"I Am Not an Engineer": Understanding How Clinicians Design & Alter Assistive Technology

In the emerging maker movement, clinicians have long played an advisory role in the development of customized assistive technology (AT). Recently, there has been a growing interest in including clinicians as builders of Do-It-Yourself (DIY) AT. To identify the needs of clinicians-as-makers, we investigated the challenges that clinicians faced as they volunteered in an AT building project where they were the primary designers and builders of assistive mobility devices for children. Through observation and co-building of modified ride-on toy cars with clinicians, we found that the rapid pace of development and transient relationship between user and builder did not allow for a complete assessment of the child's mobility. Furthermore, clinicians struggled to actualize concepts borne out of their clinical intent due to a lack of engineering skill. This study highlights the need for tools that support clinicians-as-makers in the AT maker process and a new conceptualization of the role of DIY-AT maker programs within the AT provider ecosystem.

[1]  Hsiang‐han Huang Perspectives on Early Power Mobility Training, Motivation, and Social Participation in Young Children with Motor Disabilities , 2018, Front. Psychol..

[2]  Melinda M. Davis,et al.  Understanding how low-income families prioritize elements of health care access for their children via the optimal care model , 2014, BMC Health Services Research.

[3]  Mary Ellen Smith Glasgow,et al.  The Nurse‐Engineer: A New Role to Improve Nurse Technology Interface and Patient Care Device Innovations , 2018, Journal of nursing scholarship : an official publication of Sigma Theta Tau International Honor Society of Nursing.

[4]  Patrick C. Shih,et al.  Understanding Volunteer AT Fabricators: Opportunities and Challenges in DIY-AT for Others in e-NABLE , 2017, CHI.

[5]  Lieven De Couvreur,et al.  Design for (every)one: co-creation as a bridge between universal design and rehabilitation engineering , 2011 .

[6]  D A Hobson,et al.  Mobility aids for the paraplegic child. , 1976, The Journal of bone and joint surgery. American volume.

[7]  Jose Gomez-Marquez,et al.  A History of Nurse Making and Stealth Innovation , 2016 .

[8]  D. Sugden,et al.  Children's perceptions of their use of assistive devices in home and school settings , 2009, Disability and rehabilitation. Assistive technology.

[9]  Hsiang-Han Huang,et al.  Modified Ride-on Toy Cars for Early Power Mobility: A Technical Report , 2012, Pediatric physical therapy : the official publication of the Section on Pediatrics of the American Physical Therapy Association.

[10]  Samuel W Logan,et al.  Why the time is right for a radical paradigm shift in early powered mobility: the role of powered mobility technology devices, policy and stakeholders , 2016, Disability and rehabilitation. Assistive technology.

[11]  Scott E. Hudson,et al.  Clinical and Maker Perspectives on the Design of Assistive Technology with Rapid Prototyping Technologies , 2016, ASSETS.

[12]  Scott E. Hudson,et al.  "Occupational Therapy is Making": Clinical Rapid Prototyping and Digital Fabrication , 2019, CHI.

[13]  Shaowen Bardzell,et al.  Reconstituting the Utopian Vision of Making: HCI After Technosolutionism , 2016, CHI.

[14]  Daniela Karin Rosner,et al.  DIY for CHI: methods, communities, and values of reuse and customization , 2009, CHI Extended Abstracts.

[15]  T. H.,et al.  The Journal of Bone and Joint Surgery , 2006 .

[16]  Isabel Marzi,et al.  Children’s Independent Mobility: Current Knowledge, Future Directions, and Public Health Implications , 2018, International journal of environmental research and public health.

[17]  J. Furumasu,et al.  The Positive Effects of Early Powered Mobility on Children's Psychosocial and Play Skills , 2013, Assistive technology : the official journal of RESNA.

[18]  Patrick Olivier,et al.  A study of the challenges related to DIY assistive technology in the context of children with disabilities , 2014, Conference on Designing Interactive Systems.

[19]  Beth A. Ferri,et al.  Tools of Exclusion: Race, Disability, and (Re)segregated Education , 2005, Teachers College Record: The Voice of Scholarship in Education.

[20]  Christiana von Hippel A Next Generation Assets-Based Public Health Intervention Development Model: The Public as Innovators , 2018, Front. Public Health.

[21]  Deborah I Cox Not your parent's wheelchair. , 2004, Rehab management.

[22]  B Phillips,et al.  Predictors of assistive technology abandonment. , 1993, Assistive technology : the official journal of RESNA.

[23]  D. Mont,et al.  Disability and poverty : a survey of World Bank poverty assessments and implications , 2009 .

[24]  David R. Marshall,et al.  Creativity and Innovation in Health Care: Opening a Hospital Makerspace , 2017 .

[25]  S. Agrawal,et al.  Power Mobility Training for a 7-Month-Old Infant with Spina Bifida , 2009, Pediatric physical therapy : the official publication of the Section on Pediatrics of the American Physical Therapy Association.

[26]  Xi Chen,et al.  Power Mobility and Socialization in Preschool: A Case Study of a Child With Cerebral Palsy , 2010, Pediatric physical therapy : the official publication of the Section on Pediatrics of the American Physical Therapy Association.

[27]  K. Turnock,et al.  The Exclusion of Children with Disabilities in Early Childhood Education in New Zealand: Issues and Implications for Inclusion , 2011 .

[28]  Shirley G Fitzgerald,et al.  Evaluation of selected electric-powered wheelchairs using the ANSI/RESNA standards. , 2004, Archives of physical medicine and rehabilitation.