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Helping clients with sensory, physical, or cognitive disabilities select the assistive technology that will improve both their functional capabilities and quality of life has become increasingly challenging as new, more sophisticated technology floods the market. Finding the proper tools requires a complete understanding of the client’s diagnosis, prognosis, functional goals, and the available products and technological capabilities.
The Rehabilitation Engineering and Assistive Technology Society of North America (RESNA) in Arlington, VA, developed two certification exams that were first offered in late 1996. Currently, 808 professionals hold the assistive technology practitioner (ATP) certification, and 527 suppliers hold the assistive technology supplier (ATS) certification, according to Jody Chavez, director of professional services for RESNA. She adds that people need not be RESNA members to be eligible to sit for the exams and that not all RESNA members are certified.
"Most people who have been doing seating and positioning for years fell into the work with no special training or education," says Weesie Griffin, ATS, CRTS, branch manager for the Atlanta office of Chattanooga, TN-based National Seating and Mobility. "When I started in this field more than 20 years ago, I knew every product on the market — I can’t say that today. It’s daunting today, the range of assistive technology products on the market. Some of it is wonderful equipment and some of it is not. It takes an experienced supplier and an experienced therapist to know which products are good and will meet a client’s needs and which aren’t."
There is no licensing required, or currently available, for the assistive technology industry, notes Griffin. "For example, anyone can present themselves to a case manager or a client as a seating specialist. The RESNA certification is a good first step to safeguard consumers and assure quality, cost-effective service."
Case manager LuRae Ahrendt, RN, CRRN, CCM, adds that working with certified suppliers and therapists is especially beneficial for telephonic case managers. "It gives the telephonic case manager the sense that she is dealing with a certain level of expertise — an individual with a certain body of knowledge and quality of service that has been established by a national professional organization. When you are relying on someone else to be your eyes and ears, it’s important to know you’ve selected an individual you can trust."
Certified individuals must adhere to the 21 standards in the RESNA Standards of Practice and the organization’s code of ethics. More important, people who sit for the ATS or ATP exam must demonstrate their understanding of a core knowledge base, which Chavez explains includes the following 10 content areas:
1. Psychology and sociology: attention span and memory; motivation; motor development; language development; cognitive development; sensory development; normal aging development; cultural values; interpersonal relations.
2. Human anatomy: central and peripheral nervous system; oral motor and respiratory systems; cardiopulmonary systems; skin and soft tissue; musculoskeletal system common to specific functional movement; biomechanics of human posture, movement, and function.
3. Basic etiologies and pathologies: physical disabilities; communication disabilities; sensory disabilities; cognitive disabilities; learning disabilities; behavioral disabilities; interaction of environment and disability; aging with functional disability; degenerative or progressive changes in functional disabilities.
4. Principles of learning and teaching: learning styles and differences; task analysis; instructional strategies and methods; measurement of task mastery.
5. Assessment procedures: current use of technology; critical functional abilities and limitations; ability to function in different environments; progress in training on technology; methods of measurement to document device or solution mastery.
6. Service delivery systems and funding for assistive technology: types of procurement systems and payers; principles of quality assurance; services and facilities that may be helpful to users and how to locate them; roles of individuals with disabilities; roles of primary physicians and therapists; roles of personal caregivers and family; roles of distributors and suppliers; roles of manufacturers’ representatives and manufacturer; roles of designers and fabricators; sources, procedures, and documentation for third-party payment; sources, procedures, and documentation for other types of funding; legislation and regulation for funding; differences in funding sources for community, outpatient, or facility-based consumers; sources and techniques for shared funding.
7. Principles of design and product development: universal design concepts; design process; architectural accessibility; environmental considerations related to design; factors that contribute to the cost of custom products; mechanics and strength of materials; electronic components; limitation and violations of warranty; preventive maintenance and repair schedules for mechanical, electrical, and electronic equipment.
8. Basic product knowledge of assistive technology devices: categories of available assistive technologies; assistive technologies characterized by features and correlated with potential applications; compatibility requirements needed to integrate technologies.
9. Integration of person, technology, and the environment: access methods to operate appropriate devices including benefits and limitations; range of appropriate interventions; relationships between therapy, therapy goals, and assistive technology interventions; impact of assistive technology on access to education, employment, and independent living.
10. Professional conduct: RESNA’s code of ethics and standards of practice; standards in an individual’s primary discipline or field; roles and responsibilities of other professionals; sources of information regarding product information, service delivery options, funding, and public policy/ legislation.
Griffin studied hard before sitting for RESNA’s ATS certification exam in 1997. "Many people were shocked to find out how difficult the exam was when it was first introduced," she notes. "I solicited help from the therapists I work with, and I studied hard for the first time in years. Even with nearly 20 years of experience in seating and mobility, I couldn’t have passed the exam without studying."
The sample questions below, found on the RESNA Web site at www.resna.org, may explain why Griffin and others take preparing for this exam seriously. (The correct answers are given after the sample questions.)
1. Which of the following abilities is necessary for development of skilled upper extremity movements?
2. A 12-year-old male with Duchenne’s muscular dystrophy is being evaluated for a mobility system. The therapist notes that he has lateral bending of the trunk and leans to the left. The most appropriate next step is assessment for:
3. An architect with C-4/C-5 quadriplegia would like to use a computer-assisted design (autoCAD) system when he returns to work. The most appropriate first step is assessment of the client’s ability to use:
[Answers: 1-C, 2-D, 3-C.]