Steps to Assistive Technology Provision: Difference between revisions

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== Introduction ==
== Introduction ==
Assistive technology (AT) is a broad term used to describe products whose primary aim is to improve or maintain an individual's independence and function.<ref>MacLachlan M, Scherer MJ. [https://www.tandfonline.com/doi/full/10.1080/17483107.2018.1472306 Systems thinking for assistive technology: a commentary on the GREAT summit]. Disability and Rehabilitation: Assistive Technology. 2018 Jul 4;13(5):492-6.</ref>  <ref name=":0">de Witte, L., Steel, E., Gupta, S., Ramos, V.D. and Roentgen, U., 2018. [https://www.tandfonline.com/doi/full/10.1080/17483107.2018.1470264 Assistive technology provision: towards an international framework for assuring availability and accessibility of affordable high-quality assistive technology]. ''Disability and Rehabilitation: Assistive Technology'', ''13''(5), pp.467-472.</ref> AT can be used for many types of impairments (e.g. vision, hearing, mobility, self-care) and by people of all ages. AT solutions can range from very simple, low-tech devices to highly complex, expensive products. The range of products and users of these products make AT provision an elaborate process. Adding to the complexity is that AT provision is not a one-size fits all, and must be tailored to the individual.<ref name=":0" />  
Assistive technology (AT) is a broad term used to describe products whose primary aim is to improve or maintain an individual's independence and function.<ref>MacLachlan M, Scherer MJ. [https://www.tandfonline.com/doi/full/10.1080/17483107.2018.1472306 Systems thinking for assistive technology: a commentary on the GREAT summit]. Disability and Rehabilitation: Assistive Technology. 2018 Jul 4;13(5):492-6.</ref>  <ref name=":0">de Witte, L., Steel, E., Gupta, S., Ramos, V.D. and Roentgen, U., 2018. [https://www.tandfonline.com/doi/full/10.1080/17483107.2018.1470264 Assistive technology provision: towards an international framework for assuring availability and accessibility of affordable high-quality assistive technology]. ''Disability and Rehabilitation: Assistive Technology'', ''13''(5), pp.467-472.</ref> AT can be used for many types of impairments (e.g. vision, hearing, mobility, self-care) and by people of all ages. AT solutions can range from very simple, low-tech devices to highly complex, expensive products. The range of products makes AT provision a complex process. This process is further complicated by the fact that AT provision is not a one-size fits all; it must be tailored to the individual.<ref name=":0" />  


== Provision ==
== Provision ==
Assistive technology provision refers to the various elements that are required to ensure a user obtains the most appropriate and beneficial AT solution for their impairment. The fundamentals of AT provision are described below:<ref name=":0" />
"Assistive technology provision" is a process aimed at ensuring that each user obtains the most appropriate and beneficial AT solution for their impairment. The fundamentals of AT provision are described below:<ref name=":0" />
* Users need to know that AT solutions exist
* Users need to know that AT solutions exist
* Quality products must be available and affordable
* Quality products must be available and affordable
* Professionals are required to provide the service, including:  
* Professionals are required to provide the following services:  
** Assessment
** Assessment
** Training
** Training
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== Four Steps To Provision ==
== Four Steps To Provision ==
The World Health Organization (WHO) has described four steps that are necessary when providing assistive technology.<ref name=":1">World Health Organization.  Training in Assistive Products Module.  2020.  Available from: https://www.gate-tap.org/all-modules/</ref> Proceeding through each step allows the user to gain the most benefit from the product and ensure safety. The four steps to AT provision include: select, fit, teach and follow-up.<ref name=":1" />
The World Health Organization (WHO) has described four steps that are necessary when providing assistive technology.<ref name=":1">World Health Organization.  Training in Assistive Products Module.  2020.  Available from: https://www.gate-tap.org/all-modules/</ref> Proceeding through each step allows the user to gain the most benefit from the product and ensure safety. The four steps to AT provision are: select, fit, teach and follow-up.<ref name=":1" />


This video by the World Health Organization summarises the four steps to assistive technology provision:
This video by the WHO summarises the four steps to assistive technology provision:
{{#ev:youtube|e1TqInVnFFQ}}
{{#ev:youtube|e1TqInVnFFQ}}


=== Select ===
=== Select ===
The select phase of service provision is essentially the assessment. It is important during the assessment to involve the user and their family or caregivers. This will allow for a better choice of AT that is tailored directly to the individual and is suitable for how how they will be using it.<ref name=":2">Oldfrey, B., Barbareschi, G., Morjaria, P., Giltsoff, T., Massie, J., Miodownik, M. and Holloway, C., 2021. [https://www.mdpi.com/2071-1050/13/19/10867/htm Could assistive technology provision models help pave the way for more environmentally sustainable models of product design, manufacture and service in a post-covid world?.] Sustainability, 13(19), p.10867.  </ref> The World Health Organization has a range of assessments forms for various assistive products that help determine the best device for the individual.<ref name=":2" /> Information that can be gathered during the select phase includes the user's:
The select phase of service provision is essentially the assessment. During the assessment, it is important to involve the user and their family or caregivers. This will ensure that the choice of AT is appropriate and tailored directly to the individual and their requirements.<ref name=":2">Oldfrey, B., Barbareschi, G., Morjaria, P., Giltsoff, T., Massie, J., Miodownik, M. and Holloway, C., 2021. [https://www.mdpi.com/2071-1050/13/19/10867/htm Could assistive technology provision models help pave the way for more environmentally sustainable models of product design, manufacture and service in a post-covid world?.] Sustainability, 13(19), p.10867.  </ref> The WHO has a range of assessments forms for various assistive products that help determine the best device for the individual.<ref name=":2" /> Information that can be gathered during the select phase includes the user's:


* Health
* Health
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=== Fit ===
=== Fit ===
After the assistive product has been selected, the next stage in the provision sequence is to ensure a proper fit. This is a crucial step as the device needs to fit well in order to be safe and not cause harm. Additionally, if the fit is not adequate, the user will not gain the intended benefit. The WHO recommends checking that the following three features are met when fitting a user to their AT:
After the assistive product has been selected, the next stage in the provision sequence is to ensure a proper fit. This is a crucial step as the device needs to fit well in order to be safe and not cause harm. Additionally, if the fit is not adequate, the user will not gain the intended benefit. The WHO recommends checking the following when fitting a user to their AT:


# It is properly assembled
# It is properly assembled
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=== Use ===
=== Use ===
The use stage can also be referred to as the teaching stage. It is when the user and/or their caregiver learns how to use their assistive device. The WHO recommends that the following steps are included in this stage:
The use stage can also be referred to as the teaching stage. It is when the user and/or their caregiver learns how to use the assistive device. The WHO recommends that the following steps are included in this stage:


# Explain
# Explain
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=== Follow-Up ===
=== Follow-Up ===
The follow-up step is crucial to ensuring that an AT product is still meeting the user's needs. If the AT is not meeting their needs, a reassessment or an outside referral may be warranted. Coming up with a solution with the user would be the best course of action in this scenario.<ref name=":1" />   
The follow-up step is crucial to ensuring that an AT product is still meeting the user's needs. If the AT is not meeting someone's needs, a reassessment or an outside referral may be warranted. Coming up with a solution with the user is the best course of action in this scenario.<ref name=":1" />   


Follow-up is also a time to check that the product is in good condition and does not require any repairs.<ref name=":1" /> Many times this step is excluded and users will not have access to repair services, especially in low-income settings.<ref name=":2" />
Follow-up is also a time to check that the product is in good condition and does not require any repairs.<ref name=":1" /> Many times this step is left out and users will not have access to repair services, especially in low-income settings.<ref name=":2" />


The WHO recommends checking for the following:
The WHO recommends checking for the following:


* Has the individual grown and the product longer works for them?
* Has the individual grown and the product no longer works for them?
* Has the individual's posture changed and the product no longer works for them?
* Has the individual's posture changed and the product no longer works for them?
* Are their any screws or bolts that are loose?
* Are their any screws or bolts that are loose?

Revision as of 11:10, 24 October 2022

Original Editor - Robin Tacchetti Top Contributors - Robin Tacchetti, Wanda van Niekerk, Jess Bell and Rishika Babburu

Introduction[edit | edit source]

Assistive technology (AT) is a broad term used to describe products whose primary aim is to improve or maintain an individual's independence and function.[1] [2] AT can be used for many types of impairments (e.g. vision, hearing, mobility, self-care) and by people of all ages. AT solutions can range from very simple, low-tech devices to highly complex, expensive products. The range of products makes AT provision a complex process. This process is further complicated by the fact that AT provision is not a one-size fits all; it must be tailored to the individual.[2]

Provision[edit | edit source]

"Assistive technology provision" is a process aimed at ensuring that each user obtains the most appropriate and beneficial AT solution for their impairment. The fundamentals of AT provision are described below:[2]

  • Users need to know that AT solutions exist
  • Quality products must be available and affordable
  • Professionals are required to provide the following services:
    • Assessment
    • Training
    • Follow-up[2]

Four Steps To Provision[edit | edit source]

The World Health Organization (WHO) has described four steps that are necessary when providing assistive technology.[3] Proceeding through each step allows the user to gain the most benefit from the product and ensure safety. The four steps to AT provision are: select, fit, teach and follow-up.[3]

This video by the WHO summarises the four steps to assistive technology provision:

Select[edit | edit source]

The select phase of service provision is essentially the assessment. During the assessment, it is important to involve the user and their family or caregivers. This will ensure that the choice of AT is appropriate and tailored directly to the individual and their requirements.[4] The WHO has a range of assessments forms for various assistive products that help determine the best device for the individual.[4] Information that can be gathered during the select phase includes the user's:

  • Health
  • Ability
  • Activity level
  • Where they will use the device
  • Support services nearby
  • Their knowledge of/experience with the device

Having a wide variety of assistive products will make it easier to match a device to the individual's specific needs.[3]

Fit[edit | edit source]

After the assistive product has been selected, the next stage in the provision sequence is to ensure a proper fit. This is a crucial step as the device needs to fit well in order to be safe and not cause harm. Additionally, if the fit is not adequate, the user will not gain the intended benefit. The WHO recommends checking the following when fitting a user to their AT:

  1. It is properly assembled
  2. It is adjusted to the right size
  3. It is comfortable and safe for the person to use[3]

When fitting individuals with a selected assisted device, always ask for feedback from the user. The device may need to be modified or adjusted during this time.[3]

Use[edit | edit source]

The use stage can also be referred to as the teaching stage. It is when the user and/or their caregiver learns how to use the assistive device. The WHO recommends that the following steps are included in this stage:

  1. Explain
  2. Demonstrate
  3. Practise[3]

Follow-Up[edit | edit source]

The follow-up step is crucial to ensuring that an AT product is still meeting the user's needs. If the AT is not meeting someone's needs, a reassessment or an outside referral may be warranted. Coming up with a solution with the user is the best course of action in this scenario.[3]

Follow-up is also a time to check that the product is in good condition and does not require any repairs.[3] Many times this step is left out and users will not have access to repair services, especially in low-income settings.[4]

The WHO recommends checking for the following:

  • Has the individual grown and the product no longer works for them?
  • Has the individual's posture changed and the product no longer works for them?
  • Are their any screws or bolts that are loose?
  • Is their any rust or are there broken pieces?[3]


This video by the World Health Organization demonstrate how to look for broken components in an assistive device:

After this visit is completed, make an appointment for the next follow-up visit.[3]

Putting it all Together[edit | edit source]

The video below by Momentum Wheels for Humanity demonstrates each step of wheelchair provision. It adds four additional stages that take place outside the clinician's role.

Resources[edit | edit source]


References[edit | edit source]

  1. MacLachlan M, Scherer MJ. Systems thinking for assistive technology: a commentary on the GREAT summit. Disability and Rehabilitation: Assistive Technology. 2018 Jul 4;13(5):492-6.
  2. 2.0 2.1 2.2 2.3 de Witte, L., Steel, E., Gupta, S., Ramos, V.D. and Roentgen, U., 2018. Assistive technology provision: towards an international framework for assuring availability and accessibility of affordable high-quality assistive technology. Disability and Rehabilitation: Assistive Technology, 13(5), pp.467-472.
  3. 3.0 3.1 3.2 3.3 3.4 3.5 3.6 3.7 3.8 3.9 World Health Organization. Training in Assistive Products Module. 2020. Available from: https://www.gate-tap.org/all-modules/
  4. 4.0 4.1 4.2 Oldfrey, B., Barbareschi, G., Morjaria, P., Giltsoff, T., Massie, J., Miodownik, M. and Holloway, C., 2021. Could assistive technology provision models help pave the way for more environmentally sustainable models of product design, manufacture and service in a post-covid world?. Sustainability, 13(19), p.10867.