July 2015

Issue 16: July/August 2015

FEATURE STORIES

A champion for access

When athletes with intellectual disabilities march onto the field of play at the Toronto 2015 Parapan Am Games, Ryerson University’s Jennifer Mactavish, Dean of the Yeates School of Graduate Studies and a professor in the School of Disability Studies, will have a special reason to cheer. She has been instrumental in ensuring these athletes aren’t left behind by international sporting competitions.

Prof. Mactavish helped draft the international eligibility criteria for athletes with intellectual disabilities (ID). This category of athletes had been out of competition since a scandal at the 2000 Sydney Paralympics. The controversy arose after athletes at those games were later revealed to not be legitimate ID athletes. The response by games officials was to ban all ID athletes.

“For me, the response was patently unfair,” says prof. Mactavish, a former collegiate athlete herself whose academic work investigates the role leisure and sports plays in our lives. She has had a lifelong interest in the Paralympic movement.

“At the end of the day, the athletes with ID didn’t cheat. So it was a lost opportunity for a full generation of top performing, elite-caliber athletes who really, by virtue of their talent, deserve a place on the world stage to demonstrate that talent.”

For the past 15 years, prof. Mactavish has collaborated with a diverse group of researchers to develop the criteria for ID athletes. “Classification for Paralympic sport has gone through changes but now it is about scientific evidence about the underlying impairment and the proficiencies required in each sport,” she says.

“The whole idea is you don’t want outcomes of performance to be based on inherent differences in ability linked to the underlying impairment. You want the winners to be differentiated by talent and training. This is to promote equity in competition and fairness in the outcomes,” prof. Mactavish says.

“My major contribution to the work is the sport knowledge: individuals with intellectual disabilities, I have worked with them for 25 years, and the theoretical and conceptual grounding. We developed a theoretical framework of what we call sport intelligence, derived from a whole host of different theories about cognition and intellectual function and how that influences our capacity.”

The result of that work meant ID athletes were able to participate in select events at the London Paralympics for the first time since the Sydney games. Prof. Mactavish and members of her research group were there in London when the ID athletes marched in the opening ceremonies. “We looked at each other and we cried. It was a powerful moment.”

In recognition for her contributions, prof. Mactavish received the 2015 Paralympic Scientific Award from the International Paralympic Committee, but the publicity surrounding that award brought an even more significant recognition.

“I got so many emails from people around the world, and most importantly from parents of athletes. It was just hugely humbling,” she says, adding that she was touched by parents’ acknowledgement of the role her research played in creating the competition criteria for athletes with intellectual disabilities. “When you realize you have played a part in a really personal way… it doesn’t get any better than that.”

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Could robots unlock some of autism spectrum disorder’s mysteries?

Given the many mysteries around autism spectrum disorder (ASD), researchers are always looking for new and innovative ways to pierce the mystery and one of the most interesting is using robots to venture into the question of language practice of children with ASD.

And robots, it turns out, may hold a key to promoting better human interactions for some children with autism.

The road to this research began for Ryerson University’s Stéphanie Walsh Matthews (Associate Professor, Department of Languages, Literatures & Cultures) when she was invited to work with an international consortium researching robots targeted to working with the elderly. Her work in the semiotic functions of repulsion and attraction is what appealed to the researchers working with geriatric users. Researchers developing cute and playful robots also noticed that children with ASD actively engaged with them. For one child, interacting with a robot prompted him to speak… something he had not done before.

“It opened up this large world where people started questioning why some children have an inclination to interact with robots,” says assoc. prof. Walsh Matthews who now investigates the language practices with children with ASD using small robots with her Ryerson Co-Investigator Jamin Pelkey (LLC).

The study also gave assoc. prof. Walsh Matthews the opportunity to use the robots to record the interactions between the children and the robots. “We had children playfully interact with the robots and collected a whole bunch of speech data and we are really proud to say we are building an original linguistic database of transcribed speech data from children with autism.”

The key question is why this kinship with robots? Assoc. prof. Walsh Matthews says it may come down to this distinction – some children with autism spectrum disorder demonstrate a certain ease when interacting with the small robots. “What some researchers have come to understand is that children respond to robots because the robots tend to have a low stimulus level. Their faces don’t move, so they are very predictable. They tend to speak in steady, predictable sentences that are idiomatic. They tend to do things in repetition and they are tireless. They don’t get impatient. They can play the same game many times over exactly the same way.”

The end goal is not to consign children with autism to non-human interactions, though. The good news is the experience of interacting with robots suggests the children come away better able to communicate with other humans.

“We have noticed, along with other researchers, that children who do interact with robots actually take the skills they acquire during these robotic interactions and apply them to people and become more familiar. They just have a practicing buddy.”

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A view to heal

People go to the hospital to get better, so what if hospital spaces could be designed in a way that enhanced the way we feel and even helped us in dealing with illness? Associate Professor Cheryl Atkinson from the Department of Architectural Science had a unique opportunity to study the interaction between architecture, patients, and health care providers with the redevelopment of Bridgepoint Active Healthcare, a 404-bed complex continuing care and rehabilitation facility on the eastern shoulder of the Don Valley in Toronto.

With grants from the Canadian Institutes of Health Research and Ontario’s Ministry of Health and Long Term Care, assoc. prof. Atkinson collaborated on the research with her Ryerson colleague, social scientist Celeste Alvaro, adjunct faculty with the Department of Architectural Sciences. Assoc. prof. Atkinson's research focuses on the sensorial properties of the built form and its impact on human social interaction, physical health, and psychological health in both urban space and architecture. This collaboration of sociologists and architects interviewed and observed elderly Bridgepoint patients and health care professionals working inside the obsolete 1963 Bridgepoint facility, and then measured that feedback against their reactions and interactions with the brand new facility.

“It was a unique opportunity to follow the same cohort of people from one building to the other,” says assoc. prof. Atkinson. “It is a rare thing to get access to the same subjects and staff and patients, and see what the impact of this state-of-the-art building would be on this cohort of people.”

Assoc. prof. Atkinson and her team of architectural students visually documented both the old Bridgepoint building, the new facility, and a third control site (West Park Long Term Care Centre in the west end of Toronto). The sociologists in the collaboration observed and interviewed patients and staff about the living environments. One of the key concerns in long-term care is management of chronic disease, particularly the depression associated with living with those illnesses. To alleviate these concerns, the new Bridgepoint was designed with an eye to bringing more light into the shared space of its patients and residents.

“There have been lots of studies that have looked at daylight and access to nature and view, and opportunities for socialization by the way the layout of the plans are organized,” she says. “We looked at daylight, because the new building has a lot of natural daylight, and organized [the space] consciously to orient it to views and nature. It is in a park. It is on the shoulder of a valley, with views out to the lake and the city beyond. It is organized so the corridors end in views. You are always oriented to corridors that are oriented to windows. It was consciously trying to avoid that maze-like condition that so many hospitals have, where they add areas constantly to existing buildings and you are in an internal maze and you depend on signage for orientation.”

Instead of eating alone in rooms, a shared dining facility opened up the possibility for more social interaction. Even the new pool was built to take advantage of views of an adjacent park land. The results were presented to the provincial Ministry of Health last spring.

“We did find across the board that people considered the newly designed hospital much more desirable than the previous hospital,” assoc. prof. Atkinson says. “There was increased positive response right across the board, yet not all aspects of the redesign were a bullseye. Westward facing verandas overlooking the Don Valley weren’t used much because patients were bothered by the sound of traffic from the roadway. On the other hand, the most popular aspect of the new design was something that wasn’t even part of the original plan — a rooftop garden where patients could tend to their own plants or simply relax in warmer months. The result was a marked increase in happiness among the residents.”

“Happiness is assumed to alleviate stress, and stress is a known factor in health care outcomes,” she says. "If someone is feeling more content and less worried, then that hopefully impacts their health and recovery.”

“People are just gradually recognizing in all aspects of their lives the importance of design, from their own houses to the way cities are made,” assoc. prof. Atkinson adds. “They thought design was a frill, but they’re recognizing it is not just about functionality. There is much greater consciousness of design.”

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Accessible environments through human-centred fashion

There are many ways to think about what we wear – as style, self-expression, protection – but for Sandra Tullio-Pow, Associate Professor at Ryerson’s School of Fashion, our clothing is an extension of the environment around us. And just as surely as we’ve become more aware of making our environment more accessible, assoc. prof. Tullio-Pow believes we must extend that perspective to the way we design our clothing.

“My source of inspiration has always been the automatic opening door that was originally invented for mobility impairment, and yet everybody uses it now,” says assoc. prof. Tullio-Pow. “We are quite used to looking at ramps and automatic door openers as enabling for people who otherwise couldn’t function because of the physical environment. Clothing is another one of those environments that can enable or disable because of the way they are made and how they interact with your body.”

This perspective has resulted in assoc. prof. Tullio-Pow developing a special focus on human-centred design, aimed at improving the lives of people with a variety of physical restrictions. “My goal was to make beautiful clothes that made women feel beautiful,” she says. “Along the way, I discovered that most people don’t fit what the media portray as ‘the fashion person,’ but they want to feel attractive and capable and have their performance enhanced. And that is why human-centered design attracted me, because it was a way to make a difference.”

Her first foray into the field came when she saw the dearth of stylish, practical and affordable clothing for her pregnant friends and colleagues, spurring her to design a collection for expectant mothers. That led to a call from the RCMP, which asked assoc. prof. Tullio-Pow to assist with the design of new uniforms for pregnant officers.

“What they were wearing before didn’t convey the image of the RCMP,” she says. “They couldn’t wear a gun holster around their waist. Some managers weren’t approving boots in a larger size, even though their feet were swelling and wouldn’t fit into their standard boots. This all impacted their ability to do their job.”

Princess Margaret Hospital also needed her help, asking her to design clothing for women recovering from lymphedema. This led to assoc. prof. Tullio-Pow and her colleagues designing a patented shoulder bag that doubles as a subtle arm sling to support the aching, swollen arms that can be a consequence of breast cancer surgery.

When Ryerson University psychologists Associate Professor Frank Russo and Dean of Arts Jean-Paul Boudreau wanted to develop a garment for children with autism that would enhance communication — enabling the child’s mother to trigger tactile vibrations in clothing by using her voice — it was assoc. prof. Tullio-Pow and her collaborators who incorporated the vibrating discs and batteries into a prototype of a child’s jumper. More recently, in partnership with Brampton Civic Hospital, her focus has shifted to the aging population and the clothing needs of people recently recovering from stroke or orthopedic surgery.

“There is a lot of research on return to dressing techniques and lots of research done on stroke and occupational therapy," she says. “They identify all these dressing problems with their lower body, and difficulties with different fasteners, but nobody has looked at it as if the clothing is the problem rather than the user. The arm hole is too high, the wrist is too small. You can’t thread your arm through the sleeve. The occupational therapists aren’t really aware of the adaptive things that are available, like magnets instead of buttons to do up your shirt.”

The opportunity to collaborate and explore aspects of fashion that truly impact and improve lives is at the core of assoc. prof. Tullio-Pow’s work.

“People think of fashion only as the runway. But there is the ‘real way’ of clothing, too. The real way impacts our self-image and well-being to a tremendous degree.”

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PARTNER IN INNOVATION

Apps made accessible

The world of digital technology has made it possible to control a variety of home functions such as the television, heating and air conditioning, lighting, and communications, all through the elegant interface of a tablet or smartphone – unless you have certain kinds of disabilities. Anyone with challenges that impact the dexterity of their hands, arms or upper body can find the functionality of a smartphone inaccessible.

However, a collaboration between researchers and entrepreneurs at Ryerson University is developing, honing and marketing a technology that makes screen-based home control applications for smart phones and tablets accessible to people who may only be able to control a single switch.

The Tecla Shield 3 was developed by Komodo OpenLab at OCAD University’s Inclusive Design Institute in Toronto, incubated as a company at Ryerson University’s DMZ, and is currently being tested by prof. Deborah Fels, Ted Rogers School of Information Technology Management and Director of Ryerson’s Inclusive Media & Design Centre.

Tecla Shield 3 works with assistive switches ranging from buttons, sip-and-puff controllers, head arrays, joysticks, and wheelchair driving controls, which open the touch screen interface up to people with upper body mobility limitations as a result of injuries to the spine, brain injuries or stroke, and diseases such as multiple sclerosis and muscular dystrophy. With funding from the Networks of Centres of Excellence — Technology Evaluation in the Elderly Network, prof. Fels’ team has collaborated with Komodo to test the Tecla Shield 3.

“Deb and her team are currently gathering feedback from individuals that are (or could be potential) Tecla users to define the requirements for the new generation of our products,” says Komodo OpenLab CEO Mauricio Meza. “We'll work with them to complete and test prototypes with users and continue to iterate. As we validate prototypes, we plan to move and complete testing in clinical settings with Deb as lead researcher due to her connection with health organizations in Ontario.”

“I advocate an inclusive design perspective on the world. If there’s thinking around inclusivity during the design process, then those problems are fewer,” prof. Fels says. “The computing environment has made things much more progressive because of the flexibility the computer offers. Accessing communications, information, education, and a whole lot of other functions, systems, devices and tasks are hard to access in the physical world… it can be easier to do in the virtual world.”

Inclusive design has been part of prof. Fels’ life and work for a long time. Back when she was still an undergraduate, a paraplegic friend of hers who was attending medical school needed a customized wheelchair to use during his surgical rotation. There was nothing available that could handle his specific needs, so she designed it for him.

“He needed a way to be in surgery for extended times while being able to make sure his legs had circulation. It’s part of the attraction of engineering for me. It is practical. I can do practical things and that was just one of them,” says prof. Fels.

The surgeon’s wheelchair is an early example of prof. Fels’ commitment to applying engineering principles to enhanced accessibility. The Inclusive Media & Design Centre is engaged in an array of projects designed to open up information, content, and experiences to people with disabilities. The team has developed everything from PEBBLES, a video conferenced robot that allows children in hospital to attend school; to the EmotiChair, which translates audio and visual content into tactile sensations; to the EnACT captioning system, which enhances normal subtitles with animations that convey the intensity and expression of the speaker’s performance.

The field of research into accessibility is growing, partly as a result of legislative changes in North America that have prompted institutions and businesses to ensure accessibility, and partly as a result of the burgeoning digital world. Although prof. Fels and her collaborators are focused on accessibility, many of the tools and technologies they develop have the potential to impact and enhance the lives of a much broader community.

“That is part of inclusive design strategy,” she says. "You build it for people on the ends of the distribution curve but you also help all the people in the middle. It is one of the goals we are always trying to achieve.”

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SPOTLIGHT

Faster, non-invasive diagnosis of concussion injuries

When athletes suffer a concussion during competition, early diagnosis is key, but minor concussions go largely undetected. It is a challenge to access expensive and in-demand diagnostic imaging via magnetic resonance imaging (MRI) or positron emission tomography (PET). What if there was a faster, cheaper, and more mobile way to see inside the brain and check for damage?

That’s one of the goals of Vladislav Toronov, Associate Professor of Physics at Ryerson University. He has been studying the use of infrared spectroscopy, which measures absorption of light and reveals the characteristics of the molecular structure in a non-invasive way. Specifically, assoc. prof. Toronov is investigating how hyperspectral infrared spectroscopy may be applied to brain diagnostics. Unlike more common multispectral spectroscopy, hyperspectral spectroscopy allows for thousands of wavelengths of light to be measured, for more accurate results.

“Typically in a sports concussion or concussion during a collision, it is mild. So the doctor would not do surgery. They traditionally will leave the person at rest for a week or two and then examine the patient and how they are feeling, basing their conclusions on the report of the patient and whether they have headaches. That is very subjective. We need some imaging techniques to look inside the brain,” says assoc. prof. Toronov, who conducts his work in collaboration with the Keenan Research Centre for Biomedical Science at St. Michael’s Hospital.

“In the case of severe injury, surgery is required and the doctor has better access to the brain. We want to develop imaging techniques to look inside the brain even in the case of mild traumatic brain injury.”

Assoc. prof. Toronov imagines a future in which sports organizations and facilities may have a suitcase-sized hyperspectral spectroscopy unit that can be deployed to analyze an injured player’s brain moments after impact. “The way it should work is that every athlete on a participating team would be scanned before any concussion so we have a baseline,” he explains. “And, then we would compare the baseline and immediately after the event, then days after and days after, to see how the changes are going and whether they return to the baseline or not.”

The goal is to adapt the technology so it can help athletes get back into the game as soon as safely possible. “Faster diagnosis is important for athletes playing sports,” assoc. prof Toronov says. “After any trauma, they are trying to return to their activity as soon as possible. The danger is if the concussion is not properly treated, the secondary concussion can cause much more significant problems and maybe irreversible changes to the brain. It is really important to be able to reliably diagnose what is going on.”

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AROUND CAMPUS