Biomedical Engineering Reference
In-Depth Information
Classification and Systems of Support for People with Intellectual and Developmental Disabilities
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edited by the AAIDD, a tool that allows the theoretical definition of the support-based
model to be translated into practice. The support-based model is conceptually compatible
with the ICF (Schalock et al. 2010). The ICF domains of body functions (impaired intel-
lectual functioning) and activities (limitations in adaptive behavior) directly relate to the
AAIDD definition of intellectual disability. In the two systems, the person is considered as
a whole within the context of the person's capacities and the expectations and supportive
resources of the environment. The major difference is that the ICF is a general model of
disability, whereas the AAIDD system is specific to intellectual disability. SIS consists of
three sections that measure the pattern and intensity of support in six life activity domains
(home living, community living, lifelong learning, employment, health and safety, and
social activities), in protection and advocacy activities, and in 16 exceptional medical con-
ditions and 13 challenging behaviors. In total, 57 various life activities are measured. The
tool is administered as a
semistructured interview with the user/client and at least other
two people who preferably live with the user/client, such as a parent and/or a caregiver.
Any other respondents should have observed the person in one or more environments for
a substantial period of time. The scale ranks each activity according to frequency, amount,
and type of support. Finally, a support intensity level is determined based on the total sup-
port needs index, which is a standard score generated from the scores for all items tested
by the scale.
2.3.1
Outcome Analysis Tools
The main goal of the multidisciplinary team, after AT provision, is to measure and con-
stantly monitor the effectiveness, efficiency, and safety (appropriateness) of the AT-user/
client match to (1) provide support to the user/client, (2) guarantee his or her greatest level
of autonomy over time, and (3) justify the resources used. The “efficacy of an assistive tech-
nology device is determined by the effect resulting from its use in comparison to the effect
claimed beforehand.” (Gelderblom and de Witte 2002)
To explain the reasons why an AT is used, disused, or abandoned; to verify the evolu-
tion over time of the assistive solution; and, moreover, to create and improve intervention
programs for the rehabilitation field, it is necessary to identify and analyze the source of
the user's satisfaction/dissatisfaction and comfort/discomfort. In general, the analysis
of results obtained by the matching process is fundamental for choosing the best solu-
tion if any problem occurs during the evaluation process.
Over the last few years, some tools aimed at measuring the outcome of aids have been
designed. However, the corresponding research field is growing slowly and the tools cur-
rently being used do not analyze every aspect of the AT matching process because they are
only able to investigate some of the dimensions correlated with the quality of life (e.g., sat-
isfaction, comfort, etc.). Among the most frequently used measuring tools we can include
the MPT model (Scherer 1998; Scherer and Craddock 2002) and COPM (Law et al. 1990,
2005).
The QUEST questionnaire (Demers et al. 2002) measures the user/client's satisfaction
with the use of AT. It can be administered to adolescents, adults, and elderly people with
physical or sensory disabilities. The theoretical background of the instrument is the MPT
model (Scherer 1998). Several years of implementation and research have confirmed its
psychometric reliability and validity as an outcome measure of the user/client's satisfac-
tion about the assigned AT. The QUEST does not evaluate the performance of the user
with a device but rather measures his or her satisfaction with the features of the device as
