[Change in technical aids (AT)--a technology assessment from the viewpoint of rehabilitation-anthropology]

Practical experience in adjusting complex computer-assisted (CAS) communication aids has resulted in a search for prognostic criteria useful in evaluating the efficacy of technical aids. Such evaluation implies a holistic approach as is included in the ICIDH-2. These circumstances are demonstrated by examples ranging from mechanical to computer-assisted (CAS) aids. "Reciprocity" has turned out to be a valid semi-qualitative criterion in describing the dynamic equilibration of the rehabilitative issues involved. Only a dialogical situation with reciprocity will lead to sustainable participation. In case of technical aids, a conjunction of abilities and the qualitative level of activities in disabled people have to be taken into account to provide all dimensions of participation. In this holistic approach, social participation and balance will equally be respected. The differentiation of social systems with unequal consequences for people with disabilities in terms of environmental factors, or e-code of the ICIDH-2, have to be considered for prognostic evaluation with regard to efficacy and possible participation. A comprehensive psycho-socio-functional rating therefore has to include a comparative (socio-structural or morphological) analysis of the environment at hand. This approach will invariably show that technical aids alone are unable to ensure individual independence but, rather, may lead to isolation if there is no regional or local networking based on partnership and close interpersonal relations to be drawn on "technically".