Biomedical Engineering Reference
In-Depth Information
• Assume responsibility for task components that have proven too complex for an
individual to complete independently so that activities in which those compo-
nents are embedded can be successfully completed;
• Provide more comprehensive interactive guidance for tasks that are too dificult
for the user to initiate or perform, even with other types of modifications and
compensatory strategies; and
• Monitor the quality of the user's task performance so errors can be tracked and
the CST intervention subsequently modified in an attempt to reduce those errors
(Scherer et al. 2005).
Regardless of the sophistication of a device, the primary goal of CST interventions is to
improve the performance of functional activities that are critical components of life role
fulfillment and participation in community activities, that contribute substantially to sub-
jective well-being and quality of life, and that significantly reduce caregiver burden.
Important aspects of technology selection are knowing the settings in which they will be
used and addressing environmental factors and accommodations. Another key is AT service
delivery and how to best match a particular individual with the most appropriate technol-
ogy for his or her use. The following case study illustrates how this can be achieved.
A support selection model has been proposed that takes these factors into account
(Scherer 2012; Scherer et al. 2007). It is aligned with the Matching Person and Technology
(MPT) model, which is depicted in Figure 6.1.
The goal of the service delivery process is to achieve an optimal match of person and tech-
nology. This requires considerations in three domains: characteristics of the person, envi-
ronments of use, and aspects of the technology product. Getting to know any given person
requires a commitment to establishing rapport and exploring strengths, needs, and goals.
This is ideally done in partnership with a cognitive therapist. Five examples of key areas to
address are shown in the chart, but there are many others that could be added. Some key
considerations regarding the characteristics and resources of the individual person include
Functional needs: Does the person have the essential requisite skills to use the tech-
nology to maximal advantage? For example, do they have keyboard skills or the
requisite ability to read?
Lifestyle: How much will use of the support affect typical routines? How much
does that matter to the person?
Personal factors: What is the person's history of prior exposure to and experiences
with technologies (and other supports)?
Expectations/mood: What are the person's dreams and goals? When faced with
change, does the person generally approach it with a positive attitude, confidence,
and self-determination, or with confusion, helplessness, and/or dependence on
others?
Motivation and readiness: Does the person view technology (or other support) use
as a desirable means of achieving dreams and goals? Does the person perceive a
discrepancy between the current and desired situation?
Characteristics of the environments of use as well as of the selected technology itself are
the next key areas to address, followed by the cycle of support selection, use, evaluation,
and accommodation. Cognitive rehabilitation depends on consistency and the ability to
generalize across settings, which sometimes actually means retraining the same skills
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