Page 57 - Handbook of Electronic Assistive Technology

44 HANDBOOK OF ELECTRONIC ASSISTIVE TECHNOLOGY

aetiology (e.g., brain injury). Issues with emotional regulation and readiness to engage
with rehabilitation mean that even those with very similar functional difficulties could
have different responses to the same EAT intervention. It is also possible to imagine
future technology being able to adapt to the needs of the user by taking into account
information about the client, and by sensing the environment. This raises important
ethical issues.

Use of Technology for Children and Young People

Young people with neurological impairments, either developmental or acquire, are likely
to benefit from assistive technology. For example, the retrospective memory aid SenseCam
has been shown to help both adults and children recollect personal events (Pauly-Takacs
et al., 2011), and prompting technology can help compensate for PM, which is often
impaired for both children and adults with ABI (Krasny-Pacini et al., 2015). However, some
of the issues that influence technology use are specific to children and young people.
Brain injury can mean that children who initially seem to have few deficits can experience
delayed onset and later arrest of development because, for example, they miss out on the
executive function and memory development and improvement that characterises typi-
cal development (Eslinger et al., 1992). Children with ABI may therefore fall further and
further behind their typically developing classmates. This highlights the need to adapt to
changing expectations when using technology with this age group. Furthermore, the fact
that children are dependent on parents, teachers and other adults means that it is dif-
ficult to intervene without the active and consistent participation of the child’s ‘everyday
people’ (Krasny-Pacini et al., 2014). A study of school children with cerebral palsy reported
that assistive technologies, particularly those that are clinically prescribed, run the risk of
being greeted with ambivalence and even exacerbating disability. However, technology can
also enhance selfhood and participation, especially if techniques to improve engagement
are used such as turning learning to use a device into a game (Øien et al., 2016). Another
unique issue to supporting young people with cognitive impairment is their success in
further education and achieving employment after obtaining qualifications. A number of
factors influence employment outcomes, including cognitive challenges (Nardone et al.,
2015). Technology can help with specific abilities required at college and work, includ-
ing scheduling work and remembering deadlines. Technologies specific to an educational
or employment context might be particularly useful for young people with neurological
impairment.

Ethical Approaches to Cognitive Support
Ethical considerations are particularly important to consider when thinking about using
technology in people’s homes, or when helping to support people who may not have
the ability to consent to the treatment being provided. It is also important to consider
the moral and ethical implications of the world view or perspectives that are driving the
research and development of EAT.