DISCUSS REHABILITATIVE,

ASSISTIVE, UNIVERSAL
TECHNOLOGIES, IT’S ROLE IN
OCCUPATIONAL PARTICIPATION
GUIDED BY PRESENTED BY
MS. SHUBHANGI S.R.DIVYA LAKSHMI
ASSISTANT PROFESSOR MOT I YEAR (NEUROSCIENCES)
CONTENTS

• WHAT IS ASSISTIVE TECHNOLOGY?

• WHAT IS REHABILITATIVE TECHNOLOGY?
• DIFFERENCE BETWEEN REHABILITATION AND ASSISTIVE TECHNOLOGY?
• UNIVERSAL DESIGN
• PRINCIPLES OF UNIVERSAL DESIGN
• HUMAN INTERFACE ASSESSMENT
• ROLE OF OCCUPATIONAL PARTICIPATION
WHAT IS ASSISTIVE TECHNOLOGY?

• Assistive technologies, therefore, are technologies that assist a person with a disability to
perform tasks.
• The Assistive Technology Act of 1998 defines assistive technology as “any item, piece of
equipment, or product system, whether acquired commercially off the shelf, modified, or
customized, that is used to increase, maintain, or improve functional capabilities of individuals
with disabilities.”
• Assistive technology can be added to the physical environment(p. 6). Some examples of
assistive technology in the bathroom can range from a long-handled sponge for bathing to
digital motion sensors to detect a fall.
• More specifically, assistive technologies are technologies, whether designed for a person
with a disability or designed for mass market and used by a person with a disability, that
allow that person to perform tasks that an able-bodied person can do without technological
assistance.
• It may be that an able-bodied person prefers to use a technology to perform a task (eg, a
television remote control), but the device does not rise to the level of assistive technology as
long as it is possible for the individual to perform the task without the technology. Some
examples of assistive technology in the bathroom can range from a long-handled sponge for
bathing to digital motion sensors to detect a fall.
• Assistive technologies replace or support an impaired function of the user without being
expected to change the native functioning of the individual.
• A wheelchair, for example, replaces the function of walking but is not expected to teach
the user to walk.
• Similarly, forearm crutches support independent standing but do not, of themselves,
improve strength or bony integrity and thus will not change the ability of the user to stand
without them.
• Because they are not expected to change the native ability of the user, assistive technologies have
different design considerations.
• These devices are expected to be used over prolonged periods by individuals with limited training
and possibly with limited cognitive skills.
• The technology, therefore, must be designed so that it will not inflict harm on the user through casual
misuse.
• The controls of the device must be readily understood, such that although some training may be
required to use the device, constant retraining will not be.
• The device should not require deep understanding of its principles and functions to be useful.
WHAT IS REHABILITATION TECHNOLOGY?

• To rehabilitate is to restore to a previous level of function.

• The term rehabilitation technology should be used to describe technologies that are
intended to restore an individual to a previous level of function after the onset of
pathology.
• When an occupational therapist (OT) uses a technological device to establish, restore, or
modify function in a client, he or she is using a rehabilitative technology.
• Physical agent modalities, such as ultrasound, diathermy, paraffin, and functional electric
stimulation, are examples of rehabilitative technology.
• Broadly, whenever an OT uses a technology, be it diathermy or a traditional OT activity
(eg, leather working) with the primary goal of restoring strength, mobility, or function,
the technology is rehabilitative.
• When these technologies have done their job, the client will have improved intrinsic
function, and the technology will be removed
• Rehabilitative technologies are generally intended to be used in a therapy setting by
trained professionals and for a short period. Because these technologies are intended to be
used by trained professionals, they can have fairly complex or cryptic controls.
• The expectation is that the professional will have had significant training before using the
technology.
• The professional guiding the use of such technologies is expected to ensure correct
application of the technology and to protect the safety of the individual using the device
DIFFERENCE BETWEEN REHABILITATION AND
ASSISTIVE TECHNOLOGY?
• A significant difference between rehabilitation technology and assistive technology can
be seen at the end of the rehabilitation process.
• At this point the client no longer uses rehabilitation technologies but may have just
completed training in the use of assistive technologies.
• The assistive technologies go home with the client; the rehabilitation technologies
generally remain in the clinic.
• Some technologies do not fit neatly into these categories because they may be used
differently with different clients.
• For some clients, the practitioner may use assisted communication as a tool to train
unassisted speech.
• For other clients, assisted communication may be used to support or replace speech.
• In the first case, the technology is rehabilitative; in the second, the same technology may
be assistive
UNIVERSAL DESIGN

•Universal design is a new category of technology.

• The principles of universal design were published by the Center for Universal Design
at North Carolina State University in 1997, their application is still very limited.
•The concept of universal design is very simple: if devices are designed with the needs
of people with a wide range of abilities in mind, they will be more usable for all users,
with and without disabilities.
•In some cases this design philosophy could make assistive technology unnecessary.
• A can opener that has been designed for one-handed use by a busy housewife will also be usable by a
cook who has suffered a cerebro vascular accident (CVA) and now has the use of just one hand.
Because the two individuals are using the same product for the same purpose, it is just technology, not
assistive technology.
• Electronic books on dedicated e-readers (eg, Kindle, iPad) include features to allow them to be used
as talking books. The goal here is to provide a hands-free, eyes-free interface so that the books can be
used by commuters while driving.
• However, the same interface will meet the needs of an individual who is blind and cannot see the
screen or who has limitations in mobility and cannot operate the manual controls. No adaptation is
necessary because the special needs of the person with a disability have already been designed into the
product.
PRINCIPLES OF UNIVERSAL DESIGN

Equitable Use: The design is useful and marketable to people with diverse abilities.
Guidelines
• Provide the same means of use for all users: identical whenever possible; equivalent
when not.
• Avoid segregating or stigmatizing any users.
• Provisions for privacy, security, and safety should be equally available to all users.
• Make the design appealing to all users.
Flexible in Use: The design accommodates a wide range of individual preferences and
abilities.
Guidelines
• Provide choice in methods of use.
• Accommodate right- or left-handed access and use.
• Facilitate the user’s accuracy and precision.
• Provide adaptability to the user’s pace
Simple and Intuitive: Use of the design is easy to understand, regardless of the user’s
experience , knowledge, language skills, or current concentration level.
Guidelines
• Eliminate unnecessary complexity.
• Be consistent with user expectations and intuition.
• Accommodate a wide range of literacy and language skills.
• Arrange information consistent with its importance.
• Provide effective prompting and feedback during and after task completion.
• Perceptible Information: The design communicates necessary information effectively to the user,
regardless of ambient conditions or the user’s sensory abilities.
Guidelines
• Use different modes (pictorial, verbal, and tactile) for redundant presentation of essential information.
• Provide adequate contrast between essential information and its surroundings.
• Maximize “legibility” of essential information.
• Differentiate elements in ways that can be described (i.e.,make it easy to give instructions or directions).
• Provide compatibility with a variety of techniques or devices used by people with sensory limitations.
Tolerance for Error: The design minimizes hazards and the adverse consequences of
accidental or unintended actions.
Guidelines
• Arrange elements to minimize hazards and errors: themost used elements should be most
accessible; hazardous should be eliminated, isolated, or shielded.
• Provide warnings of hazards and errors.
• Provide fail-safe features.
• Discourage unconscious action in tasks that require vigilance.
Low Physical Effort: The design can be used efficiently and comfortably and with a
minimum of fatigue.
Guidelines
• Allow user to maintain a neutral body position.
• Use reasonable operating forces.
• Minimize repetitive actions.
• Minimize sustained physical effort.
Size and Space for Approach and Use: Appropriate size and space is provided for approach,
reach, manipulation, and use regardless of user’s body size, posture, or mobility.
Guidelines
• Provide a clear line of sight to important elements for any seated or standing user.
• Make reach to all components comfortable for any seated or standing user.
• Accommodate variations in hand and grip size.
• Provide adequate space for the use of assistive devices or personal assistance.
 HUMAN INTERFACE ASSESSMENT

The human interface assessment (HIA) model, developed by Anson et al.,5 provides a detailed look at
(1) The skills and abilities of humans in the areas of motor output, cognitive processing, and

communication/interaction
(2) The demands of an activity
• The HIA model suggests that when the demands of a task do not exceed the skills and abilities of an
individual, no assistive technology is required, even when a functional limitation exists .
• Conversely, when a task makes demands that exceed the native abilities of the individual, the individual
will not be able to perform the task in the prescribed manner
• In these cases an assistive technology device may be used to bridge the gap between demands and
abilities
• Although an assistive technology must be able to assist the individual in performing the
desired task, it also presents an interface to the individual that must match his or her
needs.
• A careful match between the abilities of the human in sensory perception, cognitive
processing, and motor output and the input and output capabilities of assistive
technologies is necessary for assistive technologies to provide effective interventions.
EXAMPLES OF BARRIERS IN HOME

ENTRANCES AND DOORWAYS IN THE HOME

• Steps at entrances
• Stairs with no railings or with inadequate railings
• Narrow doorways
• Heavy doors
• Door hardware and locks that are difficult to manipulate
• Thresholds over 1⁄2-inch high
GENERAL CIRCULATIONTHROUGHOUT THE HOME
• Slippery floors
• Uneven floor surfaces, multiple levels
• Loose carpeting
• Throw rugs
• Poorly lit areas (e.g., hallway/stairway)
• Lack of color contrast on edges of counters, doorways, etc.
• Clutter on floors or stairs
BATHROOMS
• Height of bathtub
• Lack of grab bars by tub and toilet
• Height of toilet
• Lack of space in bathroom for wheelchair, walkers, assistant
• Nonslip resistant flooring in bathtub/shower
KITCHENS
• Counter heights either too low or too high
• Lack of space for wheelchair, walkers
• Height and depth of cupboards, shelves
• Appliances that are difficult to use (e.g., handles/controls)
GENERAL
• Loose cords (e.g., extension cords, cables)
• Low-volume telephone/doorbell
• Small-button telephone
• Heights of seats including chairs, sofas
• Small print on items (e.g., cleaning products/medications)
• Sharp corners on furniture and fixtures
 OCCUPATIONAL THERAPY IN THE SCHOOLS

The physical accessibility of schools and school playgrounds and access to barrier-free transportation
to and from school are important steps toward achieving the integration of students with disabilities.
In
addition, the ADA requires school districts to provide programs and services that are readily
accessible

and usable by individuals with disabilities thus enabling students, parents, teachers, and
others with disabilities to access schools.
The ADA-ABA Accessibility Guidelines (U.S. Access Board, 2004) are based on both adult and
child dimensions and anthropometrics and should be applied in renovating or constructing new
schools. Occupational therapists can consult about and advocate for architectural accessibility and
the use of universal design principles within schools.
For example, in Ontario, Canada, occupational therapists can consult with school boards to prepare
annual accessibility plans, mandated by the ODA (Government of Ontario, 2001),or to assist in the
design and planning of new schools and planning for major renovations to make schools more
accessible
Abend’s (2001) guide, Planning and Designing for Students with Disabilities, provides useful
design principles that are applicable to students with various disabling conditions, including
physical, sensory, attention and/or learning impairments, and universal design principles. For
example, Abend suggests that versatile classroom spaces with a small alcove off a large common
classroom area can help to control noise and visual distractions for students with attention deficits.
Modular furniture can be combined or separated to support a variety of activities, such as individual
and group work, and can include accessible desks and computer workstations to accommodate
students who use wheelchairs or who need writing aids such as laptop computers
. Several physical barriers that have been consistently identified by students with disabilities are steep
ramps, heavy doors and raised door thresholds at school entrances ,a lack of elevators to a second
level, and inadequate accessibility on school playgrounds (Hemmingsson & Borell,2000; Pivik,
McComas, & LaFamme, 2002).
School cafeterias should have wheelchair-accessible food aisles, food placed within reach of people
who use a wheelchair ,and accessible seating arrangements. Way-finding within a school can pose
problems for many students, including those with visual, cognitive, and perceptual impairments.
Clear signage in corridors that provides directions around the school and distinctive color-coding in
sections of buildings can assist students and others to find their way around the school.
ASSISTIVE TECHNOLOGY IN ELDERLY CARE
CASE STUDY
REFERENCES

• WILLARD AND SPACKMAN 13TH EDITION

• PEDRETTI 8TH EDITION
• TROMBLY 7TH EDITION
• ASSISTIVE TECHNOLOGY IN ELDERLY CARE