assistive technology: tools for the ot toolbox

Karen Dishman, OTR

ASSISTIVE TECHNOLOGY:TOOLS FOR THE OT TOOLBOX

Why Assistive Technology is Occupational Therapy?

Definition of Occupational Therapy:OTs help people across the lifespan participate in the things they want and need to do through the therapeutic use of everyday activities (occupations).

Definition of Assistive Technology:AT is any item, piece of equipment, or product system, whether acquired commercially or off the shelf, modified, or customized, that is used to increase, maintain, or improve functional capabilities of individuals with disabilities.

Hmmmmmm……….

AT “Tools for Occupational Therapy”• Technology is a valuable tool for occupational therapists

and occupational therapy assistants to use in assisting individuals with moving toward their highest level of independence and with the process of adaptation to disability.

• As occupational therapists, we can make an important difference. AT is an area in which we have the potential to be experts.

• Occupational therapists are the natural professionals to become heavily involved in supporting AT. Our training focuses on modifying activities and recommending adaptive equipment to help our clients to perform valued activities as independently as possible.

Assistive Technology in the Schools

For children with disabilities in public school classrooms, assistive technologies are tools to extend their physical, social and

communicative abilities. They also provide the means for academic and cooperative inclusion.

AT is anything that makes "it" easier for a student to...

Communicate

Read & Learn

Physical Adaptations

Organize

Write

Computer Access

In the Evansville Vanderburgh School Corporation, we have an assistive technology team!

Our Team includes a assistive technology coordinator (special education teacher), occupational therapist, physical therapist,

psychologist and speech language pathologist.

Assistive technology teams provide • Assistive Technology/Augmentative Communication

assessments and/or consultations.

• Borrow equipment for trial and data collection

• Provide training on the operation and application of the assistive technology to school staff and families.

• Maintain devices and equipment

• Provide equipment per IEP team recommendation

• Collaborate with other IEP team members on how assistive technology can be used to support curriculum and instruction

Resources for AT Teams• http://atto.buffalo.edu/index.php - Resource through the

University at Buffalo for assistive technology teams

• http://edsrc.coe.uky.edu/www/ukatii/ - Resource through the University of Kentucky that provides methods and data collection for teams

• http://www.wati.org/?pageLoad=content/supports/free/index.php - Resource through the Wisconsin Assistive Technology Initiative (WATI) with a full manual. assessments and data collection for AT teams

• http://www.bvsd.org/assistivetechnology/Pages/Assistive%20Technology%20Main%20Page.aspx – Resource through Boulder Valley School District in Colorado with explanations of an AT team, books, articles, assessments and data collection forms

The Rehabilitation, Engineering and Assistive Technology Society of North America (RESNA) furthers the field of assistive technology by offering certification, continuing education and professional development.

The RESNA certification exam for Assistive Technology Professional (ATP)

Covers the following practice areas:

• Seating and Mobility• Augmentative & Alternative Communication• Computer Access• EADLS (Environmental Control)• Technology for Sensory Impairment• Recreation• Environmental Modification• Accessible Transportation• Technology for Learning Disabilities

Framework for Assistive TechnologyHuman Activity Assistive Technology (HAAT) Model

Four Components

1. Human 2. Activity

3. Assistive Technology 4. Context

1. Human• Physical: Strength, Range

of Motion, Coordination, Balance, etc.

• Cognitive: Attention, Judgment, Problem Solving, Concentration and Alertness

• Emotional Aspects: Motivation, Self-Efficacy and Perception

2. ActivityThe process of doing something!

1. Activities of Daily Living

2. Productivity and Work

3. Play and Leisure

3. Assistive Technology

Human/technology interfaceRepresents the boundary between human and assistive technology

ProcessorTranslates information and forces received from the human into signals that are used to control the activity outputThe processor links the human-technology interface and the activity output

4. Contextsthe setting that the human carries out the activity in

Physical Social

Cultural Institutional

Seating & MobilitySeating & Positioning is one of the most important factors to

consider for a client to use AT

In her presentation, Providing Access to Students Challenged with High Tone, Karen Kangas lists the following:

New Paradigms We Need to Embrace

1. Seating must allow for task participation and performance

2. Seating must provide pelvic weight bearing for visual convergence

3. Seating must be situationally specific, and task specific and change

4. For hands to work, heads must work, for heads to work, the pelvis must be weight bearing

Seating Needs

1. Postural Control• Stability- allows an individual to maintain upright seated • Mobility- allows movement that enables function

Most important principle is that proximal stabilization, near the center of the body, facilitates movement and control of the head and extremities.

2. Tissue Integrity

Most important is to manage sitting pressure and maintain the skin in a healthy condition to prevent pressure ulcers.

3. Comfort

Three distinct populations can benefit from these seating technologies:

• Wheelchair users who have sitting discomfort and pain (postpolio syndrom, ALS, MS)

• Elderly

• Individuals with low back pain, which can keep them from effectively performing their jobs

Resources for Seating & Mobility

http://www.rifton.com/products/sitting/activitychair/

http://www.wati.org/content/supports/free/pdf/Ch2-PositioningSeatingMobility.pdf

http://www.ambucs.com/amtryke/

http://www.rifton.com/products/transfer/tram/

http://www.youtube.com/watch?v=ZLwIP8cBaWA(Ergonomics video)

http://www.usatechguide.org/links.php?catid=82(wheelchair reviews and links for used equipment)

Augmentative & Alternative CommunicationEveryone can have a voice!

Silly therapists, AAC is not just for kids!

AAC1. No-Tech AAC systemsgestures, facial expressions, and body movements, formal signing systems (ASL)

2. Low-Tech AACcommunication simple board, Picture Exchange Communication (PECS), visual

schedules, choice boards, token boards

3. High-Tech AACSpeech Generating Devices (SGD) such as keyboards, switches, joysticks, pointing interfaces, computers, iPads, iPods

AAC Resourceshttp://www.adaptedstories.com/stories/index.cfm?session_id=CCF0974B-3048-B8B4-60A7FCD91B2EB49C&loaded=1(AAC handouts)

http://www.handsinautism.org/tools.html(visual schedules and visual tools)

http://www.everymovecounts.net/(sensory based communication teaching)

http://www.aacinstitute.org/(AAC resources)

http://apps4stages.wikispaces.com/(Stages of switch use and communication)

www.boardmarkershare.com(boardmaker projects already completed)

Computer AccessInvolves the human-technology

interface

1. Control Interfacehardware by which human in the AT system operates or controls a device (input device)

2. Selection Setitems available from which choices are made

3. Selection MethodDirect Selection: able to use the control interface to randomly choose any of the items (typing)

Indirect Selection: intermediate steps are involved in making a selection (scanning)

Computer Access Resources

http://apps4stages.wikispaces.com/(stages for switch use)

http://www.helpkidzlearn.com/games(online switch games)

http://www.inclusive.co.uk/software(products and software)

http://www.bbc.co.uk/schools/typing/(fun online typing program)

http://www.shinylearning.co.uk/freegames/index.shtml(online switch games)

**Accessibility options for computer**

EADLS (environmental control)

Low-Tech Aids for Manipulation

• General purpose aids- mouthsticks, head pointers, reachers

• Special purpose aids- lengthening a handle or reducing reach required, modifying handle of utencil, converting two-handed tasks to one-handed, amplifying the force a consumer can generate with hands

Special Purpose EADLSElectromechanical Aids

• Electrically powered feeders• Electrically powered page

turners

Electronic Aids to Daily Living• Unit that control multiple items

in the environment such as lights, telephone, TV and computer

EADL Resources

Vision Aids

1. Reading • magnification aids

(optical, non-optical and electronic)

• Access to visual computer displays for low vision (screen magnification, accessibility options built into computer)

• Devices for automatic reading of text (camera , scanner based and Optional Character Recognition “OCR” converts from scan to speech or braille)

• Braille (refreshable braille displays with raised pins, embossed braille print, portable braille note takers)

• Access to visual computer displays for blind (Screen Readers both universal built in and commercially available)

Technology for Sensory Impairment

Mobility for Vision Impairment

• Canes

• Guide dogs

• Electronic travel aids (ETA) – additions to cane of auditory tones and vibration

• Navigation guides (GPS)

Vision Aid Resources• http://www.w3.org/WAI/gettingstarted/ (web accessibility help) • www.trace.wisc.edu/world/web (web accessibility help)

• http://www.afb.org/default.aspx (Resources)

• http://www.familyconnect.org/parentsitehome.asp (Family resources)

• http://www.visionaware.org/ (Resources)

1. Hearing Aids• Air conduction- deliver

output into listener’s ear canal

• Bone conduction- inputs are converted to mechanical vibrations that shake the skull

• Cochlear Implants- if there is damage to the cochlea of the inner ear, an auditory prosthesis can provide some sound perception

• FM systems- used for group settings with microphone for teacher and receiver

Sensory Aids for Auditory Impairment

2. Visual Substitution• Teletype devices (TTY) –

telephone aid that displays words person is saying **Now, we can just use texting**

• Visual telephones– video calling

• Alerting devices with flashing light or vibration for smoke alarms, telephones, doorbells and child’s cry

• Closed-captioned television and movies (CCTV)

Technology for Cognitive Disabilities

General Memory Aids• Recording

• Word completion/prediction

• Information retrieval

• Medication boxes

• Fall alarms

• GPS watch

• Smart house (monitoring , communication, household functions, physiological measurements and medication alerts.

Memory AidsPrompting/Cueing/Coaching

• Electronic schedules (watch or visual display)

• Visual schedules (written, picture)

• Computer or internet based schedule

• Alarm clocks and watches

Memory AidsTime Management

Technology for Cognitive DisabilitiesConcept Organization and Decision Making

• Organization strategies and software (Inspiration graphic organizer, Wonkido online visual organizer)

• Alternative Input and Output (voice recognition, word prediction, text to speech)

Cognitive Technology Resources• http://

www.intellitools.com/default.html?utm_source=INT&utm_medium=email&utm_campaign=teacher_spotlight_4_16_2012

(products– Kurzweill)

• http://polk-fl-net.campuspack.net/Groups/PDS-13648/Course_Wiki/SMART_Resources

(well organized teacher resources)

• http://www.bvsd.org/assistivetechnology/Pages/AssistiveTechnologyInformation-Literacy.aspx

(lots of software and online information)

• http://udltechtoolkit.wikispaces.com/(Resources)

• http://www.schoolbehavior.com/disorders/executive-dysfunction/(executive dysfunction)

• http://dyslexiahelp.umich.edu/tools/software-assistive-technology(Resources)

• www.wonkidoorganizer.com (visual calendar and online organizer)

iPad App Resources

• http://www.appitic.com/

• http://www.appymall.com/

• http://bridgingapps.org/ (apps and disabilities)

• http://www.buildingblocksmedia.com/Apps/MusicalPaint/

• http://cardonadesigns.com/wordpress/2010/04/08/text-to-speech-on-the-ipad/

(text to speech and ibooks article)

• http://assistivetechnj.blogspot.com/2011/12/app-attack-switch-accessible-apps.html

(switch accessible apps)

Other Favorite Resources

• www.patinsproject.com

• http://www.eastersealstech.com/ (Indy Easter Seals site)

• http://nolimitstolearning.blogspot.com/2012/11/the-adapted-stylus-which-one-would-you.html

(AT blog)

• http://www.rehabtool.com/links.html (comparing products)

• http://www.katsnet.org/services/reutilization/atex/atex_list.html#daily (Used technology for sale)

• http://www.atxchange.org/v3/items_available.php?category=10 (Used technology for sale)

• http://www.iod.unh.edu/PriorityAreas/assistivetechnology/default.aspx (making AT)

• http://www.yourtherapysource.com/ (lots of OT ebooks)

• http://www.ot-mom-learning-activities.com/shoulder-exercises-for-kids.html• (lots of OT ideas)

Presentation Resourceshttp://www.aota.org/Pubs/OTP/1997-2007/Features/2003/f-011803.aspx

https://www.disability.gov/home/i_want_to/assistive_technology/assistive_technology_in_schools

http://atto.buffalo.edu/registered/ATBasics/Foundation/intro/introdefine.php

http://www.aota.org/Consumers.aspx

http://www.sandi.net/page/819

Cook & Hussey’s Assistive Technologies: Principles and Practice, by Albert M. Cook and Jan Miller Polgar; third edition