As indicated earlier, disability is the outcome of the interaction between a child with an impairment and an environment with barriers that hinder his or her participation on an equal basis with others. Assistive technology can reduce or eliminate such barriers. However, obtaining such technology is not always possible due to product and service related barriers.
Lack of awareness
Many people with disabilities and their families have limited awareness of assistive products and services. This makes it difficult for children and their families to know what assistive technologies are available or suitable and how they can be beneficial.
Lack of governance including legislation, policies and national programmes
The 2005 ‘Global survey on government action on the implementation of the Standard Rules on the Equalization of Opportunities for Persons with Disabilities found that of the 114 responding countries 50% had not passed relevant legislation and 48% did not have policies in place relating to the provision of assistive technology. This indicates that for many States the provision of assistive technology is a relatively low area of priority.
Lack of services
Assistive technology services are often in short supply and located far away from where children with disabilities live. In the above mentioned global survey, 53% of the 114 responding countries had not initiated programmes relating to the provision of assistive technology.
Non-governmental organizations rarely have the financial means or capacity to develop country-wide sustainable service delivery systems. With limited geographical coverage, their services often focus on specific types of assistive technology or disabilities.
Current service delivery is not equitable. Inequities have been found not only between people living in different countries or regions of a country, or under different economic conditions: they have also been found among people with different impairments, genders, ages, languages and cultures.
Children are often less likely than adults to access assistive technology. In addition to reduced financial means, it is culturally impossible for girls in certain regions to access assistive technology when services are staffed only by male personnel.
Lack of products
In many countries, there is no production of assistive products—or production occurs on a small scale. It is small not only in terms of quantity, but also in terms of the range of types, models and sizes of the products. Limited access to the materials and equipment needed to produce assistive products can hamper production.
Market-related factors can also limit production. Limited awareness of assistive technology or purchasing capacity leads to a limited demand. This results in few incentives to engage in production. Local production may not be cost-effective where local markets are small. Moreover, duty and import taxes associated with assistive technology can discourage local businesses to import materials, equipment or assistive products.
Although a wide range of types of assistive products are available globally, they are not available everywhere, and all designs are not appropriate in all settings. Therefore, product research and development is still required. Unless the design of an assistive product meets a child’s and the family’s needs and preferences, and is suitable in their physical, social and cultural environment, there will continue to be a low demand for products.
Physically or cognitively inaccessible environments act as barriers to assistive technology. For example, inaccessible transport systems or service centers prevent children from having easy access to the services and products they need. Physical barriers include stairs or poor lighting, while cognitive barriers include texts that are not clear or symbols that are difficult to understand. Further, regardless of the cost or availability of a wheelchair, a child will not be able to use it in an inaccessible house, road or school. Barriers are often exacerbated during natural disasters and conflicts.
Lack of human resources
Another barrier to assistive technology is a lack of personnel properly trained in manufacturing or adapting products, or delivering services. Many countries report inadequate numbers of rehabilitation personnel.