1. IMPACT OF EMERGING TECHNOLOGIES ON CHILDREN WITH DISABILITIES
PAUL H WISE, MD MPH
STANFORD HEALTH POLICY
DEPT OF PEDIATRICS, STANFORD SCHOOL OF MEDICINE

2. HALFON, HOUTROW, LARSON, NEWACHECK …
DISABILITY
HALFON, HOUTROW, LARSON, NEWACHECK …

3. ASSISTIVE TECHNOLOGY
“any item, piece of equipment or product system—whether acquired commercially, modified, or customized—that is used to increase, maintain, or improve functional capabilities or individuals with disabilities.”

4. AT EPIDEMIOLOGY AND NEED
Limited evidence
Primarily on communicative and mobility devices
Generally improved child functional outcomes
Little or no information on care-givers or family functioning
Varying populations but substantial unmet needs for assistive technologies

5. EMERGING TECHNOLOGIES
Nanotechnology
Robotics
Digital Environment

6. TECHNICAL INNOVATION AND SOCIAL DETERMINANTS OF HEALTH
Tension between technical innovation and social determinants of health
Historical tensions
Disciplinary
Integrated analytic framework
Pivot on efficacy
Dynamic
Developmental complementarity

7. ACCESS MECHANISMS
Child health care system poorly situated to provide assistive technology
Mismatch of delivery system to need (medical home)
Poor provider training
Prospect of Medicaid contraction
Early Intervention
Educational System

8. DISPARATE DIFFUSION PATTERNS

9. IMPLICATIONS FOR DESIGN
Accommodative (compensatory)--Orphan
Universal

10. Summary Growing need Dynamic technologic environment—Growing Efficacy
Blurred boundaries
Deteriorating public commitment to provision of AT – Need for new delivery and financial structures