Rehabilitation Science & Technology Department School of Health and Rehabilitation Sciences A Model for Developing and Prescribing Assistive Technology Devices Mary Ellen Buning, PhD, OTR/L, ATP Jue Wang, PhD University of Pittsburgh

Rehabilitation Science & Technology Department School of Health and Rehabilitation Sciences The Important Question Where do rehabilitation professionals begin to understand the application of assistive technology? –A model is a helpful place to begin

Rehabilitation Science & Technology Department School of Health and Rehabilitation Sciences The Institute of Medicine Model In this model, the person with the impairment is the focus.In this model, the person with the impairment is the focus. The person must always be considered in the context of “environment.”The person must always be considered in the context of “environment.” The environment is a mat.The environment is a mat. Environment is both physical and social.Environment is both physical and social.

Rehabilitation Science & Technology Department School of Health and Rehabilitation Sciences The Institute of Medicine Model For most people the environment supports or allows people to perform functional activities like self-care, work, and care of others.For most people the environment supports or allows people to perform functional activities like self-care, work, and care of others.

Rehabilitation Science & Technology Department School of Health and Rehabilitation Sciences The Institute of Medicine Model When impairment occurs it is difficult or impossible to perform functional activities.When impairment occurs it is difficult or impossible to perform functional activities. Functional limitation causes:Functional limitation causes: –Inability to care for self or others –Inability to contribute to society –Feelings of failure and shame –Low quality of life

Rehabilitation Science & Technology Department School of Health and Rehabilitation Sciences The Institute of Medicine Model The goal of rehabilitation is to reduce the effects of the impairment leading to permanent disability.The goal of rehabilitation is to reduce the effects of the impairment leading to permanent disability. If we want people to function we change the environment toIf we want people to function we change the environment to Enable performanceEnable performance Support adaptationSupport adaptation Facilitate independenceFacilitate independence

Rehabilitation Science & Technology Department School of Health and Rehabilitation Sciences Disability Requires a More Resilient Environment When impairment is severe, it causes the person to sink deeply into the environmental mat causing great restriction.When impairment is severe, it causes the person to sink deeply into the environmental mat causing great restriction. The mat must offer greater resilience to offset the effects of the impairment.The mat must offer greater resilience to offset the effects of the impairment.

Rehabilitation Science & Technology Department School of Health and Rehabilitation Sciences Assistive Technology Modifies the Environment AT makes the “Environmental Mat” more resilient by: Providing a device that substitutes for a missing performance skillProviding a device that substitutes for a missing performance skill Modifying a toolModifying a tool Removing physical barriers to buildings and programsRemoving physical barriers to buildings and programs Modifying instructionModifying instruction Integrating AT solutions into personal care, home management, education, and employment.Integrating AT solutions into personal care, home management, education, and employment.

Rehabilitation Science & Technology Department School of Health and Rehabilitation Sciences Wheelchairs: compensate for paralysis, weakness or in-coordination Participating in sports, attending school are possible with a wheelchair that has features that meet the needs of the user and the tasks they are trying to perform.

Rehabilitation Science & Technology Department School of Health and Rehabilitation Sciences Wheelchairs: Access to community Employment and active participation in the community are possible with a wheelchairs and environments that allow entrance and ease of movement to wheelchair users.

Rehabilitation Science & Technology Department School of Health and Rehabilitation Sciences Artificial limbs: restore function This grandmother’s prosthesis has a sensors that detect the amount of grip strength needed. This man’s right prosthesis returns him to two-handed activities and back to employment.

Rehabilitation Science & Technology Department School of Health and Rehabilitation Sciences Augmentative Communication Devices: compensate for loss of voice When speech is lost or fails to develop, voice output communication devices based on microprocessors and speech digitization make participation, communication, learning, and full language development possible.

Rehabilitation Science & Technology Department School of Health and Rehabilitation Sciences Adaptive Computer Access Blindness, paralysis, in- coordination, and weakness do not prevent computer use.Blindness, paralysis, in- coordination, and weakness do not prevent computer use. Adaptations allow computers to be used for education, communication, employment, management and recreation.Adaptations allow computers to be used for education, communication, employment, management and recreation.

Rehabilitation Science & Technology Department School of Health and Rehabilitation Sciences Accessible Environments Environments that offer entry, freedom of movement, and safety give another method to overcome the effects of impairment.

Rehabilitation Science & Technology Department School of Health and Rehabilitation Sciences How do you know which solutions are best for a particular person? Ask the person what they want to accomplish.Ask the person what they want to accomplish. Each person has talents, interests, and wishes for the future.Each person has talents, interests, and wishes for the future. Each has a desire for meaningful role in society.Each has a desire for meaningful role in society. For example: ask two women about their futureFor example: ask two women about their future –one will desire to be a mother –another will desire to be an engineer Both roles are important to society Assistive Technology help both women.Assistive Technology help both women.

Rehabilitation Science & Technology Department School of Health and Rehabilitation Sciences Assistive Technology Products and Services Match with the needs of the person who has an impairment.Match with the needs of the person who has an impairment. Use current rehabilitation technology expertise.Use current rehabilitation technology expertise. Are adapted to the topography, climate and culture.Are adapted to the topography, climate and culture. Help a culture grow in understanding and acceptance of persons with disability as they become included in society.Help a culture grow in understanding and acceptance of persons with disability as they become included in society.