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Rehabilitation technology: engineering new careers in rehabilitation.

The exciting and challenging career of rehabilitation engineering provides an engineer with the opportunity to apply his/her education and skills in a rather nontraditional way.

Instead of working in a production plant or with the hardcore design and testing of equipment and products, you are presented with the ultimate challenge in problem solving. Your assignment: design a product, a workstation, a layout, a facility, or a computer interface for a person with a disability that will "immediately" bridge the gap between that person's capabilities and the requirements of the task at hand.

Engineers are not the only professionals involved in these activities. Many occupational therapists, physical therapists, scientists, physicians, speech pathologists, special education teachers, industrial designers, and technicians also apply technology to their work with people who have disabilities. For this reason, the field is more broadly referred to as rehabilitation technology.

Rehabilitation Technology Service Provision

Rehabilitation technology is the systematic application of scientific and engineering principles to the rehabilitation process for the removal of barriers to employment and independent living. Thus, the end goal of rehabilitation technology is to enhance the employability, education, communication, daily functioning, and recreational activities of people with disabilities.

There are many aspects of rehabilitation technology service provision. These include:

* evaluation to determine which types of assistive devices or modifications best suit the needs of a person with a disability;

* provision of assistive devices/adaptive equipment which will bridge the gap between the capabilities of a person with a disability and the requirements of the task, which can be accomplished by purchasing an available (off-the-shelf) product, modifying an available product, or designing a product which is customized for the individual;

* modification of the task to alter the existing method of completing a task so that it can be accomplished in an alternative manner; and

* modification of the environment to remove or alter physical or environmental barriers to task completion (environmental barriers can also include noise, lighting, etc.).

Technical Areas

Rehabilitation Technology is comprised of many technical areas. Each of the aforementioned aspects of the field must be considered in light of the requirements and qualifications that are specific to each technical area. Thus, for example, a person who is qualified to perform an evaluation for a vehicle modification will not likely be qualified to accomplish an evaluation for computer access. The major technical areas that are traditionally involved within the overall field of rehabilitation technology are presented below.

* Augmentative Communication involves the provision of an alternative method of communication for a client who is non verbal or who possesses severely impaired communication skills. This type of service is included in rehabilitation technology because it often involves an evaluation for, and prescription of, an electronic augmentative communication device. This device is a portable computer that uses synthetic speech to communicate words and messages stored within its memory.

A licensed speech language pathologist with specialized training in electronic communication devices is the most qualified person to accomplish the evaluation, prescription, and programming for these devices.

* Computer Access involves the provision of an access method to a client whose disability prevents him/her from accessing a computer in the standard way. The access method that is provided is determined by studying the client's computer application requirements (e.g., word processing) and assessing his/her physical and visual capabilities. Thus, the technologist is able to configure a computer system that will run the requisite application and support the prescribed access device(s). Computer access is often subdivided into those cases involving visual impairments and those dealing with physical disability. This is due, in part, to the specialized evaluation equipment and disability-related knowledge needed in each of the two cases. When visual impairment is involved, a technologist may recommend large print software for a person with low vision, for example, or refreshable braille and voice output for a person with total blindness.

Technologists most often in this field are engineers (computer, industrial, mechanical, biomedical, electrical) who have knowledge of computer applications and special training in rehabilitation. Some graduate engineering programs are now offering specializations in rehabilitation engineering. Occupational therapists with specialized training in computer access are also involved in the field.

* Worksite Modification concerns design and layout changes in the workplace. They include: modifications to tools, equipment, and the workstation; alterations in work methods; removal of architectural barriers; and changes in the environment (e.g., lighting). This area of rehabilitation technology is where one would most likely find people with traditional engineering degrees (industrial, mechanical, electrical). It is important that the engineer have a knowledge of ergonomics -- the art and science of designing a workplace or other environment to fit the person, instead of expecting the person to fit into the existing environment. Ergonomics is a methodology that is used to design to accommodate the capabilities and limitations of the person. A successful design not only allows the person to complete a task, but allows the person to accomplish it in the best, safest, and most efficient way possible. This is achieved by considering the following three principles:

1) The design should take full advantage of a person's capabilities.

2) The design should not stress a person beyond his or her limitations.

3) The design should not aggravate the existing disability, nor should it cause a new disability.

* Seating and Mobility involves the provision of powered mobility and contoured seating appropriately designed to suit the client's needs for support and mobility. The appropriate cushioning must be selected or designed to achieve optimal positioning in the chair, a control system must be chosen (e.g., joystick, head switch, sip-n-puff), and controls must be properly mounted along with any other devices or controls that are needed. These accommodations are best accomplished by a rehabilitation technology team consisting of an engineer and a physical therapist with background in seating and positioning.

* Home Modification and Independent Living involve accommodations to increase independence in daily activities. Architectural changes to increase accessibility to and within the living environment include modifications to bathroom and kitchen facilities and the installation of ramps, stair glides, and elevators. People with disabilities are often provided assistive devices called aids to daily living (ADL's). These devices are designed to assist in the performance of common household and grooming tasks. They include such things as modified kitchen utensils, boxtop openers, buttonholers, and spring-loaded scissors.

Another way to increase independence in the home for people with high level quadriplegia is the provision of environmental controls. These controls enable clients to remotely control such devices as power door openers, lights, and electronic appliances such as television sets and stereos.

An interdisciplinary team can most effectively address the diversity of components that constitutes the home accessibility problem. A person with expertise in architecture or industrial design can best address the architectural changes with input from an engineer or occupational therapist. The provision of ADL's and environmental controls will most likely be handled by an occupational therapist and an engineer.

Employment Opportunities

Ever-increasing employment opportunities for rehabilitation technologists are emerging. The Americans with Disabilities Act of 1990 has given rise to a growing need for people who have experience in reasonable accommodation to advise private sector employers seeking compliance with the act. This, in turn, will increase the opportunities for independent (consultative) rehabilitation technologists.

The recent shift in emphasis by state vocational rehabilitation agencies toward serving people with more severe disabilities has created a tremendous need for technology service providers. In response, many rehabilitation technology centers have been established which employ interdisciplinary teams. It has also created a tremendous opportunity for technology consultants, especially those who are highly specialized (e.g., those who provide computer access to people with visual impairments).

Yet another wave of opportunities in rehabilitation technology is being created by the awarding of the Technology-Related Assistance grants to the individual states by the U.S. Department of Education. As each state brings up programming under its grant award, positions in rehabilitation technology are being created. These positions are often within state governments and usually similar to jobs of program specialists.

Still more opportunities lie in the educational environment as schools strive to provide students of all ages an accessible educational experience.

Career Ladders

Rehabilitation technologists can pur- chase many different career paths. A per- son who wishes to provide evaluation/prescription/modification/design services directly to clients can choose to become affiliated with a rehabilitation technology center or work as a private consultant. Many rehabilitation technology centers hire people with a variety of backgrounds (engineers, occupational therapists, speech pathologists). They are thus able to utilize a team approach and provide a broad range of technology-related services. These centers can be located within hospitals, independent living centers, sheltered workshops, universities, or nonprofit rehabilitation organizations such as Goodwill or United Cerebral Palsy. Starting salaries for such positions vary widely with degree, experience, location, and type of facility.

Private consultants usually provide a specific service consistent with their overall education and experience. Depending upon the need for this service, the consultant may cover a rather large geographic area. Consultant fees for rehabilitation technology services vary widely.

People interested in a more global career in rehabilitation technology may choose to work with a state vocational rehabilitation agency as a program specialist. A person in such a position would provide technical assistance to vocational rehabilitation counselors regarding the provision of the most appropriate technology to clients with disabilities. a rehabilitation technologist in this setting should possess a broad-based knowledge that includes all of the sub specialties within the field. Such program specialists are often responsible for providing technology training to the counseling staff and for developing technology service delivery resources within the state.

Many new positions in the field of rehabilitation technology have been created as a result of the awarding of Technology-Related Assistance grants to a number of states by the Department of Education's National Institute of Disability and Rehabilitation Research (NIDRR). Eventually, all states will be awarded grant money for the purpose of creating a statewise consumer-responsibe system of service delivery for technology-related services. Grant-sponsored activities may include the provision of public awareness training concerning rehabilitation technology. Such training would provide information on the availability and usefulness of the various types of technology for people with disabilities. Other grant activities include advocacy, direct service provision, the organization of technology expositions, and the creation of technology databases and informational hotlines. Again, the required skills and educational background will vary greatly depending on the activities specified in a particular state's grant.

Research can also provide a career opportunity in rehabilitation technology. Such research focuses on the development of assistive devices, computer software, or techniques for successfully providing technology services. Often, these research projects are housed within universities or teaching hospitals and require advanced degrees.

Other Resources

Following are further resources available to anyone interested in a career in rehabilitation technology.

* The Rehabilitation Engineering Society of North America (RESNA) is an interdisciplinary association for the advancement of rehabilitation and assistive technologies. RESNA maintains and distributes information on all aspects of rehabilitation technology, holds an annual national conference, and publishes a quarterly journal, Assitive technology.

RESNA also administers the Technical Assistance Project funded by NIDRR. This project provides technical assistance to states funded under Technology-Related Assistance grants.

Information concerning rehabilitation technology, RESNA membership, or states funded under Technology-Related Assistance grants may be obtained by contacting RESNA at the following address: RESNA, Suite 700, 1101 Connecticut Avenue, N.W., Washington, DC 20036 Telephone: (202) 857-1199.

* Georgia Institute of Technology's Center for Rehabilitation Technology has assembled a listing of graduate programs in rehabilitation engineering. For a copy of this listing, please contact: Linda Carson, Georgia Tech, CRT Department 490 10th Street, Atlanta, GA 30332-0156 Telephone: (404) 894-4960.

Dr. McQuistion is Coordinator of the Rehabilitation Technology Support Unit at the Ohio Rehabilitation Services Commission and is also a consultant in the areas of rehabilitation engineering and ergonomics.
COPYRIGHT 1992 U.S. Rehabilitation Services Administration
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Title Annotation:Careers in Rehabilitation
Author:McQuistion, Linda
Publication:American Rehabilitation
Date:Jun 22, 1992
Previous Article:What does the future hold?
Next Article:Careers in rehabilitation psychology.

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