The Scottish Government

A general term used to describe the degree to which a system is usable by as many people as possible without modification.

The disability rights movement advocates equal access to social, political and economic life which includes not only physical access but access to the same tools, organisations and facilities which we all pay for.

Accessibility is strongly related to universal design in that it is about making things as accessible as possible to as wide a group of people as possible. It is not to be confused with usability which describes how easily a thing can be used by any type of user.

While it is often used to describe facilities or amenities to assist people with disabilities, as in 'wheelchair accessible' the term can extend to Braille signage, wheelchair ramps, audio signals at pedestrian crossings, walkway contours, website design, and so on. Also known as universal access or access for all in information and communications technology (ICT) and used in electronic assistive technology to refer to specialist interfaces and control devices to make ICT products accessible to people with high levels of impairment.

"A tool or implement that makes a particular function easier or possible to perform. This may be as simple as an electric toothbrush or as elaborate as an environmental control system that can be operated with a mouth switch by someone who has lost the use of their limbs". [1]

It is also used by companies working in the Information and Communications Technologies (ICT) sector.

A label applied to devices for personal use created specifically by applying scientific principles and engineering methodologies (rehabilitation engineering) to enhance the physical, sensory and cognitive abilities of people with disabilities and to help them function more independently in environments oblivious to their needs

More recently the Audit Commission report Fully Equipped 2000 suggested 'assistive technology' as an alternative to 'disability equipment' and this is now used in England to capture "any equipment or system that assists people who have difficulties due to age or disability in carrying out everyday activities for example, walking stick or helping hand (ICES)". 'Equipment and adaptations' captures this in Scotland.

Methods of communication which can be used to add to the more usual methods of speech and writing when these are impaired and can be a way to help someone understand, as well as a means of expression. It includes unaided systems such as signing and gesture (sometimes referred to as linguistic communication), as well as aided techniques ranging from picture charts to the most sophisticated computer technology currently available. [2]

A concept defined in Housing for Varying Needs [3] as housing and its environment that is designed to allow for the needs of almost everyone.

This includes:

• people with temporary or permanent impaired mobility due to accident, illness or
  old age and who may use a wheelchair for some of the time;
• people who have difficulty with steps, bending down or reaching or who lack
  dexterity;
• people with impaired sight or hearing;
• people with impaired memory, learning or reasoning;
• people pushing and manoeuvring prams.

The key features of barrier free housing allow people to reach the entrance from a road or parking area and enter the dwelling, move around the dwelling, and access essential rooms including the bathroom, operate all fittings, services and controls. Such design is more convenient for everyone, it prevents people having to move because their abilities have changed and it is more economically adapted to suit specific needs if this becomes necessary.

Describes "the disadvantage or restriction of activity caused by a contemporary social organisation which takes no or little account of people who have physical impairments and thus excludes them from participation in the mainstream of social activities". [4]

'Interfaces' that enable people with impairments and/or chronic health problems to control electrical and/or electronic devices.

An EAT service provides assessment, advice, design expertise and, if required, the associated manufacture of interfaces to people of all ages. It can be closely allied with bioengineering, powered wheelchair provision and communication 'aids' and includes:

• The fitting of commercially available environmental control systems;
• Device specific environmental control where the provision of a full environmental control system is inappropriate, for example interfaces to enable the control of a television, reclining chair or alarm;
• The adaptation of existing controls for powered chair users, such as specialised joystick mounts for remote joysticks, tray modifications or the provision of specialised interfaces that enable the control of the chair from single or groups of switches using a variety of scanning techniques;
• Specialised switches, switch mounts, communication aid mounts and specialised aids to communication;
• Computer accessibility, including specialised keyboards and mouse alternatives; specialised software for keyboard and mouse emulation and improved access efficiency.

Equipment systems that enable people with higher levels of physical impairment or chronic health problems to control access to their home, to summon emergency help and to operate domestic appliances.

Typical devices that can be operated with an EC system include:

• voice output communications aids (VOCA);
• wheelchair control systems
• door entry systems e.g. door intercoms, door release mechanisms, alarms etc.;
• adapted loud speaking telephones (which may include amplification for hard of hearing people)
• curtain controllers
• heating and lighting
• home entertainment equipment e.g. televisions and associated terrestrial, satellite / digital and cable decoders, video recorders, DVD players, hi-fi stereos, CD players and miniDisc players
• internal intercoms
• pagers
• personal controllers
• powered profiling adjustable beds and riser/recliner chairs
• page turners
• plug-in device to normal sockets
• computers

A collective term used by the Strategy Forum: Equipment and Adaptations for a broad range of products and changes to the fabric of a building that help people of all ages to carry out ordinary activities of daily life that have become difficult or impossible due to impairment, ill health, traumatic injury, the effects of ageing or a change in circumstances. It includes technology but not anything that is invasive to the body or part of medical treatment.

Equipment has replaced 'aids' in everyday use and generally refers to products that are portable in nature, where as adaptations generally require changes to the fabric of a building. However distinctions are not always clear and there are gaps and overlaps.

Describes "lacking part of all of a limb, or having a defective limb, organ or, mechanism of the body". [4]

A "process-driven approach whereby designers and industry ensure that products and services address the needs of the widest possible consumer base, regardless of age or ability, with emphasis on working with 'critical users' to stretch the design brief". [5]

Inclusive design:

• places people at the heart of the design process;
• acknowledges human diversity and difference;
• offers choice where a single option cannot accommodate all users;
• provides for flexibility in use;
• aims to provide buildings and environments that are safe, convenient, equitable; and enjoyable to use by everyone, regardless of ability, age or gender.

According to the Centre for Accessible Environments [6] "it is not a set of rules or solutions. It is a journey towards improved expectations of, and attitudes about, the built environment which makes the wide diversity of everyday experiences central to design".

"All people having the same choice, control and freedom as any other citizen - at home, at work, and as members of the community" [7]

As this can be misinterpreted to mean doing everything for your self, some disabled people now using 'self determination' for control over their life even though they may be highly dependent on another person to exercise that control.

A broad subject concerned with technology and other aspects of managing and processing information, especially in large organizations.

Also known as Information technology (IT) which deals with the use of electronic computers and computer software to convert, store, protect process, transmit, and retrieve information.

A concept with sixteen design features that ensure a new house or flat will meet the needs of most households.

According to the Joseph Rowntree Foundation Lifetime Homes Group [8] (1991) the accent is on accessibility and design features that make the home flexible enough to meet whatever comes along in life: a teenager with a broken leg, a family member with serious illness, or parents carrying in heavy shopping and dealing with a pushchair.

A term covering all products except medicines used in healthcare for the diagnosis, prevention, monitoring or treatment of illness or disability.

The range of products is very wide encompassing those legally defined in the Medical Devices Regulations 2002 (Statutory Instrument 2002 No.618) and other medical devices and assistive technologies including: contact lenses and condoms; heart valves and hospital beds; resuscitators and radiotherapy machines; surgical instruments and syringes; wheelchairs and walking frames.

The application of engineering principles and technology in the provision of services and research and development to meet the needs of disabled people. It involves the production of assistive devices to help reduce environmental barriers or the restoration or improvement of the physical, mental and social function. This can inlcude original equipment design or customised modifications to existing equipment, postural support and biomechanics for wheelchair users, electronic assistive technology including environmental controls and gait analysis and support to other areas e.g. prosthetics and orthotics.

A collective term used to encompass devices such as wheelchairs and seating, prosthetic (artificial replacements for body parts) and orthotics devices (use of special devices that support weakened or abnormal joints and limbs), and environmental control systems, together with related developments in electronic assistive technology and customisation of equipment to meet specific needs.

Appears to come from the computer industry where reliability prediction technology - or Self-Monitoring, Analysis and Reporting Technology (S.M.A.R.T.) - provides an early warning system that allows enough lead time to back up data should a failure become imminent, emerging from a widely-recognized need to protect mission-critical information stored on computer disc drives.

SMART technology displays a level of in-built intelligence that can analyse itself and provide important information back to the operator. Innovations cover a broad spectrum ranging from fairly simple applications of sensors and control systems to the most futuristic automated homes.

Such technology has the potential to create SMART systems that automatically adjust or adapt their behaviour in response to external stimuli and can be flexibly re-programmed to meet the varying needs of individuals. Existing applications include engine management in cars, image stabilisation systems in digital and video cameras, and SMART homes where a communications infrastructure allows the various systems and devices in the home to communicate with each other - so that central heating, fire and security alarms and devices such as televisions and lights that usually exist in total isolation from each other are able to pass information and commands between them so that for example the security alarm can turn the lights on or off.

This presents a range of opportunities to the health and care sector using a communications network that connects the key electrical appliances and services and allows them to be remotely controlled (from within or out with the dwelling), monitored or accessed.

SMART technology in the home can:

• provide a constantly monitored environment to ensure the occupant is safe;
• automate specific tasks that the occupant is unable to perform e.g. turning lights on and off;
• provide a safe and secure environment by alerting the user of potentially dangerous activities;
• alert helpers or carers should the occupant be in difficulty e.g. by linking to the local community alarm scheme;
• enable and empower the user;
• facilitate the rehabilitation of individuals e.g. by giving prompts that could be auditory and/or visual.

"The remote or enhanced delivery of health and social services to people in their own home by means of telecommunications and computerised systems". [9]

Telecare usually refers to equipment and detectors that provide continuous, automatic and remote monitoring of care needs (real time emergencies and lifestyle changes over time in order to manage risks associated with independent living) using information and communication technology (ICT) to trigger human responses or shutdown equipment to prevent hazards. It can:

• Set off an alarm (e.g. siren, flashing light);
• Turn off a cooker or turn on a table lamp during the night;
• Shut off a gas supply or provide an alert for flooding;
• Detect falls;
• Monitor movements and patterns of movement;
• Send a message to a control centre as an alert;
• Maintain an open line to a control centre for the user to talk in an emergency;
• Request a visit from response of back up services e.g. carer to visit, ambulance service.

Sometimes organised into three groups by their primary function:

1. Devices that predict problems and alerts professional carers, such as the WristCare system that monitors a person's physical state and the environment around them. (It can also raise an alarm after an event.)
2. Devices that prevent problems, such as a bed sensor that can help prevent falls by activating a light when someone gets out of bed so that there is no need to reach for the light switch or move around in the dark. It can also raise an alarm if the person does not return to bed within a predetermined time and by getting help quickly problems do not escalate.
3. Devices that mitigate harm by raising an alert after a pre-determined event, such as a device that activates when the temperature rises rapidly or reaches a high or low point, indicating a risk of fire or hypothermia.

May be referred to as different generations where: first generation = handsets and pendants; second generation = home monitors; third generation = mobile and wireless technology.

"The practice of medical care using interactive audio visual and data communications, this includes the delivery of medical care, diagnosis, consultation and treatment, as well as health education and the transfer of medical data". [10]

This can include any healthcare related activity (including diagnosis, advice, treatment and monitoring) that normally involves a professional and a patient (or one professional and another) who are separated in space (and possibly also in time) and is facilitated through the use of information and communication technologies. For example, a home unit to measure and monitor temperature, blood pressure and other vital signs for clinical review at a remote location (for example, a hospital site) using phone lines or wireless technology.

It is also known as 'medical Telecare' and 'Telehealth'.

Extends the concepts of Barrier-Free Design and Universal Access to include access to products and services. Originating in the USA and underpinned by 7 principles set out by Architect and Designer Ron Mace and taken up enthusiastically in Japan.

Though coming from quite different histories and directions the purpose of universal design and assistive technology is the same: to reduce the physical and attitudinal barriers between people with and without disabilities. The point at which they intersect is a grey zone in which products and environments have characteristics of the other type of design. A number of products enjoy crossover success often starting as assistive devices and becoming mainstream products such as the kitchen utensils with thick grips popularised by Oxo International in their 'Good Grips' line. A few products have moved the other way, typically conceived as high-tech devices for small markets that find new applications in the rehabilitation arena such as voice recognition software.

Commercial designers have much to learn from those familiar with the ergonomics of disability and ageing, who in turn can benefit form designers' expertise in creating products and environments that are functional, safe, attractive and marketable to a diversity of users.

Sources

1. The MS Information Sourcebook www.msrc.co.uk
2. Communication Matters: UK national charitable organisation of members concerned with the augmentative and alternative communication (AAC) needs of people with complex communication needs www.communicationmatters.org.uk/
3. Housing for Varying Needs Part 1 and Part 2 were produced by Scottish Homes (now Communities Scotland) in 1998 and 1999, respectively at the request of the Scottish Office (now the Scottish Executive) and replace Scottish Housing Handbooks 5, 6 and 7, Housing for the Elderly, Housing for the Disabled and Housing for Single People, Shared Accommodation and Hostels, produced by The Scottish Office in the late seventies and early eighties.
4. Union of the Physically Impaired against Segregation, (UPIAS) (1976), Fundamental Principles of Disability, London, UPIAS
5. European Design for All e-Accessibility Network (EdEAN) www.edean.org
6. The Centre for Accessible Environments www.cae.org.uk
7. Disability Rights Commission www.drc-gb.org/
8. The Joseph Rowntree Foundation www.jrf.org.uk/housingandcare/lifetimehomes/
9. Barnes, N.M, Edwards, Rose, D.A.D, Garner, P. Lifestyle monitoring - technology for supported independence. IEE Computing and Control Engineering Journal. Vol 9, No 4 (1998)
10. World Health Organisation www.who.int/en/