Assistive Technology Service Models
Andrich, R., M. Ferrario, et al. (1998). "A model of cost-outcome analysis for assistive technology." Disabil Rehabil 20(1): 1-24.
During the CERTAIN study (research carried out in 1994-96 within the Technology Initiative for Disabled and Elderly (TIDE) programme of the European Union), a number of real life case studies of provision of assistive technology to disabled persons were investigated in order to assess the applicability of socio-economic principles, methods and techniques already available from Health Care Technology Assessment studies. A retrospective study on cost, effectiveness and utility resulting from the implementation of assistive technology was carried out over a sample of disabled persons who had adopted technical aids before the start of the project. The sample was selected in such a way to include different pathologies (steady or progressive), impairments, ages, technology and social environment. Each case was described by considering all clinical, technical and social aspects; a common structure for case reporting was developed and tested; attempts were carried out to apply and refine concept and tools derived from health technology assessment studies; on the grounds of such experience a decision support model was elaborated for the choice between different alternatives in order to maximize the client's quality of life while making efficient use of scarce resources. A computer implementation of such a model was also developed, along with a mathematical structure of cost analysis. Within a national research programme such findings were further exploited, leading to the development of a prototype cost-outcome instrument designed for use in clinical practice in the provision of assistive technology to individual cases.
Barbara, A., & Curtain, M. (2008). Gatekeepers or advocates? Occupational Therapists and equipment funding schemes. Australian Occupational Therapy Journal, 55, 57-60.
Craddock, G. and L. McCormack (2002). "Delivering an AT service: A client-focused, social and participatory service delivery model in assistive technology in Ireland." Disability & Rehabilitation 24(1-3): 160-170.
Dijcks, B. P., R. D. Wessels, et al. (2006). "KWAZO, a new instrument to assess the quality of service delivery in assistive technology provision." Disability & Rehabilitation 28(15): 909-914.
PURPOSE: Currently no well validated instrument exists to assess the quality of the assistive technology delivery from the client's perspective. An instrument was developed called KWAZO, consisting of seven questions related to accessibility, knowledge, coordination, efficiency, flexibility and influence of the user. KWAZO, meaning "quality of care", can be completed by the clients without any assistance. In this study, the feasibility, internal consistency and convergent validity of KWAZO were examined. METHOD: The data stem from a large monitoring study into non-use of and satisfaction with assistive technology (n = 4637) using a mailed questionnaire. Feasibility was tested by studying the rate of non response for each of the questions. To test convergent validity the KWAZO total score was compared to answers on a question about overall satisfaction with service delivery of D-QUEST. RESULTS: Only few missing values were seen (3.1 - 7.5%). Cronbach's alpha was good (0.89), indicating that KWAZO reliably measures one concept. Convergent validity was shown by a moderately strong correlation between KWAZO and the D-QUEST question (0.54; p < 0.001). A difference of about 2.5 points seems to reflect a relevant difference in user satisfaction. CONCLUSIONS: KWAZO is a new questionnaire to assess the quality of an assistive technology provision process from a client's perspective. KWAZO has decent measurement properties and its self-report format makes it an easy-to-use tool for assessment of the quality of assistive technology provision.
Edyburn, D. (2001). "Models, theories, and frameworks: Contributions to understanding special education technology." Special Education Technology Practice 4(2): 16-24.
Edyburn, D. and R. Smith (2004). "Creating an assistive technology outcomes measurement system: Validating the components." Assistive Technology Outcomes and Benefits 1(1): 8.
Fuhrer, M., J. Jutai, et al. (2003). "A framework for the conceptual modelling of assistive technology device outcomes." Disability & Rehabilitation 25(22): 1243-1251.
Hartley, S. D. and S. L. Wirz (2002). "Development of a 'communication disability model' and its implication on service delivery in low-income countries." Soc Sci Med 54(10): 1543-1557.
This paper argues that higher priority should be given to the development of services which support people with communication disabilities in low income countries and that these services should be different from those in other countries. Present services for this population group have poor coverage levels, tend to be centrally located and are orientated to specialist services. WHO (Health Programme Evaluation, Geneva, WHO, 1981) argue that health services should be based on meeting people's needs. This paper describes an analysis of 'needs related' qualitative data concerning people with communication disabilities and their families in two low income countries and examines the results in relation to service development. The data was collected as part of five different studies concerning people with communication disabilities carried out in Uganda and Nigeria. Using the principles of established theory, these data helped develop, a theoretical model. This model is compared with WHO's classification of Impairment Disability and Handicap ICIDH-2 WHO (International Classification of Impairments Disabilities and Handicaps (ICIDH-2), A manual of classification relating to the consequences of diseases, Geneva, WHO. 1997a; 1999). Suggestions are made as to how this model might inform planning and practice from the perspective of the five major stakeholder groups; government and non-government organizations, people with communication disabilities, their families and professionals. Consideration is also given as to how this theory can be used to strengthen existing services, or encourage a complete paradigm shift, with the creation of different services in new and innovative ways.
Judge, S. (2002). "Family-centered assistive technology assessment and intervention practices for early intervention." Infants & Young Children 15(1): 60.
Lahm, E. and L. Sizemore (2002). "Factors that influence assistive technology decision making." Journal of Special Education Technology 17(1): 15-26.
Lenker, J. A. and V. L. Paquet (2003). "A review of conceptual models for assistive technology outcomes research and practice." Assist Technol 15(1): 1-15.
Conceptual models provide a theoretical basis for advancing scientific knowledge and improving professional practice. Although numerous assistive technology-related models have appeared in the literature, there has been no systematic effort to assess them. Six conceptual models are reviewed here: Cook and Hussey's Human-Activity-Assistive Technology model; the World Health Organization's International Classification of Functioning, Disability, and Health; Scherer's Matching Person and Technology model; Gitlin's model of an AT user's "career"; social cognition decision-making theories; and Rogers' Perceived Attributes Theory. The models are reviewed in terms of six domains: background and goals; descriptive characteristics; indication of outcome measures; predictive characteristics; validation in the literature; and utility to assistive technology practitioners, developers, and consumers. The salient strengths and limitations are highlighted for each. Application of the models to advance theory, research, and practice is discussed.
Lenker, J. A. and V. L. Paquet (2004). "A new conceptual model for assistive technology outcomes research and practice." Assist Technol 16(1): 1-10.
Predictive conceptual models help us frame research questions, interpret results, and guide clinical practice. Although numerous models have appeared in the assistive technology (AT) literature, none has been shown to predict AT usage. The lack of a valid predictive model indicates the need for development of new approaches to modeling AT outcomes. This article proposes a user-centered conceptual model that predicts AT usage as a function of the perceived relative advantages of AT. Device usage is not modeled as a one-time, all-or-nothing proposition, but as a decision process recurring over time. The influence of parallel interventions working concurrently with, or as an alternative to, AT is a central consideration that ultimately drives AT usage. Usage is shown as a proximal influence on AT impact, and AT impact is shown to be a predictor of future use. Research is cited supporting various elements of the new model.
Long, T., L. Huang, et al. (2003). "Integrating assistive technology into an outcome-driven model of service delivery." Infants & Young Children 16(4): 272.
Ripat, J. and A. Booth (2005). "Characteristics of assistive technology service delivery models: Stakeholder perspectives and preferences." Disability & Rehabilitation 27(24): 1461-1470.
Scherer, M. (2002). "The change in emphasis from people to person: introduction to the special issue on Assistive Technology." Disability & Rehabilitation 24(1): 1-4.
Scott, S. (1997). "Comparison of service delivery models influencing teachers' use of assistive technology for students with severe disabilities." Occupational Therapy in Health Care 11(1): 61-74.
Shone, S. M., S. Ryan, et al. (2002). "Toward a comprehensive evaluation of the impact of electronic aids to daily living: evaluation of consumer satisfaction." Disabil Rehabil 24(1-3): 115-125.
PURPOSE: It is generally accepted that electronic aids to daily living (EADLs) play an important role in the lives of many people with severe disabilities by providing the means to access and control devices for daily living activities. Despite this, little proof exists to support the contention that consumers are satisfied with relevant aspects of these assistive devices. The purpose of this study was to explore consumer satisfaction with EADLs and investigate the value that people with degenerative neuromuscular conditions place on these technologies. METHOD: Interviews were conducted with 40 EADL users and non-users to compare their views about these devices and their daily life experiences. Users were interviewed twice, six months apart, to establish the stability of their views and experiences with EADLs. The Functional Independence Measure (FIM instrument), the personal profile and Quebec User Evaluation of Satisfaction with assistive Technology (QUEST) were administered to determine functional levels of participants, gather personal data pertinent to the study of device utility and explore user satisfaction with EADLs. RESULTS: Results suggest that overall consumers were quite satisfied with their EADLs and that this was relatively stable over time. However, some consumers expressed concerns regarding the cost of these technologies and their associated services. Both users and non-users rated EADLs similarly in relation to relative degree of importance ascribed to them. CONCLUSIONS: Combining the QUEST with outcome measurement tools that explore other important dimensions such as the effect on quality of life and psychosocial impact will help service providers to justify the costs associated with the prescription of sophisticated, costly assistive devices such as EADLs.
Walker, L. (2008). Provision Models in Posture and Mobility. Postural Management Group Journal, 25(1).
Wissick, C. and J. Gardner (2008). "Conducting Assessments in Technology Needs: From Assessment to Implementation." Assessment for Effective Intervention 33(2): 78.
Practitioners with an expertise in assistive technology and technology assessments are in demand to be full participants in the selection, planning, and implementation of instruction for students with mild disabilities. Frequently, practitioners with knowledge of assistive technology are assigned to evaluate students with sensory, physical, language, or severe disabilities. Our article highlights aspects of technology assessments and progress monitoring that can be used for students with mild disabilities. Given the impact that technology integration can have on the access that students with mild disabilities have to the general education classroom, we argue that all practitioners should be cognizant of protocols for assistive technology assessment and evaluation and that all evaluation teams should include an assistive technology specialist.
Zabala, J., M. Blunt, et al. (2000). "Quality Indicators for Assistive Technology Services in School Settings." Journal of Special Education Technology 15(4): 25-36.