Biomedical Engineering Reference
In-Depth Information
With the biopsychosocial approach and the ICF framework as a foundation, the totality of
cognitive, emotional/behavioral, and psychosocial functioning of the individual is consid-
ered when planning interventions. Testing and measurement are imperative to obtaining
this understanding. Once an individual with a new cognitive disability is medically sta-
bilized, rehabilitation can begin. True to the biopsychosocial model, rehabilitation encom-
passes not only the cognitive therapy provided but the consideration of supports for the
person's functioning, community living, and social participation.
It has been shown that comprehensive rehabilitation that integrates interventions for cog-
nitive, interpersonal, and functional skills yields greater improvements in self-regulation
of cognitive and emotional processes, community integration, employment, and quality of
life compared with standard discipline-specific neurorehabilitation treatment (High et al.
2005; Hart 2010) and it has been shown to be effective (Cicerone et al. 2000, 2004, 2005,
2011; Tsaousides and Gordon 2009; Altman et al. 2010). The goal of cognitive rehabilitation
is to increase the individual's functioning, adaptation, and quality of life by reinforcing,
strengthening, or re-establishing previous learned patterns of behavior and establishing
new patterns through compensatory mechanisms.
Problems with memory, conceptualizing, planning, and sequencing thoughts and
actions; a lack of concentration, increased anxiety, and irritability; and difficulty inter-
preting subtle social cues and understanding numbers and symbols are common, as
are visual, auditory, and/or vestibular deficits, balance problems, and loss of coordina-
tion. Thus, cognitive rehabilitation addresses memory retraining and problem-solving
as well as enhanced self-awareness; compensation and coping; social skills; emotional
self-regulation; participation in social, work, and leisure activities; health maintenance;
and personal care. Personal assistance and support from technologies as well as envi-
ronmental restructuring and the use of cognitive and behavioral strategies are all impor-
tant resources.
6.5 Assistive and Cognitive Support Technologies
The ICF is in line with the UN Convention on the Rights of Persons with Disabilities (2006)
in recognizing the importance of assistive technology (AT) devices and products for an
individual's functioning, performance of activities, and successful participation in desired
life roles and situations (Bickenbach 2009).
The World Health Organization recognizes that the ICF does not contain the depth
and detail needed by those who specialize in the design, manufacture, distribution, and
provision of AT devices. Therefore, in 2003, the ISO 9999 (Assistive Products for Persons
with Disability—Classification and Terminology) was accepted as a related member of
the WHO Family of International Classifications (WHO-FIC). ISO 9999 is a product of the
International Organization for Standardization (ISO 2007) and is an international classi-
fication of assistive products in which all products that can be used by persons with dis-
abilities are included. As presented by Heerkens et al. (2010), the definition of an assistive
product in the fifth edition of ISO 9999 is
Any product (including devices, equipment, instruments and software), especially pro-
duced or generally available, used by or for persons with disability
