Page 98 - Handbook of Electronic Assistive Technology

Chapter 4 • Assessment and Outcomes 85

devices. Successful applicants can then use the title Assistive Technology Practitioner with
specific competencies in analysing the needs of consumers with disabilities, assisting in
the selection of appropriate AT for the consumers’ needs and providing training in the use
of selected devices. In the United Kingdom, healthcare scientists when specialising in AT
complete a broader range of competencies to gain state registration as clinical scientists.
It is important that the personnel involved in delivering AT have the necessary
knowledge to prevent potential harm associated with incorrect assessment and fitting.
Appropriate services can have a substantial impact on the outcomes of using AT. Borg et al.
(2015) outline some of these impacts by stating that ‘for children it provides the means of
access to and participation in educational, social and recreational opportunities; empow-
ers greater physical and mental function and improved self-esteem; and reduces costs for
educational services and individual supports’.

Assessment Models

Assessment is part of the process of providing AT (Federici and Scherer, 2017). It is part
of an iterative cycle because the needs of a person change, for example, as they age, as
their lifestyle/circumstances change or as their disability changes. The literature indicates
that the quality of assessment impacts on the abandonment of technology. AT devices are
abandoned or disused for many reasons and sometimes AT abandonment is based on a
mismatch between the individual’s desires and/or needs. In other instances the individual
outgrows the capabilities of the device (Phillips and Zhao, 1993; Verza et al., 2006; Copley
and Ziviani, 2004). Therefore effective assessment and review are required to minimise
this risk.
Bernd et al. (2009) published a systematic literature review on published methodologies
on the selection and advisory process of AT. The results yielded just 16 papers within the
timeframe of interest, with nine of the papers being literature reviews and none contain-
ing experimental design. Their conclusion is that this is a poorly developed field resulting
in a lack of evidence-based procedures for AT selection.
In assessing for AT we are required to consider a range of factors, all of which influ-
ence successful provision of AT. Scherer et al. (2007) proposed an Assistive Technology
Device Framework which identified a model of factors influencing consumer predisposi-
tions and provider practices related to procuring/providing a particular AT device. This
work notes that the decision on whether a device is appropriate, desirable and supports
an individual is the result of a process ‘which is affected by a broader societal climate that
determines, in part, unique personal climates which then foster unique provider and con-
sumer perspectives predisposing each to the selection of a particular device’. The authors
consider a range of factors, which impacts on the provider and the consumer alongside
the assessment of objective need (e.g., the consumer cannot walk 50 feet on a smooth
surface) against subjective need (e.g., strong desire to independently move 50 feet on a
smooth surface).