ICRA '95 - NAGOYA ROBOTS FOR THE DISABLED AND ELDERLY
THE WAY FROM NEED TO DEMAND Jean-Claude Gabus
Swiss Foundation for Electronic Aids
Neuchâtel, Switzerland
What is the Swiss Foundation for Electronic Aids?
The FST, a non profit-organisation, was created in December 1982 by the Swiss Spastic Society and
the Swiss Paraplegic Foundation. FST is the continuation of the activities of CARBA-LINGUADUC
assistive technologies, developed between 1972 and 1980 in a commercial context. The FST's goal
is to provide technology to help the physically disabled. Main activities from 1982-1991 were :
1982-83: developed a set of keyboard emulators (large and mini keyboard, scanner) for APPLE and
COMMODORE C64 micro-computer. This equipment was supplied to 20 schools for the physically
handicapped following a workshop organised by FST.
1984: developed the first commercially available free programmable text-to-speech communication
aid. Today, about 300 users (from ages five to 78 years old) are using this machine called
"HECTOR", which provides an integrated range of ergonomic interfaces.
1986: developed "JAMES" infrared programmable mental environment control, also with integrated
range of input. From 1987 to the end of 1994, 4,000 "JAMES" were already installed. Eighty per cent
of them are not in Switzerland but in France, Germany and all Scandinavian countries.
1989 end of 1995: developed an integrated system IRIS as well as a contribution to the first
polyvalent standard allowing integrated technical aids in the field of mobility, robotics, environmental
controls, keyboard emulation through the use of ergonomic special interfaces and communication
for non-oral disabled people using speech synthesiser.
This standard is today under finalisation. The definitive specifications should be ready between May
and July 1995 and an optimal interface (customised chip) between the applications and the M3S bus
should be available early 1996. M3S work is strongly supported by the European Community within
its R&D programs.
FST is deeply involved in Research and Development at the European level. Its participation as a
partner in EU programmes is as follows :
- TIDE, pilot phase, project M3S
- TIDE, bridge phase, project HEART
- TIDE, main phase, project LAMP/MOVAID/FOCUS
- SPRINT, project IMMEDIATE
FST is also collaborating with the SWISS NATIONAL SCIENTIFIC FUND, in the field of assistive
technologies for elderly people.
FST currently employs 28 collaborators. In Switzerland (7,000,000 citizens) about 2,400 disabled
people are using an electronic aid provided by FST. FST not only promotes its own developments
and products. It also has a range of about 300 other different products and of these about 70% are
imported from France, Sweden, U.S.A., Germany and Holland.
FST's financial resources are mainly in the service delivery system. Providing equipment represents
about 30% of FST's income. Its 1995 total budget is Sfr. 4,000,000.--.
The Impact of Technical Creativity in the Rehabilitation Field....
Foreword
In the brief lines below and before developing the robotics field aspect, I would like to outline the
creative process, as experienced by a creator and his creation, from the original idea to the point at
which the creation acquires a commonplace status, i.e., at which consumers fully adopt the new
concept and make it commonplace.
First Condition: What to Create
In most situations, if a consumer is asked what product he would like to see launched on the market
in the future, he or she will be unable to go beyond the limits of previous experience. In other
words, it is very difficult to (dare to) imagine the use of a new product. If a creator presents a new
idea for Evaluation, based on a project or prototype, the best he can hope to obtain is confirmation,
sometimes no more than partial, that a specific need could be answered by the product he
proposes. The user confuses the idea of need and the demand generated by that need. In the end,
the product's utility will be proved by the demand for the product. Unfortunately, the concept of
demand is very rarely generated on presentation of an idea. Demand does not really begin to arise
until the first applications of the product take place. Therefore, a risk directly proportional to the size
of the project must be assumed.
The creator's interest is centred principally on the potential uses of an idea or product, rather than
on the idea of the product itself. In addition to creating the references necessary to invent a new
item, he must be able to calculate its impact. A creator must learn from the past in order to
understand why the present is as it is. The present can then be used as a basis for evaluating the
future. A creator knows that he must rely mainly on his own forecast of the demand which will be
generated for the product he intends to create.
From an observer's standpoint, a creator essentially follows his intuition. In reality, he pursues a
relatively logical reasoning process. Taken to extremes, this process may be characterised as
intuitive, provided that intuition is defined along the following lines: "a logical process of which the
detail and development escape our conscious awareness".
In this country, the public's interest in new products is not of overwhelming significance. The
present and its slow and pensive evolution offer comfort (reassurance?) in which the Swiss are
perhaps more willing to indulge than are the citizens of other countries. I do not decry the art of
cultivating these values; however, I do regret that we find an incompatibility between what may be
termed "the right to create and to recognise the values engendered by creation" and the value
attached to what is now thought and done, or was always thought and done.
Second Condition: How to Create
The greater the innovative nature of the projected creation, the less recourse to acquired knowledge
is theoretically possible. Knowledge can stifle creativity, by providing security and tending to
validate existing choices. The inability to identify references in support of a project from one's own
knowledge, or that of others, can become - with a sort of "academic blessing" -an excellent reason
for inaction.
A creator's priority should not be what he knows (or others know), but rather what he can make of
what he knows. For this purpose, one solution is to work with a team whose members are
competent in several fields. We must also recognise that new ideas are often produced by people
who are not experts on a particular subject; nevertheless, if the idea is to be developed, a specialist
will be better able to bring it to fruition.
Third Condition: the Necessary Means and Support
The initiator must convince others that the project he wishes to develop has merit. The great
difficulty here is the inventor's tendency to underestimate the problems he will encounter. I do not
take this for a deliberate manipulation, but rather as a healthy reaction: if a creator were to know
beforehand the extent and nature of the problems facing him, he would hesitate to proceed with, or
even renounce, his project. However good the idea, a creator must not forget that it is of fleeting
value as long as it is not shared with other like-minded people.
Fourth Condition: Patience
Based on the creative experiments carried out by the foundation, I have observed that a new
creation goes through several stages. When a new product is launched, consumers rarely applaud.
The creator should not be surprised at this, nor offended by a lukewarm response from potential
users. He must accept that a reliable judgement can only be formed if enough tests have been
performed, i.e. where critical mass is achieved. It is best to warn the project contributors of this,
even at the risk of causing a disappointment which may have grave consequences.
Fifth and Last Condition: BELIEVE IN IT !
A creator's task begins by an assumption of risk (by the creator and those involved in the project).
In spite of continuing doubt, he must not be afraid to seek solutions to the series of problems his
creation will pose.
A creator must remain confident and meditate on the following maxim: having self-confidence does
not mean ignoring doubts, but learning to handle them. At critical moments, it often occurs to me
that "things are going well when one's available energy is sufficient to respond to the problems that
arise".
How to increase the p otential r ehabilitation m arket in the r obotics field
In the field of Assisting Technology for the disabled, the "Environmental Control Systems (ECS)" offer
the paralysed person control upon his living environment. Turning on and off electrical appliances,
making a phone call, controlling audio and video equipment as well as opening or closing windows
and doors, and even using a lift, are the most common applications.
There are about 4,000 ECS systems provided by the FST in Europe. In Switzerland, 30% of them
are used at home, 30 % in special institutions and the rest in hospitals or residences for the elderly.
When the building of a special institution is planned, FST is required for providing its equipment with
ECS. The technology applied is a kind of "smart home" concept dedicated to this special need. For
quadriplegics, this means increased autonomy through the use of the installed ECS to open and
close windows and doors, call and operate a lift, adjust the heater etc...
This concept is well accepted and the demand is concrete. Unfortunately, it is in service only in
institutions which are equipped with this kind of ECS. Problems appear as soon as the disabled
persons living in such institutions go into public buildings.... No possibility for them even to open a
door.....a.s.o.
These problems are serious. They are one of the reason why the FST's involvement in the
rehabilitation' robotics field is increasing continuously.
Before developing the "why", we should like to develop basic marketing considerations related to
highly innovating products.
FST, as already mentioned, is active in three R&D projects related to the field of robotics. Our
contribution is mainly in the users definition, evaluation and, from the technical point of view, in the
development of the basic man/machine interfaces for the severely disabled.
In one of these research projects, called TIDE-MOVAID, we already provided some considerations
with respect to this specific field. The following part of the presentation is based on this work. It now
is important to keep in mind that the user's need analysis takes into consideration both the user and
the carer. Being severely disabled means to be completely dependant upon carers (family and
professionals). Applying technologies in this field means taking into account user and carer needs,
demand... and behaviour.
Definition of the words "need" and "demand"
Need: theoretical analysis definition of the users/carers situation and related weakness
possibly compensated by assistive technology.
Demand: based on the total needs (according to the abovementioned definition), the demand
is the part which is precisely recognised by both the user and the carer(s).
If a product evaluation is based only on the "need" aspect, its results could be either too pessimistic
or too optimistic. One should also take into consideration that doing such an evaluation can be
difficult, if the initial motivation of both user and carer(s) is too low. As a consequence, being faced
with problems (for example technical ones) during the evaluation will create a good or better reason
to stop it.
Again, from an ideal point of view, if the evaluation is made with a confirmed demand from both the
user and the carer(s), the "reliability" of the results will be higher.
Postulate about demand
From an ideal point of view, a demand should be formulated in this way : "I am living in an adapted
apartment or home. With the help of my environmental control system, the motorised doors and
windows can be remote controlled. I like not being completely dependant upon others to be able to
do these things. After some time, I realise this autonomy is available only in an adapted
environment. If I stay in another building, a non-adapted one, doors remain closed... as well as
windows. It would be interesting to have access to a system which is not adapted to a specific
environment....
The probability of such formulations being made is very slight. Anyway, when a need is identified,
the corresponding demand can be revealed. The creation of similar formulations is rarely purely
intellectual but is usually based on a real experience or a good simulation.
The evaluator must have those considerations in mind during all the contacts with potential
users/carers, in order to stimulate the demand as much as possible before the evaluation is made.
BASIC PROPOSAL FOR USER'S EVALUATION
WHOM?
First of all, we propose that evaluation with users should not only focus on users themselves but
also on the carers. Based on FST's experiences in assisting technologies for disabled users, reports
based on applications or tests results only are interesting, but not enough. Consequently, the
evaluations results obtained on the first evaluations are not easily reproducible at other places,
because the general conditions might not be the same at the new place.
The evaluation should take into consideration the reactions of carers as well as the conditions in
which the complete evaluation process is made. In other terms, we propose that:
- description of the time needed to train up the carers has to be taken into account.
This will describe under which conditions, how long and how many times training will be given to
the "user-carer", not only to operate the system, but to carry out some minor maintenance,
including a good verbal or written explanation of the possible technical problems which may appear.
- description of both the users and carers' backgrounds, their knowledge, their experience with
assisting technology, etc....
It is important that the background of both user/carer be well described in this context. In a situation
in which technically sophisticated aids are being used successfully for many years one can suppose
that training time will be shorter if compared with another team with no (or bad) experience in the
matter.
- how much time must the technician spend installing the system and how frequently he has to be
present, in order to complete training or to carry out maintenance.
Unfortunately and very often, the carer's team changes (nobody else knows how to operate the
system) or, in case the system is not manipulated by the carer for some weeks, the carer, even if
he/she was trained before, does not remember how to proceed with the equipment anymore.
BASIC APPROACH TO TESTING
The wider goal of assisting technical aids is to enable elderly and disabled users to make use of their
own abilities, so that everyday tasks can be performed with a higher degree of comfort and
independence. The goal of user testing must be to determine whether technical aids do indeed assist
users during the performance of such tasks. In principle, two approaches could be taken into
account for the testing : the absolute and relative.
The absolute approach
It consists of evaluating manipulator or robotics systems without reference to other rehabilitation
products (or method of carrying out tasks), measuring the system performance on the basis of user
performance and subjective responses (both quantitative and qualitative) while carrying out
specified tasks.
The main advantages of this approach are that testing would be methodologically simple; we would
know whether the systems were effective and acceptable for users; and any major problems would
be identified.
The main disadvantage is that it would be difficult to determine (in an objective way) whether
manipulator systems had actually improved the user's situation. Knowing the investment in robotics
products, it would be folly to ignore this factor in the evaluation: for this reason alone, the absolute
approach cannot be considered as suitable.
The relative approach
It would be to test manipulators systems against the baseline of the user's existing rehabilitation
technology (or method of carrying out tasks), again measuring system performance on the basis of
user performance and subjective responses while carrying out specified tasks.
The main advantages: in this way, any differences between manipulators systems and the user's
existing situation could be made explicit; it would be possible to identify and rank any problem areas
(allowing decisions to be made about resource allocation to solutions); and it will also be possible to
identify major successes.
The main disadvantages of the relative approach are that users will need practice with the
manipulators systems; they will have to take part in at least two test sessions; and the test
methodology will be more complex. Nevertheless, the advantages outweigh the disadvantages, s o
the relative approach will be adopted for user testing.
Conclusion
In the context of technology and social services, to create is to remember that the primary factor in
the process is not the technological advances made, but man's capacity to make use of them. Like
those in many other fields, a creator must accept reversals from time to time, which may even
compromise his career. Above all else, creation brings the pleasure of seeing one's ideas fully
accepted and adopted by consumers.
In social services, creation can be summarised in this maxim:
Reconcile high tech, ethics and tact !
Jean-Claude Gabus – May 1995
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