What the HECK is a Rehab Engineer?!

So, what the heck IS a Rehab Engineer?!

You have likely heard of rehab professionals, such as Occupational, Physical and Speech therapists.  You have likely heard of engineers, such as electrical, mechanical and civil. But what the heck is a rehab engineer?

Well, it is sort of a hybrid of the rehab and engineering professions. A rehab engineer works with individuals with a temporary or permanent disability to design and implement (assistive) technology solutions.

According to the Rehabilitation Engineering Society of North America (RESNA), Rehabilitation Engineering is,

“the systematic application of engineering sciences to design, develop, adapt, test, evaluate, apply, and distribute technological solutions to problems confronted by individuals with disabilities in functional areas, such as mobility, communications, hearing, vision, and cognition, and in activities associated with employment, independent living, education, and integration into the community.”

For those of you less familiar with the industries surrounding persons with disabilities, “assistive technology, also known as AT, is defined as,

“Any item, piece of equipment, or product system, whether acquired commercially, off the shelf, modified or customized, that is used to increase, maintain, or improve the functional capabilities (Individuals with Disabilities Education Act, 2004)” of an individual with a disability.

Although technology has been modified as needed to best meet the needs of the user for almost 150 years, starting when the Audiophone Bone Conduction Amplifier (first hearing aid) was invented in 1874, the modern Assistive Technology industry is relatively young as far as industries go.  Let me give you a brief history of modern AT development (and – watch for a future blog on the details of the History of AT, including legislative impacts).

• Sep 21, 1981 – The first computers to aid children with learning disabilities were used in classrooms.

• Between 1982 and 1996 several assistive technology companies, such as Dynavox and Kurzweil, were founded in an effort to create tools for improved access to educational, computer and communication related activities.

• 1996-2008- There were relatively few notable technology developments to highlight. 

• 2006- This is the year I entered the industry out of graduate school. This was also about the time when the mainstream population was just starting to explore all the ways that assistive technology could be “applied to problems confronted by individuals with disabilities in functional areas, such as mobility, communications, hearing, vision, and cognition, and in activities associated with employment, independent living, education, and integration into the community.”

• 2008 and beyond –
  • New generations of early technologies released;
  • High tech devices for computers, communication and environmental controls were developed;
  • Automated systems and interfaces continue to develop;
  • Mainstream commercial companies, such as OXO, incorporate universal design into their product lines;
  • AI, robotics and architecture have taken an interest in AT and universal design/access.
  • Initiatives from modern research spawns new innovations each year.

In the world of healthcare professionals and rehab engineers, we use a collaborative approach to service delivery in order to focus on helping individuals access functional activities of daily living in the areas of education, vocation, recreation, home and community.

The focus of an Occupational Therapist is on rehabilitating and improving deficits or impairments via the use of functional activities, often employing assistive technology as a rehab tool.

The focus of a rehab engineer is on the strengths of the individual, and providing them with tools that enable them to be functional in their preferred activities and to see new possibilities in living.

So,  what exactly do we do?  The challenge in answering that question is that there is more that we can do, than we can’t. We can address AT needs in all ages, across all environments, to address goals in all areas of living.  Here is an example to highlight the process and outcome for one area of focus.

Claire is a high school student with Cerebral Palsy approaching graduation.  Her goal is to start college in the fall.  Although she will have a Personal Care Aide as a roommate in the dorm, and an academic aide in the classrooms, she wants to perform her academic tasks with as much independence as possible. This means she needs a reliable, efficient access option for note taking and computer access for course work, such as reading and writing assignments.

Due to a high level of muscle spasticity in her upper extremities, her access barrier for computer access is related to efficient access for typing and mouse activation.  Since her dexterity is affected she also needs alternate support for note taking.  The assessment process identifies that her speech is not clear enough for voice recognition software for long dictation, but use is possible for simple commands. The main focus for computer access shifts to interface method, control sight, software and positioning for best functional movement.

The resulting system consists of a laptop with a modified mount on Claire’s wheelchair tray in order for her to obtain the best angle of access for her field of vision, and best access with a joystick and sip and puff activation.  The pneumatic switch is placed near the left side of Claire’s face, as scoliosis makes it easiest to activate switches on the left side.  In addition to utilization of the voice recognition features in the computer OS, a word prediction software was recommended for extended typing activities.  Note taking assistance was provided via Livescribe pen which recorded the audio of the lectures, as well as the visual and audio feedback for the written notes taken.  This would be used by any aide assisting Claire in classes, also providing a study aid for test preparation. Additional academic support software was provided to aid in reading textbook material, as well as an ability to make annotations independently as needed via computer.

These components together helped position Claire for the greatest chance at success academically as she transitioned to college, but also addressed her goal (and motivation) of performing her academic tasks with the highest level of independence possible.

By bringing a knowledge of human physiology, engineering and rehab services, Rehab Engineers are a versatile and valuable member of the service delivery team responsible for assessing, designing and implementing assistive technology solutions.