title: Essential elements for assessment of persons with severe neurological impairments for computer access utilizing assistive technology devices: a Delphi study.
abstract: OBJECTIVE
  The objective of this study was to determine prospective elements that should comprise a comprehensive and valid assessment of persons with severe disabilities for access to computers utilizing assistive technology (AT). Currently, there is a lack of guidelines regarding areas that permit a satisfactory measure of a person's need for AT devices to enable computer access, resulting in substandard services.
  
  
  METHODS
  A list of criteria for elements that should be incorporated into an instrument for determining AT for computer access was compiled from a literature review in the areas of neuroscience, rehabilitation, and education; and a Delphi study using an electronic survey form that was e-mailed to a panel of experts in the field of AT. Only those areas rated as essential to the assessment process ('very important' or 'important' by 80% of the respondents) were chosen as important criteria for an assessment instrument.
  
  
  RESULTS
  The initial Delphi survey contained 22 categories (54 subcategories or elements) for incorporation into an assessment for computer access. The second round of the survey completed the Delphi process resulting in a consensus for inclusion of 39 of the elements in an assessment instrument.
  
  
  CONCLUSIONS
  There are inherent obstacles to prescribing the proper AT device to assist disabled persons with computer access due to the complexity of his/her condition, and the multitude of technological devices available to aid persons in accomplishing diverse tasks. This study reveals the intricacy of the assessment process, especially in persons with severe disabilities associated with neurological conditions. An assessment instrument should be broad ranging, integrating both intrinsic and extrinsic factors, considering the multidimensional nature of AT prescription for computer access.
authors.affiliation: Physical Therapist, Assistive Technology Specialist, National HealthCare Inc., Tennessee, USA. brianhoppestad@comcast.net
authors.forename: Brian Scott
authors.initials: BS
authors.lastname: Hoppestad
mesh_terms: D003697:Delphi Technique; D004185:Disability Evaluation; D006233:Persons with Disabilities; D004867:Equipment Design; D006801:Humans; D020380:Needs Assessment; D009422:Nervous System Diseases / Q000503:physiopathology*; D012656:Self-Help Devices / Q000706:statistics & numerical data*; D014584:User-Computer Interface