Edward Steinfeld

Environmental Problems in Homes of Elders with Disabilities

Reporting on results from the University at Buffalo Consumer Assessments Study, this paper examines environmental problems in the homes of elderly persons with disabilities. For the study, 127 persons over the age of 60 were interviewed; all had received, or were currently receiving, services from a senior services agency or hospital rehabilitation program. An average of almost four problems per home were identified. Problems are grouped into categories by room and by area such as ‘lighting’ and ‘steps’ and described in more detail. Since all subjects had been referred to the project through an agency or hospital providing services, the results suggest that the home environment needs of elders are not adequately addressed by these service providers. An environmental interventions model, developed following an analysis of study results, is presented to guide service providers in setting priorities for recommending home modifications. Occupational therapists are qualified to provide home assessments, and must play a greater role in ensuring that these assessments and interventions are provided for non-institutionalized older persons with disabilities.

Anthropometry and Standards for Wheeled Mobility: An International Comparison

ABSTRACT Space requirements for accommodating wheeled mobility devices and their users in the built environment are key components of standards for accessible design. These requirements typically include dimensions for clear floor areas, maneuvering clearances, seat and knee clearance heights, as well as some reference dimensions on wheeled mobility device sizes. Recent research from four countries was reviewed and compared with their prevailing accessibility standards to identify needs for improving standards. Findings from ongoing anthropometry research on wheeled mobility in the U.S. were used for evaluating the adequacy of existing U.S. accessibility standards. Preliminary analysis suggests that the U.S. standards, which are based on research conducted in the 1970s, need to be updated to address advances in wheeled mobility technology and changes in user demographics. The analysis highlights the importance of integrating research with standards development, organizing international collaborations, and developing international standards.

Use of Passenger Vehicles by Older People with Disabilities

The goal of this study was to identify the range of problems faced by frail older people in using private passenger vehicles and to identify how assistive technology and selection of vehicles may reduce those problems. Research activities included a review of existing research, a review of assistive technology for vehicle use, four focus group sessions, and a survey of 101 older people with disabilities. The findings of the research indicated that frail older people had significant problems both as drivers and as passengers. Although they are reluctant to self-report driving problems, they did report many problems entering and exiting vehicles. Forty percent of those surveyed reported difficulty getting their legs in and out. The study identified many ways that occupational therapists can assist frail older people and their caregivers in using passenger vehicles. It also identifies gaps in research, vehicle design, and assistive technology that need to be addressed.

Space Requirements for Wheeled Mobility Devices

Research on the size of wheeled mobility devices in the UK and Canada suggests that the dimensions for “clear floor area” of wheeled mobility devices as specified in U.S. standards are too small. Anthropometric research was conducted to verify that findings in other countries are relevant for the U.S. Findings support increasing the clear floor area dimensions. To provide universal access to buildings, it is necessary to exceed the current requirements of minimum standards until they are revised to reflect the increased size of wheeled mobility devices.

Space Requirements for Wheeled Mobility Devices in Public Transportation: Analysis of Clear Floor Space Requirements

Recent research on the anthropometry of wheeled mobility devices and their users (n = 369) indicates that the current dimensions for clear floor area prescribed in U.S. accessibility standards for transportation are inadequate for accommodating many users of wheeled mobility devices, especially those who use power chairs and scooters. The current report presents anthropometry data for determining the dimensions of clear floor area on the basis of occupied device length and width to achieve a specified level of physical accommodation. The implications of the findings and the need to revise guidelines for accessible public transportation systems are discussed. The transportation industry as well as mobility device manufacturers, vendors, and prescribers should understand the limitations of current standards and become involved in the dialogue about how to improve them.

Universal Design for Quality of Life Technologies

Engineers and other designers commonly use specifications to frame a projects objectives and constraints. These are supplemented by standards, codes, and regulations to create the design package. However, typical design practices often inadvertently ignore the usefulness of the product, environment or information system by people for whom the product would benefit. Consequently, an early design does not work and requires additional iterations and phases of redesign. This drives up the design costs, delays the process, or by tradeoff, prevents individuals with various types of abilities and disabilities to use the design. The universal design approach offers an efficient cost-effective method to expand the population of potential consumers of a product design. Quality of life technologies demand designs that consider populations that are often missed. This paper defines the need for and characteristics of good universal design with illustrations of successful universal product design as well as erred designs that neglected significant populations of potential product users. By definition, quality of life technologies are inclusive, such as aging populations who function with impairments in vision, hearing, and motor abilities. Executing universal design strategies create more successful outcomes.

Measuring the Influences of Physical Environments on the Behaviors of People with Impairments

Disease or disorder need not be present for an impairment to exist, impairment need not be present for a disability to exist, and disability need not be present for a handicap to exist. The physical environment alone is often sufficient to occasion any of those conditions—impairment, disability, or handicap.

Performance of Visually Impaired Users during Simulated Boarding and Alighting on Low-Floor Buses

Low-floor buses with folding ramp access represent a significant improvement in accessible public transit for passengers with mobility disabilities. However, the safety and usability aspects of the interior design of low-floor buses on blind and visually impaired users has not been studied in much detail. A laboratory study was completed using a static full-scale simulation of a low-floor bus to evaluate the impact of seating configuration and crowding on interior movement and accessibility for individuals with (n=18)) and without visual impairments (n=17). The protocol simulated bus journeys including boarding, fare payment, seating, and alighting. Results from video observations and subjective assessments showed differences in boarding and alighting performance and users’ perceptions of task difficulty across different bus layout designs The results suggest the need for more supportive design features (e.g. guide rails, handholds), legroom, and space for guide dogs too improve accommodation for passengers who are visually impaired. Such design improvements will also support a universal design approach that takes into consideration the needs of a diverse passenger population.

Development of A New Assessment of Effort and Assistance in Standing Pivot Transfers With Functional Electrical Stimulation

Abstract Background: Currently available clinical tools for assessing rehabilitation outcomes do not capture both the effort exerted and assistance required for persans with spinal cord injuries to perform a standing pivot transfer using fundianal eledrical stimulation (FES). This study was undertaken to develop and apply a clinical tool to measure the ability to stand and transfer with eledrical stimulation. Methods: The Fundianal Performance Measure (FPM) methodology was chosen to develop a tool to measure performance. Through an iterative review of videotaped FES transfers, fundamental components of the standing pivot transfer were identified and standardized performance criteria for user effort and helper assistance were developed for every phase using the 8-point FPM scales. Results: Interraterand intrarater reliability were established with a simple kappa coefficient for the effort scale and assistance scale. The final version of the tool has been applied to users of the implanted FES standing neuroprosthesis to describe the effort and assistance required for the transfer. Conclusion: The tool has been shown to capture the effort and assistance needed during FES-assisted standing pivot transfers throughout all phases of the transfer.

Measuring “Fit” between Individual and Environment

Three new instruments were developed that measure the degree to which an environment supports or hinders use by people with disabilities. Reliability and validity of these measures was tested through a series of experiments. The three measures proved to be reliable and valid in terms of both construct validity and cross validity with an established measures of human performance. They can be used to study usability of both environments and products.