Use of technology by people with physical disabilities in Australia

PURPOSE: This study aimed to quantify the extent to which computers and assistive devices were being used by people with physical disabilities and the levels of computer training being undertaken by this group. METHOD: With the help of Queensland disability associations a written survey was distributed to people over 15 years in age with physical disabilities living in the greater Brisbane metropolitan area. Responses were received from 82 people (comprising spinal cord injuries (n = 71), cerebral palsy (n = 8), muscular dystrophy (n = 3)). RESULTS: Indicate that 60% of respondents were computer users, while only 15 respondents used assistive devices. Computer ability was correlated to age and time of disability onset. Respondents with quadriplegia had higher levels of computer ability than those with paraplegia. The study indicates that while many people with disabilities have used computers and assistive devices, many have not. CONCLUSIONS: The low rate of assistive device use by people with high-level quadriplegia is of concern. This study suggests that increased levels of training in the use of computers and assistive devices needs to be provided to people with physical disabilities.     

Assistive technology and learning disabilities: today's realities and tomorrow's promises

Many forms of technology, both "high" and "low," can help individuals with learning disabilities capitalize on their strengths and bypass, or compensate for, their disabilities. This article surveys the current status of assistive technology for this population and reflects on future promises and potential problems. In addition, a model is presented for conceptualizing assistive technology in terms of the types of barriers it helps persons with disabilities to surmount. Several current technologies are described and the research supporting their effectiveness reviewed: word processing, computer-based instruction in reading and other academic areas, interactive videodisc interventions for math, and technologies for daily life. In conclusion, three themes related to the future success of assistive technology applications are discussed: equity of access to technology; ease of technology, use; and emergent technologies, such as virtual reality.     

Hearing aid use and benefit and uptake of aural rehabilitation services by New Zealand hearing aid wearers

AIM: To provide the first extensive survey in New Zealand of hearing aid use and benefit and the accessibility of Hearing Association services. METHOD: A mail-out questionnaire was used to survey 197 Auckland adult hearing aid wearers regarding patterns of hearing aid use and benefit and the accessibility of Hearing Association aural rehabilitation services. RESULTS: Hearing aid benefit was moderate and was not related to age or hearing aid use variables. Knowledge and usage of local rehabilitation services was limited. Perceived functions of the Hearing Association included adult audiometry and counselling. Respondents wanted assistance with hearing aid management and assistive listening devices. Physical access, financial and time constraints were seen as barriers to using rehabilitative services. DISCUSSION: It appears that there is not a simple relationship between perceived benefit or satisfaction and the amount of time people wear their hearing aids. The low level of awareness and participation in Hearing Association services is consistent with the underutilisation of such services found previously.     

Mapping of neural and signal transduction pathways for lordosis in the search for estrogen actions on the central nervous system

Assistive devices minimize limitations from physical impairment and are integral to rehabilitation. Little is known about older patients' concerns, perceptions, and beliefs about assistive devices. This study used a structured, qualitative approach to describe device perceptions of 103 stroke patients in rehabilitation. Six dimensions of patient concerns were identified, including the operation and utility of devices, social contexts and consequences, and attributions of cultural meanings of use. Initial device use posed cultural value dilemmas originating in discrepancies between sociocultural beliefs and conflicting normative expectations. Knowledge of these dimensions suggests new areas for social science research and refinements to clinical practice.     

Assistive devices used by home-based elderly persons with arthritis

OBJECTIVE: This article examines assistive device use by home-based elderly persons with arthritis. METHOD: Sixty-six persons were interviewed for the State University of New York at Buffalo (University at Buffalo) Rehabilitation Engineering Research Center Consumer Assessment Study, which sought information on need for and current use of assistive devices. Subjects were assigned to a moderate or a severe arthritis group according to the impact of arthritis on their activities. RESULTS: Subjects in the severe arthritis group had more chronic diseases, a higher level of pain, and a lower level of independence in self-care activities than subjects in the moderate arthritis group. Similarities between the groups included relatively poor health, high rate of medication use, depression, use of a high number of assistive devices (about 10 per person), and an expressed need for additional devices, such as reachers, magnifiers, grab bars, jar openers, and hearing aids. Generally, there was a high rate of satisfaction with the assistive devices used. Most subjects missed being able to participate in at least one activity; most of these activities were active and many related to leisure time. CONCLUSION: Findings also revealed that subjects had inadequate information on assistive devices, which suggests the importance of more occupational therapy involvement with elderly persons in selecting devices.     

Quality of life. Issues for persons with neuromuscular diseases

Improving quality of life has always been a goal of rehabilitation medicine. However, health care providers often do not know much about the quality of life of individuals with neuromuscular diseases, nor what factors are critical to achieving a good quality of life. Lack of knowledge about subjective quality of life factors can negatively influence expectations and selection of treatments. In the most glaring cases, a physician's subjective but incorrect assessment of a disabled individuals' quality of life may prevent life-sustaining interventions. As a group, the quality of life of individuals with NMD is not much different than nondisabled controls and is substantially better than presumed by the general public and, often times, by health care workers. Nevertheless, their quality of life is reduced in certain areas. Surprisingly, level of disability is not a critical factor that significantly alters life satisfaction. Presumably, this is because physical functioning has been adequately managed. The greatest problems that individuals with neuromuscular disease identified were: lack of information about the disease and services; poor coordination of services; negative attitudes; and a diminished expectation of their potential. In addition, people with severe disabilities had significant problems obtaining, financing, and managing personal care attendants. Factors related to a good quality of life were related to perceived control, perceived health status, but not disability. The more that people could do for themselves, either on their own or with personal care assistants, assistive devices, and use of technology, the better their quality of life.     

Peripheral blood stem cells in acute myeloid leukemia: biology and clinical applications

Fifteen persons with profound mental retardation were divided into two groups. One group was identified with chronic training needs by habilitative staff and the other group served as a control. In an attempt to identify a reinforcer, each participant received a preference assessment and a simple, low-effort treatment procedure. In Experiment 1, only individuals who approached at least one stimulus on 80% or more of the preference assessment trials ("high preference") showed reinforcement effects in treatment. However, three individuals showing high preference failed to show treatment effects. All persons identified with chronic training needs failed to show reinforcement effects. Experiment 2 analyzed characteristics of the two groups and found significant differences in overall movement and response latency. Limitations of the current reinforcement technology were apparent for identifying reinforcers in the group with chronic training problems. Research is suggested for evaluating training alternatives for people with profound multiple disabilities who move very little or who respond with very long latencies.     

Amphotericin B-intralipid 20% combination. In vivo evaluation of its tolerability

Among 136 adults with mental illness and mental retardation who were consecutively treated at a developmental disabilities clinic, 25 reported that they currently smoked cigarettes. Among those with mild and borderline retardation, smoking rates were 30 and 37 percent, respectively. Smokers were significantly more likely than nonsmokers to drink alcohol, use other drugs, and be sexually active. Multiple regression analysis found that a mild or borderline level of retardation and a diagnosis of schizophrenia were significant predictors of smoking. Mentally retarded persons with mental illness are at risk of tobacco-related disease and may benefit from prevention and smoking cessation interventions.     

Assessing mental retardation in death penalty cases: Critical issues for psychology and psychological practice.

In 2002, the United States Supreme Court decided the Atkins case, which held that mentally retarded defendants could not be executed. The opinion gave no guidance on the definition of mental retardation, preferring to leave to individual states the task of determining not only the definition of mental retardation but also the assessment procedures to be used in making the diagnosis. This lack of guidance has resulted in many issues, including varying definitions of what constitutes mental retardation across states, use of different assessment procedures to make the determination that a person has mental retardation, and numerous psychometric concerns regarding the provision of psychological assessment services to the courts in capital cases that involve a defendant who may have mental retardation. This article examines these latter issues in detail from both psychological and legal perspectives and makes recommendations for practicing psychologists. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Simultaneous and delayed matching to sample in gesture users and speakers with mental retardation

Sixty-eight participants with severe mental retardation participated in a study of representational matching to sample. Participants were asked to match objects to identical objects, line drawings, miniature objects (icons), pantomimes, and spoken names. Participants who were successful in these matching tasks also experienced delayed matching tasks. Participants differed in their expressive communication and comparisons were made between symbolic (speaking) individuals, distal gesture users, and contact gesture users. Contact gesture users were significantly worse on identical matching to sample tasks than other participants. Mean scores on matching objects to line drawings were significantly better than mean scores on other matching tasks. In delayed matching, however, scores for matching objects to spoken names were significantly better than other tasks. The implications of these results for learning to use an augmentative communication device are discussed.     

Integrating behavioral and physiological models of hippocampal function

Mortality of people with mental retardation receiving services in California was examined. The large population (N = 118,653) enabled us to work directly with mortality rates at specific ages. Up to about age 35, mortality rates of people with Down syndrome were comparable to those of people with mental retardation due to other causes. Subsequently, the increase was much more rapid in the group with Down syndrome. Mortality rates of individuals with Down syndrome doubled every 6.4 years compared to 9.6 years for people without Down syndrome. Life tables were constructed; the remaining life expectancy of a 1-year-old child with Down syndrome with mild/moderate retardation was 55 years and with profound mental retardation, 43 years.     

Estimation of the benefit of bone-anchored hearing aids

Implantable bone conduction hearing aids are a valuable alternative to conventional aids for those who cannot use a conventional air conduction aid or find it difficult to use because of an aural discharge, most commonly due to chronic otitis media. Previously reported series of the use of a bone-anchored hearing aid (BAHA) come from the originators of this device, and an independent report of their benefit and use, especially in previous air conduction aid users, would be of value. Twenty-three patients were evaluated at least 6 months after implantation of a BAHA. All 7 previous bone conduction aid users were delighted with their BAHA, reporting increased comfort and hearing benefit that was backed by audiometric evidence. Of the 16 individuals who previously used an air conduction aid, 11 (69%) were delighted users of their BAHA. Unfortunately, the other 5 (31%) reverted to solely using their air conduction aid. There was no obvious predictor as to how these individuals might have been identified prior to implantation. In particular, their pure tone thresholds, especially the bone conduction thresholds, were no different from those of the 11 BAHA users. However, in free field audiometry, the users gained superior benefit from their BAHA compared to their air conduction aid, whereas the nonusers did not. In conclusion, in all series to date, previous users of a conventional bone conduction aid have been delighted users of a BAHA and have gained superior audiometric benefit. This is not necessarily the case with previous air conduction aid users.(ABSTRACT TRUNCATED AT 250 WORDS)     

Development of a psychopathology rating scale for children with mental retardation.

A total of 583 children and adolescents with mental retardation were rated on a new psychometric instrument designed to screen for dual diagnosis (psychopathology in individuals with mental retardation). Two psychiatrists and 2 clinical psychologists judged the items to have face validity as expressions of psychopathology in children and adolescents with mental retardation. Cronbach's alpha coefficient was .91 for the total score and varied between .57 and .86 for 10 psychometric scales. Children and adolescents who had a dual diagnosis obtained total scores approximately 1 standard deviation higher than those who did not have a dual diagnosis. Each of 4 diagnostic groupings had test profiles in accordance with expectation. The results suggest that the instrument is particularly well suited for use in screening and for help in the analysis of the relationships between certain behavior problems and psychopathology. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Enhanced production of IL4 but not of IFN gamma and IL 10 by peripheral blood mononuclear cells from atopic children in response to CD2 plus CD28 stimulation

Because individuals with mental retardation have recently been identified as a group at-risk for developing HIV infection, HIV/AIDS training programs for service providers working with this population are critical. In this study an HIV/AIDS education program for family-based foster care providers was described and evaluated. The results indicate that although these service providers had some prior knowledge about HIV and AIDS, there were significant improvements in knowledge following the training. Implications of these findings for individuals with mental retardation were discussed.     

It is time for nursing

Historically, the perceived relation between mental illness and mental retardation has undergone substantial changes. During the past 2 centuries, clinical observations and systematic research addressing these 2 constructs have developed along separate lines. Consequently, the pathogenesis and treatment of psychopathology, emotional disorders, and behavior problems experienced by individuals with mental retardation have not been the purview of mainstream clinical psychology. This article initiates a special section on mental retardation and mental illness to provide up-to-date summaries of various key clinical and research issues regarding this population (i.e., individuals with "dual diagnoses").     

Advance directives for mental health care: An analysis of state statutes.

State statutes enabling individuals to draft written durable advance directives for health care have approached future decisions about mental health care and treatment in several quite different ways. While some states incorporate mental health care into the generic advance directive law, others exclude some kinds of mental health care from the generic law, and a growing number of states have established distinct processes for mental health directives. The author surveys the state statutes and examines the extent to which the statutes may create barriers to the use of advance directives by people with mental illness. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Dental care for children with mental retardation: thoughts about the Americans with Disabilities Act

The Americans with Disabilities Act bars discrimination in public accommodations, housing, employment and health care for people with disabilities. Efforts to "mainstream" (in housing and education) many of the individuals with mental retardation have altered the setting for dental services and place demands for services by dental practitioners in the community. These developments should be considered within the jurisdiction of this new legislation. Demographic characteristics and dental needs of children with mental retardation are reviewed to provide a background for this discussion.