Social Lives
Author: Emma Smith, Assisting Living and Learning (ALL) Institute Member and Post-Doctoral Researcher; recipient of the prestigious Marie Sklowdowska Curie Actions Individual Fellowship
On Wednesday, October 12th, the ALL Institute was pleased to welcome Dr. Natasha Layton to our first ALL Brown Bag Lunch. Dr. Layton is a Senior Research Fellow at Monash University’s Rehabilitation, Ageing, and Independent Living (RAIL) Research Centre in Australia. Dr. Layton drew from her experiences as an assistive technology provider, researcher, and consultant to key global organizations to share ‘what works’ in assistive technology provision on both a global and national scale.
While Dr. Layton spoke broadly about her experiences in assistive technology policy both nationally and internationally, I would like to highlight three key ideas which Dr. Layton talked about, which stood out as requiring further consideration and thought for us in Ireland, but also for those of us working globally.
Assistive Technology User Engagement
The disability rights movement has placed a significant focus on the concept Nothing About Us, Without Us, highlighting the critical need to ensure that people with disabilities are a part of, and central to, policy decisions which are related to disability. This has been highlighted in the international Assistive Technology (AT) space by placing People at the centre of the conceptual model of assistive technology provision. Dr. Layton shared an approach they have used at the RAIL centre to ensure representation of a diversity of voices of persons with disabilities in their work. They have identified a group of assistive technology users with a range of functional impairments who use a diversity of assistive products to accommodate for those impairments. In particular, they have focused on ensuring this diversity is inclusive of each of the six areas of functioning in the International Classification of Functioning, Disability, and Health (ICF): cognitive and mental functions, neuromusculoskeletal functions, bone, skin, and related structures, sensory functions, cardiorespiratory functions, and other internal functions and structures. All of the work which is done at RAIL is then viewed through the lens of these individuals, to ensure the work does not miss critical components of functioning and is truly inclusive. This approach differs from those often taken elsewhere, where a particular disability group may be overrepresented as compared to others, and what works for one group may not work for another. Viewing the work through the lens of each of these individuals ensures issues of inclusion and accessibility for all people with disabilities are considered.
Measuring Outcomes and A Framework for Assessment
To build effective policy, not only is it important to ensure adequate representation from people who will be impacted by that policy, it is also important to have a clear understanding of the needs and outcomes associated with assistive product provision. Dr. Layton spoke about the work which has been done by the Global Alliance of Assistive Technology Organizations (GAATO) to identify key challenges to be addressed globally in the area of Assistive Technology Outcomes. I have been fortunate to have been a part of this process, where we identified six high-level challenges in measuring the outcomes and impacts of assistive technology: masuring need, documenting inputs, measuring outcomes, measuring impact, sharing data, and informing policy. You can read the GAATO AT Outcomes project report here.
In tandem, Dr. Layton and her team have been working on the development of a framework for Assistive Technology evaluation – the My Assistive Technology Outcomes Framework (MyATOF) – which she generously shared with us during her presentation. This framework contains evidence-based outcomes tools across the areas of necessary supports, outcomes associated with AT provision, costs, services received, personal experiences, and rights realization. This holistic approach to assistive technology outcomes measurement ensures a full picture and understanding of the variety of impacts which occur from AT provision and will help to drive the field forward as data is collected, shared, and acted upon.
Unintended Consequences
Finally, Dr. Layton described a long-standing advocacy effort to develop and implement an individualized funding program for assistive technology in Australia, resulting in the implementation of the National Disability Insurance Scheme (NDIS). While the NDIS was a much anticipated opportunity to ensure access to assistive technology for all, there were unintended consequences of changing eligibility criteria. In particular, access to assistive technologies among older adults was significantly diminished, as compared to their younger counterparts. Given the increasing rate of assistive product use among older and ageing adults, this is concerning. It is a stark reminder for those of us working in assistive technology and related health policies that it is critical these policies be developed in partnership with assistive technology users across all ages, abilities, and conditions.
We always benefit from new perspectives, and new approaches. For those of us working in the field of assistive technology, it was wonderful to hear the experiences of Australia in delivering assistive technology services and the next steps in where we should be going next.