Overview

OCC204:
Enabling strategies:
• Person-led assessment
Working with Assistive technologies • Assistive technology processes and service
Assistive technology delivery
processes and decision- • Features and feature-matching
making: features and • Funding
feature-matching 💰💵
TRINA PHUAH

AT Assessment (strategies, devices, design) Person-led assessment

Need to consider: “Being informed, demanding and responsible consumers of assistive
technology”
the occupation “organisations of people with disability strongly advocate a user-centred
– what does the person want/need to do? approach, where the end-user is the main protagonist and decision
the person maker”
– what can the person do? “professional services are still recognised as being fundamentally
important, but tend to be seen as options and not obliged pathways”
the context (environments)
– social, cultural, physical: where/when/with who?
Andrich and Besio (2002)

1
Who is the ‘expert’ here?
Joan is a sixty-six year old woman who is
currently a rehabilitation inpatient
following a stroke 3 months ago. She will
return home to live with her husband and
needs a wheelchair/s for all her indoor
and outdoor mobility. The family is very
shocked and stressed about what their
new life is going to be like.
You are the (new graduate) OT who has
been working with Joan and who will
organise her mobility equipment.
AT Service Delivery Processes
The assistive technology process
Jim is a 47 year old man who lives with a • AT can be seen as the solution or answer before the
C5/C6 spinal cord injury sustained in a problem has been clearly articulated or identified, or
football accident when he was 17 years
old. He lived in Sydney for many years may not have been considered
working for ParaQuad NSW and now is
back in the Riverina where he lives with • Always aim to start with the person. Some key
his wife. questions:
He needs new manual wheelchair. You
are the community (and new graduate) •
OT who has the referral to assist in the
process. •
•
•
A Balanced AT Solution
Considers contexts and is:
• Task/ -focussed
• Person- /person-led
• Requires access to:
‒ information to support informed
choice and decision-making
‒ products and
‒ : discrete and ongoing
(Andrich et al., 2013, p. 136)
2
Consider: Identify
A person is issued with a power
wheelchair, with features
Potential factors (e.g. social,
carefully selected to match their
individual preferences and environmental, cultural etc)
requirements. The wheelchair has that may support or inhibit the
been introduced with the person’s participation at home,
intention to support their
mobility at home, in the
in the community and at work.
community and to enable
participation in their employment
Image: https://pixabay.com/en/motorized-wheelchair-wheelchair-952190/
CC0 1.0

Ideas? If an assistive device is indicated…

Environment Support Inhibit

Physical How can you identify
which assistive
Social device/product is
Cultural part of the solution?
Other?

3
 Assistive technology…

Features and feature-

matching

TRINA PHUAH

If an assistive device is indicated…

How can you identify

Feature-
which assistive
device/product is
part of the solution?
matching!

4
Feature-matching Features?? Label them!
• Process of -
• Consider the important factors from your assessment:
what does the person want to do?
• Envisage an ‘ideal’ solution: why are there difficulties;
what does the assistive device need to do to be able to
support the person to achieve their goal/s?
• A general understanding of product is
useful, but you don’t necessarily need to know specifics
(use and the skills of the )
Image: Aidacare website

Meet Trevor: Referral for a new mobile

shower/commode
• Mid-30s, experienced an acquired brain
injury and incomplete SCI in his late teens
• Lives in Specialist Disability
accommodation and receives assistance
Feature-matching? with personal care and most ADLs
• Uses a power wheelchair for mobility
Have a go…. • Able to do standing pivot transfers with
assistance
• Has reduced upper limb skills and
restrictions in movement/sensation in his
lower limbs.
• Reduced trunk control when fatigued

5
 Potential device features:
Consider: Feature-matching example
Consideration/ Performance issue Feature/s
:
Able to do standing pivot transfers Swing away
What does Trevor want to do? Suitable height for
: reduced upper limb skills: unable to -propelled
self-propel ?supportive
Trevor’s strengths, supports and challenges restrictions in movement/sensation Suitable support for LL;
: in his lower limbs - seat
physical, social, cultural contexts of use: Reduced trunk control when fatigued supports on seat
?high back rest/head support
Who, where, why, how? ?Tilt-in-
Is there other information you need? Need to use over toilet, in shower Height and depth to fit toilet
waterproof

Options? Additional considerations for the solution…

Image: https://at-aust.org/items/13201
Image: https://at-aust.org/items/9554
• Trial
• Transfers on/off
• of use
• Funding /
• Staff training
• re: dressing/bathing/toilet
• Trevor’s choice and control in the activities
and ability/opportunity to be actively involved
• and repair
Image: Aidacare

6
Ethical practice Summary and notes
“It is the professional and ethical responsibility of occupational therapy
practitioners to provide services only within their own level of
competence and scope of practice.” (Bondoc et al., 2016, p.4)

“SWEP recognises that threshold qualifications alone, don't necessarily

prepare health professionals to implement assistive technology (AT)
solutions to expected performance levels and that there are a range of
ways clinicians grow in their proficiency in this area of practice
e.g. reflective practice, clinical supervision, performance enhancement,
formal and informal education, training and experience.”
(SWEP website https://swep.bhs.org.au/prescriber-education.php)

References and resources References and resources

Andrich, R., & Besio, S. (2002). Being informed, demanding and responsible consumers
of assistive technology: An educational issue. Disability & Rehabilitation, 24(1-3),
152-159.
Andrich, R., Mathiassen, N.-E., Hoogerwerf, E.-J., & Gelderblom, G. J. (2013). Service
delivery systems for assistive technology in Europe: An AAATE/EASTIN position
paper. Technology & Disability, 25(3), 127-146
Bondoc, S., & Goodrich, B. (2016). Assistive technology and occupational performance.
American Journal of Occupational Therapy, 70, (Supplement 2), 701240030p1-
701240030p13.
Waldron, D., & Layton, N. (2008). Hard and soft assistive technologies: Defining roles
for clinicians. Australian Occupational Therapy Journal, 55(1), 61-64.
Riemer-Reiss, M. L., & Wacker, R. R. (2000). Factors associated with assistive technology
discontinuance among individuals with disabilities. Journal of Rehabilitation, 66(3),
44-50.
Scherer, M. J., Sax, C., Vanbiervliet, A., Cushman, L. A., & Scherer, J. V. (2005). Predictors
of assistive technology use: The importance of personal and psychosocial
factors. Disability & Rehabilitation, 27(21), 1321-1331.
Steel, E., Gelderblom, G. J., & de Witte, L. P. (2011). Development of an AT selection
tool using the ICF model. Technology and Disability, 23(1), 1-6.
World Health Organization. (2016, May). Priority Assistive Products List. Retrieved from
http://apps.who.int/iris/bitstream/10665/207694/1/WHO_EMP_PHI_2016.01_eng.
pdf?ua=1