1994 VR Conference Proceedings

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Using Virtual Individualized Residential Alternatives (VIRAs) to Match Consumer Disabilities with Appropriate Assistive Technologies

By: Thomas E. Murphy, Michael Van der Gaag, John C. Briggs
NorthLight Technologies
42 Buffard Drive
Rochester N.Y. 14610
716-381-7308

Marcia J. Scherer
National Technical Institute for the Deaf /RIT
52 Lomb Memorial Drive
Rochester N.Y. 14623
716-475-6598

Introduction

Federally mandated least restrictive environments for persons with disabilities are motivating the development of Individualized Residential Alternatives (IRAs). This paper describes our use of Virtual Reality (VR) and an array of related technologies as tools in IRA design and development. The purpose of our work is to maximize the individual independence of persons with disabilities who will live in IRAs through appropriate choice and integration of technologies.

A Virtual IRA (VIRA) is being developed by NorthLight Technologies, the Rochester Center for Independent Living (RCIL) and the Monroe Developmental Disabilities Service Organization (MDDSO) with the assistance of national level representatives of the American Institute of Architects. This paper describes the VIRA concept, the VIRA design and development process, how VIRAs are used, and how VIRAs may be utilized in the future.

Our general goal is to establish and maintain the process of placing consumers in a life situation where they are independent to the maximum possible degree. We are engaged in exploring how to design, implement and manage that process. In this paper we focus on the design of Individual Residence Alternatives (IRAs) which are mandated housing alternatives for consumers who are presently supported in larger-scale institutions. We visualize the IRAs as "Assistive Systems" which fill the gap between the consumer's needs and abilities and the demands of their environment. Our view of the residence as a support system is very general. While some of our consumers will have disabilities relative to the general population, everyone has gaps between their abilities and the demands of their environment. The processes of life, and hence these gaps, are dynamic, changing with age, experience and situation. VIRAs are the tools for designing IRAs and training the consumers and staff in using the IRA facilities.

The consumer, the environment (or milieu) the consumer lives in and the technologies used to support the consumer form the three dynamic elements of the process we are developing. The consumer learns and develops and matures through life as does everyone. The environment, composed of physical, social, economic and political factors is obviously dynamic. The technologies selected to support the consumer most often evolve rapidly. The process of maintaining a consumer in a state of maximum independence is a continuous one. It is not a "one shot" effort and it is inefficiently done at present.

The combination of consumer + environment + Assistive System is an example of a Living System [1]. Living Systems are composed of infrastructure and living entities. Large Living Systems are composed of smaller units which are also living systems. For example, societies are composed of organizations, organizations are composed of groups, groups are composed of individuals, individuals are composed of organs, and organs are composed of cells. At the group level and above, the infrastructure is furnished by a combination of technology and people (groups of people etc.). The building blocks for the supporting infrastructure are those which support the two dozen or so basic functions which each level of living systems must perform. They are the basis of the "building block talents or abilities" proposed by Gardner [2]. Modeling and designing must also include elements of the external environment, the experiences of the consumer and the internal mental management by the consumer as proposed by Sternberg [3]. These structures, functions and processes are the building blocks we are exploring using the VIRA tool to design an IRA .


Maintaining Maximum Independence:

The process of maintaining a person in a maximum situation of independence is illustrated in Figure 1. External to the process is an ever-improving pool of technologies, methods, devices and systems. External sources exist for Federal, State and local funding, social services, rehabilitation and employment services, emergency services, transportation, entertainment, communication and information systems. In addition, Federal and State mandates and statutes regulate the services. We seek to make the process in Figure 1 a well defined and well managed one.


Components of Maintaining an Independent Consumer:

The context of the process of maintaining a maximally independent consumer is the focus of Figure 1. To understand and manage a process involving Living Systems we must at least understand one level above and one level below the process level of interest. Often several levels above and below are needed. The component subprocesses of the process to "Maintain a Maximally Independent Consumer" are shown in Figure 2.


Assessing the Consumer:

Attention to consumers' needs, preferences and abilities is the first and foremost concern for any activity supplying products or services. We are engaged in visiting and documenting the present lifestyles and life situations of four adults with developmental disabilities. Each of these persons currently lives in separate localities but will be living in the same four-person IRA. Since they do not currently live together, it is important to meet with each person to assess their capacity and capabilities and to record this in a way that enables easy retrieval of this information for comparison with that of the other three consumers.

Each consumer is interviewed and asked to go about typical activities of daily living such as bathing, toileting, transferring into and out of bed, participating in rehabilitation processes and favorite activities, hobbies and so on. The consumer demonstrates capacities and limitations in these areas while fully clothed. Observations are made regarding each skill and potential technology or procedure to meet special needs. A video tape is created for sharing with the full team. During one of the meetings with the consumer, the Assistive Technology Device Predisposition Assessment (ATD PA) is administered [4]. The ATD PA addresses the

characteristics of four influences on technology use:

  1. the Assistive technology
  2. the person's Temperament and personality
  3. the individuals Disability
  4. the Psychosocial Arenas in which the person will use the Assistive Technology.

The ATD PA is a consumer-driven method of assessing, from the consumers' perspective, areas where there may be barriers to a good match of person and technology. There are two parts to the assessment form. One part is given once to each consumer and inquires into physical and sensory capabilities, personality and psychosocial characteristics as well as the person's view of his or her disability and current quality of life. The other part is given for each technology being matched with the person.


Life Spectra Model of the Consumer:

A useful way to understand and address the consumers needs for independence is to consider their spectrum of abilities contrasted with the demands of their environment. The resulting 'Life Spectra' are shown in Figure 3. The difference between the Environmental Demands spectra and the Abilities spectra must be provided by the Assistive System and the technologies it uses. These spectra and their gap graphically characterize the consumer, the assistive technology and the environment measured by the assessment methods mentioned above.

The Abilities Spectrum in Figure 3 illustrates the areas of our abilities plotted against the extent or degree we have developed those abilities at a particular time in our lives. The graph is a rough and linearized approximation of highly interactive and evolving areas of abilities. Any position in an area on the spectrum has developed over time and experience under the influence of many other underlying areas. The spectrum of environmental demands which is placed against our abilities is superimposed to highlight the gap which we must fill. For instance, in order to be independent and productive, we need a house to assist us in supplementing our physical need for warmth and shelter. We need communication and informational devices to learn and supplement our social and intellectual abilities. We need a quiet place to collect our thoughts and introspect, etc.

Abilities develop on top of prior ability and opportunity to progress. During our development we acquire peaks in some abilities. When the environment demands more than our native abilities supply we have a gap and must supplement the native abilities with Assistive Technologies and Systems. The IRA and the VIRA design and training tools are examples of Assistive Systems.

The dynamic nature of the environment and our abilities means that the spectra grow and shrink as time and circumstances change. We may have an accident, the economy may decline, a cold winter may occur, we may complete a level of education, we may be called on to play a recital, we may have additions to or deaths in our families. Living Systems, systems of people and the things around them with which they interact, are dynamic. The Assistive Systems, devices and technologies must adapt to those dynamics.


Matching Consumer Needs with Assistive Systems:

Based on the assessment of the consumers' psychological, physical and economic abilities, we can select and apply the most appropriate collection of technologies. The model of the consumers' spectrum of abilities, needs, readiness for assistive technologies and personal preferences was developed in the preceding assessment phase using interviews, video tapes of typical activities, and the Scherer MPT (Milieu, Person, Technology) instruments [4]. A design for the IRA is formulated to contain modular components which are complementary to that 'Life Spectra' of the consumer. That design is then represented in Virtual Reality to produce the VIRA.

The process of VIRA design and development emphasizes the participation of those people with disabilities who will live in IRAs. Future IRA residents can experience and help design their environment using Virtual Reality (VR). The VIRA, a VR simulation of the IRA, will also be used to train the staff who will be working in the IRA. Testing the IRA design in VR offers a cost-effective way to iteratively discover and evolve appropriate designs. VIRAs are an essential vehicle for discovering the building blocks of Appropriate Assistive Technologies and architectural design. We are struck by the similarity of our process and that suggested by Christopher Alexander who has addressed the foundations of architectural design [5].

The concept of matching 'Life Spectra' to architectural design and choices of assistive technologies also generalizes, for example, to care and support of the elderly. Each person's Life Spectra evolves with age and experience. VIRAs are therefore beneficial tools for us all regardless of our current abilities and preferences.

The design of a living environment adaptive enough to accommodate the wide range of disabilities and consumer preferences requires a broad range of modular building blocks. Each building block represents a response to some consumer need. Clearly, an integration of existing services into a design which can be customized to each individual consumer is essential. It is also cost effective, when building IRAs, to have a flexible and modular design from the start. Therefore, a broad range of expertise is needed to design all of the diverse aspects of total living. The skill mix of people working on the VIRA development process includes not only consumers and Virtual Reality experts but also experts in Human Factors, Psychology, Biophysics of Vision, Computer Systems, Human Interface Design, Artificial Intelligence, Architecture, Independent Living, and Rehabilitation Services.


Implementing the Assistive System:

Our rule of thumb is to solve problems with the most appropriate technology which performs effectively. The most appropriate technology may not be the most sophisticated solution but rather a simple and elegant one. We acknowledge that we, like most technology aware scientists and engineers, tend to talk about the newer and more novel applications of technology. Once the most appropriate Assistive Technologies and Systems are identified they are implemented using the same broad skill mix in the assessment, matching and VIRA design steps. The refined VIRA design is the basis for the IRA design and implementation.


Representing Assistive Intelligent Agents in the VIRA:

A particularly supportive building block technology for the VIRA and IRA is an Artificially Intelligent Consumer Knowledgeable Agent. The agent, as part of the Assistive System, has the job of supplementing the consumer's abilities to the level of environmental demands. The VIRA offers an excellent way to introduce and evaluate an agent to assist both the consumer and the staff. Such an agent must have common sense as well as expert and consumer-specific knowledge. The CYC Large Scale Knowledge Base System has extensive common sense [6]. One of the authors has worked with this system and its developers at the Microelectronics and Computer Technology Corporation (MCC). Common sense is the knowledge we learn from our family and environment as we grow up to about the age of 12 years. Common sense therefore has a strong cultural and social content and is the base for expertise and specific personal characteristics. It is knowledge we rarely discuss with others and usually assume others have "just like we do." That is a risky assumption to make about people and a bad assumption about most computer agents. Intelligent computer agents do not usually have such knowledge and must be supplied with basic common knowledge to really understand how to be of service to people. Common sense, supplemented with expertise in assistive methods and specific needs of the consumer, allows easy communication with the consumer, adaptive rather than brittle responses to consumer problems, and more sound judgment about overall consumer and IRA management. An agent with substantial common sense can be given an understanding of the needs and preferences of the consumer and staff and will reason as to why services are requested, how conflicts arise, and conclude how to resolve and schedule the activities of the combined Consumer - Staff - Assistive System (IRA).


References

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