Towards Comprehensive ICF Compatible Sociodigital Approaches to Choice and Use of Assistive Technology for Young Children Jennifer George 1 and Gilbert Cockton 2 1 Qantm College, 2-12 Pentonville Road, Angel, London N1 9HF, UK, Phone: +44-(0)20 7833 0578, Fax: +44 (0)20 7833 4562, e-mail: jennifer.george@sae.edu 2 Department of Computing, Engineering and Technology, University of Sunderland, Sunderland SR6 0DD, UK, Phone: +44-(0)191 515 3394, Fax: +44-(0)191 515 3394, e-mail: gilbert.cockton@sunderland.ac.uk Abstract – The WHO has set demanding requirements for Assistive Technologies through its ICF, which existing approaches to assessment and design cannot fully meet. We use the ICF and a typical day at school for a child with severe motor impairment to review some existing approaches to assessment of children’s special needs and to the design of Assistive Technologies to meet those needs. No approach reviewed can cover the broad range of considerations in the ICF. We therefore briefly review leading edge approaches to Interaction Design that may be able to meet the requirements for the worthwhile socio-digital systems implicit in the ICF. I. INTRODUCTION Many assessment methods are used to guide selection of communication and other aids for young children with motor impairment. For example, motor ability has been assessed by ambulation, manual dexterity, sensory ability in hearing and vision [1]. Simple scales of manual ability from „normal‟ to „unable to dress without assistance‟ have been used to assess group children with Cerebral Palsy, but they could also be used for more general physical capability limitations in children. Such assessments can guide the choice of Assistive Technologies (ATs), but essentially such biomedical approaches to assessment are narrow relative to current approaches to disability. For example, the International Classification of Functioning Disability and Health (ICF) is the framework used by the World Health Organisation (WHO). It models capability as the result of interactions between body function and structure, activities, participations of individuals and the contextual factors [2]. Contextual factors include the physical environment and personal values of the care circle of family and individuals encountered on a daily basis. Psychological and social factors must thus be considered, as an individual‟s environment disables them, and not merely bio-medical diagnoses of physical or other limitations. This paper begins with at an ordinary day for a child, classified as „disabled‟, to illustrate social settings and the associated care circle. It next looks at some assessment methods used to select Assistive Devices, and then some models that have been developed to assist in choosing and using Assistive Devices. In both cases, assessment methods and models can rarely cover the full range of factors within the scope of the ICF. The paper closes by presenting current leading edge approaches from Human-Computer Interaction (HCI) that could move design, selection and use of AT beyond biomedical approaches to the full range of biopsychosocial considerations advocated in the ICF. II. A TYPICAL DAY AT SCHOOL A typical school day in a special school lasts from 9.00am to 3.00pm. The children start the day with a time of singing during which the children have to welcome each other and sing along. All teachers, teaching assistants (TA) and therapists are present for this session and help children carry out tasks. Non-verbal children would press buttons to indicate a hello and children with only eye movement would use eye gazer to select the relevant words. Actions for the songs are also introduced and encouraged and posture is continuously checked by the occupational therapist and the other helpers. After singing time, children are grouped into two or three and sent for physical exercises guided by occupational therapists and class teachers where they exercise without any normal limb support. During this time the speech therapist also tries to get them to practice sounds while exercising. After their physical and speech training, they have drawing lessons where they develop fine motor control. Children who cannot draw with their hands use eye gaze or click buttons and switches to draw. After this, they have a break with drinks and go for a walk in the garden pushing a doll in a pushchair for support. The children go for a swimming lesson with support workers and thereafter have lunch. All teachers and helpers try to make children independent by encouraging them to eat by themselves, but end up feeding most of them.