I. The ATOMS Project
A. RFP from NIDRR
NIDRR specifically requested that the two assistive technology outcomes projects (CATOR from Duke University) and the ATOMS Project based at the University of Wisconsin – Milwaukee address three specific areas. These were to a) perform a needs assessment about assistive technology outcomes, b) develop and explore new measurement methodologies, and c) examine the issues surrounding assistive technology device abandonment.
The goals of the ATOMS Project were developed around these three charges from NIDRR. Extending previous work in this area and launching new initiatives to push the field forward the ATOMS Project identified several strategic core values that included:
- Applying a strong multidisciplinary team philosophy,
- Focusing on practical use of measurement instruments,
- Building on past outcomes research,
- Keeping the person with disability central in mind, and
- Using technology and science to advance AT outcomes measurement.
B. ATOMS Project Objectives & Timeline
Five specific project objectives targeted the ATOMS Project activities from 2001-2006. First, we planned to perform a comprehensive needs assessment that included field scans, focus groups, and database analyses. Second, we proposed to develop several prototype instruments and revise current promising methodologies as indicated by the needs assessment. These included instruments that focused on school system assistive technology programs, an assistive technology outcomes isolation estimation measure, a cost identification protocol, and updates to the School Functional Assessment (SFA) and Occupational Therapy Functional Assessment Tool (OT FACT) instruments. Third, we proposed to establish consensus regarding assistive technology outcomes systems design. This included holding a number of participatory research focus groups and holding assistive technology symposia and consensus meetings. Fourth, we created an objective to perform an abandonment research analysis. Fifth, we planned to create a centralized web-based dissemination medium for review papers, articles, and other AT outcomes resources.
The timeline to launch the ATOMS Project was the five year span from 2001 to 2006. The initial years focused on the needs assessment expanding into the exploratory studies and the abandonment analyses. By the end of the five years, a long list of accomplishments had been achieved.
C. ATOMS Project Scope
The scope of the ATOMS Project was broad, however, focused on outcomes measurement as opposed to outcomes research. The project was not created to perform outcomes research studies, but to examine the methodologies and explore new methodologies for measuring assistive technology outcomes beyond traditional instruments and approaches. The ATOMS Project stakeholders were defined as people with disabilities, service providers, manufacturers, assistive technology developers, funding agencies, researchers and the scientific community.
The ATOMS Project was highly interdisciplinary in both the educational backgrounds and experience of its personnel. Ten professional areas were represented: rehabilitation engineering, industrial engineering, health services administration, vocational rehabilitation, occupational therapy, assistive technology, special education, psychology/economics, occupational science, and health services outcomes.
R2D2 Center team
- Roger O. Smith, Ph.D., OT
- Dave Edyburn, Ph.D.
- Todd Schwanke, MSE, ATP
- Kathy Rust, M.S., OT
- Sally Fennema-Jansen, Ph.D., OTR
- Neil Oldridge, Ph.D.
- Mary Taugher, Ph.D., OTR
- Bonnie Kennedy, Ph.D., OTR
- Kelly Fonner, M.S.
- Laura Owens, Ph.D.
- Hanh Trinh, Ph.D.
- Mike Brondino, Ph.D.
The project also supported 17 graduate students and seven undergraduate students.
B. Partners and Advisors
The ATOMS Project depended highly on partners across the nation and work teams within different areas of assistive technology outcomes measurement. These included some significant subcontracted work with the following investigators and agencies as well as non-paid collaborators.
- Mary Binion, formerly of the Ohio Department of Education, Columbus, Ohio;
- Al Noll of the University of Wisconsin-Stout, Stout Vocational Rehabilitation Institute, Menomonee, Wisconsin;
- Gerry Warren of Warren and Associates, Seattle, Washington;
- Fran Harris of Georgia Tech, CATEA, Atlanta, Georgia, formerly of Helen Hayes Hospital, New York City, New York;
- James Lenker and Tina Oddo of University of Buffalo (SUNY), Buffalo, New York;
- Steven Mendelsohn, Attorney, New York City, New York.
- Cathy Bodine of the University of Colorado, Denver;
- Cleo Eliason of the Wisconsin Division of Vocational Rehabilitation, Madison, Wisconsin;
- David Gray of the Washington University School of Medicine, St. Louis, Missouri;
- Gregg McGrew of the University of Colorado, Denver formerly of Helen Hayes Hospital, New York City, New York;
- Lee Schultz of Independence First, Milwaukee, Wisconsin;
- Steven Sprigle of CATEA, Atlanta, Georgia formerly of Helen Hayes Hospital, New York City, New York.
C. Consensus Meetings
The ATOMS Project held numerous consensus meetings, focus groups and a key methodology summit. These included a set of assistive technology consumer focus groups with people with disabilities. We also held a symposium with assistive technology outcomes researchers at a St. Louis conference midway through the ATOMS Project’s first five years. We held town halls at three major assistive technology conferences (RESNA, CTG, and ATIA) and an assistive technology N = 1 methodology summit in the final year of the ATOMS Project specifically to discuss the value of an N = 1 methodology for assistive technology outcomes research. These meetings and symposia have been documented through our technical reports and proceedings which are available on the ATOMS Project website.
D. Dissemination Strategies
Numerous dissemination mechanisms have been applied throughout the first five years of the ATOMS Project. The bibliography of publications follows as Appendix B. The ATOMS Project website (www.atoms.uwm.edu) includes primary resources, links to other resources, and highlights of the ATOMS Project 2001-2006 activities. The website is divided into two major resource categories, the first being Activities and the second Products. The Activities page generally follows the ATOMS Project objectives and goals dividing the resources into categories of 1) Needs Assessment, 2) Research and Development Projects, and 3) Abandonment Analysis. Finally, a fourth major category relates to publications, presentations, and bibliographies.
In addition to numerous technical reports, the bibliographical documents on the website provide a substantial resource for ATO researchers. The Activities webpage links directly to activity reports organized by the original RFP charge and our exploratory R&D projects in addition to other resources which were developed or accumulated by the ATOMS Project. The Products webpage specifically lists the materials developed by the ATOMS Project including organized by eight categories. It provides an AT outcomes master bibliographical listing which is searchable using the find feature within a web browser. The Product webpage also includes links to the technical reports including field scans, an interactive database on assistive technology assessments, educational materials, two key theoretical models, and annotations of websites related to assistive technology outcomes.
The ATOMS Project team delivered 76 presentations related to our work during the 2001-2006 time period. The majority of these were peer reviewed conference submissions, however several were invited presentations (see Appendix C).
III. ATOMS Project Findings and Accomplishments
We have divided the major accomplishments from the 2001 through 2006 period of the ATOMS Project into five major categories:
- Scientific support for theory development
- Articulated needs and strategies for ATO in the schools
- Instrument development – development of alternative methodologies for ATO collection in natural environments
- Needs assessment discoveries, and
- Making resources available.
These categories cite 25 specific accomplishments as significant contributions to the assistive technology outcomes measurement field. Each accomplishment lists references of ATOMS Project products as supportive documentation. The Accomplishments listing follows as Appendix A.
IV. Impact, Implications, Recommendations
A. AT Outcomes – So What?
The ATOMS Project, 2001 through 2006, has brought a substantial amount of information to the field about the needs in assistive technology outcomes measurement. Additionally, the ATOMS Project has explored and suggested several new methodologies and approaches for measuring assistive technology outcomes not only in single instruments but as a system. This significant set of resources is available on the ATOMS Project website (http://www.r2d2.uwm.edu/atoms/) for any future efforts in the assistive technology outcomes investigations or measurement.
We recommend that any future work in assistive technology outcomes research and measurement carefully examine the accomplishments and the resources provided by the ATOMS Project. It is obvious to the ATOMS Project team that substantial advances are still required to adequately document the impact and assure accountability for the assistive technology interventions that are so essential for people with disabilities.
The ATOMS Project outcomes measurement resources are highly appropriate across service settings which provide assistive technology. These include:
- the school systems which have assistive technology teams or provide assistive technology for students with disabilities,
- the vocational rehabilitation system that provides assistive technology and services for people with disabilities in search of improved employment and productive work activities,
- the medical rehabilitation system where assistive technology is provided in acute, sub-acute and long-term care programs for people with disabilities, and
- for people with disabilities and the independent living community services that address the implementation of assistive technology in the natural and living environments.
These four service settings tend to act independently and be funded by separate entities. However, the ATOMS Project has identified overlap of AT devices for individuals who use assistive technology devices across the lifespan. To more clearly and empirically document the true benefits of assistive technology devices and services for people with disabilities ATO funding needs to be integrated across settings.
Finalized March 29, 2007