Page 186 - Handbook of Electronic Assistive Technology

174 HANDBOOK OF ELECTRONIC ASSISTIVE TECHNOLOGY

Assessment for EC Provision

In the majority of countries with widespread provision of EC, along with other AT, the
process includes an assessment by experienced practitioners with specialist skills and
knowledge. In the United Kingdom this role is usually undertaken by clinical scientists,
specialist occupational therapists and rehabilitation physicians, who form part of a mul-
tidisciplinary team, which typically also includes clinical technologists, technicians and
rehabilitation assistants.
The assessment may be undertaken based on a variety of conceptual models (Preston
and Edmans, 2016) and utilising established intervention processes. Adopting such a sys-
tematic approach has been shown to improve the outcomes (Desideri et al., 2013).
The assessment incorporates consideration of a range of factors or domains which
influence the prescription choice for that individual. It identifies the needs and goals for
EC prescription and explores how these may be met. Measurable goals established by or
with the user can form part of a rehabilitation plan and be used to evaluate the provision of
the equipment and its configuration or customisation for the user (Dahlberg et al., 2014).
The assessment may also identify the need for other AT and the potential for linking
between devices of different functions, but sharing a common means of access. This may
also result in the option of an integrated system such as for EC with augmentative and
alternative communication and/or wheelchair control, as described in Chapter 10.

Assessment Domains for EC Provision
The domains covered in the assessment typically include the following.
Patient related:
• Medical diagnosis, comorbidities, prognosis, rate and manner of change, relevant
medications and interventions by other health services.
• Functional movement and capabilities (especially upper limbs and hand function),
including levels of coordination, tone and fatigue – primarily to identify the means of
access for EC.
• Sensory abilities, vision, hearing, sensation (especially of the hands).
• Patient understanding: This will include some evaluation of cognitive and memory
function as well as learning more about the patient’s understanding of technology and
their capacity to learn new information and patterns of activity.
• Communication abilities and methods (including any barriers).
• Physiological and emotional well-being, including the motivation to make use of EC
equipment independently and in a sustained manner.
• Patient goals: Establishing what the patient wants to achieve with the EC system
provision, identifying measurable goals and prioritising these if necessary.

Social situation:
• Social circumstances and interactions – coresidents, pattern of carer support and
availability of support for set-up of EC equipment if required.