Factors Associated with Assistive Technology Discontinuance Among Individuals with Disabilities

Journal of Rehabilitation, July-Sept, 2000 by Marti L. Riemer-Reiss, Robbyn R. Wacker

Assistive technology devices enable individuals with disabilities to participate in society as contributing members. These devices are also credited with helping individuals with disabilities achieve optimal functional ability and independence (Phillips & Zhao, 1993). Furthermore, technology is recognized as a means for individuals with disabilities to access the mainstream society (Uslan, 1992) and as a mode to potentially equalize the capabilities of persons with and without disabilities (Scherer, 1993a). According to the National Center for Health Statistics, more than 17 million Americans used an assistive technology device in 1994 to accommodate for an impairment (National Center for Health Statistics, 1997, November 13).

The increase in assistive technology use may be attributed to the federal laws passed which support funding for assistive technology devices and services. Although these laws increase the accessibility of assistive technology, many recipients are dissatisfied with devices and services. Dissatisfaction typically results in discontinuance of assistive technology devices. A national survey on technology abandonment found that 29.3% of all devices obtained were abandoned (Phillips & Zhao, 1993). Discontinuance of assistive technology represents a waste of time and money. There is however, limited research documenting factors related to assistive technology discontinuance from consumers' perspectives. It is important to gain an understanding of these factors to aid professionals in designing assistive technology service delivery techniques. The purpose of this study was to determine the factors associated with assistive technology continuance or discontinuance. This article discusses the concepts of Rogers' diffusion of innovation theory and the background literature related to assistive technology discontinuance. The methodology, participants, results and implications of this study are also summarized.

This research is guided by Rogers' theory of diffusion (1995) which offers a comprehensive philosophy regarding the processes involved in accepting or discontinuing use of technology. According to this theory, discontinuance is a decision to discard an innovation after previously accepting it. The two types of discontinuance are replacement (rejection of an innovation for an improved one) and disenchantment (rejection of an innovation due to dissatisfaction). Relative advantage, compatibility, trialability and re-invention are concepts derived from the diffusion of innovations theory. They are examined in the present study to determine if they are related to continuance/discontinuance of assistive technology devices by individuals with disabilities.

Relative advantage is identified as a significant factor associated with continuance or discontinuance of technology. This factor relates to the characteristics of the device itself (Rogers, 1995) and examines the relative advantage that continued use of a device offers a user over discontinuing its use. A study of long term consumers of assistive technology devices indicated that three of the four most important criteria consumers used to assess assistive technology devices (effectiveness, operability and durability) were related to relative advantage (Batavia & Hammer, 1989).

The second concept, compatibility, refers to the degree an innovation is perceived as consistent with the needs of the adopter (Rogers, 1995). According to Rogers, compatibility is a factor related to continued use of an innovation.

Trialability, the degree to which the user can experiment with the technology prior to acquisition, was also related to continued use of technology (Rogers, 1995). Research demonstrated, however, that individuals with disabilities are not often given the opportunity to try out assistive technology devices prior to purchasing them. For instance, Parette, VanBiervliet and Holbrook (1990) found that almost half of the individuals with visual impairments sampled were unable to try out their devices prior to purchasing them. Individuals denied the opportunity to try out technology before purchasing it must rely on the judgment of the professional who selects the device for them (Parette & VanBiervliet, 1992). Theoretically, and pragmatically, trialability has been noted as an effective means to prevent technological discontinuance and promote ongoing use (Parette & VanBiervliet, 1992). It has not, however been fully incorporated into the process of distributing technology to individuals with disabilities.

The degree to which technology is changed or modified by a user in the process of its adoption and implementation is termed re-invention (Rogers, 1995). Many individuals with disabilities have devised additions or modifications to their devices to meet their unique needs (Zola, 1982). As a result of re-invention, technology can become more appropriate in meeting an individual's present needs and more responsive to future needs that arise (Rogers, 1995). Although re-invention was studied extensively from a broad theoretical perspective in the diffusion of innovations theory, empirical research relating re-invention to continued use of assistive technology by individuals with disabilities is nonexistent.