A client-centred approach is a basic condition for self-determination and empowerment of the user in all assessment work. Use of an assessment model offers an effective means of ensuring consensus within the team and a high quality outcome. The assessment model referred to here is based on the Canadian Model of Occupational Performance (CMOP) (Townsend, 1997) and has been adapted for the assessment of Assistive Technology (AT). It has resulted in the book “Be active using a computer – possibilities for people with physical disabilities” (Lidström and Zachrisson 2005). The structure of its clinical process is based on the Occupational Performance Process Model (Townsend, 1997), which has a client-centred perspective. It is easy to follow and is applicable in most cases (Buchholz and Holmqvist 2009). The steps of the process are summarized as follows:
Identify, describe and prioritize issues
Select theoretical approaches
Describe the conditions for the activities
Describe targeted outcomes and develop an action plan
Implement plans
Evaluate outcomes
The work of identifying, describing and prioritizing occupational performance issues is, whenever possible, undertaken mainly by the user. The results are used as a foundation for further assessment. To achieve this, we need to listen to the user and ask appropriate questions.
The issues addressed must be specific and describe the limitations in the daily life of the user. The aim is to establish close cooperation between the user and the team members and to work towards a common goal. The user (with support from the team) decides which issues and activities are most important to them. If needed, the interview and discussions with the user should be adapted to meet his or her cognitive and physical abilities. Different approaches are used depending on whether the user is an adult or a child and whether there are cognitive and/or communicative problems. For many users with communicative and cognitive disorders use of the Talking Mats method is useful in helping make the decision-making process easier (Murphy and Cameron 2006).