Marcia J. Scherer

Predictors of assistive technology use: The importance of personal and psychosocial factors

Objective. To validate an assistive technology (AT) baseline and outcomes measure and to quantify the measures value in determining the best match of consumer and AT considering consumer ratings of their subjective quality of life, mood, support from others, motivation for AT use, program/therapist reliance, and self-determination/self-esteem. Design. Prospective multi-cohort study. Setting. Vocational rehabilitation offices and community. Participants. Over 150 vocational rehabilitation counselors in 25 U.S. states with one consumer each receiving new AT. Interventions. Counselor training in the Matching Person and Technology (MPT) Model and consumer completion of the MPT measure, Assistive Technology Device Predisposition Assessment (ATD PA). Main outcome measures. Total and subscale scores on the ATD PA as well as counselor-completed questionnaires. Results. ATD PA items differentiated consumer predispositions to AT use as well as AT and user match. There were no significant differences due to gender, physical locality, or age within this sample of working-age adult consumers. Vocational rehabilitation counselors exposed to training in the MPT Model achieved enhanced AT service delivery outcomes. Conclusions. The ATD PA is a valid measure of predisposition to use an AT and the subsequent match of AT and user. Rehabilitation practitioners who use the ATD PA will achieve evidence-based practice and can expect to see enhanced AT service delivery outcomes.

Assistive technology : matching device and consumer for successful rehabilitation

An exploration of the ways in which psychologists and other helping professionals can collaborate with users of assistive technology to help them get the most out of these devices. Thanks in large part to the 20th centurys advances in technology, people with disabilities can live independent lives, contribute to their communities, attend regular schools, and work in professional careers as a result of assistive technology. This technological evolution has formented a shift from a medical model to a social model of technology delivery, an approach that puts as much emphasis on the users community integration as it does on his or her physical capabilities. This change means that those in the field can no longer focus on the delivery of technology as an end in itself, but must go one step further and partner with consumers and communities to ensure that assistive devices are put to their best possible use. The volume provides research-based guidance on finding the perfect match between device and consumer, including key information on personality assessment, the influence of pain, coping skills, and the power of new technology and social programmes. It should be useful to psychologists, researchers and anyone working with or using assistive technology.

The relationship of personal factors and subjective well-being to the use of assistive technology devices

Purpose. To describe a measure and its performance specific to the relationship of personal factors and subjective well-being (SWB) to the use of assistive technology devices (ATDs). The primary hypothesis is that responses to a 33-item personal factors scale and a 12-item SWB scale are good indicators of an individuals predisposition for using, and subsequent match with, a given ATD. Methods. Data analyses from a number of studies using the 33-item personal factors and the 12-item SWB scales of the Assistive Technology Device Predisposition Assessment with persons of various ages and types of disabilities. Results. Regardless of type of disability or age of respondent, the ATD PA personal factors and the SWB scales identified important differences in predispositions to use an ATD as well as the subsequent quality of the match of person and device. Conclusions. A quantifiable relationship exists between the ATD PAs measure of personal factors and the SWB such that it is possible to characterise an individuals predisposition to use a particular ATD. Results also show that the scales are predictive of the quality of the ATD and user match at follow-up. Rehabilitation practitioners who use the ATD PA may achieve enhanced assistive technology service delivery outcomes by using this evidence-based measure.

Psychometric and Administrative Properties of Measures Used in Assistive Technology Device Outcomes Research

Although there have been numerous calls for increasing the quantity and quality of assistive technology outcomes research, no one has analyzed the nature of data that the field has been accumulating. This article summarizes our evaluation of 82 outcome studies, published between 1980 and 2001, addressing assistive technology devices (ATDs). Our data indicate that the “typical” ATD outcomes study published in the past 20 years is one that (a) used a sample population that was diverse in terms of age, disability population, and type of ATD being used; (b) measured user-reported dependent variables with instruments designed specifically for the study; (c) did not report adequate information on the reliability and validity for the measurement instruments that were used; (d) did not discuss the staff workload associated with learning, administering, and scoring its data collection tools; and (e) did not differentiate its findings in terms of distinguishable participant subgroups. Several suggestions are provided to guide future development of assistive technology outcome measures in the domains of usability, quality of life, and social role performance. In addition, seven recommendations are offered to outcomes researchers, policy makers, journal editors, and reviewers in order to improve the reporting of assistive technology outcomes research.

Technology for improving cognitive function. A workshop sponsored by the U.S. Interagency Committee on Disability Research (ICDR): Reports from working groups

The U.S. federal Interagency Committee on Disability Research (ICDR) and its Subcommittee on Technology (IST) sponsored a state of the art workshop on “Technology for Improving Cognitive Function”, from 29 – 30 June 2006 in Washington, D.C. This paper summarizes the content of the working groups charged with providing strategic direction for the future of technology for persons with cognitive disabilities.

Assessing consumer profiles of ‘ideal’ assistive technologies in ten categories: An integration of quantitative and qualitative methods

This paper focuses on two trends in the field of disability and rehabilitation: (a) the desire to conserve resources and yet provide consumers with the highest quality assistive technologies that they find personally appealing and useful; and (b) the involvement of the consumers of rehabilitation services in key decisions regarding the products and services they receive. The Rehabilitation Engineering Research Center on Technology Evaluation and Transfer (Buffalo, NY, USA) has endeavoured to accomplish both by employing a mixed methods approach to consumer-identified needs and preferences regarding several categories of assistive technology. The purpose of this paper is to describe the methods used in sufficient detail for replication by other researchers.

Treatment Theory, Intervention Specification, and Treatment Fidelity in Assistive Technology Outcomes Research

ABSTRACT Recent reports in the rehabilitation literature have suggested that treatment theory, intervention specification, and treatment fidelity have important implications for the design, results, and interpretation of outcomes research. At the same time, there has been relatively little discussion of how these concepts bear on the quality of assistive technology (AT) outcomes research. This article describes treatment theory, intervention specification, and treatment fidelity as interconnected facets of AT outcome studies that fundamentally affect the interpretation of their findings. The discussion of each is elucidated using case examples drawn from the AT outcomes research literature. Recommendations are offered for strengthening these components of AT outcomes research.

Organizing future research and intervention efforts on the impact and effects of gender differences on disability and rehabilitation: The usefulness of the International Classification of Functioning, Disability and Health (ICF)

The International Classification of Functioning, Disability and Health (ICF) is discussed as being relevant to research and service delivery for women with disabilities. The personal meaning a disability has for a woman is shaped largely by Personal Factors. These, in turn, have historically been affected strongly by Environmental Factors such as culture and attitudes. Too often both Personal Factors, and how they are shaped by Environmental Factors, are not adequately addressed in our intervention programs. The interaction of Personal and Environmental Factors is illustrated by examples from the technology use and non-use literature.

Three model curricula for teaching clinicians to use the ICF

Purpose. Three systematic programmes to train health professionals to use the World Health Organizations International Classification of Functioning, Disability, and Health (ICF) are described, along with efforts to evaluate their effectiveness. Methods. The first programme was a randomized study comparing the effects of a 2-hour instructor-led programme and a self-directed learning module on ICF-related knowledge, attitudes, and coding skills among occupational therapy graduate students. The second programme was a series of intensive 3.5-day workshops for public sector rehabilitation professionals in South Africa. The third programme involved a series of internet-based teaching modules regarding the ICF for graduate students in rehabilitation counselling. Results. The first project found that both instructor-led and self-guided training formats were effective in improving basic ICF-related knowledge, but only instructor-led training led to a significant improvement in coding skill. It also had more positive effects on ICF-related attitudes. This approach to learning assessment was generalizable to multidisciplinary health professionals in South Africa, who achieved a relatively high degree of coding accuracy after the 3.5-day workshop. Participant evaluations supported the structure, content, and length of the training. Students in the third programme also reported a very positive learning experience and positive views of the ICF. Conclusions. An empirical basis is important for identifying the best and most efficient training methods for particular audiences and specific purposes. The length and format of training can be differentially related to specific training goals (i.e., knowledge, attitudes, and coding skills). Interactive distance learning methods may help to overcome the weaknesses of self-directed training in comparison to face-to-face training.

Tracking Mobility-Related Assistive Technology in an Outcomes Study

The objective of this follow-up study was to describe changes in the mobility-related assistive technology devices (ATDs) that are used from shortly after discharge from a hospital setting until 5–6 months later. One hundred and thirty-nine participants who had one or more mobility ATDs (canes, crutches, walkers, and wheelchairs) that had been recommended during hospitalization were interviewed an average of 5.5 weeks after discharge and an average of 23.2 weeks later. Information about mobility ATD usage was obtained by questionnaire during face-to-face interviews. The SF-36 was used to assess perceived health status, both physical and mental, as an additional outcome. Results show that at follow-up, only 23.3% of participants were using the ATD provided at baseline as their primary aid. Seven distinct groups of participants were noted based on individual experience with ATD use from the time of discharge to follow-up. Those groups varied according to continued versus discontinued use of an ATD, single versus multiple ATD use across time, and primary versus secondary importance attributed to the ATD. The groups also differed in terms of their differential association with rehabilitation diagnosis, age, as well as physical and mental perceived health status. The findings have implications for designing ATD outcome studies and for interpreting the relationship of ATD outcomes to other variables. The information about changes in mobility-related ATDs can also help rehabilitation specialists at the point of device referral target their patients for interventions that will either increase their adherence to device prescriptions or support nondevice strategies for managing disabilities.