Assistive Technology 1

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Activity

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execution of tasks. AT model that defines the goal of the AT system

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Alpha testing

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Evaluation of a production prototype; in AT it is often one or two untis. Usually conducted in-house by manufacturers

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Assistive Technology

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any item, piece of equipment or product system whether acquired commercially off the shelf, modified, or customized that is used to increase, maintain, or improve functional capabilities of individuals with disabilities

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Assistive Technology practicioner

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typically has a professional background in one of several areas, including engineering, OT, PT, rec therapy, special ed, speech path, or vocational rehab councelor

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Assistive Technology service

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any service that directly assists an individual w/ a disability in the selectin, acquisition, or use of an assistive technology device

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Assistive Technology supplier

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distribution of assistive technologies through a dealer or supplier. ONe who provides enabling tech in the areas of wheeled mobility, seating, and alternative positioning, ambulation assistance, environmental control and activities of daily living

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Beta testing

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after alpha testing, several individuals simultaneously engage in more extensive eval of the set of prototypes. Usually done w/ clinicians, consumers, and others who can give the preproduction prototyples a thorough eval. These will form the initial production run

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consumer of assistive technologies

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recipient, or end user, of assistive technology

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Devise

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a piece of hardware or software used by an individual to accomplish a task

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direct consumer services

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component in which a consumer's need for assistive technology is identified, and ecaluation is completed, recommendations are made, and the system is implemented. Assistive tech services provided to a consumer

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participation

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involvement in life situations

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prototype

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initially new device that is produced. Consumers are involved in the design process and in trial testing it

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Quality assurance

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broad area of fundamental importance to the safe and effective application of assistive technologies. It involves two basic considerations: the quality of the services rendered and the quality of the devices supplied. Closely tied with reimbursement, and as the number of devices and practitioners increases, third-party payers are requiring some indication that the services and devices are necessary, safe, and effective

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reasonable accomodation

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any modification or adjustment to a job or the work or educational environment that will enable a qualified applicant, employee, or learner with a disability to participate in the application process, perform essential job functions, or participate fully in the educational program; also includes adjustments to ensure that a qualified individual with a disability has rights and privileges in employment and education equal to those of employees w/out disabilities

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telerehabilitation

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use of telecommunications technologies to capture and transmit visual and audio information, biomedical data, and consumer info

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transdisciplinary team approach

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crossing over of professional boundaries and sharing of roles and functions in an assistive technology team, with all individual team members well grounded in their profession but also comfortable extending their roles beyond their professions

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universal design

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the design of products and environments to be usable by all people, to the greatest extent possible, without the need for adaptation or specialized design

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assistive technology system

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consisiting of an assistive technology device, a human operator who has a disability, and an environment in which the functional activity is to be carried out.

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contexts

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the portion of the human activity-assistivbe technology model that includes 4 major considerations 1. setting 2. social context, 3. cultural context and 4. physical context

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extrinisic enablers

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also known as assistivbe technologies because they provide the basis by which huan performance is improved in the presence of disability

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function allocation

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the allocation of functions in any human/device system in which some functions are allocated to the human, some to the device, and some to the personal assistant services

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Human activity assistive technology model

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proposed as a framework for understanding the place of assistive technology in the lives of persons with disabilities, guiding both clinical applicationsand research investigations. 4 major parts: activity, context, human skills, assistive technologies

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occupation

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self-care, productivity, and leisure, wheras the environment consists of physical, social, cultural, and institutional elements. The dynamic interaction of these elements influences an individuals performance in chosen or required occupations

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occupational competence

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dynamic context to the understanding of human abilities and how a person changes and adapts hiw or her engagement in activity in response to environmental demans and his or her own abilities. The ability to meet the demands that are required for successful engagement in various life roles

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Performance areas

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what activities are categorized within: activities of daily living, work and productive activities, and play and leisure activities

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tasks

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small elements in which activities can be broken down

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assessment

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a process through which info about the consumer is gathered and analyzed so that appropriate assistive technologies can be recommended and a plan for intervention developed

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criteria for service

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the recognition of a need for assisitive technology services that triggers a referral for services

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criterion referenced measurement

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a measurement in which the person's own skill level in using the system is used as the standard

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device characteristics

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general properties of the hard technology portions of an assistive technology system

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expert systems

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computer based software that assists in the decision-making process for assistive technologies

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functional performance measures

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measurement that address whether the individual can accomplish tasks that he or she could not do w/out the assistive technology

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follow-along

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those activities that take place over a longer period. This phase address factors such as changes in needs or goals, availability of of new devices, and other concerns

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follow-up

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activites that occur during the period immediately after delivery of an assistive technology system and that address the effectiveness of the device, training, and user strategies

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health-related quality of life

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the impact of helath services on the overall QOL of individuals; represents the functional effect of an illness and its consequent therapy

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implementation phase

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the portion of the service delivery process in which the recommended technology is ordered, modified, and fabricated as necessary; set up; delivered to the consumer; and initial training takes place

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needs identification

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the portion of the assessment during which more detailed specification of the consumer's assistive technology needs is made

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norm-referenced measurements

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the ranking of the performance of the individual or system according to a sample of scores others have achi3eved on the task

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operational competence

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skills required for the individual and his aides to use the basic features of the assistive technology device

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outcome measures

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used to evaluate the end result of the assistive technology intervention

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performance aid

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a document or device containing info that an individual uses to assist in the completion of an activitiy

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qualitative measurement

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assumesx that each individual has a different experience and that it is important to provide the opportunity to capture that experience. There is no attempt to measure a particular construct. Rather, the purpose is to describe and understand the user's experience with the technology. They may include observation, either directly or by videotape, or interview with the client and othrs.

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referral and intake

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the portion of the assessment in which the consumer, or someone close to the consumer, has indentified a need for which assistive technology intervention mayt be indicated and contacts an assistive technology practitioner; basic info is gathered and a determination of the match between the services provided and the identified needs of the consumer is made; funding is also identified and secured at this stage

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strategic competence

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skills in the use of strategies that maximize the effectiveness of the assistive technology

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technology abandonment

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a situation in which the consumer stops using a device even though the need for which the device has been obtained still exists

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user satisfaction

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the consumer's perception of the degree to which the assistive technology system achieves the desired goals

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user satisfaction measures

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measures that address whether the assistive technology services and devices provided meet the consumer's needs from the consumer's point of view

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appeals process

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the means whereby the assistive technology prqactitioner can appeal a funding denial

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diagnosis codes

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describe the person's condition or medical reason for the services being requested; the key to establishing medical necessity

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fee for service

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the traditional method of payment for health care under shich providers are paid a certain rate per unit of service

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managed care

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any method of health care delivery designed to reduce unnecessary use of services and provide for cost containment while ensuring that high-quality care or performance is maintained

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medicaid

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a health insurance program, established 1965 by title XIX of the social security act, administered at the state level for persons who are unable to pay the costs of their medical care

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medical necessity

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a specific criterion for funding under medicare, medicaid, and private health insurance that requires identification of a medical diagnosis or condition that is specifically coupled to the functional impairment being addressed by the device

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medicare

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the health insurance program operated by the US government; covers individuals aged 65 years and older and those adults under 65 years who are blind, are totally and permanently disabled, and have received social security disability insurance benefits or adult disabled child benefits for at least 24 mos

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plan for achieving self-sufficiency (PASS)

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a program that allows individuals to put aside income for equipment or services that will assist them in achieving a vocational objective

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procedure codes

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a numerical system used to describe the services that the provider carried out and is billing for; the most commonly used procedure coding system is the common procedure coding system (HCPCS) of the health care financing administration (HCFA)

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public funding sources

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government funding at the federal, state or local levels

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third party payer

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a funding source that is public or pricvate and covers the cost of devices and services

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tricare

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federally funded program that provides medical benefits to active duty military service members and their dependents and to military retirees and their dependents

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center of gravity

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the point in the body at which the acceleration caused by gravity is localized

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center of pressure

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center of gravitational forces when measured in posterior-anterior and lateral planes

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compression

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occurs when forces act toward each other (pushing together), such as the force of the vertebrae on the discs in the spinal column

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dampening

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the ability of a material to soften on impact

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density

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the ratio of the weight of a material to its volume

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envelopment

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the degree to which the person sinks into a seating cushion and the degree to which the cushion surrounds the buttocks

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equilibrium

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the situation in which the force generated by one object is equal in magnitude and opposite in direction to the force generated by another object

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fixed deformity

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a permanent change taking place in the bones, muscles, capsular ligaments, or tendons that restricts the normal range of motion of the particular joint and affects the skeletal alignment of the other joints

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flexible deformity

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appearance of a deformity as a result of increased tone and muscle tightness causing the person to assume certain postures; externally applied resistance (passive stretch) in the opposite direction allows movement of the joint and reduction of the "deformity"

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force

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anything that acts on a body to change its rate of acceleration or alter its momentum

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frictional forces

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resulting forces from movement in opposite directions between 2 bodies in contact; may be static or dynamic

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fulcrum

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the axis around which rotational movements occur

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gravitational line

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the axis of the body along which the force of gravity acts

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line of application

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the particular direction along which forces are applied, either pushing or pulling

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mobility

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allows movement that enables function in a seated or standing position

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pelvic obliquity

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one side of the pelvis is higher than the other when viewed in the frontal plane

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pelvic rotation

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one side of the pelvis is forward to the other side

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planar

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flat seating components that support the body only where it easily comes into contact with the supporting system

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pressure

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force per unit area

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pressure ulcer

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a lesion that develops as a result of unrelieved pressure to an area and that results in damage to underlying tissue

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recovery

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the degree to which a cushion returns to its preloaded state when a load is remobed

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resilience

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ability of a material to recover it's shape after a load is removed or to adjust to a load as it is applied

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rotational

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when the direction, distance and time of a movement occur simultaneously, but the movement is through an angle instead of in a straight line

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scoliosis

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lateral curvature of the spine

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shearing

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occurs when forces are parallel (sliding across the surfaces), such as the movement that occurs as the head of the femur moves across the acetabulum during hip movement

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sliding resistance

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a cushion property related to friction that describes the forces that influence movement of the user across the surface of a seat cushion

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stability

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allows an individual to maintain an upright seated position

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stability zone

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the balance limits for a person in either sitting or standing

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stiffness

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how much a material gives under load

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stress

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the resulting molecular change inside biological (soft tissue/bone) or non-biological (metals, plastics, or foams) material

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tension

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forces that act in the same line but away from each other (pulling apart), such as the force applied on the antagonist muscle during contraction of the agonist muscle

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windswept hip deformity

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when one hip is adducted and the other hip is abducted

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anti-tip devices

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small wheels, attached to a rod and mounted at the back of the chair that prevent the chair from tipping backwards

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armrests

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part of a WC that provides support for the user's arms; they may be fixed or removable and may be height adjustable

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bariatrics

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a term that describes the practice of medicine concerning individuals who are significantly overweight

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camber

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the degree to which the wheel is mounted off vertical, usually 1 to 4 degrees. Camber tips the wheel so the top is closer to the user's body. when the wheels are set this way, the wheelchair becomes more stable and propulsion is more efficient

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center of mass

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point in the center of an object of any shape around which the gravitational forces acting on the body balance each other. the center of mass of an empty wheelchair is located under the seat, in front of the drive wheels

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dependent mobility system

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mobility systems that are propelled by an attendant

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electrically powered wheelchair

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a wheeled mobility base with a power drive to the wheels, a control interface that the consumer uses to direct the movement of the wheelchair, an electronic controller, and powered accessories

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front rigging

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leg rests and footplates on a wheelchair that support the user's feet

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independent manual mobility system

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systems in which the user has the ability to propel the device by body power only

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independent powered mobility

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motorized wheelchairs that are controlled by the user

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lightweight wheelchair

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a wheelchair that weighs less than the standard chair and has greater flexibility in choice of seat width and adjustment of back height

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low shear systems

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systems in which the back hinges to the seat in a manner that reduces the movement of tissue across the seating surface during tilting or reclining of the seat

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manual wheelchair

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wheelchair that the user propels with his own muscle power

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nonproportional control

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electrically powered wheelchair control that operates the chair at a predetermined speed in a selected direction. The speed is not proportional to the displacement of the joystick

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propelling structure

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the portion of a manual wheelchair consisting of the wheels and an interface that the consumer uses to move the wheelchair; the portion of a power wheelchair consisting of a wheeled mobility base with a power drive to the wheels, a control interface that the consumer uses to direct the movement of the wheelchair, an electronic controller, and powered accessories

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proportional control

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with 360 degree directionality, the wheelchair moves in whichever direction the joystick is displaced; the greater the displacement, the faster the chair moves

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push handles

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used by an attendant or caregiver to maneuver the wheelchair

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recline

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systems that allow a change in the seat to back angle of the wheelchair that provides for greater hip flexion and a position of rest

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rigid ultralightweight wheelchair

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has quick release rear wheels and a back that folds down to facilitate transfer and storage of the chair in a vehicle. The axle of the rear wheel of these chairs can be adjusted relative to the center of gravity of the user

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scooter

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a power wheelchair design featuring 3 or 4 wheels, a tiller steering system, and a bucket mounted to a single post coming up from the base; often used by marginal ambulators who need mobility assistance to conserve energy;

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smart wheelchair

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either a standard power wheelchair to which a computer and a collection of sensors have been added or a mobile robot base to which a seat has been attached

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standard wheelchair

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generally useful for very short term use such as rentals at an airport or shopping mall

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standing frame

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categorized as prone stander, supine standers, upright standers, and mobile standers. They support an individual in a standing position

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standing wheelchair

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alters the position of the seat to support the user in a standing position. Many of these wheelchairs allow the user to move while in the standing position. The change to and from the standing position may be manually or electronically controlled

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supporting structure

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consists of the frame of a wheelchair and its attachments

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tilt

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wheelchair systems in which all seating angles are preset to consumer's needs and the entire seating system is tilted back as one piece

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transitional mobility device

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powered mobility devices that can be used to augment a young child's independent locomotion with out the complexity and expense of a power wheelchair

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ultralightweight wheelchair

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retains the folding frame and is available with a lower seat to floor height for individuals who propel with their feet. The axle of the rear wheel is adjustable relative to the center of gravity of the user

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wheel lock

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the devices that prevent the wheels from moving during transfers and other stationary activities