Rehabilitation service evaluation: a follow-up of the extent of use of technical aids for disabled children

The User's Perspective on the Provision of Electronic Assistive Technology: Equipped for Life?

The variety of electronic assistive technology (EAT) available for people with physical disabilities is constantly increasing. It includes items such as powered wheelchairs, equipment for communication and environmental control systems. The timely provision of this equipment can enhance the quality of life of users and carers alike.

This paper presents the findings of a survey of the experiences of people with physical disabilities who used this equipment. This was part of a project investigating the provision of EAT in two regional health authorities. The survey asked questions covering subjects such as funding sources, referrers, training and maintenance, time delays, the range of equipment used by individuals and the problems encountered obtaining the equipment.

The response rate was 54% (135 out of 250 questionnaires were returned). The results showed that the majority of the equipment was used regularly, with many respondents using between three and six items. Sixty per cent of respondents reported a problem with current provision processes. The most common of these were funding issues, information availability, maintenance, training, switches, assessment and delays. The role that all services can play in eliminating these problems is discussed and the importance of cooperation and effective links between services is emphasised.

The use and impact of assistive devices and other environmental modifications on everyday activities and care in young children with cerebral palsy

PURPOSE

The study describes use of assistive devices and other environmental modifications, and their impact on everyday activities and care in young children with cerebral palsy (CP).

METHOD

Ninety-five children (55 boys, 40 girls; mean age 58 months, SD 18 months) and their parents were studied using a cross-sectional design. The Pediatric Evaluation of Disability Inventory (PEDI) was applied to assess daily activities using the three measurement scales: functional skills, caregiver assistance, and modifications of the environment. Use of modifications was described related to the five severity levels of the Gross Motor Function Classifications System (GMFCS). Impact was rated on the Caregiver Assistance scale of the PEDI and on a five-point Likert scale.

RESULTS

Out of the 1075 provided environmental modifications, 980 were in regular use to support mobility, self-care and social function among 84 children. The number increased with GMFCS levels; children at levels IV and V used 80% of the modifications, with large variations between the children at same level. Adaptations of housing and transportation facilitated effective use of assistive devices. Half of the parents rated the modifications to have moderate to very large effect on the child's mobility, 25% on self-care skills, and 20% on social function. Furthermore, 65% reported that the modifications lightened the caregiving for mobility, 75% for self-care and 25% for social function. Functional independence and care demands often benefited from different types of modifications.

CONCLUSION

The variations in use and benefits of environmental modifications indicate need of comprehensive assistive technology assessments, including child factors, family factors, technology factors and service system factors.