Assistive Technologies and Environmental Interventions in Healthcare An Integrated Approach

Providing a holistic and client-centered approach, Assistive Technologies and Environmental Interventions in Healthcare explores the individual’s needs within the environment, examines the relationship between disability and a variety of traditional and cutting-edge technologies, and presents a humanistic discussion of Technology-Environment Intervention (TEI).

Written by a multidisciplinary team of authors, this text introduces readers to a variety of conceptual practice models and the clinical reasoning perspectives. It also provides insight into how designers go about solving human-tech problems, discusses best practices for both face-to-face and virtual teams, and looks at the psychological, sociocultural, and cognitive factors behind the development and provision of assistive technologies.

• Examines a wide range of technologies and environmental interventions
• Demonstrates how a better understanding of the complexity of human interaction with both the physical and social environment can lead to better use of technology
• Explores the future of technology and research in TEI

Complete with a range of learning features such as keywords, case studies and review questions, this book is ideal for undergraduate and graduate students in occupational therapy and other related health professions, as well as those undertaking certification and board examinations.

Lynn Gitlow is an Associate Professor in the Department of Occupational Therapy at Ithaca College in Ithaca, New York, USA. She has practiced in the area of assistive technology for over 20 years.

Kathleen Flecky is an Associate Professor in the Department of Occupational Therapy in the School of Pharmacy and Health Professions, Creighton University in Omaha, Nebraska, USA. She has been teaching and practicing in the area of community health and health promotion for 19 years.

List of contributors xiii

About the companion website xv

1 The person, the environment, and technology: Introduction to the human‐tech ladder 1
Lynn Gitlow and Kathleen Flecky

The person, the environment, and technology: Introduction to the human‐tech ladder 2

Models of disability 3

Assistive technology and the environment 4

Choosing the human‐tech ladder 5

Human‐tech ladder 6

Why are definitions important? 7

Defining technology 8

Defining AT 8

Environmental interventions 9

Categories of AT 11

Summary 12

References 12

2 Conceptual practice models and clinical reasoning 14
Lynn Gitlow, Douglas Rakoski, and Robert C. Ferguson

Introduction 15

What are conceptual practice models? 16

Need for conceptual practice models 17

Conceptual practice models that guide TEI 17

Clinical reasoning I 24

Clinical reasoning II 26

Summary 32

References 33

Additional resources 34

3 The design process: Solving human‐tech problems 35
Susan Camp

Part one: Asking questions, getting started 36

Part two: What is design and why should we care? 37

Part three: The design process – who can do it? 43

Part four: The design process – getting started 44

Part five: A design case study 47

Summary 49

References 52

4 Funding in the United States 54
Lewis Golinker

Introduction 55

The roles of the practitioner 55

Funding sources for assistive devices 55

Health benefits program funding for assistive devices 59

Benefits request – funding process: Four questions 59

The assistive device treatment plan 67

Summary 68

Notes 68

5 Outcomes, assessment, and research in assistive technology 71
Glenn Goodman, Jennifer Dunn, and Anne Bryden

Outcomes, assessment, and research in assistive technology 72

Conceptual models for AT Outcomes and Practice 73

Outcomes 76

AT‐specific assessment tools 77

Promising general outcome measures 79

Research designs and methods 80

Methodological research, systematic literature reviews, and critical appraisals 84

Summary 87

References 88

6 Educational organizations 92
Kirk Behnke

Introduction to educational organizations 93

Consideration of AT in the IEP 98

Results of AT consideration 100

Other considerations 101

Summary 104

References 104

7 Technology, employment, and disability: Creating a technology accessible vocational environment: Legal and organizational considerations 105
Wendy Strobel Gower and LaWanda Cook

Introduction 106

Creating an ideal technology organization 106

The Americans with Disabilities Act (ADA) 110

The ADA and reasonable accommodation 112

The accommodation process 112

Summary 115

References 115

8 Technology and environmental interventions for the home environment 117
BevVan Phillips

Technology and environmental intervention for the home environment 118

Qualifications and perspectives of home modification professionals 131

Structural aspects and technology factors 133

The human‐tech ladder and technology relevant to TEI in the home 136

Summary 138

References 139

9 Working and communicating in face‐to‐face teams 141
M. Gayl Bowser

Introduction 142

What is a team? 143

Why work in teams? 144

Elements of effective teamwork 147

Structures of AT teams 148

Contributions of individual team members 148

Team operation 149

How do collaborative AT teams function? 150

When team issues arise 152

Summary 153

References 153

Additional resources 154

10 Working and communicating in virtual teams 155
M. Gayl Bowser

Introduction 156

A day in the life of a virtual team member 156

Working and communicating in virtual teams 156

Benefits and drawbacks of virtual teamwork 158

Considerations for using virtual team strategies in client‐focused teams 159

Virtual AT teams 160

What makes virtual teams successful? 163

Summary 163

References 164

11 Technology and environmental intervention: Psychosocial considerations 167
Michèle Verdonck

Technology and environmental intervention: Psychosocial considerations 169

Psychosocial considerations and the human‐tech ladder 169

The lived experience of TEI 170

Personal fit of TEI 173

TEI to enable autonomy in occupation 175

TEI and identity 176

Take‐home messages: What does this all mean for you and the TEI user? 177

Summary 178

References 178

12 Sociocultural considerations 181
Jacquie Ripat

Introduction 182

Social constructionism 182

Sociocultural factors 183

Providing culturally relevant services 188

Summary 193

References 193

13 Technology and environmental interventions for cognition 197
Tony Gentry

Introduction 198

Cognitive impairment in everyday life 199

Matching device and user 204

Environmental and smart home adaptations 204

Mid‐tech solutions 208

High‐tech smart home solutions 208

Assuring the just‐right fit 209

References 211

14 Assistive technology to support learning differences 213
Judith Schoonover

Introduction 214

What is a learning disability? 214

Legislation and learning disabilities 216

UD: Creating accessible physical environments 217

Assistive technology 220

What a difference the environment makes: The role of environment in AT 224

Technology and environmental competencies needed for UDL implementation and assessment 231

Summary 233

References 235

15 Seating and positioning factors in wheeled mobility 239
Lindsey Veety and Amy Baxter

Introduction 240

Human factors and common conditions requiring wheeled mobility 241

Wheelchairs 247

Wheelchair seating 252

References 258

Additional resources 259

Digital reference 259

16 Positioning and mobility technology and environmental interventions other than wheeled mobility 268
Amy Baxter and Lindsey Veety

Introduction 269

Human‐tech ladder 269

Human factors and common conditions that challenge seating and positioning 270

Notes 286

References 286

Additional resources 286

17 Communication‐related factors 287
Tina N. Caswell

Introduction 288

Legal and policy influences 290

Who needs AAC? 291

AAC assessment 291

AAC intervention – psychosocial and physical levels of the human‐tech ladder 297

Summary 301

References 303

18 Hearing loss and hearing‐related factors: Technology and environmental interventions 306
Amy Rominger and Leisha R. Eiten

Introduction 308

Definitions related to hearing loss 308

Prevalence of hearing loss 308

Descriptive characteristics of hearing loss 309

Effects of hearing loss 313

The human‐tech ladder, hearing loss, and hearing‐related factors 314

Selecting assistive technology for hearing loss 317

Hearing assistance technologies 319

Assistive technology for persons not using amplification 326

TEI and the deaf population 327

Environmental modifications and communication strategies 328

Summary 329

References 329

Additional resources 331

19 Technology and environmental intervention for visual impairment 332
Stacy Smallfield

Technology and environmental intervention (TEI) for visual impairment 334

Definitions of visual impairment 334

Select eye conditions that lead to visual impairment 334

Application of the human‐tech ladder to individuals with visual impairment 336

Considerations in assessment for AT for visual impairment 339

Select TEI strategies for visual impairment 342

Non‐optical devices for reading and viewing 347

Illumination and contrast for reading and viewing 348

AT for daily activities 348

Summary 352

Acknowledgments 353

References 353

Additional resources 355

20 Technology and environmental interventions to promote community mobility 356
David Joseph Feathers

Introduction 357

Part I: Accessibility and the human–environment interactions of community participation 357

Part II: Inclusive designing and the SRK model 359

Part III: Profiles from the community 361

Part IV: Evidenced‐based design and research for community participation: Current and future needs 364

Acknowledgments 365

References 365

21 Leisure: Technology and environmental interventions 367
Nathan “Ben” Herz

Leisure defined 368

Leisure as part of a meaningful life 368

Leisure activities across the life span 369

The human‐tech ladder 371

Assessment and evaluation of leisure 373

Quality of life measures 373

Leisure‐specific assessments 373

The relationship of leisure to injury and illness 373

Role of TEI in participation 374

General leisure activities TEI strategies 374

Organized sports 374

Examples of TEI for specific sports 375

Outdoor mobility and TEI strategies 376

Digital media and TEI strategies 377

Accessibility 378

Gaming systems 378

Summary 381

References 381

22 Physical factors focused on activities of daily living (ADLs) and electronic aids to daily living (EADLs) 383
Lynn Gitlow

Introduction 384

Human‐tech ladder 385

Definitions 386

Organizational level 386

Team considerations 387

Psychological level 387

Physical level 387

Evaluation and assessment tools 388

TEI for ADLs 389

Bathing and washing 389

Bathing 390

Water for bathing 391

Hair care options 393

Caring for fingernails and toenails 393

Toileting 394

Dressing 395

Eating and drinking 396

Taking care of one’s health 399

Electronic aids to daily living (EADLs) 400

References 401

23 Implications for future practice and research in technology and environmental interventions 405
Steve Jacobs

Introduction 406

Technology’s impact on the definition of a “public accommodation”: Political and organizational levels of vicente’s human‐tech ladder 406

Assistive technology vs.“Universally‐designed” technology 408

Global public inclusive infrastructure 409

Business models that encourage accessible ICT development 416

Overview of the CSIM’s technical assistance components 418

Software distribution services 418

Accessibility value chain concept 418

Notes 419

Index 421

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