ArticlePDF Available

An ideal model of an assistive technology assessment and delivery process

Authors:

Abstract

The purpose of the present work is to present some aspects of the Assistive Technology Assessment (ATA) process model [1] compatible with the Position Paper 2012 by AAATE/EASTIN [2]. Three aspects of the ATA process will be discussed in light of three topics of the Position Paper 2012: (i) The dimensions and the measures of the User eXperience (UX) evaluation modelled in the ATA process as a way to verify the efficient and the evidence-based practices of an AT service delivery centre; (ii) The relevance of the presence of the psychologist in the multidisciplinary team of an AT service delivery centre as necessary for a complete person-centred assistive solution empowering users to make their own choices; (iii) The new profession of the psychotechnologist, who explores user’s needs by seeking a proper assistive solution, leading the multidisciplinary team to observe critical issues and problems. Through the foundation of the Position Paper 2012, the 1995 HEART study, the Matching Person and Technology model, the ICF framework, and the pillars of the ATA process, this paper sets forth a concept and approach that emphasise the personal factors of the individual consumer and UX as key to positively impacting a successful outcome and AT solution.
An ideal model of an assistive technology assessment and delivery process
Stefano Federici
1
, Marcia J. Scherer
2
, and Simone Borsci
3
1
Department of Philosophy, Social & Human Sciences and Education, University of Perugia, Perugia, IT
2
The Institute for Matching Person and Technology, Webster, NY, USA
3
Department of Information Systems and Computing, Brunel University, London, UK
Corresponding author: Stefano Federici, Department of Philosophy, Social & Human Sciences and
Education, University of Perugia, Piazza G. Ermini 1, 06123 Perugia, Italy, Tel. +39 075 5854921 - Fax
+39 075 9660141, email: stefano.federici@unipg.it.
Abstract
The purpose of the present work is to present some aspects of the Assistive Technology Assessment
(ATA) process model [1] compatible with the Position Paper 2012 by AAATE/EASTIN [2]. Three aspects
of the ATA process will be discussed in light of three topics of the Position Paper 2012: (i) The
dimensions and the measures of the User eXperience (UX) evaluation modelled in the ATA process as a
way to verify the efficient and the evidence-based practices of an AT service delivery centre; (ii) The
relevance of the presence of the psychologist in the multidisciplinary team of an AT service delivery
centre as necessary for a complete person-centred assistive solution empowering users to make their own
choices; (iii) The new profession of the psychotechnologist, who explores user’s needs by seeking a
proper assistive solution, leading the multidisciplinary team to observe critical issues and problems.
Through the foundation of the Position Paper 2012, the 1995 HEART study, the Matching Person and
Technology model, the ICF framework, and the pillars of the ATA process, this paper sets forth a concept
Page 1 of 31
proof copy
and approach that emphasise the personal factors of the individual consumer and UX as key to positively
impacting a successful outcome and AT solution.
Keywords
Assistive Technology Assessment process, Service delivery systems, ICF, Psychotechnologist,
Psychologist, MPT model.
Page 2 of 31
proof copy
1. Background and purpose
The model of the Assistive Technology Assessment (ATA) process was developed by Federici and
Scherer [1] with the contribution of 55 scholars from five continents. It models the functioning process
of centres for assistive technology (AT) evaluation and provision independently from the model of local
or national service delivery systems. The aim is to suggest practical guidelines for a quality control of
effective processes of matching individual users with the most appropriate technology. The ATA process
borrows a user-driven working methodology from the Matching Person and Technology (MPT) model
of Scherer [3, 4]. Furthermore, the ATA ideal model embraces the ICF biopsychosocial model [5], aiming
at the best combination of AT to promote the customer’s personal well-being.
The ATA process can be read both from the perspective of the user or from the perspective of the Center
(Figure 1).
[INSERT FIGURE 1 ABOUT HERE]
Since the ATA process is a user-driven process any activity of the AT service delivery must find a
correspondence to a user action and vice-versa. The users’ actions of the ATA process can be grouped
into three phases.
Phase 1 The user seeks a solution for one or more activity limitations or participation
restrictions and seeks assistance from a center.
Phase 2 The user checks the solution and tries and checks one or more technological aids
provided by the professionals in a suitable evaluation setting (Center, house, hospital, school,
rehabilitation center, etc.)
Phase 3 The user adopts the solution after obtaining the technological aid(s) from the public
health system (or public/private insurance), receives training for the daily use of the AT and
receives follow-up.
Page 3 of 31
proof copy
The actions of the Center can be grouped into four phases.
Phase 1 (a) The center for assistive product welcomes a user’s request by activating an initial
meeting at a time and location that is satisfactory to the user/client population. (b) The initial
interviewer is focused on gathering the user’s background information and psycho-socio-
environmental data. (c) When the user provides data to the center, data are collected and the
case is opened and transmitted to the multidisciplinary team.
Phase 2 (e) The multidisciplinary team evaluates the data and user’s request and arranges a
suitable setting for the matching assessment.
Phase 3 (f) The multidisciplinary team, along with the user, assesses the assistive solution
proposed, tries the solution and gathers outcome data. (g) The multidisciplinary team evaluates
the outcome of the matching assessment, then (h) proposes the assistive solution to the user.
When the assistive solution proposed requires an environmental evaluation, the team initiates
the Environmental Assessment Process.
Phase 4 (j) When the technological aid is delivered to the user, follow-up and on-going user
support is activated and the assistive solution is evaluated in the daily life context of the user.
The ATA process model is built on five pillars from disability studies and rehabilitation research:
i. The ICF: International Classification of Functioning, Disability and Health biopsychosocial model
[5]. Activities and social participation are strictly related to the body’s functions and structures,
so that the individual’s functioning is the outcome of a triadic reciprocal relationship among
health condition, environmental factors, and personal factors. According to this view of human
functioning, the ATA process models service delivery provision in such a way that all dimensions
affecting the user’s functioning (health condition and contextual factors) must be evaluated
when the analysis of the user’s request and the selection of the AT is carried out by a centre.
These dimensions are also criteria to verify the success of a good assignment and AT solution.
ii. The MPT model [3, 4]. It contends that the characteristics of the person, milieu/environment,
and technology should be considered as interacting when selecting the most appropriate AT
Page 4 of 31
proof copy
solution for a particular person’s use. Moreover, the MPT model overcame the traditional one-
way process from provider to consumer by involving the user in AT selection for the first time.
The ATA process borrows a user-driven and collaborative working methodology from the MPT
model, fostering a continuous dialogue between user and professional or team of professionals
to make manifest different aspects of the person’s needs and appropriate supports. It models a
user-driven process guaranteeing that any activity in an AT service delivery centre must find a
correspondence to a user action and vice-versa;
iii. The definition of an assistive solution stated by the Association for the Advancement of Assistive
Technology in Europe (AAATE) from 2003 [6]. The solution for a user provided by an AT service
delivery centre must “involve something more than just a device, it often requires a mix of
mainstream and assistive technologies whose assembly is different from one individual and
another, and from one context to another. We may label it assistive solution” [6]. The assistive
solution is the goal of the entire ATA process which, hypothetically, might not require any
technological aid (e.g., just changes to fit the environment or a blend of use of a device and
personal assistance) [7]. It is also crucial when pursuing the goal of the assistive solution that
the user’s request is taken seriously, often requiring an exploration to capture and understand
the user’s real needs. For this reason, the ATA process sees the role of the psychologist as
essentiala pillar of the modelto help guarantee a user-centred evaluation and to empower
users to make their own choices.
iv. The role of the psychotechnologist. The psychotechnologist [8-10] is an expert in both
psychology and AT, in particular in Human-Computer Interaction (HCI) and human factors. He
or she analyses the relations emerging from the person-technology interaction by taking into
account all the psychological and cognitive components, and the possibilities of adapting and
designing systems and services in an adaptable and accessible manner. Because of the
characteristics of his or her professional background and training, the psychotechnologist is an
ideal support for the multidisciplinary team in the assessment phase and in the decision-making
process, by leading the team to observe critical issues and problems among the user’s needs and
assistive solutions proposed. The role of the psychotechnologist should not be confused with
Page 5 of 31
proof copy
that one of the psychologist, whose profile and expertise are only partly shared with the
psychotechnologist [11]. The psychotechnologist is more focused on the technological side of
matching the person with technology and less oriented to the clinical and psychological
dimensions of human-technology interactions relationships, and communication [10].
v. The role of the psychologist. The psychologist in an AT service delivery process provides an
appropriate psychological evaluation or a precise clinical intervention with the users and/or their
significant human context over the course of the whole AT assignment process. We believe that to
invest in personal factors represents an important turning point for a successful match between
person and technology. Assigning greater importance to personal factors would help dramatically
to reduce the abandonment rate of technologies by users [4, 11-20].
The ATA process can be used by professionals to check the functioning and to (re-)conceptualize the
phases of an AT delivery system according to the biopsychosocial model of disability stated by the ICF
[5]. Figure 2 displays the ICF model as it fits the ATA process.
[INSERT FIGURE 2 ABOUT HERE]
The ATA process model can be a useful driver for re-arranging the relationships among professionals
and end-users, and for defining when a multi-perspective assessment of the match between the user
and the AT is a mandatory phase in a delivery process [1]. It has been thought to indicate an ideal process
of AT assessment and delivery process for any kind of AT (limb prosthetics, mobility devices, simple
daily living equipment, communication devices, etc.). Nevertheless, given that it stresses the role of the
psychologistas guarantee of a user-centred evaluation and empowering users to make their own
choicesand the role of the psychotechnologistas an expert in HCI and human factors among the
relations emerging from the person-technology interactionthe ATA process model seems to be
particularly helpful for the evaluation and delivery processes of ICT-based AT and cognitive-oriented
devices.
Page 6 of 31
proof copy
Finally, as previous empirical studies have confirmed, the ATA can be used as a valid tool for helping
practitioners to compare their AT service delivery systems [21] or to re-think the AT delivery process
in terms of a process for the delivery of an assistive solution. The ATA process model was used as an
ideal model to analyse and compare the AT service delivery system of the Umbria (Italy) Region’s
Territorial Health Service Providers in order to build up a best practice guide capable of unifying and
standardising the different kinds of assignation processes [22].
Purpose
The purpose of the present study is to verify the compliance of some aspects of the ATA process model
with the guidelines proposed by AAATE and EASTIN (European Assistive Technology Information
Network) [2] in order to identify conceptual and methodological similarity and dissimilarity.
Specifically, by using as a driver the recent Position Paper [2] by AAATE and EASTIN, we reread three
strengths of the ATA process: (i) The dimensions and the measures of the User eXperience (UX)
evaluation modelled in the ATA process as a way to verify the efficient and evidence-based practices of
an AT service delivery centre; (ii) The relevance of the presence of the psychologist in the
multidisciplinary team of an AT service delivery centre as necessary for a complete person-centred
assistive solution empowering users to make their own choices; (iii) The new profession of the
psychotechnologist guide to coordinate the AT service delivery process for the user.
2. Modelling the User eXperience in an AT service delivery centre
The first topic tackled by the Position Paper 2012 is about the need for evidence-based practices in
service delivery systems. The reasons for the importance of this topic in the report are mainly related
to macroeconomic factors: “the today’s [European] political climate of budget containment and
accountability[6], which results in a containment of public spending within the health services. The
evidence-based practices in the AT and rehabilitation field requires that making decisions about
treatments and technological solutions are to be grounded in the best available evidence with
practitioner expertise and scientific research and with the characteristics, state, needs, values, and
Page 7 of 31
proof copy
preferences of users. This has to be pursued in a manner that is compatible with the user’s
milieu/environmental and the national and local health systems. Evidences is comprised of research
findings derived from the systematic collection of data through observation and experiment and the
formulation of questions and testing of hypotheses[23].
Since the ATA process models an AT service delivery process in a centre for AT evaluation and provision
explicitly specifying its theoretical and methodological bases (see above the five pillars and [1]) and
scientific evidences and good practices [1, 22], its entire model outlines an ideal process which provides
reference guidelines for evidence-based practices steering both public and private centres to compare,
evaluate, and improve their own matching model. Nonetheless, in this section we focus on how the ATA
process provides to practitioners a model to design evidence-based practice parameters on the
management of a user-driven and person-centred matching process in an AT service delivery centre.
When defining a set of steps that lead users to achieve an assistive solution, practitioners are designing
a process that can be perceived by users, and their caregivers, as good or bad, satisfactory or
unsatisfactory, stressful and frustrating or supportive. The users’ perception of an AT service delivery
process is a key factor for achieving a good match between the user and the AT solution, because on the
basis of their judgements about the process, users will react to the requests of the professionals in a
different way (e.g. acceptance or not of professional recommendations). In light of this, it is extremely
important for the professionals of AT centres to assess their service delivery processes in terms of UX
by measuring how the process is perceived by the user “to ensure access to appropriate, timely,
affordable, and high-quality rehabilitation interventions[19] and to provide AT solutions that are
“suited to the environment” and “suitable for the user” by also granting an “adequate follow-up to ensure
safe and efficient use” [19].
In the HCI field, UX is a broad concept that refers to how a system (e.g., AT service delivery centre) is
“perceived, learned and used. It includes ease of use and, most important of all, the needs that the
product fulfils” [24], and it is hierarchically related to the possibility of the users to get into the system
and obtain the information (accessibility) and to use effectively and efficiently the system in a
Page 8 of 31
proof copy
satisfactory way (usability) [25, 26]. Whereas the analysis of the accessibility and usability at the AT
service delivery centre (the system) is useful for defining a basic level of UX during the user interaction
with an AT, the overall UX of the interaction can be measured only in the user’s daily life
milieu/environment after a long period (at least 3 months) of use (follow up level of UX). Practitioners,
by estimating the difference between basic and follow up levels of UX, can reliably assess whether the
interaction between the users and the AT is positively increased over time or whether it decreased,
affecting the users’ performances and/or their well-being. As Figure 3 shows, in the ATA process model,
the basic and the follow up assessments of the UX are a core part of an AT system delivery process. They
help practitioners evaluate the relationship between user and system by measuring the accessibility and
the usability of the interaction with the AT, and the effectiveness of the assistive solution provided by
measuring the user’s satisfaction after the AT provision.
Nevertheless, as Figure 3 exemplifies, we propose to use the UX assessment also for analysing all the
steps that comprise a process of system delivery as a framework for an evidence-based procedure. In
light of this, we offer a process for technology matching in which accessibility and usability are measured
as follows:
i. Accessibility of the process is measured by analysing the users ease of accessing the AT service
delivery centre, how the centre receives and sustains the requests of the user, and the user’s
satisfaction with his or her initial relationship with the centre (contact). Therefore, accessibility
is determined by the ease of access to the centre and the satisfaction of the contact, measured
by: (a) the costs perceived by the users, in terms of use and access to the service for achieving
the goal; (b) the possibility to reach the service (availability); (c) the ease of contact (comfort);
(d) the expectation of the users (anticipation of benefit); and (e) the users’ perceived (or known)
service/centre performance.
ii. Usability of the process can be measured by considering effectiveness, efficiency, and
satisfaction perceived by the user among the different steps of the process, from the beginning
contact to the support after the AT assignation and acquisition. The efficiency, intended as
“resources expended in relation to the accuracy and completeness with which users achieve
Page 9 of 31
proof copy
goals” [27], is measured through costs in terms of time and workload perceived by the user to
obtain the AT. The measure of efficiency, defined as “accuracy and completeness with which
users achieve specified goals” [27], is strictly connected with the UX assessment of the AT. When
the professional assesses the basic level of UX in the laboratory, they can only measure the
effectiveness in terms of efficacy of AT use “in an ideal condition”. Only when professionals
gather data about the UX in daily life (follow up) through surveys and questionnaires, can they
measure the real effectiveness of the process by determining the difference between basic and
follow up levels of UX. In this way, the users’ satisfaction and their overall perspective about the
quality of the AT obtained and the actions of the AT service delivery centre process is obtained,
providing reliable evidence-based data.
[INSERT FIGURE 3 ABOUT HERE]
In tune with the Position Paper 2012, we believe that the framework and the methods of the HCI can
strongly support professionals of the AT centres by providing them with a set of reliable and well-tested
evidence-based practices in order to design, assess, and re-define, their system delivery processes under
the umbrella of a user-centred perspective.
4. The psychologist: The steward of a complete person-centred assistive solution
The whole Position Paper 2012 owns a strong person/user-centred vision. From the basic definition of
AT and assistive solutionthrough the equation of the “four A”, the meaning of accessibility and the
reasons that push public service delivery systems to provide AT with the intermediation of AT service
delivery centresuntil the lists of recommendations, the independence and well-being of the persons
are the primary goal of the document. It is in the eighteen recommendations about “user influence
(fifteen in the sub-section “Recommendations for improvement at national or local level” and three in
“Suggestions for actions at EU level that could support improvement”) that the user/person centrality
is better expressed.
Page 10 of 31
proof copy
What emerges is a clear picture of a successful AT service delivery programme that is aimed at assuring
that “[t]he individual AT programme should be built in relation to what life goals the user wants to
achieve” through an evaluation and assignment process “designed in a way that empowers users to
make their own choices” and “tailored to different needs” [2]. The assistive solutions cannot be obtained
without the “involvement of disabled persons”. For this reason “[i]n the various steps of the service
delivery process, users should be empowered and receive all information needed to make informed
choices […, as] a specialist him/herself of his/her needs”.
The ATA process model has taken into serious account the importance of direct user involvement in the
functioning of an AT service delivery centre, because it has embraced both a user-driven theoretical
model from the MPT model (see the second pillar above) and the ICF biopsychosocial model of disability
that overcomes a vision of disability as a consequences of disease focusing on the individual’s
functioning (see the first pillar above). In light of this, the ATA process models the flow chart of the
functioning of AT service delivery both from the perspective of the user and from the perspective of the
centre (Figure 1; [1]). Furthermore, our model has strongly reaffirmed the role of the psychologist
within a multidisciplinary team of professionals in an AT service delivery centre. Out of all the
professionals comprising the multidisciplinary team, the psychologist is the one who, in terms of
curriculum and training, is the greatest expert in personal factors as they are conceptualized by the ICF.
In an AT service delivery process, the psychologist provides an appropriate psychological evaluation
and a precise clinical intervention with the user and/or their significant human context over the course
of the whole AT assignment process. To guarantee a process designed in a way that empowers users to
make their own choices, tailored to different needs, by involving disabled persons in the various steps
of the service delivery process as a specialist him/herself of his/her needs [2], it is not sufficient to know
about what personal factors are, but it requires specific competences about the dynamics of the
subjective dimensions and individual functioning and their assessment. It also requires training in the
ways in which to help individuals express themselves and uncover their true goals. Theoretical
knowledge of personal factors does not reveal the psychological and existential side of the individual’s
Page 11 of 31
proof copy
functioning. Therefore, the ATA process model stresses the psychologist’s role in the multidisciplinary
team by considering it essential to an effective AT selection and matching process.
The psychologist in an AT service delivery process provides an appropriate psychological evaluation or a
precise clinical intervention with the users and/or their significant human context over the course of the
whole AT assignment process. In the third point of the Position Paper 2012’s second recommendation, we
find how the psychologist’s tasks in an AT service delivery centre empowers users to make their own
choices: “a) educating professionals to have an attitude of equity towards users; b) providing
information and consultation to enable users to make responsible choices; c) allowing users to try out
products for a reasonable time before making the final choice; d) providing the possibility, to both users
and professionals, to change decisions that have been made[2]. In spite of these four recommendations
being originally intended for all professionals involved in “[a] good service delivery process […]
designed in a way that empowers users to make their own choices” [2], they must be considered to
specifically affect the role of the psychologist, because he or she not only has an attitude about user’s
personal factors but he or she is also skilled and specialised in subjective dimensions and individual
functioning.
The intended meaning of the Position Paper 2012 is that all professionals involved in a service delivery
process should be educated to have an empowerment attitude; however, only the psychologist can be
considered an expert in personal factors. Knowing about personal factors is not equivalent to knowing
subjective dimensions and individual functioning. Theoretical knowledge of personal factors and
training in empowerment attitude do not convey the psychological and existential dimensions of the
individual’s functioning [28]. For these reasons, we claim that the psychologist might provide his or her
expertise to guarantee a user-centred evaluation and empowering users to make their own choices.
In the ATA process model five actions in the psychologist’s role and the professional skills of psychologists
have been defined [11, 21]:
1. Identify the user’s personal factors, priorities, preferences, etc.;
Page 12 of 31
proof copy
2. Advocating the user’s request in the user-driven process through which the selection of one or
more technological aids for an assistive solution is reached;
3. Acting as mediator between users seeking solutions and the multidisciplinary team of an AT
service delivery centre;
4. Team facilitating among members of the multidisciplinary team; and finally
5. Reframing the relationship between the client and his or her family within the framework of
the new challenges and activity limitations or participation restrictions they face.
The role of the psychologist within the ATA process is displayed in Figure 4.
[INSERT FIGURE 4 ABOUT HERE]
We believe that to invest in personal factors represents an important turning point for a successful match
between person and technology. Assigning greater importance to personal factors would help
dramatically to reduce the abandonment rate of technologies by users [4, 11-20].
5. The psychotechnologist’s role in the multidisciplinary team
The structure, level of intensity, and services available for rehabilitation vary widely from one area to
another, whether comparing facilities, cities, states, or countries. Despite this, there is considerable
consistency worldwide in the list of professionals comprising a multidisciplinary rehabilitation team. As
one illustration, a review of traumatic brain injury rehabilitation [29] listed the following professionals:
Patient and patients’ family or caregiver; Rehabilitation physician or physiatrist; Rehabilitation nurse;
Rehabilitation technicians; Primary neurosurgeon; Allied health professionals: physiotherapist,
occupational therapist, speech and language pathologist, clinical psychologist, neuropsychologist, social
worker and counsellor; Paramedical health professionals: dietician, orthotist, and rehabilitation
engineer; Other medical specialists: ophthalmologist, otorhinolaryngologist, orthopaedic surgeon,
Page 13 of 31
proof copy
gastroenterologist and neurologist for electrophysiological studies; Vocational rehabilitation services
and counsellors; Volunteers from support or spiritual groups. The Joint Committee on Interprofessional
Relations Between the American Speech-Language-Hearing Association and Division 40 (Clinical
Neuropsychology) of the American Psychological Association [30] also provided a list of professionals
comprising the brain injury interdisciplinary team:
“Besides the patient and caregivers, interdisciplinary teams may include, but are not limited to,
the following professionals: speech-language pathologist, clinical neuropsychologist,
audiologist, rehabilitation psychologist, behavioral specialist, dietitian, educator, occupational
therapist, physical therapist, primary care physician, psychiatrist, physiatrist, rehabilitation
nurse, social worker, case manager, therapeutic recreation specialist, vocational rehabilitation
counselor, and paraprofessionals. When cognitive, communication, emotional, and psychosocial
domains are affected, the team should include at least a clinical neuropsychologist and speech-
language pathologist. Team membership will vary with the age of the persons served, the type
of impairment, the stage of recovery, and the special training of team members.”
Thus, there is considerable consistency in these two views of the rehabilitation team, the first from
Singapore and the second from the United States.
In an AT service delivery centre it is not necessary for all the professionals listed above to be present on
a multidisciplinary team assembled for a given individual. In fact, the multidisciplinary team can rely on
the expertise of outside professionals whenever necessary. Furthermore, the composition of the
multidisciplinary team will depend on the services offered by the centre. Regardless of the composition
of the multidisciplinary team, however, it needs to be led by professionals with a multidisciplinary
background and training, with the precise charge of coordinating the interdisciplinary team and the
entire ATA process.
A professional with the appropriate training and background for supporting both the assessment of the
match between AT and users and the process of AT delivery decision-making was already identified in
Page 14 of 31
proof copy
the rehabilitation psychologist [31]. Scherer [32] describes the role of rehabilitation psychologists as
follows in the 4
th
Edition of the The Concise Corsini Encyclopedia of Psychology:
Rehabilitation Psychologists’ work includes assessment and intervention regarding the range
of physical, personal, psychosocial, cognitive, and behavioral factors that may be affected, such
as neurocognitive status, sensory difficulties, mood/emotions, desired level of independence
and interdependence, mobility/freedom of movement, self-esteem and self-determination,
behavioral control and coping skills, subjective view of capabilities and quality of life. In addition,
Rehabilitation Psychologists consider the influences of culture, ethnicity, language, gender, age,
developmental level, sexual orientation, social network, residence and geographic location,
socioeconomic status, and relative visibility and/or assumption of disability on attitudes and
available services. When planning interventions and recommending services, Rehabilitation
Psychologists involve the rehabilitation team and consider the network of an individual’s
environments (e.g. familial, social, cultural, physical, service availability, and political) and the
means of addressing barriers in these areas, such as personal adaptation, the use of assistive
technology and personal assistance services and modifications of physical and social
environments [33, 34]. It is frequently a blend of such products and services that is most
beneficial to individuals in achieving desired goals and well-being. The preferences, needs, and
resources of persons served are taken into account in treatment planning, and any obstacles
preventing the highest level of personal and social functioning are identified and reduced or
removed when feasible.”
The term “psychotechnology” was coined in 1991 by Canadian sociologist Derrick De Kerckhove to refer
to “any technology that emulates, extends or amplifies sensory-motor, psychological or cognitive
functions of the mind[35]. In 2002, Federici added the term modifies to the definition: “any technology
that emulates, extends, amplifies and modifies sensory-motor, psychological or cognitive functions of
the mind” which conveys a biopsychosocial model of interaction [8, 10]. A practitioner of
psychotechnology is a psychotechnologist.
Page 15 of 31
proof copy
Miesenberger, Corradi and Mele [10] describe the role of the psychotechnologist as working with the
multidisciplinary team in a user-driven assessment process to achieve a person-technology match that
fosters, in keeping with the ICF biopsychosocial model, the person becoming social and active with the
mainstream population. Thus, the psychotechnologist is one who fulfills the definition of rehabilitation
psychologist above, but who additionally has expertise in multiple areas of AT, Information and
Communication Technology, e-Accessibility, universal design, and so on.
The psychotechnologist may, indeed, be the most appropriate support among the multidisciplinary
team for the individual with needs under the ICF components of Global and Specific Mental Functions,
as well as the person with significant incentives and disincentives under Personal Factors.
The Position Paper 2012 points out “coordination” as one of six quality indicators valid to monitor the
quality in an AT service delivery system. This coordination must take place on three levels: micro level,
i.e., “within the primary process of service delivery”; meso level, i.e., “during the various steps of the
service delivery system process”; macro level, i.e., “within other policies and processes […] involving
assistive technology[2]. Furthermore, in the Recommendations about coordination, the Position Paper
2012 stresses that “[a] knowledgeable guiding person should be available to coordinate the service
delivery process [i.e. micro and meso level] for the user”.
The ATA process model has identified the guiding role in the psychotechnologist [8-10]. The relevance
of the psychotechnologist within the ATA process is crucial for an effective service delivery system
process at such point to consider the introduction of this professional as a pillar of the model (see above
the fifth pillar).
AT is increasingly complex and sophisticated and this requires inter- and multi-disciplinary approaches
to assessment that involves a wide range of disciplines and in some cases the emergence of new
interdisciplinary approaches [36]. The psychotechnologist is not a clinical/dynamic psychologist, but he
or she has a background in psychology, especially in rehabilitation. The psychologist is also
distinguished as a cognitive ergonomist because the latter evaluates the interaction according to a
dualistic reciprocity between two poles: the user system and the artifact system [37]. Conversely, the
Page 16 of 31
proof copy
psychotechnologist evaluates the interaction between person and technology by following a user-AT-
milieu holistic model, as in the MPT model [3, 15], that is to say, he or she is an expert in assistive
solutions (Figure 5). By means of the use of different toolse.g., the Survey of Technology Use (SOTU)
and the Assistive Technology Device Predisposition Assessment [ATD-PA; 3], the Quebec User Evaluation
of Satisfaction with Assistive Technology [QUEST; 38], the Software Usability Measurement Inventory
[SUMI; 39], etc.the psychotechnologist explores the user’s needs by seeking a proper assistive
solution, leading the multidisciplinary team to observe critical issues and problems [40]. (For a complete
presentation of how the psychotechnologist works in an AT service delivery centre, refer to [10, 21]).
[INSERT FIGURE 5 ABOUT HERE]
6. Conclusions
Since the time of the 1995 HEART study and the dissemination of Scherer’s original research [41, 42],
we have seen tremendous growth in the number, quality, and versatility of AT devices. Unfortunately,
over this time period we have not seen concomitant advances in the quality of AT delivery systems. It
remains true that too many people who can benefit from AT solutions are uninformed as to who to turn
to, what to ask for, and what to do with their AT devices once they are obtained. There is no standard of
AT service provision, and different disciplines, while following their guidelines for practice, often do not
collaborate. This can lead to service gaps where, typically, the end user loses the most. This paper began
with the foundation of the Position Paper 2012, the 1995 HEART study, the MPT model, the ICF
framework, and the pillars of the ATA process to set forth a concept and approach that emphasise the
personal factors of the individual consumer and UX as key to positively impacting a successful outcome
and AT solution. This core target determines what the aspects of service delivery and assistive solution
must be.
Page 17 of 31
proof copy
Throughout Italy, specific AT Service Delivery Centres exist as a dynamic and multifaceted approach
towards achieving many of the aspirations of the Position Paper 2012. These Centres have already been
described [1] as a means of implementing the ATA model. While certainly not a perfect or complete
model, they do represent one basis for a multinational discussion on the individual points of the Position
Paper 2012. By addressing the various existing systems of AT service delivery operating today within
the European Union, and analysing what is working well and the key elements of successful practices,
AAATE can take a leading role in organizing data that can be utilised broadly.
The growth in the numbers of aging persons and those with disabilities and chronic illnesses, and the
economic uncertainties in many parts of the world, mean we cannot wait any longer to address the
longstanding need to improve the ways in which we match person and technology.
Page 18 of 31
proof copy
References
[1] Federici S, Scherer MJ, editors. Assistive Technology Assessment Handbook. Boca Raton, FL: CRC
Press; 2012. doi:10.1201/b11821
[2] AAATE, EASTIN. Service Delivery Systems for Assistive Technology in Europe: Position Paper:
Aaate.net; 2012 [cited 2012 Sep 27]. Available from: http://www.aaate.net/
.
[3] Scherer MJ. Matching Person & Technology. A Series of Assessments for Evaluating
Predispositions to and Outcomes of Technology Use in Rehabilitation, Education, the Workplace & Other
Settings. Webster, NY: The Institute for Matching Person & Technology, Inc.; 1998.
[4] Scherer MJ, Craddock G. Matching Person & Technology (MPT) assessment process. Technol
Disabil. 2002;3(14):12531.
[5] World Health Organization (WHO). ICF: International Classification of Functioning, Disability
and Health. Geneva, CH: WHO; 2001 2001.
[6] AAATE. AAATE position paper: A 2003 view on Technology and Disability: Aaate.net; 2003 [cited
2012 April 10]. Available from: http://www.aaate.net/
.
[7] Federici S, Scherer MJ. The Assistive Technology Assessment Model and Basic Definitions. In:
Federici S, Scherer MJ, editors. Assistive Technology Assessment Handbook. Boca Raton, FL: CRC Press;
2012. p. 110. doi:10.1201/b11821-2
[8] Federici S, Corradi F, Mele ML, Miesenberger K. From cognitive ergonomist to
psychotechnologist: A new professional profile in a multidisciplinary team in a centre for technical aids.
In: Gelderblom GJ, Soede M, Adriaens L, Miesenberger K, editors. Everyday Technology for
Independence and Care: AAATE 2011. 29. Amsterdam, NL: IOS Press; 2011. p. 117884.
doi:10.3233/978-1-60750-814-4-1178
[9] Federici S, Scherer MJ. Preface. In: Federici S, Scherer MJ, editors. Assistive Technology
Assessment Handbook. Boca Raton, FL: CRC Press; 2012. p. xvxviii. doi:10.1201/b11821-1
[10] Miesenberger K, Corradi F, Mele ML. The Psychotechnologist: A new profession in the Assistive
Technology Assessment. In: Federici S, Scherer MJ, editors. Assistive Technology Assessment Handbook.
Boca Raton, FL: CRC Press; 2012. p. 179200. doi:10.1201/b11821-12
Page 19 of 31
proof copy
[11] Meloni F, Federici S, Stella A, Mazzeschi C, Cordella B, Greco F, et al. The Psychologist. In: Federici
S, Scherer MJ, editors. Assistive Technology Assessment Handbook. Boca Raton, FL: CRC Press; 2012. p.
14977. doi:10.1201/b11821-11
[12] Phillips B, Zhao H. Predictors of Assistive Technology Abandonment. Assist Technol.
1993;5(1):3645. doi:10.1080/10400435.1993.10132205
[13] Riemer-Reiss ML, Wacker R. Factors Associated with Assistive Technology Discontinuance
Among Individuals with Disabilities. J Rehabil. 2000;66(3):4450.
[14] Riemer-Reiss ML, Wacker RR. Assistive Technology Use and Abandonment among College
Students with Disabilities. International Electronic Journal for Leadership in Learning [Internet]. 1999;
3(23). Available from: http://www.ucalgary.ca/iejll/riemer-reiss_wacker
.
[15] Scherer MJ. Living in the state of stuck: How technologies affect the lives of people with
disabilities. 4
th
ed. Cambridge, MA: Brookline Books; 2005.
[16] Scherer MJ, Sax CL, Vanbiervliet A, Cushman LA, Scherer JV. Predictors of assistive technology
use: The importance of personal and psychosocial factors. Disabil Rehabil. 2005;27(21):132131.
doi:10.1080/09638280500164800
[17] Söderström S, Ytterhus B. The use and non-use of assistive technologies from the world of
information and communication technology by visually impaired young people: a walk on the tightrope
of peer inclusion. Disabil Soc. 2010;25(3):30315. doi:10.1080/09687591003701215
[18] Verza R, Carvalho ML, Battaglia MA, Uccelli MM. An interdisciplinary approach to evaluating the
need for assistive technology reduces equipment abandonment. Mult Scler. 2006 2006;12(1):8893.
doi:10.1191/1352458506ms1233oa
[19] World Health Organization (WHO), World Bank. World Report on Disability. Geneva, CH: WHO;
2011.
[20] Meloni F, Federici S, Stella A. The Psychologist’s Role: A Neglected Presence in the Assistive
Technology Assessment Process. In: Gelderblom GJ, Soede M, Adriaens L, Miesenberger K, editors.
Everyday Technology for Independence and Care: AAATE 2011. 29. Amsterdam, NL: IOS Press; 2011. p.
1199206. doi:10.3233/978-1-60750-814-4-1199
Page 20 of 31
proof copy
[21] Federici S, Corradi F, Meloni F, Borsci S, Mele ML, Dandini de Sylva S, et al. A Person-Centered
Assistive Technology Service Delivery Model: A Framework for Device Selection and Assignment. Life
Span Disab. Accepted for pubblication.
[22] Federici S, Borsci S. The use and non-use of assistive technology in Italy: A pilot study. In:
Gelderblom GJ, Soede M, Adriaens L, Miesenberger K, editors. Everyday Technology for Independence
and Care: AAATE 2011. 29. Amsterdam, NL: IOS Press; 2011. p. 97986. doi:10.3233/978-1-60750-814-
4-979
[23] EBBP.org project. Defining Evidence-Based Behavioral Practice. Northwestern University, IL:
EBBP.org; 2013 [cited 2013 Jan 15]. Available from: http://www.ebbp.org/ebbp.html
.
[24] Norman DA. The Invisible Computer: Why Good Products Can Fail, the Personal Computer is So
Complex, and Information Appliances are the Solution. Cambridge, MA: MIT Press; 1998.
[25] Borsci S, Kurosu M, Federici S, Mele ML. Computer Systems Experiences of Users with and
without Disabilities: An Evaluation Guide for Professionals. Boca Raton, FL: CRC Press; 2013.
doi:10.1201/b15619-1
[26] Federici S, Borsci S. Usability evaluation: models, methods, and applications. 2010. In:
International Encyclopedia of Rehabilitation [Internet]. Buffalo, NY: Center for International
Rehabilitation Research Information and Exchange (CIRRIE); [117]. Available from:
http://cirrie.buffalo.edu/encyclopedia/article.php?id=277&language=en
.
[27] ISO 9241-11:1998 Ergonomic requirements for office work with visual display terminals Part
11: Guidance on usability.
[28] Federici S, Meloni F, Borsci S, Corradi F, Mele ML, Dandini de Sylva S, et al., editors. Assistive
Technology Assessment Process in a Center for Technical Aid: New Professional Profiles within a
Multidisciplinary Team. The Rehabilitation Engineering and Assistive Technology Society of North
America Annual Conference: RESNA ’12; 2012 Jun 28-Jul 3; Baltimore, MD: RESNA.
[29] Chua KSG, Ng Y-S, Yap SGM, Bok C-W. A Brief Review of Traumatic Brain Injury Rehabilitation.
Ann Acad Med Singapore. 2007;36(1):3142.
[30] Joint Committee on Interprofessional Relations Between the American Speech-Language-
Hearing Association and Division 40 (Clinical Neuropsychology) of the American Psychological
Page 21 of 31
proof copy
Association. Structure and Function of an Interdisciplinary Team for Persons With Acquired Brain Injury
[Guidelines]: American Speech-Language-Hearing Association; 2007. Available from:
http://www.asha.org/docs/pdf/GL2007-00288.pdf
.
[31] Brown KS, Deleon PH, Loftis CW, Scherer MJ. Rehabilitation psychology: Realizing the true
potential. Rehabil Psychol. 2008;53(2):11121. doi:10.1037/0090-5550.53.2.111
[32] Scherer MJ. Rehabilitation Psychology. In: Weiner IB, Craighead WE, editors. The Concise Corsini
Encyclopedia of Psychology and Behavioral Science. 4
rd
ed. Hoboken, NJ, US: John Wiley & Sons; 2010. p.
14447.
[33] Scherer MJ. Connecting to Learn: Educational and Assistive Technology for People with
Disabilities. Washington, DC: American Psychological Association; 2004 2004.
[34] Scherer MJ, editor. Assistive Technology: Matching Device and Consumer for Successful
Rehabilitation. Washington, DC: American Psychological Association; 2002.
[35] De Kerckhove D. Communication Arts for a New Spatial Sensibility. Leonardo. 1991;24(2):131
5. doi:10.2307/1575281
[36] Müller D. Foreword: Global Perspectives and Emerging Themes in Assistive Technology
Assessment. In: Federici S, Scherer MJ, editors. Assistive Technology Assessment Handbook. Boca Raton,
FL: CRC Press; 2012. p. ixxii. doi:10.1201/b11821-1
[37] Norman DA. Some Observations on Mental Models. In: Gentner D, Steven AL, editors. Mental
Models. Hillsdale, NJ: Lawrence Earlbaum Associates; 1983. p. 714.
[38] Demers L, Monette M, Lapierre Y, Arnold DL, Wolfson C. Reliability, validity, and applicability of
the Quebec User Evaluation of Satisfaction with assistive Technology (QUEST 2.0) for adults with
multiple sclerosis. Disabil Rehabil. 2002 2002;24(1-3):2130. doi:10.1080/09638280110066352
[39] Kirakowski J, editor. SUMI User Handbook. 2
nd
ed. Cork, IE: Human Factors Research Group;
1998.
[40] Scherer MJ, Jutai J, Fuhrer M, Demers L, Deruyter F. A framework for modelling the selection of
assistive technology devices (ATDs). Disabil Rehabil Assist Technol. 2007 Jan;2(1):18.
doi:10.1080/17483100600845414
Page 22 of 31
proof copy
[41] Scherer MJ, McKee B. Computer aids for handicapped persons in the U.S.: What separates the
users from the nonusers? 1
st
International Conference on Computers for Handicapped Persons;
University of Vienna, AU: Austrian Computer Society; 1989. p. 20110.
[42] Scherer MJ, McKee B. But will the assistive technology device be used? 12
th
Annual Conference:
Technology for the Next Decade; Washington, DC: RESNA; 1989. p. 3567.
[43] Federici S, Meloni F. The Biopsychosocial Model and Reciprocal Triadic Causation. In: Borsci S,
Kurosu M, Federici S, Mele ML, editors. Computer Systems Experiences of Users with and without
Disabilities: An Evaluation Guide for Professionals. Boca Raton, FL: CRC Press; 2013. p. 603.
doi:10.1201/b15619-4
Page 23 of 31
proof copy
Figure 1. Flow chart of the ATA process ideal model [1]. On the left of the User Action flow chart and on
the right of the procedures of the AT Service Delivery, the numbers refer to the phases and the small-
cap letters the steps for each phase.
Figure 2. The ATA process according to the ICF’s biopsychosocial model. In the upper left side, the
biopsychosocial model and, in right side, the ATA process flow chart are shown. The solid line connects
the components of Body Functions and Structure with the phases 1 and 2 of the ATA process: The
individual functioning and disability of the user are taken into account by the multidisciplinary team
that evaluates health conditions of the user. The dashed line connects Activities component with the
phase 3 of the ATA process: The matching process aims to support activity limitations and enhance
individual functioning. The dotted line connects the Participation component of the ICF with the
Environmental assessment process and the phase 4 of the ATA process: Overcoming a disablement may
involve something more than just a device, it often requires a mix of mainstream and assistive
technologies whose matching is different from one individual and another, and from one context to
another [6]; therefore, the multidisciplinary team has to take in a serious account the participation
restrictions.
Figure 3. Dimensions and measures of the UX evaluation of an AT system delivery process. In the ATA
process model, the UX framework and the dimensions of accessibility and usability are adopted in order
to assess both the interaction between user and AT and user and the process in an AT system delivery
centre. The ATA process model provides reference guidelines for evidence-based practices steering both
public and private centres to compare, evaluate, and improve their own matching model.
Figure 4. The psychologist’s role in the ATA process model. The ATA process can be read both from the
perspective of the user or from the perspective of the AT Service Delivery centre. In the ATA process
model five actions in the psychologist’s role and the professional skills of psychologists have been
defined [11, 21]. The five actions (identify, advocate, mediate, facilitate, and reframe) of the psychologist
in the ATA process are shown in relation to the User’s Actions and the AT Service Delivery procedures.
Page 24 of 31
proof copy
Figure 5. The socio-environmental system according to the biopsychosocial perspective [5, 43]. The
psychotechnologist meets the user’s needs by seeking a proper assistive solution (in cooperation with
the multidisciplinary team). With the use of different tools (MPT measures (including the ATD-PA),
QUEST, SUMI, IPDA, etc.), the psychotechnologist coordinates the team of professionals in an AT service
delivery centre by observing critical issues and problems.
Page 25 of 31
proof copy
Figure 1. Flow chart of the ATA process ideal model [1]. On the left of the User Action flow chart and
on the right of the procedures of the AT Service Delivery, the numbers refer to the phases and the
small-cap letters the steps for each phase.
Page 26 of 31
proof copy
Figure 2. The ATA process according to the ICF’s biopsychosocial model. In the upper left side, the
biopsychosocial model and, in right side, the ATA process flow chart are shown. The solid line connects
the components of Body Functions and Structure with the phases 1 and 2 of the ATA process: The
individual functioning and disability of the user are taken into account by the multidisciplinary team
that evaluates health conditions of the user. The dashed line connects Activities component with the
phase 3 of the ATA process: The matching process aims to support activity limitations and enhance
individual functioning. The dotted line connects the Participation component of the ICF with the
Environmental assessment process and the phase 4 of the ATA process: Overcoming a disablement may
involve something more than just a device, it often requires a mix of mainstream and assistive
technologies whose matching is different from one individual and another, and from one context to
another [6]; therefore, the multidisciplinary team has to take in a serious account the participation
restrictions.
Page 27 of 31
proof copy
Page 28 of 31
proof copy
Figure 3. Dimensions and measures of the UX evaluation of an AT system delivery process. In the ATA
process model, the UX framework and the dimensions of accessibility and usability are adopted in order
to assess both the interaction between user and AT and user and the process in an AT system delivery
centre. The ATA process model provides reference guidelines for evidence-based practices steering both
public and private centres to compare, evaluate, and improve their own matching model.
Page 29 of 31
proof copy
Figure 4. The psychologist’s role in the ATA process model. The ATA process can be read both from the
perspective of the user or from the perspective of the AT Service Delivery centre. In the ATA process
model five actions in the psychologist’s role and the professional skills of psychologists have been
defined [11, 21]. The five actions (identify, advocate, mediate, facilitate, and reframe) of the psychologist
in the ATA process are shown in relation to the User’s Actions and the AT Service Delivery procedures.
Page 30 of 31
proof copy
Figure 5. The socio-environmental system according to the biopsychosocial perspective [5, 43]. The
psychotechnologist meets the user’s needs by seeking a proper assistive solution (in cooperation with
the multidisciplinary team). With the use of different tools (MPT measures (including the ATD-PA),
QUEST, SUMI, IPDA, etc.), the psychotechnologist coordinates the team of professionals in an AT service
delivery centre by observing critical issues and problems.
Page 31 of 31
proof copy
... The study conceptualized ATD provision processes as the Assistive Technology Assessment (ATA) process model [10], which includes the Matching Person and Technology (MPT) model [11]. Scherer's MPT model emphasizes a user-driven process of ATD selection, where a user collaborates with multidisciplinary professionals. ...
... Previous studies on ATD provision have revealed that multidisciplinary collaboration is a key factor for increasing the effects received by using them [10,[16][17][18]. Because the needs and contexts for ATDs largely vary according to clients even with the same diagnosis and symptoms, social and environmental factors play an important role [19]. ...
Article
Full-text available
Selection of assistive technology devices (ATDs), which are imperative for persons with disabilities to improve their quality of life, requires collaboration of users and multidisciplinary professionals. However, it is still unknown how to design and implement an adequate collaborative work flow and a professional team. Under Japanese governmental ATD provision system, based on the application by clients, ATDs are mainly selected through collaborative processes with the clients and health professionals in public organizations, rehabilitation counseling centers (RCCs). By employing qualitative study methods in this study, we investigated the ATD selection process in which health professionals in RCCs collaboratively assess clients with physical disabilities so as to support them in selecting the adequate ATDs. To identify the perspectives required for ATD selection completely, the assessment processes were recorded and analyzed with a pseudo setting in two RCCs. Content analysis of the conversations between the client and professionals revealed the characteristics of the information exchanged in the assessment processes. A total of 760 assessment items were identified, thus indicating a broad array of interest. Despite the richness of information collected for the assessment, half of the assessment items did not have corresponding items in the documents that were employed during the prescription process. Thematic analysis of the interviews that followed revealed the common values and collaborative processes in ATD selection, which were shared and elaborated among the staff in daily social interactions. To facilitate implementation of ATD provision in various areas with few resources, it may be effective to convert this tacit-to-tacit knowledge sharing into a more explicit sharing by promoting analyses of good practices.
... Long term use and acceptance of assistive technology devices depends on the interaction of milieu/environment, person, and the technology (see Figure 8) (Lenker and Paquet 2003;Federici, et. al., 2014). It is acknowledged that there is no standard for AT provision, and often this can lead to service gaps for the person as a result of lack or collaboration between disciplines (Federici et al. 2014). ...
... al., 2014). It is acknowledged that there is no standard for AT provision, and often this can lead to service gaps for the person as a result of lack or collaboration between disciplines (Federici et al. 2014). ...
Thesis
Older adults may have some prior use and knowledge of technology, but may also express or experience the digital divide, whereby the pace of emerging technology can present challenges to older adults and their ability to ‘keep up’. This can be a factor to device abandonment or loss in confidence to adopt the technology. The experience of ageing can be a positive one, with many older adults expressing the freedoms of mind and body when possible. Exoskeletons and exosuits offer capacity to augment the ability and mobility of older adults who experience functional limitations. However, these emerging technologies also present challenges of acceptance and adoption by older adult users. It is critical that understanding and insights are incorporated throughout concept development phases as a means to optimise acceptance and adoption. Study 1 explored and engaged with 22 older adult participants in order to observe and understand challenges to mobility and quality of life as we age. In addition, it implemented a number of design methods and collaborative approaches in order to share the findings from the fieldwork, culminating in a Co-Design Symposium. Study 2 completed a narrative review regarding the Technology Acceptance Models and user centred design guidance in relation to older adults’ acceptance of exoskeletons. Study 3 was an opportunity to conduct a second phase of fieldwork with 24 new older adult participants. The purpose of this fieldwork was to investigate the perceptions older adults have to emerging technologies, including exoskeletons. Study 4 Upon completion and analysis of the fieldwork, novel outputs emerged that created the basis for a Pilot study with older adult participants and XoSoft exoskeleton in a lab setting. Globally, as the ageing population currently continues to grow, the intervention of social robots and robotic assistive devices offers potential additional supports to independence and quality of life. Gerontechnology ensures we, as designers or developers of emerging technologies include understanding of the older adults’ experience and acceptance as part of a user-centred design approach. Older adults have specific acceptance criteria regarding exoskeletons and exosuits, and to date, this is currently not widely understood or documented. This research documents a ground theory approach, gaining knowledge, understanding and insights from older adults. It offers interpretations and analyses that have emerged as crucial factors to the development of an original approach to exoskeleton and exosuit development. URL: http://hdl.handle.net/10344/8489
... A well-known North American model described by Cook and Polgar defines the AT-SDP as "any service that directly assists an individual with disability in the selection, acquisition, or use of an assistive technology device" [5]. The contents of the AT-SDP have been described by different models including similar steps of the process, mostly differing regarding the degree of detail [5][6][7]. In Europe a model developed about 25 years ago encompassing generic steps of the AT-SDP is often used, and lately the steps of the model have been included in a GATE position paper [4]. ...
... -Reintegration (RNLI) improved over time -Caregivers had significant reductions in burden scores over time Correlation between changes in AT users' functional autonomy (SMAF ADL & mobility) were significantly correlated with changes in caregivers' activity-specific burden (CATOM [1][2][3][4][5][6][7][8][9][10][11][12][13][14] for the IG at the two first follow-ups and not for the CG. At the third follow-up there was a correlation for the CG and not for the IG. ...
Article
Purpose: The objective of this systematic review was to investigate effects of different assistive technology service delivery processes (AT-SDPs) for people with functional limitations, including investigation of factors associated with positive outcomes. Materials and methods: The study was registered in PROSPERO, registration number CRD42018097030. Included were quantitative studies published in peer reviewed journals: randomized controlled trials, cohort, case-control and analytical cross-sectional studies investigating effects of different AT-SDPs or factors associated with the AT-SDP and with n ≥ 10 participants. A systematic literature search was carried out in the databases PsycINFO, CINAHL, SSCI and Medline from 1 January 2008 to 25 July 2018. Besides, four journals were hand searched. The Joanna Briggs Institute MAStARI Critical Appraisal Tools were utilized to assess the risk of bias. Results: The search resulted in a total of 2947 references of which 12 articles representing 10 studies were included. Five studies were experimental, two were cohort, and five were cross-sectional studies. Conclusions: This systematic review confirms previous findings that assistive technology users should be involved in the AT-SDP in order to achieve positive outcomes. The level of evidence is, however, low, and it is not clear which of the applied methods are most effective. The review also gives some indication that new technologies could be used to improve the AT-SDP and reduce costs and that training in using the assistive devices seems to be useful. Even though some evidence of effective AT-SDP methods has been identified, more research is still needed to give valid recommendations to AT-SDP practice. • Implications for rehabilitation • Assistive technology users should be involved in the AT-SDP in order to achieve positive outcomes, but it cannot be determined which methods are the most effective. • New digital technologies could be used to improve the AT-SDP and reduce costs. • Training of the users in using their devices is probably useful, but since no specific methods nor extent or dose can be recommended, the professionals still need to use their clinical experience and reasoning to assess the user’s needs for training.
... A personalised approach to online support corresponds with what various authors from the research field of disability studies and the use of assistive technology have stressed, namely the importance of matching technologies with the needs, preferences and expectations of individual persons and their environments (e.g. Federici, Scherer, and Borsci 2014;Krantz 2012;Leopold et al. 2015;Scherer and Federici 2015). ...
Article
Full-text available
eHealth applications are increasingly being used in services for people with intellectual disabilities (ID). DigiContact is an online support service that uses videoconferencing techniques to enable people with ID to contact a team of specially trained support workers 24/7. In this qualitative and participatory study we aimed to explore the experiences of independently living people with ID with what it is like to be supported online. Five online support users were each interviewed twice and the transcripts were analysed using a phenomenological hermeneutic method. Choice and control played a central role in their shared experiences, as well as the relationship with online support staff. The results indicate that the suitability of online support depends on the needs, capabilities and preferences of each individual support user. This underlines the importance of a personalised approach to the planning and delivery of online support. • Points of interest • In this research we interviewed five persons from the Netherlands about what it is like for them to be supported by the online service DigiContact. • They felt that DigiContact helped them to have access to sufficient professional support. Without DigiContact this would have been impossible, because of a reorganisation of the national long-term care system and cuts in care budgets. • They also felt that DigiContact gave them control over their support and stimulated them to take on an active role towards solving their problems. • Online support felt relatively impersonal, because they had contacts with different support workers. • We conclude that online support seems not to be equally suitable for everybody. Whether online support is suitable, and in what form, depends on someone’s personal needs, wishes and preferences in support. Service organisations should look carefully at each individual person when planning the use of online support.
... Non-use of AE is of particular concern to publicly funded AE provision services (Federici, Scherer, & Borsci, 2014). In addition to the resource issues that non-use of AE raises, its occurrence suggests that greater understanding is needed about the AE user's experience over time. ...
Research
Background.: Adaptive equipment (AE) is frequently provided during stroke rehabilitation by occupational therapists. Purpose.: This study aimed to identify the AE that people typically use after a stroke and the outcomes achieved as a result, and to explore people's experiences obtaining and using AE, to inform both practice and policy in this field. Method.: A mixed-methods study, involving a postal questionnaire and interviews, used descriptive statistics and grounded theory to analyze the quantitative and qualitative data, respectively. Findings.: Questionnaire data ( n = 258) revealed mobility AE was issued most frequently, with increased safety as the primary reported outcome. Interview data ( n = 15) indicated relationships with health professionals and the hospital environment shaped early AE selection and use. Once home, making sense of AE and community participation were more influential. Implications.: Therapeutic relationships and reflection time are critical to maximize AE use after stroke. Policy and related funding for AE need to prioritize community participation.
... It is important to consider ways in which the technology can be designed to minimize the need for support, and improve the impact and reach of the technology. The Assistive Technology Assessment and delivery process [70] suggests practical guidelines for quality control of effective processes of matching individuals with the most appropriate technology. Part of the proposed assessment process is investigating the amount of technological support and training needed for the technology. ...
Article
This study sought to understand the perceptions of special education staff and caregivers (n = 6) who took part in a brain-computer interface (BCI) technology trial for individuals with severe cerebral palsy. Participants were interviewed post-trials regarding the different BCI components. The transcripts were coded and analyzed using thematic analysis. Results showed that BCIs are not suitable for independent use outside of clinical/laboratory settings. The hardware needs to be configurable, comfortable and accommodate physical support needs. The training approach needs to be less cognitively demanding, motivating and support personalized mental tasks. For BCIs to transition into the real world, there should be adequate technological support, improved reliability, and a systemic assessment of how the technology will fit into the lives of end users. Participants emphasized the on-going need to involve users and individuals who support them, to create a system that truly meets the needs of the users.
... Many products cannot be distributed without competent evaluations and properly trained service providers that are capable of eliciting user needs and goals. Matching assistive technology products must include a needs assessment process with appropriate assessment instruments and personnel who are trained to work with people with disabilities and, as appropriate, their families to perform these assessments [35,36]. Products cannot effectively be distributed without a replacement and loaner plan. ...
Article
Full-text available
This paper is based on work from the Global Research, Innovation, and Education on Assistive Technology (GREAT) Summit that was coordinated by WHO’s Global Cooperation on Assistive Technology (GATE). The purpose of this paper is to describe the needs and opportunities embedded in the assistive product lifecycle as well as issues relating to the various stages of assistive product mobilization worldwide. The paper discusses assistive technology product terminology and the dangers of focusing on products outside the context and rolling out products without a plan. Additionally, the paper reviews concepts and issues around technology transfer, particularly in relation to meeting global needs and among countries with limited resources. Several opportunities are highlighted including technology advancement and the world nearing a state of readiness through a developing capacity of nations across the world to successfully adopt and support the assistive technology products and applications. The paper is optimistic about the future of assistive technology products reaching the people that can use it the most and the excitement across large and small nations in increasing their own capacities for implementing assistive technology. This is expressed as hope in future students as they innovate and in modern engineering that will enable assistive technology to pervade all corners of current and potential marketplaces. Importantly, the paper poses numerous topics where discussions are just superficially opened. The hope is that a set of sequels will follow to continue this critical dialog. • Implications for Rehabilitation • Successful assistive technology product interventions are complex and include much more than the simple selection of the right product. • Assistive technology product use is highly context sensitive in terms of an individual user’s environment. • The development of assistive technology products is tricky as it must be contextually sensitive to the development environment and market as well. • As a field we have much to study and develop around assistive technology product interventions from a global perspective.
Article
Purpose Assistive Technology (AT) devices provide essential means of mobility, employment, communication, social engagement for older adults and people with different disabilities, if prescribed correctly to match users’ needs and goals. Regardless of the setting or location, a successful AT service delivery model includes the multidisciplinary collaboration of the people with disabilities and the specialists who have knowledge and expertise in the design and application of AT. In Saudi Arabia, unfortunately, the availability of AT devices is mainly limited to basic mobility and daily living aids such as wheelchairs and seating systems, prosthetics and orthotics, communication devices, low-vision devices, and adapted transportation equipment. The aim of this perspective is to provide clinicians and healthcare professionals in Saudi Arabia with a model for the optimisation of the provision of AT devices decision making regarding AT devices for people with disabilities by adhering to a user-centered team approach throughout the service delivery process Method The policy, human, activity, assistance, technology, and environment (PHAATE) model is used as a conceptual framework and guideline for this paper. Results and conclusion The PHAATE components could serve as a guideline for a wide range of stakeholders in Saudi Arabia (e.g., researchers, product developers, practitioners, clinicians, third-party reimbursement entities, consumers, and educators) when developing service delivery systems. • IMPLICATION FOR REHABILITATION • Despite the support and funding resources of AT devices by the Saudi government, there is still the needs to increase awareness and knowledge about AT application and services, as well as optimal service delivery models of AT devices. • AT service delivery provision models such as PHAATE model may help clinicians and other medical professionals in Saudi Arabia to make informed decisions about the provision of AT device services.
Chapter
This paper’s goal is to identify the different methods and techniques of assistive technology evaluation with users with disabilities, focusing on the post-design phase. As a method, we carried out a literature review regarding user-centered design and assistive technology. For the data analysis strategy, we followed three stages: 1- Descriptive analysis (based on the information provided by the authors); 2- Grouping methods and techniques by similarity; 3- Quantitative analysis (based on the incidence of the methods and techniques found. As a result, were identified 20 evaluation methods and techniques. The highest incidence were: survey, questionnaires, interviews and focus groups.
Chapter
This chapter discusses the influence of cognitive impairment in the prescription and effective use of electronic assistive technology (EAT). The authors consider the impact of cognitive, emotional and executive impairments on the use of EAT, and the effect of the course and prognosis of different types of neurodevelopmental versus acquired or progressive disorders. Self-awareness and motivation are also considered as key influences on the use and outcome of EAT. The effects of executive, attention and memory impairments on the ability to engage with technology and its implications for the uptake of EAT are explored, alongside strategies and technology developed to address these problems. The authors conclude the chapter by emphasising the importance of the development and improvement of affordable technologies with health applications. They highlight the usefulness of the neuro-socio-technical and technology acceptance models as a framework to adopt when prescribing EAT to people with cognitive impairments to fully consider the interplay between clinical presentation, social environmental factors and technological capabilities.
Article
Full-text available
The Matching Person & Technology (MPT) assessment process is a set of person-centered measures, all of which examine the self-reported perspectives of adult consumers regarding strengths/capabilities, needs/goals, preferences and psychosocial characteristics, and expected technology benefit. There are separate measures for general, assistive, educational, workplace, and healthcare technology use; in Ireland, the measures were used to assess outcomes of assistive technology (AT) provision for (a) people throughout the country participating in a new localized AT service delivery process and (b) students transitioning from secondary education. There are companion provider forms so that consumer-provider shared perspectives can be assessed and to ensure that the matching process is a collaborative one; the Irish version assumes collaboration from the start. Each measure can be used when evaluating a person for technology use and as person-centered, ideographic, outcomes measure. The measures have been determined to have good reliability and validity.
Article
Full-text available
Background. The introduction of assistive technology (AT) into people’s lives is a deliberative and long-term process, which presupposes teamwork as much as professionalism, time, and experience. The aim of the assistive technology assessment (ATA) process is to suggest guidelines to follow in order to reach valid results during the AT selection and assignment process. Purpose. Critically discuss the application of the model of the ATA process developed by Federici and Scherer in the 2012. Method. Cross-cultural comparison of AT service delivery systems and discussion of the ATA process model adopted by Leonarda Vaccari Institute of Rome. Conclusion. Nowadays, the wide variety of AT devices on the market opens new frontiers to the individual’s enhanced functioning, inclusion, and participation. Since the choice of the most appropriate match is often a complex process, a systematic selection process such as the ATA process described in this article can help practitioners to efficiently achieve successful outcomes.
Book
Full-text available
The book we propose is not only a classic handbook or a practical guide for evaluation practictioners that presents and discusses one or a set of evaluation techniques for assessing diferent aspects of interaction. Our proposal is at first a new theoretical perspective in the human computer interaction evaluation that aims to integrate, in a multisteps evaluation process, more techniques for obtaining a whole assessment of interaction. Our theorical perspective is supported by an historical and experimental argumentation. Secondary our book by merging a user center perspective with the idea of user experience and with the growing need of disabled users partecipation in the evalaution and in the improvment of the HCI, proposes a reconceptualization of the web, social and portable tecnologies in a new category the “psychotecnologies” with specific properties. The integrated methodology of intercation evalaution is proposed as a framework for practictioners in order to evaluate all the aspects of the interaction from the accessibility (i.e. the more obejective point of view) to the staisfaction (i.e. the most subjective poitn of view). The evalaution techniques we analyse and the evaluation tools we propose in the book are supported by experimental exemplifications and are correlated to their application in the integrated methodology. Our goal is not only to presents the correct application of the techniques, but also to promote a standard evaluation process in which disabled and not disabled peoples are involved in the assessment.
Article
Full-text available
Numerous individuals with disabilities are dissatisfied with their assistive technology and discontinue its use (Phillips & Zhao, 1993). Abandonment rates of assistive technology range from eight percent to 75 percent (Tewey, Barnicle, & Perr, 1994). Factors associated with continuance/discontinuance of assistive technology among individuals who received assistive technology through Colorado agencies (funded under the Technology-Related Assistance for Individuals with Disabilities Act) were investigated. The sample consisted of 115 individuals with disabilities who were provided with funding for 136 assistive technology devices. Independent variables (relative advantage, support, consumer involvement, trialability, changes in consumers, re-invention and compatibility) were examined to determine if they were associated with assistive technology device continuance/discontinuance. Analysis of the results suggests that relative advantage and consumer involvement have a significant influence in predicting discontinuance.
Conference Paper
Full-text available
The process of matching assistive technology to person requires a well-designed and researched sequential set of assessments that are administered by professionals with different areas of expertise in specialized centers for technical aids. The team of experts acts as a mediator between the person with a disability and the assistive technology. The context for this workshop rests on the following main features: the scientific power of the Assistive Technology Assessment (ATA) process, the presentation and discussion of new professional profiles within a multidisciplinary team working in a center for technical aid, and techniques and tools for assessing personal and environmental factors within the ATA process.
Article
The use of assistive technology by college students with disabilities is a necessary tool to enhance their academic success. Many individuals with disabilities, however, discontinue use of their technology. Discontinuance represents a waste of functional abilities and a disadvantage to college students with disabilities. The purpose of this study was to report the rate of use and abandonment of assistive technology among college students with disabilities. Fifty-three college students with various disabilities participated in a survey on assistive technology device use and abandonment across the domains of home, school, recreation, leisure, hearing, vision, and mobility. Results showed that a total of 51 devices were abandoned across all domains. School was the domain with the highest rate of use and the second highest rate of abandonment. The mobility domain represented the second largest number of devices used and the largest number of devices abandoned. These findings demonstrate that college students are using assistive technology devices for school and mobility. However, they are also abandoning them at a high rate.
Article
Historical OverviewDefinition and Scope of the FieldKey Research Findings and ApplicationsFuture Developments, Challenges, OpportunitiesPublic Policy ImplicationsReferences
Article
Psychotechnologies are technological extensions of our mind that cover the surface of the earth via radio, telephone and computers. Psychologically, however, we have not matured sufficiently to integrate the extended dimensions of our technological reach. Our response to the planetary environment at the social and political levels is still informed by obsolete Western and Renaissance notions of humankind, which are wholly inadequate. We need a new spatial sensibility to appreciate the complexity of our satellite and networked environment. The role of communications art is to emphasize how communication technologies are changing our psychological relationship to space and spatial concepts.