Assistive Technology Use and Provision During COVID-19: Results From a Rapid Global Survey

Document Type : Original Article


1 Assisting Living and Learning Institute, Maynooth University, Maynooth, Ireland

2 Independent Researcher, Madrid, Spain

3 Athena Institute, Vrije Universiteit, Amsterdam, The Netherlands

4 Global Disability Innovation Hub, University College London, London, UK

5 Center for Interdisciplinary Research in Rehabilitation and Social Integration, Universite Laval, Québec, QC, Canada

6 Centre for Global Health, Trinity College Dublin, Dublin 2, Ireland

7 University College London Interaction Centre, University College London, London, UK

8 Assisting Living and Learning Institute, Department of Psychology, Maynooth University, Maynooth, Ireland


The coronavirus disease 2019 (COVID-19) pandemic has impacted all segments of society, but it has posed particular challenges for the inclusion of persons with disabilities, those with chronic illness and older people regarding their participation in daily life. These groups often benefit from assistive technology (AT) and so it is important to understand how use of AT may be affected by or may help to mitigate the impacts of COVID-19.
The objectives of this study were to explore the how AT use and provision have been affected during the initial stages of the COVID-19 pandemic, and how AT policies and systems may be made more resilient based on lessons learned during this global crisis.
This study was a rapid, international online qualitative survey in the 6 United Nations (UN) languages (English, French, Spanish, Russian, Arabic, Mandarin Chinese) facilitated by extant World Health Organization (WHO) and International Disability Alliance networks. Themes and subthems of the qualitative responses were identified using Braun and Clarke’s 6-phase analysis.
Four primary themes were identified in in the data: Disruption of Services, Insufficient Emergency Preparedness, Limitations in Existing Technology, and Inadequate Policies and Systems. Subthemes were identified within each theme, including subthemes related to developing resilience in AT systems, based on learning from the pandemic.
COVID-19 has disrupted the delivery of AT services, primarily due to infection control measures resulting in lack of provider availability and diminished one-to-one services. This study identified a need for stronger user-centred development of funding policies and infrastructures that are more sustainable and resilient, best practices for remote service delivery, robust and accessible tools and systems, and increased capacity of clients, caregivers, and clinicians to respond to pandemic and other crisis situations.


Main Subjects

  1. Douglas M, Katikireddi SV, Taulbut M, McKee M, McCartney G. Mitigating the wider health effects of covid-19 pandemic response. BMJ. 2020;369:m1557. doi:10.1136/bmj.m1557
  2. Mesa Vieira C, Franco OH, Gómez Restrepo C, Abel T. COVID-19: the forgotten priorities of the pandemic. Maturitas. 2020;136:38-41. doi:10.1016/j.maturitas.2020.04.004
  3. Pineda VS, Corburn J. Disability, urban health equity, and the coronavirus pandemic: promoting cities for all. J Urban Health. 2020;97(3):336-341. doi:10.1007/s11524-020-00437-7
  4. Hossain MM, Mazumder H, Tasnim S, Nuzhath T, Sultana A. Geriatric health in Bangladesh during COVID-19: challenges and recommendations. J Gerontol Soc Work. 2020:1-4. doi:10.1080/01634372.2020.1772932
  5. Xie B, Charness N, Fingerman K, Kaye J, Kim MT, Khurshid A. When going digital becomes a necessity: ensuring older adults' needs for information, services, and social inclusion during COVID-19. J Aging Soc Policy. 2020;32(4-5):460-470. doi:10.1080/08959420.2020.1771237
  6. Kang C, Yang S, Yuan J, Xu L, Zhao X, Yang J. Patients with chronic illness urgently need integrated physical and psychological care during the COVID-19 outbreak. Asian J Psychiatr. 2020;51:102081. doi:10.1016/j.ajp.2020.102081
  7. Hosseinpoor AR, Stewart Williams JA, Gautam J, et al. Socioeconomic inequality in disability among adults: a multicountry study using the World Health Survey. Am J Public Health. 2013;103(7):1278-1286. doi:10.2105/ajph.2012.301115
  8. Achterberg TJ, Wind H, de Boer AG, Frings-Dresen MH. Factors that promote or hinder young disabled people in work participation: a systematic review. J Occup Rehabil. 2009;19(2):129-141. doi:10.1007/s10926-009-9169-0
  9. Beckung E, Hagberg G. Neuroimpairments, activity limitations, and participation restrictions in children with cerebral palsy. Dev Med Child Neurol. 2002;44(5):309-316. doi:10.1017/s0012162201002134
  10. Reichard A, Stolzle H, Fox MH. Health disparities among adults with physical disabilities or cognitive limitations compared to individuals with no disabilities in the United States. Disabil Health J. 2011;4(2):59-67. doi:10.1016/j.dhjo.2010.05.003
  11. Groce N, Kett M, Lang R, Trani J-F. Disability and poverty: the need for a more nuanced understanding of implications for development policy and practice. Third World Q. 2011;32(8):1493-1513. doi:10.1080/01436597.2011.604520
  12. Sauer AL, Parks A, Heyn PC. Assistive technology effects on the employment outcomes for people with cognitive disabilities: a systematic review. Disabil Rehabil Assist Technol. 2010;5(6):377-391. doi:10.3109/17483101003746360
  13. United Nations. Convention on the Rights of Persons with Disabilities. United Nations; 2006.
  14. Ripat JD, Woodgate RL. The role of assistive technology in self-perceived participation. Int J Rehabil Res. 2012;35(2):170-177. doi:10.1097/MRR.0b013e3283531806
  15. Borg J, Ostergren PO, Larsson S, Rahman AA, Bari N, Khan AN. Assistive technology use is associated with reduced capability poverty: a cross-sectional study in Bangladesh. Disabil Rehabil Assist Technol. 2012;7(2):112-121. doi:10.3109/17483107.2011.602173
  16. Brandt A, Samuelsson K, Töytäri O, Salminen AL. Activity and participation, quality of life and user satisfaction outcomes of environmental control systems and smart home technology: a systematic review. Disabil Rehabil Assist Technol. 2011;6(3):189-206. doi:10.3109/17483107.2010.532286
  17. Salminen AL, Brandt A, Samuelsson K, Töytäri O, Malmivaara A. Mobility devices to promote activity and participation: a systematic review. J Rehabil Med. 2009;41(9):697-706. doi:10.2340/16501977-0427
  18. Khasnabis C, Mirza Z, MacLachlan M. Opening the GATE to inclusion for people with disabilities. Lancet. 2015;386(10010):2229-2230. doi:10.1016/s0140-6736(15)01093-4
  19. World Health Organization. Assistive Technology Fact Sheet.
  20. Eide AH, Øderud T. Assistive technology in low-income countries. In: Maclachlan M, Schwarts L, eds. Disability and International Development: Towards Inclusive Global Health. New York, NY: Springer; 2009:149-160. doi:10.1007/978-0-387-93840-0_10
  21. Rios A, Miguel Cruz A, Guarín MR, Caycedo Villarraga PS. What factors are associated with the provision of assistive technologies: the Bogotá D.C. case. Disabil Rehabil Assist Technol. 2014;9(5):432-444. doi:10.3109/17483107.2014.936053
  22. Braun V, Clarke V. Using thematic analysis in psychology. Qual Res Psychol. 2006;3(2):77-101. doi:10.1191/1478088706qp063oa
  23. United Nations Development Program. Human Development Index. Human Development Report.  Published 2016.
  24. Ohannessian R, Duong TA, Odone A. Global telemedicine implementation and integration within health systems to fight the COVID-19 pandemic: a call to action. JMIR Public Health Surveill. 2020;6(2):e18810. doi:10.2196/18810
  25. World Health Organization Executive Board. Resolution EB142.R6 Improving Access to Assistive Technology. Geneva, Switzerland: WHO; 2018.
  26. Boldrini P, Garcea M, Brichetto G, et al. Living with a disability during the pandemic. "Instant paper from the field" on rehabilitation answers to the COVID-19 emergency. Eur J Phys Rehabil Med. 2020;56(3):331-334. doi:10.23736/s1973-9087.20.06373-x
  27. Smith EM, Gowran RJ, Mannan H, et al. Enabling appropriate personnel skill-mix for progressive realization of equitable access to assistive technology. Disabil Rehabil Assist Technol. 2018;13(5):445-453. doi:10.1080/17483107.2018.1470683
  28. Desmond D, Layton N, Bentley J, et al. Assistive technology and people: a position paper from the first global research, innovation and education on assistive technology (GREAT) summit. Disabil Rehabil Assist Technol. 2018;13(5):437-444. doi:10.1080/17483107.2018.1471169
  29. MacLachlan M, Banes D, Bell D, et al. Assistive technology policy: a position paper from the first global research, innovation, and education on assistive technology (GREAT) summit. Disabil Rehabil Assist Technol. 2018;13(5):454-466. doi:10.1080/17483107.2018.1468496
  30. Aranda Jan C, Boutard A. Understanding the Mobile Disability Gap. London: GSMA; 2019.
  31. Barbareschi G, Holloway C, Arnold K, et al. The Social Network: How People with Visual Impairment use Mobile Phones in Kibera, Kenya. In: Proceedings of the 2020 CHI Conference on Human Factors in Computing Systems. April 2020. doi:10.1145/3313831.3376658
  32. Dobransky K, Hargittai E. Unrealized potential: Exploring the digital disability divide. Poetics. 2016;58:18-28. doi:10.1016/j.poetic.2016.08.003
  33. Ramsetty A, Adams C. Impact of the digital divide in the age of COVID-19. J Am Med Inform Assoc. 2020;27(7):1147-1148. doi:10.1093/jamia/ocaa078
  34. Barbareschi G, Aranda Jan C, Nique M, Ramos Barajas F, Holloway C. Mobile phones as assistive technologies: gaps and opportunities. In: MacLachlan M, Berman-Bieler R, eds. Proceedings of the GReAT Summit 2019. Geneva, Switzerland: WHO; 2019.
  35. Rajasekaran K. Access to telemedicine-are we doing all that we can during the COVID-19 pandemic? Otolaryngol Head Neck Surg. 2020;163(1):104-106. doi:10.1177/0194599820925049
  36. Núñez A, Madison M, Schiavo R, Elk R, Prigerson HG. Responding to healthcare disparities and challenges with access to care during COVID-19. Health Equity. 2020;4(1):117-128. doi:10.1089/heq.2020.29000.rtl
  37. Beaunoyer E, Dupéré S, Guitton MJ. COVID-19 and digital inequalities: reciprocal impacts and mitigation strategies. Comput Human Behav. 2020;111:106424. doi:10.1016/j.chb.2020.106424
  38. Smith E, Borg J, Mannan H, MacLachlan M. Assistive technology content in United Nations convention on the rights of persons with disabilities reports by states parties. In: Layton N, Borg J, eds. Global Perspectives on Assistive Technology: Proceedings of the GReAT Consultation 2019. Geneva: WHO; 2019:350-361.
  39. Emerson E, Fortune N, Aitken Z, Hatton C, Stancliffe R, Llewellyn G. The wellbeing of working-age adults with and without disability in the UK: associations with age, gender, ethnicity, partnership status, educational attainment and employment status. Disabil Health J. 2020;13(3):100889. doi:10.1016/j.dhjo.2020.100889
Volume 11, Issue 6
June 2022
Pages 747-756
  • Receive Date: 28 July 2020
  • Revise Date: 13 October 2020
  • Accept Date: 14 October 2020
  • First Publish Date: 11 November 2020