Integrating control of multiple assistive devices: a retrospective review

Advances in technology now allow individuals to operate multiple assistive devices through a single, integrated control. A retrospective review of clients at the Center for Applied Rehabilitation Technology (CART) was conducted to determine the factors that support the recommendation of integrated controls. A total of 290 client charts were reviewed; data from 87 clients met the study criteria and were included in the review. For each individual, information was obtained on available access sites, types of assistive technology controlled, and types of input devices used. Meetings were held with CART therapists to determine reasons for recommending specific access configurations for each individual. Twelve reasons falling into four general categories (i.e., performance, functional abilities, subjective, and external) were identified and used to code responses. The findings indicated that integrated controls may be useful in the following cases: 1) when an individual has a single, reliable access site; 2) when the optimum access method for each assistive device is the same; and 3) when the individual prefers integrated control for personal reasons (e.g., aesthetics). Integrated controls may not be appropriate in the following cases: 1) when performance on one or more assistive devices is severely compromised by integrating control; 2) when the individual wishes to operate an assistive device from a position other than from a powered wheelchair; 3) when physical, cognitive, or visual/perceptual limitations preclude integrating; 4) when it is the individual's personal preference to use separate controls; and 5) when external factors such as cost or technical limitations preclude the use of integrated controls.