After reading this please leave your thoughts in the comments. Thanks
Last week’s newsletter email listing 12 Remote Support providers available in the United States had lots of feedback and questions. People are wondering how we defined Remote Supports compared to Assistive Technology and Enabling Technology. This is our attempt to help clarify and describe a few key differences and similarities. This is meant to be the start of a conversation that needs to happen, and is not intended to be the “final word” on this subject.
There are many amazing technology solutions available to support people with varying abilities. These low-tech and high-tech solutions are all classified as Enabling Technologies. There are many technology vendors - each vendor is slightly different than the next and offer varying services using different and similar technologies.
This article is our attempt to: Define the difference between Enabling Technologies (ET), Remote Support (RS), and Assistive Technology (AT).
Enabling Technology: “Enabling Technology (ET) is the use of various forms of devices and tech to support a person with disabilities to live as independently as possible. These types of technologies include sensors, mobile applications, remote support systems, and other smart devices. Enabling Technology can support a person in navigating their jobs and communities, gain more control of their environment, and provide remote support and reminders to assist a person in independent living.” -TN DIDD
Assistive Technology: “Assistive Technology (AT) is any item, piece of equipment, software program, or product system that is used to increase, maintain, or improve the functional capabilities of persons with disabilities.” -ATiA
Remote Supports: “Remote support (RS) means the provision of supports by staff of an agency provider at a remote location who are engaged with an individual through equipment with the capability for live two-way communication. Equipment used to meet this requirement shall include one or more of the following components……” -Ohio Administrative Code 5123-9-35
In looking at these three definitions a few key differences jump out:
Enabling Technologies encompass both AT and RS
AT is an item, hardware, equipment, software, and/or a product system. These terms make me think of something someone uses.
RS are supports by a remote caregiver. RS are a human to human service that use technology to facilitate caregiver support. The person receiving the support doesn’t necessarily have to “use” any of the technology.
AT does not require live two-way communication and is very broad in what qualifies (low-tech and high-tech). RS require that the individual can communicate through two-way communication.
There are other key differences between RS and AT in many states’ Waiver service definitions, but for purposes of simplification I’m proposing we simply define the difference as:
Remote Supports are the provision of a caregiving service where the individual can interact in real-time with an offsite caregiver using Enabling Technologies. AT (which is also ET) assists a person in improving functional capabilities without a live caregiver involved.
How are they the same: RS and AT are both a form of Enabling Technologies that are assistive to the person (aren’t all technologies assistive by nature?). RS are a form of ET, in that this remote method of support helps the person improve functional capabilities (but that’s also the definition of AT). Are we having fun yet???
The fundamental difference of the presence of a caregiver in Remote Supports are why most states are creating new service definitions independent of AT (not many states recognize the term ET yet). However, some states are not making this distinction and have included remote supports (remote caregivers) in their AT service definitions. (Tennessee has coined the term Enabling Technology to lump RS and AT together under one umbrella term.)
Ohio is a great example the need for different service definitions related to RS and AT. In 2011 they amended Waivers that included a new service definition for RS (called Remote Monitoring at that time). In late 2018 they realized that they wanted to fund/regulate other technologies that didn’t fit in the RS service definition because of the lack of caregiver involvement in these other techs (AT/ET). They created a new service definition for AT that includes the equipment/hardware used when RS is being provided. However, the RS service (the caregiving part) was left as its own service definition. (Both of these separate service definitions could be grouped together under a new future service definition called Enabling Technologies.)
This is a perfect example of how the RS service is not AT, but the RS equipment/hardware kind of is AT; but is better defined as ET.
Clear as mud? Please don’t get bogged down in these details. All of these technologies have their place and are often used side-by-side or in succession, as a person’s capabilities and preferences change.
Remote Supports are caregiver supports facilitated by technology
AT is technology used by the person that improves functional capabilities
ET is both AT and RS (we need more acronyms don’t we)
Many ET vendors offer a form of RS and AT that can be independent from one another or blended together.
In all situations, start by looking at the person’s goals, desired outcomes, and preference - then find the best form of Enabling Technology that meets their needs – then, if necessary, figure out if the tech should be defined as RS and/or AT.
Disability Cocoon will put together a new list of Remote Support providers that distinguishes between 1) RS providers that have their own support center (staff with their employees as remote caregivers), and 2) RS providers that have platforms that allow other entities to provide the support themselves with their own paid staff and/or natural supports.
We will also put together a list of the other Enabling Technology vendors we have interacted with. As you know, AT has been around for decades and it isn’t possible to list all ET/AT vendors.
Until then….I hope this helps. Please leave your thoughts below.