Biomedical Engineering Reference
In-Depth Information
• A user-driven evaluation of how different environments support/hinder the user's
participation in various life activities with and without the recommended AT; and
• A determination of possible UD and sustainable strategies for adapting the envi-
ronment for optimal and flexible AT usage over the long term.
Under the auspices of these four criteria, we present and discuss an environmental assess-
ment (EA) (Üstün et al. 1997) process that provides a way of systematically choosing AT
that matches the user's needs while considering the three dimensions of the environment:
accessibility, UD, and sustainability. As an ongoing component of the ATA process, the
overall aim of this EA process is to help practitioners obtain the best possible match among
the user, AT, and environment to arrive at an assistive solution that will optimize user
participation and satisfaction in the context of use.
4.4 The Environmental Assessment Process: An Overview
As depicted in Figure 4.3, the EA process should ideally be carried out collaboratively
between the AT user and a multidisciplinary evaluation team within a center for technical
aid. Acknowledging that the environment is antecedent to the AT and crucial for deter-
mining the limits of AT use and functionality, the EA occurs at the beginning of the ATA
process, specifically during the user data collection phase. When a user arrives at a center
for technical aid seeking an assistive solution, the multidisciplinary team must initiate
a systematic process in which they, together with the user, reflect on the environment(s)
where the proposed AT will be used and evaluate each environment along the dimensions
of accessibility, sustainability, and UD.
When evaluating the environment for accessibility, the multidisciplinary team may ask
questions around what accessibility guidelines and mandates are operant at the national
and local levels that inform design and modification of buildings, facilities, and programs
for people with disabilities. Examples of such guidelines and mandates include the AADAG
in the United States and Build-for-All
in Europe, as described previously in this chapter.
The team may then discuss implications of these accessibility guidelines with the user dur-
ing the EA process. For example, a multidisciplinary team may use knowledge of physical
access laws when evaluating a workplace and seeking an assistive solution with a user who
has physical access needs. On the basis of the results of their evaluation, they might need
to collectively decide whether the workplace environment needs to be modified to sup-
port AT functioning, and consequently the user's productivity, and the extent and costs of
modifications required. A knowledge of local policies governing accessibility will also help
to determine whether the AT and environmental modifications will be publicly or privately
funded, a key factor in determining the feasibility of the proposed assistive solution.
UD is the second dimension to consider when collecting data for the EA process to arrive
at an assistive solution. UD represents an aim for the built environment to be both aestheti-
cally pleasing and usable to all (Mace et al. 1991). In evaluating the environment along this
dimension, it may be helpful to consider the seven principles of UD as identified by the
Center for Universal Design (1997):
1. Equitable use
2. Flexibility in use
