Rehabilitative and Assistive Technology

Rehabilitative and assistive technologies are tools, equipment, or products that can help people with disabilities function successfully at school, home, work, and in the community.

Assistive technology can be as simple as a magnifying glass or as complex as a digital communication system. An assistive device can be as large as a power wheelchair lift for a van or as small as a handheld hook that assists with buttoning a shirt.¹

Tools to help people recover or improve their functioning after injury or illness are sometimes called “rehabilitative technology.” But the term is often used interchangeably with the term “assistive technology.”

NICHD supports research on developing and evaluating technologies, devices, instruments, and other aids to help people with disabilities achieve their full potential.

Rehabilitative engineers use scientific principles to study how people with disabilities function in society. They study barriers to optimal function and design solutions so that people with disabilities can interact successfully in their environments.

Some examples of assistive technologies are:

• Mobility aids, such as wheelchairs, scooters, walkers, canes, crutches¹, prosthetic devices, and orthotic devices.²
• Hearing aids to help people hear or hear more clearly.³
• Cognitive aids, including computer or electrical assistive devices, to help people with memory, attention, or other challenges in their thinking skills.³
• Computer software and hardware, such as voice recognition programs, screen readers, and screen enlargement applications, to help people with mobility and sensory impairments use computers and mobile devices.^4,5
• Tools such as automatic page turners, book holders, and adapted pencil grips to help learners with disabilities participate in educational activities^4,6,7
• Closed captioning to allow people with hearing problems to watch movies, television programs, and other digital media.⁴
• Physical modifications in the built environment, including ramps, grab bars, and wider doorways to enable access to buildings, businesses, and workplaces.^8,9
• Lightweight, high-performance mobility devices that enable persons with disabilities to play sports and be physically active.⁴
• Adaptive switches and utensils to allow those with limited motor skills to eat, play games, and accomplish other activities.⁴
• Devices and features of devices to help perform tasks such as cooking, dressing, and grooming; specialized handles and grips, devices that extend reach, and lights on telephones and doorbells are a few examples.⁴

For more information about types of assistive devices, check out the following resources:

• The National Institute on Deafness and Other Communication Disorders provides detailed information on Assistive Devices for People with Hearing, Voice, Speech, or Language Disorders.
• PBS "Move to Include" provides examples of assistive devices for people who need assistance to produce or comprehend spoken or written language.
• The Christopher & Dana Reeve Foundation has information about available assistive technology to help people with impaired mobility or other disabilities drive motor vehicles .
• The Rehabilitation Engineering and Assistive Technology Society of North America describes standards for different types of assistive technology  on its website.

Rehabilitative technologies and techniques help people recover or improve function after injury or illness. Examples include the following:

• Robotics. Specialized robots help people regain and improve function in arms or legs after a stroke.
• Virtual reality. People who are recovering from injury can retrain themselves to perform motions within a virtual environment.
• Musculoskeletal modeling and simulations. These computer simulations of the human body can pinpoint underlying mechanical problems in a person with a movement-related disability. This technique can help improve assistive aids or physical therapies.
• Transcranial magnetic stimulation (TMS). TMS sends magnetic impulses through the skull to stimulate the brain. This system can help people who have had a stroke recover movement and brain function.
• Transcranial direct current stimulation (tDCS). In tDCS, a mild electrical current travels through the skull and stimulates the brain. This can help recover movement in patients recovering from stroke or other conditions.
• Motion analysis. Motion analysis captures video of human motion with specialized computer software that analyzes the motion in detail. The technique gives health care providers a detailed picture of a person’s specific movement challenges to guide proper therapy.

Some devices incorporate multiple types of technologies and techniques to help users regain or improve function. For example, the BrainGate project, which was partially funded by NICHD through the NCMRR, relied on tiny sensors being implanted in the brain. The user could then think about moving their arm, and a robotic arm would carry out the thought. Learn more about brain-computer interfaces at https://www.nichd.nih.gov/news/releases/032013-sensor.

Rehabilitative technology can help restore or improve function in people who have developed a disability due to disease, injury, or aging. Appropriate assistive technology often helps people with disabilities compensate, at least in part, for a limitation.

For example, assistive technology enables students with disabilities to compensate for certain impairments. This specialized technology promotes independence and decreases the need for other support.¹

Rehabilitative and assistive technology can enable individuals to:

• Care for themselves and their families
• Work
• Learn in typical school environments and other educational institutions
• Access information through computers and reading
• Enjoy music, sports, travel, and the arts
• Participate fully in community life

Assistive technology also benefits employers, teachers, family members, and everyone who interacts with people who use the technology.

As assistive technologies become more commonplace, people without disabilities are benefiting from them. For example, people for whom English is a second language are taking advantage of screen readers. Older individuals are using screen enlargers and magnifiers.²

The person with a disability, along with his or her caregivers and a team of professionals and consultants, usually decide which type of rehabilitative or assistive technology would be most helpful. The team is trained to match particular technologies to specific needs to help the person function better or more independently. The team may include family doctors, regular and special education teachers, speech-language pathologists, rehabilitation engineers, occupational therapists, and other specialists, including representatives from companies that manufacture assistive technology.³

What conditions may benefit from assistive devices?

Some disabilities are quite visible, while others are “hidden.” Most disabilities can be grouped into the following categories⁴:

• Cognitive disability: intellectual and learning disabilities/disorders, distractibility, reading disorders, inability to remember or focus on large amounts of information
• Hearing disability: hearing loss or impaired hearing
• Physical disability: paralysis, difficulties with walking or other movement, inability to use a computer mouse, slow response time, difficulty controlling movement
• Visual disability: blindness, low vision, color blindness
• Mental conditions: post-traumatic stress disorder, anxiety disorders, mood disorders, eating disorders, psychosis

Hidden disabilities are those that might not be immediately apparent when you look at someone. They can include visual impairments, movement problems, hearing impairments, and mental health conditions.⁴

Some medical conditions may also contribute to disabilities or may be categorized as hidden disabilities under the Americans with Disabilities Act (ADA). For example, epilepsy; diabetes; sickle cell conditions; HIV/AIDS; cystic fibrosis; cancer; and heart, liver, or kidney problems may lead to problems with mobility or daily function, and may be viewed as disabilities under the law. The conditions may be short term or long term; stable or progressive; constant or unpredictable; and changing, treatable, or untreatable. Many people with hidden disabilities can benefit from assistive technologies for certain activities or during certain stages of their diseases or conditions.⁵ Visit https://www.ada.gov/ada_intro.htm for more information about the ADA.

People who have spinal cord injuries, traumatic brain injury, cerebral palsy, muscular dystrophy, spina bifida, osteogenesis imperfecta, multiple sclerosis, demyelinating diseases, myelopathy, progressive muscular atrophy, amputations, or paralysis often benefit from complex rehabilitative technology. The assistive devices are individually configured to help each person with his or her own unique disability.⁶

For more information about conditions that may benefit from assistive technology, visit the following resources:

• MedlinePlus, a service of the National Library of Medicine, provides information about assistive devices for various conditions.
• The Paralysis Resource Center   provided by the Christopher & Dana Reeve Foundation explains some of the different paralytic conditions that can benefit from assistive technology.
• The LD Online website contains information on the use of assistive technologies  for children with learning disabilities.
• The American Speech-Language-Hearing Association website  includes blog posts, articles, brochures, and other resources about hearing assistive technology.
• The National Institute of Neurological Disorders and Stroke provides information on assistive technology for people with various conditions, including muscular dystrophy and cerebral palsy.