AT Assessment Goes Electronic: It's Now Easier to Obtain Consumer Input and Assessment Results

Marcia J. Scherer, Ph.D. &
Caren Sax, Ed.D.

ABSTRACT

The purpose of this research was to d evelop the content for interpretive guidelines and an interactive training program for professionals using the Assistive Technology Device Predisposition Assessment (ATD PA) Consumer Form. Participants were vocational rehabilitation counselors from over a third of the U.S. who were enrolled in an on-line course on AT and who used the ATD PA, training CD and computerized scores and interpretations with their consumers. The results strongly support the value of the information from, and time saving aspect, of the use of the electronic materials.

Key Words :

Assistive technology device, assessment, consumer

Background

There are two often opposing forces AT professionals must contend with today: (a) People with disabilities who want more ATDs and services available to them, and to be involved in the ATD selection process and (b) the need to contain costs and provide services in the most time- and cost-efficient manner possible. It is also the case that, more than ever, people with disabilities say they want as much attention paid to their quality of life and social participation as to their functional capabilities (1,2).

Expanded choice in ATDs now means differences among individual users can be accommodated, making the process of matching person and technology complex because people's expectations of and reactions to technologies are complex (1). These reactions are also highly individualized. They emerge from varying needs, abilities, preferences, and past experiences with and exposures. Predispositions to ATD use also depend on one's temperament/personality, subjective quality of life/well-being, views of physical capabilities, expectations for future functioning, and financial and social/environmental support for ATD use (1). One model that has been posited to account for these influences is the Matching Person and Technology (MPT) Model, first presented in 1989 (3).

The Matching Person & Technology (MPT) Model and accompanying assessments address three primary areas to assess: (a) determination of the milieu/ environment factors influencing use, (b) identification of consumer needs and preferences, and (c) description of the functions and features of the most desirable and appropriate ATD. To operationalize the model and theory, assessment forms were developed through participatory action research addressing differences between ATD users and non-users. The assessments are been determined to be reliable and valid and to predict predispositions to the use of one or more ATDs and to predict the quality of the selected ATD and user match at follow-up (4,5).

The goals of the present study addressed the utility of a direct electronic-based means of administering the Assistive Technology Device Predisposition Assessment (ATD PA) Consumer Form and the usefulness and "predictive value" of the computer scored results (with interpretations and guidelines for the AT practitioner). The direct electronic input version of the ATD PA and results of the computerized scoring and interpretations will be shown during the presentation of this paper. Since the value of an electronic means of data collection can be assumed, and because the page requirement for this paper is short, the remainder of this paper will focus on the counselor provided feedback regarding the value of the computerized scores and interpretations.

Scores and Interpretations of the ATD PA Results. The outcome of the computerized scoring consists of the following:

1. a significantly simpler scoring process and a fast means of obtaining the results.
2. a guide to numeric scores, in order to have an immediate view of options for proceeding with the consumer's ATD selection.
3.   guidelines for questions which are personal, since the rofessional may not have the time or feel comfortable addressing these issues
4. guidelines encouraging goal setting and interaction as well as "where we go from here."
5. considerations for training the consumer in using a new AT.

Use of the follow-up versions of the ATD PA (also provided on the CD) are encouraged. These should be done after the ATD is in place and being used in order to explore the desirability of additional training, a product upgrade, etc.

METHOD

A multi-cohort study of vocational rehabilitation counselors was conducted. At the time of the study, the counselors were employed by State Departments of Rehabilitation and were concurrently enrolled at San Diego State University in a Masters of Science program in Rehabilitation Counseling, as required by the Comprehensive System of Personnel Development (Section 101(a) (7) of the Rehabilitation Act Amendments of 1992).

One of the required courses in the program is Applications of Rehabilitation Technology, developed by the second author. This 12-week course is interactive, using mediated technology (e.g., discussion boards, weblectures, video and audiostreaming). The purpose of the course is to equip rehabilitation professionals with the knowledge and skills to support a consumer-driven process for assessing AT needs. The major course project (representing over a third of the students' course grade) requires students to identify an individual who is interested in and may benefit from the use of assistive technology, and to help them make informed decisions on the assistive technology devices that best fits his or her needs. Students were required to view the interactive CD training, "Matching Person and Technology", which describe the Matching Person & Technology process, rationale, and procedures as well as specific assessment forms. The steps and components of the course project include:

1. Identification of a person with a disability who is interested in and who may benefit from ATD.
2. Use of the ATD PA to interview the individual to help identify a desired activity and to determine incentives and disincentives for using AT.
3. The students sent their completed ATD PA Person and Device Forms by e-mail to the first author where the responses were computer scored and interpretations were generated.
4. The scores with interpretations were returned to the students electronically. This included summaries of the ATD PA subscale scores (physical capabilities, subjective quality of life, psychosocial and temperament characteristics, device features) for any given respondent with accompanying suggestions for further assessment, training, and environmental support or accommodations. The goal is to provide respondent profiles which will allow the professional to identify particular areas in need of intervention. ( Since the MPT assessments are designed to inform, not to replace professional judgment, and are screening tools, their purpose is only to indicate areas in need of further assessment and intervention). A prototype exists as an Excel spreadsheet program.
5. Finally, students were asked to evaluate the process from beginning to end and its impact on their role as a professional.

Accessibility of the Materials . The materials are fully accessible to individuals with low vision or who are blind. All text is presented in visual as well as audio and in Spanish as well as English.

Research with Human Subjects Approval . The Council of State Administrators of Vocational Rehabilitation (CSAVR) approved the participation of the distance education students in the research activities. The Council's Committee on Rehabilitation Research is charged with the consideration of all issues involving research affecting the State-Federal Rehabilitation Program and it reviews requests for State Vocational Rehabilitation Agencies to participate in national surveys.

RESULTS

In general, the professionals and consumers who participated in the study found the MPT process and ATD PA assessments to be useful and rated their value quite highly. Specific comments include:

• encourages client participation in process of developing and setting goals; helps client better understand their own needs and interests
• useful when client is a complicated case, good tool for assessing a client's "story" with AT; helps avoid the "one size fits all" mentality; useful as case documentation
• reduces worry that professional is omitting something, forces one to be thorough
• places some responsibility on client without giving them "whole ball of wax" to figure out what they need; lets client be the person who makes final decision
• helps organize thoughts and focus on entire picture
• good framework in which to build the counselor-client relationship

The respondents (both professionals and consumers) were highly positive towards the MPT process and ATD PA. They especially liked the way the process and forms (a) engage the consumer in the process of technology evaluation and (b) structure the discussion to include key considerations that might be missed otherwise (such as topics in which the professional might have some discomfort in raising, personal and social/ environmental influences). The forms helped to ensure all relevant areas were systematically reviewed and that a comprehensive assessment was done.

CONCLUSIONS

Participants articulated a strong regard and desire for these products and services. The ability to provide such products efficiently, scientifically, and in an accessible manner forms the basis for quality AT assessment. However, further collaboration at multiple sites in a variety of contexts would add evidence to the results.

Acknowledgements

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 Institute for Matching Person & Technology, Inc.

References

1. Scherer, M. J. (2005). Living in the State of Stuck: How Technology Impacts the Lives of People with Disabilities, Fourth Edition. Cambridge , MA : Brookline Books.
2. Scherer, M. J. (2002, May). Policy issues in evaluating and selecting assistive technology and other resources for persons with disabilities. Bridging gaps: Refining the disability research agenda for rehabilitation and the social sciences. Washington , DC . National Institute for Disability and Rehabilitation Research.
3. Scherer, M.J. (2005). The Matching Person & Technology (MPT) Model Manual and Assessments, 5 th edition [CD-ROM]. Webster , NY : The Institute for Matching Person & Technology, Inc.
4. Scherer, M.J. & Craddock, G. (2002). Matching Person & Technology (MPT) assessment process. Technology & Disability: The Assessment of AT Outcomes, Effects and Costs , 14(3), 125-131.
5. Scherer, M.J., Sax, C., Vanbeirvliet, A. , Cushman, L.A. & Scherer, J.V. (2005). Predictors of assistive technology use: The importance of personal and psychosocial factors. Disability & Rehabilitation , 27(21), 1321-1331.