what-when-how
In Depth Tutorials and Information
and (2) since AT is designed for direct use by the end user rather than being a
component in a solely technological system (e.g., a planetary gear in a transmis-
sion), studying AT in use must involve including in investigations all the direct
stakeholders. hese stakeholders include, besides the direct end user of the AT, pro-
fessional caregivers, familial caregivers, medical personnel, and legal and govern-
mental users, as well as those involved in the AT supply chain—from designers to
sales to support. Studying the long-term adoption process must necessarily include
looking at the environment of adoption (and use), as well as other parameters which
we will explore in the section on deconstructing elements in an STE.
7.2.1 AT for Persons with Cognitive Disabilities
A unique aspect of software and systems for persons with cognitive disabilities is
that, while the focus is on the end user, for the person with cognitive disabilities,
design and evaluation must involve their caregiver; in fact, it may be taken as an
axiom [3] that every system is used and must accommodate a dyad—the end user
and a caregiver. Typically, the caregiver assists in the setting up and maintenance
of assistive technology systems, as they often are too difficult for the person with
cognitive disabilities to set up and keep up to date. Also pertinent and contribut-
ing to the success or failure of a design being adopted or abandoned are the lesser
stakeholders. hese include the family of the person with cognitive disabilities, the
AT designers, product salesmen, and technical support, persons and organizations
involved with funding the (often very expensive) AT devices, and the legal and
regulatory personnel and systems designed to protect and respond to the needs of
persons with cognitive disabilities. Often the motivation and goals of these differ-
ent stakeholder roles can be divergent and even conflicting.
Advanced and complex AT for the cognitively disabled can take several
forms, which can be classified according to the function that is being supported.
Missing or deficient executive functionality and mnemonic lack is addressed by
systems that support task completion [2]. Mnemonic difficulty can be alleviated
using scheduling systems [25]; missing or deficient communication functional-
ity is addressed by a wide range of augmentative and alternative communica-
tion (AAC) devices [26]. Harbingers of future AT for those with more profound
cognitive disabilities are an application and environment that aides elders with
Alzheimer's in properly washing hands, COACH (cognitive orthosis for assisting
with activites in the home) [27] using video recognition, an instrumented bath-
room, and AI to detect deviation from proper handwashing process and guided
the end user back on track.
7.2.2 AT: Adoption and Abandonment
Device rejection is the fate of a large percentage of purchased assistive technol-
ogy [12,13]. Caregivers report that difficulties in configuring and modifying
