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In this chapter, we present the findings of the National Assistive Technology Research Institute (NATRI). The institute was funded in October 2000 as a cooperative agreement with the U.S. Department of Education, Office of Special Education Programs to take a comprehensive look at the factors related to the planning, development, implementation, and evaluation of assistive technology (AT) services in schools. We present the data from seven research areas: (1) the status of AT use in schools, (2) policies and procedures in the development and delivery of AT services, (3) AT decision-making by IEP teams, (4) integration of AT use in learning environments (facilitate instruction, access to curriculum), (5) effects of AT use on academic, social, functional performance of students, (6) training and technical support needed by persons implementing AT, and (7) the extent to which institutions of higher education (IHEs) were developing AT knowledge and skills. In each area we summarize the lessons learned as a result of the research to assist policy-makers, researchers, and practitioners in improving AT services and delivery systems.

This chapter offers descriptions of many current uses of video conferencing technology for the delivery of assistive technology (AT) services at a distance. It begins with definitions of remote AT services, virtual teams and virtual teamwork and moves to a discussion of the advantages and disadvantages of remote AT supports for individuals, teams and organisations. A review of research regarding the outcomes of remote services helps to clarify ways that assistive technology providers can enhance function and build agency capacity by working, at least in part, in a virtual support environment. The chapter provides a discussion of various aspects of virtual teamwork that affects how individuals work together remotely as well as potential barriers to the provision of remote AT services. Multiple examples are provided throughout as well as descriptions of specific features of video conference technology options that should be considered before adoption. A planning form for the integration of remote assistive technology supports into the array of AT support services is included.

The development of telecare services across the UK has been supported by grants from the respective governments of Scotland and Wales, and by the DH in England. New services are being established to sometimes operate alongside existing community equipment services and community alarm services. Elsewhere they are embracing a wider range of services including rehabilitation, intermediate care and health services designed to reduce the use of unscheduled care services. This paper discusses the difficulties in understanding the scope of telecare services, and the definitions of services that will need to be confirmed so that service users can choose appropriately if offered direct payments. Two different service models are offered, one of which uses telehealth as an umbrella term to cover all telecare, e‐care and m‐care, and telemedicine where the former includes all such services offered in the service user's home, including those of a medical nature. The second model views telecare alongside assistive technologies and telemedicine as one of three different technology groups designed to make people more independent or to bring care closer to home. There is significant overlap between the three groups, which justifies the introduction of a new term ‐ ARTS (assistive and remote technology services) ‐ to describe this area of support.

The ramifications of assistive technology for both current and future service provision are wide. In recent years, policy makers have become increasingly aware of the potential of these services to maintain older and disabled people in their own homes. The purpose of this paper is to report on a literature review and provide illustrations of how the evidence can be used to underpin the development of assistive technology services for older and disabled people and disabled children. The aim is to support the development of user‐focused, accessible services.

This paper explores the wider significance that the development of telecare services has for social care in addition to supporting people to remain independent at home. It considers the impact of this particular development as a model for change management and as a model for developing a social care workforce ‘fit for the future’. The paper takes a whole‐systems, integrated approach to service development and highlights important issues such as infrastructure, management, the capacity to innovate and workforce development. The paper emphasises that the development of new skills and new ways of thinking are even more important than the technology itself and that partnership is an essential ingredient for success. The context and content of this paper are informed and influenced by the experience of developing a new worker role, the assistive technology support worker, in Norfolk; and from the experience of designing and implementing a successful county‐wide technology‐based service.

This paper explores the wider significance that the development of telecare services has for social care in addition to supporting people to remain independent at home. It considers the impact of this particular development as a model for change management and as a model for developing a social care workforce ‘fit for the future’. The paper takes a whole‐systems, integrated approach to service development and highlights important issues such as infrastructure, management, the capacity to innovate and workforce development. The paper emphasises that the development of new skills and new ways of thinking are even more important than the technology itself and that partnership is an essential ingredient for success. The context and content of this paper are informed and influenced by the experience of developing a new worker role, the assistive technology support worker, in Norfolk; and from the experience of designing and implementing a successful county‐wide technology‐based service.

The UK government is committed to preventative technologies and increasingly they are being incorporated into residential services for people with learning disabilities. This paper describes an evaluation of a sample of settings in which various assistive technology (AT) devices have been installed following the assessment of individual residents' needs. The impact of this on residents' objective quality of life was assessed using a range of quantitative measures and through some qualitative questions. Despite some positive consequences of the AT being reported by staff in response to the qualitative items, there was no significant impact on any of the quantitative measures. In isolation, AT does not appear to be sufficient to significantly improve objective quality of life outcomes for people with learning disabilities in residential services. Equally, AT does not appear to reduce objective quality of life outcomes. The challenge to service providers is to ensure that the introduction of AT and any associated change to staffing levels or support procedures translates into improvements in residents' overall quality of life. To detect such improvements future research might have to broaden the range of quantitative methods used and supplement them with qualitative techniques.

Assistive Technology (AT) helps address social and economic barriers and can positively impact the lives of people with disabilities. Single-entry point (SEP) systems have been shown as successful models for reducing barriers encountered when acquiring and using AT. This chapter highlights a mixed method case study in the province of Newfoundland and Labrador (NL), which sought to explore barriers consumers faced in acquiring and being satisfied with AT, as well as the potential for an SEP system in NL. NL is an Atlantic Canadian province characterized by a small population dispersed over a large island and remote mainland. Data were collected using individual interviews with disability service providers in community and post-secondary settings across the province and a survey to assess barriers to accessing AT, AT utilization, and satisfaction among consumers with disabilities. Many consumers and service providers demonstrated that they recognized the benefits of AT but expressed dissatisfaction with existing programs and services citing cost, lack of knowledge, training, and funding subsidies as the most significant barriers to access. Improving access to AT is a necessary step toward enhancing education and employment opportunities, facilitating social inclusion, and optimizing overall health for people with disabilities. Investigating the feasibility of SEP programs modeled after American and Australian initiatives should be part of future planning for Canada, especially in small urban, rural, and remote areas where demand for provision of AT is under-resourced.

The term assistive technology (AT) is relatively new but its origins go back a long way. Some of the elements of assistive technology, such as aids and adaptations, have been a feature of policies for many years. Before the late 1990s it was more usual to focus on the most common types ‐ telephones, alarms, aids and adaptations. More recently telemedicine and smart houses have come to the fore in policies and research. What is confusing now is that a variety of other terms are being used. In this paper the development of these terms in recent policies and the changing terminology are traced. It is suggested that a narrow interpretation can play down the important role of AT in enabling older people to maintain their independence but that it must be seen in conjunction with other services, especially housing.

The importance and weighting given to certain factors by occupational therapists, during the assessment process for assistive technology (AT), may have an affect on the eventual outcome for the client. Factors examined included risks around the user, carer and their environments, training and knowledge of AT, policy issues on provision and actual practice, choice of AT and whether AT has an impact on care provision. Out of 50 anonymous questionnaires sent out to collect information, 36 were returned direct to the researcher by stamped addressed envelope. 19 respondents from health and 17 from social services provided a good balance and allowed an opportunity for cross comparison. Areas of practice around multidisciplinary team working and client follow‐up were found to be weak. Frequency of social alarm referrals where no lifeline existed was low. Thematic analysis from feedback also identified concerns over knowledge and awareness of assistive technology. Differences between health and social services were detected. The research identified that many of the factors were being considered by occupational therapists, however, some of these factors were not permeating through to actual practice and application, which highlighted inconsistency in OT practice and the effect of local practice conditions on AT prescription.