Objectives. Within the overall individual rehabilitation plan, selection and fitting of assistive technology equipment (AT) is often carried out within occupational therapy (OT) programs. An analysis of working practices revealed that most OT programs focus on the recovery of the person's “intrinsic” abilities, while the assessment for technological enablers (AT devices, environmental adaptations etc.) tends to take place towards the very end of the treatment. This yields three drawbacks: 1) the user is discharged from the treatment cycle without being familiar enough with the AT he or she will need in the daily life context; 2) the AT choice may be driven only by professionals without informed and responsible user's participation and 3) the devices risk to be delivered to the user long after the treatment has finished, with little or no control by the rehab team on possible technical malfunctions. In this paper, a revised protocol for OT programs is proposed that embodies early assessment for AT.

Method. An analysis of current practices in occupational therapy was carried out in the OT Department of the “S.Maria Nascente” Rehab Hospital of the Don Gnocchi Foundation in Milano. Staff members were interviewed and asked to report anecdotally the work done with “typical” patients. A critical analysis followed, based on literature findings, that showed strengths and weaknesses in relation to the AT issue. Focus groups were carried out to find out how such weaknesses could be overcome; an upgraded OT protocol was eventually defined that takes into account the candidate AT equipment at earlier stages, and empowers the user to make informed and responsible choices before the end of the treatment.

Results. The upgraded protocol is composed of 15 conceptual steps serving as a guide to the therapist for planning the individual treatment. AT assessment takes place at step 5 (initial), 7 (intermediate) and 12 (final). A purposely developed checklist (DAT-OT-OBJ) helps to carry out this steps. A case history of a client who went through the new protocol (“Alberto”) is presented.

Conclusion. Recent advancement in AT has opened unprecedented opportunities for people with disabilities; within OT programs, it calls for an empowerment approach leading the client to become informed and responsible user of AT. The upgraded protocol showed effective for this goal; however it may require re-training and some cultural paradigm shift in the involved professionals.