Biomedical Engineering Reference
In-Depth Information
that is easy to clean and maintain with nonchemical-based solutions to further minimize
any negative environmental impact of the assistive solution.
Considerations of sustainability during the EA process must focus not only on solutions
that are ecologically sound and environmental friendly but also on choosing solutions
that will meet the user's changing needs over a period of time, ideally a life span. For
example, consider the evolving needs of a student with gradually deteriorating vision who
is transitioning to college. In thinking about changing needs of this student over the life
span, a multidisciplinary team seeking an assistive solution would need to evaluate what
would be a better AT for this student: a computer with built-in screen magnification or a
computer installed with screen reading software. The final solution would depend on the
rate of vision decline and the extent to which alternative learning formats are supported
in the college environment.
A potential framework for guiding this “life-span” understanding of sustainability is
the evaluation guide for livable communities developed by the American Association
of Retired Persons (AARP) Public Policy Institute in the United States (2005). This frame-
work can be used to broadly evaluate the environment and its dynamic interaction with
life-span functional changes. Although it was created for aging populations living in
urban and suburban United States and would need to be adapted for other age groups and
cultures, it may be a useful resource for determining common environments of use and
evaluating these environments to meet the needs of users throughout the life span.
Although each of the three dimensions discussed earlier is individually useful in evalu-
ating the environment in the EA process, it is the intersection of accessibility, sustainabil-
ity, and UD that supports an ideal design solution to enhance the assistive solution for a
user. It is in this intersection that AT supports the individual user to fully participate in
life (accessibility), is seamlessly incorporated into the environment and useful to all users
(universal design), and has a low environmental impact (sustainability).
4.4.1 The eA Process: Step-by-Step Decision Making
The EA process offers a guide for the user and multidisciplinary team to effectively evalu-
ate and determine a best assistive solution for the user's needs. The evaluation of the envi-
ronmental dimensions of accessibility, UD, and sustainability, along with an assessment
of the user's needs and features of the proposed AT, occurs in step 1 of the EA process, as
indicated in Figure 4.3. It is at this step that an ATA occurs, the user's needs and desires
are assessed, and the environment is evaluated for its impact to support or obstruct full
participation for the user. In the assessment of the environment, the three dimensions
of accessibility, UD, and sustainability are explored for impediments and opportunities
within the environment.
Upon completing the environmental evaluation in step 1, if there is a match among
the environment, user, and AT (step 2), the assistive solution is achieved, the EA process
ends, and the evaluation is discussed by the multidisciplinary team and user in the ATA
process. If a match does not occur at this point in the EA process, possible modifications
may be made to the environment (step 3) or the user and multidisciplinary team may reas-
sess the interactions among the environment, user, and AT in a new matching process,
thereby determining the impact of this process on the user (step 4). At this point, options
to achieve the match are evaluated for the most effective and efficient assistive solution
(step 5). This solution may involve modifying the environment to achieve maximal acces-
sibility, sustainability, and/or UD (step 6); changing the AT to match the user's needs
(step 8); or making changes to both the environmental dimensions and AT (step 7). This
