaboration among those providers who focus on individuals with functional loss, regardless of the type and degree of loss and age at the onset of the loss. Some important issues and challenges exist, however, and I hope Disability and Rehabilitation: Assistive Technology will continue to serve as an international and interdisciplinary platform for sharing of research results, ideas and strategies for advancing AT devices and services.
Some challenges we face going forward
(a) Different views of desirable AT outcomes
Table 1, while oversimplified and incomplete, lists key AT stakeholders and their fundamental priorities regarding AT outcomes. While all emphasize enablement and the performance of activities and participation, they vary in and weigh differently their attention to the person and personal factors, milieu and environments of use, and technology functions and features. For example, the primary job of engineers and computer scientists is to design and develop usable and safe products with commercial appeal. Clinic directors need to emphasize consumer satisfaction with the devices and services received while containing clinic costs. The providers of rehabilitation and AT services are licensed/certified to improve the functional situation of the people they serve. They and psychologists, counselors or social workers, additionally enhance quality of life and subjective well-being as well as social participation.
Users themselves want devices that benefit their performance of activities and participation as well as subjective well-being and quality of life. When a product or system meets standards of good design and usability, its use and realized benefit from use depend heavily on initial expectations of benefit, involvement in product and feature selection, and adequate training for use.
AT users may be satisfied with the clinic’s services, have the necessary funding for the device, received a product that is usable, looks good, functions well and meets all safety standards, and helped them achieve functional gain – but if it is a hassle to use, set-up and maintain, if it doesn’t fit with their needs/preferences/lifestyle, if they feel self-conscious using it, insecure with use even though it is safe, if they are socially and physically and emotionally uncomfortable with use, then they are not realizing benefit from use and will not use it. It is not a good match of person and AT. Ultimately, it is the user experience (UE) and realization of benefit that drives and determines whether or not a device is used, for how long, what percent of the time and in which environments.
(b) Inconsistent terminology that hampers understanding and collaboration, and service transitions
We have many words we use for the people we serve: Consumers, clients, customers, patients, AT users. Inconsistency in terminology also results from the need to use the language of our funders and decision-makers. This can vary nationally as well as internationally. Advocating for a more standard language in the AT field would greatly impact global collaboration and clarity of service delivery, especially when transitioning between service systems.
(c) The existence of professional silos
We need all the stakeholders mentioned in the Table to work together and achieve integrated outcomes. We also need to work together to achieve a standard terminology and shared understanding of AT user needs, priorities and preferences. The last column in the Table indicates that the different AT stakeholders often read and contribute to literature in many different disciplines. This is a major reason why Different views of desirable AT outcomes, Inconsistent terminology, and The existence of professional silos are related to one another and are interactive.
As stated earlier in this article, Disability and Rehabilitation: Assistive Technology endeavors “to serve as an international and interdisciplinary platform for the sharing of research results, ideas and strategies for advancing both AT devices and services.” The goal is to foster an exchange among disciplines as well as to provide a global home for professionals in the field of AT to network and cooperate. I look forward to seeing what this volume year brings to our collaboration.
Examples of various AT outcomes according to stakeholderTable Footnote*.
Disclosure statement
The author reports no conflicts of interest. The author alone is responsible for the content and writing of this article.