Biomedical Engineering Reference
In-Depth Information
There is another big issue in giving such importance to the user/client's subjective per-
spective in measurement. As Brown and Gordon claimed,
Measurement and assessment, occurring within both research and clinical service
contexts, typically involve an imbalance of power between professionals and persons
with disabilities. Power is evidenced in who controls decisions about measurement and
whose perspective—the subjective values of the measured person or the objective or
normative values of the measurer—is given primacy. (2004, p. S13)
The imbalance of power “can affect the 'something important' that is at stake in measure-
ment because the failure to share power can produce less useful measures” (Brown and
Gordon 2004, p. S13). Ordinarily, the imbalance is determined in the selection, use, and
interpretation of measures that usually incorporate the preferences and perspectives of the
professionals but not of the user/client.
In this context, the person who is measured can have very different positions on many
aspects of functioning with regard to the person who measures. For example, the person who
is measured “may agree that income is important to his or her QOL but disagree with the soci-
etal or normative assumption that a higher income is better” (Brown and Gordon 2004, p. S14).
The point being questioned is the professional-user/client relationship. The ATA process
can amplify the relationship's imbalance because the presence of a multidisciplinary team,
in which each professional carries out his or her values and preferences, exponentially
increases the shadow over the disabled person's point of view. Such a risk can be avoided
by adopting a user-driven approach or person-centered planning (Menchetti and Sweeney
1995; Holburn and Vietze 2002; Schalock and Alonso 2002; Steiner et al. 2002; Gzil et al.
2007; Leplege et al. 2007), which places the disabled “at the center of a planning effort, often
including a planning group (or circle) comprised of service professionals, family members,
and people from the community” (Brown and Gordon 2004, p. S14).
From a professional point of view, namely from this handbook's perspective, a central
role in the empowerment of who is measured is played by the psychologist as an expert in
human relationships. The psychologist not only administers measures and interprets test
results but also plays a key role in both counterbalancing the professional-disabled rela-
tionship by paying attention to the powerless at each stage of the assessment process and
makes easier connections among the different perspectives of the team of professionals.
2.2 How to Measure Individual Functioning
The purpose of this handbook is not to precisely define a default set of measurement tools
that would contradict what we wrote in the previous section. We take responsibility for
both pointing out some guiding principles for choosing and applying a set of measures
and for suggesting some tools which, together, we believe fit these principles.
2.2.1
guidelines for Measurement and Assessment
The guiding principles are
• The ultimate purpose of the ATA process is the enhancement of the subjective
well-being and the QOL of the user/client through the best match with an assis-
tive solution.
