Definition/Introduction

Healthcare professionals strive to help their patients recover from illnesses or injuries to regain the ability to function independently. Patient ability levels vary as they represent a standard population, and billions worldwide require assistance when considering the definition of disability. At the intersection of disability and clinical practice, patients can still achieve independent functioning or increase their ability to function through assistive devices. Assistive technology devices (ATDs) are any systems, items, or equipment that assist individuals with disabilities in improving their daily functioning.[1]

ATDs can be high-technology devices such as eye-gaze systems, augmented communication boards, environmental control systems, or simple, low-tech devices such as reachers, walkers, and ramps. These devices are commercially manufactured or customized to a patient's living space. To maximize functional outcomes, patients should be assessed for the need for an ATD, assisted in acquiring the ATD, and given the appropriate training and follow-up to ensure that the assistive device meets their evolving needs.[2][3] Continuous evaluation may be required in cases requiring consultation from segments such as education or social services. In the United States, these consultations typically occur during childhood through local education departments to ensure compliance with ATD standards.

Issues of Concern

ATDs facilitate the maintenance of normal living standards, supporting diverse populations ranging from accident survivors to children with autism spectrum disorder to seniors aging in place.[4][5][6] An ATD is a part of the rehabilitation process and can be temporary or lifelong. For example, glasses are considered an ATD and are mandatory for daily function in visually impaired individuals, many of whom are high-functioning.[7][8][9] Because the usefulness of ATDs covers such a broad spectrum, healthcare professionals may face difficulty matching patients with effective devices. Assessment of the individual, their abilities, and their environment can help identify a patient's needs.

Some approaches to ATD assessment and matching include:

• Human, Activity, Assistive Technology model (HAAT model): This practice model evaluates key considerations when selecting ATDs. The HAAT model examines how ATDs are used in conjunction with individuals within the limitations of their environment. 

• Assistive Technology Service Method (ATSM): This method is based on the International Classification of Functioning (ICF) model. The process includes assessing an individual, establishing a baseline ability level, and developing a strategy for intervention. The ATSM method may also use the Assistive Device Classification (ATDC) tool to identify ATDs that benefit a patient based on the information gathered. 

• Matching Person and Technology (MPT): The MPT tool underscores the importance of considering the patient's context, activity, and personal traits in achieving appropriate matching and utilization of ATDs.[10] 

Global Perspectives

Since 2016, the World Health Organization (WHO) has identified a list of priority assistive products based on the needs of nearly 2.5 billion people as of 2022.[WHO. Global Report on Assistive Technology] The compensation structures for assistive technology vary based on country income level, and countries with universal health care likely cover the costs. Several Nordic countries provide assistive technology for free.[11] A significant research constraint is the limited data availability at a population level within several countries.[12] The ethical implications relate to healthcare interpretation as a right, particularly for marginalized populations.[13]

Use Within Clinical Practice

Several ATDs are integrated into clinical practice. However, clinicians do not typically refer to them as such, that is, when providing a patient with crutches for outpatient use or placing a splint on a patient. Interprofessional collaboration could be emphasized between clinicians, physical therapists, and occupational therapists, particularly in sports medicine, orthopedics, and rehabilitation.[14] Designating the devices with the correct jargon could increase access to data for further research in the medical care of patients with disabilities.[15][16] 

Clinical Significance

ATDs can positively impact the independence and functioning of individuals across the lifespan.[4][5] The assessment and matching of ATDs for patients are of clinical significance because they lead to better functional outcomes and increased quality of life for patients with disabilities, caregivers, and families.[1][7][6][9] As such, the risks and benefits of ATDs are essential to disclose when a clinician recommends or prescribes any qualifying devices, including whether they are covered by insurance or available free of cost.

Nursing, Allied Health, and Interprofessional Team Interventions

Collaboration between clinicians is essential for delivering patient-centered care, particularly in contexts where health services are often distinct from social services within various healthcare organizations. Occupational therapists, physical therapists, and speech-language pathologists are among the healthcare professionals routinely involved in assessing and matching patients with ATDs. However, they may not work within the same facility; instead, they receive referrals from treating clinicians. Assistive Technology Professionals (ATPs) are trained service providers consulted for activities such as selection, acquisition, and training related to ATDs.[17] 

Given the segmented nature of the treatment process, effective communication is crucial to ensure the best patient outcomes. Seamless coordination among these diverse professionals is essential to guarantee that the prescribed assistive technologies align with the individual patient's needs and abilities, facilitating the most effective rehabilitation and functional independence. By fostering collaborative relationships and establishing clear communication channels, healthcare teams can enhance the quality of care delivered to patients requiring assistive technology interventions.