Abstract

In lieu of an abstract, here is a brief excerpt of the content:Experiencing Assistive Technology:A Pragmatist Inflection for Occupational TherapyNate Whelan-Jacksonshortly after i wake up, I put braces on my legs. I wear them throughout the day. Often, I don't notice them. If I'm walking on a flat surface, they often fade into the background of my consciousness. I make allowances without thinking about how they structure my gait and the space they take up. Rarely, I misjudge this, and occasionally fall. In those moments, their presence is apparent, coming to the foreground of my experience as a problem, something I need to accommodate as I collapse. When they need to be repaired, I notice them all of the time. As a user of assistive technology, the way in which I experience the technology can swing from regarding them as part of my body, to an external tool, to an object in my environment. This experience is fluid, weaving moments where a sense of my embodiment includes the devices with moments where they are alien to me. Even when they are alien to me, I use them successfully (most of the time). Reading reports of the experiences of other users of assistive equipment, especially prosthetics, I do not seem to be alone in experiencing this fluidity with respect to these devices. These experiences raise questions for me. Is "successful use" sufficient as a goal as I learn and re-learn how to walk with them? Often, I prefer the experience of braces as part of myself: How might that be cultivated? Perhaps the fluidity of encountering them at times as tools and at times as part of myself is a strength, one that I might reasonably seek to develop. How might education or therapy accommodate and prepare for this feature of experience with assistive technology?Phenomenological analyses of symptoms of "phantom limbs," use of prosthetics, and even of physical impairment more generally, highlight the fluidity of disability experience, emphasizing the experience of having to continually revise ways of navigating our environments. For many disabled people, this precarious character of experience might demand that we learn to use new [End Page 60] assistive technologies. This education often takes place in the context of occupational therapy (hereafter OT), a form of therapeutic intervention using "occupations," or purposive tasks, to facilitate independence. In this process, persons might not just learn to make use of a technology or perform a task, but also to experience the technology in a variety of ways—for instance, as an obstacle, as a tool, or as a part of their bodies. Thus, OT becomes not only a locus for developing new modes of coping and performing daily tasks, but a site at which relationships to assistive technologies come to the foreground.Those relationships, in various theoretical models underlying OT, are often analyzed in terms of task performance, and different elements modified in order to complete a given occupation. A person might make changes in their own habits of moving (for instance, learning to move their legs a certain way to facilitate walking), the environment (e.g., modify furniture or a configuration of a room), or some combination thereof. However, some experiences of disability call into question features of popular models underlying OT, like the person-environment-occupation model. In particular, features of the situation, like the equipment, can occupy multiple roles, or even change roles, from person to environment or vice versa, within the context of performing daily tasks. I suggest that John Dewey's work on education and analysis of habits with relationship to a creature's broader environment provide a useful framework for articulating models of experiencing assistive technologies that appreciate their fluidity within experiences of disability. This model offers a helpful orientation for OT, one that offers an expansive account of the potential "ends" of OT, from re-molding habits to complete tasks to supporting plasticity in an individual's relationship to different elements of the model itself.Occupational TherapyBroadly, occupational therapy fosters independence through a number of means. Occupational therapists can aid in re-training how to perform everyday activities, construct exercises to strengthen or re-habituate new uses of muscles, make recommendations for changing features of home or...