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Web Posted on: August 4, 1998


Assistive Technology education for end-users: the Eustat perspective

Renzo Andrich
Serenella Besio

SIVA
Fondazione Don Gnocchi IRCCS
via Capecelatro 66, I-20148 Milano
tel: +39 2 40090157
fax: +39 2 4048919
email: renzo.andrich@siva.it

1. Summary

Based on the findings of the TAP/Eustat project, this paper describes critical factors related to the process of knowledge transfer on Assistive Technology to end-users, highlights strategies that maximise the effectiveness of such process, and reports on the results of a comparative analysis of existing experiences of end-users education on AT in Europe.



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2. Introduction

Knowledge of assistive technology is one of the key factors that facilitates empowerment of people with disabilities and the elderly. Education of end-users to Assistive Technology is the focus of the EUSTAT study (Empowering USers Through Assistive Technology), carried out by a Consorium led by SIVA which includes three Users Organisations (in Belgium, France, Italy), two research centres (in Denmark and Italy) and one academic Institution (in Portugal). EUSTAT is currently developing a User Manual an AT, and a set of Guidelines for educational activities aimed at transferring AT knowledge to end-users. As a background for these achievements, the study first investigated the critical factors that have a role in the process of knowledge transfer to such an heterogeneous population, and analysed the educational experiences (mainly carried out by user organisation) that currently take place in Europe and North America.

In the context of this study, the concept of end-users of assistive technology (AT) refers primarily to people with disabilities and elderly people. However, it was found that such concept should be in some cases extended to include family members, helpers and personal assistants whenever AT has an impact inside the whole primary network around the individual. The term end-users is adopted to distinguish them from other actors (e.g. rehabilitation professionals, AT specialists) who might be also considered "users" in a broader sense (since they use AT as a tool in their professional activity), but should be more appropriately identified as AT providers or AT advisers.

EUSTAT found that the concept of autonomy is the one that best seems to describe the ultimate goal of AT. Autonomy can be defined as ability to plan one's own life, to enter into relation with the others and, together with them, to actively participate in the construction of society. This definition establishes a kind of equation like autonomy = relation, which in turn includes three types of relations: with self, with others, and with the environment. The onset of a disability brings about a change in the individual's life; in order to achieve again a situation of autonomy he or she needs a personal restructuring, that means to build a new relation with self, with the others and with the environment. AT is instrumental to such goal, and thus can be seen as a tool for relation.

To be effective for such a goal, and consistent with an empowerment perspective, the transfer of AT knowledge to end-users should not be limited to just information on what is available on the market, but rather assist the user in the four stages that lead to the fulfilment of a need: 1) identification of need, 2) definition of goals, 3) designing a project and 4) deciding and carrying out action. Various kinds of knowledge (theoretical, procedural, practical and know-how) need to be delivered at each stage through an appropriate process.



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3. Processes of knowledge transfer

Five types of knowledge transfer processes have been identified and described, each having a specific role and complementing each other: counselling, training, teaching, information, awareness campaigns. The training and teaching processes often take place in conjunction with each other, and can be referred together with the more general term education.

Counselling can be defined as the process through which a person, on the basis of his/her professional expertise (professional counselling) or his/her own personal experience of a similar situation (peer counselling), helps the individual end-user to make choices and take initiatives by giving information, helping to better understand one's own situation, favouring motivation. Professional counselling is now a well-studied technique in the field of psychology where the relationship between the actors is established as well as the objectives and the subjects' roles.

Training is the process through which one or more trainers transfer to an individual or a group of trainees practical knowledge, competence and abilities to enable them to better cope with a subject, that can be very specific (eg. wheelchairs and seating) or broader (eg. training for personal autonomy with the support of AT).

Teaching is the process through which a higher level of understanding, competence and problem-solving ability is provided to a group of users.

Information is the process through which notions pertaining to the field are given to users. Information is generally addressed to a large audience aiming at increasing general competence.

Awareness campaign is the process through which attention is raised on specific issues with the intention of shaping the attitude towards them.


For supporting empowerment all five processes above should take place. AT end-users may need education, information or counselling at different times and for different purposes; awareness campaigns may help to increase the interest of people towards AT and thus favour their access to the other four processes. These can be seen as differently "positioned" with regards to the stress they put on supporting the end-users initiative, or providing them with technical competence. EUSTAT analysed more in depth the education processes, they being the main focus of the Study.



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4. Critical Factors in end-users' education in relation to AT

Education initiatives are activities where an organiser (usually an institution or an association) delivers knowledge to a group of trainees in a structured way according to a given programme and a given method. The most effective initiatives are those where not only information and notions are offered to the trainees, but where AT education is aimed at modelling the personal growth of each of them in such a way as to enable to identify their own needs and set their goals, to work out effective projects able to achieve such goals in the daily life context, and to carry out actions able to put projects into practice. Needs, goals, projects and actions cannot be standardised, since each individual is unique in setting his/her values, priorities, choices, and lives in a different human, cultural and physical environment. An effective education is respectful of this specificity: in metaphoric terms it should provide the "fishing rod" instead of the "fish".

In designing educational initiatives, the organiser has to consider a number of critical factors and take decisions on them. The term "critical factors" refers to all those aspects influencing the transfer of knowledge on AT to the trainee, and his/her resulting ability to make informed, effective and satisfactory choices. There may be critical factors that have negative influence, others with positive influence, other that may act positively or negatively when cross-related with other critical factors.

A checklist has been developed covering 60 critical factors, clustered round four groups. No inherent hierarchy can be established among them a priori. The scope of this classification is only to bring critical factors to the fore, to sort and describe them in a logical manner, so as to offer the organiser a checklist of aspects to be considered.

A. Positioning factors of the knowledge transfer process
A.1 Type of knowledge transfer process

B. Factors related to the transfer of knowledge to groups of trainees
B.1 Pedagogical factors
B.2 Contents factors
B.3 Targeting factors
B.4 Management / organisational factors

C. Factors related to the reception of knowledge by the individual
C.1 Predisposition factors
C.2 Pathology-related factors
C.3 Individual attitudes towards disability
C.4 Individual expectations

D. Factors related to transforming knowledge into individual initiative
D.1 Social attitudes towards disability
D.2 Physical environment factors
D.3 Social support factors
D.4 Market factors
D.5 Social network factors



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5. Existing esperiences in end-users education


A survey of existing experiences of end-user education was carried out at international level. A questionnaire was designed, pre-tested within the EUSTAT Consortium, and then sent out to 687 Organisations. 163 questionnaires were returned, coming mostly from EUSTAT partner countries. A significant number of organisations claimed to have a concrete involvement in training courses and seminars devoted to AT as an instrument for autonomy. In particular, 87 specific educational programmes were identified and described. In order to collect further elements for a deeper understanding, seven on-site visits were also carried out to some of them.

The survey revealed a great variety of approaches, each rooted in different cultural environment, tradition and attitude towards disability. There are user-driven experiences with strong accent on self-advocacy and self-determination; experiences carried out by professionals or through co-operation between users and professionals, often seen as an extension of the rehabilitation process; experiences aimed at educating to autonomy and shaping independent living attitude, often with focus on training peer-counsellors or peer-mentors; experiences where the boundaries between education and counselling are blurred. They are sometimes monographic (i.e. exclusively focusing on AT), but more often AT education is delivered as part of wider programmes aimed at more comprehensive objectives like rehabilitation and social integration, development of personal autonomy, qualification for receiving social benefits, independent living and self determination, and peer counselling/training
The weight assigned to AT in such programmes is still uneven throughout Europe with respect to other topics (eg. legislation on disability, civil rights etc..), however it is recognised that 1) AT knowledge is a fundamental and 2) educational material is needed to facilitate all people with disability becoming knowledgeable, informed and demanding consumers of AT. The most frequent areas of AT dealt with in such programmes are communication, followed closely by "general accessibility issues" and "mobility". Other key areas are "employment", "house", "self-care", "reading/writing".
Another notable finding was that the terminology used by those active in the field is far from being standard. The meaning associated to keywords like independent living, autonomy, independence, rehabilitation, education, training, etc. often differs from one country to another. This may well be due not only to the semantic bias associated to language translation, but also to differences in cultural heritage linked to local legislation, service delivery organisations, and the level of end-user involvement in policy development. What's more, there is still little communication between the promoters of the various programs. Hence, the myriad of different perspectives often makes it difficult to compare programs originated in different contexts.

Conversely, a common feature throughout is the liveliness of the programmes, the wealth of ideas, the willingness to self-evaluate and improve, the interest in experiencing new ways of doing things. Many respondents welcomed the questionnaire as an opportunity for self-reflection about their activities and for discovering that other methods exist. A widely shared objective seems to lie in the strong accent put on change in the individual rather than just providing information and knowledge. This suggests that the environment is very dynamic, open and promising.



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Literature

EUSTAT Consortium. Critical Factors in End-Users Education in relation to Assistive Technology. European Commission DGXIII - TAP/Eustat Deliverable D03.2. http://www.siva.it/research/eustat
EUSTAT Consortium. Programs in Assistive Technology education for end users in Europe. European Commission DGXIII - TAP/Eustat Deliverable D04.2. http://www.siva.it/research/eustat



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