Page 97 - Handbook of Electronic Assistive Technology

84 HANDBOOK OF ELECTRONIC ASSISTIVE TECHNOLOGY

The Nordic Centre for Rehabilitation Technology (NCRT) published a report in 2007
highlighting pressures or challenges that Nordic countries face. Many will be recognisable
to those working in the United Kingdom in an AT service:
• Growing public expenditure: This is due to an ageing population and an increase in
the rights of disabled people.
• Rapid changes in technology: While this opens up new opportunities, it can also
create new barriers against participation as it requires constant reconsideration.
• Coordinated working across agencies: The responsibility for the provision of AT lies
with different agencies and therefore coordination between them is key to its success.

In some instances, the model of provision of AT is incorporated into a model which
considers a broader spectrum of support systems. For example, in Denmark the deci-
sion on AT is based on an overall assessment by a case handler. Decision making takes
into account whether it is appropriate to provide personal assistance or not. Each area
or municipality runs its own warehouses of AT. However, there is an increasing tendency
for municipalities to lease their AT from the private sector. Each municipality covers the
cost of AT devices and consultations, and therefore there is no central, national purchas-
ing function. In addition, in the Danish model, users are expected to pay some costs for
the use of their equipment. For example, batteries for powered wheelchairs (NCRT, 2007).
In other countries, models work effectively across several statutory organisations, i.e.,
in Iceland there are a number of players from various sectors involved in the provision
of AT. Depending on the individual’s requirement the organisations involved may be the
rehabilitation sector, the health sector, schools, workplaces, as well as other services. It
is, however, the Social Security Administration’s Assistive Technology Centre that has the
greatest responsibility for disabled people living at home. The function of this is to ensure
that AT devices are provided for activities of daily living at home, driving, communication,
orthopaedics, disposable daily living items and medical-related AT such as medication
administration equipment (e.g., syringe pumps). The centre is responsible for all relevant
services such as consultation, case handling, recycling, maintenance, supply, procure-
ment and information for users (NCRT, 2007).
In Nordic countries those prescribing AT devices are usually occupational therapists,
physiotherapists, speech therapists and nurses. AT centres are consulted if those profes-
sionals do not feel adequately skilled to assess and prescribe. Users have a significant role
in their care plan and choice of AT devices.
The Assistive Technology Industry Association in the United States reports that an AT
team may include family doctors, teachers, speech-language pathologists, rehabilitation
engineers, occupational therapists and other specialists, including representatives from
companies that manufacture AT. The Rehabilitation Engineering and Assistive Technology
6
Society of North America provides training and accreditation in the provision of AT

6 https://www.resna.org/get-certified/atp/atp-0.