Assistive technology selection to outcome assessment: the benefit of having a service delivery protocol

The original 2007 Framework for Modeling the Selection of Assistive Technology Devices (ATDs) [1] was developed as a companion article to the Framework for the Conceptual Modeling of Assistive Technology Device Outcomes published in 2003 [2]. Our thinking was that the best way to achieve good AT outcomes was to start at the beginning of the service delivery process and focus on the key inputs into the selection of the most appropriate match of person and AT (in other words, we believed GIGO or garbage in, garbage out). The Selection Framework was subsequently modified in Scherer 2012 [3] to reflect an expansion of relevant areas to consider as depicted in Figure 1 below and to conform to elements within the Matching Person and Technology (MPT) Model and guided by the use of the MPT assessment process [4]. Importantly, as highlighted by van Niekerk et al. [5], the availability and affordability of relevant products is considered to be a fundamental environmental factor that needs to be considered. A number of other factors are listed in the figure, although this cannot be considered by any means to be an exhaustive set of influential factors.

Figure 1. Reproduction of the 2012 version of the AT selection framework. Source: Scherer [3], page 230.

In 2014, The World Health Organization (WHO) established the Global Cooperation on Assistive Technology, known as GATE for short, to improve access to high-quality affordable assistive products globally and it has focused on five interlinked priority areas (5 P): people, policy, products, provision and personnel [6]. They are included in Figure 1 in one form or another. Detailed papers on the 5Ps from the First Global Research, Innovation, and Education on Assistive Technology (GREAT) Summit held in August 2017 in Geneva, Switzerland at WHO Headquarters were published in this journal as Volume 13, Issue 5 and they open access [7].

Appropriate assistive technology provision remains problematic for many persons, and in a wide variety of global areas [8,9,10]. Even within well developed nations, there are geographic areas that receive poor services or lack fundamental resources such as occurs in many rural areas that lack cell phone and internet services and even basic healthcare.

It is crucially important, actually vitally important in the literal sense, that we get the appropriate assistive technology products and solutions to the people who need them. When this does not occur or is inadequate, outcomes assessment is necessary to pinpoint areas and issues to address. We might think about standardized areas of consideration for AT selection, but identifying particular outcomes to measure can be challenging due to the differing mandates and interests of varied stakeholders [8,11]. For example, the MPT assessments [4] address psychological and sociocultural factors affecting consumer perspectives of the benefit they realize from use of an AT [10], prescriber goals of functional gain and personal well-being, as well as design elements and product usability that are the primary concerns held by engineers and suppliers of AT products [8,12]

Thus, a system of practice that includes a mix of validated tools and measures to address different purposes and perspectives would likely yield important data and be very beneficial for all concerned.

Marcia J. Scherer
Institute for Matching Person & Technology, Webster, NY, USA
[email protected]

Correction Statement

This article has been republished with minor changes. These changes do not impact the academic content of the article.