Biomedical Engineering Reference
In-Depth Information
The process generally begins with someone envisioning doing something or anticipating
the potential of technology (Alliance for Technology Access 2005). Some people come to
the process with this vision, but this vision often evolves slowly throughout the process.
Consequently, service providers need to embrace people's visions of what they want to be
able to do and provide them with information on technologies that can enable them to real-
ize these visions. For those who have not yet developed a vision, the OT works with them
to imagine what might be possible by exploring the technology and introducing them to AT
users who are using technology to achieve their goals (Baum 1998).
Once a vision has been created and the person's need and desire for technology have
been identified, the potential of technology can be explored (Scherer and Galvin 1996). At
this stage the therapist gathers information about the person's preferences, past experi-
ences, and expectations of technology and examines if they are open to the use of technol-
ogy and able to manage it. Further, the capacity of the application environment(s) to accept
and support the technology is considered (Scherer and Galvin 1996). Although some AT
users can have very clear and specific goals (Sprigle and Abdelhamied 1998) others require
further assistance to develop and articulate their goals (Scherer 2000). Therapists often col-
laborate with other stakeholders (e.g., family, teachers, therapists, or employers) to develop
specific goals and expectations if the AT user is uncertain or unable to articulate their
gaols (Nochajski and Oddo 1995; Scherer and Galvin, 1996; Sprigle and Abdelhamied 1998;
Cook et al. 2007).
Therapists commonly use informal interviews to develop an understanding of a person's
goals; however, structured processes offered by tools such as the Canadian Occupational
Performance Measure (COPM) (Law et al. 1994) can assist in developing an understand-
ing of the person's current performance and priorities. This and similar tools such as
Goal Attainment Scaling (GAS) (Malec 1999) and the Individualized Prioritised Problem
Assessment (IPPA) (Wessels et al. 2002) also provide a mechanism for evaluating the effec-
tiveness of the technology in addressing the person's goals. The MPT assessment process,
specifically designed to examine a person's technology needs, has dedicated forms that
provide a structure for exploring goals, preferences, and the person's view of technology
(Scherer 2000). Once the person's overall goals have been determined, the specific require-
ments can be detailed.
The next stage of the process focuses on establishing the user's specific requirements
(Bain and Leger 1997; Sprigle and Abdelhamied 1998; Kelker and Holt 2000; Cook et al.
2007). A clear understanding of the user's requirements is essential to identifying the best
technology (Sprigle and Abdelhamied 1998). Therapists have traditionally focussed on
anthropometric data such as the person's age, size, weight, etc. (Sprigle and Abdelhamied
1998) to determine the appropriate dimensions of the device. Further, the person's specific
skills and abilities have been evaluated (Bain and Leger 1997; Sprigle and Abdelhamied,
1998; Cook et al. 2007). Many AT users with established impairments are able to provide a
reliable report of their functional capacities that would be sufficient to enable the service
provider to identify the type of technology options to explore without the need for further
assessment. However, it is often more useful to examine the person's ability to access and
use the technology to develop a clear understanding of the user's actual abilities because
it is not always possible to predict how well someone will manage a piece of technology.
When establishing user's requirements, it is also necessary to define the requirements
of the activity/activities to be undertaken. Valued activities identified by the AT user are
examined in detail to understand how they want to engage in these activities and all of the
tasks involved in full participation. By defining discrete tasks, the barriers to participation
and performance can be examined for all aspects of the activity. For example, wheelchairs
