Revolutionising accessibility, the APD way

Around 1 billion people (15% of the global population) have a disability, as per a World Bank study. India has 40-80 million people with disabilities, and they often struggle with basic self-care and hygiene tasks known as activities of daily living (ADLs). Assistive adaptive technology is crucial in helping PwDs overcome these challenges.

In light of the recent celebration of National Technology Day, it is an apt time to examine how rehabilitative technology can assist persons with disabilities to lead fulfilling lives. And how we here at the Association of People with Disability (APD) are doing our bit.?

Adapt to Assist

Assistive adaptive technology (AAT) is an expanding field that aims to enhance the quality of life for individuals with disabilities. AAT refers to any device, system, or product that is used to improve the functional abilities of people with disabilities, ranging from mobility aids such as wheelchairs and walkers to hearing aids, braille printers, computer screen readers, and sound-modifying systems for visually impaired.

Assistive technology can be custom-made at specialised AAT units, like the one present at the APD campus, or bought from a hospital or a medical store.

To prevent negative outcomes such as pressure sores, muscle tightness/thinning, contractures, deformities, and joint subluxation (partial dislocation), it is advisable to acquire AAT devices from a provider that can customise the equipment to the individual's specific needs, and provide proper training on its use and adjustment. Ill-fitting aids can impede an individual's recovery and exacerbate secondary complications.

The AAT department at APD's Lingarajapuram campus operates on the principle of "For the people, By the people," as the individuals working in this unit have disabilities themselves.

Several individuals who have come to APD to obtain assistive devices and equipment have shown a keen interest in learning the skill themselves, which they have turned into a source of livelihood. Around 20 persons with disabilities are now employed in APD’s AAT unit and can relate to and empower the lives of those they serve through the products they produce.

The unit manufactures and donates 7000+ customised AAT devices annually. Major products that are designed at APD include but are not limited to, Ankle Foot Orthosis (AFO) as well as Knee Ankle Foot Orthosis (KAFO) devices, and customised products that include gaiters, hand splints, body braces, standing frames, artificial limbs, rollators, posterior walkers, footwear, posterior walker, CP chairs, corner chairs, hearing aids amongst others.

When a suitable product is not readily available, APD engages in reverse engineering to modify and create customised products that cater to the unique requirements of individuals with disabilities.

Why customise & train?

Since individuals with disabilities have a distinct need with regard to body composition, muscle mass, joint range of motion, and environmental factors, personalisation and customisation of products are crucial.

Once assistive devices and equipment are provided, the staff at APD also extend training to the individuals on how to use them effectively, and their immediate family members are also trained. Dr. Senthil Kumar, CEO of APD, highlights the distinctiveness of this approach, “When we give a wheelchair to the beneficiary for the first time, we need to teach them how to manoeuvre the wheelchair. On ramps, you can’t just push the wheelchair from the top to the bottom. That is a dangerous mistake which could lead to severe injury. Instead, you need to reverse the wheelchair and take the person down backwards. This kind of learning is essential. We also teach them basic maintenance and troubleshooting.”

He adds, “We hold camps across south India, take measurements, and customise models according to people’s needs. We take the finished aids and do a final fitment and adjustment with the person. We also do follow-ups within a week to understand the adaptation.”

Approach towards decision-making

APD adopts a client-centric approach rather than a prescriptive model. This entails taking individuals with disabilities through a process where their background, situation, disability, and whether they will be operating equipment independently or with the assistance of a family member, are all carefully considered. It also follows the matching person technology approach which aims at selecting the best device for the user.

“We study the person and their disability. Our rehab expert then provides the appropriate device. We help them understand what the device actually does, we allow them to experience it, wear it, and feel it. We encourage peer-to-peer interaction. Individuals can come to visit our centre to understand what type of wheelchair and assistive devices we have. They can use it as a demo unit and can talk to beneficiaries and learn from them.”

Sudha, a key member of the prosthetic and orthotics department at APD and a cerebral palsy survivor, shares, “It brings me a lot of pleasure to make gaiters for others and hear their concerns. When I see them walk comfortably, it brings me relief. Having a disability myself, I can understand where they are coming from. For the people, By the people model is something that I really appreciate the most about APD.”

Article written by Urvi Jacob