What is an Assistive Technology Assessment?


What is an assistive technology assessment? How do I know if I need one?

Assistive technology refers to a broad range of devices, services, strategies and practices that are designed to increase the functional competencies of persons who have disabilities.

An Assistive technology assessment answers the question Which technologies and strategies can I use to improve my functioning during a specific activity?

A formal assistive technology assessment is provided by someone who is recognized as a provider of assistive technology services by public and private funding agencies.

Do I Need a Formal Assistive Technology Assessment?

You may need a formal assistive technology assessment if one is required by your funding source. State agencies, such as Office of Rehabilitation Services, educational agencies (school districts), and medical insurers (private companies, Medicaid, Medicare) usually require an assessment. They will want to see that an assistive technology service provider verifies your need for technology to maintain or improve functioning, and verifies that the technology selected will meet your needs. Your funding agency will tell you if an assessment is needed. If you are unsure, ask your case manager, funding agent, or counselor.

Who Can Help You Select Assistive Technology?

As more and more people are hearing about what a powerful difference using assistive technology (AT) can make, and as more and more equipment/devices are being developed and marketed, persons with disabilities are left with an interesting dilemma; Where can I get the help I need in selecting the assistive device that is right for me?

Whether looking for a simple gadget to help arthritic hands open a jar, a speech output communication device to speak out in class, or a sophisticated computerized system to compete in the workplace, most people seek some assistance in selecting AT. Who you chose to help you make an AT decision depends primarily on 4 factors:

 

1. the type of equipment/device (simple over the counter, individually fitted or prescriptive),

2. the complexity of the system involved (single item or complex integrated system),

3. your own knowledge, experience, and comfort level with AT ("new user" or "old pro), and,

4.) the requirements of the procurement/funding source.



Let's take a look at each of these.

The type of equipment you are looking for will help you decide who could help you select the right device.

Generally speaking, if a device does not require "fitting" or "prescription", and is not at risk for causing injury, it can be bought "off the shelf" or selected from disability product catalogs. Such products include magnifiers, large print playing cards, adapted eating utensils, flashing smoke alarms etc. Other devices need careful personal fitting such as adapted seating systems, adapted skis, communication devices etc., and some need prescriptions such as power wheelchairs. Prescriptive devices are usually medically necessary devices that will be paid for by an insurance funding source. Fitted and prescriptive devices need to be reviewed and recommended by experienced, and in some cases licensed, persons. Devices that do not need personalized fitting or prescription are often selected using common sense and trial use.

The complexity of the device or system you need often makes a difference in whom you will want to have help you find the right device to meet your needs.

AT devices are often single stand alone items, such as a closed circuit TV (CCTV) that enlarges print, a switch operated toy, a talking calculator, etc. But often AT systems consist of several components (such as a talking computer that speaks scanned text), or they need to be compatible with other AT devices (such as an environmental control unit that operates using a wheelchair driving mechanism). The more complex the system, the greater the need for experienced assistance.

If you are have experience with other pieces of assistive technology and feel comfortable asking questions and getting information, you will most likely seek different help than if you are unfamiliar with what is available and have little experience working with vendors and health professionals.

Some individuals have had a lot of experience with technology and are comfortable using their knowledge and experience to make informed decisions about AT. Other individuals are new to technology and some may even be technophobic! Generally speaking, the less experience and knowledge you have and the lower your comfort level with AT, the greater need you will have to find experienced persons to help you select your equipment.

Specific funding sources may require that you have an "Assistive Technology Evaluation or Assessment" done by a professional before they will pay for an AT device or service.

The funding or procurement source is a very important consideration in determining who should assist you . Educational (school districts), vocational (Office of Rehabilitation Services), and medical (insurance companies, Medicaid, Medicare) funding sources will usually require verification of need and verification that the AT selected will meet that need in the form of an "evaluation" or "assessment". Other funding sources (low interest loans, private grants, gifts) do not require assessments. Your funding source may determine who you need to get assistance from.

Who can do an Assistive Technology Evaluation or Assessment?

Currently, there is no credentialing or licensure available for AT assessment, and evaluation providers are most often licensed and or certified in related fields such as Physical Therapy, Occupational Therapy, and Speech/Language Pathology. Rehabilitation Engineers, while not certified/licensed, have engineering or technology backgrounds. Other persons who provide evaluation information often include AT Specialists/Practitioners who have identified themselves as having experience and knowledge in AT.

Occupational Therapists, Physical Therapists, Speech Language Therapists are professionals who have training and expertise in clinically recognized areas. All practicing therapists must pass standardized tests and be certified or licensed in their field. However, there is no special requirement for assistive technology applications and a therapist may or may not have experience and expertise in assessment and recommendation for AT. You will need to ask if your therapist is qualified in the area of AT. Qualified therapists have a working knowledge of assistive technology foundations, devices, and applications, and can complete a formal AT assessment which may be required by your funding source. Standards for formal AT assessments vary, but a good assessment should verify a need for assistive technology and verify that the recommended AT will meet that need. There is almost always a charge for AT services provided by therapists. Depending on the service it may or may not be covered by insurance payers

Rehabilitation Engineers are providers who have engineering and/or technology backgrounds and are very familiar with assistive technology devices. As there is no AT credentialing or license, they may or may not have the clinical experience of working with individuals with disabilities and AT. You will need to ask about their experience and expertise to determine if they are able to meet your needs for assessment or recommendation. Rehab engineers most often provide services in non-medical related areas such as home modification, work site accommodations, and computer adaptations.

Assistive Technology Practitioners/Specialists are individuals who have identified themselves as having knowledge and experience in assistive technology. Generally speaking, such persons have a clinical background in working with persons with disabilities and have specialized in assistive technology applications. Most provide complete assessments and training with devices. Again, as there is no credentialing, you will want to ask about the individual's experience and expertise to determine if the provider is appropriate for your needs. AT Specialists usually charge for their services.

If you don't have a funding source that requires an evaluation or assessment, who are the people that can help you select assistive technology devices or services?

Be aware, opinionated friends are always willing to offer advice and assistance. Listen with care as opinions almost always reflect only personal experience and prejudices which may not be true for you! Friends may be a good resource for simple, inexpensive solutions, but you'll need more objective assistance for more complex technology decisions.

Experienced peer users may be helpful, but again, their advice almost always reflects only personal experience. It is important to remember that a lot of assistive technology requires personal fitting, so what is appropriate for one person may not be appropriate for someone else, even if that person has the same disability. Peer users are good sources of information about vendor services such as technical support or vendor responsiveness, and a successful user may also act as a motivator for "hanging in" during the training time most technology requires.

Product Company Representatives are employed and salaried by a company to represent a device or product line. Company reps are well informed about their products and will often demonstrate a device for a customer at no charge. Some have had clinical experience and may be able to help you decide if a device is best for you, while others are primarily sales people. Company reps believe in their products and want to sell them, but will generally not sell you a product that is not appropriate for you. Reps usually provide excellent follow-up and post installation support for the devices they sell, usually at no additional charge.

Rehabilitation Counselors often assist individuals in identifying assistive technologies for vocational purposes. While some counselors may have knowledge of specific technologies or areas of technology application, there is no formal training required in AT and consumers need to inquire about their counselors level of experience and expertise in assistive technology. Most often, counselors will refer out to qualified providers and then work with you to interpret the assessment results and obtain the appropriate equipment.

To summarize, selecting the assistive technology that will work for you is important. If you are not happy or completely satisfied with the assistance you have received (no matter the source), it would benefit you to ask for further assistance or seek a second opinion from another source. Remember, you are the one who needs to be satisfied, and you are the only one who can determine if the assistive technology selected is right for you. No matter what the cost, not matter who prescribed it for you, if your goal of increased functioning has not been reached, you haven't found the right solution and your assessment is not finished! Contact your assessment team, and discuss the next steps to take.