Challenges of user-centred assistive technology provision in Australia: shopping without a prescription

Abstract

Purpose: People with disability have a right to assistive technology devices and services, to support their inclusion and participation in society. User-centred approaches aim to address consumer dissatisfaction and sub-optimal outcomes from assistive technology provision, but make assumptions of consumer literacy and empowerment. Policy discourses about consumer choice prompt careful reflection, and this paper aims to provide a critical perspective on user involvement in assistive technology provision.Method: User-centred approaches are considered, using literature to critically reflect on what user involvement means in assistive technology provision. Challenges at the level of interactions between practitioners and consumers, and also the level of markets and policies are discussed, using examples from Australia.Results: There is no unanimous conceptual framework for user-centred practice. Power imbalances and differing perspectives between practitioners and consumers make it difficult for consumers to feel empowered. Online access to information and international suppliers has not surmounted information asymmetries for consumers or lifted the regulation of publicly funded assistive technology devices.Conclusions: Ensuring access and equity in the public provision of assistive technology is challenging in an expanding market with diverse stakeholders. Consumers require personalised information and support to facilitate their involvement and choice in assistive technology provision.

“You have to argue the right way”: user involvement in the service delivery process for assistive activity technology

“…Moreover, training in using the technology has been shown to positively affect the outcomes of the service delivery process for AT users [6,11] and to support more individually appropriate choices of the technology [12]. Such findings confirm that taking a client-centred approach in the service delivery process is important to satisfy AT users [6,11,[13][14][15][16].…”

“…and "How did you influence the decision to obtain the specific technology that you received?" With reference to earlier research on AT use [16,[38][39][40][41], the interview guide built upon five themes: allocation process and user involvement, technology and function, identity and personal preferences, social interaction, and physical activity. The first two themes yielded the most information relevant to the topic under study.…”

User Involvement of People with Mild Disabilities in Technology Innovations: Does It Make a Difference?

“…Also, the conclusions cannot be generalized to other research settings, for example, research settings addressing moderately or severely disabled people (rather than mildly disabled people); innovations of food, clothes, or other products (rather than energy-efficient technologies); phase 4-5 of the innovation process (rather than phase 1-3); and innovations that will be launched in markets (rather than innovations that might be launched). Research shows that innovation processes often include researchers, businesses, and other stakeholders with different perspectives and that the relationship between the different stakeholders can be characterized by asymmetric information and power imbalances (Steel, Layton, Foster, & Bennett, 2014). Hitherto, little is known about how processes of user involvement unfold (Geer & Lei, 2012).…”

“The fact that I can be in front of others, I am used to being a bit behind”: how assistive activity technology affects participation in everyday life

“…Personal factors are important for meanings assigned to AT and for technology use [16][17][18]. However, a person-centred practice in the allocation of AT is difficult to implement [19]. Assistive technology can support participation but can also prevent it because the technology may be perceived negatively as an item or tool that affects the individual's self-image and may, therefore, be abandoned [11,13,20].…”