students with a qualifying disability. files provided are in xml format and used as a starting platform for braille readers, screen readers, and other digital text software. idea defines assistive technology as follows: "any item, piece of equipment, or product system, whether acquired commercially off the shelf, modified, or customized, that is used to increase, maintain, or improve functional capabilities of a child with a disability. (b) exception.--the term does not include a medical device that is surgically implanted, or the replacement of such device." assistive technology listed is a student's iep is not only recommended, it is required (koch, 2017). these devices help students both with and without disabilities access the curriculum in a way they were previously unable to (koch, 2017). occupational therapists play an important role in educating students, parents and teachers about the assistive technology they may interact with. assistive technology in this area is broken down into low, mid, and high tech categories. low tech encompasses equipment that is often low cost and does not include batteries or requires charging. examples include adapted paper and pencil grips for writing or masks and color overlays for reading. mid tech supports used in the school setting include the use of handheld spelling dictionaries and portable word processors used to keyboard writing. high tech supports involve the use of tablet devices and computers with accompanying software. software supports for writing include the use of auditory feedback while keyboarding, word prediction for spelling, and speech to text. supports for reading include the use of text to speech (tts) software and font modification via access to digital text. limited supports are available for math instruction and mostly consist of grid based software to allow younger students to keyboard equations and auditory feedback of more complex equations using mathml and daisy. computer accessibility a sip-and-puff device which allows a person with substantial disability to make selections and navigate computerized interfaces by controlling inhalations and exhalations one of the largest problems that affect disabled people is discomfort with prostheses. an experiment performed in massachusetts utilized 20 people with various sensors attached to their arms. the subjects tried different arm exercises, and the sensors recorded their movements. all of the data helped engineers develop new engineering concepts for prosthetics. assistive technology may attempt to improve the ergonomics of the devices themselves such as dvorak and other alternative keyboard layouts, which offer more ergonomic layouts of the keys. assistive technology devices have been created to enable disabled people to use modern touch screen mobile computers such as the ipad, iphone and ipod touch. the pererro is a plug and play adapter for ios devices which uses the built in apple voiceover feature in combination with a basic switch. this brings touch screen technology to those who were previously unable to use it. apple, with the release of ios 7 had introduced the ability to navigate apps using switch control. switch access could be activated either through an external bluetooth connected switch, single touch of the screen, or use of right and left head turns using the device's camera. additional accessibility features include the use of assistive touch which allows a user to access multi-touch gestures through pre-programmed onscreen buttons. for users with physical disabilities a large variety of switches are available and customizable to the user's needs varying in size, shape, or amount of pressure required for activation. switch access may be placed near any area of the body which has consistent and reliable mobility and less subject to fatigue. common sites include the hands, head, and feet. eye gaze and head mouse systems can also be used as an alternative mouse navigation. a user may utilize single or multiple switch sites and the process often involves a scanning through items on a screen and activating the switch once the desired object is highlighted. home automation the form of home automation called assistive domotics focuses on making it possible for elderly and disabled people to live independently. home automation is becoming a viable option for the elderly and disabled who would prefer to stay in their own homes rather than move to a healthcare facility. this field uses much of the same technology and equipment as home automation for security, entertainment, and energy conservation but tailors it towards elderly and disabled users. for example, automated prompts and reminders utilize motion sensors and pre-recorded audio messages; an automated prompt in the kitchen may remind the resident to turn off the oven, and one by the front door may remind the resident to lock the door. assistive technology and innovation conventional assistive technologies patent filings between 2013 and 2017. 177,398 patent families have been filed. 64% of the filings are in the mobility assistive technology. emerging assistive technologies patent fillings between 2013 and 2017. 15,592 patents families have been filed. 32% of the filings are in the hearing assistive technology. innovation is happening in assistive technology either through improvements to existing devices or the creation of new products. in the wipo published 2021 report on technology trends, assistive products are grouped into either conventional or emerging technologies. conventional assisting technology tracks innovation within well-established assistive products, whereas emerging assistive technology refers to more advanced products. these identified advanced assistive products are distinguished from the conventional ones by the use of one or more enabling technologies (for instance, artificial intelligence, internet of things, advanced sensors, new material, additive manufacturing, advanced robotics, augmented and virtual reality) or by the inclusion of implantable products/components. such emerging assistive products are either more sophisticated or more functional versions of conventional assistive products, or completely novel assistive devices. for instance, in conventional self-care assistive technology, technologies involved typically include adaptive clothing, adaptive eating devices, incontinence products, assistive products for manicure, pedicure, hair and facial care, dental care, or assistive products for sexual activities. in comparison, emerging self-care assistive technologies include health and emotion monitoring, smart diapers, smart medication dispensing and management or feeding assistant robot. although the distinction between conventional and emerging technologies is not always clear-cut, emerging assistive technology tends to be "smarter", using ai and being more connected and interactive, and including body-integrated solutions or components. to a great extent this « conventional » versus « emerging » classification is based on the who's priority assistive products list and the iso 9999 standard for assistive products for persons with disabilities, the apl delineating the absolute minimum that countries should be offering to their citizens and iso 9999 defining those products which are already well established in the market. this "well-established status" is reflected in the patent filings between 2013 and 2017. patent registrations for assistive technologies identified as conventional are nearly eight times larger than the ones for emerging assistive technologies. however, patent filings related to more recent emerging assistive technologies are growing almost three times as fast as those pertaining to conventional ones. patent filings in both conventional and emerging assistive technology are highly concentrated on mobility, hearing and vision. investment in emerging assistive technology also focuses on environment. in the conventional sector, mobility represent 54% of all patents fillings, and is an indication of increased interest in advanced mobility assistive product categories, such as advanced prosthetics, walking aids, wheelchairs, and exoskeletons. number of patent applications for conventional (top) and emerging (bottom) assisting technologies between 2000 and 2017. china surpassed the annual filings of the us in 2008 and has recorded a very strong growth ever since in both conventional and emerging sectors. in the past, the top patent offices for filing, and therefore perceived target markets, in assistive technology have been the u.s. and japan. patenting activity has, however, been declining in these two jurisdictions. at the same time, there has been a surge in patent filings in china and an increase in filings in the republic of korea. this pattern is observed for both conventional and emerging assistive technology, with china's annual filings surpassing those of the u.s. in 2008 for conventional and 2014 for emerging assistive technology. patent filings related to conventional assistive technology have also declined in europe, especially in germany, france, the netherlands and norway. patenting activity indicates the amount of interest and the investment made in respect to an invention's applicability and its commercialization potential. there is typically a lag between filing a patent application and commercialization, with a product being classified in various stages of readiness levels, research concept, proof of concept, minimum viable product and finally commercial product. according to the 2021 wipo report, the emerging technologies closest to a fully commercial product were for example: myoelectric control of advanced prosthetics and wheelchair control (mobility), environment-controlling hearing aids (hearing), multifocal intraocular lenses and artificial retina, along with virtual and augmented reality wearables (vision); smart assistants and navigation aids (communication); smart home appliances (environment); medication management and smart diapers (self-care). the technology readiness level and the related patenting activity can also be explained through the following factors which contribute to a product's entry to market, such as the expected impact on a person's participation in different aspects of life, the ease of adoption (need for training, fitting, additional equipment for interoperability, and so on), the societal acceptance and potential ethical concerns, and the need for regulatory approval. this is mainly the case for assistive technology that qualifies as medical technology. among these aspects, acceptability and ethical considerations are particularly relevant to those technologies that are extremely invasive (such as cortical or auditory brainstem implants), or replace the human caregiver and human interaction, or collect and use data on cloud-based services or interconnected devices (e.g., companion robots, smart nursing and health-monitoring technologies), raising privacy issues and requiring connectivity, or raise safety concerns, such as autonomous wheelchairs. beyond the patent landscape, industrial designs have an added importance for the field of assistive technology. assistive technology is often not adopted, or else abandoned entirely, because of issues to do with design (lack of appeal) or comfort (poor ergonomics). design often plays a role after the patenting activity, as a product needs to be re-designed for mass production. impacts overall, assistive technology aims to allow disabled people to "participate more fully in all aspects of life (home, school, and community)" and increases their opportunities for "education, social interactions, and potential for meaningful employment". it creates greater independence and control for disabled individuals. for example, in one study of 1,342 infants, toddlers and preschoolers, all with some kind of developmental, physical, sensory, or cognitive disability, the use of assistive technology created improvements in child development. these included improvements in "cognitive, social, communication, literacy, motor, adaptive, and increases in engagement in learning activities". additionally, it has been found to lighten caregiver load. both family and professional caregivers benefit from assistive technology. through its use, the time that a family member or friend would need to care for a patient significantly decreases. however, studies show that care time for a professional caregiver increases when assistive technology is used. nonetheless, their work load is significantly easier as the assistive technology frees them of having to perform certain tasks. there are several platforms that use machine learning to identify the appropriate assistive device to suggest to patients, making assistive devices more accessible. history in 1988 the national institute on disability and rehabilitation research, nidrr, awarded gaulladet university a grant for the project "robotic finger spelling hand for communication and access to text by deaf-blind persons". researchers at the university developed and tested a robotic hand. although it was never commercialized the concept is relevant for current and future research. since this grant, many others have been written. nidrr funded research appears to be moving from the fabrication of robotic arms that can be used by disabled persons to perform daily activities, to developing robotics that assist with therapy in the hopes of achieving long-term performance gains. if there is success in development of robotics, these mass-marketed products could assist tomorrow's longer-living elderly individuals enough to postpone nursing home stays. "jim osborn, executive director of the quality of life technology center, told a 2007 gathering of long-term care providers that if such advances could delay all nursing home admissions by a month, societal savings could be $1 billion monthly". shortage of both paid personal assistants and available family members makes artificial assistance a necessity.