The National Institute on Disability and Rehabilitation Research (NIDRR) and the National Center for Health Statistics (NCHS) co-sponsored a survey on assistive technology (AT) devices, as part of the National Health Interview Survey of 1990. The Survey showed that more than 13.1 million Americans, about 5.3 percent of the population, used AT devices. More people use AT devices for mobility (6.4 million) than any other general type of AT: 4.4 million use a cane or walking stick; 1.7 million use a walker; 1.4 million use wheelchairs; and 1.2 million use back braces.
In spite of the fact that provision of AT to people with disabilities is encouraged in a succession of U.S. statutes, and that there are federal mandates for comprehensive, consumer-responsive AT and technology-related services, obtaining devices and services remains an arduous task for both user and provider. The match of person and technology requires attention to aspects of the environments in which the AT will be used, the needs and preferences of the user, and the functions and features of the technology. If the match is not a quality one from the standpoint of the consumer, the AT may not be used, or will not be used optimally. There is a need for an improved evaluation because studies and reports show a high level of dissatisfaction and nonuse of technology by consumers.
An assessment process exists that has been effective in addressing and organizing the influences that impact on AT use: the Matching Person & Technology (MPT) Model and its accompanying assessment instruments. The Model/theory addresses three primary areas to assess: (1) environment factors; (2) user needs and preferences; and (3) desirable and appropriate technology functions and features. To operationalize the Model and theory, an assessment process consisting of several instruments has been developed.
The MPT Model consists of a set of instruments that have been validated for use by persons with disabilities (ages 15 and up). Results of its use have resulted in a high satisfaction in the selection of useable technology. It is a practical research tool that identifies barriers to AT use for a particular individual.
A research project was designed to develop prototypes of: (a) a series of interpretive guidelines for implementing a consumer-directed and cost-effective process for matching person and AT; and (b) an interactive training program designed to address the AT educational needs of rehabilitation professionals. The methodology involved: recruitment of 20 professional users of the existing MPT assessment process and one-to-two of their consumers; surveys and interviews regarding the process of completing the MPT instruments; the development of prototype AT user profiles, computerized interpretive guidelines, and the content for an interactive training program for MPT; and an assessment of the influence of reimbursement (payer and/or insurance) on the designation of the AT prescribed or ordered for each consumer. Providers and consumers confirmed the importance of reimbursement/payer on AT ordered. Other results produced the content for and prototypes of the interpretive guidelines and interactive training program. These prototypes are ready for refinement and validation during subsequent research and testing.
This research was funded by the National Institutes of Health, National Institute of Child Health and Human Development, National Center for Medical Rehabilitation Research, through grant number HD38220 to the IMPT.