Assistive Technology Chapter 8

1. Assistive TechnologyChapter 8 By Christiaan Kier, BFA

2. Technology-Related Assistance for Individuals with Disabilities Act of 1988 Any item, piece of equipment, or product system, whether acquired commercially, off-the-shelf, modified, customized, that is used to increase, maintain or improve the functional capabilities of individuals with disabilities Broader definition The applications of science, engineering, and other disciplines that results in processes, methods, or inventions that support people with disabilities Definition of Assistive Technology (AT)

3. Why is AT Important? • A grabber can eliminate the need for a home assistant • Communication devices can allow a person to order food independently at a restaurant • A wheelchair allows active participation • Ability to be involved in recreation, work, education, or social activities have powerful effects because they allow the person to be fully participating members of society

4. Some AT devices are necessary to save a person’s life Kidney dialysis equipment Some AT devices are seen as a quality of life issue Wheelchair Why is AT important?

5. Background • Historical Perspective • Not a new concept • Tree-branch crutches • Artificial limbs • Wheelchairs

6. Rehabilitation Act of 1973 Rehabilitation Act Amendments of 1978 Rehabilitation Act Amendments of 1986 Technology-Related Assistance for Individuals with Disabilities Act of 1988 Americans with Disabilities Act (ADA) of 1990 Assistive Technology Act of 1998 Assistive Technology Act of 2004 (amendment of 1998) Federal Legislation

7. Technology-Related Assistance for Individuals with Disabilities Act of 1988 (Tech Act) To encourage the development and implementation of AT service delivery systems by awarding grant monies Spreading the word about potential power of AT Have greater control over their lives Participate in and contribute more fully to activities in their homes, school, and work environment and in the community Interact to a greater extent with non-disabled individuals Otherwise benefit from opportunities that are taken for granted by individuals who do not have a disability Federal Legislation

8. Assistive Technology Act of 1998 (AT Act) Capacity building services were continued: Community outreach Public awareness Advocacy Technical assistance Assistive Technology Act of 2004 (amendment) Mandating easier access Direct client services More funds are allocated Device loan Reutilization Demonstration Alternative financing Accountability Measurable goals Program evaluations Federal Legislation

9. Key Entities • Veterans Administration (VA) • Civil War • Injured soldiers needed services • WWI & WWII • Lead the way to disability related research • National Academy of Science collaborated with Surgeon General of the United States Armed Forces on artificial limbs. • First biomedical teams developed

10. National Institute on Disability and Rehabilitation Research (NIDRR) Formerly known as the National Institute of Handicapped Research Created in 1978 To establish and coordinate a comprehensive rehabilitation research network Rehabilitation Engineering Centers (RECs) / Rehabilitation Engineering Research Centers (RERCs) Rehabilitation Engineering is the application of engineering to improve the quality of life a person with the disablity through a team approach to rehabilitation Each center had a major area of research focus (Chapter 8, Table 1: Rehabilitation Engineering Research Centers) Key Entities

11. Rehabilitation Engineering & Assistive Technology Society of North America (RESNA) Mostly a technical organization, dominated by research, development, and engineering Also incorporated the delivery of assistive technology services as a key component in its overall agenda National Aeronautical and Space Administration (NASA) and National Science Foundation (NSF) Focused on hardware development Rechargeable cardiac pacemaker Key Entities

12. Principles • Involve the user • The user should always be the first source of information when considering technology • Access to Information • Access to information is key • Technology changed so rapidly that it is difficult to remain current • The Internet allows access for research • The KISS (Keep It Simple, Stupid) Principle • Take the simplest path; do not overcomplicate • Adaptability refers to the the flexibility • Normalization refers to how similar the device is to others around the AT user

13. Wheelchair does not fit under the table “normalization” Add blocks to elevate the table Table still looks like other work tables in office, just several inches higher KISS Principle

14. Principles • AT Needs are Fluid • Needs changes as much as technology changes • Individualized Process • Approach people as unique individuals • Example: motorized wheelchair vs. manual wheelchair • Focus on Functional Limitations Not Disability Type • Restrictions in the physical or mental functioning that limit a person’s ability to perform activities of daily living • Holistic Approach • What may work at home or hospital may not be good for work • Take account of all areas of the person’s life

15. Low-Tech Commonly basic, cheap, and readily available devices and equipment Easy to replace No training Manual wheelchair High-Tech Electrical or electronic and can be expensive Can be purchased off the shelf, specialized AT vendors, or custom-made Training, maintenance, repairs, and replacements costs are major factors Power wheelchair AT Devices

16. Categories of AT Devices • Aids for Daily Living • Architectural Accommodations • Cognitive Aids • Communication Aids • Computer • Controls • Mobility Aids • Prosthetics and Orthotics • Recreation • Seating & Positioning • Sensory Aids • Transportation • Vocational

17. AT Services • Services that assist a person with a disability in selecting, obtaining, and using AT devices • Positive match is the most important • Assessment and Evaluation • Ability to use a computer, augmented communication boards, modified controllers • Technical Assistance and Maintenance • Help in understanding purchasing or leasing options • Understanding the maintenance • If it is expensive, there is no back-up while in the repair shop • Customization • Either modify an existing device or to completely create a new one

18. Assistive Technology Match • The right match must occur to ensure increased functioning and independence • Human Activity Assistive Technology Model (HAAT) • Matching Person and Technology Model (MPT) • Psychosocial Impact of Assistive Devices Scale (PIADS)

19. The Technology Type, capabilities Performance Ease of use, reliability Durability Shelf-life, usability Availability Ease of purchase, training Cost Device, training, maintenance, repair, modifications Aesthetics Acceptable by user Environment Does it work in all environments? Easy to transport? Funding Source of funding for purchase and future repairs Institute on Rehabilitation Issues

20. Technological Abandonment (Non-Use) • Abandonment occurs when people do not feel it will improve their quality of life, psychological well-being, independence, self-esteem, sense of control, empowerment • Positive abandonment • No longer needed • Negative abandonment • Poor match • Too much energy • Unwanted attention

21. Technological Abandonment (Non-Use) • National Survey on Abandonment of Technology • 29% non-use • Other studies • Up to 70% non-use • In the first 3 months of use • Higher rate of non-use in recently acquired disability

22. AT Teams • Use of interdisciplinary teams in rehabilitation is a well-established practice • Person using AT • Family members who work with the person • Rehabilitation counselor, case manager, social worker • Physician or nurse • Physical therapist, occupational therapists, and speech therapists • Education: technology specialist, office for students with disabilities

23. Home House must be accessible in order to fully be a home Education Entitled to free and appropriate education in the least restrictive manner (mainstreaming) Work Identity and self-worth are often tied to what you do Past 5 years: unemployment rate is about 70%; college graduates is 40% Recreation Social isolation is the most damaging part of having a disability Children Participate with peers in recreational activities is vital Adults Paralympics and Special Olympics Positive attitudes in a society that is receptive to inclusion of people with disabilities Assistive Technology Settings

24. Funding • Lack of funding is second to inadequate information on AT • Three types of funding: • Individual pays • Credit/loan • Third party payers • Potential Funding Sources (Table III) • Public- medicaid, medicare, state-funded vocational rehabilitation services, special education, Veterans Administration, worker’s compensation • Private - private lenders, civic groups (kiwanis clubs, lions clubs), church groups, disability organizations

25. Current Trends • The future of assistive technology and its impact upon the lives of people with disabilities is very exciting • Computer chips will get smaller and cheaper and more powerful • Smart homes will require less human operations • Universal design = less modifications

26. Questions Reed, B. J., & Saladin, S. P. (2008). Assistive Technology. In Andrew, J. D. & Faubion, C. W. (Eds.), Rehabilitation services: An introduction for the human services professional (2nd ed.) (pp. 188-227). Linn Creek, MO: Aspen Professional Services.