The Right Stuff . . . Choosing Appropriate Technology.
People with disabilities can use technology to develop new skills, keep old ones and live more independently. However, choosing the right technology is often a difficult task. This TECHNOTE offers strategies and tips to use when considering a technology solution.
Being informed about purchases is important in the '90's. Funding sources want to make sure any device they purchase with dwindling resources is fully utilized. So, whether you are using your own precious resources, or third-party payer funds, consumers need to ensure that they spend money wisely.
Take some time to read through this document. Use it as a guide to help you decide if a specific device will help you do specifically what you need/want to do.
The principles below are universal. No matter what the technology, where it is used or the age of the user . . . applying these principles will ensure that the device helps you do the job.
A Team Approach is Always Best.
Even when you are choosing a very simple, low-tech piece of equipment, talking it over with another user, or a person who knows you well, will offer another perspective. He/she may also see some pitfalls that weren't obvious to you.
Technology assessment teams usually come from different disciplines and can vary from team to team depending on the user's abilities and needs. Traditionally, the user, a family member or significant other, medical personnel, rehabilitation specialists and occupational, physical and/or speech therapists are members of the team.
Try adding nontraditional team members if you think it will improve the group's problem solving skills. A custodian, shop teacher, local handy-person or someone good at crafts, or even a classmate will look at the issues differently and often have valuable insights. Don't be afraid to be a courageous problem solver. It will make for a much more elegant solution.
The User is The Most Crucial Team Member.
Think about your closets for a few minutes. Is there something there that you do not use? Why aren't you using it? The wrong size? Not your style? Uncomfortable to use? Ugly? It's too fancy and you're a jeans and sweatshirt kind of person?
Spend a few minutes trying to decide all the reasons this perfectly good item doesn't work for you. More than likely your reason will be in the category of "It's just not who I am!" Like most things we use, technology must 'fit' who we are . . . physically, emotionally, culturally and personally. When the user is central to making the decision, the more likely it will effectively promote independence.
Significant Others Are The Next Most Crucial Members.
This is especially true for children. Parents will provide the reinforcement, maintenance, training and other aspects of supporting the technology the child will use. If a child needs a computer-based communication device and the only mouse the parents know is the Disney character . . . the team needs to be aware of that fact and deal with it. If parents are not comfortable with the technology solution, then the child is not likely to see any benefit.
For adults, this can also be true, depending on the user's need for assistance. However, it's important to remember that just because a person needed assistance in the past, does not necessarily mean that he/she will need it in the future. An appropriate technology solution may dramatically decrease a person's need for help or eliminate it all together.
Focus on Function.
Often disability distracts people. They are unable to see any potential or ability . . . only the disability. By focusing attention on functional skills, we move away from looking at someone in a clinical way and more toward a functional assessment.
A good question to ask when you want to focus on function is, "What does this person want or need to do that he/she currently cannot do?" From there the team can begin to look for ways to alter the environment to enable the person to function more independently.
Strive for Simplicity.
Techies love wonderfully complicated electronic gizmos with a zillion or more functions. However, technology users only need what will help in accomplishing the task, in the simplest, most efficient way. It's been said that the best technology solution is a no-technology solution.
For example, a reacher is very simple technology. It allows a person to grab an object they could not otherwise reach. It's uncomplicated, and not very costly . . . so a good solution, right? Not necessarily. It may be a better solution to move the out-of-reach items within reach so the user doesn't need any technology at all.
Keeping solutions simple also reduces maintenance and repair costs. Simple solutions are often easier to use and therefore will be used. Generally they are cheaper solutions, so a funding source (whether it is the user or a third party source) is more likely to fund it.
Generalize About The Use of The Device.
Where will you use the device? Could it be helpful in other settings? Are there other members of the family who could use the device?
By thinking in general terms about the device, you can get more use or increase the effectiveness of the device. Sometimes parents consider purchasing a computer for their child so he/she can do homework. When they consider the purchase, they need to look at the computer needs of the entire family. Could an older sibling use it to write reports? If it came with a modem, can dad or mom fax or E-mail work from home? A computer with a CD ROM drive or modem provides 'paperless' access to a wealth of information. Generalizing about the who, when, where, why and how aspects of the product can help the user find a product that meets many, rather than just a specific need. However, remember that if several family members use a device, it will limit access to third party payers.
Technology users need to be informed consumers. They need to be smart shoppers, not satisfied with just having someone tell them what they need. They should constantly ask questions about how the technology will work for them. No matter who pays for the device, technology users are obligated to ensure the device is used. To ensure that, they need to make sure it 'fits' them.
But, how is that done? By simply asking yourself, the team, other users and the equipment vendors questions and continue to ask them until he/she has a satisfactory answer. Here are some questions a consumer should ask to make sure a device will help him/her accomplish his/her goals.
Considerations for Choosing Technology
Does it help me do what I want/need to do? If it doesn't, don't get it! This may sound like an elementary question, but, many people receive technology and from day one it does not work for them. When this happens, you can be sure the user was not an integral part of the assessment team. More than likely the team told the user what would work for him/her. As a consumer of technology and services, you should never allow that to happen. Speak up for yourself and your needs.
Are there any limitations or risks? Users often see the benefit of AT, but don't bother looking at the other side, and there is nearly always another side. While the technology may help you do what you want to do, it may also limit other aspects of your life.
For example, a user is considering purchasing a standing wheelchair to improve circulation and movement. He/she should also know that standing wheelchairs can weigh up to three times more than a lightweight manual chair. While it may improve movement and circulation, the weight could cause exhaustion. Does that mean a standing wheelchair is not a good product? Not at all, it just means that the user will need to measure the pluses and the minuses. Maybe he/she will want to keep his/her old lightweight chair and use one or the other when it's appropriate.
Is it comfortable to use? Have you ever worn a shirt a half-size too small? If you have, when it was time to wear it again, you probably thought twice about it. If there was at least one other clean shirt in your closet, the small one would just sit there. The same applies to any technology you use. If it is not comfortable, you will eventually discard it. Better to speak up during the assessment process than wait until it's over and the device is in the closet, and you are no closer to your goal than you were before the process began.
May I have a trial period to see if it works for me? Let the buyer beware. Don't get caught in the trap of thinking you have to purchase the device outright before you agree to use it. Ask for a trial period. Most reputable vendors will allow you to rent the device for a month or two and then apply the rental payments toward the purchase. Others have a 30-60 day return policy on the device if it does not work for you.
It's common for users to successfully use a device in an insulated clinical setting (when evaluating or learning about the device) and still be unable to use it in a 'real world' setting. A child may be able to use a communication device in formal speech therapy sessions, but be unable to use it to order lunch at McDonald's. It's not until you try it in the real world that you can be sure the device will work for you!
Is it ready to use? Imagine this. A user receives his/her technology at home or office. The box is placed in the center of the room and the delivery person leaves. The user did not ask about set up procedures or support. He/she can't open the box. Even if the box were open, he/she would not know how to set the device up. By asking this question ahead of time, a user can eliminate these problems once the device arrives.
What skills do I need to learn? Let's assume a user and his/her team decide a specific computer and software package is just the thing to help a child benefit from his/her educational program. However, he/she has never used a computer alone before. He/she will need many skills before the device really helps. Until that day comes, the team needs to have alternate plans in place. The child needs to become proficient in using the technology. By asking this question, you ask the team to consider technology's appropriateness and any learning curve the user may need to get comfortable with a device.
How does it work? The device you are trying out may seem simple enough to use, but it may have taken the evaluator three days to program it so that you could use it. Ask about set up, what you will need to know about it, what other functions it has and how can you access those too.
Where do I get training? Will the person who conducts the assessment also provide your training? Do you have a good rapport with him/her? Will the training come from the sales representative? Is there a 24-hour support line available should you need it? How long will that be available to you?
Is training included in the purchase price? Wow, what a shock to learn you're responsible for training, when you assumed the price included it. Unfortunately, some folks don't ask ahead of time.
Also, decide who needs training. Certainly the user will need it, but what about others? Teachers, family members, roommates, spouses are just a few examples of others who may need to know the device as well, or better than the user.
Where can I use the AT? Think about what uses you have for a specific device. If you will use it in multiple settings, how well will it travel? Is there room for it there? Is it noisy? Will it disturb others around you? Will it need to be reprogrammed to use it in different settings? Who will do that? Will that limit the use?
Is it bulky? A device that works well in a stationary setting, may be just fine, unless you need to lug it to the library twice a week. Imagine all the settings you will be using the device in and consider how portable it needs to be.
Can I use it indoors or out? How does moisture affect functioning? Climate changes can affect how a device works. If you will be operating the device at the bus stand and it starts to rain, or you drool, you may need to be concerned about this issue. Ask!
What is the battery life? Battery life is a HUGE issue when considering technology. If you don't stop to ask this question PRIOR to the purchase, you may have a non-functioning device when you need it. If the device requires recharging after every three hours of use, and you will use it twice that amount of time, obviously you'll need extra batteries. But if you don't ask, you won't know. Batteries eventually wear out. Find out how soon you will need new ones.
If powered, can you plug it in, or is there a power source where you want to use it? You can often conserve battery life by "plugging in." So, think about the places you can hook your technology to an electric outlet. For example, consider sitting next to the wall outlet when you take a laptop to class. You will have more battery life for times when no outlet is convenient.
Repair and Maintenance.
Is it reliable? The best place to get this information is to ask other users. They have experience with the device, its quirkiness, features and reliability. To find other users, contact a local independent living center, or other disability related social service agency. Ask them to help you find someone who has used the device. Remember that the vendors and manufacturers are there to sell products, not necessarily to be candid about product reliability.
What is the life expectancy? Nothing lasts forever and at some point your technology will reach the end of its natural life. Knowing the life expectancy of a device will help you decide if it's time to repair or replace the device. Funding sources should also be aware that eventually, replacing the device is far more cost effective or efficient than repairing it.
What is average use? All technology has a lifespan. Not all devices can be used constantly. Find out what the manufacturer considers an average amount of use for the device. For example, you plan to purchase a device and anticipate using it every 25 seconds. However, average use is once every 10 minutes. The device is going to wear out much quicker than usual. Again, if you don't ask . . . you don't know. ASK!
What does the guarantee/warranty cover? Some manufacturers provide a 'bumper-to-bumper' warranty, others provide a sort of "cash and carry/as is" coverage for their device. Finding out what the guarantee/warranty covers after the purchase, is too late. Remember to ask.
What is the service record of the manufacturer/vendor? Again, to be a good self advocate, you must check the sales/service record of the manufacturer and vendor of the device. You could find a device that works very well for you, but unfortunately, other users have had nothing but problems with the vendor's reliability with follow-up and regular maintenance. Unless you ask other people who have worked with them, you don't know.
Is repair service convenient? Find out where the device will need to go for maintenance and repair. If you need to send it to Outer Mongolia, it's going to take a long time to get there and get back. Perhaps another device can do the same job and repairs will be closer. Also, find out if the vendor has loaner equipment available while your device is in the shop.
What is considered regular maintenance? You may be able to perform some of the maintenance yourself. Other maintenance may need specialized training. Find out what kind of maintenance your device needs and to prolong the life of the device, follow the directions carefully.
Financial issues often scare people away from devices. They think, "I'd love to have that, but gosh . . . I could never afford it." Don't get caught in that mind set. Often going through the process of finding out exactly what you need will provide the documentation that a funding source needs to purchase the device for you. You may also find out that other funding sources are more appropriate than the one you originally thought.
What is the total final cost? Some devices come all in one piece, others come with add-ons that will up the cost of the device. Be sure to get the total cost of the item with all the add-ons you need. Are there package deals? Will you need a specifically designed mounting system? Will you need two battery packs instead of one? It's frustrating to finally get the device and then find out that you need another item to make it work for you.
Are there training costs? Is training included in purchase price? If you don't ask these questions prior to purchase, you may find training costs will make the device unattainable. Purchasing it and being unable to use it because you lack training is a discouraging experience.
Who will fund maintenance and repairs? Imagine how you will feel if your device needs repair, and you find out that you are responsible for the cost of repairs and you didn't know it. Ask before the purchase!
Are rental/lease plans more cost effective? If you are going to use the device on a short term basis, you may want to consider renting or leasing options. It's also a good idea to try out the device before you invest much money in it. Most reputable dealers have rental/lease options that either will let you apply the money toward the purchase price, or offer a 30-60 day return policy. You'll need to ask so you know the specific details of the 'trial' period.
If you are working with a vendor that does not allow that type of option, look elsewhere. They may not be there after the purchase if they are so uncompromising prior to it.
Will I need to change devices or upgrade soon? If you are gaining and/or losing skills because of the type of disability you have, consider how much time you will be using the device. Measure these factors into the equation about whether the device will work . . . really work . . . for you.
Will I get a trade-in/upgrade allowance? With the rapidly changing world of technology, things you purchase may be obsolete in a year. As long as the device still works for you, that's fine. However, you need to realize that it will have very little market value if you need another device or decide to upgrade.
Consumers with disabilities need to become advocates for their own needs. Relying on professionals alone to figure out what you need means you will not get the best device for you. You need to use professionals to help figure out the kinds of devices that will help you perform certain tasks; however, you alone will ultimately decide if a device works for you. If you are not comfortable with a device for any reason, speak up! It will be better in the end if you express your opinions prior to the purchase. Complaining to a funding agent that a device doesn't meet your needs months after the fact, is upsetting and disheartening for the funder and you.
Finally, it's important to realize that often the best technology solution is a 'simple-tech' solution. Consider how environmental adaptations can meet your needs prior to purchasing any device. Environmental changes are long lasting and usually don't require ongoing repair and maintenance. However, environmental changes aren't the answer for all the barriers people with disabilities face. After deciding that an environmental change won't work, technology may be the most practical option . . . however, always keep in mind that the technology solution should be appropriate for the task and meet your need as well as your own sense of who you are.