Selecting and Obtaining Assistive Technology

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Posted by Elizabeth on January 06, 2003 at 20:55:25:

In Reply to: How to decide what technology is right for you? posted by Elizabeth on December 29, 2001 at 00:10:30:

Selecting and Obtaining Assistive Technology

Assistive technology is any item, piece of equipment, or product system, whether commercially, modified, or custom built, that is used to maintain or increase the functional capabilities of a person with a disability.

Buying a telephone is pretty simple these day. Pick one up at your local discount electronics store, take it home, plug it in, and call a friend. If it doesn’t work or lacks the features you want, just take it back and exchange it.

Selecting assistive technology is usually not so simple. Finding the "best fit" between person, environment, and technology is a multi-step process. Prospective consumers and those helping them must carefully gather and evaluate information, and then make informed decisions. This process is important because bad decisions waste time, money, and patience. Poorly chosen equipment may be of little help to the user, or even end up unused in a closet.

Steps in Selecting and Obtaining Assistive Technology

1. Define Your Goal: What Do You Want To Accomplish?

The first and primary question that you must answer is: What is the goal of the "match" between the technology and the user? What will the technology enable the user to do that he or she is currently limited in doing?

2. Determine the Assessment Team

Assessment is a complex task which requires input from the consumer, family members, educational and medical professionals, co-workers, caretakers—anyone who will frequently work with the consumer or the technology. If funding is tied to educational objectives or medical diagnoses, there may be formal requirement that certain professional be involved and certain documentation obtained. Including the appropriate individuals on the assessment team is vital to a successful outcome.

3. Assess the Prospective Consumer

An assessment should include a precise determination of the abilities and the limitations of the consumer in sensory, cognitive, and motor terms. What is the consumer able to do? What assistance does he or she need?

4. Assess the Environment

Will the technology enable the user to achieve the desired functional goal in all the environments where it is likely to be used? What other people will be interacting with the consumer and the technology in these various settings?

5. Assess the Technology
If choices are available, what device, adaptation, or system is the best match with the needs of the prospective user and the environments in which they will function?

Consider Other Important Factors

* Consumer independence: Which device allows the user the greatest independence?

* Ease of use/need for training: If training is required, where and how can it be obtained? What does it cost?

* Transportability: If the device will be used in more than one setting, is it easy to transport from place to place?

* Reliability and durability: What is the "track record" under actual use conditions of the devices under consideration? If a breakdown occurs, how difficult and time-consuming is it to obtain service?

* Safety: How safe is the device, both for the primary consumer, and for others who may work with it?

* Comfort/attractiveness/age-, gender- and culture-appropriateness: Does the consumer feel comfortable with the way that the technology looks, feels, and sounds?

Choose a Device/System

1. Select a Vendor
It is not enough that a particular vendor sells a piece of equipment that you are interested in. The dealer’s consumer-responsiveness, professionalism, and service orientation should be an important part of your decision process.

Some questions to ask:

How long has the dealer been in business?
What is his/her knowledge of particular disabilities, and of the equipment being sold? How was that knowledge gained?
Does that dealer participate in "continuing education" to stay up-to-date on new developments in both technology and rehabilitation?
How long has the dealer supplied the device you are interested in?
What is the dealer’s responsibility if error occur in measuring, ordering, assembling, or delivering the equipment?
Does the dealer provide training or refer to sources of training?
Does the dealer carry professional liability insurance?
Is the dealer willing to provide the names of previous customers using similar equipment as references?

Some questions about service that you might ask:

Does the dealer have in-house service people and parts inventory adequate to locally service your device?
What is the average or typical turn-around time for a repair?
Will the dealer give you a written estimate of cost and time for a repair?
Will the dealer make comparable loaner equipment available during a repair?
Does the dealer provide a warranty on service or customization of equipment?

2. Seek Funding

Assistive technology ranges from relatively inexpensive to extremely expensive; a wheelchair/seating system, for example, can cost as much as a car. Finding assistance with funding may take considerable time and effort, so you should begin to investigate funding sources at the same time you start looking at technology.

Major sources of third party payments for the purchase of assistive technology are insurance, agencies that provide educational and vocational service, philanthropic organizations, and loan closets. Determining eligibility, obtaining the required documentation, and monitoring the approval process take time, patience, and attention to detail. Purchasing used equipment can reduce cost

3. Determine Training Needs

The arrival of a piece of equipment is not the end of the process. Both the user and anyone else who works with the user and the device should receive appropriate training. This may be provided by the dealer, a representative of the manufacturer, or a staff person from an educational or medical institution. Training insures that the technology is used effectively, safely, and consistently in all the relevant settings. Proper use and maintenance also minimizes the cost and inconvenience of breakdowns and repairs.

4. Conduct Follow-up

Short-term follow-up should be performed within a couple of months, after the individual has had a chance to become familiar with the technology.

Does the assistive technology permit the use to achieve the stated functional goals?
Is the user comfortable and proficient with the technology, or in the case of more complex technology (augmentative communication systems, for example), making good progress in learning the system? If not, what changes can be made to ease this process?
Are adjustments in the equipment or additional training needed?
Long-term re-evaluation should also be performed on a regular basis, perhaps annually. This is necessary because people change, environments change, and technologies change.

Have the functional capabilities of the user increased or declined in ways that affect use of the technology?
Is the individual functioning in environments different from those when the technology was first selected?
Has the device developed problems that justify replacing it, or do newer versions have sufficiently greater capabilities or ease of use to justify a substitution?
Consumers who experience changes—either in themselves or their environment—that affect the usefulness of their equipment need to be proactive in seeking re-evaluation.

Source: Infotech / Iowa Program for Assistive Technology

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