Angélica M. Martínez Pérez, Fabricio E. Balcazar, Elsa M. Orellano-Colón
9 min
This study sought to identify and explore the multilevel environmental barriers to accessing and using assistive technology (AT) among Hispanics with disabilities in the United States. While AT is recognized for its potential to increase autonomy, safety, and quality of life for people with disabilities (PwDs), Hispanic populations face documented disparities in AT access and utilization. To capture these complex experiences, the authors employed a descriptive qualitative design, conducting in-depth interviews with nine Hispanic individuals with disabilities and their caregivers who had received services at an outpatient AT clinic in Chicago. The study utilized the Social Ecological Model (SEM) to categorize barriers across four levels: individual, relationship, community, and societal.
The researchers discovered that barriers to AT use exist across all levels of the SEM, revealing that these obstacles are deeply interconnected rather than isolated. Key findings include:
This research highlights how systemic attitudes and structural flaws in healthcare and policy intersect to marginalize Hispanics with disabilities. By prioritizing the lived experiences of these participants, the study demonstrates that the low uptake of AT in this population is not a matter of individual preference but a direct result of environmental barriers. These findings provide a roadmap for policymakers and clinical stakeholders to improve service delivery by investing in linguistically appropriate information, reducing administrative complexity, and dismantling the systemic biases that hinder equitable access to life-changing technology.
Purpose: Assistive technology (AT) can increase or maintain the quality of life and overall well-being of people with disabilities. Nevertheless, access to AT is limited among Hispanics with disabilities in the United States (U.S.). AT research representing the experiences of Hispanics is limited, potentially leading to disparities in AT use. Moreover, poor inclusion of Hispanics neglects the needs of this population, resulting in discrepancies in research, practice, and policy related to AT. To address these limitations, this study aimed to identify and explore multilevel environmental barriers to AT use among a sample of Hispanics in the U.S. Methods: This was a descriptive qualitative research design study guided by the Social Ecological Model framework using in-depth interviews to collect data. Nine Hispanic individuals with disabilities and their caregivers who received AT services at the University of Illinois at Chicago Assistive Technology Unit outpatient clinic were interviewed. Data was analyzed using a qualitative thematic analysis approach. Results: Barriers to AT use were found to exist in all levels of the Social Ecological Model. The most common barriers to AT use were identified in the community domain, which was related to the lack of AT information, and in the societal domain, which was related to sociocultural norms and the availability of AT funding, policies, and regulations. Conclusions: The participants’ lived experiences and perspectives underscored that environmental barriers to AT use are not isolated occurrences; rather, systemic attitudes permeate across all levels of the Social Ecological Model.
Sam: Before we follow that argument further, who actually spoke in these interviews? That matters for claims about users’ experiences.
Alex: Caregivers answered on behalf of seven participants with intellectual and developmental disabilities. Participants with physical disabilities answered for themselves. So most accounts are caregiver perspectives, not direct testimony from the person using the technology.
Sam: And how did they move from those conversations to the themes? I’d want more than illustrative quotations selected afterward.
Alex: Interviews lasted roughly two hours and were conducted in Spanish or English. The researchers transcribed them and used thematic analysis, coding recurring patterns. They combined categories from the ecological framework with themes emerging from the interviews.
Sam: Did they check those interpretations with anyone beyond the lead researcher?
Alex: Another researcher participated in coding and discussions to reach agreement on themes. The study also used member checking, asking participants to respond to synthesized findings. Those steps strengthen credibility, though they don’t make the sample representative.
Sam: Let’s turn to the findings. Which barriers appeared most consistently?
Alex: Every participant’s account raised difficulty accessing information about assistive technology. Both English and Spanish speakers struggled, but Spanish-speaking participants described additional challenges. Some families learned about communication devices only when their children reached high school.
Sam: That makes information a service issue, not simply a family’s knowledge gap. Were providers supplying that information?
Alex: Not consistently. Some caregivers said primary care providers or educators never discussed assistive technology. One described a provider being surprised when her son communicated using his tablet. Accounts also differed between smaller community clinics and major rehabilitation hospitals.
Sam: Those are reported experiences, rather than an audit of providers’ knowledge. What did families say happened after they found services?
Alex: They described delays, confusing applications, funding difficulties, and inadequate training. One participant learned to use his ceiling track lift without training. Another received chairlift instructions in English, although Spanish was her primary language and she preferred instructions in Spanish.
Sam: Language access, then, extends beyond finding the clinic. It includes installation, maintenance, and learning how to operate the equipment.
Alex: Those stages all appear in the accounts. Participants also described device performance problems. Communication-device batteries limited use, while a malfunctioning stair chair lift left a participant stranded partway along the stairs.
Sam: The study puts its strongest emphasis on community and societal barriers. What supports that emphasis beyond these individual examples?
Alex: Funding policies and regulations appeared in eight participants’ accounts. Families described administrative burdens, insurance restrictions, and uncertainty about who could approve applications. One participant reported waiting about a year for state documentation to be processed.
Sam: Those counts could sound like prevalence estimates. What should listeners understand them to mean?
Alex: They count participants who voiced a theme, not how common that barrier is among all Hispanic technology users. There’s no separate comparison population. The evidence maps experiences in this sample; it doesn’t estimate disparities or establish their causes.
Sam: How do attitudes connect to those service barriers? Funding paperwork and social exclusion could be different problems.
Alex: The authors interpret them as connected parts of an environment that constrains use. Caregivers reported professionals assuming their children couldn’t learn to use devices. Some also described verbal speech being prioritized while communication technology was delayed or never offered.
Sam: So expectations about what communication should look like can shape which options families hear about.
Alex: That’s the interpretation supported by these accounts. The authors discuss ableism: attitudes that devalue people because of disability. But interviews cannot tell us how often particular provider beliefs produced particular service decisions.
Sam: What is the biggest reason to hold back from generalizing? The sample size, the location, or the reliance on caregivers?
Alex: For claims about users’ lived experiences, caregiver reporting is the sharpest limitation. The authors explicitly say they cannot claim to have recorded those users’ experiences. For broader application, recruitment from one Chicago-area clinic through convenience sampling is another major constraint.
Sam: There are also reasons memories might be selective. Some participants were recalling services received years earlier.
Alex: The authors acknowledge recall bias, and possible bias because some participants might remember the interviewer from clinic intake. My reading is that this is useful exploratory evidence. It identifies problems to investigate, not their population frequency or a proven solution.
Sam: What solutions do the authors propose, while keeping that distinction clear?
Alex: They propose culturally and linguistically informed community education, partnerships with agencies serving Hispanics, and clearer insurance information. They also call for reducing administrative burdens and involving users and technology specialists in funding decisions. This study did not test whether those changes improve access.
Sam: Who should read the full document, and where should they start?
Alex: Researchers studying assistive technology equity, rehabilitation providers, and service or funding designers should read it. Start with the community- and societal-level Results, where quotations show how barriers operate. Then read the Limitations before treating the policy discussion as a guide to action.
Sam: And what should everyone else remember?
Alex: In these families’ accounts, access depended on more than getting equipment. Providing a device is not the same as enabling someone to use it.
Sam: Thanks for listening.