A)+The+Past



 History of Adaptive/Assistive Technology

Assistive Technology (AT) is a part of societys attempt to cope with the misfortunes of physical or sensory impairments and resulting handicaps. In the very beginning nature did its regulating task by just letting the victim of a functional impairment die. When the care of infections and the chance of survival improved for people with disabilities, their sources of help were members of the clan, neighbours or paid servants. With the increasing importance of tools and industrialization, 'tools for living' (an expression created by Prof. Heinz S.Wolfe in the early 70s in England) became more and more important. The more they are used by people with disabilities, the more they represent what we understand as Assistive Technology (AT). A number of factors have advanced AT: Examples of technical aids (e.g. wheeled chairs) that compensate for permanent impairment can be found even in ancient times, mainly made by artisans for persons with high social status who had disabilities. In the XVI century a relevant interest in the field of limb replacement is reported in literature.
 * Events like wars or the thalidomide disaster
 * Key persons
 * Special technologies
 * Visions and ideas of user
 * Financial resources
 * Public awareness
 * Activity of lobbies
 * Personal commitment of persons in responsible positions

However, since that time until recently the application of technology to people with disabilities was mainly restricted to the field of prosthetics (technology replacing missing body functions) and orthotics (technology supporting existing although damaged functions), with a view to re-build a situation as near as possible to bodily normality.

The main areas of interest were limb impairment and hearing loss. Blind war veterans gained great public awareness and sympathy throughout their nations. Institutions like the Perkins School for the Blind in the USA, the Royal National Institute for the Blind in Great Britain or the deutsche Blindenstudienanstalt in Germany did pioneer work in AT by promoting the use of Braille for reading and writing, by producing and selling Braille printing devices and by organizing the provision of literature printed in Braille.

Sir Ludwig Guttmann, the 100th anniversary of whose birth was celebrated in July this year, had to flee from Germany in the 1930s. At Stoke Mandeville, England, he took care of the numerous war victims with lesions due to injuries of spinal cord. In addition to developing the treatment of secondary medical problems, he created and promoted the idea that the goal of treatment should be full social integration, and not simply the necessary medical care. So he can be seen as the founder of multidisciplinary rehabilitation. This includes vocational training, self-support, independence, sports, and, last but not least, assistive technology. Since Guttmanns day, this idea has been primarily pursued by occupational therapists. Europeans admired the consistent manner in which the Swedes took care of their handicapped people, helping them to gain self-confidence and increasing public awareness. It goes without saying that the Swedish Institute included a department for technical aids where research, testing, assessment and the dissemination of information have been done in an exemplary manner. A big push towards a major development in the field came from the Second World War, where the great number of veterans with disabilities posed a dramatic social problem and prompted the US Veterans Administration to launch firstly a prosthetic and sensory aids program, followed by many initiatives that gave birth to modern research into rehabilitation and AT. Gradually the idea took shape that a person with a disability should not necessarily aim at bodily normality but rather at life normality, which inspired the first programmes of vocational rehabilitation aimed at regaining access to work and productive life. In addition to wars, AT has been advanced in a number of other ways, for example thalidomide in the 1960s. Prosthetics and orthotics grew to new heights, and the development of many sophisticated ADLs (aids for daily living) date from that time. Widespread publicity and almost unlimited financial resources helped here. There are even indications that in some cases the enthusiasm of researchers carried them too far, being guided more by set ideas and not enough by the personal needs and wishes of the users. Certain technologies stimulated the development of AT, e.g. piezo-electronics, which led to the development of the Optacon (a Silicon Valley product). Optacon made it possible for blind people to read normal printed material. After an intensive but manageable phase of learning to use the technology, printed material could be identified by the shape of a letter using a vibrating tactile display of fingertip size.

In Germany alone, about 130 blind computer programmers between 1971 and 1990 have had vocational training based on the Optacon. Times and technology have changed, and nowadays the peculiarities of computer-access for the blind and the partially sighted is the subject of many conferences, seminars and papers. Visions and obsessions are the most frequent contributors to the advancement of AT. Just one example: the dream of stair-climbing is as old as the wheelchair itself. In 1972, USA engineers proposed a stair-climbing wheelchair. It was to have four low - pressure tires of about 50 cm diameter and be pulled forward by a hand lever drive. This might have worked on steps, but how far could the user have gone afterwards with such tires and so large a chair after having struggled up a flight of steps? Until now technology has only definitely proven that a stair-climbing wheelchair is possible. Some years ago, with the support of private funds in Germany, the Rollsteiger was produced in limited series. But approximately 80% of the weight went for battery and electro-mechanics necessary for stair-climbing, making the chair excessively heavy and virtually immovable when used in flat areas. This thus convincingly demonstrated that the stair-climbing device should be separate from the wheelchair.

The principle of equal opportunities had great penetration in society all over the world and was gradually endorsed by authoritative Bodies like the United Nations, US Federal Legislature, and European Commission of European Union. In 1993 the UN issued the so called Standard Rules for equalization of opportunities for persons with disabilities, where AT, environmental accessibility and personal assistance are recognized as fundamental supports to enable disabled persons to participate in society on an equal footing; likewise, the US Americans with Disabilities Act introduced, in 1990, the principle of non-discrimination (e.g. when recruiting workers), and described AT as a tool to ensure that reasonable accommodation of the worksite is provided in order to fully exploit the worker's potential. Parallel to these cultural trends, technological developments in the AT field dramatically grew and expanded far beyond the traditional prosthetics field.

After the first wheelchair inspired by a modern view of the persons autonomy was designed by Everest & Jennings at the beginning of this century, a wealth of technical aids have been designed to accommodate mobility problems, personal hygiene and self-care, housekeeping, building adaptations, communication, environmental control, worksite adaptation and leisure activities. It is possible to say that virtually any activity of a human being, even if severely disabled, can be accommodated today.

AT grew to be recognised as a specific discipline, and scientific societies were initiated like the Rehabilitation Engineering Society of North America (RESNA, founded 1980) or the Association for the Advancement of AT in Europe (AAATE, founded 1995). ICTA Europe (International Commission for Technology and Accessibility) as a part of ICTA Global, which is a Commission of Rehabilitation International (RI) has brought many initiatives in area started in the early 1960s.

There were few international bodies working with technical solutions to facilitate activities of daily life for older people or people with disabilities. In the early years RI Commission activities were expected to be self supporting, however, this depended on the bearers having available resources and back up. In fact at that time the election of the most senior ocer was dependent on this premise. In earlier years the Swedish Handicap Institute provided a considerable personal and financial support for the ICTA Information Centre and resources for publications, such as ICTA Inform. Major projects such as creating the International Symbol of Access in1969, were carried through. ([])

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[|Historical Foundations of Assistive Technology Outcomes Measurement]

[|The Evolution of Assistive/Adaptive Technology]

[|Adaptive Technology Oral History Project]