Page 99 - Handbook of Electronic Assistive Technology

86 HANDBOOK OF ELECTRONIC ASSISTIVE TECHNOLOGY

Federici et al. (2014) propose an ideal model for the Assistive Technology Assessment
Process that can be viewed from the perspective of the user or the AT service. In this model
the prescriber’s recommendations can be a combination of solutions, including physical
devices, care/support and environmental interventions. While this book focuses on dif-
ferent types of technology it needs to be acknowledged that these alone are not always
enough for many of the clients seen in AT services, but part of an array of structures/
supports they might have in place in their lives, enabling their participation in activities.
These other structures might include support workers physically aiding them, task adap-
tion such as an adapted school curriculum appropriate to the student’s needs or other
devices which meet some but not all the needs required for the activity of interest.
Federici et al. (2014) report that the ‘provision process’ is a user-driven process and any
activity of the AT service must find an equivalence to a user action and vice versa. They
propose that the user actions can be put into three phases:
1� The user seeks a solution for one or more forms of activity limitation or participation
restriction by seeking assistance from a centre for AT.
2� The user checks the solution and tries to check aids provided by the professionals in a
suitable evaluation setting.
3� The user adopts the solution after obtaining the assistive devices from the service,
etc., receives training for the daily use of AT and receives follow-up.

Therefore the provision of AT is not a one-off exercise but a loop. Each circuit of the
loop requires reconsideration of factors to ensure that the solution proposed contin-
ues to best meet the clients’ needs. Ideally, the provision process should consider the
needs of the individual at the time of assessment as well as looking forward. That is to
be aware of what changes might occur and could give rise to additional support being
required. For example, when assessing someone with a condition such as motor neu-
ron disease for AT, the assessor will also need to take into account the client’s rapidly
changing needs by putting in place equipment which may be adapted quickly to meet
the likely future requirements. If working with children, the child’s developmental needs
should be considered. For example, if providing a powered wheelchair, the requirements
of a 5-year-old child born with quadriplegic cerebral palsy who has never experienced
mobility will be different to those of an adult with an acquired spinal injury. The adult
will have knowledge and experience of movement, of being able to identify an object
and experience getting that object, whereas a child with complex needs may not have
experienced this and may have lived with others anticipating their needs. They will need
time to learn about the chair and have the opportunity to play and experience using
it, supported by others around them to ensure safety; they will then begin to develop
an understanding of how they can use the chair to move with purpose and accuracy.
Different access methods may need to be trialled. The adult with a spinal injury will
equally need support and advice to adapt and effectively use their wheelchair; however,
the task of developing their skills will be different.