A Model for Developing and Prescribing Assistive Technology Devices

1. A Model for Developing and Prescribing Assistive Technology Devices Mary Ellen Buning, PhD, OTR/L, ATP Jue Wang, PhD University of Pittsburgh Rehabilitation Science & Technology Department School of Health and Rehabilitation Sciences

2. The Important Question Where do rehabilitation professionals begin to understand the application of assistive technology? • A model is a helpful place to begin Rehabilitation Science & Technology Department School of Health and Rehabilitation Sciences

3. The Institute of Medicine Model • In this model, the person with the impairment is the focus. • The person must always be considered in the context of “environment.” • The environment is a mat. • Environment is both physical and social. Rehabilitation Science & Technology Department School of Health and Rehabilitation Sciences

4. For most people the environment supports or allows people to perform functional activities like self-care, work, and care of others. The Institute of Medicine Model Rehabilitation Science & Technology Department School of Health and Rehabilitation Sciences

5. The Institute of Medicine Model • When impairment occurs it is difficult or impossible to perform functional activities. • Functional limitation causes: • Inability to care for self or others • Inability to contribute to society • Feelings of failure and shame • Low quality of life Rehabilitation Science & Technology Department School of Health and Rehabilitation Sciences

6. The Institute of Medicine Model • The goal of rehabilitation is to reduce the effects of the impairment leading to permanent disability. • If we want people to function we change the environment to • Enable performance • Support adaptation • Facilitate independence Rehabilitation Science & Technology Department School of Health and Rehabilitation Sciences

7. When impairment is severe, it causes the person to sink deeply into the environmental mat causing great restriction. The mat must offer greater resilience to offset the effects of the impairment. Disability Requires a More Resilient Environment Rehabilitation Science & Technology Department School of Health and Rehabilitation Sciences

8. Assistive Technology Modifies the Environment • AT makes the “Environmental Mat” more resilient by: • Providing a device that substitutes for a missing performance skill • Modifying a tool • Removing physical barriers to buildings and programs • Modifying instruction • Integrating AT solutions into personal care, home management, education, and employment. Rehabilitation Science & Technology Department School of Health and Rehabilitation Sciences

9. Wheelchairs: compensate for paralysis, weakness or in-coordination • Participating in sports, attending school are possible with a wheelchair that has features that meet the needs of the user and the tasks they are trying to perform. Rehabilitation Science & Technology Department School of Health and Rehabilitation Sciences

10. Wheelchairs: Access to community • Employment and active participation in the community are possible with a wheelchairs and environments that allow entrance and ease of movement to wheelchair users. Rehabilitation Science & Technology Department School of Health and Rehabilitation Sciences

11. Artificial limbs: restore function • This grandmother’s prosthesis has a sensors that detect the amount of grip strength needed. This man’s right prosthesis returns him to two-handed activities and back to employment. Rehabilitation Science & Technology Department School of Health and Rehabilitation Sciences

12. Augmentative Communication Devices: compensate for loss of voice • When speech is lost or fails to develop, voice output communication devices based on microprocessors and speech digitization make participation, communication, learning, and full language development possible. Rehabilitation Science & Technology Department School of Health and Rehabilitation Sciences

13. Adaptive Computer Access • Blindness, paralysis, in-coordination, and weakness do not prevent computer use. • Adaptations allow computers to be used for education, communication, employment, management and recreation. Rehabilitation Science & Technology Department School of Health and Rehabilitation Sciences

14. Accessible Environments • Environments that offer entry, freedom of movement, and safety give another method to overcome the effects of impairment. Rehabilitation Science & Technology Department School of Health and Rehabilitation Sciences

15. How do you know which solutions are best for a particular person? • Ask the person what they want to accomplish. • Each person has talents, interests, and wishes for the future. • Each has a desire for meaningful role in society. • For example: ask two women about their future • one will desire to be a mother • another will desire to be an engineer • Both roles are important to society • Assistive Technology help both women. Rehabilitation Science & Technology Department School of Health and Rehabilitation Sciences

16. Match with the needs of the person who has an impairment. Use current rehabilitation technology expertise. Are adapted to the topography, climate and culture. Help a culture grow in understanding and acceptance of persons with disability as they become included in society. Assistive Technology Products and Services Rehabilitation Science & Technology Department School of Health and Rehabilitation Sciences