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Assistive Technology Device Predisposition Assessment

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Purpose

The Assistive Technology Device Predisposition Assessment (ATD PA) is designed for rehabilitation professionals and consumers to select new and/or additional AT. As the only international measure with specific evidence available to assess the best match between person and technology, it can be used to compare expectations of benefit at time of selection with realization of benefit at follow-up with, but not limited to, spinal cord injury, brain injury, and neurologic impairment, intellectual and developmental disabilities, limb loss and mobility impairment.

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Instrument Details

Acronym ATD PA

Area of Assessment

Activities of Daily Living
Life Participation
Functional Mobility
Quality of Life
Communication
Hearing
Infant & Child Development
Patient Satisfaction

Assessment Type

Patient Reported Outcomes

Administration Mode

Computer

Cost

Free

Cost Description

Available here: http://www.matchingpersonandtechnology.com/orderform.html

Diagnosis/Conditions

  • Brain Injury
  • Cerebral Palsy
  • Limb Loss & Impairment
  • Multiple Sclerosis
  • Parkinson's Disease + Neurologic Rehabilitation
  • Spinal Cord Injury
  • Stroke Recovery

Key Descriptions

  • The ATD-PA consists of two forms.
  • The Person Form consists of 54 items across three domains:
    1) Section A (9 items): The patients ratings of functional abilities (5-point Likert scale)
    2) Section B (12 items): quality of life / subjective well-being in the context of the World Health Organization’s International Classification of Functioning, Disability and Health (ICF) domains of Activity and Participation (5-point Likert scale)
    3) Section C (33 items): The patient's personal and psychosocial characteristics comprised of eight sub scales: Mood, Self-Esteem, Self-determination, Autonomy, Family Support, Friend Support, Therapist and Program Reliance, and Motivation to Use Support.
  • The Device Form includes 12 items assessing their expectations of benefit from using a particular Assistive Technology. The follow-up version assesses realization of benefit after a period of use and, if relevant, reasons for non-use.
  • A score of 60 is interpreted to mean that the patient expects to experience maximum benefit from the use of an Assitive Technology.

Number of Items

66

54 (Person Form)

12 (Device Form)

Equipment Required

  • computer with web accessibility for online access to the forms and manual

Time to Administer

30-60 minutes

May take an hour or longer

Required Training

Reading an Article/Manual

Required Training Description

Training videos, demos of the forms and process, and the written manual are available at no cost at www.MatchingPersonandTechnology.com

Reading books/articles/manual to gain knowledge about the Matching Person and Technology model and expertise in using ATD PA, such as:
• Awareness that the matching person and technology process is a person-centered and user driven process
• Understanding the specificity of the user's needs, preferences and predispositions, especially when considering the context of use of technology.
• Item scoring and interpretation

Age Ranges

Adult

18 - 64

years

Elderly Adult

65 +

years

Instrument Reviewers

Updated in 2020 by: 

Stefano Federici, Ph.D., University of Perugia, Perugia, Italy

Marcia J. Scherer, Ph.D., Institute for Matching Person & Technology, Webster, NY, USA

ICF Domain

Participation
Body Function
Activity
Environment

Measurement Domain

Activities of Daily Living

Professional Association Recommendation

  • American Psychological Association Division 22 (Rehabilitation Psychology)
  • American Congress of Rehabilitation Medicine
  • Rehabilitation Engineering and Assistive Technology Society of North America
  • Association for the Advancement of Assistive Technology in Europe
  • Australian Rehabilitation & Assistive Technology Association
  • WHO’s Global Cooperation on Assistive Technology (GATE)

Considerations

  • Each match of person and technology is unique and requires individual attention.
  • The ATD PA can be administered across settings from hospital to rehabilitation centers to home to community.
  • If user has inadequate reading ability or vocabulary, words can be substituted as long as the concept remains the same.
  • While comprehensive information is best obtained from responses to all the ATD PA sections and items, one or more sections of the ATD PA can be used separately (see MPT manual) as sections have their own reliability/validity.
  • Computerized scoring and interpretations are available as an additional service and currently for a fee.
  • Useful in follow-up evaluations as needed to track outcomes of the match over time.
  • The ATD PA is designed to inform, not to replace professional judgment.
  • The measure is currently available free of charge in nine languages/versions: Brazilian Portuguese, (Alves et al., 2017; A. C. Braccialli et al., 2019; L. M. P. Braccialli et al., 2019), French, German (Bruckmann, 2015; Keller, 2019), Greek (Koumpouros et al., 2017), Hungarian, Irish (Craddock, 2006; Craddock & McCormack, 2002), Italian (Scherer, 2002b), Korean (Lee et al., 2014), and Hebrew (preliminary unvalidated translation). An Arabic version (preliminary unvalidated translation) is also in development and will be available shortly.

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Non-Specific Patient Population

back to Populations

Normative Data

Vocational Rehabilitation: (Scherer et al, 2005; n = 159; done as part of a training program; patients were either drawn from the students case-load or were friends of the student; respondents reported functional limitations in mobility, upper and lower extremity control, eyesight, hearing, and speech communication issues)

Normative Data Across Various Diagnosis:

 

 

Age

   

Gender

 

Cohort

n

Mean

S.D.

Range

Male

Female

2002

91

37.59

14.40

17 – 75

41

33

2004

68

38.09

15.40

17 – 77

20

37

It is a strength of ATD PA to observe and describe the particular characteristics of each person requiring assistive technology. The users’ diagnosis and the technology demanded give the professional an important indication of the type of individual functioning and, therefore, their belonging to an epidemiological/normative group. However, studies on the measurement of disability and those on the user experience of technology use, when matched together, give us distinctive and idiosyncratic profiles, which make a user, almost always, a unique case, hardly traceable to average values of a normative group.

Therefore, it is strongly recommended not to rely so much on the normative values of a group as on individual responses over time.

Test/Retest Reliability

Mixed population: [(Koumpouros et al., 2017); n = 115; age = 62.45, private rehabilitation center in Greece]

  • Excellent reliability (ICC = .981)

The stability of the score is not a priority of this measure.  In fact, a strength of the measure is the opportunity to observe change over time.

Interrater/Intrarater Reliability

Greek Rehabilitation Hospital: (Koumpouros et al. 2017; n=115)

  •  Excellent interrater reliability (ICC=0.981, ranging from 0.973-0.987)

Mixed population: [(Scherer and McKee, 1992) n = 30].

30 conference participants—all professionals or graduate students in such fields as rehabilitation engineering, medicine, speech and physical therapy—rating same 3 ATD PA potential users.

  • High for Items related to device itself and its use.

  • Low for Items concerned with user characteristics and incentive to use.

Internal Consistency

Mixed Population: (Scherer et al., 2006); n = 213, complex medical condition, hip fracture and stroke]

  • Person Form Cronbach’s alpha = .79 (adequate)
  • Device Form Cronbach’s alpha = .74 (adequate)

Mixed population: (Demers et al., 2008, n=139, mean age = 64.2(16.2) neurological conditions, lower extremity orthopedic, complex medical condition)

  • All participants were in a longitudinal investigation of AT device users following:
    1. 40.3% lower-extremity orthopaedic conditions (traumatic injuries of the lower extremity or pelvis)
    2. 33.8% complex medical impairments (conditions not immediately life-threatening)
    3. 25.9% neurological (central nervous system impairments affecting mobility 
  • All participants were interviewed an average of 5.5 weeks after discharge and an average of 23.2 weeks later.

Vocational Rehabilitation: (Scherer et al, 2005)

Internal Consistency Across ATD-PA Domains:

Domain

Items

Strength

2002

Strength

2004

QOL

12

Excellent

0.89

Excellent

0.88

Family Support

11

Excellent

0.80

Excellent

0.81

Motivation for AT Use

14

Excellent

0.82

Excellent

0.83

Self-Determination

14

Excellent

0.82

Excellent

0.84

Therapist-Program Reliance

12

Excellent

0.81

Adequate

0.73

Mood

15

Excellent

0.82

Excellent

0.85

Friend Support

12

Excellent

0.80

Excellent

0.81

Autonomy

13

Excellent

0.80

Adequate

0.76

Self-Esteem

13

Excellent

0.80

Excellent

0.83

 

Greek Rehabilitation Hospital: (Koumpouros et al. 2017; n = 115; age = 62.45, private rehabilitation center in Greece).

  • Adequate internal consistency (Cronbach's alpha =0.701, ranging from 0.605-0.701)

Criterion Validity (Predictive/Concurrent)

Vocational Rehabilitation: (Scherer et al, 2005)

Participants were asked 3 to 4 months after their first assessment to rate how well the selected Assisitve Technology (AT) matched their needs. On a 10 point scale participants in the 2002 cohort gave a mean rating of 6.2, while the 2004 cohort reported a mean rating of 8.1. These results provide preliminary support for the measure's ability to predict how well an AT matches the needs and preferences of participants.

The ATD PA items differentiated consumer predispositions to assistive technology use as well as assistive device and user match at follow-up.  Differences due to gender, physical locality, or age were not significant.  The study was carried out with the collaboration of 150 trained vocational rehabilitation counselors in 25 states within the U.S.

Construct Validity

Convergent Validity

Greek Rehabilitation Hospital: (Koumpouros et al. 2017; n=115)

  • Adequate-Excellent construct validity for items in the Adaptablility subscale (r=0.537 to 0.783)
  • Excellent construct validity for items in the Fit to Use subscale (r= 0.691 to 0.801)
  • Adequate-Excellent construct validity for items in the Socializing (r= 0.498 to 0.767)

Discriminant Validity 

Greek Rehabilitation Hospital: (Koumpouros et al. 2017; n=115)

  • Low correlation coefficients between each subscale, indicating subscales measure unique constructs

Subscale

Adapatbility

Fit to Use

Socialization

Adaptability

1

0.087

0.191

Fit to Use

-

1

0.08

Socialization

-

-

1

Content Validity

The ATD PA was developed by incorporating the experiences of technology users and non-users providing evidence of content validity (Scherer, 2005b; Scherer and Cushman, 2001).

Face Validity

The ATD PA was developed with the input of AT users.

Floor/Ceiling Effects

Although a ceiling effect can be expected, it has not yet been calculated.

Spinal Injuries

back to Populations

Normative Data

Acute SCI: (Scherer et al, 2001; n = 20; mean age = 51.05 (16.44) years; 13 = paraplegia (4 complete), 7 = tetraplegia (1 complete))

 

ATD PA Sections B and C

Item

Mean (SD)

10

3.15 (1.14)

11

4.10 (0.85)

12

2.95 (1.10)

13

3.25 (1.12)

14

3.20 (1.15)

15

2.50 (1.32)

16

3.05 (1.32)

17

3.00 (1.30)

18

3.55 (1.10)

19

1.75 (1.21)

20

1.95 (1.47)

Criterion Validity (Predictive/Concurrent)

Acute SCI: (Scherer et al, 2001; n = 20; mean age = 51.05 (16.44) years; 13 = paraplegia (4 complete), 7 = tetraplegia (1 complete))

Quality of Life Subscale of the ATD PA was estimated correlating with:

  • Diener’s Satisfaction (Diener et al., 1985) with Life Scale  and total of ATD PA Section B and C QoL subset was r = 0.89, p < 0.01;
  • Brief Symptom Inventory (Heinrich et al., 1994) with Depression subscale and total of ATD PA Section B and C QoL subset was r = -71, p < 0.01.

Construct Validity

Acute Spinal Cord Injury: (Scherer and Cushman, 2001; n = 20; mean age = 51.05)

Concurrent: Significant (p < 0.01) positive correlations between the ATD PA’s QOL subset (Sections B and C) and SWLS and significant (p < 0.01) negative correlations with the BSIdep [r = 0.48 to 0.62; p < 0.01 or 0.05].

Correlations Between Measure of Quality of Life:

Variable

BSIdep

SWLS-total

ATD-PA QOL Items

BSIdep

1.00

   

SWLS-total

- 0.64**

1.00

 

QOL-total

- 0.71**

0.89**

1.00

** p < 0.01

Brief Symptom Inventory=  BSIdep

Satisfaction with Life Scale = SWLS-total

ATD-PA (Sections B and C)

Bibliography

Alves, A. C. d. J., Matsukura, T. S., & Scherer, M. J. (2017, 2017/02/17). Cross-cultural adaptation of the assistive technology device – Predisposition assessment (ATD PA) for use in Brazil (ATD PA Br). Disability and Rehabilitation: Assistive Technology, 12(2), 160–164. https://doi.org/10.1080/17483107.2016.1233294

Braccialli, A. C., Araújo, R. d. C. T., & Scherer, M. J. (2019, Jun 6). Translation and cross-cultural adaptation of the Educational Technology Device Predisposition Assessment into Brazilian–Portuguese language. Disability and Rehabilitation, 1–7. https://doi.org/10.1080/09638288.2019.1624839

Braccialli, L. M. P., Braccialli, A. C., Audi, M., & Scherer, M. J. (2019). Tradução e Adaptação Cultural de Instrumentos para Avaliar a Predisposição do Uso de Tecnologia Assistiva que Constitui o Modelo Matching, Person & Technology [Translation and Cultural Adaptation of Instruments to Assess the Predisposition of Assistive Technology Use that Constitutes the Matching, Person & Technology Model]. Revista Brasileira de Educação Especial, 25(2), 189–204. https://doi.org/10.1590/s1413-65382519000200001

Bruckmann, N. (2015). MPT & ATD PA – Matching Person and Technology Model (MPT-Modell) und Assistive Technology Device Predisposition Assessment (ATD PA) ein klientenzentrierter Wegweiser für die Hilfsmittelberatung und -Versorgung in Deutschland. Schulz-Kirchner.

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Craddock, G., & McCormack, L. (2002, 2002). Delivering an AT service: a client-focused, social and participatory service delivery model in assistive technology in Ireland. [Article]. Disability and Rehabilitation, 24(1–3), 160–170. https://doi.org/10.1080/09638280110063869

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