Assistive Technology Provision Research Articles

Lessons learned from health system rehabilitation preparedness and response for disasters in LMICs: a scoping review.

Disasters such as earthquakes, conflict, or landslides result in traumatic injuries creating surges in rehabilitation and assistive technology needs, exacerbating pre-existing unmet needs. Disasters frequently occur in countries where existing rehabilitation services are underdeveloped, hindering response to rehabilitation demand surge events. The primary aim of this scoping review is therefore to synthesize the evidence on rehabilitation and assistive technology preparedness and response of health systems in LMICs to the demand associated with disasters and conflict situations. A secondary aim was to summarize related recommendations identified in the gathered literature. A scoping review was conducted using the Arksey and O'Malley framework to guide the methodological development. The results are reported in accordance with PRISMA-ScR. Four bibliographic databases were used: CINHAL, Cochrane, Pubmed, Scopus and. Key international organisations were also contacted. The search period was from 2010-2022. Eligible publications were categorized for analysis under the six World Health Organization health systems buildings blocks. The findings of this scoping review suggest that rehabilitation is poorly integrated into health systems disaster preparedness and response in LMICs. Of the 27 studies included in the scoping review, 14 focused on service delivery, 6 on health workforce, 4 on health information systems and 3 on the leadership and governance building block. No study focused on financing nor assistive technology. This review found the most frequently referenced recommendations for actions that should be taken to develop rehabilitation services in disasters to be: the provision early and multi-professional rehabilitation, including the provision of assistive technology and psychological support, integrated community services; disaster response specific training for rehabilitation professionals; advocacy efforts to create awareness of the importance of rehabilitation in disasters; and the integration of rehabilitation into disaster preparedness and responseplans. Findings of this scoping review suggest that rehabilitation is poorly integrated into health systems disaster preparedness and response in LMIC's, largely due to low awareness of rehabilitation, undeveloped rehabilitation health systems and a lack of rehabilitation professionals, and disaster specific training for them. The paucity of availableevidence hinders advocacy efforts for rehabilitation in disaster settings and limits the sharing of experiences and lessons learnt to improve rehabilitation preparedness and response. Advocacy efforts need to be expanded.

Worldwide Survey on Digital Assistive Technology (DAT) Provision.

Occupational therapists have long been involved in assistive technology (AT) provision worldwide. AT is recognized by the World Health Organization (WHO) to enhance functioning, independence, and autonomy and ultimately promote well-being for people living with disabilities. With the digitalisation of societies, the everyday lives and occupations of individuals are changing, becoming more reliant on digital solutions. The development of digital assistive technology (DAT) also offers opportunities for people with disabilities to access, interact, and pilot the digital world. However, we do not know how occupational therapists are involved in DAT provision worldwide. A survey was conducted in the global occupational therapist's community in June 2022 to describe DAT provision and the factors influencing it. Occupational therapy practitioners were included (n = 660) in the analysis. In DAT provision, occupational therapists mostly provide advice to people, assess their needs, provide instruction or training, prescribe DAT, and fit DAT to people and their environment. The clients served through DAT provision are most frequently people with neurological impairments, chronic illnesses, sensory impairments, and older people. The reasons for providing DAT focus on education, work, school, and leisure. It is expected that DAT provision will enhance independence, self-esteem, occupational participation, and social relationships. Issues faced by occupational therapists when providing DAT are costs of product and funding schemes, sufficient knowledge, and access to knowledge sources. Survey respondents are mostly from Western countries with access to the Internet and the digital world, including having digital literacy, highlighting the digital divide that exists between world regions and countries, but also within countries worldwide. There is a need to continue research to better understand the issues related to digitalisation and the digital participation of people living with disabilities.

Accessible Consumer Electronics Are Essential to Closing the Gap in Assistive Technology Provision.

According to the Global Report on Assistive Technology (2023) [1] more than 2.5 billion people require one or more assistive products - a number that is expected to grow to over 3.5 billion by 2050 due to the aging of our societies. Over the past decade, the design of products that empower people with a disability has shifted from specialized and dedicated products designed only for those with a disability to features and functions integrated into cost-effective consumer technologies for the benefit of all. The opportunity to expand the availability of such technologies is at risk of being ignored due to models of AT delivery that are founded in medical devices, and which have failed to reflect trends in our understanding of technology and the choices and preferences expressed by persons with a disability. This research suggests that such expansion offers significant benefits to people with a disability and better both economic and social return on investment for authorities.

Digital Enabling Assistive Technology Through the Provision Lens - A Global Perspective in a Nordic Context.

The Nordic healthcare system is well-established, taxation-based, and locally administered, featuring person-centered care as a social welfare pillar. Public provision of assistive technology and welfare technology within healthcare systems means every citizen has equal access to services. But how well are policies and procedures keeping pace with demographic changes and technology developments?. This study critically analyses qualitative data from 24 stakeholders involved in municipal-level procurement and allocation of assistive and welfare technology in Sweden with a specific focus on emerging digital technology. An extant analysis framework was used: the World Health Organization-GATE 5P framework for strengthening access to AT. Recommendations are made for agile procurement and an outcome-based decision frame. The voice of the AT user may be a valuable addition to inform policy.

Repair strategies for assistive technology in low resource settings

Purpose To investigate the practices of repair that exist for users of mobility assistive products in low resource settings, as well as the psychosocial impact that the repair, or non-repair, of these devices has on users’ lives. Materials and Methods This article collates data on repair practices and the responses from participants on the topic of repair from studies conducted by the authors across four different low resource settings in Kenya, Uganda, Sierra Leone, and Indonesia. This data was then analyzed to identify the common themes found across geographies. Results Three major models of repair practice emerged from the data: “Individual or Informal Repair in the Community”; “Local Initiatives”; and “Specialist AT Workshop Repair”. Additionally, the wider impact on the participants’ lives of “Problems & Concerns with Repair”; “Experiences of Breakages & Frequencies of Repair” and the “Impact of Broken Devices” are explored. Conclusions The results of this analysis demonstrate the paramount importance of community-based repair of devices, and how despite this importance, repair is often overlooked in the planning and design of assistive products and services. There is a need to further incorporate and support these informal contributions as part of the formal provision systems of assistive device. IMPLICATIONS FOR REHABILITATION A lack of available specialist repair services in low resource settings hinders the potential impact of assistive technology provision systems. Community-based repair is the major route by which assistive devices are repaired in low resource settings. Appropriate community-based repair strategies should be incorporated into and supported by the formal assistive technology provision models in order to optimise outcomes. A lack of data on outcomes across the lifecycle of assistive products hinders progress on improving focus on follow-up services – in particular repair & maintenance. By supporting community-based repair, repairs that are inappropriate for that approach could be better directed to specialist repair services.

How do mobility device users integrate their devices into occupational performance? A narrative literature review

Introduction: Knowledge about how mobility devices are integrated into occupational performance is important to improve participation in daily life among users and assistive technology provision. This study aimed to identify and synthesise literature on how mobility device users integrate their devices into occupational performance. Methods: A narrative review was conducted with a systematic search in PubMed, CINAHL, PsycINFO and SocINDEX for scientific, original, peer-reviewed journal publications in the English or Scandinavian languages. Following search terms were used: mobility devices, occupational performance and synonyms. Publications were screened and read, and data were extracted by two authors independently. Results: A total of 4088 hits led to the identification of six publications. Two categories were identified: (1) how mobility devices are integrated into occupational performance and (2) for what types of occupations beyond mobility are mobility devices used for; seven types were revealed. Conclusion: Mobility devices are integrated into occupations in unique ways to the individual users, shaping how occupations are performed and are used for different types of occupations beyond mobility. Since mobility device use is situational, it is suggested to investigate assistive technology use, applying a transactional perspective to improve assistive technology provision to increase fulfilment of users’ needs and preferences.

Establishing the normative and comparative needs of assistive technology provision in Queensland from the agency and funding scheme perspective.

Assistive technology services and devices support the participation and inclusion of people living with disability. In Australia, the regulatory bodies, agencies and schemes that manage assistive technology provision are governed by national and / or state-based Acts and Legislation. This study examined the assistive technology sector from the perspective of the regulatory bodies, agencies and schemes. Regulatory bodies, agencies and schemes that manage funding for assistive technology in Australia were identified by the research team. A website audit reviewed publicly available documents and information. Semi-structured interviews with representatives from the agencies and schemes were audio-recorded and transcribed verbatim. The audit (n =17) found that the range and level of information publicly available was variable. The availability of assistive technology for driving and transport, design and building for access and safety, and mobility was most often promoted. The qualitative findings (n = 11) indicated variability and challenges within four themes: operationalising the legislation; internal assistive technology processes; reasonable and necessary; and risks in the assistive technology pathway. Regulatory bodies, agencies and schemes are critical to the effectiveness of the sector. The findings identified opportunities for the organisations to review how internal processes are communicated publicly, and for the sector to address the perceived risks related to health professional availability, knowledge and skills, and limited accessibility to trial assistive technology. Subsequent studies explored the perspectives of the assistive technology advisors and suppliers and the recipients of assistive technology services and devices.

A perspective on occupational therapy and assistive technology: Research, contributions, challenges and global initiatives

ABSTRACT Many occupational therapists are skilled assistive technology practitioners and provide a variety of services to assistive technology users and their families through their use of intervention models that integrate the client, occupation and environment. Occupational therapy education, translation of current research into practice and clinical competency ensure that assistive technology users can enjoy accessing their community and environment independently, safely, adequately, and freely. This white paper illustrates the role of occupational therapists in the provision of assistive technology devices to promote better understanding of facilitators and challenges affecting the provision of assistive technology globally. It also reviews literature and discusses positions of professional organizations. Finally, we summarize global efforts, recommendations and strategies to build collaborative partnerships, develop innovative service models, use best available evidence, advocate for supportive public policy, promote occupational therapy services and professional development relating to assistive technology provision, and increase access to affordable, quality assistive technologies worldwide.

Assistive technology services for adults with disabilities in state-federal vocational rehabilitation programs

Purpose Prior research indicates that the provision of assistive technology (AT) services positively predicts successful employment outcomes in vocational rehabilitation (VR) programs. While AT services can be promising, they are underutilized overall, and there are apparent disparities in AT service utilization. The purpose of this study was to identify sociodemographic factors which may act as barriers to receiving AT services in VR programs. Recognizing potential disparities is the first step in improving equity in access to beneficial services. Materials and methods This study is a retrospective analysis of national data collected by the Rehabilitation Service Administration’s Case Service Report from fiscal years 2017–2019. The sample included 788,173 cases that reported having a disability, were aged ≥18 years old, was deemed eligible for VR services, and had a complete set of data. Results Less than 9% of VR clients received AT services. We ran a multiple logistic regression analysis to examine the independent effects of various sociodemographic variables on the likelihood of receiving AT services through VR programs. The following client characteristics were associated with a lower likelihood of receiving AT services: men, unemployed, minority, low income, significant disability, non-enrolled in post-secondary education, mental or cognitive disability, less education, and younger age (all p < .001). Conclusion The findings emphasize the need for more research to identify underlying mechanisms and potential solutions to these apparent disparities in access to AT services for adults with disabilities. Future research and implications are provided. IMPLICATIONS FOR REHABILITATION Increasing assistive technology (AT) training in counsellor education and offering more AT training for in-service rehabilitation counsellors to increase their competence to serve individuals with diverse disabilities, particularly those with cognitive and mental disabilities. Counsellors should be encouraged to use a team approach to ensure the most effective AT solutions are provided, and improve access to age-appropriate AT for younger individuals. Counsellors should identify alternative funding sources and refine eligibility criteria for low-income individuals, and develop effective means for educating less-informed individuals about the benefits of AT, and recognise the limited access of minority groups to receive services within vocational rehabilitation programs.

Assistive technology in palliative medicine: equipment needs

ObjectivesMost people prefer to die at home. Timely and appropriate provision of assistive technology can support people to remain at home in the palliative phase. A state-wide palliative care equipment...

Empowering Individuals with Disabilities through Entrepreneurship in Nigeria: An Integrative Review

This paper examined the available literature on persons with disabilities (PWDs) in Nigeria with respect to empowering them through entrepreneurship. Using the integrative review research method, this paper highlighted some of the barriers faced by PWDs in becoming successful entrepreneurs as well as offered possible solutions/strategies to overcome these barriers. Three databases were searched with search terms carefully coined to generate relevant results. Based on the available literature, the idea of empowerment for the disabled in Nigeria varies across religious and cultural diversity. Empowerment could mean a mandatory religious practice of giving alms (Zakat) to the most deserving individuals. It could be used as a political tool by people in government offices. Empowerment obliges privileged people to remember the less privileged and disabled in the society. Some of the common barriers faced by PWDs in venturing into entrepreneurship were found to include a lack of entrepreneurial education, discrimination, difficulty in raising start-up capital, and poor enactment/implementation of legislation among others. However, potential solutions to these challenges were found to include the enactment and enforcement of legislation favourable for PWDs to thrive in entrepreneurship, educational investment, provision of accommodating environment, adequate financing, and provision of assistive technology among others. Nigeria still has a long way to go in assisting PWDs to achieve their full potential. Empowerment of PWDs should come in the form of entrepreneurial education with which they can learn to become self-reliant and financially independent.

Development of Adaptive Sitting Cum Standing Positional Device - User's Centric Approach

Background As per India Census 2011 Cerebral palsy affects 3.8 of Indians or roughly 15-20 of physically challenged children. An estimated 31000 live births are affected in India. The most prevalent motor impairment in children is cerebral palsy. The adaptive devices need to accommodate different factors in terms of individual health condition body structure body function capacity gender age ethnicity and preference. In addition physical changes that occur in children as they grow and develop need to be accommodated. UNICEF stated that the frequency of changes to be made in an assistive product depends on how fast the child develops and grows which will vary over time as well as between children. This adds to the economic burden especially in families below the poverty line.Aim To build a device for dual usage seating cum standing for children with delayed milestones with versatile features to accommodate as they grow.Methods Anthropometric measurements of children with delayed milestones aged between 3-12 years were collected and assimilated in building the innovative twin device and its features. User satisfaction feedback was collected about the innovative twin device using Quebec User Evaluation of Satisfaction with Assistive Technology QUEST using a prospective qualitative study design. Simple random sampling methods were used to recruit 255 parents of children with delayed milestones from 2016 to 2019 across India and Bangladesh. They were prospectively observed and the perceived effectiveness usability and service delivery system of twin device was collected from parents mostly through telephonic and in-person interviews after three months. Results Around 121 usersparents gave their QUEST feedback. The mean satisfaction on the twin device was recorded as 4.16 Quite satisfied and the service delivery was rated 4.81 Very satisfied. Overall QUEST score was recorded as 4.48 Quite satisfied. The three most satisfying features of the device reported were safe and secure 61.16 easy to use 57.02 and comfortable 56.2.Conclusion Twin device and delivery services quality was measured through user satisfaction in terms of strength durability capacity safety and comfort. Provision of assistive technology includes the design production user satisfaction and quality of life.

تحديات التعلم عبر االنترنت للطلبة ذوي اإلعاقة: حلول النفاذ الرقمي والتصميم الشامل للتعلم

This study aimed to investigate the challenges faced by students with disabilities in online education and to review scientific solutions, digital access solutions and assistive technology for these challenges in higher education institutions. This study analyzed and compared more than seventy references from recent studies that reviewed the challenges and technological solutions available to students with disabilities in some higher education institutions in the United States of America, Australia and the United Kingdom; The aim is to benefit from these experiences in developing support for students with disabilities in online education at Qatar University. It was found throughout the literatures review that the challenges that students with disabilities face in the online learning process are mostly related to the poor technical skills of students and faculty members, insufficient provision of assistive technology; lack of digital accessibility for course materials, and inadequate access to teaching and assessment methods for groups of students with disabilities. To address these challenges, this research reviewed the universal design for learning as a scientific framework that built on the latest studies in neuroscience, computer science, assistive technology, communications and digital accessibility. The aim of this literatures review is to help educators in designing an inclusive, effective and accessible virtual learning environment for all students, including students with disabilities.

Does the Provision of Assistive Technology Increase Disability Employment?

This paper examines various literature regarding the relationship between the provision of assistive technology (AT) and workplace integration for people with disabilities (PwD). A systematic review was conducted to map existing literature using the PRISMA framework in the last ten years. This study reveals that AT has an enormous significance in the employment of PwD. However, the provision of AT as workplace accommodations is not always uncomplicated as three aspects mainly impact it: employers’ perspective, accessibility of AT, and the availability of support from vocational and rehabilitation services. It is suggested that the provision of AT as workplace accommodations to increase disability employment should be supported collectively by society, with employers and the government as critical players. This study contributes to the perspectives of managers and the government by highlighting the roles they could carry out to create a more accessible provision of AT and an inclusive work environment.

Utilization of Assistive Technology for Effective School Library Service Delivery to Students with Disabilities in Nigeria

Disability is a part of the human condition. Everyone might experience disability either permanently or temporarily at some point in their life. It was estimated that about 25 million people live with one form of disability or more. This study explored the utilization of assistive technology for effective school library service delivery to students with disabilities in Nigeria. The study adopted descriptive survey design and used online structured questionnaires to collect data from school librarians. A total of 240 school librarians responded to the online survey across the 36 states in Nigeria. Data collected through online questionnaires were analyzed using percentage, mean and standard deviation. The study revealed that, there is inadequate availability of assistive technologies for effective school library service delivery to students with disabilities in Nigeria. Also, the extent of utilization of assistive technologies for effective school library service delivery was very low except for braille technology and Hearing Aids. The major challenges associated with the utilization of assistive technology for effective school library service delivery to students with disabilities in Nigeria are lack of support from the government, inadequate assistive technology in the school libraries, ranked together with inadequate funding of the school libraries; and unstable electric power supply. The study recommended; Provision of adequate assistive technology in the school libraries by the government. Training of both students with disabilities and school librarians in the use of assistive technology. Developing adequate interest in inclusive school library service by the government. Adequate funding of the school libraries by the government. Adequate support from the government through provision of material and human resources. Provision of adequate support service on the use of assistive technology by the manufacturers or vendors. Provision of stable electric power supply through installing solar power systems or purchasing standby generators.

Bridging gaps in the design and implementation of socially assistive technologies for dementia care: the role of occupational therapy

Dementia is a global health challenge, and people living with dementia (PLWD) are especially susceptible to reduced engagement in meaningful occupations, including social participation. In the past few decades, socially assistive technologies continue to be developed amidst a rapidly evolving technological landscape to support the social health of PLWD and their caregivers. Examples include social robots, virtual reality, smart home technology, and various digital technologies, such as mobile applications for tablets and smartphones. Despite an increasing body of research and interest in this field, several gaps relating to the design and implementation process of socially assistive technologies continue to undermine their relevance for PLWD in daily life. In this paper, some of these gaps are highlighted and the role of occupational therapy in the design and implementation of socially assistive technology is presented. In the design process, occupational therapists are uniquely skilled to advise and advocate for the tailoring and personalisation of technology to address the occupational needs of PLWD. In the implementation of socially assistive technologies, occupational therapists are skilled to educate, train, and conduct ongoing evaluations with PLWD and their caregivers, to incorporate socially assistive technologies into their routine and daily lives. We recommend that occupational therapists should continue to be acquainted with such technologies through continuous professional development and educational curricula. Moreover, we highlight the necessary collaboration between occupational therapists, technology developers, and researchers to enhance the process of designing and implementing socially assistive technology, so that their relevance for PLWD and their caregivers can be maximised. Implications for rehabilitation Developers and designers of socially assistive technology should consider the disease trajectory of different types of dementia, as well as the different needs, abilities, preferences, occupations and routines of people living with dementia (PLWD) and/or their caregivers. Collaborations between technology developers, researchers, and occupational therapists should take place iteratively throughout the process of designing and implementing socially assistive technology to maximise their relevance and applicability for people living with dementia and their caregivers. To continue enhancing the current role of occupational therapy in socially assistive technology provision, occupational therapists should keep up to date with socially assistive technology that are being developed to support the social health of PLWD.

Assessing the use of co-design to produce bespoke assistive technology solutions within a current healthcare service: a service evaluation

Purpose Co-design involves engaging with the end-user in the design process and may help reduce the barriers to assistive technology use. Previous research has used co-design in the provision of assistive technology, but no research has looked at applying it within a healthcare setting. This service evaluation examines the use of co-design in providing customized assistive devices within a current UK healthcare based Rehabilitation Engineering department. Methods This evaluation reports on three case studies. Individuals identified a range of challenges in daily living. The participants worked with the clinician in trialling prototypes and providing feedback to develop custom devices. A mixed-method approach of questionnaires and semi-structured interviews were used to evaluate the devices provided and the co-design approach. The resources required to provide the device were also calculated. Results Five different devices were developed, which were able to overcome the challenges identified. Results indicated participants were satisfied with both the devices and service provided. Participants expressed other benefits including increased independence, increased positive emotions and reduced mental load. Participants indicated they liked being involved in the design process and their feedback helped ensure the devices were customized to their needs. Conclusions The use of co-design was able to produce customized assistive device that met the needs of the individuals within a current healthcare service. Further work is required to assess the feasibility of utilising a co-design approach for the provision of other custom assistive technology in the future and explore if this can overcome the barriers to assistive technology use. Implications for rehabilitation End-user involvement, the design process can help enable customized assistive devices to be provided that better meet the user’s needs. The custom assistive devices provided not only helped the individuals overcome the challenges identified but had wider reaching benefits for the individuals physical and mental health and wellbeing. End-users valued being able to input into the co-design process and working closely with the clinician in developing the device.

Could Assistive Technology Provision Models Help Pave the Way for More Environmentally Sustainable Models of Product Design, Manufacture and Service in a Post-COVID World?

From multiple studies conducted through the FCDO AT2030 Programme, as well as key literature, we examine whether Assistive Technology (AT) provision models could look towards more sustainable approaches, and by doing this benefit not only the environment, but also address the problems that the current provision systems have. We show the intrinsic links between disability inclusion and the climate crisis, and the particular vulnerability people with disabilities face in its wake. In particular, we discuss how localised circular models of production could be beneficial, facilitating context driven solutions and much needed service elements such as repair and maintenance. Key discussion areas include systems approaches, digital fabrication, repair and reuse, and material recovery. Finally, we look at what needs be done in order to enable these approaches to be implemented. In conclusion, we find that there are distinct parallels between what AT provision models require to improve equitable reliable access, and strategies that could reduce environmental impact and bring economic benefit to local communities. This could allow future AT ecosystems to be key demonstrators of circular models, however further exploration of these ideas is required to make sense of the correct next steps. What is key in all respects, moving forward, is aligning AT provision with sustainability interventions.

Provision of Assistive Technology for Students with Disabilities in South African Higher Education.

This paper used the Critical Disability Theory (CDT) to analyse the provision of assistive technology (AT) and assistive devices at an institution of higher education in South African. In this empirical study, data were collected through interviews with students with disabilities and Disability Rights Centre staff members. The paper sought to explore the effectiveness of the provision of AT and assistive devices, in terms of enabling students with disabilities’ learning. The provision was deemed inadequate, and a specific AT and assistive device was inaccessible to one category of disability, consequently limiting learning. The paper concludes that the provision of assistive devices at the institution enabled students with disabilities’ learning, however, there was a need for improvement by way of the Universal Design for Learning (UDL). The UDL will help all diverse students, including students with disabilities in all their categories of disability, to be assisted to learn through the provision of AT and assistive devices. It is hoped that the paper will contribute to contemporary debates on the provision of AT and assistive devices for people with disabilities in low-resource settings, from a South African context specifically, and in higher education broadly.

Perspectives of rehabilitation professionals on assistive technology provision to young children in South Africa: a national survey

Purpose Various factors influence the selection of assistive technology for young children within a context with limited resources, such as South Africa. Rehabilitation professionals are required to weigh up different factors as part of their professional reasoning process when making assistive technology (AT) selections. Insight into the perceived influence of different factors may assist in understanding how professionals make decisions about AT in this context. Materials and methods An online survey with questions designed using best–worst scaling was distributed to rehabilitation professionals throughout South Africa. Factors influencing assistive technology selection included in the best–worst survey were identified in previous phases of a larger project. A total of n = 451 rehabilitation professionals completed the survey by selecting the factors that were most and least influential on their assistive technology provision. Results Results of the survey were obtained by calculating the number of times each factor was selected as most influential across the entire sample, and across all questions, enabling the researchers to sort the items in terms of the frequency of selection. Conclusions Even though the rehabilitation professionals that participated in the study provide services in a context with limited resources, assessment and factors pertaining to the assistive technology itself were generally perceived to be of greater influence than environmental factors. It is recommended that these factors be reflected in frameworks and models of AT selection. IMPLICATIONS FOR REHABILITATION The family’s ability to support the implementation of AT is an important resource that is perceived to influence the selection of AT by an RP. Insight into the mind-set of professionals that are used to selecting AT within settings with limited resources may provide RPs in well-resourced contexts with guidance on how to do more, with less. RPs should aim to determine child preference and attitude towards AT during the AT selection process. RPs should be aware of their own influence on AT selection. Existing AT Selection models should be adapted to clearly reflect the influence of the recommending professional.