AOTA’s NBCOT® Exam Prep
Activity Analysis, Assistive Technology, EvidenceBased Practice, and Home Accessibility
Activity and Occupational Analysis
I. Definition and Goals of Activity and Occupational Analysis
A. Occupational analysis includes contexualization of the activity from the perspective of
the client’s situation and desires (needs and wants) for occupation. (AOTA, 2020).
B. Activity analysis involves analyzing an occupation or activity from a broader
perspective within a given culture without contextualization. “Many professions use
activity analysis, whereas occupational analysis requires the understanding of
occupation as distinct from activity and brings an occupational therapy perspective to
the analysis process” (Schell et al., 2019, in AOTA, 2020, p. 19).
C. “Occupational therapy practitioners analyze the demands of an occupation or activity
to understand the performance patterns, performance skills, and client factors that are
required to perform it” (AOTA, 2020, pp. 19–20).
D. “The goal of occupational or activity analysis is to identify the demands of occupations
and activities on the client” (AOTA, 2020, p. 22).
II. When Occupational Analysis and Activity Analysis Are Performed
A. Occupational analysis and activity analysis are one part of the analysis of occupational
performance. On reviewing a client’s evaluation and goals, occupational therapists may
begin to design a client-centered and occupation-based treatment plan that targets
specific performance skills they have selected. On the basis of the client’s health
condition and ability, preferences, and needs, occupational therapists select an
appropriate therapeutic occupation or activity on the basis of their thorough
knowledge of activities.
B. Quick analyses of occupations and activities are ongoing as occupational therapists
deliver a treatment session; occupational therapists must, of course, be flexible in their
treatment plan. For instance, suppose an occupational therapist had intended to review
fall prevention strategies with the client during a breakfast preparation task but learns
at the start of the session that the client has already eaten and is not hungry. A new
plan must be proposed; the occupational therapist chooses to review the fall prevention
techniques by having the client perform a similar task of gathering and folding clothes
(Crepeau et al., 2014, pp. 244–247).
III.
Format of Activity Analysis
A. Identify occupation or activity demands, person capabilities, and context to determine
which aspects to target in intervention (Grabanski & Janssen, 2020).
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1. Activity demands are the “aspects of an activity needed to carry it out, including relevance and
importance to the client, objects used and their properties, space demands, social demands,
sequencing and timing, required actions and performance skills, and required underlying body
functions and body structures” (AOTA, 2020, p. 74; see Table 11, p. 57).
2. Person capabilities include performance patterns, performance skills, and client factors.
a. Performance patterns are used in the process of engaging in occupations and may support or
hinder performance (AOTA, 2020, p. 12). Performance patterns consist of
i. Habits
ii. Routines
iii. Roles
iv. Rituals (AOTA, 2020, Table 6).
b. Performance skills are “observable, goal-directed actions that result in a client’s quality of
performing desired occupations” (AOTA, 2020, p. 80). Performance skills are typically
categorized as follows:
i. Motor skills
ii. Process skills
iii. Social interaction skills (AOTA, 2020, Table 7).
c. Client factors relate to specific person capabilities that are within the person and impact
occupational performance (AOTA, 2020, p. 14). Client factors consist broadly of three
categories:
i. Values, beliefs, spirituality
ii. Body functions
iii. Body structures (AOTA, 2020, Table 9).
3. “Context is the broad construct that encompasses environmental factors and personal factors”
(AOTA, 2020, pp. 9, 36–40). Context can affect occupational performance.
a. Personal factors relate to a person’s background of demographic factors, customs, and
beliefs. These are not considered positive or negative; rather, they are considered internal
to the individual. Some examples of personal factors include age, gender, sexual
orientation, cultural identification, and social background (AOTA, 2020, Table 5).
b. Environmental factors are physical, social, and attitudinal elements that surround the
individual. Environmental factors generally facilitate or hinder a person’s functioning and
are external to the individual (AOTA, 2020). Examples include natural and human-made
elements, products and technology, relationships, and services and policies (AOTA, 2020,
Table 4) and include environmental demands such as space demands, equipment height,
work space surface area, visual contrast, social demands, and temperature (Grabanski &
Janssen, 2020, Table 3-1).
B. Match the activity with the chosen theoretical lens.
1. When working with people whose injuries warrant a biomechanical approach, analyze
activities in terms of the typical strength, ROM, and endurance needed to perform them
(Crepeau et al., 2014, p. 236).
2. For people who have mental illness, analyze activities by their use of social skills,
communication, and emotion regulation capabilities (Crepeau et al., 2014, p. 244).
C. Adjust the difficulty level of the occupation or activity using a variety of approaches to
promote client performance.
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1. Grading
a. Based on a client’s performance, grading involves increasing (“upgrading”) or decreasing
(“downgrading”) the demands of an activity step by step to promote occupational
performance when tasks are too easy or too difficult to complete.
b. Activities are graded to improve the deficits or skills and to promote psychomotor learning
(Grabanski & Janssen, 2020); the occupational therapist carefully changes the demands of
the activity to more appropriately match the client’s ability (Gillen, 2014, p. 323).
2. Fading: As a client’s skills emerge or improve, the occupational therapist slowly lessens or
eliminates the support provided. The result is improved independence in the task or activity
(Helfrich, 2014, p. 592).
4. Coaching: This approach includes communicating expectations and support in a way that helps
the client perform and improve in tasks and skills (Helfrich, 2014, pp. 598–599).
5. Adaptation and modification
a. This approach is also known as activity synthesis: “the process of combining component
parts of the human and nonhuman environment so as to design an activity suitable for
evaluation or intervention relative to performance” (Cole, 2018, p. 7), and it involves
modifying an activity to match the client’s abilities.
b. Adaptation and modification aim for the client’s successful involvement in preferred
occupations; instead of working to improve or change a client’s ability, this strategy focuses
on changing the activity demands to match a person’s current ability (Gillen, 2014, pp. 331–
333). This may focus on specific body functions, required actions and performance skills,
objects and their properties, sequence and timing (Grabanski & Janssen, 2020).
i. Decrease the demands.
•
•
Make the activity require less cognitive skill.
Reduce or change the necessary physical skills to complete the task.
•
Empower clients to instruct their caregivers; for example, a patient with end-stage AIDS who
mostly stays in bed can be encouraged to alert his or her caregiver to the time for
repositioning, how to use wedges or pillows to properly protect skin, and how to examine skin
for any signs of breakdown.
Instruct clients in adaptive positioning or organization of workspaces to ease occupational
performance; for example, a client with carpal tunnel syndrome can modify home and work
office to promote neutral wrist positioning during computer tasks.
ii. Implement the use of adaptive equipment or assistive devices; for example, instruct a
client with hip precautions to use a sock donner.
iii. Alter the social or physical environment.
•
Assistive Technology
I. Definitions
A. Assistive technology devices are defined as “any item, piece of equipment or product
system whether acquired commercially off the shelf, or customized, that is used to
increase, maintain or improve functional capabilities of individuals with disabilities”
(Assistive Technology Act of 2004, Pub. L. 108-364; Schwartz, 2020, p. 445).
B. Assistive technology services are defined as “any service that directly assists an
individual with a disability in the selection, acquisition, or use of an assistive
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technology device” (Assistive Technology Act of 2004, Pub. L. 108-364; Cook & Polgar,
2015, p. 2).
II. Terminology
A. No technology refers to, for example, hook-and-loop fasteners, grab bars, and built-up
handles.
B. Low technology includes inexpensive items that are readily available commercially (e.g.,
jar opener, sock aids, reacher).
C. High technology includes devices, hardware, or software that may require specific
training to use (e.g., augmentative communication devices, powered mobility).
III.
Frames of Reference (Cook & Polgar, 2015, pp. 7–14)
A. Human Activity Assistive Technology (HAAT) model (Schwartz, 2020, p. 446); includes
interactions and balance among four major elements:
1.
2.
3.
4.
Human
Activity
Assistive technologies
Context
B. Information-Processing Model of the Assistive Technology System User
1. Sensors; used to obtain data from the environment
a. Visual function, visual acuity, visual field, tracking, scanning, and accommodations
b. Auditory function and thresholds
c. Somatosensory function
d. Control of posture and position
2. Central processing
a. Perception
b. Cognition
c. Psychosocial
d. Neuromuscular control
3. Effectors: the neural, muscular, and skeletal elements of the human body that provide
movement or motor output
a. Resolution
b. Range
c. Strength
d. Endurance
e. Versatility
IV. Evaluation of Assistive Technology
A. Identify task or activity that the client wants to accomplish.
B. Identify the occupation or activity demands and person capabilities to determine which
aspects to target in intervention.
C. Determine the environment and context in which the activity will occur.
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1.
2.
3.
4.
5.
6.
7.
Home
School
Work
Community
Social
Cultural
Virtual
D. Identify assistive technology devices.
1. Determine the human–assistive technology interface: How will the device be activated (e.g.,
switches, keyboard, joystick, mouth stick, voice activation, eye gaze)?
2. Consider the processing method (i.e., how the device will process the information after input).
3. Determine the output (e.g., turn on the lights, close the garage door, reply to e-mail).
4. Determine whether built-in feedback is needed to ensure proper use of the device (e.g., auditory
feedback, tactile feedback).
E. Identify funding source.
1.
2.
3.
4.
5.
6.
7.
8.
Private, state, and federal insurances
Workers’ compensation
State vocational and educational services
Department of Vocational Rehabilitation
Private
Donation
Loaner
Grant
V. Intervention
A. Gather information from various sources, including the client, supporting family or
caregiver, and all team members.
B. Consider proximal stability through proper positioning.
C. If possible, obtain loaner or demonstration pieces for trials.
D. Ensure proper positioning of the device to enable ease of access.
E. Keep devices as simple as possible—more is not better.
F. Ensure the chosen device is dependable (i.e., consistent performance in every use).
G. Provide multiple training opportunities in different environments and contexts.
VI. Technologies as Sensory Aids
A. For visual impairment (Cook & Polgar, 2015, pp. 314–351)
1. Use of alternative sensory pathway
a. Tactile substitution (e.g., bump dot, braille)
b. Auditory substitution (e.g., books on tape, text to speech, talking devices and appliances)
2. Reading aids
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a. Reading aids (e.g., handheld magnifier, field expanders, telescopes, braille, recorded audio
material, optical character recognition)
b. Nonoptical aids (e.g., enlarged print; reverse reading, i.e., white print on a black
background)
c. Electronic aids (e.g., closed-circuit TV, electronic magnifier, tablet computers)
3. Mainstream technologies accessibility
a. Graphic user interface
b. Computer adaptations (magnification window for physical screen, screen readers)
c. Mobile phones and tablets
d. Visual access to Internet (user agent, web browsers, web site accessibility)
4. Mobility and orientation aids
a. Cane with warning device (e.g., UltraCane with ultrasound beams and sensors [Sound
Foresight Technology Ltd., Harrogate, England], laser cane)
b. Alternative mobility devices
c. Electronic travel aids
d. Global positioning system displays
e. Indoor navigation
5. Occupational aids (self-care, work and school, play and leisure)
a. Kitchen aids (e.g., boil alert, liquid level indicator, talking kitchen scale)
b. Medication management (e.g., “talking” medication box, magnifying pill cutter, jumbo pill
box)
c. Miscellaneous (e.g., lighted magnifying makeup mirror; large universal remote control for
television; talking watch or clock, bar code reader with recorded speech)
B. For auditory impairment (Cook & Polgar, 2015, pp. 352–374)
1. Use of an alternative sensory pathway
a. Tactile substitution (e.g., Tadoma method—tactile lipreading by putting the thumb on the
speaker’s lip and the fingers along the speaker’s jawline; vibration)
b. Visual substitution (e.g., flashing lights, speech-to-text, captioning)
2. Hearing aids
a. Air conduction
b. Bone conduction
c. Cochlear implants
3. Telephone access
a. Teletype device
b. visual telephones
c. voice over Internet
d. Mobile phone access
4. Alerting devices (telephones, doorbells, smoke alarms)
5. Captioning
VII.
Compensatory Technologies for Cognition (Cook & Polgar, 2015, pp. 375–410)
A. Memory aids (e.g., personal digital assistants, smartphones, digital recorders, reminder
applications)
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B. Time management: devices that remind the client of the preprogrammed task or event
to occur (e.g., smartphone, tablet computer)
C. Prompting, cueing, and coaching (e.g., medical paging system, global positioning system
locator, smart house)
VII.
Mobility Technologies (Cook & Polgar, 2015, pp. 229–262)
A. Wheelchair
1. Manual versus powered (Consider the control interfaces for powered mobility system: e.g.,
joystick, head control, sip and puff.)
2. Recliner, tilt-in-space
3. Standing frames
4. Stand-up wheelchair
5. iBOT Mobility System (Independence Technology LLC, Warren, NJ)
VIII. Environmental Control Technologies (Cook & Polgar, 2015, pp. 284–313)
A. Enhance the client’s independence in operating appliances or devices in the
environment
B. Low technology (e.g., key holder, stove knob turner, doorknob extender)
C. EADLs
1. Control functions: on–off light control, television, radio and appliances, open or close door or
drapes
2. Transmission methods: remote control, X10 house wiring, ultrasound, infrared, radio
frequency, Bluetooth
3. Trainable versus programmable controllers
IX. Augmentative and Alternative Communication (AAC) System (Cook & Polgar, 2015,
pp. 411–456)
A. For clients who have severe speech and language impairments across the life course
B. Team approach
1.
2.
3.
4.
5.
Client and family
Speech–language pathologist
Physical therapist
Teacher
Teacher’s aide or job coach
C. Evaluation and intervention processes
1. Evaluation
a. Predictive assessment—understanding the client’s current needs and predicting future
needs
b. Serial assessment—continuing evaluation to meet changing needs
c. Curriculum-based assessment—to help coordinate and integrate use of AAC in classroom
d. Assessing barriers to participation
i. Cultural
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ii. Social
iii. Physical
iv. Performance skill
e. Assessing representation—what types of symbols the client will use to communicate
2. Matching the human–technology interface with the client’s physical and performance skill
abilities
a. Joystick
b. Keyboard
i. Expanded keyboard: large keys for clients with limited motor control and accuracy
ii. Miniature keyboard: small keys for clients with limited ROM and control
iii. Light touch activation system for clients with decreased strength
iv. Delayed touch activation system for clients with poor motor control and accuracy
v. Keyboard guard to prevent clients from making mistakes when they have poor motor
control or ataxia
c. Switches; can be positioned to be operated by different parts of the body and extremities
(e.g., head control, between legs, elbow or shoulder control)
d. Alternative pointing interfaces
i. Eye gaze: for clients with very limited to no hand function but good stability control of
the head
ii. Mouth stick: for clients with very limited to no hand function and good head control or
movement; must have adequate respiratory support
iii. Head pointer: for clients with very limited to no hand function and good head control or
movement. Electronic head-controlled pointing systems convert head movements into
mouse movements on computer screens (University of Washington, n.d.).
iv. Voice control: for clients with very limited to no hand function or incoordination
•
•
Determine vocabulary retrieval techniques.
Determine the optimal visual display for the user.
3. Implementation
a. Mounting and positioning of devices
b. Vocabulary selection and expansion
c. Physical skill development
d. Developing three types of communication competency through systematic training:
i. Operational competence: competency in operating the AAC device
ii. Linguistic competence: thorough understanding of the AAC device’s symbol system and
rules of organization
iii. Social competence: knowledge of skills in sociolinguistic (e.g., turn taking, initiating a
conversation) and sociorelational (i.e., understanding the interaction between people in
conversation) areas
e. Periodic follow-up
4. Special considerations
a. Portability: easy to use in a variety of environments and contexts
b. Accessibility: mounting and positioning for independent operation
c. Dependability: durable, consistent performance
d. Vocabulary flexibility
e. No tech (e.g., gestures, facial expression), low tech (e.g., communication board, labeling),
high tech (e.g., computerized, speech output)
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Evidence-Based Practice
I. Evidence-based practice is the integration of research evidence into reasoning
processes to make decisions, explain rationales, and predict outcomes. Demand in
current practice to use evidence to guide decision making (Schell et al., 2014, p. 55)
A. Occupational therapy practitioners need to know how to
1. Access evidence,
2. Evaluate the quality of the evidence, and
3. Support their assessment and intervention plans with evidence.
B. Practitioners must also be able to
1. Synthesize multiple forms of evidence to support their recommendations and
2. Communicate relevant research findings to their clients and relate these findings to expected
intervention outcomes. Doing so will help clients to make informed decisions about their care.
II. Occupational therapy practitioners must be open to changing their practice
patterns on the basis of evidence.
III. Different type of evidence can be used for different purposes (Baker & TickleDegnan, 2014, pp. 399–400).
A. Descriptive and qualitative research gives the practitioner an idea of typical
occupational experiences and needs that clients with particular conditions may have.
1.
2.
3.
4.
5.
Qualitative designs
Case studies
Case series
Cohort studies
Cross-sectional studies.
B. Exploratory research that evaluates assessment tools, such as cross-sectional studies
and case-control studies, can help practitioners understand the quality of different
assessment tools and procedures.
C. Experimental and exploratory research can help practitioners make decisions about the
types of interventions they use with their clients as well as the probable outcomes.
1. Randomized clinical trials
2. Quasi-experimental studies
3. N-of-1 studies (single-subject design), cohort studies, and case series designs.
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Home Accessibility
I. Americans With Disabilities Act of 1990 (ADA; Pub. L. 101-336)
The ADA established accessibility guidelines for buildings and facilities (see Phillips et al., 2020;
Foti & Koketsu, 2013, pp. 179–194; U.S. Department of Justice, 2010).
A. Accessible route: The minimum clear width of an accessible route is 36 inches, except at
doors.
1. Ramp
a. The maximum slope of a ramp is 1:12. Ramp slopes between 1:16 and 1:20 are preferred.
Most ambulatory people and most people who use a wheelchair cannot manage a slope of
1:12 for 30 feet.
b. The maximum rise for any run is 30 inches.
c. The minimum clear width of a ramp is 36 inches.
d. A ramp run that has a rise of more than 6 inches or a horizontal projection of more than 72
inches should have handrails on both sides.
2. Stairs: All steps should have uniform riser heights and uniform tread widths of no less than 11
inches.
3. Handrails
a. Clear space of 1–1½ inches between the handrail and the wall
b. A height of 34–38 inches, or waist height depending on the person’s height, measured to the
top of the gripping surface from the ramp surface or stair nosing, is recommended for
adults.
c. A maximum height of 28 inches is recommended for children.
4. Doorway
a. The minimum clear opening is 32 inches. (Note: The minimum width for a standard adultsize wheelchair is 26 inches; the minimum width for a walker is 18 inches.)
b. Thresholds at doorways should not exceed ¾ inch in height for exterior sliding doors or ½
inch for other types of doors.
c. Raised thresholds and floor-level changes at accessible doorways should be beveled with a
slope no greater than 1:2.
d. Door hardware for accessible door passages should be mounted no higher than 48 inches
above the finished floor.
5. Wheelchairs: minimum of 60-inch diameter or a 60-inch by 60-inch T-shaped space for a
pivoting 180° turn to avoid the need for repeated tries and bumping into surrounding objects
II. Universal Design
A. “Universal design (UD) seeks to simplify daily activities for all people by designing
features and devices that can be used by everyone to the greatest extent possible,
regardless of age, size, or ability” (Phillips et al., 2020, p. 459).
B. Principles (Connell et al., 1997)
1. Equitable use
2. Flexibility in use
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3.
4.
5.
6.
7.
Simple and intuitive use
Perceptible information
Tolerance for error
Low physical effort
Size and space for approach and use
C. General considerations
1. Competence–environmental press
a. All environments have expectations for behavior.
b. The adaptive zone is an area in which individual competence is in balance with the
environmental demands.
c. Maladaptive behavior may occur when the environmental demands exceed or fall below the
level of individual competence.
d. The physical characteristics of the environment can be either a barrier or a facilitator of
optimal occupational performance.
2. Before the home assessment, the occupational therapist should have knowledge of the client’s
current performance skills level, limitations in client factors, and previous and expected
performance patterns in the home environment.
3. Recommendations after home assessment may include
a. Physical modifications such as rearrangement of furniture, installation of handrails or grab
bars, removal of throw rugs, installation of task lamps, decluttering of the environment,
rearrangement of kitchen storage area
b. Introduction of assistive devices such as three-in-one commode, bathtub bench, shower
chair, raised toilet seat, reacher
c. Behavior changes such as using a tote bag instead of a big laundry basket, strategically
placing cordless telephones around the house, leaving commonly used pots and pans on the
stovetop instead of storing in the cabinet
d. Strategies for pacing and energy conservation, such as placing high barstool in kitchen for
meal preparation, strategically placing chairs around the house as rest stations
e. Strategies to ensure safety for clients with cognitive impairment, such as door alarm, bed
alarm, wall or door poster to hide door handle and lock, placing side bolt high out of client’s
reach
f. Strategies for safe mobility and activity demands modifications for clients with low vision
or who are blind
g. Introduction of electronic aids to daily living (formerly known as environmental control
units)
4. Special considerations for age-related physical changes (Phillips et al., 2020, pp. 460–465)
a. Mobility
b. Carrying items
c. Climbing stairs
d. Sitting
e. Rising
f. Stability
g. Bending
h. Reaching
i. Grasping
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j.
Pinching
III. Home Assessment
A. Goal: modification of the environment, context, and activity demands to support
client’s safe and independent occupational performance at home
B. Three types of home assessment
1. By evaluating the environment (e.g., architectural barriers or fire hazards in the home, without
consideration of the person living in the home) using a home safety checklist (Foti & Koketsu,
2013, Figure 10-3)
a. Self-assessment that can be done by the person or other family members
b. Increases awareness of potential hazards at home
c. Can receive general information with minimum professional input
2. By evaluating the person (e.g., using standardized or general assessment tools that do not
specifically pertain to home safety)
a. Assessment of performance skills, performance patterns, client factors, and client’s areas of
occupation
b. Professional opinion for general home modifications based on the client’s abilities and
limitations
c. Very little to no regard of the environment itself
4. By evaluating the interaction of the person with the environment for person–environment fit,
using a home evaluation checklist (Foti & Koketsu, 2013, Figure 10-4)
a. Only done when an on-site home evaluation is feasible
b. Important areas and environments to assess are those in which the client has activity
engagement (e.g., bathroom, bedroom, kitchen, but not necessarily laundry room if the
client does not need to do his or her own laundry)
c. Important to assess how the client interacts with the environment during the activity (e.g.,
reaching for the light in the bedroom, using a chair to sit down for dressing, using a walker
in the kitchen while cooking)
C. On-site home evaluation
1. Assess client’s safety when
a. Getting in and out of the house or apartment
b. Getting in and out of bed
c. Getting on and off the toilet
d. Getting in or out of the shower or bathtub
e. Reaching and carrying with or without use of mobility aids
f. Sitting and rising up from a chair
g. Stepping over a threshold
h. Mobility on changed floor surfaces (e.g., carpet to hardwood floor or hardwood floor to tile
floor)
2. Ease of functional mobility
a. Using a cane or quadcane: walking around obstacles and furniture and walking on different
floor surfaces
b. Using a walker: maneuvering around obstacles and furniture, handling walker on different
floor surfaces
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c. Using a wheelchair: maneuvering on different floor surfaces or threshold, making turns
from hallway to room and reverse, making turns within the tight space of a room,
transferring on and off the wheelchair to other surfaces such as toilet or bed
d. Stair management: ability to use handrails, ability to carry object going up and down the
stairs, endurance when using stairs
e. Chair, bed, and toilet: ease of sitting down or rising up from different heights
f. Kitchen mobility: reaching; carrying; turning in tight spaces; opening and closing cabinets,
drawers, and refrigerator; bending; multitasking; walking on tile or linoleum floor surface
g. Bedroom mobility: reaching into closet, opening and reaching into drawers, bending,
carrying, walking on carpet or hardwood floor
h. Bathroom mobility: Opening and closing shower door or curtain; stepping over shower
threshold or bathtub; availability of grab bars and position for toilet and shower transfer;
walking on carpet, tile, or linoleum floor; adequate space for the wheelchair to get into the
bathroom or proximity to the toilet or shower for transfer
i. Entrances: All available entrances, stairs versus threshold
3. Ease of occupational performance in the home environment
a. Dressing
b. Toileting
c. Bathing
d. Hygiene and grooming
e. Dining
f. Meal preparation
g. Laundry management
h. Household management
i. Gardening or horticulture
j. Leisure activities such as watching TV and reading
k. Social activities
l. Work activities such as use of computer
m. Taking care of pets
n. Taking care of others
o. Any other significant role for the client
References
American Occupational Therapy Association. (2020). Occupational therapy practice framework: Domain and process
(4th ed.). American Journal of Occupational Therapy, 74(Suppl. 2), 7412410010.
https://doi.org/10.5014/ajot.2020.74S2001
Americans With Disabilities Act of 1990, Pub. L. 101-336, 42 U.S.C. § 12101.
Assistive Technology Act of 2004, Pub. L. 108-364, 118 Stat 1707.
Baker, N., & Tickle-Degnen, L. (2014). Evidence-based practice: Integrating evidence to inform practice. In B. A. B.
Schell, G. Gillen, M. E. Scaffa, & E. S. Cohn (Eds.), Willard and Spackman's occupational therapy (12th ed.,
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