Biomedical Engineering Reference
In-Depth Information
designers, researchers and prescribers, with the potential to create ever more
complex technology to address physical, cognitive, or sensory impairment
without the necessary consideration of the influence of technology on the
user's self-perception. Focus on device functionality may limit understanding
that the technology holds meaning to the consumer and significant others,
in other words, that technology is not neutral. Meaning is often a factor in
whether technology will be used or put into the closet. This chapter will ex-
plore various meanings that users ascribe to AT and the implications of these
meanings to the design, recommendation, selection and evaluation processes.
Two related constructs will guide this exploration: stigma and liminality.
Stigma was described by Goffman [
2
] as possession of an external charac-
teristic that discredits the individual. The presence of a physical impairment
becomes the source of a spoiled identity. He discusses the concept of “spread”
where the discrediting attribute attains a “master” status so that it defines
the individual, and all other personal accomplishments or attributes are ig-
nored. Stigma is context dependent; environments of various physical, social,
or institutional elements either reinforce or limit the perception of stigma.
Liminality is an anthropological term that conveys the notion of transition
and is often used to characterize the period of development of moving from
childhood to adolescence. It frequently involves a change of status, social
isolation, and/or physical removal of an individual. Liminality for a person
with disabilities has been described by Murphy [
7
] as feeling distant from
society, although not specifically excluded from it; as being between health
and illness. Murphy's 1990 topic
The Body Silent
describes his transition
from full participation in society as an academic anthropologist to living
with the physical abilities that resulted from a spinal cord tumor that caused
increasing paralysis. His account ably describes the experience of being and
becoming a person who has a disability [
10
].
These two constructs, stigma and liminality, are used to frame the dis-
cussion of the meaning of assistive technology for individuals who use it,
including the consumer and their families or other caregivers. They will be
applied to the following ideas to give context to results of various research
projects that included a component of the meaning that individuals ascribe
to the technology they use and to promote awareness in AT designers and
prescribers of why a device that is anticipated to be of benefit to the user in
their daily life is not embraced or is even discarded.
2.1 Source of the Data
The following ideas come from various research projects: a qualitative explo-
ration of how persons with disabilities chose to complete daily activities, a
phenomenological study of the lived experience of using AT when assisting
