Assistive Technology Interventions 

Assistive Technology Interventions from a Vision Rehabilitation Clinic
Bryan Wolynski, OD, FAAO, Inna Babaeva, PhD, OTR

Introduction

• Lighthouse Guild (LGI) provides comprehensive multidisciplinary medical and vision rehabilitation services, including assistive technology (AT) evaluations, that inspire people with vision loss to attain their goals. 
• Available AT includes; Tech devices developed for a specific task, as well as accessible mainstream technologies (AMT). Both AT and AMT have shown to
  be useful and effective (1,2,3).
• Multicomponent AT evaluations and recommendations at LGI are provided by occupational therapists (OT) after initial exam by one of LGI low vision optometrists or their own eyecare provider.
• AT recommendations of 243 LGI clients over a 19-week period were reviewed. 

Methods

• OT records between 03/01/22 to 07/22/22 were reviewed.
• Number of OT technology assessment visits (Table 1), age composition (Table 2) and AT recommended (Figure 1). 
• Interventions were counted if documented as recommended — whether educated, demonstrated or trained on, and categorized as shown in Figure 1. 

Results

Visits	Number of Clients
322 OT	294
260 OT Tech	243

Age	%
10-19	0.82%
20-29	2.47%
30-39	5.76%
40-49	5.76%
50-59	9.47%
60-69	14.81%
70-79	17.28%
80-89	27.16%
90+	16.46%

Discussion 

CCTV was most recommended followed by Smart Phone/Tablet & Apps while HMD, EAD, Computer/Software and Other AT’s were less recommended (Figure 1). 

• As many already own a smart phone/tablet and use Apps, consideration of these as initial AT interventions can determine effectiveness and avoid additional expenses.
  AMT can possibly replace other AT (4)
• Age composition (Table 2) of the clients were predominantly older. Different goals based on age or co-morbidities may have resulted in more/less preferred AT interventions.

LGI clients are educated on a wide variety of AT. The OT assessment, results in the best device to fit the needs and goals of an individual, followed by training to ensure optimal use and safety.   

• A World Health Organization report on assistive technology suggests that training from a professional decreases the chances of ineffective AT choices (5). 
• A multidisciplinary approach may be of benefit to identifying other interventions for clients. 

Conclusion

Both AT and AMT interventions resulting from a multicomponent professional evaluation within a multidisciplinary vision rehabilitation clinic are advantageous.   

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References 

1. Crossland MD, Silva RS, Macedo AF. Smartphone, tablet computer and e-reader use by people with vision impairment. Ophthalmic Physiol Opt. 2014 Sep;34(5):552-7.

2. Wittich W, Jarry J, Morrice E, Johnson A. Effectiveness of the Apple iPad as a Spot-reading Magnifier. Optom Vis Sci. 2018 Sep;95(9):704-710.

3. Goodrich GL, Kirby J. A comparison of patient reading performance and preference: optical devices, handheld CCTV (Innoventions Magni-Cam), or stand-mounted CCTV (Optelec Clearview or TSI Genie). Optometry. 2001 Aug;72(8):519-28. 

4. Martiniello N, Eisenbarth W, Lehane C, Johnson A, Wittich W. Exploring the use of smartphones and tablets among people with visual impairments: Are mainstream devices replacing the use of traditional visual aids? Assist Technol. 2022 Jan 2;34(1):34-45.

5. Global report on assistive technology. Geneva: World Health Organization and the United Nations Children’s Fund (UNICEF), 2022.