Evidence-Based Assessment Approach to Assistive Technology:…

December 2023 / January 2024 Closing The Gap Solutions - Evidence-Based Assessment Approach to Assistive Technology: MPT and MATCH-ACES Assessment By Susan A. Zapf

assessment & IEPs

Evidence-Based Assessment Approach to Assistive Technology: MPT and MATCH-ACES Assessment

INTRODUCTION Have you questioned your abilities when completing an ef- fective evidence-based assistive technology assessment? As- sistive technology (AT) assessments are comprehensive as ev- ery individual we evaluate is unique with strengths, goals and dreams, areas of needs, and personal preferences in regards to their learning and participation in daily activities. AT is a broad array of products that include specific device features, system requirements, and environmental considerations to assure good-feature match to the user. There is limited information and educational resources on the process of AT evaluations and what should be included within the assessment process. BUT… help is on the way as a new resource was released in June 2023, “Evidence-Based Assessment Approach to Assistive Technology: MPT and MATCH-ACES Assessment, edited by Dr. Susan A. Zapf, Ph.D., OTR/L, BCP, ATP; and published in the “Rehabilitation Sci- ence in Practice Series”, by CRC Press. This book is your guide to an effective and evidence-based AT assessment process.

SO… WHAT IS INSIDE THIS FABULOUS EVIDENCED- BASED APPROACH TO AT ASSESSMENTS? This resource is a comprehensive international AT assessment guide featuring the use of the Matching Person and Technolo- gy (MPT) Framework in AT assessment and service delivery in both the educational and medical settings. The book features the MPT assessment, Matching Child and Technology (MATCH), and the Matching Assistive Technology and Child-Augmentative Communication Evaluations Simplified (MATCH-ACES) assess- ment forms. The book also includes a focus of case study exam- ples and resources from a student/child focus to adult learners in secondary education and vocational rehabilitation. The book is divided into three sections. The first section of the book provides the reader with a thorough explanation of the MPT framework and the psychometrics of the MPT and MATCH-ACES assessments. This section also includes valuable information on the International Classification System of Functioning, Disability, and Health; also known as the ICF, and the alignment of the MPT framework with the ICF and the Global Cooperation on Assistive Technology. The second section embraces five chapters on the international application of the MPT in Ireland, Israel, Brazil, Italy, and Spain. Within these chapters, the authors discuss

SUSAN A. ZAPF, Ph.D., OTR/L, BCP, ATP: Susan Zapf is an Occupational Therapist and Assistive Tech- nology Professional with over 29 years of experience working with the pediatric population in both private practice and the school-based settings. She received her undergraduate degree in Recreation, Park, & Leisure Studies from the University of Minnesota and her Master of Occupational Therapy (MOT) and Master of Occu- pational Therapy/Rehabilitation Technology degrees (MA) from Texas Woman’s University. In April 2012 she graduated from Rocky Mountain University of Health Professions with a Doctor of Philosophy (Ph.D.) in Pediatric Science. Dr. Zapf’s research emphasis is on Assistive Technology assessment and outcome effectiveness.

Dr. Zapf owns The Children’s Therapy Center, Inc., a well-established pediatric clinic that provides occupational and speech therapy services to children with Autism, sensory processing disorders, and other neurological needs. She is Board Certified in Pediatrics through AOTA, certified in the Sensory Integration Praxis Test, and certified through RESNA as an Assistive Technology Professional (ATP), and has completed her Level II coursework in Hippotherapy. She is the primary author of the MATCH-ACES Assistive Technology Assessment and The Service Animal Adaptive Intervention Assessment. Dr. Zapf teaches a doctoral course on Assistive Technology for Rocky Mountain University of Health Care Professionals, Doctoral of Science in Rehabilitation: Pediatric Science Program. Dr. Zapf has presented throughout the United States and Internationally on assistive technology assessment and implementation. As an occupational therapist, she is passionate about helping children and their families develop skills to reach their full potential and she believes that occupational therapy and assistive technology can be powerful interventions to assist in this process.

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the adaptions of MPT and MATCH assessments and provide examples of assessment forms and case examples. The third section of this book provides an in-depth review of the research application on the MPT outcomes in cognitive rehabilitation, secondary education, vocational rehabilitation, and pre- inservice education for health care and educators. This section also includes a chapter on personal realization of the benefit of technology. Also discussed within this section are strategies in conducting an effective interview with the AT consumer to assure user-involvement. THE MATCHING PERSON AND TECHNOLOGY FRAMEWORK: The Matching Person and Technology model developed by Dr. Marcia Scherer is a user-centered framework that that aims to match the person and AT based on personal and contextual fac- tors that can impact the person’s use of AT (Scherer, 2005; Scher- er & Craddock, 2002; Scherer, 1998, 1997). The framework is de- signed as a rotating wheel (Figure 1) in aligning with the idea of a continuous and dynamic model. The center of the wheel is the goal of matching person/child to appropriate AT. Within the first layer of this framework is the person or consumer of AT and personal factors that can contribute or influence a person’s use of AT, such as lifestyle and customary routines, history of using AT, and psychosocial considerations such as motivation and flex- ibility. These factors are based on research that resulted in the development of the MPT and MATCH-ACES assessments (Zapf et al. 2016, Scherer, 2005; Scherer & Craddock, 2002; Scherer, 1998). The next layer is the milieu (environmental) factors that can im- pact a person’s use of AT. This is an area often overlooked but plays a critical role in the use of AT. If the environment does not support the AT, it is likely that the AT will not be used. Factors identified in the environmental/milieu include; the attitudes of others, environmental structure, the culture, economics, and po- litical laws and policies that affect the service and delivery of the AT. The third layer of this comprehensive model is technology that is being considered for the person. This layer includes spe- cific device features, usability factors of the device, performance, appearance, availability, and cost, all of which can impact the selection of AT and realization of benefit from use. The outer layer of the MPT process is the continuous process of evaluat- ing, selecting the device, accommodating needs and potential changes with service follow-up, and use of AT. When all three layers are assessed properly there is a better chance of meeting the goal of matching the person and technology.

Figure 1.

SO HOW DOES THE MPT ASSESSMENT FRAMEWORK DIFFER FROM OTHER MODELS? This question was posed in a presentation at Closing the Gap Conference in 2023 as many educational AT Teams utilize the SETT (Student, Environment, Task, and Technology) Frame- work (Zabala, 2005) within the school setting. Both the MPT and SETT assessment frameworks are valuable, and each AT pro- vider will need to determine which evaluation process meets their requirements and the needs of the client/student they are assessing along with best consideration practice in using a person-centered and evidence-based assessment process. The models are compatible and the MPT was used to help inform the SETT. At the ATIA conference in 2004, Dr. Scherer, Dr. Za- bala, Dr. Reed, as well as other AT colleagues discussed current models of AT assessment and commonality of the person, envi- ronment, and technology concepts that were integrated across each of these AT models (Zabala et al., 2004). While these AT as- sessments complement each other with a goal to provide pro- fessionals with options for AT evaluations, there are clear differ- ences between these assessment frameworks and the research validating the frameworks. The SETT is a framework whereas the MPT is a framework with an accompanying research-based as- sessment process that includes specific forms to guide support selection and then outcomes of use. As an Assistive Technology Professional (ATP) in both clinical and educational practice, I uti- lize the MPT process to guide my evaluation process because of the evidence to support the process, person-centered focus, and the flexibility in the assessment forms to streamline the process. As stated above, one value of the MPT assessments is the depth of research to validate this assessment process. The MPT process

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determinants (impairments associated with health conditions such as diseases, injuries, and aging) and milieu determinants (including AT) create the experience of technology adoption, acceptance, satisfaction, and benefit (i.e., the various AT use out- comes) (Scherer, 2017b). Items on the MPT assessment forms have been successfully cross-walked to the ICF that support a universal assessment process, measurement of AT outcomes to support participation, and providing scientific rigor for potential research in the field of AT. The MPT also aligns with the Global Report on Assistive Tech- nology by the World Health Organization (WHO, 2022). The report provides a key blueprint for advancing AT products and services globally, and outlines 10 overarching recommenda- tions that will enable this AT initiative. The MPT supports three of the recommendations within this global initiative as outlined below: • Recommendation 3: Enlarge, diversify, and improve workforce capacity. Knowledge, skills, motivation, atti- tudes, and deployment of personnel working in the assistive technology sector are keys to success. In support of Rec- ommendation 3, the MPT and MATCH-ACES assessments provide personnel with tools to foster user engagement in the assessment process and help ensure providers ad- dress and assess key influences on technology use and realization of benefits. • Recommendation 4: Actively involve users of assistive technology and their families. • The MPT and MATCH-ACES assessments. The MPT and MATCH-ACES assessments were designed to be used to actively involve users of AT and their families or caregiv- ers in ensuring AT recommendations are made on the basis of the user’s goals, preferences, and priorities con- sidering environmental factors of relevance. There are separate forms for the consumer’s care or educational team to compare perspectives (provider, family member, caregiver, and educator) as the identification of differing perspectives can help overcome barriers to engagement in the AT selection process. • Recommendation 8: Develop and invest in enabling en- vironments. Enabling environments are critical for users’ in- dependence, comfort, participation, and inclusion, as they allow users to use their assistive products as intended with minimum effort by the user or caregiver by including strat- egies for re-assessment and measurement of AT outcomes. The MPT and MATCH-ACES follow-up forms are used as outcome measures. These forms are useful in identify- ing environmental obstacles and barriers and providing strategies to facilitate AT success through the collabora- tion of the AT user, AT evaluator, and other team mem- bers.

is the expansion of this assessment across the educational and rehabilitation field, at a national and international level, that has cultivated a growing body of evidence over the past 25 years. The MPT process has been found to be a reliable and valid assessment for use by persons with disabilities (ages 15 and older), and it is applicable across a variety of users, cultures, and settings. Separate versions exist for early intervention children (MATCH) and special education students (MATCH-ACES). The MPT and MATCH-ACES measures have good psychometric properties, and numerous studies have demonstrated their reliability and validity (Federici et al., 2021; Zapf et al., 2016, Scherer, 2005a; Scherer & Craddock, 2002; Scherer & Cushman, 2000). The use and non-use of technology as conceptualized in the MPT model have been validated by many researchers and authors globally who represent the fields of rehabilitation engineering, occupational therapy, physical therapy, speech- language pathology, psychology, and education (Federici & Scherer, 2018). The MPT website (https://sites.google.com/ view/matchingpersontechnology/home?authuser=0) provides details about translations and validation studies conducted over the years (Scherer, 2022). The MPT was a catalyst in the move for user-centered AT as- sessments and has been foundational in educating other pro- fessionals on the importance of including the consumer from the beginning of the assessment process. The MPT model uti- lizes assessment forms and an interview process that facilitates dialogue between the AT evaluator, the user/client and sup- port team to target the users dreams, goals, strengths, areas of need, predisposition factors that can influence AT readiness and usability. The MPT and MATCH-ACES assessment forms are designed to lead the team in a meaningful discussion and a con- sideration process that highlights if the user is ready for AT and what factors one should consider when assessing technology features and personal characteristics. In an AT course for profes- sionals learning AT assessments the students were taught the MPT Framework and assessments. One student reported “the MPT process helped the team understand the groundwork that needed to be done before jumping into implementation of AT solutions”. This student further stated, “the team missed the per- spective of the user before we went through the MPT process. It was an eye-opener to me that a formal assessment procedure is so important, so that we don’t skip any details” (Sax et al, 2023)”. The International Classification of Functioning, Disability, and Health (ICF) is adopted as the worldwide standardized language with which to frame individual functioning and disability (WHO, 2001). Users of the MPT model have found common ground as the contextual constructs of the ICF aligned with the MPT frame- work, therefore, supporting an international and authoritative framework for further confirmation of the strength and scien- tific rigor (Scherer & Sax, 2005). Inherent in the MPT model of a user-driven and person-centered AT assessment process for human functioning and disability is the idea that both health

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Evidence-Based Assessment Framework for Assistive Technology THE MPT AND MATCH�ACES ASSESSMENTS

Evidence-Based Assessment Framework for Assistive Technology

EDITED BY Susan A Zapf

The MPT and MATCH-ACES Assessments Edited by Susan A. Zapf, Rocky Mountain University of Health Professions, USA The primary focus of this book is to educate the reader on the Matching Person and Technology model and assessment process that will guide the reader on consumer-centered assistive technology assessment and outcome measures designed to be used for individual of all ages and all types of disabilities. This book is targeted to the AT providers and policy makers (healthcare, education, and rehabilitation engineering), the university student pursuing a career in these areas, and the consumer of assistive technology.

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AT OUTCOMES USING AN MPT PROCESS: The assessment of AT outcomes is of interest to multiple groups of stakeholders from user, to their caregivers, service providers and policy makers. As stated in the book (Zapf 2023): The MPT and MATCH Assessment Processes, as evidence-based process standards and educational frameworks for improved in- terdisciplinary service delivery, have been shown through over 30 years of academic and gray literature, conferences, and books to support the capacity building necessary to assure meaningful out- comes for the provision of AT. The use of the MPT repeatedly result in a good solution and outcome for the technology user and, in many cases, directed a modified process. Such outcomes, as the ultimate measure of value, can only be achieved when person- focused assessments are a critical compo- nent of the service delivery process. The MPT process and assess- ments will be used when both provider and user gain from its use and achieve a true win-win outcome such as engagement in the process, the avoidance of mistakes, and frustration arising from failed results (Sax et al., 2023, pp 215-216). CLOSING COMMENTS: The MPT family is a group of dedicated professionals in as- sistive technology around the globe with a mission to provide effective consumer-based assessments to individuals with dis- abilities to help them achieve their goals and dreams. The MPT and MATCH-ACES assessment process is a valuable tool that can guide you in an effective consumer-focused assessment process that benefits the potential AT user and team. The Evi- dence-Based Assessment for Assistive Technology: The MPT and MATCH-ACES Assessments is a resource that provides the reader with a foundation of the framework and examples of use from child to adult, with a national and international focus. Dr. Scher- er and I invite you to our MPT family!!’ REFERENCES: Craddock, G. 2002. Partnership and assistive technology in Ireland. In M.J. Scherer (Ed.), Assistive technology: Matching device and consumer for successful rehabilitation , pp. 253–266. Washing- ton, DC: APA Books. Federici, S., & Scherer, M.J. (Eds.). 2018. Assistive technology as- sessment handbook (2nd ed.). Boca Raton, FL: CRC Press. https:// doi.org/10.1201/9781351228411. Federici, S., Scherer, M.J., & Ehrlich-Jones, L. 2021. Measure- ment characteristics and clinical utility of the assistive technolo- gy device predisposition assessment (ATD PA) among mixed pa- tient populations. Archives of Physical Medicine and Rehabilitation, 102 (4), 805–806. https://doi.org/10.1016/j.apmr.2020.11.007

the use of technology. In Zapf, S. (ed.). Evidence-based assess- ment framework for assistive technology: MPT and MATCH-ACES assessments. Pp. 215-216. Boca Raton, FL: CRC Press. Scherer, M.J. 2002. MPT: Matching persons and technology. Strumento per la valutazione della predisposizione individuale all’uso di ausili tecnologici. Milan: Fondazione don Carlo Gnocchi. Scherer, M.J. (1997). Matching assistive technology & child (MATCH) for early Intervention. Webster, NY: The Institute for Matching Person & Technol- ogy, Inc. Scherer, M.J. (1998). Matching person and technology (MPT) model manual and accompanying assessments (Third Edition Ed.). Webster, NY: Institute for Matching Person and Technology, Inc. Scherer, M.J., & Craddock, G. (2002). Matching person & tech- nology (MPT) assessment process. Technology and Disability, 14(3), 125-131. Scherer, M.J., & Cushman, L.A. (2000). Predicting satisfaction with assistive technology for a sample of adults with new spinal cord injuries. Psychological Reports, 87(3 Pt 1), 981–987. https:// doi.org/10.2466/pr0.2000.87.3.981 Scherer, M.J., Sax, C., Vanbiervliet, A., Cushman, L.A., & Scher- er, J.V. (2005) Predictors of assistive technology use: The impor- tance of personal and psychosocial factors, Disability and Reha- bilitation ,27:21, 1321-1331, DOI: 10.1080/09638280500164800 World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF). 2022. Global report on assistive tech- nology . Geneva: License: CC BY-NC-SA 3.0 IGO Zabala, J. (2005). Ready, SETT, go! Getting started with the SETT framework. Closing the Gap: Computer Technology in Special Education and Rehabilitation , 23(6), 1-3. Zabala, J., Scherer, M., Reed, P., McClosky, S., Lahm, L., Korsten, J., Holland, R. & Case, D. (2004, January 14). Alliance for Tech- nology Access (ATA) and CEC Technology and Media (TAM) Joint Pre-Conference Full Day Session: Finding the Right Fit!: Assistive Technology Evaluation by Design. ATIA 2004 Conference and Ex- hibition, January 14-17, 2004, Lake Buena Vista, Florida. Zapf ,S.A., Scherer, M.J., Baxter, M.F., & Rintala, D.H. (2016). Validating a measure to assess factors that affect assistive tech- nology use by students with disabilities in elementary and sec- ondary education. Disability and Rehabilitation: Assistive Technol- ogy,11 (1), 38-49.

Sax, C, Layton, N., Elsaesser. L., Scherer, M. (2023). Assessing MPT outcomes and the person’s realization of the benefit from

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