Biomedical Engineering Reference
In-Depth Information
repositioning or supporting the person on performance before exploring assistive devices.
Similarly, an individual with limited experience using a keyboard may benefit from skills
training before looking to introduce an alternative access method.
Assistive technologies have long been considered an essential intervention strategy
by occupational therapists (Ostensjo et al. 2005). Traditionally viewed as an accommo-
dation for a loss of function, assistive devices were frequently prescribed by therapists
on the basis of the individual's impairment. For example, a manual wheelchair would
be recommended for someone with paraplegia because they could push the chair inde-
pendently, whereas a motorized wheelchair would be recommended for someone with
tetraplegia who was unable to use their arms to push. Little consideration would be
given to the various activities the person wanted to engage in or the range of envi-
ronments they sought to mobilize in. More recently, the enabling capacity of assistive
technologies has been recognized and devices are selected with the aim of optimiz-
ing activities and participation in all relevant environments. With the focus on what
the person needs to be able to do and where they need to do these activities, assistive
technologies are being designed and selected to meet the activity and environmental
demands. For example, the person with paraplegia, referred to previously, may need to
move quickly across a university campus between classes and would therefore prefer a
motorized chair so that they are not too exhausted from pushing a wheelchair to take
notes on their laptop.
Although occupational therapists (OTs) routinely use AT to assist individuals to opti-
mize their functional abilities, OTs also need to seek further training in AT and stay
abreast on current research on AT assessment and device outcomes. The field of AT is
ever changing with new technology devices added every year. In a study by Long and
colleagues (2007), investigating competency levels of OTs in the area of AT, therapists
were found to have decreased confidence in providing AT services in the educational set-
ting. They found that 68% of OTs surveyed lacked confidence in evaluating an individual
for AT device and service and 79% lacked confidence in selecting and matching AT to
the individual needs. Long and Perry (2008) did a similar survey with pediatric physical
therapists (PTs) and found that 62% of PTs surveyed lacked confidence in assessing an
individual for AT and 79% lacked confidence in matching and selecting a device to needs.
OTs are crucial members of the AT team because of their background in occupation per-
formance and motor development. They can provide information to the assessment on a
person's movement and function to access or position AT devices, identify key compo-
nents of the whole person that can contribute or hinder the use of AT access, and identify
functional performance skills and need matched to the specific features of the AT device.
There is a need for more AT training for OTs to build confidence in AT assessment and
delivery of services.
11.3 The Definition and Role of AT
AT is “an umbrella term for any device or system that allows individuals to perform
tasks they would otherwise be unable to do or increases the ease and safety with which
tasks can be performed” (World Health Organization 2004, p. 10). This definition rec-
ognizes both the physical device (hard technology) and the system
s
(soft technologies)
that enable a person to use that technology (Cook et al. 2007; Waldron and Layton 2008).
