Department of Occupational Therapy, University of Florida, Gainesville, FL, USA
Following a stroke or traumatic brain injury (TBI), a person may have residual deficits even after completing a therapeutic program designed to regain function. The deficits may be physical, cognitive, and/or psychosocial. To overcome these deficits, people frequently use assistive technology (AT). The terms assistive technology, assistive device, and assistive technology device are used synonymously. AT device refers to "any item, piece of equipment, or product system, whether acquired commercially, modified, or customized, that is used to increase, maintain, or improve functional capabilities of individuals with disabilities" (Assistive Technology Act, 2004). Assistive devices include both low-technology items such as a long-handled shoehorn, and higher-technology devices such as computers with special interfaces. Assistive devices range from basic consumer products like a television remote, cordless phone, and microwave oven to more specialized devices such as walkers, assistive listening devices, or dressing sticks.
Environmental control devices provide another example of assistive devices. Environmental control devices can be set up to remotely operate electronic devices in the home (Mann, 1998), including lights, television, radio, phone, furnace, or air conditioner. Light timers, for example, are simple environmental control devices that turn lights on and off at pre-set times of day.
The AT increases a person's level of independence in performing tasks, and it may also have a positive impact on self-esteem. For example, after having a stroke, a woman experiences hemiplegia and becomes dependent on her husband for cutting food. This dependency may make her feel more like a child than a wife. To overcome the dependency, the woman works with an occupational therapist, who shows her how to use a rocker knife. This is an adaptive utensil that allows people to cut food with one hand. With the rocker knife, she no longer needs to rely on her husband. Her newly acquired independence makes her feel more self-reliant.
This chapter focuses on use of AT to address residual deficits resultant from a brain injury. While we recognize psychosocial issues may have an impact on the person's life and their response to AT, use of AT for physical and cognitive deficits is emphasized. Firstly, the chapter will outline considerations for intervening with AT following a neurologic condition resultant from injury or disease. Secondly, we will discuss AT for neuromotor impairments. Thirdly, we will present AT for cognitive impairments. Fourthly, we will address AT for sensory-perceptual impairments. Then, we will cover AT by categories of activities of daily living (ADL) including: bathing, dressing, grooming, toileting, eating/drinking, walking/mobility, telephone use, medication management, food preparation, shopping, and leisure. Finally, the chapter will end with a discussion about future AT.
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