Discussions regarding the delivery of rehabilitation services today frequently include some mention of consumer empowerment. Federal legislation such as the Americans with Disabilities Act and the Rehabilitation Act Amendments of 1992 mandated a continued growth in consumer involvement. Service delivery models that subscribe to a consumer empowerment model attempt to "...facilitate and maximize opportunities for individuals with disabilities to have control and authority over their own lives" (Emener, 1991, p. 8).
The traditional service delivery model, often called the medical model, encourages a passive role for the consumer with the ultimate decision making performed by the rehabilitation professional. A professional operating from this system would tend to dictate a solution to the consumer (e.g., "You need this training program"). Conversely, the consumer driven model expects the active support and participation of the person with a disability. A professional operating from this service delivery model would try to educate the consumer as to various options and facilitate decision making by the individual (e.g., "Here are some options that might work; which one is best for you?"). Anticipated benefits of following a more participatory model include increased service quality and consumer satisfaction (Patterson & Marks, 1992).
In addition to this trend toward consumer involvement in the rehabilitation process, an increased role in the use of technology in the lives of people with disabilities has occurred. Typically referred to as assistive technology (or rehabilitation technology), it has been defined as items and services that increase the functional capacities of people with disabilities (Institute on Rehabilitation Issues, 1986; Langton, 1991). Assistive items can range from "low-tech" devices (e.g., blocks of wood to raise the level of a desk) to "high-tech" equipment (e.g., laser activated communication boards) with many points in between. Assistive technology services might include evaluation, design, construction, repair, and training.
Assistive technology can impact any sphere of a person's life including education, social, recreation, mobility, work, daily living, transportation, etc. (Reed, 1993). This use of technology can be seen as an empowering tool as it can greatly increase an individual's functioning. The use of independent living aids such as a "grabber" (a device that assists a person in reaching and grasping items), for example, might reduce or even eliminate the need for home visits. Likewise, computer technology might assist a person to successfully complete a training or educational program not accessible without computer assistance. Technology can, therefore, greatly increase a person's options.
Recognizing the potential of assistive technology, Congress passed the Technology-Related Assistance for Individuals with Disabilities Act of 1988 (P.L. 100-407). By making federal monies available to individual states, Congress helped expand the role and public visibility of this technology. As of June 1992 forty-two states had been awarded a demonstration grant of a least $500,000 (RESNA, 1992). States receiving this federal support were required to promote assistive technology. Demonstration centers, training and support services for potential users and service providers as well as information and referral networks were some of the primary services required of grant recipients (National Institute on Disability and Rehabilitation Research, 1993). In addition to direct services, this legislation had a stated purpose of encouraging the development and initiation of assistive technology service delivery systems (Parette & VanBiervliet, 1991).
This article presents an overview of common service delivery models for the provision of assistive technology. With a continued trend toward increased consumer involvement and empowerment within the field of rehabilitation, the need for service delivery systems that encourage consumer empowerment is vital. …