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Psicologia del funzionamento e della disabilità. 4. La valutazione delle tecnologie assistive. Prof. Stefano Federici – A.A . 2012-2013. Segment 1: Factor 1  Modeling the ATA process. Segmento 1: Fattore 1  Modellizzare l’ATA process. 5 pillars of the ATA process model. ATA PROCESS.

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Psicologia del funzionamento e della disabilit

Psicologia del funzionamento e della disabilità

4. La valutazione delle tecnologie assistive

Prof. Stefano Federici – A.A. 2012-2013


Psicologia del funzionamento e della disabilit

Segment 1: Factor 1 Modeling the ATA process

Segmento 1: Fattore 1 Modellizzare l’ATA process


5 pillars of the ata process model

5 pillars of the ATA process model

ATA PROCESS


The assistive technology assessment process

Phase 1:

Theuser seeks a solution

Phase 1:

User data collection

The Assistive Technology Assessment process

Phase 2:

Evaluation data

Phase 2:

Theuser checks the solution

Phase 3:

Matching process

Phase 3:

Theuser adopts the solution

Phase 4:

Assistive Technology Provision

and Follow-up of the assistive solution in context


The ata process under the lens of the icf biopsychosocial model

The ATA process under the lens of the ICF biopsychosocial model

Health condition

(disorder or disease)

Body Functions

and Structures

Activities

Participation

Assistive Solution

Medical diagnoses*

User driven process **

Support & follow up ***

ICF – biopsychosocial model

MPT

Well-being

Environmental

Factors

Personal

Factors


Limiti e vantaggi di un modello ideale di ata process

Limiti e vantaggi di un modello ideale di ATA process

Limiti 

  • La difficoltà di definire un unico AT system delivery

    • La straordinaria varietà di sistemi sanitari influenza in differenti modi le specifiche caratteristiche che delineano ogni singolo Centro.

  • La comunità scientifica sta perseguendo un AT system delivery che sia sempre piùindividualizzato. Come si usa dire Centratosullapersona.

Vantaggi

  • Emerge come una sintesi di esperienze di modelli regionali.

  • Si condivide un modello teorico e criteri di valutazione.

  • Permette di condividere dati essenziali alla ricerca scientifica.

  • Aiuta a pianificare e valutare politiche nazionali e internazionali.

  • Può aiutare a valutare la qualità dei servizi.


Summarizing the 3 main elements identified in segment 1

Summarizing the 3 main elements identified in SEGMENT 1


Question time segment 1

Question time – SEGMENT 1

  • If the goal of the ATA process is to model an effective assessment process for providing an assistive solution, why does (in the phase 4 of the ATA process) the Center provides an “Assistive Technology” and not an Assistive Solution?

    • Because in the phase 4 we are referring to the provision of an assistive device, evaluated as needed to reach an assistive solution.

    • The assistive solution is the entire process and the outcome.


Psicologia del funzionamento e della disabilit

Segment 2: Factor 2  Managing the ata process: the psychotechnologist

Segmento 2: FaTtore 2  dirigere l’ata process: lo psicotecnologo


Tra l utente e la tecnologia lo psicotecnologo

Tra l’utente e la tecnologia: Lo psicotecnologo

Caratteristiche

della tecnologia

Bisogni dell’utente

psicologo

tecnologo


What the psychotechnologist is and is not

What the Psychotechnologist is and is not

  • Cognitive ergonomist

    • Evaluates the interaction according to a dualistic reciprocity between two poles: the user system and the artifact system (Norman 1983).

  • Psychologist(in Center for AT provision)

    is an expert in

    • personal factors;

    • human relationships and communication;

    • psychological assessment and intervention;

    • dynamic biopsychosocial variables.

  • Why not?

  • Psychotechnologist is not a clinic/dynamic psychologist.

  • Psychotechnologist has a background in (rehabilitation) psychology.

  • Why not?

  • Psychotechnologist evaluates the interaction according to a user-AT-milieu holistic model.

  • Psychotechnologist is an expert of assistive solutions.


Cosa fa lo psicotecnologo

Cosa fa lo psicotecnologo

  • Strumenti:

    • ATD-PA

    • QUEST,

    • SUMI,

    • IPDA…

Sistema

Tecnologico

Barriere e facilitatori

Sistema-utente

Sistema socio-ambientale

Prospettiva biopsicosociale


University courses

University courses

Assistec – Austria(Miesenberger, 2006)

  • Corso e-learning;

  • 4 moduli e 17 seminari;

  • Diploma in Esperto in Tecnologie Assistive.

Modulo 1: Fondamenti

Modulo 2: Conoscenze specifiche sulle Tecnologie Assistive

Modulo 3: Processi di Assortimento e Fornitura di TA e ICT

Modulo 4: Tecnologie Assistive in Pratica e Applicazioni


University course

University course

Master in Psicotecnologie per Soluzioni Assistive

  • Corso universitario;

  • 4 moduli, 1000 hdi insegnamento frontale, 500 h tirocinio and workshop;

  • Diploma in Esperto in psicotecnologie.

Modulo 1: Fondamenti

Modulo 2: Introduzione alla Psicotecnologia

Modulo 3: Elementi di base e avanzati su Tecnologie Assistive

Modulo 4: Soluzioni Assistive


Summarizing the 3 main elements identified in segment 2

Summarizing the 3 main elements identified in SEGMENT 2


Question time segment 2

Question time – SEGMENT 2

  • Does a psychotechnologist have something to do with the method of psychotechnology in the applied psychology proposed by Igor Smirnov to manipulate human mind by means of technology?

  • No, it doesn't! Not at all. As we previously explained, the psychotechnologist does not have anything to do with thought control!

  • In fact, the current concept of psychotechnology is related to a neologism to explain a new professional figure which investigates the psychological and cognitive components involved in the interaction environment, be it either a physical environment or a Information and Communication Technology one.


Psicologia del funzionamento e della disabilit

Segment 3: assessing personal factors in a center for technical aid


The number o ne suspect in at abandonment personal factors

The Number OneSuspect in AT abandonment: Personal factors

  • Philips & Zhao (1993) Predictors of Assistive Technology Abandonment

  • Scherer et al (2005) Predictors of assistive technology use

  • Dijcks et al (2006) Non-use of assistive technology

  • Lauer et al(2006) Factors in Assistive Technology Device Abandonment

  • Verza et al (2006) Evaluating the need for assistive technology reduces equipment abandonment

  • Federici & Borsci (2011) The use and non-use of assistive technology


What the personal factors are

Health condition

(disorder or disease)

What the personal factors are

Body Functions

and Structures

Activities

Participation

ICF - biopsychososcial model

Environmental

Factors

Personal

Factors


Why the at service provision is an expensive process

Why the AT Service provision is an expensive process

The variability is an obstacle because it is a cost


Return on i nvestment roi in assessing personal factor

Return on Investment (ROI) in assessing personal factor

Matching Aid and Person, financed by the Italian Umbria Region in 2009 

Identify the percentage of AT non-use and the users’ satisfaction of AT in a national health system.

  • Federici, S., & Borsci, S. (2011). The use and non-use of assistive technology in Italy: A pilot study. In G. J. Gelderblom, M. Soede, L. Adriaens & K. Miesenberger (Eds.), Everyday Technology for Independence and Care: AAATE 2011 (Vol. 29, pp. 979-986).

    Results

  • Mean of non-use 18%(good!)

  • Main reason of AT non-use  Personal Factors

  • ROI

    on personal factors

    in Umbria Region

    =

    $ 2,000,000

    Umbra Region Aid and Prosthetic Service Provision

    Economic waste 2007-09

    Economic waste 2009

    Umbria population = 908,000


    How to invest in personal factors

    How to invest in personal factors

    Macro-level

    • WHO Develop personal factor categories within the ICF

      Local-level

    • Employ psychologist as expert in personal factors

      • Meloni, F., Federici, S., Stella, A., Mazzeschi, C., Cordella, B., Greco, F., et al. (2012). The Psychologist. In S. Federici & M. J. Scherer (Eds.), Assistive Technology Assessment Handbook (pp. 149-177). Boca Raton, FL, US: CRC Press.

    Psychologist

    in a AT service delivery process

    provides

    an appropriate psychological evaluation or a precise clinical intervention with the user/client and/or their significant human context over the course of the whole AT assignment process.


    What the psychologist does

    What the psychologist does

    • Identifythe user’s personal factors, priorities, preferences, etc.;

    • advocatethe user’s request;

    • act as mediator between users seeking solutions and the multidisciplinary team;

    • act as team facilitatoramong members of the multidisciplinary team;

    • reframethe relationship between the client and his or her family.


    The role of the psychologist in the ata process

    Psychologist’s role

    User Actions

    Center for Technical Aid

    TEAM

    TEAM

    START

    User/client REQUEST

    FACILITATE

    The role of the psychologist in the ATA process

    Contact

    Request to solve activity limitations

    Request to solve environmental restrictions

    FACILITATE

    User data collection

    IDENTIFY

    Providing history (medical, rehabilitation, support use) and psycho-socio-environmental data

    Multidisciplinaryteam meeting for:

    - user data valuation and - setting design

    NOT

    ADVOCATE

    Identify 

    Advocate 

    Mediate 

    Facilitate 

    Reframe 

    User subjective evaluation of technological aids

    Setting set-up

    Matching process:- assistive solution proposal- assistive solution user-trial- assistive solution outcome

    MEDIATE

    User evaluation of assistive solution

    Assistive solution Multidisciplinaryteam evaluation

    NOT

    NOT

    NOT

    Assistive Technology obtained:public health system or public/private insurance

    User agreement

    NOT

    Short/Long-term use

    • Effectiveness

    • Efficiency

    • Usability

    • Personal, emotional, social, comfort with use

    • Subjective well-being

      -Benefit

    Assistive Technology Provision

    REFRAME

    User Support

    Follow up


    Summarizing the 3 main elements identified in segment 3

    Summarizing the 3 main elements identified in SEGMENT 3


    Question time segment 3

    Question time – SEGMENT 3

    • Why is the engineer not an expert in personal factors?

      • The engineering curriculum does not typically include this.

      • Because knowing about personal factors is not equivalent to knowing subjective dimensions and individual functioning.

      • Theoretical acknowledge of personal factors does not reveal the psychological and existential side of the individual’s functioning.


    Psicologia del funzionamento e della disabilit

    Segment 4: assessing environmental factors in a center for technical aid


    Why assess the environment

    Why assess the environment


    What the environment is in the ata process

    Health condition

    (disorder or disease)

    What the environment is in the ATA process

    Body Functions

    and Structures

    Activities

    Participation

    Definition

    ICF

    Contextual Factors

    ICF - biopsychosocial model

    Environmental

    Factors

    Personal

    Factors

    Environmental

    Factors

    Personal

    Factors

    Dimensions


    How to assess environment

    How to assess environment

    ICF Constructs

    Output

    User’s Performance


    How to improve the user s performance at facilitator

    How to improve the user’s performance  AT facilitator

    Measures of Environment and AT impact

    Mirza, Gosset, & Borsci 2012

    Decisions for Improving User’s Performance

    • Modify Environment

    • Modify AT

    • Modify AT and Environment


    Assess the match between at and environment

    Assess the match between AT and environment

    • Accessibility

    Ideal fit

    • Universal

    • Design

    • Sustainability


    Assess the match between at and environment1

    Assess the match between AT and environment


    How to assess accessibility

    How to assess accessibility


    How to assess universal design

    How to assess Universal Design


    How to assess sustainability

    How to assess sustainability


    Psicologia del funzionamento e della disabilit

    Center for Technical Aid

    Environmental Assessment Process

    Check

    the match

    Environment data collecting

    START

    Environment

    Contact

    Universal design

    Accessibility

    Sustainability

    AT/end user

    User data collection

    MATCH

    ENDEXIT TO

    Multidisciplinaryteam meeting for:

    - user data valuation and - setting design

    YES

    NOT

    NOT

    Check the

    impact

    Modify the environment in use

    (Mod–Env)

    Proposal of a new

    matching process

    or strong

    personalization (Prop–nMP)

    IF

    IF

    Setting set-up

    Matching process:- assistive solution proposal- assistive solution user-trial- assistive solution outcome

    Impact of environment modification

    Impact of a new matching process

    Climate

    Impact

    Assistive solution Multidisciplinary team evaluation

    Mod–Env Results

    Prop–nMP Results

    NOT

    Take

    a decision

    MATCH

    Mod–Env<Prop–nMT

    Prop–nMP

    < Mod–Env

    IF

    IF

    EXIT

    User agreement

    IF

    NOT

    Prop–nMP

    =Mod–Env

    NOT

    Assistive Technology Provision

    Results

    Change the AT

    ENDEXIT TO

    User Support

    Change both

    Change the environment

    Change the AT

    Change

    AT and

    environment

    Change Environment

    Follow up


    Summarizing the 3 main elements identified in segment 4

    Summarizing the 3 main elements identified in SEGMENT 4


    Question time segment 4

    Question time – SEGMENT 4

    • Must we restart the Environment Assessment process when the result of the process suggests a need to modify or completely change the AT?

      • Yes, you should. All the steps of the Environment Assessment decision-making process might need to be repeated when a modified or a completely new AT is proposed by the multidisciplinary team.


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