{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,14]],"date-time":"2026-02-14T03:53:21Z","timestamp":1771041201199,"version":"3.50.1"},"reference-count":24,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,7,25]],"date-time":"2025-07-25T00:00:00Z","timestamp":1753401600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,7,25]],"date-time":"2025-07-25T00:00:00Z","timestamp":1753401600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["PM&amp;R"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The critical need for assistive technology (AT) for children with brain injury is recognized. Despite its importance, there is scant literature on how delays and denials in the provision of AT affect recovery and rehabilitation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To examine the complex ecosystem of AT usage and barriers to access, drawing upon the perspectives of clinicians, vendors, and parents in an exploratory qualitative study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>This is a companion study to a quantitative retrospective medical chart review using grounded theory methods. Two focus groups with clinical staff, one focus group with vendors, and six interviews with parents of children with brain injury were conducted. The narrative data were combined to maximize the triangulation of themes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Pediatric rehabilitation hospital.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Multidisciplinary rehabilitation clinicians, vendors who provide AT, and parents of children with brain injury.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Primary themes included coordinating with insurance, vendors, and funding; fostering age\u2010appropriate independence; family's familiarity with AT; understanding the dynamic nature of development and recovery; impact on family relationships; costs\/financial considerations; accepting role of AT; discovering new AT; accepting child's reality; and advocating for AT access.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      The ethical implications of delays in access to AT, particularly in children with maturing and recovering brains, are far reaching and bring to the forefront concerns about the potential impact of disability stigma, social justice, and access to devices and information and the importance of maximizing self\u2010determination and enabling independence and autonomy. Delays in access to AT preclude both a child's\n                      <jats:italic>rights<\/jats:italic>\n                      and\n                      <jats:italic>capabilities,<\/jats:italic>\n                      adversely affecting their recovery and maturation and limiting their integration into society under disability law.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pmrj.13444","type":"journal-article","created":{"date-parts":[[2025,7,25]],"date-time":"2025-07-25T10:29:37Z","timestamp":1753439377000},"page":"152-161","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Access to assistive technology in pediatric brain injury care: Narrative perspectives of clinicians, vendors, and parents"],"prefix":"10.1002","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8233-8608","authenticated-orcid":false,"given":"Debjani","family":"Mukherjee","sequence":"first","affiliation":[{"name":"Division of Medical Ethics Weill Cornell Medical College  New York NY USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0892-6185","authenticated-orcid":false,"given":"Kaiulani S.","family":"Shulman","sequence":"additional","affiliation":[{"name":"Division of Medical Ethics Weill Cornell Medical College  New York NY USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7221-0053","authenticated-orcid":false,"given":"Joseph J.","family":"Fins","sequence":"additional","affiliation":[{"name":"Division of Medical Ethics Weill Cornell Medical College  New York NY USA"},{"name":"Solomon Center for Health Law &amp; Policy Yale Law School  New Haven CT USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,7,25]]},"reference":[{"key":"e_1_2_9_2_1","volume-title":"Global Report on Assistive Technology","author":"World Health Organization and the United Nations Children's Fund (UNICEF)","year":"2022"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1080\/09638288.2020.1768303"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1080\/07434619612331277438"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1080\/13682820701267444"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2008\u20100695"},{"key":"e_1_2_9_7_1","article-title":"Access to pediatric assistive technology: a moral test","author":"Shulman KS","year":"2024","journal-title":"Hastings Cent Bioeth Forum"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/htr.0000000000000876"},{"key":"e_1_2_9_9_1","volume-title":"The Promise of Assistive Technology to Enhance Activity and Work Participation","author":"National Academies of Sciences, Engineering, and Medicine","year":"2017"},{"key":"e_1_2_9_10_1","first-page":"273","volume-title":"Handbook of Qualitative Research","author":"Strauss A","year":"1994"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/1475\u20106773.12275"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102019\u2010036682"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0246514"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.3109\/02699052.2012.667590"},{"issue":"41","key":"e_1_2_9_15_1","first-page":"1","article-title":"Examining the potential of combing the methods of grounded theory and narrative inquiry: a comparative analysis","volume":"17","author":"Lal S","year":"2012","journal-title":"Qual Rep"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1353\/ken.1997.0013"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/hast.260"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pmrj.2016.08.028"},{"key":"e_1_2_9_19_1","unstructured":"EisenmengerA.Ableism 101.2019Access Livingblog. 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