The impact of assistive technology and environmental interventions on function and living situation status with people who are ageing with developmental disabilities

Purpose: A longitudinal study of 109 people with developmental disabilities, age 35 and older, was done to study the additive impact of mid to later life assistive technology and environmental interventions (AT-EI) on function and living situation status. All subjects were trying to transition out of institutional settings to community settings. Method: Functional status were measured at two times (Time 1 baseline and Time 2 an average of three years post intervention) on 32 functional activities under two conditions: without AT (person only) and with AT (environment adjusted). Rasch analysis was performed to convert ordinal functional scores to equal interval measures, with 95% confidence intervals computed to compare differences in function, with and without AT, across time. Results: Results indicated that over 70% of subjects had better function with AT versus without AT at both time points. Over time, function did not change when rated without AT; however, when rated with AT, 13.6% had better function at Time 2. Subjects living in the community at Time 2 had significantly higher functional scores as compared to subjects in institutions, regardless of AT condition. Additional quantitative and qualitative data on AT-EI use, needs, and barriers and supports to its integration into everyday activities are reported. Conclusions: Results suggest a beneficial impact of later life AT-EI assessment and programming for people who are ageing with developmental disabilities, and qualitatively point to the influence of the social and physical living context upon AT-EI use and relationship to community living decisions long term.