Conversations That Matter: Assistive technology and occupational therapy

Against this backdrop, an interactive ‘Conversations That Matter’ session hosted by ARATA Board Members (see Figure 2), using participant polling via Mentimeter illustrated with examples asked:

I. Which recommendations from the WHO/UNICEF Global Report on AT are most relevant to occupational therapy practice in Australia?

II. Among these recommendations, what specific suggestions can be provided to individual OTs and the profession as a whole to drive meaningful change?

Of the participants who attended this Conversation, 62 registered to respond in Mentimeter, and 58 (94% of registered respondents) ranked the recommendations in order of the perceived relevance to occupational therapy. See Figure 3 for the polling results.

After this initial ranking by session attendees, the top-ranked recommendations (see Figure 3) were then explored with session participants using Mentimeter and group ‘conversations’. The aim was to gather examples of occupational therapy principles and/or practices that responded to or enabled each recommendation. Participants provided their suggestions on how OTs - either individually or as part of a professional group - could drive change. The original text was then summarised into key messages by the group facilitators. See Table 1 for the resultant key messages for the top two ranked recommendations.

The broad-ranging discussion across these and other recommendations drew together some key principles. These included taking a person-centred approach, embedding user involvement in all steps, enabling access, supporting advocacy, and providing education. An understanding of AT policies and legislation

Recommendation 2: Ensure that assistive products are safe, effective, and affordable.

• Work within scope: prescribe within knowledge/skills.

• Follow guidelines: use a structured assessment and prescription process (e.g., 5-step/good practice guidelines).

• Use standardised assessments.

• Ensure right product is recommended and fit for purpose.

• Perform risk assessments.

• Listen to users’ wants and needs.

• Consider client’s/user’s available funding or budget.

• Don’t use funding to make your decision, use clinical reasoning.

• Assess environmental fit.

• Collaborate with a specialised team.

• Involve all key stakeholders in decision-making.

• Schedule follow-up visits post-provision.

• Measure outcomes in relation to client/user goals.

• Encourage client/user reviews to promote optimal products.

• Share relevant equipment standards and unbiased reviews.

• Insist on trials and demonstrations.

• Consider hiring before purchase.

• Engage a helpful equipment supplier and utilise supplier knowledge.

• Request a safety statement from suppliers.

• Establish competitive buying groups for AT.

• Prioritise evidence-based practice.

• Conduct research and consult with professionals.

• Educate users and providers on AT use and issues.

• Implement AT recycling initiatives and have plans/funding for maintenance.

• Advocate for training, guidelines, and policy inclusion.

• Enforce legislation for mainstream technology accessibility.

Recommendation 4: Actively involve users of assistive technology and their families.

• Use frameworks and models for guidance.

• Prioritise client-centred practice and co-design processes.

• Engage, involve, consult, research, and share information.

• Enhance communication by asking, listening, advising, and avoiding assumptions.

• Fund user participation and incorporate user input.

• Foster a vision of possibilities.

• Insist on client/user involvement and maintain a record of this.

• Use user-centred and collaborative assessments, considering all ICF domains, observation, and activity analysis.

• Focus discussions on client-identified needs, provide education and options, ensuring client choice and control.

• Involve clients/users and their families in planning and design.

• Include all relevant parties in problem and solution discussions.

• Educate family members on AT usage and conduct trials in various settings with input from all involved parties.

• Provide physical spaces for AT users to share expertise and equipment.

• Provide accessible support and normalise AT use.

• Encourage non-judgmental responses to other AT users.

• Actively seek feedback from clients/users and their families.

• Evaluate user experiences and measure outcomes with users.

• Allocate sufficient time and funding for OTs to assess and follow up properly with clients/users.

was also identified as critically important for the assessment, supply, customisation and/or revisions of AT over time.

The WHO/UNICEF recommendations (WHO & UNICEF, 2022), designed to improve access to AT, hold significant relevance for the occupational therapy profession. The GAATO Assistive Technology Outcomes and Impact Model (GAATO, 2022) offers an additional focus on approaches to measure outcomes and impacts for AT advisors, including OTs. By engaging in a ‘Conversations That Matter’ session with OTs who practice, research and/or educate in the field of AT –employing group consensus-building techniques – future directions and suggestions have been made by the profession to support the actioning of these global AT recommendations in Australia. Many of the suggestions reflect the commitment of OTs to enable meaningful participation and enhance the lives of individuals and communities.

The WHO/UNICEF Global Report on AT highlights that achieving universal access to AT requires collaborative efforts across diverse stakeholders (WHO & UNICEF, 2022). For OTs, this means actively involving users and their families in the decision-making process, promoting awareness, empowering users, and connecting them with good AT advice and provision principles, and supporting outcome measurement and other research to continually improve AT solutions. Moreover, in advocating with AT users, OTs and our national professional bodies can seek to influence policy and coordinate efforts with local and national governments, in alignment with the WHO/UNICEF report’s recommendations.

Given the profession’s innate expertise in person-centred practice, OTs play a vital role in the effective implementation of these recommendations. By embracing innovation and collaboration and ensuring that environments are accessible to and enabling for all users, the profession can significantly contribute to nurturing a more inclusive AT ecosystem. Overall, these profession-made suggestions enable a conversation that matters. They do this by offering one contribution to a roadmap for the occupational therapy profession to further our mission of enhancing individuals’ access to and utilisation of assistive technology, ultimately improving occupational performance and quality of life.

The authors are Voluntary Board Members of the Australian Rehabilitation and Assistive Technology Association (ARATA) and a dedicated volunteer who participated in the “Conversations that Matter” session at the OTA Conference.

ARATA is a national peak body for assistive technology stakeholders with an overarching mission to build and sustain an inclusive assistive technology community of practice. ARATA collaborates regularly with Occupational Therapy Australia, including within the National Assistive Technology Alliance, which is chaired by ARATA - see https://www.arata.org.au/access-&funding/towards-a-national-assistive-technology-alliance/