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Disability in America: Toward a National Agenda for Prevention
more efficiently and more effectively with the social and physical elements of their environment. Assistive technologies encompass a broad range of devices. Some incorporate the most advanced offerings of high technology, but the great majority of assistive devices are "off-the-shelf" products that can be used with little or no modification. A microwave oven, for example, may allow a person who is limited in movement to cook, whereas an electric or gas stove may not. At the high end of the technology range (and still under development) are voice-activated robotic arms that can prepare a meal and assist individuals in performing a variety of basic activities such as feeding, tooth brushing, face washing, and hair combing.
By helping people to interact more fully with their environment, assistive technologies can improve or at least maintain functional capacity, and by fostering greater control over one's activities, assistive technologies foster autonomy, which often translates into a higher quality of life. In turn, these benefits spawn the additional advantage of reducing the risk of secondary conditions.
There are three categories of assistive technology: (1) personal technologies, such as tools used in grooming and other hygienic tasks, exercise, and skin protection; (2) activity-specific technologies such as writing and other communication aids and equipment that enable participation in recreational or work-related activities; and (3) environmental technologies, primarily those that ensure physical access (e.g., curb cuts and building ramps) and also those that offer opportunity for participation in societal affairs (e.g., closed-caption programming and specially adapted telephones that allow people to converse by typing and reading). Many assistive technologies directly or indirectly reduce the risk of injury. Grab bars and nonslip bathtubs, for example, greatly reduce the risk of injury in the bathroom, and curb cuts and ramps not only help people with disabling conditions but also assist those carrying heavy objects or pushing strollers.
Advances in electronics and the associated miniaturization of devices open the door to exciting opportunities for developing highly useful assistive technologies. Perhaps the most interesting avenues lie in the area of implantable devices that can substitute for damaged body parts. Yet despite the sizable benefits to be reaped by applying today's high technology to the needs of people with disabling conditions, many manufacturers of medical devices are scaling back their investments in research and development because of government regulations on the pricing of devices (National Academy of Engineering, 1988).
Although complex applications of cutting-edge technology attract most of the public's attention, the greatest benefits, at least in the short term, are likely to come from applying "low technology" to the needs of people with disabling conditions. Such simple devices as adaptive eating implements for people with manual limitations cost only a few dollars, but they can