Page 113 - Handbook of Electronic Assistive Technology

100 HANDBOOK OF ELECTRONIC ASSISTIVE TECHNOLOGY

Determining which outcome measure is most suitable in the context of AT is complex
because:
• Each outcome measure on its own cannot paint a full picture of AT outcomes due to
AT’s multidimensional characteristics.
• Incorporating outcomes in everyday practice can be time consuming for clinicians
and it appears that to gain a good understanding of AT outcomes a few measures may
be needed.
• The patient group that uses AT may have a combination of disabilities such as visual
and hearing impairment, physical impairment, cognitive processing and memory
issues along with communication barriers that make the use of these scales more
difficult and result in fatiguing them, making the implementation in routine practice
more difficult.

Other factors such as progressive conditions, delays due to funding and other obstacles
could have a significant impact on AT outcome measures.
To address some of these issues, Jutai et al. (2005) propose a new approach that they are
calling ‘Taxonomy of Assistive Technology Device Outcomes’. This is expected to accom-
modate the widest variety of AT applications, type, service, reflecting combination of user
population and context for use. In doing this they have identified three domains: effective-
ness, social significance and subjective well-being.
The advantage of this proposal is that it promotes consistency in the language used for
categorising AT outcomes. This will then potentially help make clear why one outcome
measure is chosen over others to assess the effect of a particular AT intervention.
As stated at the beginning there are strong reasons to use standardised outcome mea-
sures; however, it is important that they are:

• Easy to use in everyday practice.
• Not used as a reward or punishment-based system for commissioning purposes, i.e.,
payment by results. This is mostly because a direct comparison between benefits and
costs cannot be made easily when considering AT.
• In addition, they must clearly identify the impact of AT. This is complex in AT
provision due to the diversity in variables (e.g., different patient groups, types of
equipment and models of provision) and outcome being a multidimensional concept;
AT is often not provided in isolation and various services may be involved; and the
goals are client specific (Gelderblom and de Witte, 2002).

References

Bailey, R.W., 1989. Human Performance Engineering, second ed. Prentice Hall, Englewood Cliffs, NJ.
Bauer, S.M., Elsaesser, L.J., Arthanat, S., 2011. Assistive technology device classification based upon the
World Health Organization’s, International classification of functioning, disability and health (ICF).
Disability and Rehabilitation: Assistive Technology 6 (3), 243–259.