Abandoning an Assistive Device: Why Does it Happen?

Student projects that design and construct custom assistive devices represent a unique means of technology transfer to users with disabilities. Students gain the experience of solving a real engineering problem while users receive custom devices at no cost. Students at Worcester Polytechnic Institute (WPI) in Worcester, MA, devote approximately one third of their senior year to a particular design project (1). Typical assistive devices that have been developed include: a lightweight wheelchair, a swingaway laptray, a force limiting joystick, a robotic reacher/gripper, a bowling machine and therapeutic tricycle.

Abandonment of assistive devices has been identified as a major problem in the delivery of services to people with disabilities. Abandoned devices represent an inefficient use of existing resources that have already been allocated to people with disabilities. Factors that have been linked to device abandonment are: lack of user involvement in selection, easy device procurement, poor device performance and changing user needs.

At WPI, we surveyed the current status of 15 custom devices that had been developed during the period from 1990 to 1995 and given to individuals (2). Seven of the devices (47%) were either in current use or had fulfilled their original purpose for more than one year. Changing user needs caused by growth or changes in medical conditions were largely responsible for the devices that had been successful but were not in present use. Four devices (27%) had seen very limited use because of lack of user and caretaker involvement in the design process, a lack of a substantial identified need (easy procurement), and poor performance. Thus 11 of 15 devices followed the pattern of use and abandonment that has been reported in the literature.

However, an additional four well-designed devices (27%) were not in use and seemed to suffer from problems specifically related to the process of using students to design and construct relatively complex assistive devices. Student projects must be completed within the constraints of the academic year. Time constraints often lead to rather limited tests of long term reliability when compared to devices produced in industrial settings. Maintenance and adjustment of student-designed devices generally become the responsibility of the user’s rehabilitation facility. These facilities may lack the time and/or expertise to repair and maintain complex electromechanical devices. Furthermore, the original student designers are no longer available for consultation or to assist with minor modifications. While academic settings are often ideally suited to design and construct complex assistive devices, additional strategies must also be developed to insure the long term viability of these devices. In particular, provisions for maintenance, repair and minor modifications must be incorporated into the long term planning for device utilization.

-Allen Hoffman, Mechanical Engineering Department, Worcester Polytechnic Institute

References

1. A.H. Hoffman and H.K. Ault, "Technology Transfer Through Student Design Projects", Proceedings of the 14th RESNA Conference, 1991, pp. 33-35.
2. A.H. Hoffman and H.K. Ault, "A Retrospective Study of the Use and Abandonment of Assistive Devices Developed by Student Design Projects", RESNA '96, pp. 131-133.