Biomedical Engineering Reference
In-Depth Information
were traditionally designed to allow people with injuries and health conditions to mobi-
lize on flat surfaces from one location to another. Today, our understanding of where and
how people move within a community and the value of being at eye level with others has
resulted in a number of features being incorporated into the design of wheelchairs that has
substantially contributed to the wheelchair user's ability to actively participate in society.
Similarly, a thorough understanding of the environments in which the person wishes
to participate now and in the near future also provides a richer and more accurate appre-
ciation of the technology requirements (Bain and Leger 1997; Cook et al. 2007). Because
OTs seek to extend rather than confine the AT user's participation, they seek to ensure
that the technology can operate in and move between as many environments as possible.
The potential demands of the environment, likely to affect technology, typically include
the physical aspects (i.e., the topography, temperature, climate, sound, and lighting con-
ditions) (Bain and Leger 1997; Cook et al. 2007), the milieu or psychological, social, and
cultural aspects of the application environment (Scherer 2000; Cook et al. 2007). The tech-
nology also needs to work well with other technologies in the environment. The aesthetic
appeal of the technology and its impact on other's perception of the user is increasingly
being recognized as a critical consideration.
Once the requirements are clearly articulated, the device criteria/characteristics can be
established (Bain and Leger 1997; Kelker and Holt 2000; Alliance for Technology Access
2005). The user's goals determine the nature of technology, whereas their preferences
influence the style of device. A user's experience with technology often dictates the level
of sophistication, whereas their skills and abilities would determine the interfaces and
programming requirements. The range of activities and tasks dictates the specific features
and functions required of the technology system(s) whereas the range of application envi-
ronments determines the characteristics required of the technology to ensure it can man-
age and be managed in the application environments.
With an ever-expanding range of mainstream and specialized technologies available,
it is increasingly difficult to distinguish between them (Alliance for Technology Access
2005). Therapists work with the AT user and other team members to develop a good under-
standing of the range of devices available and the features and characteristics that are best
suited to the user, the activities he or she wishes to engage in, and the environments where
the technology is to be used. During this stage it is imperative to trial the device and allow
the user to review the aesthetics, comfort, and usability of the device. The trial further
affords the user, the therapist, and other team members an opportunity to evaluate how
each device meets the criteria and discuss the relative merits of each option (Scherer and
Galvin 1996; Bain and Leger 1997; Sprigle and Abdelhamied 1998; Alliance for Technology
Access 2005; Cook et al. 2007).
Therapists also assist the user to explore funding sources and navigate the adminis-
trative processes to secure the appropriate technology. Once the best device is selected
(Nochajski and Oddo 1995; Alliance for Technology Access 2005), it is then purchased
(Cook et al. 2007). Although many consider the purchase of the device to be the end of the
process, for the AT user, there are an important number of stages they need to continue to
manage.
After the device is purchased, it may need to be fitted to the specific requirements of
the user (Nochajski and Oddo 1995; Scherer and Galvin 1996; Bain and Leger 1997; Kelker
and Holt 2000; Alliance for Technology Access 2005; Cook et al. 2007) and set up by some-
one with appropriate expertise (Scherer and Galvin 1996; Cook et al. 2007) to ensure it
is operating as intended and is integrated with other technologies (Nochajski and Oddo
1995). Many devices require further customization after purchase to ensure the device