Page 101 - Handbook of Electronic Assistive Technology

88 HANDBOOK OF ELECTRONIC ASSISTIVE TECHNOLOGY

Similarly, physical skills can change. A person’s physical ability (i.e., control of head,
arms and hands) may be optimised when in a highly supportive seating system. When out
of the seat (e.g., lying in bed, sitting in a sofa) these skills change due to the decrease in
postural support and so type of access may need to change. In considering AT for the role
of supporting communication we need to ensure that we consider all of these settings and
be assured we understand from the user these contexts, activities and abilities/skills to
ensure the client can communicate optimally.
A further consideration is whether the activity or function is appropriately matched
to the person’s cognitive skill set, i.e., is the activity proposed and enabled by this tech-
nology appropriate to the developmental or cognitive level of understanding of the user?
The chapter on cognition supports the decision-making process regarding when and what
technologies might be appropriately used. The client must be able to learn how to use the
device and remember how to use the equipment; be able to find the actions they want in a
timely manner; and be able to proactively use the device without another person prompt-
ing use if it is to fulfil its purpose of increasing independence and function.

The Assessment Team

The provision and therefore the assessment for EAT is ideally a multidisciplinary process.
Professions such as occupational therapists, speech and language therapists, physiothera-
pists, doctors and engineers take part in EAT service delivery and all have a role to play.
In the United Kingdom some professions play different roles in different settings (e.g., in
some services a physiotherapist will lead on powered mobility, seating and posture and in
others occupational therapists or engineers will lead).
The latest NHS England Complex Disability Equipment service specification outlined
8
the professional groups required to be available to prescribe EAT. This included thera-
pists, clinical scientists, technicians, as well as other ad hoc members of the team.
Other professionals’ advice is also often required to provide the optimum solution (e.g.,
audiologist, ophthalmologist, psychologist, teacher, orthopaedic surgeon).
It may be that all these team members are not readily available, and you may have to
engage with other services to find the answers to the questions you have or refer your client
on to other services to fully inform the EAT decision-making process. An example would
be having input from a speech and language therapist to determine safe seating positions
for eating and drinking when considering use of a powered chair for the first time.
In places where the delivery of AT is not well developed, some of these professionals
may be unclear on their role in this process. You will therefore need to be clear why you are
seeking their advice and what you are trying to achieve in your assessment and provision
process.

8 https://www.england.nhs.uk/commissioning/wp-content/uploads/sites/12/2016/03/aac-serv-spec-
jan-2016.pdf.