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  1. Function and Design Steve Bauer

  2. Human Functioning

  3. ICF Functioning Environmental Factors Body Structures andBody Functions Activities and Participation b100: Mental Functions d100: Learning and applying knowledge C1: Structures of the nervous systems e100: Products and technologies b200: Sensory Functions and Pain d200: General tasks and demands C2: Eye, ear and related structures e200: Natural environment and human made changes to environment b300: Voice and speech functions d300: Communication C3: Structures involved in voice and speech b400: Functions of cardiovascular, Hematological, Immunological, Respiratory systems d400: Mobility e300: Support and relationships C4: Structures of cardiovascular, immunological, respiratory systems d500: Self-care b500: Functions of digestive, metabolic and endocrine systems e400:Attitudes C5: Structures of digestive, metabolic and endocrine systems d600: Domestic life b600: Genitourinary and reproductive functions e500: Services, systems and policies C6: Structures of genitourinary and reproductive d700: Interpersonal interactions and relationships b700: Neuromusculoskeletal and movement related functions C7: Neuromusculoskeletal and movement related structures b800: Functions of skin and related structures d800: Major life areas C8: Skin and related structures d900: Community, social and civil life

  4. ICF Functioning Environmental Factors Body Structures andBody Functions Activities and Participation b001: Mental Functions d100: Learning and applying knowledge s100: Structures of the nervous systems e100: Products and technologies b200: Sensory Functions and Pain d200: General tasks and demands s200: Eye, ear and related structures e200: Natural environment and human made changes to environment b300: Voice and speech functions d300: Communication s300: Structures involved in voice and speech b400: Functions of cardiovascular, Hematological, Immunological, Respiratory systems d400: Mobility e300: Support and relationships s400: Structures of cardiovascular, immunological, respiratory systems d500: Self-care b500: Functions of digestive, metabolic and endocrine systems e400:Attitudes s500: Structures of digestive, metabolic and endocrine systems d600: Domestic life b600: Genitourinary and reproductive functions e500: Services, systems and policies s600: Structures of genitourinary and reproductive d700: Interpersonal interactions and relationships b700: Neuromusculoskeletal and movement related functions s700: Neuromusculoskeletal and movement related structures b800: Functions of skin and related structures d800: Major life areas s800: Skin and related structures d900: Community, social and civil life

  5. Learning & Applying Knowledge (d100-d199) • Purposive sensory experience (d110-d129) • Watching (d110), Listening (d115) • Basic learning (d130-d159) • Copying (d130), Rehearsing (d135), Learning to read (d140), Learning to write (d145), Learning to calculate (d150) • Focusing attention (d160-d179) • Focusing attention (d160), Thinking (d163), Reading (d166), Writing (d170), Calculating (d172), Solving problems (d175), Making decisions (d177)

  6. Concepts & Terminology BF&S impairments… normally distributed, measured Activity limitations… normally distributed, measured Participation restrictions… not statistically distributed, “judged” Capacity highest probable level of functioning…measured (standard tools, environments, professionals) Performance actual level of functioning…measured (in context) Levels no, mild, moderate, severe, complete…impairment (or limitation)

  7. Legal Disability

  8. ADA 2009: Disability • The term "disability" means, with respect to an individual • (A) a physical or mental impairment that substantially limits one or more of the major life activities of such individual; • (B) a record of such an impairment; or • (C) being regardedas having such impairment.  

  9. ADA 2009: Major Life Activities #1 • “Major Body Functions” • ADA2008 Section 12102 (2) (B) • “the operation of a major bodily function, including but not limited to, functions of the immune system, normal cell growth, digestive, bowel, bladder, neurological, brain, respiratory, circulatory, endocrine, and reproductive functions.” BF&S

  10. Major Life Activities #2: ADA 2009 • “In General” • ADA2008 Section 12102 (2) (A) • “caring for oneself, performing manual tasks, seeing, hearing, eating, sleeping (mental function), walking, standing, lifting, bending, speaking, breathing, learning, reading, concentrating, thinking, communicating, and working.” A&P

  11. Disability Demographics

  12. ICF – Legal Disability Moderate Complete Severe Mild No BF&S impairment [2] [1] [3] Legally - Disabled Legally - Not Disabled

  13. Disability Model

  14. MF C/S/M/M/N Impairment L&AK C/S/M/M/N Limitation SF&P C/S/M/M/N Impairment GT&D C/S/M/M/N Limitation V&S C/S/M/M/N Impairment Com C/S/M/M/N Limitation NMS&MR C/S/M/M/N Impairment Mob C/S/M/M/N Limitation

  15. MF C/S/M/M/N Impairment L&AK C/S/M/M/N Limitation SF&P C/S/M/M/N Impairment GT&D C/S/M/M/N Limitation V&S C/S/M/M/N Impairment Com C/S/M/M/N Limitation NMS&MR C/S/M/M/N Impairment Mob C/S/M/M/N Limitation Microsoft (2003, 2004) Note: A third “column” can be added to this “model” for the five (nominally) “participation” chapters (e.g. self-care, interpersonal relationships, major life areas etc.). Activity limitations in the second column then contribute to participation restrictions in the third column.

  16. C/S/M/M/N Restrictions C/S/M/M/N Limitations C/S/M/M/N Impairment Self-care Mental functions Learning & applying knowledge Domestic life Sensory functions & pain General tasks & demands Interpersonal interactions & relationships Voice & speech Communication Major life areas Neuromusculoskeletal & movement related Mobility Community, social & civil life Body Functions & Structures & Participation Activities Note: Historically, there was a great fight in the ICF community as to whether Activities & Participation are separate, distinct or overlapping. The final position is that they overlap… and cannot be fully teased apart as we suggest above. From the perspective of provision of clinical services… the separation provides a useful if not completely literal mnemonic.

  17. Human Factors

  18. Human Factor Model • Human Factors is “a multidisciplinary field incorporating contributions from psychology, engineering, industrial design, statistics, operations research and anthropometry. It is a term that covers: • The science of understanding the properties of human capability (Human Factors Science). • The application of this understanding to the design, development and deployment of systems and services (Human Factors Engineering). • The art of ensuring successful application of Human Factors Engineering to a program (sometimes referred to as Human Factors Integration). It can also be called ergonomics.” Reference: http://en.wikipedia.org/wiki/Human_factors

  19. Human Factors has a very, very long history • ~300 BC (Battlefield, Greek Surgical Instruments), ~1450 AD (Farms, Worker Productivity), ~1900 AD (Factories, Worker Productivity), ~1940 (Battlefield, Control of War Machines), ~1973 (Rehab Act, “Accessible Design” Defined), ~1980 (Disability Rights, “Universal Design” Defined), ~1990 (OXO Good Grips, UD and Mainstream Products), ~2000 (Human Activity Assistive Technology Model, ATD and IWD)

  20. Human Factors: Industrial Engineering Device User Task Environment Contextual Factors

  21. USER BF&S Impairments A Limitations P Restrictions “ATD/UTD” Input Interface Output Interface Processing Power Decode Encode CRITICAL TASK(s) Activities & Participation + - + - DEVICE augments, restores, or compensates for the loss of usable USER FUNCTIONING + - CONTEXTUAL FACTORS

  22. Device Types

  23. Functioning & Device Design

  24. Assistive Technology (individual)  UT   MT  • AT  M F D D* S F & P D E D V & S F F D NMS & MR F Braille Notetaker (D), Glasses (E), Mobility Cane (F) 26

  25. Universal Technology (single domain)  UT   MT  • AT  M F H S F & P V & S F J NMS & MR F Closed Captioning (H), Curb Cuts (J) 27

  26. Universal Technology (multiple domains)  UT   MT  • AT  K M F K S F & P V & S F K NMS & MR F Universal (Elder) Thermostat (K) 28

  27. Uptake, Use, & Abandonment

  28. DEVICE ABANDONMENT MODEL Techno-Centric Considerations Service-Centric Considerations Person-Centric Considerations

  29. Critical Tasks, Provided Functioning, Required Functioning

  30. STRATEGIZE for Individual Clients   Can Critical Task be completed with available (BF&S, A&P) functioning? Is this a Critical Task?   Does person have sufficient (BF&S, A&P) FUNCTIONING REQUIREDto use AT/UD device? Can Critical Task be completed with (BF&S, A&P) FUNCTIONING PROVIDEDby AT/UD device? Inspired by: Krantz, O. (2012). Assistive devices utilization in activities of everyday life – a proposed framework of understanding a user perspective. Disability and Rehabilitation: Assistive Technology, 7(3), 189-198.

  31. SUBJECTIVE OBJECTIVE   USER + TASK USER + DEVICE   + + ATD Acceptable to Client? [Bio-Psycho-Social Context] Environmental Barriers to ATD use? [Physical Context] MPT

  32. Capacity, Performance, Disability & Non-Disability Domains

  33. E.g. “typical” functioning required to “operate…” a device Any person with at least this level of functioning can “operate…” the device capacity – standard context, measured, known performance – context dependent, unmeasured, rarely known Capacity data is typically collected. What may be more useful to designers is performance data. Low Functioning High Functioning

  34. Person has significant impairment in SF&P (C) and significant limitation in L&AK (C). SF&P and L&AK are the device’s “disability domains” For most chapters & domains, person doesn’t have significant impairments or limitations. MF, V&SF, N&MRF and GT&D, COM, & MOB are the device’s “non-disability domains” C C C C C C C MF C SF&P V&SF N&MRF Functioning Required-> L&AK GT&D Assessment and provision takes place in a clinical setting consequently, you are assessing the person’s capacity to use the device. Typically (but counter-examples can be found), the person’s capacity will exceed their performance. COM • Any computer [or any] device can be characterized by the levels of functioning required for its use in ICF BF&S and A&P chapters. • For a computer [or any] device the most [commonly] relevant ICF chapters are: BF&S – MF, SF&P, V&S & NMS&MR; and A&P – L&AK, GT&D, Communication & Mobility MOB

  35. AT or UD access device Augments/Compensates for loss of/Restores the person’s capacity in SF&P and L&AK chapters. After device provision person would not have a legal disability. Actually… person would not have a legal disability if either the impairment or limitation was not significant. NOTE: Person has sufficient capacity to use device in each of the disability and non-disability domains. Training optimizes capacity!!! C C C C C C C C C NEW Functioning -> Required in Non-Disability Chapters C MF SF&P V&SF NMS&MF L&AK GT&D Typically, after AT or UD access device is provided, functioning required to use the device will in be increased in many or all non-disability domains. COM • After provision of the AT or UD access device, the person’s capacity to use the computer exceeds levels of required functioning (for combined access device + computer) MOB

  36. Capacity (C) normally exceeds Performance (P) though exceptions can easily be constructed. NOTE: Person lacks sufficient performance to use AT or UD device + computer in the BF&S – N&MRF and A&P – L&AK, COM, & MOB domains!!! Trialing assesses performance!!! Following trialing, the UD or AT access device might be further adapted, or other UD or AT access device solutions considered. P C C P C P P C C P P C C P C P C NEW Functioning -> Required in Non-Disability Chapters C MF SF&P V&SF NMS&MF L&AK GT&D Typically, after access device is provided, functioning required to use the device will in be increased in many or all non-disability domains COM • When the AT or UD access device + computer is used in context, performance (P) must be substituted for capacity. MOB

  37. Computer Model

  38. Recharge Analog Voice Mouse Keyboard Internal Ports Replace Digital Data I/O User Output Power Use Input Processing External (PAN) Inductive Visual Network (LAN) Audio Digital Video (WAN)

  39. Access ATD/UDT

  40. Access AT & UT Output Interface Recharge Analog Voice Mouse Keyboard Internal Ports Replace Digital User Output Data I/O Power Use Input Processing External (PAN) Inductive Visual Network (LAN) Audio Digital Video (WAN) Access AT & UT Input Interface

  41. Communication Model (late 1940s) Communication “components” An information source, which produces a message. A transmitter, which encodes the message into signal A channel, to which signals are adapted for transmission A receiver, which 'decodes' (reconstructs) the message from the signal. A destination, where the message arrives. Computer Output Interface Channel Input Interface Computer

  42. Verbal Communication (e.g.) (Human) Receiver (Human) Transmitter Source Channel Destination MF, SF&P (V,H,T) …; L&AK, GT&D, COM, MOB… MF, V&SF, N&MRF…; L&AK, GT&D, COM, MOB… “Person #1” “Person #2” AIR “Encoding” “Decoding” V&SF (and structures) with CV&RF (and structures) encode communication into air movements. Air waves carry the signal. SF&P:Hearing (and structures) with decode air movements into communication. MF, V&SF, N&MRF…; L&AK, GT&D, COM, MOB…

  43. Interpersonal Communication • Source? • Transmitter? • Channel? • Receiver? • Destination? Person #1 Person #2

  44. Shakespearean Play • Source? Shakespeare’s brain. • Transmitter? • Channel? • Receiver? • Destination? Shakespeare wrote his play in long-hand. Unbelievably, the girl pictured is reading the original copy!

  45. Communication Model – ACCESS ATD/UDD+ICT TRANSMITTER (Encoding) Human as Transmitter Computer as Transmitter “Source” e.g. PAN, LAN, W-LAN… Air… ACCESS ATD USER MF, V&SF, N&MRF…; L&AK, GT&D, COM, MOB… ICT “Channel” “Data Output Interface” “Human Output Interface” “Computer Input Interface” “User Output Interface” “Data Input Interface” “Human Input Interface” ACCESS ATD USER ICT MF, SF&P (V,H,T) …; L&AK, GT&D, COM, MOB… “Channel” e.g. PAN, LAN, W-LAN… Air… Human as Receiver Computer as Receiver “Destination” RECEIVER (Decoding)

  46. Communication Model – ACCESS ATD/UDD+ICT TRANSMITTER (Encoding) Human as Transmitter Computer as Transmitter “Source” e.g. PAN, LAN, W-LAN… Air… ACCESS ATD USER MF, V&SF, N&MRF…; L&AK, GT&D, COM, MOB… ICT “Channel” “Data Output Interface” “Human Output Interface” “Computer Input Interface” “User Output Interface” “Data Input Interface” “Human Input Interface” ACCESS ATD USER ICT MF, SF&P (V,H,T) …; L&AK, GT&D, COM, MOB… “Channel” e.g. PAN, LAN, W-LAN… Air… Human Receiver Computer Receiver “Destination” RECEIVER (Decoding)

  47. Refreshable Braille Display • Source? • Transmitter or Receiver? • Channel(s)? • Destination?

  48. Eye gaze System • Source? • Transmitter or Receiver? • Channel(s)? • Destination?