Definition/Introduction

Healthcare professionals work to heal their patients so that they might return to independent functioning. Patient ability levels often vary, and many face challenges that they are unable to overcome with their base level of functioning. In many cases, a patient can still achieve independent functioning or increase their ability to function through the use of assistive devices. Assistive technology devices (ATDs) are any systems, items, or pieces of equipment that help individuals with disabilities improve their functioning with daily tasks.[1]

ATDs can be high tech devices such as eye-gaze systems, augmented communication boards, and environmental control systems, or simple low tech devices like reachers, walkers, and ramps. An ATD can be commercially made, or they can be custom tools built in the patient’s own home. To maximize a patient’s functional outcomes, patients should be assessed for need of an ATD, assisted in the acquisition or making of the ATD, and given the appropriate training and follow-up to ensure that the assistive device meets their individual needs.[2][3]

Issues of Concern

ATDs can benefit a wide range of patients, from patients recovering from a stroke,[4] to children with autism spectrum disorder,[5] to individuals aging in place.[6][7] An ATD may be used temporarily as part of the rehabilitation process, for example, a patient recovering from stroke using a hemi-walker as they gait train.[4] Alternatively, ATDs can be long-term and life-changing devices, for example, a text-to-speech application for an individual with low vision or vision impairment.[8] Because the usefulness of ATDs covers such a broad spectrum, it can be difficult for healthcare practitioners to appropriately match patients with devices that may be the most effective for individual patients. Assessment of the individual, their abilities, and their environment can help identify a patient's specific needs.[9]

Some approaches to ATD assessment and matching include:[9]

• The Human, Activity, Assistive Technology model (HAAT model)
  • This is a model of practice that evaluates key considerations during the selection of ATDs. The HAAT model examines how ATDs are used in conjunction with individuals within the limitations of their environment. 
• The Assistive technology service method (ATSM)
  • This is a method based on the International Classification of Functioning (ICF) model. The ATSM includes an assessment of an individual, establishing a baseline of ability level, and development of a strategy for intervention. The ATSM method may also use the Assistive Device Classification (ATDC) tool to identify ATDs that may be beneficial to a patient passed on the gathered patient information. 
• Matching person and technology (MPT)
  • The MPT tool emphasizes that the approach to appropriate matching and use of ATDs is to consider the context, activity, and personal traits of the patient.

 Appropriate matching of ATDs to patients is crucial because improperly ATDs can lead to nonuse or even harm to the patient or people in their surroundings.[9] If a patient receives a poorly matched ATD, they may be resistant to trying other devices, or they may no longer possess the resources to acquire an appropriate ATD, especially if the poorly matched ATD is costly.[9] It is important to consider each patient, their personal factors, and environmental factors when matching a patient with an ATD.

Clinical Significance

ATDs can have a positive impact on the independence and functioning of individuals across the lifespan.[5][6] Effective implementation of ATDs can help improve functioning in individuals with different levels of ability. The assessment and matching of ATDs for patients are of clinical significance because it leads to better functional outcomes and increased quality of life for patients with disabilities, as well as for caregivers and families of an individual with a disability.[1][4][5][6][8][7]

Nursing, Allied Health, and Interprofessional Team Interventions

Collaboration between health care providers is essential for patient-centered care. Many different types of healthcare professionals will likely be involved in some kind of ATD assessment and matching. Occupational therapists, physical therapists, and speech-language pathologists are just a few examples of healthcare professionals that commonly assess and match patients with ATDs. Additionally, Assistive Technology Professionals (ATPs) are trained service providers that can be consulted for the selection, acquisition, and training in the use of ATDs.[10] [Level V]