There is a lack of evidence on the effects and quality of assistive technology service delivery (ATSD). This study presents a quasi-experimental 3-months follow-up using a pre-test/post-test design aimed at evaluating outcomes of assistive technology (AT) interventions targeting children with physical and multiple disabilities. A secondary aim was to evaluate the feasibility of the follow-up assessment adopted in this study with a view to implement the procedure in routine clinical practice. Forty-five children aged 3-17 years were included. Parents were asked to complete the Individual Prioritised Problem Assessment (IPPA) for AT effectiveness; KWAZO (Kwaliteit van Zorg [Quality of Care]) and Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST) 2.0 for satisfaction with ATSD; Siva Cost Analysis Instrument (SCAI) for estimating the social cost of AT interventions. At follow-up, 25 children used the AT recommended. IPPA effect sizes ranged from 1.4 to 0.7, showing a large effect of AT interventions. Overall, parents were satisfied with ATSD, but Maintenance, Professional Services, and AT Delivery were rated not satisfactory. SCAI showed more resources spent for AT intervention compared to human assistance without technological supports. AT may be an effective intervention for children with disabilities. Issues concerning responsiveness and feasibility of the IPPA and the SCAI instruments are discussed with a view to inform routine clinical practice.
Abstract:The present paper reports on a series of studies conducted at the Regional Center for Assistive Technology (Centro Regionale Ausili, CRA) in Bologna, Italy. Our purpose was to identify a set of internationally validated instruments and a training circuit with a view to developing a structured and validated Powered Mobility Device (PMD) assessment and training program. To develop the program, three studies were conducted in order to identify: validated measures for assessing the user's driving skills and training needs for using a PMD (Study 1); measures for evaluating the outcomes of the PMD (Study 2); and, the elements necessary for building a circuit for conducting PMD training (Study 3). In studies 1 and 2, the Wheelchair Skill Test 4.2 Power Wheelchair (WST) and the Wheelchair Outcome Measure (WhOM) were selected and pilot tested using QUEST 2.0. These studies represent an important step in the development and definition of a PMD assessment and training program to be implemented in routine clinical activities in a regional center for assistive technology in Italy. The measures, the circuit and the program will be further tested in future for validity and reliability in order to assess their efficacy in helping professionals to select the most adequate PMD for users, to conduct specific PMD training, and to evaluate PMD outcomes.
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