Individual assessment for assistive technology solutions: Reflections on a thirty-year experience

Individual assessment for assistive technology solutions (AT) is often carried out as a specialist consultation in Assistive Technology Centres (ATCs), especially when inter-disciplinary competence and trial equipment are required. The SIVA service of the Don Gnocchi Foundation was the ATCs pioneer in Italy. SIVA stands for Servizio Informazione Valutazione Ausili (Assistive Technology Information and Assessment Service). In over 30 years of activity it offered about 23.000 individual consultations to clients from all over Italy, and developed methodologies and protocols for provision of this service. In parallel, it established a national AT information system-first as a local database, then as a web Portal (Portale SIVA) that later was the initiator of the European Assistive Technology Information Network (EASTIN)-and various educational initiatives including a Postgraduate Course and a permanent education programme composed of monthly Seminars. These parallel activities helped disseminate AT knowledge among end-users, health care professionals, industrialists and policy makers; contributed indirectly to the establishment of other ATCs throughout Italy, most of them participating today in a national network called GLIC; and also led to a gradual change in the profile of clients who applied for individual consultation. As time evolved, the clients' requests tended to be more focused and complex, as answers to simpler problems could be more often found in their community services, or in local ATCs, or even online through the SIVA and the EASTIN portals. This article offers a retrospective look at this thirty-year experience, which in turn is divided into three ten-year phases: the pioneer age (1983-1992, in which the service gradually took shape), the maturity age (1993-2002, in which the service operated as a self-standing Unit with nation-wide scope) and the integration age (2003-2012, in which the service was up-taken by the clinical rehabilitation services of the Don Gnocchi Foundation). The evolutions of client profiles, topics addressed and organisational models are described; they are also correlated to the parallel evolution of the SIVA information system and educational activities.