How Technology Solutions Support people with Intellectual and Developmental disabilities (I/DD)What to consider before purchasing a new device or solution for your child

Vincent Bemmel, PhD, Director, Technology and Innovation
A child listens to headphones while an adult looks on.

The prevalence of intellectual and developmental disabilities (I/DD) is on the rise1 and so is our interest in using technology as a way to improve the quality of life of people with I/DD. Today approximately 6.5 million people in the United States have an intellectual disability.

Technology solutions vary from ‘low tech’ (paper calendar) to ‘high tech’ (smart home). There are many valid and proven low tech solutions out there, but the emergence of powerful high tech solutions especially represents a very exciting alternative.

The power of high tech has been evolving quickly, delivering a wide range of solutions to global consumers. These solutions combine state-of-the-art capabilities (mobile, connectivity, internet, cloud, AI) into very powerful, yet affordable devices and apps.

For people with I/DD, there is a wide range of tech solutions to choose from today – however, this can be overwhelming to those that are not so tech-savvy.  In addition, potential benefits are often overstated by vendors.

Selecting the appropriate tech requires an understanding of what these solutions really can and can’t do for the people (clients, parents or caregivers or clinical team) they are supposed to serve.  This article presents a framework that guides you through the journey of tech selection and discusses all the different choices that have to be considered.

Technology affects almost every aspect of our lives, including transportation, safety, access to food, healthcare, socialization and productivity. The power of the internet has enabled global communities to form, and ideas and resources to be shared more easily.2

In the lives of people with I/DD, six common categories of technology are illustrated below:

Technology chart

Figure 1. Common Technologies for people with I/DD

Here are brief descriptions of what these are:

Table chart

Assistive Technology 

Today, many high-tech assistive technology solutions for people with I/DD consist of a combination of:

  • Smartphone or tablet – carried by the client, caregiver or clinical team to monitor data from the client or to interact with apps
  • Smart watch or other wearables – worn by the client to collect sensor data and send to the cloud, and/or receive data from the  support  team
  • Communications capability (Internet, Bluetooth, WiFi) for “connected solutions” – solutions where a device connects to servers in the cloud for remote monitoring or control
  • Cloud-based servers and databases where collected data is processed and made available to caregivers or clinicians via dashboards or apps
Best solution chart

Figure 3.  Tech Selection Criteria

Each of these criteria can be addressed via a set of questions as shown in the table below.

Table chart

The use of technological advancements such as virtual agents, artificial intelligence, virtual reality and augmented reality undoubtedly provide a comfortable environment that promotes constant learning for people with ASD6. However, it is important to note that overall there is a lack of published evidence of the effectiveness of technology-based therapies7. Some extra due diligence is warranted when evaluating the solution benefits.

Examples

Table chart

To illustrate some of the solutions out there, the table below shows examples  of solutions that are commonly being used by people with I/DD:

How tech can help:

  • Joe was diagnosed with ADHD and has challenges with distractions and focusing. Joe uses a smartwatch app to minimize distraction. The app requests him to check in periodically, allowing Joe to re-focus  often and be less distracted. In addition, the app sends behavior data to the cloud for clinician access for monitoring and insights. This is an example of a high-tech support app.
  • Jan is autistic and identifies as non-binary and struggles with anxiety. They use a therapeutic game (with biofeedback) three times a week that teaches them how to do breathing exercises whenever their anxiety level peaks. As a result, Jan can better manage their anxiety. The game sends metadata to the cloud, allowing clinicians to follow Jan’s progress and prescribe treatment.
  • Mary is an autistic youth that has difficulties remembering sequence steps of daily living skills. Together with her mother, she created a visual schedule on her smartphone of some of her most challenging common activities such as brushing her teeth.  Now she just follows the schedule to get through these tasks.
  • Paula is an autistic teen who is nonverbal and also diagnosed with generalized anxiety disorder.  She normally uses an AAC to communicate, but often cannot communicate when anxiety is building up. Her parents used to misunderstand the triggers of her tantrums and felt helpless.  Now she uses a smartwatch solution that alerts them of emerging heightened anxiety events so they can intervene early and prevent tantrums. It also serves as an educational tool, allowing her parents to get better insights into how they can adjust their own behavior to avoid triggers in the first place.
  • Johnny is a 5-year-old boy with Down syndrome. He has a habit of eloping, which can get risky, causing a lot of anxiety and worry to his parents. They recently got a small wearable GPS tracker that alerts them on their smartphone whenever Johnny crosses a certain distance from their home (geofence), giving them the needed peace of mind.
  • Peter is an autistic teen who loves going to the mall and other social events with his friends. He struggles with auditory hypersensitivity, so he uses noise-canceling headphones to block the sound. Depending on the situation he uses an app to adjust the level of cancellation.
  • Angel is an autistic young adult who just got her first job. Because she has challenges with planning and scheduling, she uses the calendar app on her smartphone to get up early enough to make it to work on time and to send herself reminders to do certain tasks she could easily forget.
3 mobile phones

Example of a Visual Schedule app

Tech Selection Process

  1. The process of selecting Assistive Technology solutions starts with assessing the person’s needs and determining functional goals that need to be addressed (e.g., more effective communication).
  2. A solution can be selected based on the different criteria in figure 3.
  3. Once a selection is made, users of the system (i.e., client, caregiver, ad/or clinical support staff) should get training on the selected tech solution, as needed.
  4. Start using the solution, while monitoring for benefits.
    • If this does not seem to be the right match, select another tech solution that may be more appropriate (2).
    • Continue to use an effective solution and re-assess regularly to ensure the solution continues to be effective (4).  At that point, you could decide to continue with this solution or look for something else.
flow chart

Figure 3 Assistive Tech Solution Selection Process

AT Resources

Below are a few good Assistive Technology resources for people with I/DD.

References

  1. https://en.wikipedia.org/wiki/Category:Assistive_technology
  2. https://tech.co/vpn/main-ways-technology-impacts-daily-life
  3. https://www.readingrockets.org/article/assistive-technology-kids-learning-disabilities-overview
  4. High tech Aids for Daily Living (ADL)
  5. [NIH] https://www.ncbi.nlm.nih.gov/books/NBK547654/
  6. [Valencia2019] Valencia, K., Rusu, C., Quiñones, D., & Jamet, E. (2019). The impact of technology on people with autism spectrum disorder: A systematic literature review. Sensors (Switzerland), 19(20), 1–22. https://doi.org/10.3390/s19204485
  7. [Liu2017] Liu, X., Wu, Q., Zhao, W., & Luo, X. (2017). Technology-facilitated diagnosis and treatment of individuals with autism spectrum disorder: An engineering perspective. Applied Sciences (Switzerland), 7(10), 1–31. https://doi.org/10.3390/app7101051
  8. [GAEBLER2008] Gaebler-Spira, D., & Desch, L. W. (2008). Prescribing assistive-technology systems: focus on children with impaired communication. Pediatrics, 121(6), 1271–1280. https://doi.org/10.1542/peds.2008-0695