Mealtime Partners, Inc.

In 2015, the U.S. Census Bureau estimated that there were nearly 40 million people, or 12.6% of the population of the United States, with a disability. As we age we are more likely to acquire a disability or multiple disabilities. 0.8% of infants and children under 5 years of age have a disability while 49.8% of those 75 years old, or older, are disabled. When statistics about disabilities are being collected, they are frequently divided into various categories: vision; cognition; ambulation; climbing stairs; self-care; independent living, etc. Depending upon the agency collecting the data, the various types of disabling conditions may be different.

In many instances those who have disabilities can gain and maintain independence with the help of assistive technology. Assistive technology (AT) is any item, piece of equipment, software program, or product that is used to increase, maintain, or improve the functional capabilities of persons with disabilities. The definition of assistive technology comes from the Acts relating to AT that have become laws over the past three decades: The Technology Related Assistance to Individuals with Disabilities Act of 1988 (Tech Act), and The Individuals with Disabilities Education Act (IDEA) of 2004.

For centuries, mankind has adapted “things” to help make tasks easier. Additionally, they have crafted items to facilitate getting around on a damaged or imperfect body. Prosthetics, crutches, and wheelchairs have all been used for centuries. As time has progressed, AT equipment has become more and more sophisticated, capable, and smaller. This evolution has been made possible by the rapid advancement of technology as a whole. Thirty years ago all AT equipment was, by today’s standards, “clunky”. However, since the creation of Apple computer products and the iPhone, the standard for aesthetically pleasing equipment has been raised. Now electronics including computers, phones, televisions and games are extraordinarily capable and visually pleasing.

New types of assistive technology (AT) are developed and sold regularly, yet some are well received by users and establish a place in the AT market place while others do not gain acceptance. A large part of why assistive technology becomes popular relates to what it does, and more importantly, how well it does it. However, the way a piece of equipment looks has a strong impact upon how a user feels about it and how well it is accepted.

An example of the appearance of a piece of AT not being accepted by a user is explained in the following true story. A young lady, who used both a powered wheelchair and communication device since she was a small child, was asked by her family if she would like to try a powered feeding device. She was unwilling to even consider it. She said that it would make her look different from everyone else! Even when family, friends, and her therapists discussed that her way of moving around, and talking, were different from most people, she was unable to be convinced that feeding herself, rather than being fed, was more likely to be perceived as being like everyone else. She remained unconvinced and was unwilling to even try a device.

Acquiring a new piece of AT is not necessarily a matter of just picking something out of a catalog. Many AT devices are very complex, and the user needs an assessment of their requirements and abilities to be conducted by someone who is knowledgeable about the equipment. This may be someone who works for the vendor, or a clinician who specializes in the specific type of equipment, e.g., a speech language pathologist who is an expert in the area of augmentative communication devices. Many clinicians develop a broad knowledge of how a wide range of different devices function and can provide guidance as to the functions of each device that may be of greatest value to a specific user. However, not all devices are created equal and one device may be more appropriate for the user than another. A good example of this is communication devices; even though communication devices may have similar features, one might suit a user better than another. Yet, when a user is shown several different devices they may choose one based on the way it looks rather than its functionality.

An example of this type of reaction was seen during the development of the assistive dining device when researchers asked potential users who were consulting on the project what needed to be improved on a prototype device. The only answer was, “it should be blue”! They were unable to see the functions of the equipment; they could only see how it looked.

Color is extremely important to some people while it has little to no significance for others. A young veteran who had been profoundly injured during the Iraq war had problems with urinary tract infections (UTI). His occupational therapist ordered him a drinking system that was to be mounted onto his wheelchair. When the equipment was delivered, the veteran would not allow it to be put onto his wheelchair. He would provide no explanation as to why. Later, after yet another UTI, he explained to another therapist that it would have, “messed up my wheelchair”. When a vendor spent time with him they found that he saw his wheelchair as his “Harley Davidson” and would only have cool looking stuff put on it. His wish was “to have it tricked out like the coolest motor cycle”. The vendor provided him with a drinking system that matched his wheelchair and was out of sight from the front of the chair. Once installed, the drinking system was used constantly by the gentleman and he stopped having UTIs.