Challenges and Barriers in Assistive Technology and the Scale for Their Assessment: A Global and Indian Perspective
DOI:
https://doi.org/10.56450//JEFI.2025.v3i1Suppl.003Keywords:
Assistive Technology, Barriers in Assistive Technology, Health Equity, Assessment in Assistive TechnologyAbstract
Assistive Technology (AT) plays a critical role in enabling independence, participation, and rehabilitation for persons with disabilities. However, current access rates remain critically low, with only 5-10% of individuals in low- and middle-income countries (LMICs) receiving the assistive products they need. This paper examines the multidimensional challenges and barriers hindering access of AT globally and in India, including policy gaps, economic constraints, service delivery limitations, and social stigma. Furthermore, it reviews existing assessment scales and frameworks such as WHO-GReAT, QUEST, PIADS, and the ATLAS framework that can systematically evaluate these barriers. The findings underscore the urgent need for comprehensive AT policies, standardized assessment tools, and inclusive implementation strategies to realize assistive technology as a fundamental right rather than a privilege and charity.
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References
1. Global report on assistive technology [Internet]. Google Books. 2022 [cited 2025 Nov 11]. Available from: https://books.google.co.in/books/about/Global_report_on_assistive_technology.html?id=8e1vEAAAQBAJ&redir_esc=y
2. Priority Assistive Products list [Internet]. www.who.int, [cited 2025 Nov 20]. Available from: https://www.who.int/publications/i/item/priority-assistive-products-list
3. Borg J, Lindström A, Larsson S. Assistive technology in developing countries. Prosthetics & Orthotics International [Internet]. 2011 Mar;35(1):20–9, [cited 2025 Nov 19]. Available from: https://doi.org/10.1177%2F030936461038935
4. Tebbutt E, Brodmann R, Borg J, MacLachlan M, Khasnabis C, Horvath R. Assistive products and the Sustainable Development Goals (SDGs). Globalization and Health. 2016 Nov 29;12(1), [cited 2025 Nov 15].
5. MDPI. International Journal of Environmental Research and Public Health [Internet]. Mdpi.com. 2020, [cited 2025 Nov 16]. Available from: https://www.mdpi.com/journal/ijerph
6. Holloway C, Morgado Ramirez DZ, Bhatnagar T, Oldfrey B, Morjaria P, Moulic SG, et al. A review of innovation strategies and processes to improve access to AT: Looking ahead to open innovation ecosystems. Assistive Technology [Internet];33(sup1):68–86, [cited 2025 Nov 22]. Available from: https://www.tandfonline.com/doi/full/10.1080/10400435.2021.1970653
7. Boot FH, Dinsmore J, Khasnabis C, MacLachlan M. Intellectual Disability and Assistive Technology: Opening the GATE Wider. Frontiers in Public Health. 2017 Feb 22;5, [cited 2025 Nov 12].
8. Rust KL, Smith RO. Assistive Technology in the Measurement of Rehabilitation and Health Outcomes: A Review and Analysis of Instruments. American Journal of Physical Medicine & Rehabilitation [Internet]. 2005 Oct 1;84(10):780[cited 2025 Nov 20]. Available from: https://journals.lww.com/ajpmr/fulltext/2005/10000/Assistive_Technology_in_the_Measurement_of.8.aspx?casa_token=RRKirROjECUAAAAA:pLdN0UbHKpsUufQc1djqysdox60SZ4AZuF_geEH6hqrHKBfLjRIyO1zUcMvY-i04jbEpuBC2XplzIqTdwwDQTEDI
9. Demers L, Weiss-Lambrou R, Ska B. Development of the Quebec User Evaluation of Satisfaction with assistive Technology (QUEST). Assistive Technology. 1996 Jun 30;8(1):3–13, [cited 2025 Nov 16].
10. Jutai J, Day H. Psychosocial Impact of Assistive Devices Scale. PsycTESTS Dataset. 1996; [cited 2025 Nov 25].
11. Scherer MJ, Craddock G. Matching Person & Technology (MPT) assessment process. Gelderblom GJ, de Witte LP, editors. Technology and Disability. 2002 Sep 29;14(3):125–31[cited 2025 Nov 14].
12. MacLachlan M, Banes D, Bell D, Borg J, Donnelly B, Fembek M, et al. Assistive technology policy: a position paper from the first global research, innovation, and education on assistive technology (GREAT) summit. Disability and Rehabilitation: Assistive Technology. 2018 May 23;13(5):454–66, [cited 2025 Nov 16].
13. Khasnabis C, Mirza Z, MacLachlan M. Opening the GATE to inclusion for people with disabilities. The Lancet. 2015 Dec;386(10010):2229–30, [cited 2025 Nov 15].
14. MacLachlan M, Banes D, Bell D, Borg J, Donnelly B, Fembek M, et al. Assistive technology policy: a position paper from the first global research, innovation, and education on assistive technology (GREAT) summit. Disability and Rehabilitation: Assistive Technology. 2018 May 23;13(5):473-85,
15. de Witte L, Steel E, Gupta S, Ramos VD, Roentgen U. Assistive technology provision: towards an international framework for assuring availability and accessibility of affordable high-quality assistive technology. Disability and Rehabilitation: Assistive Technology. 2018 May 9;13(5):467–72[cited 2025 Nov 24].
16. Auger C, Demers L, Gélinas I, Jutai J, Fuhrer MJ, DeRuyter F. Powered Mobility for Middle-Aged and Older Adults. American Journal of Physical Medicine & Rehabilitation. 2008 Aug;87(8):666–80, [cited 2025 Nov 21].
17. Removing financial barriers to access to assistive technology | ATscale [Internet]. Atscalepartnership.org. 2020 [cited 2025 Nov 27]. Available from: https://atscalepartnership.org/global-enablers/removing-financial-barriers-access
18. Matter R, Harniss M, Oderud T, Borg J, Eide AH. Assistive technology in resource-limited environments: a scoping review. Disability and Rehabilitation: Assistive Technology. 2016 Jul 21;12(2):105–14,
19. Rad J. Health inequities: A persistent global challenge from past to future. International Journal for Equity in Health. 2025 May 23;24(1), [cited 2025 Nov 25].
20. Borg J, Lindström A, Larsson S. Assistive technology in developing countries. Prosthetics & Orthotics International [Internet]. 2011 Mar;35(1):20–9,
21. Borg J, Östergren PO. Users’ perspectives on the provision of assistive technologies in Bangladesh: awareness, providers, costs and barriers. Disability and Rehabilitation: Assistive Technology. 2014 Oct 27;10(4):301–8, [cited 2025 Nov 20].
22. Tangcharoensathien V, Witthayapipopsakul W, Viriyathorn S, Patcharanarumol W. Improving access to assistive technologies: challenges and solutions in low- and middle-income countries. WHO South-East Asia journal of public health [Internet]. 2018 [cited 2025 Nov 28];7(2):84–9. Available from: https://www.ncbi.nlm.nih.gov/pubmed/30136666
23. Scholars@Duke publication: Evaluating outcomes in assistive technology: do we understand the commitment? [Internet]. Scholars@Duke. 2026 [cited 2025 Nov 26]. Available from: https://scholars.duke.edu/publication/666852
24. Parette P, Scherer M. Assistive Technology Use and Stigma. Education and training in developmental disabilities. 2004 Sep 1;39(3):217–26.
25. Phillips B, Zhao H. Predictors of Assistive Technology Abandonment. Assistive Technology. 1993 Jun 30;5(1):36–45, [cited 2025 Nov 13].
26. Cook AM, Jan Miller Polgar. Assistive technologies : principles and practice. St. Louis, Missouri: Elsevier/Mosby; 2015, [cited 2025 Nov 15].
27. Scherer MJ. Living in the State of Stuck [Internet]. 2005 [cited 2025 Nov 17]. Available from: https://www.researchgate.net/publication/319968008
28. Eide AH, Muller S, Zhang W, Khasnabis C, Antypas K, Blakstad M, et al. Barriers for Accessing Assistive Products in Low- and Middle-Income Countries (LMICs). Studies in Health Technology and Informatics [Internet]. 2023 Aug 23;306:297–302.
29. Gowran RJ, Bray N, Goldberg M, Rushton P, Barhouche Abou Saab M, Constantine D, et al. Understanding the Global Challenges to Accessing Appropriate Wheelchairs: Position Paper. International Journal of Environmental Research and Public Health. 2021 Mar 24;18(7):3338.
30. Visagie S, Eide AH, Dyrstad K, Mannan H, Swartz L, Schneider M, et al. Factors related to environmental barriers experienced by persons with and without disabilities in diverse African settings. Federici S, editor. PLOS ONE. 2017 Oct 12;12(10):e0186342, [cited 2025 Nov 12].
31. Whiteneck GG, Harrison-Felix CL, Mellick DC, Brooks CA, Charlifue SB, Gerhart KA. Quantifying environmental factors: A measure of physical, attitudinal, service, productivity, and policy barriers11No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the authors(s) or upon any organization with which the author(s) is/are associated. Archives of Physical Medicine and Rehabilitation. 2004 Aug;85(8):1324–35, [cited 2025 Nov 19].
32. Day H, Jutai J, Campbell KA. Development of a scale to measure the psychosocial impact of assistive devices: lessons learned and the road ahead. Disability and Rehabilitation. 2002 Jan;24(1-3):31–7, [cited 2025 Nov 24].
33. Factors Impacting Consumers’ Assistive Technology Device (ATD) Selection [Internet]. Resna.org. 2026 [cited 2025 Nov 19]. Available from: https://resna.org/sites/default/files/legacy/conference/proceedings/2006/Research/Outcomes/Scherer.html
34. Federici S, Corradi F, Meloni F, Scherer M. A Person-Centered Assistive Technology Service Delivery Model: A Framework for Device Selection and Assignment. Life Span and Disability [Internet], [cited 2025 Nov 22]. Available from: https://www.researchgate.net/publication/270214053
35. Hafner BJ, Morgan SJ, Askew RL, Salem R. Psychometric evaluation of self-report outcome measures for prosthetic applications. Journal of Rehabilitation Research and Development. 2016;53(6):797–812, [cited 2025 Nov 25].
36. Edyburn DL. Assistive Technology and Students with Mild Disabilities. Focus on Exceptional Children. 2017 Dec 1;32(9),[cited 2025 Nov 20].
