Cover
Half Title
Series Page
Title Page
Copyright Page
Table of Contents
Preface
Editors
Section I Introduction and overview
Chapter 1 History of rehabilitation engineering
1.1 Chapter overview
1.1.1 History of engineering
1.1.2 Biomedical engineering
1.2 Assistive technology
1.2.1 Prosthetics
1.2.2 Technology for vision impairments
1.2.3 Technology for hearing impairments
1.2.4 Technology for mobility impairments
1.2.5 Technology for communication impairments
1.2.6 Computer technology
1.3 The beginning of modern rehabilitation engineering
1.4 Rehabilitation engineering service delivery
1.5 Rehabilitation engineering affects the complex rehabilitation technology market
1.6 Rehabilitation engineering finds a home
1.7 Summary and conclusions
1.8 Discussion questions
Bibliography
Chapter 2 Assistive technology
2.1 Chapter overview
2.2 Theoretical models and frameworks: Structuring assistive technology reasoning
2.2.1 Informing research and development
2.2.2 Informing practice
2.2.3 Informing education
2.3 Assistive technology: Models and frameworks
2.3.1 The HAAT model
2.3.1.1 Human Understanding the person guides AT development and selection by clarifying what the client can do and what personal skills and abilities the technology needs to augment or replace. In service delivery, consideration is given to the client’s
2.3.1.2 Activity Activity (or occupation) includes areas of self-care, instrumental activities of daily living, productivity and leisure as well as manipulation, cognition, mobility and communication that support these daily activities. Further, when unde
2.3.1.3 Context The context in which the person engages in activities is comprised of physical, social, cultural and institutional elements. Physical aspects include the built or natural environment as well as physical aspects of heat, light and sound tha
2.3.1.4 Assistive technology AT includes devices and strategies in the continuum of low to high complexity. Low technology is simple, often easy to obtain, like a mouth stick or head pointer. High technology is more complex and more difficult to obtain, s
2.3.2 The SETT framework
2.3.3 The CAT model
2.3.4 The MPT model
2.3.5 Theoretical career path
2.3.6 The HETI model
2.4 Assistive technology: The human
2.4.1 Needs and wants
2.4.2 Body structures and functions
2.4.3 Habits and roles
2.4.4 Technology acceptance
2.5 Assistive technology: The activity
2.5.1 Mobility
2.5.2 Manipulation and control of the environment
2.5.3 Communication
2.5.4 Cognition
2.6 Ethical tensions in assistive technology: Challenges and opportunities
2.6.1 Autonomy
2.6.2 Fidelity
2.6.3 Beneficence and non-maleficence
2.6.4 Justice
2.6.5 Stigma
2.7 Future vision
2.8 Discussion questions
Bibliography
Chapter 3 Key human anatomy and physiology principles as they relate to rehabilitation engineering
3.1 Chapter overview
3.2 Musculoskeletal system
3.2.1 Skeletal system
3.2.2 Muscular system
3.3 Integumentary system
3.4 Respiratory and cardiovascular systems
3.5 Nervous system
3.6 Future developments
Bibliography
Chapter 4 Psychosocial and cultural aspects of rehabilitation engineering interventions
4.1 Overview
4.1.1 Communication
4.1.2 Service delivery
4.1.3 Special groups
4.2 Defining personal factors
4.3 Importance of personal factors in the successful use of assistive technologies
4.3.1 Desire for Support
4.4 Milieu/environment factors influencing use
4.4.1 Personal attitudes
4.4.2 Personal physical context
4.4.3 Legislative/political context
4.4.4 Economic context
4.4.5 Cultural context
4.5 Culture and assistive technology: how culture impacts use and reflects good (or bad)
4.6 Culture and stigma
4.7 The inclusive engineer
4.8 Conclusion
4.9 Future vision
4.10 Discussion questions
Bibliography
Chapter 5 Overview of disease, disability, and impairment
5.1 Chapter overview
5.2 Background
5.2.1 Disease and health
5.3 Disability and functioning
5.4 Impairment and participation
5.5 Barriers and facilitators
5.6 Disability, rehabilitation, and assistive technology
5.7 Future vision
5.8 Discussion questions
Bibliography
Chapter 6 Rehabilitation engineering across the lifespan
6.1 Chapter overview
6.2 Theories relevant to examining lifespan
6.2.1 Stage theories of human development
6.2.2 Lifespan developmental theories
6.2.3 Life course theory
6.2.4 Developmental systems theory
6.3 Development across the lifespan
6.3.1 Early development
6.3.2 Adolescent development
6.3.3 Adult development
6.3.3.1 Early adulthood A variety of physical changes are associated with early adulthood. In the period between 20 and 30 years of age, physical abilities and performance reach their greatest extent (Thies and Travers 2001). Between the ages of 18 and 25
6.3.3.2 Middle adulthood During middle adulthood, some bodily changes are notable with resultant declines in some physical abilities and comparatively stable cognitive abilities. In the musculoskeletal structures, bone and muscle mass decline, while the p
6.3.3.3 Later adulthood While many individuals are healthy and active in later adulthood, bodily changes are even more marked, and physical changes are also more apparent. Bone mass, lean body mass, and water content continue to decline (Thies and Travers
6.4 Variations in development with health-related conditions and disability
6.4.1 Early development
6.4.2 Adult and older adult development
6.5 Care approaches across the lifespan: who is the client?
6.6 Misconceptions related to working with clients across the lifespan
6.6.1 Age discrimination
6.6.2 Ableism
6.6.3 Assuming incompetence
6.6.4 Therapeutic nihilism
6.6.5 Expectations related to normative development
6.7 Future vision
6.8 Discussion questions
Bibliography
Section II Key topics in rehabilitation engineering
Chapter 7 Policy and regulations in rehabilitation engineering
7.1 Chapter overview
7.2 Unique aspects of education and training in rehabilitation engineering
7.3 Formal education, training, and accreditation
7.3.1 Graduate attributes in international accords
7.3.2 Attributes for rehabilitation technologists, technicians, and associates
7.3.3 Competencies for independent practice
7.3.4 Credentialing in rehabilitation engineering and assistive technology competencies
7.3.5 Ongoing and continuing professional development
7.4 Regulations affecting professional practice
7.4.1 Workplace and industrial legislation and regulations
7.4.2 Industry – and service setting-specific legislation and regulations
7.4.3 Statute, corporate, and case law
7.5 Technical policies and regulations relating to technologies
7.5.1 Product and process standards
7.5.2 Medical device regulations
7.5.3 Protecting intellectual property
7.6 Future vision
7.7 Discussion questions
Bibliography
Chapter 8 Ethical issues in rehabilitation engineering
8.1 Chapter overview—what is ethics?
8.2 What is “rehabilitation” engineering?
8.3 The AT evaluation process
8.3.1 Implementing the HAAT model
8.3.2 The value of the client-centered intervention
8.3.3 Holistic intervention
8.3.4 The other AT team members
8.4 Your role on the AT team
8.5 The RESNA code of ethics for rehabilitation engineers
8.5.1 Hold paramount the welfare of persons served professionally
8.5.2 Practice only in their area(s) of expertise
8.5.3 Maintain the confidentiality of privileged information
8.5.4 Engage in no conduct that constitutes a conflict of interest or that adversely reflects on the association, and more broadly, on professional practice
8.5.5 Seek deserved and reasonable remuneration for services
8.5.6 Inform and educate the public on rehabilitation engineering and assistive technology and its applications
8.5.7 Comply with the laws and policies that guide professional practice
8.6 Conclusion
8.7 Case study #1
8.7.1 Ethical response
8.7.2 Ethical principles being violated
8.8 Case study #2
8.8.1 Additional questions for discussion for case study #2
Bibliography
Chapter 9 Rehabilitation engineering in the assistive technology industry
9.1 Chapter overview
9.2 The role of rehabilitation engineering in the AT industry
9.3 AT classification systems
9.3.1 Formal classification systems
9.3.2 Informal classification systems
9.3.2.1 United States All AT devices are intended to address functional limitations by providing interventions for the person, the task or the environment. Consequently, human functions are, so far, the most successful organizing constructs for AT product
9.3.2.2 European Union The European Union applied the structure found within the International Standards Organization (ISO) to create the first alpha-numeric classification system for AT devices consisting of a hierarchical structure of classes, subclasse
9.4 Obstacles preventing a clear definition of the AT industry
9.4.1 Primary obstacle to AT industry definition
9.4.2 Secondary obstacles to clearly define the AT industry
9.5 Provisional profile for the AT industry
9.5.1 A sample of AT companies
9.5.2 AT industry factors and dynamics
9.5.3 Barriers to entry
9.5.4 Crucial information gaps in the AT industry
9.6 Future of the AT industry
9.6.1 AT industry performance as an indicator of future trends
9.6.2 AT industry life cycle path
9.6.3 AT industry globalization efforts
9.7 Discussion questions
Bibliography
Chapter 10 Understanding the end user
10.1 Chapter overview
10.2 Introduction
10.2.1 The evolution of user-centered models of technology design
10.3 Methods for understanding the user
10.4 Connecting with the user
10.5 Case studies
10.5.1 Case study 1: user-directed implementation of adapted controls for driving (written by Johnny Kelley)
10.5.2 Case study 2: involving end users in research to design and develop novel assistive technologies for home use
10.6 Ethical considerations
10.7 Conclusions
10.8 Future vision
10.9 Discussion questions
Bibliography
Chapter 11 Rehabilitation engineering in less resourced settings
11.1 Chapter overview
11.2 History
11.3 Context
11.4 Availability of materials in LRS
11.4.1 Wood
11.4.2 Metals
11.4.3 Rubber
11.4.4 Foams and fabrics
11.4.5 Plastics
11.5 Availability of tools in LRS
11.5.1 Hand tools
11.5.2 Power tools
11.6 Product development for LRS
11.7 Product testing in LRS
11.7.1 Testing principles
11.7.2 Qualifying tests
11.7.2.1 R&D tests Introduction: When a new wheelchair is designed, an existing design is modified, or new components are designed or modified it is important to perform tests prior to launching the product. Testing will help ensure the product is safe an
11.8 Extended user trials
11.9 The user experience
11.10 Organizations engaged in LRS
11.11 Sustainability
11.12 Working in LRS
11.13 Ethics
11.14 The future of RE and provision of AT in LRS
11.15 Discussion questions
Bibliography
Section III Rehabilitation engineering and areas of application
Chapter 12 Rehabilitation engineering seating and mobility
12.1 Chapter overview
12.2 Introduction
12.3 Assistive technology service delivery
12.4 Transportation for wheelchair users
12.5 Basic seating principles
12.5.1 Manual wheelchairs
12.5.2 Powered wheelchairs
12.5.3 Control system
12.6 Robotic and connected wheelchairs and seating
12.6.1 Robotic-powered wheelchairs
12.6.2 Assistive robotic manipulators
12.7 Basic wheelchair design principles
12.7.1 User needs and characteristics
12.7.2 Manual wheelchairs
12.7.3 Powered wheelchairs
12.7.4 Drive wheel configurations
12.7.5 Seating system
12.8 Wheelchair maintenance
12.9 Key concepts
12.10 Custom wheelchair accessories through digital fabrication
12.11 Discussion questions
Bibliography
Chapter 13 Universal design and the built environment
13.1 Chapter overview
13.2 The need for universal design
13.3 Evolution of universal design
13.4 Who benefits from universal design?
13.5 Universal design and housing
13.6 Universal design and public accommodations
13.7 Universal design and streetscapes
13.8 Universal design and public transportation
13.9 Universal design and products
13.10 The future
13.11 Discussion questions
Bibliography
Chapter 14 Wireless technologies
14.1 Chapter overview
14.2 Evolution of mobile phone use by people with disabilities: 1990s–present
14.2.1 Deaf consumers
14.2.2 Hearing aid users
14.2.3 Blind and low vision consumers
14.2.4 Consumers with complex communications needs
14.2.5 Consumers with mobility and dexterity limitations
14.3 Legislation and regulation
14.4 Wireless device ownership and activities
14.5 Internet of Things: Smart homes and wearable technology
14.6 Future vision – “you are the product”: Mass data intelligence, pervasive systems
14.7 Discussion questions
Bibliography
Chapter 15 Transportation access
15.1 Chapter overview
15.2 Pedestrian travel
15.2.1 Accessible routes
15.2.2 Wayfinding and navigation
15.2.3 Bicycles and non-roadway vehicles
15.3 Automobiles
15.3.1 Ingress/egress
15.3.2 Securement
15.3.3 Vehicle control
15.3.4 Driver-vehicle interaction
15.4 Mass transportation
15.4.1 Pre-trip
15.4.2 Wayfinding and navigation
15.4.3 Ingress/egress
15.4.4 On-board circulation
15.4.5 Human service
15.5 Future vision
15.5.1 Connected vehicles and pedestrians
15.5.2 Autonomous vehicles
15.5.3 Guardian angel systems
15.6 Opportunities for rehabilitation engineers in transportation
15.7 Discussion questions
Bibliography
Chapter 16 Rehabilitation robotics
16.1 Chapter overview
16.2 Need/motivation and definitions
16.2.1 Target populations
16.2.1.1 Stroke A stroke or a cerebrovascular accident occurs when blood flow to the cerebral vasculature is blocked or cut off, resulting in a failure to supply oxygen to brain cells. This causes brain cells to die due to oxygen deprivation. A stroke may
16.2.1.2 Traumatic brain injury A traumatic brain injury (TBI) is typically caused by a bump, blow, jolt, or other head injuries that cause damage to the brain. Half of TBIs are caused by motor vehicle accidents, with other causes being falls and military
16.2.1.3 Spinal cord injury A spinal cord injury (SCI) impacts the vertebral column disrupting the signals between the body and the brain. The annual global incidence of SCI ranges from 13.1 to 163.4 per million new cases each year. The most common causes
16.2.1.4 Parkinson’s disease Parkinson’s disease is a movement disorder that occurs when the brain nerve cells do not produce enough of a chemical called dopamine (Abbruzzese et al. 2016). It is estimated that about ten million people worldwide have Parki
16.2.1.5 Multiple sclerosis Multiple sclerosis (MS) is a disorder of the nervous system that impacts the brain and the spinal cord by damaging the myelin sheath that surrounds and protects the nerve cells. This damage slows down or blocks messages between
16.2.1.6 Cerebral palsy Cerebral palsy is a group of neurological disorders that appear in infancy or early childhood that affect body movement and muscle coordination caused by damage to the brain. According to the Centers for Disease Control and Prevent
16.2.1.7 Elders The population of older adults is growing around the world. There were 962 million individuals aged 60 and older in 2017 and this number is expected to increase to 2.1 billion by 2050, especially due to the aging of the baby boomer generat
16.3 Therapy robots
16.3.1 Lower limb therapy robots
16.3.2 Upper limb therapy robots
16.3.3 Simpler and more affordable therapy robots
16.4 Assistive robots
16.5 Clinical considerations
16.6 Robot design considerations
16.7 Future directions
16.8 Discussion questions
Bibliography
Chapter 17 Universal interfaces and information technology
17.1 Chapter overview
17.1.1 We will all experience disabilities – if we live long enough
17.2 Spectrum of user interface needs
17.3 Strategies for addressing user needs
17.3.1 General approaches
17.3.2 Pluggable user interfaces
17.3.3 Working together, blending together
17.3.4 Specific strategies to address needs
17.4 Priorities in implementation
17.4.1 First dimension for prioritization: Accessibility/usability
17.4.2 The second dimension affecting prioritization: Independence vs. co-dependence
17.4.3 The third dimension affecting prioritization: Efficiency and urgency requirement
17.4.4 A pseudo-priority dimension: Ease of implementation
17.4.5 Cognitive constraints: A unique dimension
17.4.6 Setting priorities
17.5 Discussion questions
Bibliography
Chapter 18 AAC in the 21st century: The outcome of technology: Advancements and amended societal attitudes
18.1 Chapter overview
18.1.1 Social history
18.2 Research
18.2.1 AAC access research: Efficiency and production rates
18.2.2 Access
18.2.3 Interaction in time with technology
18.2.4 Integrating research findings into practice: Responsibilities of the rehabilitation engineer
18.3 Synthetic speech
18.3.1 Speech synthesis and personal identity
18.3.2 Voice banking
18.4 Alternative access technologies for AAC
18.4.1 Access defined
18.4.2 Assessment of alternative access technologies
18.4.3 Exploring alternative access technologies
18.4.3.1 Direct access methods Traditional input devices should first be considered such as mice, trackpads, trackballs, and joysticks controlled by a hand, foot, or mouth. External input devices can connect to computers, mobile devices, and SGDs through
18.4.3.2 Indirect access methods Adaptive switches allow a person to activate assistive technology devices in their environment. A switch acts as an interface between the user and a computer, toy, environmental control unit, or other device. The individua
18.4.4 Switch skill progression
18.4.5 The future of alternative access technologies
18.5 Low- and mid-technology options
18.5.1 Benefits and limitations of low-tech and mid-tech AAC
18.6 High-technology communication options
18.6.1 Types of high-tech AAC
18.6.2 Display options
18.6.3 Physical access options
18.7 Service delivery
18.7.1 Participation and feature matching models
18.7.1.1 Participation model Currently, two complementary models of assessment and service delivery are considered to be best practice. They are the participation model and the feature matching model. The participation model focuses on providing the indiv
18.7.1.2 Feature matching model Imagine a room filled with the latest and most effective low-, mid-, and high-tech devices along with a growing collection of peripherals such as symbol sets, switches, mounting hardware, and so on. This assembly of product
18.7.2 Changes to service delivery models in the last decade
18.8 Conclusion
18.9 Discussion questions
References
Chapter 19 Cognitive technologies
19.1 Chapter overview
19.2 Introduction: Background
19.2.1 Cognitive disability statistics
19.2.2 Cognitive disability
19.2.3 Overview of design and development considerations
19.3 Mobile technologies
19.3.1 Activities of daily living
19.3.2 Workplace
19.3.3 Training/therapy
19.4 Computer-driven software
19.4.1 Activities of daily living
19.4.2 Training/therapy
19.4.3 Education
19.5 Virtual reality
19.5.1 Training/therapy
19.6 Social assistive robots
19.6.1 Activities of daily living
19.6.2 Training/therapy
19.6.3 Assessment
19.7 Smart home technology
19.7.1 Activities of daily living
19.8 Future vision
19.9 Discussion questions
Bibliography
Chapter 20 Technology for sensory impairments (vision and hearing)
20.1 Chapter overview
20.2 Introduction: Historical overview
20.3 The visually impaired population: User characteristics and needs
20.4 Impact of emerging visual prostheses and new medical treatments
20.5 Vision measures and assessment
20.6 Technology for reading, writing, and note taking
20.6.1 Audio recordings
20.6.2 Braille reading and writing technology
20.6.3 Optical low vision aids
20.6.4 “CCTV” magnifiers
20.6.5 Pocket electronic magnifiers
20.6.6 Head-mounted electronic devices
20.6.7 Large print production
20.6.8 Low vision writing aids
20.6.9 Lighting
20.7 Access to graphical and pictorial information
20.7.1 Textual image description
20.7.2 Tactile and audio-tactile graphics
20.7.3 Active tactile displays
20.7.4 Computer graphics access
20.8 Access to computers and the internet
20.8.1 Screen readers
20.8.2 Speech output
20.8.3 Braille output
20.8.4 Screen magnification software
20.8.5 Internet access
20.8.6 Access to video information
20.9 Access to communications and portable computing devices
20.9.1 Landline phones
20.9.2 Smartphones
20.9.3 Smartphone apps
20.10 Access to appliances, displays, and daily living activities
20.10.1 Appliances with mechanical controls
20.10.2 Access to appliances with digital displays and controls
20.10.3 Talking appliances
20.10.4 “Connected” appliances
20.10.5 Lighting
20.11 Jobsite, career, and STEM technology
20.11.1 Technologies for traditional professions
20.11.2 Technology for STEM careers and pastimes
20.12 Technology for independent travel
20.12.1 Canes and guide dogs
20.12.2 Obstacle detectors and environmental sensors
20.12.3 Accessible GPS
20.12.4 Accessible signage
20.12.5 Travel with low vision
20.12.6 Tactile, audio-tactile, and large print maps
20.13 Recreational technology
20.13.1 Physical recreation
20.13.2 Indoor recreational activities
20.13.3 Music
20.13.4 Television and movies
20.13.5 Low vision aids
20.14 General purpose remote assistance technology
20.15 Hearing loss: Prevalence and types of loss
20.15.1 Causes of hearing loss
20.15.2 Types of hearing loss
20.16 Evolution of the hearing aid
20.16.1 The pre-electronic era
20.16.2 The electronic era
20.16.3 The digital era
20.17 The hearing aid as a personal communication aid
20.18 Future vision
Bibliography
Chapter 21 Prosthetic and orthotic devices
21.1 Chapter overview
21.2 Prosthetic devices
21.2.1 History of limb prostheses
21.2.2 Amputation levels and etiology
21.2.3 Rehabilitation and prosthetic design for lower extremity amputees
21.2.3.1 Rehabilitation A successful functional outcome for a patient with limb loss requires the cooperation and communication of the rehabilitation team. This collaborative effort may begin before amputation. For example, the amputation surgeon (e.g.,
21.2.3.2 Prosthetic prescription Reimbursement criteria for prosthetic devices via both federal and private insurance in the United States typically adhere to Medicare policies and guidelines. These guidelines are based on functional level definitions tha
21.2.3.3 Prosthetic components and design Various prosthetic components are available, from many manufacturers, to meet the different functional needs of the individual. New components are frequently introduced to address unmet needs, reduce prosthesis ma
21.2.3.4 Sports/running prostheses Other technologies include activity-specific prostheses such as “running blades” (Figure 21.8), swim legs, modified feet for rock climbing, and rotators to facilitate golfing and dancing. The running feet incorporate car
21.2.3.5 Prosthetic fit, volume adjustment, and alignment While the fit and comfort of the prosthetic socket are critical to prosthesis use, the stability and function of the prosthesis are also dependent on the alignment of the various prosthetic compone
21.2.3.6 Functional outcomes In addition to the qualitative assessment of socket fit and static/dynamic prosthetic alignment, quantitative evaluation of functional outcomes is imperative in demonstrating the medical necessity for the prescribed prosthesis
21.2.3.7 Emerging technologies in lower extremity prosthetic devices and amputation surgery Emerging technologies include recent advances in prosthetic power and control. Until recently, all lower limb prostheses were passive, relying on the remnant muscu
21.2.4 Upper extremity amputation, rehabilitation, and prosthetic devices
21.2.4.1 Rehabilitation In contrast to lower limb amputees for whom physical therapy is critical for successful prosthetic outcomes, both physical and occupational therapy are important for upper extremity amputees. Many activities of daily living require
21.2.4.2 Prosthetic prescription There is a wide variety of prosthetic components available to address the functional needs of upper extremity amputees at the various amputation levels. As the most common upper extremity amputation levels are at the trans
21.2.4.3 Prosthetic components Similar to lower limb prostheses, upper limb prostheses vary based on amputation level, proximal joint mobility, functional needs, desired reliability, comfort, cosmesis, and cost constraints. These factors influence the sel
21.2.4.4 Emerging technology in upper extremity prosthetic devices and amputation surgery Recent advances in upper extremity componentry include externally powered prosthetic hands that incorporate independent finger movement and variable grasp patterns,
21.3 Orthotic devices
21.3.1 History of orthotics
21.3.2 Types of orthoses
21.3.3 Lower limb orthoses
21.3.4 Upper limb orthoses
21.3.5 Spinal orthoses
21.3.6 Orthotic design and treatment objectives
21.3.7 Medical conditions benefiting from orthotic intervention
21.3.8 Orthotic prescription and fitting
21.3.8.1 Prefabricated versus custom orthoses Orthoses may be classified as prefabricated or “off-the-shelf” (OTS), custom-fitted, and custom-fabricated. Prefabricated orthoses are available in a variety of sizes and require minimal adjustments to fit an
21.3.9 Orthotic design
21.3.10 Functional outcomes
21.4 Future vision
21.5 Discussion questions
Bibliography
Chapter 22 Neural engineering
22.1 Chapter overview
22.2 Functional electrical stimulation
22.2.1 Introduction to functional electrical stimulation
22.2.2 Drop foot stimulator
22.2.3 FES for standing
22.2.4 FES for walking
22.2.5 Spinal cord stimulation
22.2.6 FES for upper limb function
22.3 Electrical neuromodulation
22.3.1 Restoring bladder function
22.3.2 Neuroprostheses for urinary incontinence
22.3.3 Neuroprosthesis for bladder voiding
22.4 Concluding remarks
22.5 Discussion questions
Bibliography
Section IV Outcomes and assessments
Chapter 23 Assessment approaches in rehabilitation engineering
23.1 Chapter overview
23.2 The rehabilitation engineering assessment methodology
23.3 Models and instruments contribute to a systematic approach of the assessment process
23.4 Best practices and commonalities
23.4.1 Individual centered
23.4.2 Family/support system inclusion
23.4.3 Goal setting
23.4.4 Consideration of environment and task
23.4.5 Transdisciplinary
23.4.6 Consideration of culture
23.5 Following best practices in lieu of REP environment or referral source constraints
23.6 Conducting a high-quality assistive technology assessment
23.6.1 Recognition of need
23.6.2 Collect information
23.6.3 Assess abilities
23.6.4 Develop specifications
23.6.4.1 Determination of access method Next, determine an access method. An access method is how the individual is going to interface with the technology. There are two components, one is input and one is feedback. How does the person know that their inp
23.6.4.2 Development and prioritization of a feature list After possible access methods are determined, the next step is the development of a feature list (also called a specification list or characteristic list). This helps the REP and transdisciplinary
23.6.5 Determine/trial possible solutions
23.6.6 Select preferred solution
23.6.7 Communicate solution and implementation plan
23.7 Continuing service delivery process – implementation and training
23.8 Quality assurance and outcome measurement in the assessment process
23.9 Future vision
23.10 Discussion questions
Bibliography
Chapter 24 Product usability testing and outcomes: What works? for whom? and why?
24.1 Chapter overview
24.2 Background and problem
24.2.1 Literature on usability testing
24.2.2 Usability standards
24.2.3 Products, interfaces and usability
24.3 Purpose of usability testing
24.3.1 Providing information to make informed decisions
24.3.1.1 Informing design Designers are not generally representative of the range of users who will use the products they design and, even when they understand the needs of some users, users often use products or expect them to function in the ways that d
24.3.1.2 Informing production Usability is a market separator. As a result, testing is used to enhance sales and get user buy-in for changes and updates. In addition, data that can be used to remedy usability problems prior to release can increase profita
24.3.1.3 Informing service provision Service providers, including rehabilitation specialists, clinicians, usability specialists, sales representatives, product support staff, third party payers and consumer organizations, among others, are responsible wit
24.3.1.4 Informing consumption/use Consumers, such as corporate buyers who purchase products for others, and actual users are most likely to know their own needs and abilities. As a result, usability information that will enable users to make their own de
24.3.2 Generating information to make informed decisions
24.3.2.1 Formative evaluation Formative evaluation is a process that provides feedback to improve product usability during the design process. In practice, formative testing is a find-and-fix approach (Redish and others 2002) focused on problem diagnosis
24.3.2.2 Summative evaluation Summative evaluation is intended to establish the usability of a complete product rather than its specific characteristics. It can be used to inform each of the four types of decisions described above, although it is most use
24.3.2.3 Formative vs summative evaluation Formative testing can be a quick-and-dirty process to quickly identify what works at the level of the product and interface features, for whom and why. As a result, it identifies the broadest range of potential u
24.4 What works, for whom and why
24.4.1 Models for understanding what works, for whom and why
24.4.2 Methods for understanding what works, for whom and why
24.4.2.1 Usability expert reviews Expert reviews are formative evaluations that occur early in the design process (i.e., at the conceptual stage) to provide feedback that will either guide or refine initial design concepts. Expert reviews are useful in pr
24.4.2.2 Focus group reviews (subject matter experts or users) Group discussions are used to provide formative evaluation of one or more prototype designs at the middle stages of the design process. It is typically effective in comparing several initial d
24.4.2.3 User testing Testing with actual product users is the most effective method of conducting both formative and summative evaluations. The former is most often implemented in a controlled laboratory setting to inform the design process. Although lab
24.5 What works: quantifying usability outcomes (dependent variables)
24.5.1 Outcome measure domains
24.5.1.1 Types of outcome domains There are two types of outcome domains – those that identify key outcomes directly and those that do so indirectly. The former, as represented by the ISO and Nielsen’s HCI domain models, directly identify performance and
24.5.2 Direct outcome measures of user interaction
24.5.2.1 Usability outcomes for mechanical and consumer products (ISO 202082-2:2013) This standard classifies usability based on ISO 9241-11, which defines usability as product effectiveness, efficiency and satisfaction. This definition has remained intac
24.5.2.2 Usability outcomes for quality in use and product quality (ISO/IEC 25010:2011) ISO/IEC 25010:2011 (2011) sets requirements for software and computer systems, although the standard recognizes that many of the characteristics are also relevant to w
24.5.2.3 HCI outcomes (Nielsen 2012) Jakob Nielsen has long proposed a system for HCI that categorizes usability by five domains: learnability, efficiency, memorability, errors and satisfaction. In many ways these domains are a hybrid of the two ISO model
24.5.3 Indirect outcome measures of product performance
24.5.3.1 Usability dimensions for consumer electronic products (Kim and Han 2008) In an effort to develop an overall usability index for consumer electronic products, Kim and Han (2008) developed a comprehensive list of the usability outcomes that would b
24.5.3.2 Usability scale for assistive technology (Arthanat and others 2007) To evaluate the usability of AT devices the usability scale for AT (USAT) was conceptualized as a function of the individual’s participation in activities with the AT device, the
24.5.3.3 Principles of universal design (Connell and others 1997) A decade before either Kim and Han’s usability dimensions or the iPhone, a group of experts representing a range of design disciplines developed the seven principles of universal design (UD
24.5.4 Performance and preference
24.5.4.1 Subjective outcomes Although subjective response outcomes are identified in all four of the other frameworks, including ISO’s domain of appropriateness recognizability, Nielsen’s satisfaction, Kim and Han’s effectiveness and USAT’s suitability an
24.5.4.2 Accessibility The UD principles are silent on the issue of accessibility for good reason. The first principle of equitable use includes a guideline that promotes the same means of use for all users, regardless of ability. Since this applies to al
24.5.4.3 Breadth By virtue of their being design guidelines, the three indirectly derived outcome domain frameworks are more comprehensive compared to the domains in the two direct frameworks, with the UD principles being the most robust. Among those doma
24.6 For whom: matching people to products
24.6.1 Accessibility vs usability
24.6.2 Identifying participants for usability testing
24.6.3 Selecting the number of participants
24.7 Why: identifying design measures (independent variables)
24.7.1 Design features
24.7.2 Design characteristics
24.8 A case study of what works, for whom and why
24.8.1 What works
24.8.2 For whom
24.8.3 Why
24.9 Chapter summary
24.10 Discussion questions
Bibliography
Index
