Biomedical Engineering Reference
In-Depth Information
and across a number of environments and each environment, whilst offering oppor-
tunities for participation, have physical, social, and cultural dimensions, which can
provide additional challenges. Because circumstances rarely remain constant, the tem-
poral aspect of the environment is also recognized as being important when selecting
and using assistive technologies because the person's past experience with technology
and their expectations for the future can have can also define their technology prefer-
ences and requirements. Increasingly, the virtual world of the Internet is an environ-
ment that people need to be able to operate in and it holds particular opportunities
for people who have difficulty navigating and participating in the natural and built
environments.
This transactive view of the person, activities, and the environment is supported by a
number of occupational therapy models including the Person-Environment-Occupation
model (Law et al. 1996) and the Person Environment Occupation Performance (PEOP)
model (Christiansen and Baum 1997) and aligns well with assistive technology (AT) mod-
els such as the Human Activities and Assistive Technology (HAAT) model (Cook et al.
2002) and the Matching Person and Technology (MPT) model (Scherer 2005) as well as
the International Classification of Functioning, Disability, and Health (ICF) (WHO 2001).
Although the terminology and emphasis varies, the primary focus of each of these models
is on optimizing activity and participation. Each model also recognizes the dynamic and
reciprocal interaction among the person, activity, and the environment. All are founded
on the notion of “goodness of fit,” or match between the person's skills and abilities and
the occupational and environmental affordances and demands. The models also reflect
the values of the disability movement, in which the environment is viewed as an agent in
creating disability and value (Brown 2009).
Given the complexity of each person's situation, occupational therapists use a client-
centered approach in which each person's unique perspective is recognized and valued.
Individuals are viewed as having distinctive personal attributes, capacities, and life expe-
riences that influence their priorities and preferences. Evaluation methods focus on iden-
tifying the AT user's goals and specific concerns about the activities they seek to engage
in and the environments where these are to be undertaken. Informal and standardized
evaluation strategies are selected to ensure
•
Occupational performance issues or problems are identified by the AT user and
his or her family,
•
The unique nature of each person's participation in occupations is recognized,
•
Opportunities for both the subjective experience and the observable qualities of
occupational performance are recorded,
•
AT users (and relevant others) have a say in how the outcomes are evaluated,
•
The unique qualities of the application environments are recognized, and
•
AT users and their family are actively engaged throughout the process and
afforded the opportunity to understand the perspective and concerns of each
stakeholder involved in the process (Law and Baum 2005).
Once the individual's situation has been fully examined and articulated, occupational
therapists then use and balance the art and science to creatively yet systematically address
his or her specific goals.
