Brian Villani, 26, Khaki tall, outgoing, opinionated and serious, he shares a garden-level apartment with two roommates in Greater Boston that is equipped with the material culture of adult youth: a large padded sofa, multiple game systems , oversized posters, a mess of plastic kitchen utensils. . He travels by train to a job he has held for years in a corporate mailbox in the city center, a job he loves: “I pick up all the packages and all my salesmen know me,” he says. He lives close — but not too close, ”he says ironically, to his parents, and has a constant passion for sports, especially the art of game-by-game advertising. He is counting the days for his brother’s wedding.
Villani moves through life, from home to work and back, with an extended set of technologies that are a mixture of the familiar and the distinctive. There is a touch screen tablet on the kitchen wall that operates the microwave using voice commands and an augmented bin with sensors that opens with just one hand or limb. Its shutters open and close automatically to greet and silence the sun, morning and evening, by applying the phone. Its shower is activated by a touch screen interface, both on / off and temperature control, simplifying the combined motor-cognitive task. It uses a smart speaker for music and internet searches, as in many homes, but Villani also has a voice-activated script on a tablet, indicated when he says “Good morning” or “Good night” to reserve his day digitally. voice reminders, large and small: news headlines, upcoming calendar events, and a daily indication to wear the office badge when you walk out the door. It is a morning routine that connects all the steps that lead from home to the office.
Like his roommates, Villani graduated from nearby Lesley University in Cambridge, where he attended the Threshold program, a two-year hybrid college curriculum for young adults with cognitive and developmental disabilities. which mixes coursework with life skills training: budgeting, time management, etc. meal planning. Now living with less human help, she has used this set of smart home tools and software applications as additional support for the daily life tasks she rehearsed at school.
“Technology is how I get the most independent skills possible,” says Villani, and expresses an idea that is rapidly changing the paradigm of prostheses and “assistive” technologies in the United States: what counts as technology, how ‘used and by whom, but also how it is paid and distributed.
A lot of people think of prosthetics and assistive technology, or AT, in a relatively narrow paradigm, imagining objects known as wheelchairs, walkers, and hearing aids. For decades, U.S. state disability services have been shaped by this clinical understanding, offering coverage for what is formally called Durable Medical Equipment because of its “medically necessary” designation. These medical technologies are still important, of course. But they often don’t address the care needs of adults like Brian.
Until recently, people with cognitive or developmental disabilities (or combined physical and cognitive barriers to accessing them) have relied heavily on human services for support, from cooking and personal hygiene to organization and reminders. Sometimes this human presence is desirable and necessary. But sometimes the self-employed, perhaps especially a new generation of people who have enjoyed greater widespread inclusion in schools, prefer a technology-based approach, with remote records and easy backup contacts, rather than a rotating staff of face-to-face assistants. .
Prostheses for this population are not so much spare parts for physical mobility. It is something less tangible, more diffuse, and requires a different paradigm for care, unimaginable even in the very recent era of the Americans with Disabilities Act, with its emphasis on crucial physical infrastructure such as ramps and elevators. . For people like Chris, support now appears as a combination of independent housing, pet company, smart home technologies, and remote support video conferencing. It is a constellation of high technology and low technology in networked tools, many of which are ready, perfectly integrated as ubiquitous features of everyday life, which can overcome some of the logistical barriers to the ‘occupation.
I a constellation of technology is, in fact, the right metaphor. There is no single way to dominate this market: no single system that equips a living space or workplace with “universal” features for accessibility. There won’t be a single “curb cut effect” for this digital world. What is required, however, is a human-centered approach to assembling a set of human services. i flexible, elegantly orchestrated tools to meet the needs and requests of one person at a time. More importantly, this future for automation should not be a wholesale and worrying replacement for human care and connection. What comes next could be more interesting and complex as a whole: a new and evolving collaboration between humans and assistive devices, low-tech and high-tech, domestic and professional. If carefully orchestrated, this expanded idea of TA can help create supports not only for medical needs, but for a complete definition of life: a life cared for by critical daily care, but without storing people with “special needs”.