Guidelines for assistive technology service provision – A scoping review

Guidelines provide trusted, standardised recommendations for practice, such as those from the World Health Organization (WHO). Assistive Technology (AT) includes both assistive products (APs) and services needed for safe, effective use. Despite international standards and growing literature, there is no universally accepted guideline for AT service delivery. Terminology, focus, and audiences vary across contexts. WHO and experts conceptualise provision broadly, encompassing assessment, fitting, training, and follow-up. Historical and recent studies affirm seven essential service delivery steps. This paper aims to synthesise global evidence to support the development of WHO Guidelines on AT provision.

Purpose:

Despite the high unmet need for effective AT provision, multiple service delivery models across different countries, and a shortage of personnel trained in this field, no widely useable and accepted Assistive Technology (AT) service provision guidelines currently exist. This review aims to provide an overview of the literature regarding AT service provision guidelines to inform the development of globally useable AT provision guidance, aligned with contemporary global initiatives to improve access to AT.

Materials and Methods:

The rapid scoping review method used a two-tiered approach to identifying relevant publications: (1) systematic search of academic databases (Medline, CINAHL, SCOPUS, and Google Scholar); (2) consultation with international AT organisations and experts. The search was conducted in March 2023 with no date limitations. Analysis was guided by the TIDE-funded HEART research on quality AT provision and service delivery processes in Europe, as well as the WHO-GATE 5 P framework for strengthening access to AT.

Results:

35 publications were identified from various countries, and directed at differing assistive products, personnel, and provision contexts. No established guidelines for AT service provision currently exist. However, despite the variety in contexts, the range of assistive products and the range of stakeholders to whom guidelines are directed, several key service delivery steps were identified that may form part of such guidelines.

Conclusions:

This review offers a strong starting point for developing guidance for AT provision to meet global needs. Careful consideration of vocabulary, process, and application to the diversity of assistive products is recommended in systematising globally applicable guidance.

Implications for rehabilitation:

• Guidelines offer accepted benchmarks for clinical practice.
• Evidence-based guidelines ensure consistent and appropriate interventions, including assistive technology provision.
• The evidence suggests global guidance is required, and a substantial evidence base can be drawn upon to formulate such guidelines