Assistive TechnologyChapter 8

By Christiaan Kier, BFA

Definition of Assistive Technology (AT)

Technology-Related Assistance for Individuals with Disabilities Act of 1988

Any item, piece of equipment, or product system, whether acquired commercially, off-the-shelf, modified, customized, that is used to increase, maintain or improve the functional capabilities of individuals with disabilities

Broader definitionThe applications of science, engineering, and other

disciplines that results in processes, methods, or inventions that support people with disabilities

Why is AT Important? A grabber can eliminate the

need for a home assistant

Communication devices can allow a person to order food independently at a restaurant

A wheelchair allows active participation

Ability to be involved in recreation, work, education, or social activities have powerful effects because they allow the person to be fully participating members of society

Why is AT important?

Some AT devices are necessary to save a person’s life

Kidney dialysis equipment

Some AT devices are seen as a quality of life issue

Wheelchair

Background

Historical Perspective Not a new concept

Tree-branch crutches Artificial limbs Wheelchairs

Federal Legislation

Rehabilitation Act of 1973 Rehabilitation Act Amendments of 1978 Rehabilitation Act Amendments of 1986 Technology-Related Assistance for Individuals with

Disabilities Act of 1988 Americans with Disabilities Act (ADA) of 1990 Assistive Technology Act of 1998 Assistive Technology Act of 2004 (amendment of 1998)

Federal Legislation Technology-Related

Assistance for Individuals with Disabilities Act of 1988 (Tech Act)

To encourage the development and implementation of AT service delivery systems by awarding grant monies

Spreading the word about potential power of AT

Have greater control over their lives

Participate in and contribute more fully to activities in their homes, school, and work environment and in the community

Interact to a greater extent with non-disabled individuals

Otherwise benefit from opportunities that are taken for granted by individuals who do not have a disability

Federal Legislation

Assistive Technology Act of 1998 (AT Act) Capacity building

services were continued: Community outreach Public awareness Advocacy Technical assistance

Assistive Technology Act of 2004 (amendment) Mandating easier access Direct client services

More funds are allocated

Device loan Reutilization Demonstration Alternative financing

Accountability Measurable goals Program evaluations

Key Entities Veterans

Administration (VA) Civil War

Injured soldiers needed services

WWI & WWII Lead the way to

disability related research

National Academy of Science collaborated with Surgeon General of the United States Armed Forces on artificial limbs.

First biomedical teams developed

Key Entities National Institute on

Disability and Rehabilitation Research (NIDRR)

Formerly known as the National Institute of Handicapped Research

Created in 1978

To establish and coordinate a comprehensive rehabilitation research network

Rehabilitation Engineering Centers (RECs) / Rehabilitation Engineering Research Centers (RERCs)

Rehabilitation Engineering is the application of engineering to improve the quality of life a person with the disablity through a team approach to rehabilitation

Each center had a major area

of research focus (Chapter 8, Table 1: Rehabilitation Engineering Research Centers)

Key Entities

Rehabilitation Engineering & Assistive Technology Society of North America (RESNA) Mostly a technical

organization, dominated by research, development, and engineering

Also incorporated the delivery of assistive technology services as a key component in its overall agenda

National Aeronautical and Space Administration (NASA) and National Science Foundation (NSF) Focused on hardware

development Rechargeable cardiac

pacemaker

Principles Involve the user

The user should always be the first source of information when considering technology

Access to Information Access to information is key Technology changed so rapidly that it is difficult to remain

current The Internet allows access for research

The KISS (Keep It Simple, Stupid) Principle Take the simplest path; do not overcomplicate Adaptability refers to the the flexibility Normalization refers to how similar the device is to others

around the AT user

KISS Principle

Wheelchair does not fit under the table

“normalization” Add blocks to elevate

the table Table still looks like

other work tables in office, just several inches higher

Principles AT Needs are Fluid

Needs changes as much as technology changes

Individualized Process Approach people as unique individuals

Example: motorized wheelchair vs. manual wheelchair

Focus on Functional Limitations Not Disability Type Restrictions in the physical or mental functioning that limit a

person’s ability to perform activities of daily living

Holistic Approach What may work at home or hospital may not be good for work Take account of all areas of the person’s life

AT Devices Low-Tech

Commonly basic, cheap, and readily available devices and equipment

Easy to replace No training

Manual wheelchair

High-Tech Electrical or electronic

and can be expensive Can be purchased off

the shelf, specialized AT vendors, or custom-made

Training, maintenance, repairs, and replacements costs are major factors

Power wheelchair

Categories of AT Devices Aids for Daily Living Architectural Accommodations Cognitive Aids Communication Aids Computer Controls Mobility Aids Prosthetics and Orthotics Recreation Seating & Positioning Sensory Aids Transportation Vocational

AT Services

Services that assist a person with a disability in selecting, obtaining, and using AT devices

Positive match is the most important Assessment and Evaluation

Ability to use a computer, augmented communication boards, modified controllers

Technical Assistance and Maintenance Help in understanding purchasing or leasing options Understanding the maintenance If it is expensive, there is no back-up while in the repair

shop Customization

Either modify an existing device or to completely create a new one

Assistive Technology Match

The right match must occur to ensure increased functioning and independence

Human Activity Assistive Technology Model (HAAT)

Matching Person and Technology Model (MPT)

Psychosocial Impact of Assistive Devices Scale (PIADS)

Institute on Rehabilitation Issues

The Technology Type, capabilities

Performance Ease of use, reliability

Durability Shelf-life, usability

Availability Ease of purchase,

training Cost

Device, training, maintenance, repair, modifications

Aesthetics Acceptable by user

Environment Does it work in all

environments? Easy to transport?

Funding Source of funding for

purchase and future repairs

Technological Abandonment (Non-Use)

Abandonment occurs when people do not feel it will improve their quality of life, psychological well-being, independence, self-esteem, sense of control, empowerment

Positive abandonment No longer needed

Negative abandonment Poor match Too much energy Unwanted attention

Technological Abandonment (Non-Use)

National Survey on Abandonment of Technology 29% non-use

Other studies Up to 70% non-use In the first 3 months of

use Higher rate of non-use in

recently acquired disability

AT Teams Use of interdisciplinary teams in rehabilitation is a

well-established practice

Person using AT

Family members who work with the person

Rehabilitation counselor, case manager, social worker

Physician or nurse

Physical therapist, occupational therapists, and speech therapists

Education: technology specialist, office for students with disabilities

Assistive Technology Settings

Home House must be accessible

in order to fully be a home Education

Entitled to free and appropriate education in the least restrictive manner (mainstreaming)

Work Identity and self-worth are

often tied to what you do Past 5 years:

unemployment rate is about 70%; college graduates is 40%

Recreation Social isolation is the

most damaging part of having a disability

Children Participate with peers in

recreational activities is vital

Adults Paralympics and Special

Olympics Positive attitudes in a

society that is receptive to inclusion of people with disabilities

Funding Lack of funding is second to inadequate information

on AT

Three types of funding: Individual pays Credit/loan Third party payers

Potential Funding Sources (Table III) Public - medicaid, medicare, state-funded vocational

rehabilitation services, special education, Veterans Administration, worker’s compensation

Private - private lenders, civic groups (kiwanis clubs, lions clubs), church groups, disability organizations

Current Trends

The future of assistive technology and its impact upon the lives of people with disabilities is very exciting

Computer chips will get smaller and cheaper and more powerful

Smart homes will require less human operations

Universal design = less modifications

Questions

Reed, B. J., & Saladin, S. P. (2008). Assistive Technology. In Andrew, J. D. & Faubion, C. W. (Eds.), Rehabilitation services: An introduction for the human services professional (2nd ed.) (pp. 188-227). Linn Creek, MO: Aspen Professional Services.