Four Steps to Assistive Technology Provision

Introduction[edit | edit source]

Assistive technology (AT) is a broad term referring to products whose primary aim is to improve or maintain and individual's independence and function.[1] [2] AT is be used for many types of impairments (vision, hearing, mobility, self-care) and by people of all ages. AT solutions can run on a spectrum from very simple low-tech to highly complex expensive products. The range of products and user's of the 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. [2]

PROVISION[edit | edit source]

Assistive technology provision is a term referring to everything that is required to ensure a user can obtain the most appropriate and beneficial AT solution needed for their impairment.The fundamentals of AT provision are described below:

  • users need to know that AT solutions exist
  • quality products available and affordable
  • professionals required to provide the service
    • assessment
    • training
    • follow-up[2]

Four Steps To Provision[edit | edit source]

The World Health Organization 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 to ensure safety. The four steps to AT provision include: select, fit, teach and follow-up.[3]

This video by the World Health Organization summarizes the four steps to assistive technology provision:

Select[edit | edit source]

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 tailored directly to the individual and how they will be using it.[4]The World Health Organization (WHO) has extensive assessments forms for a variety of 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/experience about the device

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

Fit[edit | edit source]

After the assistive product has been selected, a proper fit is the next stage in the provision sequence. This is a crucial step in that 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 for the following three features 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 individual's 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 as the user and/or their caregiver learns how to use their assistive device. The WHO recommends the good practice during this step include:

  1. explain
  2. demonstrate
  3. practise[3]

Follow-Up[edit | edit source]

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

Follow-up is also a time to check that they product is in good condition and does not require any repairs.[3]Many times this step is excluded and user's will not have access to repair services, specifically in low-income settings.[4]

The WHO recommends checking for the following:

  • has the individual grown and the product longer works for them
  • has the individual posture changed and the product no longer works for them
  • are their any screws or bolts that are loose
  • is their any rust or broken pieces[3]

This video by the World Health Organization demonstrate how to look for broken component 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 adding four additional stages that take place outside the clinicians 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 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:
  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.