With the increasing speed at which technology advances nowadays, it is no surprise that devices used in therapy have evolved quite a bit from what they were 20, even 10 years ago. Brand-new gadgets and new models of existing gadgets are constantly being introduced to the market. While most of these advances are geared toward patient comfort and convenience, sometimes it takes a little bit of education and training to make these seemingly autonomously-functioning tools work for the patient instead of against him.

The sheer number of items that can fall under the assistive technology category is astonishing. Anything from wheelchairs and canes to verbal communicators and speech-recognition devices can be considered assistive technology. Despite whatever form the item happens to take, be it the latest high-tech gadgetry or something as basic as a walking cane, each device requires a certain amount of training to be able to use it correctly and effectively. Depending on the individual, sometimes a motorized wheelchair requires just as much training to operate as a speech device.

This is where OTs take up the mantle. Selecting and making recommendations for which devices will work best for the patient is their prerogative. In some cases, training the patient in the proper use of the devices also falls into the hands of the OT, depending on the device.

At the Courage Center in Minneapolis, Sue Redepenning, OTR/L, knows the importance of looking at the individual when deciding what device would work best with what patient. “At Courage Center, our assistive technology program is comprehensive. We offer the medical side which is the therapy, so we have occupational therapy, speech therapy, and physical therapy that addresses assistive technology and each of those practice areas does it differently,” she says.

Redepenning supervises the assistive technology department at Courage Center, and one of her primary concerns is how the patient will utilize and adapt to the new devices. She says, “We’re definitely looking at what their needs are, what’s really important to them.”

Just as the assistive devices themselves cover a wide range of technological and practical fields, the patients who make use of these devices also come from equally varied backgrounds. Some have preexisting conditions such as blindness, autism, or dyslexia. Others suffer from injuries to the head and neck, or spinal cord. Making a recommendation for a device comes down to a case-by-case basis.


According to Redepenning, several factors come into play when evaluating a patient for a device. “We look at what their physical abilities are, what their cognitive thinking and memory skills are, and what their vision is like. We have to look at how they’re going to best use the equipment that we might be recommending for them and if they have the knowledge-base to learn,” she says.

Whether the patient was involved in an accident or requires the use of a device because of a condition such as autism does not matter. Using a device requires the patient to adopt an entirely new way of living.  Sometimes this transition is simple and doesn’t involve too much effort. Other times, it may be a big change of pace.

According to Lyn Weber, OTR/L, at Sacred Heart Hospital near Eau Claire, Wis., the greatest hurtle is acclimating to the technology involved in some of the devices. “The biggest difficulty patients face is becoming used to the gadgets and technology,” she says.

Redepenning concurs, “Sometimes, for our older clients it can be a barrier at first, and you have to work with them at the lower technology before introducing something that they perceive as a little more complicated.” The other issue facing patients as they become accustomed to the use of the devices is maintenance. Many times, a patient will discontinue use of a device because of failure to keep up with maintenance.

“[The client] will always need something, and if the client isn’t invested in it when the technology even needs a battery change, they’re putting it in the closet and not touching it again. We have to make sure we look at all those pieces with our clients and have a plan in place so that the technology keeps being used,” says Redepenning.

Zack Craft, ATS, ATP, CAPS, RRTS, works for Sanford, Fla.-based Total Medical Solutions, a company that specializes in recommending assistive devices to clients suffering from work-related injuries. “I’m dealing with patients that were walking maybe a month ago and then were in a car accident while on the job or in a fork lift accident… so when we first deal with them at the hospital it’s pretty tricky. A lot of them are still in denial, so when we start talking about product, it is a little scary for them.”


Craft works with both OTs and directly with patients to train both in proper use of the devices. Much of his work is helping to make recommendations to OTs and other therapists about what product would best benefit the patient.

For Craft, a large part of what will qualify as a device that best suits a patient’s needs is a device that will be functional within the patient’s home. He says, “A lot of times recommendations need to be based off of the environments instead of just the standard diagnosis at the hospital. A lot of the bad habits that happen at home don’t really happen in the facility because all of the equipment is right.”

Craft elaborates on the “bad habits.” These are simple and mostly overlooked aspects of a patient’s living situation, such as the cleanliness of the home, access to the front and rear exits of a home, and the land surrounding the home. “So you really try to look for those bad habits, you look for those areas of concern. If the house is dirty now, it’s going to be dirty when they get there, and it’s going to be dirty while they’re there,” Craft says.

Beyond evaluating patients and training for use of devices, Craft also deals with medical insurance companies to help patients afford the new technology they may need to utilize. He explains that, while insurance companies are helping worker’s compensation sufferers offset the cost of the products they need for rehabilitation, they may only focus on one injury, if a patient has multiple, to keep the cost low. Craft negotiates with insurance companies to ensure that patients receive the product that is going to best help their patient, both in terms of convenience and performance.

He says, “We’re looking for a higher-quality product to push, because we don’t want to have to do any repairs. If we can have longevity in the product, we can save money versus having to replace the product two years earlier than we would be recommending. It’s a lot more about relationship-based sales, than let somebody buy the product because somebody scripted it.”

In the end, the most important aspect of assistive devices is that the power is now back in the patient’s hands. With the help of such instruments, patients can once again gain their independence.

— Richard Schupp is a freelance writer based in Allentown, Pa. Questions and comments can be forwarded to editorial@therapytimes.com.