Rehabilitation Science & Technology Department School of Health and Rehabilitation Sciences A Model...

Rehabilitation Science & Technology DepartmentSchool of Health and Rehabilitation Sciences

A Model for A Model for Developing and Prescribing Developing and Prescribing

Assistive Technology DevicesAssistive Technology Devices

Mary Ellen Buning, PhD, OTR/L, ATPMary Ellen Buning, PhD, OTR/L, ATP

Jue Wang, PhDJue Wang, PhD

University of PittsburghUniversity of Pittsburgh


The Important QuestionThe Important Question

Where do rehabilitation professionals begin to understand the application of assistive technology?

– A model is a helpful place to begin


The Institute of Medicine ModelThe Institute of Medicine Model

• In this model, the person with the In this model, the person with the impairment is the focus.impairment is the focus.

• The person must always be The person must always be considered in the context of considered in the context of “environment.”“environment.”

• The environment is a mat.The environment is a mat.• Environment is both physical and Environment is both physical and

social.social.



• For most people For most people the environment the environment supportssupports or or allows people to allows people to perform perform functional functional activities like activities like self-care, work, self-care, work, and care of and care of others.others.



• When impairment occurs it is difficult or When impairment occurs it is difficult or impossible to perform functional activities.impossible to perform functional activities.

• Functional limitation causes: Functional limitation causes: – Inability to care for self or others– Inability to contribute to society– Feelings of failure and shame– Low quality of life



• The goal of rehabilitation is to reduce the The goal of rehabilitation is to reduce the effects of the impairment leading to effects of the impairment leading to permanent disability.permanent disability.

• If we want people to function we change the If we want people to function we change the environment to environment to

•Enable performanceEnable performance•Support adaptationSupport adaptation•Facilitate independenceFacilitate independence


Disability Requires a More Resilient Disability Requires a More Resilient EnvironmentEnvironment

• When impairment is When impairment is severe, it causes the severe, it causes the person to sink person to sink deeplydeeply into the environmental into the environmental mat causing great mat causing great restriction.restriction.

• The mat must offer The mat must offer greater resiliencegreater resilience to to offset the effects of offset the effects of the impairment.the impairment.


Assistive Technology Modifies the Assistive Technology Modifies the EnvironmentEnvironment

AT makes the “Environmental Mat” more resilient by:AT makes the “Environmental Mat” more resilient by:• Providing a device that substitutes for a missing Providing a device that substitutes for a missing

performance skillperformance skill• Modifying a toolModifying a tool• Removing physical barriers to buildings and Removing physical barriers to buildings and

programsprograms• Modifying instructionModifying instruction• Integrating AT solutions into personal care, home Integrating AT solutions into personal care, home

management, education, and employment.management, education, and employment.


Wheelchairs: compensate for paralysis, Wheelchairs: compensate for paralysis, weakness or in-coordinationweakness or in-coordination

Participating in Participating in sports, attending sports, attending school are possible school are possible with a wheelchair with a wheelchair that has features that has features that meet the that meet the needs of the user needs of the user and the tasks they and the tasks they are trying to are trying to perform.perform.


Wheelchairs: Access to communityWheelchairs: Access to community

Employment and Employment and active participation active participation in the community in the community are possible with a are possible with a wheelchairs and wheelchairs and environments that environments that allow entrance and allow entrance and ease of movement ease of movement to wheelchair to wheelchair users.users.


Artificial limbs: restore functionArtificial limbs: restore function

This grandmother’s This grandmother’s prosthesis has a prosthesis has a sensors that detect sensors that detect the amount of grip the amount of grip strength needed.strength needed.

This man’s right This man’s right prosthesis returns prosthesis returns him to two-handed him to two-handed activities and back activities and back to employment.to employment.


Augmentative Communication Devices: Augmentative Communication Devices: compensate for loss of voicecompensate for loss of voice

When speech is lost or When speech is lost or fails to develop, voice fails to develop, voice output communication output communication devices based on devices based on microprocessors and microprocessors and speech digitization speech digitization make participation, make participation, communication, communication, learning, and full learning, and full language development language development possible.possible.


Adaptive Computer AccessAdaptive Computer Access

• Blindness, paralysis, in-Blindness, paralysis, in-coordination, and coordination, and weakness do not prevent weakness do not prevent computer use. computer use.

• Adaptations allow Adaptations allow computers to be used for computers to be used for education, education, communication, communication, employment, employment, management and management and recreation.recreation.


Accessible EnvironmentsAccessible Environments

Environments Environments that offer entry, that offer entry, freedom of freedom of movement, and movement, and safety give safety give another method another method to overcome the to overcome the effects of effects of impairment.impairment.


How do you know which solutions How do you know which solutions are best for a particular person?are best for a particular person?

• Ask the person what they want to accomplish.Ask the person what they want to accomplish.• Each person has talents, interests, and wishes for the Each person has talents, interests, and wishes for the

future.future.• Each has a desire for meaningful role in society.Each has a desire for meaningful role in society.• For example: ask two women about their futureFor example: ask two women about their future

– one will desire to be a mother– another will desire to be an engineer

• Both roles are important to society• Assistive Technology help both women.Assistive Technology help both women.


Assistive Technology Products and Assistive Technology Products and ServicesServices

• Match with the needs of the person who has an Match with the needs of the person who has an impairment.impairment.

• Use current rehabilitation technology expertise.Use current rehabilitation technology expertise.• Are adapted to the topography, climate and Are adapted to the topography, climate and

culture.culture.• Help a culture grow in understanding and Help a culture grow in understanding and

acceptance of persons with disability as they acceptance of persons with disability as they become included in society.become included in society.

Rehabilitation Science & Technology Department School of Health and Rehabilitation Sciences A Model...

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