Greve J, Kaiser H, Schian H M, Neuhäuser G
Institut für angewandte Rehabilitations-Wissenschaft (IfaR), Köln.
Rehabilitation (Stuttg). 2000 Oct;39(5):249-54. doi: 10.1055/s-2000-7858.
Practical experience in adjusting complex computer-assisted (CAS) communication aids has resulted in a search for prognostic criteria useful in evaluating the efficacy of technical aids. Such evaluation implies a holistic approach as is included in the ICIDH-2. These circumstances are demonstrated by examples ranging from mechanical to computer-assisted (CAS) aids. "Reciprocity" has turned out to be a valid semi-qualitative criterion in describing the dynamic equilibration of the rehabilitative issues involved. Only a dialogical situation with reciprocity will lead to sustainable participation. In case of technical aids, a conjunction of abilities and the qualitative level of activities in disabled people have to be taken into account to provide all dimensions of participation. In this holistic approach, social participation and balance will equally be respected. The differentiation of social systems with unequal consequences for people with disabilities in terms of environmental factors, or e-code of the ICIDH-2, have to be considered for prognostic evaluation with regard to efficacy and possible participation. A comprehensive psycho-socio-functional rating therefore has to include a comparative (socio-structural or morphological) analysis of the environment at hand. This approach will invariably show that technical aids alone are unable to ensure individual independence but, rather, may lead to isolation if there is no regional or local networking based on partnership and close interpersonal relations to be drawn on "technically".
在调整复杂的计算机辅助（CAS）通信辅助设备方面的实践经验，促使人们寻找有助于评估技术辅助设备功效的预后标准。这种评估意味着采用国际功能、残疾和健康分类第二版（ICIDH-2）中所包含的整体方法。从机械辅助设备到计算机辅助（CAS）辅助设备的各种示例都证明了这些情况。“互惠性”已被证明是描述所涉及的康复问题动态平衡的一个有效的半定性标准。只有具有互惠性的对话情境才能带来可持续的参与。对于技术辅助设备而言，必须考虑残疾人的能力与活动质量水平的结合，以提供参与的各个方面。在这种整体方法中，社会参与和平衡将同样受到尊重。在对功效和可能的参与进行预后评估时，必须考虑社会系统在环境因素（即ICIDH-2中的e编码）方面对残疾人产生不同后果的差异。因此，全面的心理-社会-功能评定必须包括对当前环境的比较（社会结构或形态学）分析。这种方法将始终表明，仅靠技术辅助设备无法确保个人独立，相反，如果没有基于伙伴关系和密切人际关系的区域或地方网络可供“技术上”利用，可能会导致孤立。
