Rehabilitation Technology

Definition

Rehabilitation technology is a profession that uses technology to help people with physical disabilities increase their independence.

Description

The goal of rehabilitation technology is to remove barriers so that people with disabilities are able to live independently. This goal could be achieved by technology ranging from a wheelchair with a customized joystick controller to a computer equipped with voice-recognition software. Those are some of the assistive devices that allow a disabled person to be socially active, for example to work and attend school.

Rehabilitation technology is a team-oriented profession that brings together people with a range of expertise. A rehabilitation technologist may work with a rehabilitation engineer. For example, the technologist evaluates a patient's wheelchair seating needs; the engineer could make necessary modifications.

Rehabilitation is a longtime goal of healthcare. During the 1990s, technological advances increased the scope of equipment and devices for use in the rehabilitation of disabilities. In addition, the Americans with Disabilities Act of 1990 banned discrimination against people with physical and mental disabilities. The federal law banned discrimination in the areas of employment, public services like transportation systems, and public accommodations such as restaurants and theaters.

While the law guaranteed rights for individuals with disabilities, the profession of rehabilitation technology provided the tools to help those people improve their quality of life. Sometimes referred to as assistive technology, rehabilitation technology generally involves the areas of: wheeled mobility and seating, computer access, augmentative communication, home and worksite modifications, and environmental controls.

Wheeled mobility and seating

Wheelchairs and scooters are evaluated for factors including the person's capabilities. The sip-and-puff wheelchair is operated by blowing and sucking air into the controller. Another issue for motorized equipment is how the person is seated and positioned in the chair. Modifications could include cushions or a redesign of the equipment.

Adaptive seating is also an issue for people with orthopedic conditions. Accommodations in the work-place and classroom include arranging for chairs that provide support.

Team members working in this area include reha-bilitation technologists or physical therapists and rehabilitation engineers.

Computer access

Computer access removes the barriers to computers for people with physical and visual disabilities.

Adaptive devices include items such as a mouth-operated joystick that is used on an onscreen keyboard. A visually impaired person with low vision could use large-print software. For the blind person, there is software that utilizes Braille and sound.

Technologists involved in this area include engineers with experience in rehabilitation and computer applications. They work with allied health professionals trained in computer access. The job title for these people may be rehabilitation technologist or occupational therapist.

Augmentative communication

Augmentative communication is also known as alternative communication. Systems in this area provide other means of communication for people with impaired speaking or writing skills. Assistive devices range from letter boards to voice-output computers and electronic augmentative communication devices. On the board are letters that the person points to as a means of communicating. The electronic devices are portable computers programmed with synthesized speech. The person uses the device to speak to others.

The professionals working in this area are licensed speech pathologists trained in augmentative devices. Another job title is augmentative communication specialist.

Home and worksite modifications

Home and worksite modifications are adaptations that allow a person to live independently and earn a living. Modifications in the home and workplace could include the installation of wheelchair ramps and lighting. In the home, doors could be widened for wheelchair access. Other changes might include lowering kitchen counters and installing handrails in the bathroom.

An occupational therapist or rehabilitation engineer would give recommendations about the modifications. The changes would be made by a professional experienced in architecture or industrial design.

Other workplace modifications could include changes to office furniture and tools that give people the ability to perform their jobs. In the home, devices that allow people to live independently include utensils with foam handles. These are easier to hold for people with limited hand function. These adaptive devices are called aids to daily living; they are also referred to as environmental controls.

Environmental controls

Environmental controls are devices or equipment that remove barriers to performing tasks such as grooming, using appliances, turning lights on, and using a telephone or VCR. The controls are available for use in the home, on the job, and in the classroom. Aids include spring-loaded scissors and a device that helps people put socks on. Furthermore, some voice-activated systems control the TV, turn lights and appliances off and on, and open and close doors.

An occupational therapist is among the team members who make recommendations about environ-mental controls.

Work settings

Rehabilitation technology is a profession that encompasses occupations in health care, technology, science, and engineering. Within those occupations are researchers, people designing or refining equipment, those who sell the equipment and individuals who help people obtain and use equipment.

Employers of rehabilitation technology professionals include rehabilitation facilities operated by private hospitals, health maintenance organizations, and state rehabilitation agencies. Other employers are businesses that design, manufacture and sell equipment. Schools employ special education technology consultants. Occupational therapists and physical therapists with rehabilitation technology experience work in rehabilitation centers, hospitals, and residentialcare facilities. Some allied health professionals have education, experience, and the job title of rehabilitation technologist. The degree and profession are sometimes known as assistive technology.

Education and training

Educational requirements vary within the professions associated with rehabilitation technology. Some community colleges offer two-year degrees in areas such as assistive technology. A two-year degree is a requirement for an occupational therapy assistant, according to the American Occupational Therapy Association. Occupational therapists must have a bachelor degree or advanced post-baccalaureate degree. Therapists and assistants must do fieldwork and pass a national certification exam. In addition, states require licensing.

Professional certification

Professional certification was voluntary as of December of 2005. At that time, RESNA offered certification exams for Assistive Technology Provider (ATP), Rehabilitation Engineering Technologist(RET), and Assistive Technology Supplier (ATS). The ATP credential demonstrates knowledge and training in the use of devices. A professional must have that credential before earning RET certification. RET skills include designing and modifying assistive technology devices. The ATS credential is for people involved in the sales and service of assistive technology equipment.

Eligibility for ATP testing was based on years of education and experience in late 2005. A person with a bachelor's degree or higher in a rehabilitation science discipline needed at least two years of direct assistive-technology experience. Requirements varied for the person with a two-year degree in rehabilitation science. A professional needed to work full time for two years in assistive technology service or three years for 20 hours per week.

For the RET certificate, a bachelor's degree was required in engineering, engineering technology, engineering-related disciplines, or computer science. Also required were at least two years of fulltime relevant employment. Furthermore, permission to test could be granted to candidates with degrees from non-accredited programs. Accreditation is granted by the Accreditation Board for Engineering and Technology, Inc.

Advanced education and training

For the allied health professional with work experience or a two-year degree, a four-year degree may be the next step in a career path. Employers sometimes require the additional education.

Advanced education programs are often at the graduate level. These include master's degrees in rehabilitation science and technology. These programs include clinical coursework as well as courses related to science and technology. Some engineering schools also offer graduate degrees in biomedical engineering with an emphasis in rehabilitation technology.

Furthermore, continuing education is crucial for all occupations within rehabilitation technology. As technology advances, professionals will need to remain current about new equipment and how to use it.

Future outlook

Employment within occupations that work with rehabilitation technology is projected to increase from 21 to 35 percent through the year 2012, according to the U.S. Department of Labor's Bureau of Labor Statistics "Occupational Outlook Handbook 2004–05." The bureau projected faster than average job growth in the occupations of biomedical engi-neering, occupational therapy, physical therapy, speech-language pathology, and rehabilitation counseling.

Although rehabilitation technology was not listed as a profession in the handbook, the reasons for increased employment would apply to allied-health professionals with expertise in assistive technology and rehabilitation technology. For biomedical engineers and the rehabilitative professions, projected job growth was related to the aging population. The number of older people continues to increase as people live longer.

While the bureau forecast increased employment, there was a caution that proposed federal legislation could place a limit on the reimbursement for services. Those changes could have negative effects on the employment of therapists, counselors, and speech pathologists. However, the bureau rated the impact as a short-term effect, and projected that the demand would continue to grow for people in those occupations.

KEY TERMS

Voice-output software— Software that converts text on the computer into spoken words.

Voice-recognition software— Software that utilizes the user's voice to perform computer functions.

Resources

BOOKS

Bureau of Labor Statistics, U.S. Department of Labor. Occupational Outlook Handbook, 2004–05 Edition, Cardiovascular Technologists and Technicians. http://www.bls.gov/oco (cited Nov. 26, 2005).

Scherer, Marcia. Living in the State of Stuck, 4th ed. Brookline, MA: Brookline Books, 2005.

PERIODICALS

Cowan, Donna M., and Yasmin Khan. "Assistive Technology for Children with Complex Disabilities." Current Paediatrics 15 i3 (June 2005): 207(6).

Gavin-Dreschnack, Deborah. "Wheelchairs: One Size Does Not Fit All." Nursing Homes 54 i4 (April 2005): 68(2).

"Technology Broadens Options." Paraplegia News 58 i8 (August 2004): 21(1).

ORGANIZATIONS

American Occupational Therapy Association. 4720 Montgomery Lane, Bethesda, MD 20824-1220. (301) 652-2682. http://www.aota.org.

Rehabilitation Engineering & Assistive Technology Society of North America. 1700 N. Moore St., Suite 1540, Arlington VA 22209-1903. (703) 524-6686. http://www.resna.org/