Rehabilitation Engineering: A perspective on the past 40-years and thoughts for the future

•Participatory action engineering has transformed assistive device design.•Assistive technologies empower people with disabilities.•Despite improvements there is still much to be done.•Low income countries lag high income countries in technical and social changes.•There are exciting emerging technologies and systems. Over the past four decades, there have been breakthroughs in communication, mobility and tools to manipulate objects. Probably the most important transformation has been the growing inclusion of people with disabilities into the prioritization, conceptualization, and design of new assistive devices. Advances in technology, demands from people with disabilities, and changes in cultural perceptions have made noteworthy changes in the technologies that have improved lives, and affected transformations that benefit both individuals and society. People with disabilities lives have been improved but there is still much to be done. Unfortunately, people with disabilities in low income countries have lagged people in higher income countries in benefitting from technical and social changes. Assistive devices have benefitted from the availability of powerful, portable computing power, from small low-power sensors, from new materials, from rapid prototyping and flexible manufacturing. There are exciting emerging technologies that show promise for future advances.