Biomedical Engineering Reference
In-Depth Information
is adjusted to the specific requirements of the user when undertaking various tasks in
a range of environments. The ongoing effectiveness of technology is dependent on the
comfort and ease of the user when using the device for extended periods of time. Recently,
research has raised concerns about the amount of pain and discomfort technology users
experience and the long-term implications of this pain (Cowan and Turner-Smith 1999;
Patterson et al. 2002). Technology interventions need to be adjusted to ensure that use does
not result in discomfort and strain (Scherer and Vitaliti 1997).
Training in use of the device is also fundamental to the ongoing effectiveness of tech-
nology interventions (Nochajski and Oddo 1995; Kelker and Holt 2000; Cook et al. 2007).
Without adequate training, the technology is likely to be abandoned (Cook et al. 2007). OTs,
who are often responsible for training, ensure the effectiveness of this stage by establish-
ing well-defined objectives (Cook et al. 2007). AT users need to develop both “operational
and strategies competence” (Cook et al. 2007) for successful AT use. Operational compe-
tence ensures that the user is able to turn the device on and off, adjust the various features,
understands the maintenance requirements, and can troubleshoot problems. “Strategies
competence (Cook et al. 2007) enables the user to use the device to perform specific tasks.
Although operational training can be provided soon after delivery, strategic training is
most effective in situ (Nochajski and Oddo 1995) when the user can develop skills in using
the device to complete activities in the application environment(s). AT users also need to
know how to maintain the device and who to contact when it is in need of repair (Kelker
and Holt 2000).
Periodic reevaluation is required because there are likely to be ongoing changes in terms
of the user's skills and abilities, the activities they wish to engage in, and the application
environments that will affect the effectiveness of the acquired technology. Scherer (2005)
identified possible factors that were associated with nonuse of AT in adults with disabili-
ties included unrealistic expectations, inappropriate needs assessment, poor device selec-
tion, lack of support from caregivers, changes in person's abilities, or any combination.
These findings indicate the importance of reassessment and need for follow-up of AT to
ensure that the AT solutions are effective and decrease the potential for AT abandonment.
Further, as technologies continue to improve, the user may benefit from technological
developments. Ongoing monitoring of the effectiveness of the technology and develop-
ments in the design of devices ensures that technology interventions are replaced and
upgraded as required.
11.5 Overview of the Process Involved in Selecting
and Using AT Case Studies
The case studies will use the PEO (Person, Environment, Occupation) format used by OTs
in practice.
11.5.1 Case Study number 1: ZA
11.5.1.1 Person
ZA is a 21-month-old female toddler who presents with neurological delays secondary
to hypoxic-ischemic encephalopathy. She has a diagnosis of congenital quadriplegia and
