The Assistive Technology Assessment
There are many factors to take into account when performing an AT assessment. Logically, an assessment would include an evaluation of a person's abilities and limitations to determine an appropriate AT. There are, however, other factors such as the user's preferences, the environments the user encounters, and potential changes in the user's situation that can effect use of the AT device. These factors all need to be considered during an assessment to result a good person-technology match. Thus, each AT assessment should have ecological, practical, and ongoing components.
AT Assessments must be
Ecological
Every AT assessment should have an ecological element. For this, AT professionals must consider the environments (home, school, work, community, etc) in which the user participates and the people with whom the user will interact as well as a person's abilities and limitations. Regardless of the person-technology match based on physical abilities and limitations, failing to take into account all necessary environments during an AT assessment can lead to user frustration (in unevaluated environments) and ultimately AT abandonment. With this in mind, only technology that functions well in all necessary environments should be recommended.
Environmental factors (e.g. background noise, lighting level, terrain, etc.) can have as much effect on the user's ability to successfully use AT as his/her physical abilities and limitations. For example, recommending speech recognition software as an alternative typing option to someone who works both at home and in a noisy office after only evaluating the home can have mixed results. At home, the software may work great. In a noisy office, the software can pick up background noise as well as the users voice, resulting in an ineffective AT solution. An ecological evaluation of the workplace would have alerted the AT professional of this potential difficulty and may have resulted in different AT recommendations for home and work. Some assistive technology such as wheelchairs and communication devices need to be used in every environment the user encounters (home, school, work, and various public settings). If this is the case, each of the environments should be evaluated prior to the AT recommendation. For example, if recommending a communication device for a person who spends time in noisy as well as quiet environments, the recommended device should have an accessible volume control so the user can "speak" in a volume appropriate for the situation.
The second important ecological aspect of an AT assessment includes the people with whom the AT user will interact (parents, teachers, siblings, spouses, friends, coworkers, aids etc.). People in general react differently toward AT and AT users. Some are very open to it and are willing to help, while others refuse to learn how to use it. An ecological assessment must identify members of the AT user's support system and determine their feelings toward possible AT interventions. If anyone in this support system reacts negatively to the AT, there is a potential risk that the AT user will not get the necessary support for successful AT usage. Even though it is important to provide AT that those in the AT user's support system are comfortable working with, the user is still the most important person in the assessment process. If a recommended AT device is a good fit on every level other than with the user's support system, steps should be taken to help make the support system comfortable with the chosen AT option. Overall, considering ecological elements an AT user will encounter as part of the assessment will result in a better person-technology match and a lower abandonment rate.
Practical
The practical element of the AT assessment process, is where the AT user's cognitive and physical abilities and functional limitations are thoroughly evaluated, quantified, and studied. The user's abilities must be understood for a functionally usable device to be recommended. The user's functional limitations must be understood to determine the types of activities the user desires to perform that he/she currently cannot due to physical limitations. Understanding the user's abilities and limitations allows for a recommendation that best utilizes these abilities to overcome physical limitations, thus providing a means to complete desired activities. This is the very basis of an AT assessment.
There are, however, other practical factors to consider during an assessment such as the user's economic and social situations, technology preferences, and tolerance for technology. If the AT user does not like, cannot afford, or refuses to use the technology recommended, he/she will not benefit from the AT regardless of how well the technology is matched to his/her functional abilities. Also, potential changes in the user's disability that could affect his/her functional abilities and limitations must be taken into account. If the user has a known progressive disability, for a good person-technology match to be achieved, the AT recommended should be able to be used through various stages of this disability. If the technology currently works but does not six months later because of a foreseeable progression in the users disability, the person technology match is not effective.
Ongoing
A successful AT assessment does not end with the recommendation of an AT intervention. It needs to be ongoing. Most people's lives are not static, they can experience significant change over the course of even a few months. The same holds true for a person with a disability. Many typical changes such as those in a person's social, economic, or professional situation, a move to a new environment, or development of new technology can have a significant effect on his/her AT needs. For someone with a progressive disability, inevitable changes in the condition of his/her disability can render AT that was previously a good match, completely ineffective.
Because these expected changes in one's life can cause a need for either new AT or an adjustment to the current device, AT assessments should be performed continuously. Thus, following initial recommendations, there should be periodic follow-ups to the person's situation to monitor changes that may lead to a new AT recommendation. An ongoing AT assessment can help to identify a possible need for adjustment to or replacement for a current AT device in a timely manner. Thus, reducing the time the user is without AT that fits his/her needs while also making a potential transition to a new AT device smoother following a significant life change. Part of the burden of an ongoing evaluation falls on the AT user as well. He or she needs to notify the AT assessor of any foreseeable change to determine it's possible effects on the user's AT needs. If the change is not foreseeable, the AT user needs to notify the AT assessor as soon as possible to limit the amount of time he/she is without a proper AT device.