Assistive Technology servicesAssistive Technology services

Hsin-yu Chiang

如何申請輔具補助？

Where?

戶籍所在地的鄉鎮市區公所社會科辦理How?

a. 設籍並實際居住該縣市 b. 持有身心障礙手冊 c. 申請補助未獲政府醫療補助或社會保

險補助

Assistive Technology services

Evaluation of the technology needs of the individual, including a functional evaluation of the individual with a disability in a customary environment.

Purchasing, leasing or otherwise providing for the acquisition of assistive technology devices for the individual with disabilities.

Assistive Technology services

Selecting, designing, fitting, customizing, adapting, maintaining, repairing or replacing of assistive technology devices

Coordinating and using other therapies, interventions, or services with assistive technology devices, such as those associated with existing education and rehabilitation plans and programs

Assistive Technology services

Assistive technology training and technical assistance for an individual with a disability, or where appropriate, the family of an individual with disabilities.

Training or technical assistance for professionals, employers, or other individuals who provide services to, employ, or otherwise are substantially involved in the major life functions of the individual with a disability.

AT Assessment Process (ATAP)

The ATAP is NOT specific to one area of AT

Uses GUIDELINES for overall AT intervention

Considers human (H), activity (AT) and context (HAAT)

Goal is to enable, not restore or rehabilitate

Is a collaborative process

Human Activity Assistive Technology (HAAT) Model

HumanActivityAssistive TechnologyContext (social, setting, &

physical)

HAAT Model

Human

Activity

AssistiveTechnology

Steps in the Service Delivery ProcessSteps in the Service Delivery Process

Referral & Intake

Initial Evaluation

Recommendations & Report

Implementation

Follow-up

Follow-along

ATAP 10 Step Process

Step 1 Intake/referral Step 2: Identification of

needs Step 3: identification of

desired outcomes Step 4: ID team

members Step 5 Skills

assessment

Step 6: device trials Step 7: revisit desired

outcomes Step 8: Procure

device Step 9: Technology

implementation Step 10:

follow-up/follow along

Step 1: Intake/Referral

Gather preliminary information on clientReferral source-might influence AT

covered and services providedPersonal, medical, & health information

gatherededucational/vocational backgroundprognosis

Step 2: ID needs

Consumers identify their:Goals InterestsDislikesPrioritiesLiving situation

Step 2 & 3: ID needs & desirable outcome

Directions

-ID life roles and performance areas

-ID activities interested in performing

-ID specific tasks difficulty performing

-ID contexts in which activities are carried out

Determine past HX of AT for the activity and the outcomes

Life Roles & Performance

Areas

Activities Difficult tasks to perform

Contexts Prior technology

history 

College Student education

Reading class assignments in textbook

holding book,turning pages

HomeLibrary

Has used mouthstick and bookholders in the past, encountered problems positioning book and mouth becoming tired from holding mouthstick.

 

Intervention Goals

Evaluate alternatives for holding reading material & turning pages in order to increase independence in reading

Barriers

Opportunity Barriers:

(not under client control)

policy practice attitude knowledge skill

Access Barriers:

(related to abilities, attitudes, resource limitations of client or support system)Resistance by

family/others to ATFundingOthers?

Step 4: ID team members

Team membersClientFamilyHealth Care professionalsSchool professionals (student)EmployersFriends

ID member responsibilities

Step 5: Skills assessment

Sensory abilities Vision, perception, tactile, auditory

Physical abilities Seating/positioning, ID control sites on body

Cognitive abilities Memory, attention, problem solving, sequencing, motivation,

ability to follow directions Understanding of cause & effect

Communication abilities Expressive and receptive, symbol use

Step 5: Skills assessment

Use of different assessment tools (WATI) http://www.wati.org/

Matching Persons & technology

http://members.aol.com/IMPT97/MPT.html

Look at Client, environment, tasks and tools

Evaluation of seating & positioning

PostureReflex patternsMuscle tone at restMuscle tone while

performing tasks

Skills Evaluation - Physical

Identifying potential anatomical sites for control Head Forehead Eye Mouth Chin Elbow/Arm Hand Knee/Leg Foot

Skills Evaluation - Physical

Comparative Testing of Control InterfacesSpeed of responseAccuracy of response

Assistive Device Characteristics

Human/Technology InterfaceProcessorActivity OutputPhysical Construction

Assistive Device Characteristics

Human/Technology Interface (the portion of the device that the individual directly interacts) Physical properties Mountability User feedback Number of inputs Selection methods (Direct or Indirect) Selection set

Assistive Device Characteristics

Physical ConstructionMountabilityPortabilityPackaging

Where to get assessment tools in Taiwan?

各地區衛生署核可之身心障礙鑑定醫療機構詢問

各地區社會局或輔具中心 - 台北市輔具資源中心 - 中華民國無障礙科技發展協會附設視障輔具中心 - 台北市南區輔具中心 ( 第一輔具資源中心 )

- 台北榮民總醫院醫療復健輔具中心 - 國立台灣大學身心障礙者輔具工程研究中心 …

中央級輔具中心

內政部多功能輔具資源整合推廣中心 內政部顏面損傷輔具資源推廣中心 內政部足部輔具資源推廣中心 內政部聽語障輔具資源推廣中心 內政部資訊科技輔具資源推廣中心

Step 6: Device trials

Negotiate ( 廠商 & 病人 )what to trySet up device trials

Rental and loaner resources Decide on data to collectSet timelines

Step 6: Device trials

Trial PeriodsTarget meaningful & motivating activitiesActivities should reflect key environmentsActivities & environments should be

consistent across trialsDocument results – successful and

unsuccessful.

Assessment process

Step 7: Revisit desired outcomesStep 8: Procure client’s own device Step 9: Implementation technologyStep 10: Follow-up/follow along

Principles of Assistive Technology Assessment & Intervention

Integrates the Human, Activity, Assistive Technology, & Context Model

Assessment is ongoing & deliberate Requires collaboration & a consumer-centered

approach Requires an understanding of how to gather &

interpret data

Source: Cook & Hussey (2002). Assistive Technologies: Principles & Practice. 2nd edition. St. Louis: Mosby.

AT can be classified as

Low techElementary techHigh tech

Low Tech

Easy to use

Minimal learning time

No electrical power

Little or no training needed

Elementary Tech

Battery operated devices

Easy to use

Minimal amount of learning time

High Tech

Complex and programmable

Requires training

AT devices can be used in more than one area…

CommunicationMobilityTherapyVocationEducationRecreation

Activity one

Name equipment and explain it’s use! Is it low, elementary or high tech?

Name equipment and explain it’s use!

Is it low, elementary or high tech?

Activity Two

Identify 2 pieces of assistive technology you use daily!

Activity Three

Name equipment and describe a client who would benefit from it!

Principles

Helps clients adapt to barriers

Must be convenient for the client

Promotes functional independence

Progression of Implementation

Use the least invasive treatment

Modify position, task, and environment

Purchase commercial products

Adapt commercial products

Design/fabricate custom equipment

References

www.buffalostate.edu/offices/disabilityservices/glossary. www.remedy.com/customers/dev_community/UserExperience/glossary.htm

http://209.85.165.104/search?q=cache:fStOT9kQJCcJ:www.6law.idv.tw/law/%E8%BA%AB%E5%BF%83%E9%9A%9C%E7%A4%99%E8%80%85%E4%BF%9D%E8%AD%B7%E6%B3%95.doc+%E6%AE%98%E9%9A%9C%E7%A6%8F%E5%88%A9%E6%B3%95&hl=zh-TW&gl=us&ct=clnk&cd=1

http://www.law.taipei.gov.tw/taipei/lawsystem/showmaster.jsp?LawID=P08E2002-20051118&RealID=08-05-3004

http://www.llaids.com.tw/support/support1.htm

Cook & Hussey (2002). Assistive Technologies: Principles & Practice. 2nd edition. St. Louis: Mosby.

Trombly C.A. (2001).Occupational Therapy for Physical Dysfunction