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ASSISTIVE TECHNOLOGY DISCONTINUANCE

Dr. Marti Riemer-Reiss, Assistant Professor
Montana State University-Billings
1500 North 30th Street
Billings, MT 59101

Assistive technology devices enable individuals with disabilities to participate in society as contributing community members. These devices have also been credited with helping individuals with disabilities achieve optimal functional ability and independence (Phillips & Zhao, 1993). According to the National Center for Health Statistics, more than 13.1 million Americans used an assistive technology device in 1990 to accommodate for a physical impairment (LaPlante, Hendershot, & Moss, 1992).

Although technology benefits many people, there are also many people who are dissatisfied with their devices. Dissatisfaction typically results in discontinuance of assistive technology devices. A national survey on technology abandonment found that almost one-third (29.3%) of all the devices previously used were completely abandoned (Phillips & Zhao, 1993). Discontinuance of assistive technology represents a waste of time, money, freedom and functioning of individuals with disabilities.

There is however, limited research documenting factors related to assistive technology discontinuance from consumers’ perspectives. It is important to gain an understanding of these factors to aid professionals in designing techniques of assistive technology service delivery. The purpose of this study was to determine the factors that were associated with discontinuance of assistive technology by individuals in the state of Colorado who received assistive technology through Technology-Related Assistance for Individuals with Disabilities ("Tech Act") grant funding.

The "Tech Act" is the most significant piece of federal legislation regarding assistive technology. It is the first federal legislation that specifically addressed the expansion of the availability of assistive technology devices and services. This act was designed to encourage the development of consumer responsive, statewide services focusing on flexible and effective funding strategies to meet the needs of individuals with disabilities (Cook & Hussey, 1995).

The current study examined the independent variables (relative advantage, support, consumer involvement, trialability, changes in consumers, re-invention and compatibility) to determine if they were associated with assistive technology device discontinuance among individuals with disabilities. The sample was comprised of 115 individuals with disabilities who were selected to receive funding for 136 assistive technology devices and agreed to participate.

The majority of the individuals reported receiving one assistive technology device (72.8%), however 16% reported receiving two devices and 11% received three devices. Each device was analyzed as an individual case as the consumers who received more than one device treated the devices differently. Assistive technology devices went to 71 males and 65 females. Many of the devices were provided to individuals under 20 (30.1%), however devices were funded for individuals of all age categories up to and including individuals over the age of 70. Individuals with physical disabilities accounted for the highest number of recipients (30.9%) followed by cerebral palsy (24.3%) and visual impairments (21.3%). The education level of the people who received funding for devices ranged from less than high school degrees (38.2%) to doctorate degrees (7.4%). Overall, 27.2% of the adults who received funding were employed and 43.4% were not employed at the time of the interview.

Individuals with disabilities received devices ranging from "high tech" devices such as personal computers and communication devices to "low tech" devices such as canes and reachers. The three devices received by the most individuals were computers (21%), followed by communication devices (16%), and adapted software (7%).

The assistive technology devices that were discontinued and not replaced by an updated version made up 32.4% of the sample. In response to the amount of time recipients used their technology prior to discontinuing its use, the modal response was one to three years (46.7%), however, 6.4% of the devices were never used and 3.2% were used over 6 years.

Analysis of the results suggests that the variables of relative advantage and consumer involvement have a significant influence in predicting assistive technology discontinuance. This finding is consistent with the literature on assistive technology. Consumers who do not believe that they are involved in the selection of their assistive technology devices, are more likely to discontinue using them than individuals who feel involved (Carroll & Phillips, 1993; Freeman & Field, 1994; Phillips & Broadnax, 1992; Tewey, Barnicle, & Perr, 1994; Turner, et al., 1995). Likewise, Batavia and Hammer (1990) found that a focus group of individuals with disabilities identified components of the variable relative advantage as priorities to evaluate when selecting assistive technology.

These results suggest that assessment practices for assistive technology should concentrate on involving the consumer in all aspects of decision making. Additionally assistive technology devices prescribed must offer consumers more advantage than the burden involved in their use. Therefore, careful evaluations to determine the costs and benefits of using assistive technology from the consumer’s perspective are crucial to avoid future discontinuance of assistive technology.

Many individuals involved in this study did receive increased access to and ownership of assistive technology devices. The 10 agencies that participated in this study reported providing funding for devices to 205 individuals with disabilities across the state of Colorado. The 115 individuals that participated in this study received a total of 136 devices. The assistive technology devices analyzed in this research were disseminated from four to eight years prior to data collection. The fact that 68% of the devices were still in use (or updated) four to eight years later, reveals that the individuals with disabilities who gained access to technology through this project integrated the technology into their activities of daily living.

References

Batavia, A. I., & Hammer, G. S. (1990). Toward the development of consumer-based criteria for the evaluation of assistive devices. Journal of Rehabilitation Research and Development, 27(4), 425-436.

Carroll, M., & Phillips, B. (1993). Survey on assistive technology abandonment by new users (Cooperative Agreement No. H133E0016). Washington, DC: National Institute on Disability and Rehabilitation Research.

Cook, A. M., & Hussey, S. M. (1995). Assistive technologies: Principles and practice. Saint Louis, MO: Mosby.

Freeman, S. A., & Field, W.E. (1994). Selection of rural assistive technology using a hypercard-based knowledge system. Assistive Technology, 6(2), 126-133.

LaPlante, M. P., Hendershot, G. E., & Moss, A. J. (1992). Assistive technology devices and home accessibility features: Prevalence, payment, needs and trends(No. 217). Hyattsville, MD: National Center for Health Statistics.

Phillips, B., & Broadnax, D. D. (1992). National survey on abandonment of technology(Cooperative Agreement No. H133E80016). Washington, DC: National Istitute on Disability and Rehabilitation Research.

Phillips, B., & Zhao, H. (1993). Predictors of assistive technology abandonment. Assistive Technology, 5(1), 36-45.

Technology-Related Assistance for Individuals with Disabilities Act of 1988, Pub.L. No. 100-407, 102 Stat. 1044 (1988).

Tewey, B. P., Barnicle, K., & Perr, A. (1994). The wrong stuff. Mainstream,19(2), 19-23.

Turner, E., Barrett, C., Cutshall, A., Lacy, B. K., Keiningham, J., & Webster, M. K. (1995). The user’s perspective of assistive technology. In K.F. Flippo, K.J. Inge, & J.M. Barcus (Eds.), Assistive technology: A resource for school, work and community (pp. 283-290). Baltimore: Paul H. Brookes Publishing Co.


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