Ethical issues in

assistive technology
Outline
 Introduction and definitions
 Any conflicts between goals of
therapists and engineers?
 Advantages and disadvantages of AT
 Some examples
 Use and abandonment of assistive
technology
 Conclusions
 Definitions
 Occupational therapy:
 helps people regain, develop, and
build skills that are essential for
independent functioning, health,
and well-being.

 Rehabilitation engineering
 the application of science and
technology to improving the
quality of life of a persons with
disabilities.
More definitions
 Assistive technology:
 products, devices or equipment … that are used to
maintain, increase or improve the functional
capabilities of individuals with disabilities (1998
Tech Act)
Any conflicts?
 OTs, (and PTs, SLPs, etc.) and Rehab
Engineers have similar goals
 Each uses different techniques to achieve
those goals
 Therapists work directly with clients to help
them develop skills needed for independent
living
 Engineers work with clients, too, but they
design and build things to help the client
The potential conflict
 Engineers (and others) can get carried
away with what we can accomplish with
technology
 Sometimes, technology isn’t the most
appropriate solution
Advantages and
disadvantages of an AT device
 Advantages
 It can always be there
 It can be powerful
 Disadvantages
 It may not always work as intended in every
possible situation
 It doesn’t “grow” with the client
 It may break
 It may encourage the consumer to rely on
(imperfect) technology instead of developing their
own skills
Some examples follow
 To build or not to build…
 Are there alternatives to AT
 When are the alternatives appropriate?
 When is the AT appropriate?
 Prosthetics

 Prosthetics can provide functionality for a lost

limb
 However, it is imperfect technology
 Are there alternatives?
 Yes, children, in particular, can learn to
compensate for a lost limb
 They may not realize they are “missing” anything
 When are the alternatives appropriate?
 When is a prosthetic device appropriate?
 Cochlear
implants
 The cochlear implant technology is still
relatively new
 The cochlea (inner ear) is very complex
 Cochlear implants do not nearly match the
performance of the human cochlea
 Are there alternatives?
 Yes, children and adults can learn to communicate
using sign language
 When are the alternatives appropriate?
 When is a cochlear implant appropriate?
 Climbing
Wheelchair
 Wheelchairs have been developed that can
climb stairs
 With this wheelchair, people with disabilities can
access more places
 But – will this work on any type of stairs? And
what if it malfunctions?
 Are there alternatives?
 modify the environment instead
 When are the alternatives appropriate?
 When is a climbing wheelchair appropriate?
 Case study:
laptop computer
 “Jim” has cerebral palsy with poor motor control
 A laptop computer was given to him in kindergarten
because he had difficulty with handwriting
 His teachers and therapists assumed that he would
eventually rely on a laptop for all his writing
 But, Jim wanted to be like everyone else and was motivated
to write like everyone else
 His therapist worked with him on handwriting skills
for the next four years
 By fourth grade, his handwriting was adequate for
his age level
Laptop computer, continued
 An individual who has poor motor control can
use a laptop for writing
 Are there alternatives?
 Yes, work with an OT and PT on handwriting
 When are the alternatives adequate?
 When is it appropriate to use a laptop for
writing?
Use and abandonment of AT
 Studies show that up to 75% of AT
devices are abandoned within 3 years
 This may be a positive thing
 Consumer no longer needs AT
 Consumer needs a more complex device
 However, it is often a negative thing
Why abandon AT?
 Not well matched to individual
 Little or no training provided
 Families not accepting of technology
 Family members from varying cultures may have
different perceptions of the need for technology
 Consumer or their family doesn’t want to “stand
out” by using the technology
 School or workplace not accepting of
technology
To be successful…
 Insure that your device will help the
client and their family achieve their
goals
 Work as a team with client, family,
therapists, teachers, supervisors, etc.
 Communication is crucial
What does this mean?
 Should engineers continue research on
cochlear implants, etc?
 What is the role of the engineer and the
clinician in discussions of new
technologies for clinical use?
 Be careful – many clinicians are fascinated
by technology, just like engineers
References
[1] Assistive Technology Training Online
Project (ATTO). http://atto.buffalo.edu/
[2] Michigan’s assistive technology
resource. http://www.matr.org/
[3] Family-Centered Decision Making in
Assistive Technology
http://jset.unlv.edu/15.1/parette/first.html
The end
 “The benefits of technology are as
extensive as the abilities and goals of
the students using them. However,
professionals and parents should
exercise certain cautions. Technology
must not been seen as a panacea.” [1]