Lots of definitions on assistive technology and devices
"Any item, piece of equipment or product system, whether acquired commercially, modified or customized, that is used to increase, maintain or improve functional capabilities of individuals with disabilities." - Assistive Technology Act, 2004
"Assistive devices are items that ease the strains of daily activities at home, at work, or at play. They include medical equipment, mobility aids, information technologies, practical aids, and gadgets to suit many different needs." - Health Canada
"Any device or product that is useful for a person's enhanced functioning and participation." - Canadian Association of Occupational Therapists
"Assistive technology (AT) is an umbrella term which covers the systems and services related to assistive products. AT increases the independence of users with disabilities and reduces the need for outside support. The AT a person relies on varies depending on their disability." - Government of British Columbia, Accessibility & Inclusion Toolkit
From low to high tech for quality of life
As you can imagine from the definitions cited above, there are a variety of assistive technology devices ranging from low tech products like dressing aids (sock aides, shoe horns, etc.) to high tech products such as powered wheelchairs and electric prostheses. These products assist people with engaging and participating in their chosen activities of daily living. Research shows this promotes peoples' independence, safety, health, well-being, and overall quality of life.
A variety of gadgets and gizmos to overcome limitations
With aging, injuries, illness, disease, and congenital or genetic factors from birth, some people experience limitations and impairments that interfere with their functioning (physical, cognitive, neurological, sensory, psychological, emotional, etc.). Broadly speaking, there are several categories of activities where people may experience challenges, including in their daily self-care, leisure, and productivity. A variety of devices to assist with these activities will fall under the following assistive technology categories:
AAC (Augmentative and alternative communication)
Accessible transportation (modifications for public transit and private vehicles)
ADL (aids to daily living or activities of daily living, such as adaptive switches, utensils, or handles to allow those with limited motor skills to do bathing, cooking, dressing, eating, grooming, etc.)
Cognitive aids (computer or electrical assistive devices to help people with memory, attention, or other challenges with thinking skills)
Computer and digital device access (software apps and hardware, such as voice recognition programs, screen readers, and screen enlargement applications)
EADL (electronic aids to daily living)
Environmental aids (physical modifications to the built environment, including ramps, grab bars, and wider doorways for access to building structures)
Learning and study aids (tools like automatic page turners, book holders, and adapted pencil grips to support participation in learning and educational activities)
Recreation and leisure (lightweight, high-performance mobility devices that enable people to play sports and engage in recreational activities)
Seating, positioning and mobility (wheelchairs, scooters, walkers, canes, crutches, bed rails, toilet safety frames/rails, floor-to-ceiling poles and bars, prosthetic and orthotic devices)
Sensory aids and accommodations (tools for hearing, vision, and other sensory needs, including closed captioning to watch movies, tv programs, and other digital media)
Vocational aids and accommodations (ergonomic seating, desks, and other devices)
Assistive device use for compensation and performance
Assistive devices are used for a variety of reasons, including: to compensate for impairments like muscle weakness or paralysis, loss of range of motion (ROM), involuntary or uncoordinated movement, pain, decreased cognition, and others. A few common approaches are used with assistive devices to enhance performance in activities of daily living. These include energy conservation, work simplification, and body mechanics. With energy conservation, the techniques of prioritizing, planning, pacing, and positioning are used to save energy and improve functioning. This may involve practicing good posture, using rest periods, prioritizing tasks, pacing, planning ahead, organizing, and reducing the workload. With work simplification, techniques are applied for performing a task in an organized, planned, and orderly way so that body motions, work load, and fatigue are reduced to a minimum. And with body mechanics (the way we move our body, spine, and extremities), techniques are used to increase the mechanical advantage (levers of muscles, bones, and joints), decrease resistance or weight (the load), increase endurance, and stabilize the body.
How will you benefit from using assistive technology devices?
You will benefit from using AT devices by working with an occupational therapist or assistive technology professional who will support you with answering the following questions to determine what device is best to recommend:
What's involved in the task or activity you want to do?
What are you currently able and wanting to do with the activity?
What level of independence are you capable of and interested in achieving?
From here, it's important to determine the teaching, learning, and training strategies that will be beneficial for introducing devices and new techniques to your tasks and activities. This may include demonstrations, practice and repetition, verbal or physical prompting, specific feedback, considerations for the relevancy and timing of tasks, backward chaining (starting from the last step and working back), and others.
Challenges with using assistive technology devices
In addition, one of the most overlooked issues for users of assistive technology devices, is that of device abandonment. Device abandonment is when the person stops or discontinues using the equipment. This is also known as discontinuance, non-compliance, non-use, or misuse. Studies show that abandonment occurs in approximately 30%-50% of all cases. To increase the likelihood for use of devices, the following factors should be considered:
Effectiveness of the device (how well it serves the intended purpose for aiding the user with engaging in and successfully performing the desired task or activity)
Operability of the device (how user friendly it is for operating)
Dependability of the device (is it reliable for consistent and frequent use, multiple times each day/week/month)
Affordability of the device (can the user afford the cost based on their income, insurance, funding, or other coverage)
Personal acceptance of the device (was the user involved in selecting and choosing the device and how do they perceive the features and benefits)
Ease of maintenance of the device (is it easily maintained or repaired when needed)
Flexibility of the device (can it be used across different environments and conditions for the intended purpose)
Durability of the device (do the components and parts of the device hold up)
Supplier repair and maintenance services for the device (does the supplier provide affordable, timely, and convenient services)
Final thoughts on supporting the use of assistive technology devices
It's very important to remember that professional support and training is essential to maintain ongoing use of a device. Also, it's very common for there to be negative perceptions about one's experience of illness or disability and for fears or anxieties (along with resistance) to be present with the loss of independence and any transition to using devices. Your chances of success and finding benefits by using assistive devices will be improved if you consider your goals and preferences; understand your intentions for using devices; consider the role that anxiety and fear may play in the process; believe in the expertise you have about your own life; remember how the environments and conditions you live in impact the activities you do; address cost/funding issues and concerns; communicate about your perceptions and acceptance (or lack of acceptance) of devices; and request (and receive) the appropriate level of initial and ongoing training.
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