. This is the slogan for the National Disa-

bled Veterans Winter Sports Clinic, and has been

for the past 30 years. For one week in Snowmass,

Colorado, the Disabled American Veterans charity

(DAV) and the Department of Veterans Affairs

partner to host the largest rehabilitative event that

aims to teach Veterans how to ski and the chance

to participate in other sports and leisure activities.

Over 400 military Veterans with qualifying disabili-

ties including traumatic brain injuries, spinal cord injuries, orthopedic amputations, visual impair-

ments, and other certain neurological disorders,

gathered this year to learn new skills, develop

friendships, and renew a sense of adventure. For

these individuals, it wasn’t just about the extreme

outdoor adventure, it was about breaking down

walls, shattering barriers, overcoming obstacles, and

transforming their life to prove that disability

doesn’t define them. More than 200 certified disa-

bled ski instructors aided in providing each Veteran

an exhilarating, life-changing experience. The clinic

offers instruction and support for all sports (skiing,

snowboarding, sled hockey, snowmobiling, scuba

diving, curling to name a few) to everyone, no mat-

ter their skill level. The program is developed for

the novice, first time Veteran all the way to the

Paralympic, seasoned athlete.

As a member of the Assistive Technology and

P r o s t h e t i c s

team this year,

our goal was

to provide an

optimal seat-

ing environ-

ment and

improve the

Veterans fit

i n t o t h e

sports equip-

ment. This

not only helps

to prevent

skin break-

down, but can

also be important in enhancing their performance

while participating in the sport. Prosthetists were

on hand to provide adjustments to prosthetic limbs

in preparation for skiing and snowboarding. It is a

collaborative team effort to ensure each Veteran’s experi-

ence is safe, effective, and enjoyable.

Since 1987, the Winter Sports Clinic has been leading the

way for adaptive sports programs around the country, and

this year was no exception. Developed through the Univer-

sity of Utah, the Tetra Ski made its debut on the white pow-

der of Snowmass. Developed for low-level tetraplegic and

high-level quadriplegic patients, the Tetra Ski allows individ-

uals to use a joystick or a sip & puff to control the skis and

direct them down the mountain. An innovative device that

proves, anything is possible if you’re willing to try. So put

your hands together and help me congratulate the 430+

Veterans that proved this year that any obstacle is conquer-

able!

Miracles on the mountainside… by: Erin Brandon, PT

I N S I D E T H I S

I S S U E :

TeleRehab Site

Visit

2

Meet AT Staff 2

Veteran’s Story 3

AT Expanding into

Mental Health

4

VACO AT WEB-

SITE: VA ATECH

5

Nuts & Bolts 6

D E P A R T M E N T O F

V E T E R A N S A F F A I R S

PM&R Assistive Technology S P R I N G 2 0 1 8V O L U M E 7 I S S U E 3

When: 1st Friday of

the month

Time: 1pm EST

Continuing Education

is offered for AOTA

and ASHA.

Registration is always

through TMS.

P A G E 2

Richmond, VA and Clarksburg, WV are working

closely to enhance access to specialized rehabilitation

services through a hub/spoke model for TeleRehabili-

tation. As a spoke site, Clarksburg has teamed up

with Richmond for assistance specifically in serving

their Veterans within the amputation system of care

and Veterans with TBI. After several teleconferences

discussing our upcoming site visit, we decided Clarks-

burg would visit the Richmond VAMC to determine

what other specialized services we could offer. We

completed our site visit about a month ago, where

we were able to review our existing programs and

develop an action plan for our future programs. In

addition, Richmond was able to provide individualized

trainings with the Clarksburg staff with our AT, OT

and Speech therapy departments focusing on what

specialty services Richmond could provide to Clarks-

burg Veterans via telehealth.

.

P M & R A S S I S T I V E T E C H N O L O G Y

Clarksburg Visits Richmond

Overall, our site visit was a huge success! Not only were

we able to create a strategic plan moving forward, we

were also able to provide several trainings to the Clarks-

burg TREWI staff in an effort to work toward enhancing

Veteran’s access to assistive technology in Clarksburg.

The Clarksburg staff are planning to consult assistive tech-

nology specifically for specialty wheelchair seating evalua-

tions, AAC for ALS, EADLs and adaptive sports equip-

ment. A special thank you to Melissa Oliver and the AT

team for helping us grow our TeleRehabilitation initiative

forward!

MEET AT STAFF… Brittany Reed, CCC, SLP Brittany Reed joined the AT Program at the

VA in January 2018. She earned her Bachelors in Com-

munication Disorders in 2010 and her Masters in Speech

Language Pathology in 2012 from UVA. For the past 5 ½

years her clinical interest have been the management of

dysphagia, treatment of Neuro disorders (ex: TBI, CVA,

PD) and the integration of technology in therapy. Learn

more about Brittany from her interview,

What do you like about working at the VA?

Of course our Veterans. I love hearing theirstories. It is

such a rewarding experience to have a role in their

rehab experience and to give hope when all hope may

have been lost.

What areas of AT are you interested in and like

working with? And Why?

AT is an umbrella term that covers many types of assis-

tive technology. I am most interested in technologies

that improve cognitive abilities—this could be something

as simple as medication reminders with timers to more

complex systems such as an intelligent personal assis-tant (Alexa).

I also really enjoy working with communication devices

to help provide a mode of communication to some-

one who otherwise doesn’t have a voice or a way of

expressing themselves. It’s tough to imagine a world

where you can’t express yourself or can’t remember

conversations you have had with a loved one. AT

allows us a chance to change that.

Why are you passionate about AT?

It’s my duty to give back and be a blessing to our

Veterans. We live in a world full of evolving technolo-

gy. It is important to me to help others in ways that

extend beyond traditional therapy techniques. The

use of AT enhances what we are already doing and

bring ideas to life. We can use AT to help someone

communicate, move, manage their personal affairs.

With AT opportunities and possibilities are endless. It

is imperative to use every tool we have to better

serve our veterans.

Tell us about other interests outside of the VA.

I am the ultimate foodie and dog lover. Most days I

am exploring new places in RVA with my husband or enjoying nature. I am also a HUGE basketball fan; I

coach a local high school girls basketball team.

Brian Burkhardt, Rehab

Engineer in Richmond VA, provided training to Brianna Cain and Cara

Damn (both OTs from Clarksburg) regarding Electronic Aids to Daily Living (EADLs).

Melissa Oliver, Assistive

Technology Program Director, and Stacy Gross, SLP, in Rich-

mond provided training

to Cris Irwin, Clarks-burg SLP, regarding AAC devices for pa-

tients with ALS.

P A G E 3 V O L U M E 7 I S S U E 3

bridge on the pool stick. It is awesome!”

Where did the idea come from? According

to Seth Hills, one of the AT rehab engi-

neers, “Nicole Shuman, one of our adaptive

sports recreational therapist, came up with

the concept by putting a toy train on the

pool stick to see if it would work and it

did. So, she asked us to further develop the

idea.” There is something similar on the

market, but it is too narrow to get on and

off the pool stick. Seth took approximately

8 hours to design the concept, and approxi-

mately 5 hours to print in nylon using the

AT Program’s 3D Printer. “We went

through three versions before finally com-

ing up with the one that Malik is using.”

Jennifer stated, “Malik is really excited to

play again.”

Motivated to move forward with his life,

Malik is doing more than playing pool,

working hard with staff of the Polytrauma

Transitional Rehabilitation Program to re-

gain his lost strength and skills. Malik is

making regular taking trips into the communi-

ty for both leisure and community reintegra-

tion, and he recently enrolled in the VA’s

Driver Rehabilitation Program so that he can

regain the skills to drive a car again.

“I am so happy with the progress that I see

with Malik Jones”, said Mrs. Vass. “His speech

and comprehension are great, and he is walk-

ing every day. He has made tremendous phys-

ical progress and, maybe more importantly, he

is far more outgoing and happy these days.

Working hard with the right attitude makes all

the difference in the world – for all of us.”

Shooting pool is a pastime many people

enjoy playing including Veterans and

Servicemembers. Navy Corpsman Malik

Jones is definitely one of those individu-

als. For years he played pool every

weekend with his friends and that all

changed, as with most everything else in

his life, on July 29, 2017 when he suf-

fered a traumatic head injury while Malik

was stateside in Virginia Beach, Virginia. Malik suffered a traumatic brain injury

and was left paralyzed on the left side of

his body as a result of this injury.

Malik, who enlisted at 19 years old and

is currently 22, is still active duty Navy,

however his treatment and rehabilita-

tion is being coordinated in partnership

with the Department of Veterans Af-

fairs. When he arrived at McGuire VA

Medical Center’s Polytrauma Rehabilita-

tion Center in Richmond, VA, Jennifer

Vass, a Certified Therapeutic Recreation

Specialist, immediately started working

to engage him back into recreational

activities he enjoyed. He wanted to play

pool, but trying to manage a traditional

pool bridge and the pool stick was next

to impossible. Jennifer had heard about

the 3D Printed rolling pool bridge the

Assistive Technology (AT) Rehabilitation Engineering team had developed, so she

tried it with Malik. “He picked up on it

really quickly and immediately had strat-

egy on how to use it,“ according to

Jennifer. Malik stated that “Depending

on how far away the cue ball is will de-

termine where I place the rolling pool

Small things making a BIG impact on quality of life!

P A G E 4

In 2008 Legislation funded the establish-

ment of four Assistive Technology (AT) Labs. In

2010, The Richmond VAMC opened and began pur-

suing The AT Programs mission, which is “to en-

hance the ability of Veterans and Active Duty mem-

bers with disabilities to fulfill life goals through the

coordination and provision of appropriate interdisci-

plinary assistive technology services and to serve as

an expert resource to support the application of

assistive technology within the VA health care sys-tem.”

The AT program at McGuire VA, continues

to expand and has recently opened an OT/AT Satel-

lite clinic located in the Mental Health Department.

The primary role of the AT Program in Mental

Health, is to evaluate, develop and implement the use

of appropriate assistive technology services, strate-

gies, devices and/or practices to improve the func-

tional challenges faced by service members and vet-

erans in their daily life roles. The AT program in

Mental Health primarily provides evaluation and

treatment for three areas of AT, including: adaptive

computer access, electronic cognitive devices and

learning technologies.

Adaptive Computer Access is a specialized

group of hardware and software designed to enable

individuals with a wide range of disabilities to use a

personal computer. The service members and veter-

ans who would benefit from adaptive computer ac-

cess are those who have experienced a traumatic

brain injury, stroke, multiple sclerosis, amyotrophic

lateral sclerosis, an upper extremity amputation,

upper extremity orthotic injuries/disease, spinal cord

injury and/or those with documented learning disabil-

ities. Some factor’s that are considered when evaluat-

ing someone for adaptive computer access are first

the veteran’s diagnosis/prognosis, and the veteran’s

current cognitive abilities. Other factors that are

considered are, the veteran’s goals (i.e. to return to

school or work…etc.), whether or not the individual

owns a computer/has access to a computer, type

and/or brand of computer they plan to utilize and

what environment they plan to use the computer (i.e.

at home, at work, at school…etc.). Some examples

of adaptive computer access are an adapted mouse

(i.e. Trackball Mouse, Rollerball Mouse, SpaceMouse),

alternative keyboards (LearningBoard, large key key-

board, large print keyboard, etc.), ZoomText, voice

control (i.e. Dragon NaturallySpeaking Software), eye

control technologies, adaptive switches…etc.).

Electronic Cognitive Devices (ECD) are

products or systems that are used by an individual to

compensate for cognitive impairments and support

his or her ability to participate in activities of daily

living (ADLs) or instrumental activities of daily living

(IADLs). The service members and veterans who

P M & R A S S I S T I V E T E C H N O L O G Y

The Assistive Technology Program at Richmond VAMC

Continues to Expand...by Mandy J. Freeman, MS, OTR/L

would benefit from ECDs, are those who have experi-

enced a traumatic brain injury, stroke, multiple sclerosis,

dementia, PTSD, schizophrenia, autism, etc. Typical cogni-

tive issues that these individuals experience are decreased

attention spans, difficulty remembering to do things (i.e.

taking medications, remembering appointments, etc.), de-

creased memory/difficulty remembering name, faces, plac-

es, etc.), difficulty with task sequencing and multi-tasking,

problems with organization, time management, and difficul-

ty with adapting to changes in their routines. There are

several factors/symptoms to consider, when determining if

an individual would benefit from an ECD and to assist in

determining which device would be most appropriate,

including: balance, visual impairment, speech impairment,

auditory impairment, behavioral changes, initiating and

perseverating, and safety awareness. Some examples of

ECDs are an iPad or iPod Touch, smart phones, Livescribe

Smart Pen, smart watches, Ablelink, Personal Information

Manager (PIM) Software…etc. There are a multitude of

different applications (Apps), that can be uploaded to these devices that can assist individuals with time management,

money management, medication management, education,

health management, behavioral management, communica-

tion & visual & hearing

impairment, etc.

Learning technologies are the

broad range of communication,

information and related technologies that can be used to

support learning, teaching, and assessment. Learning Tech-

nologies can assist individuals in many ways, at work or in

school. At work, learning technologies can help an individ-

ual with word finding, word prediction, recalling infor-

mation from meetings/conversations, with document accu-

racy & with reading comprehension. At school, learning

technologies can help an individual with word

P A G E 5 V O L U M E 7 I S S U E 3

If a provider has a patient that has

an identified loss of function, due to illness

or disability and the patient may benefit

from an AT evaluation, then a consult to

the Physical Medicine and Rehabilitation

(PM&R) AT program must be placed. Of

note, the consult must be entered by a

physician, physician assistant or a nurse

practitioner. Once the PM&R AT consult is

received, the service member/veteran will be evaluated by an AT Team Member.

After a veteran is evaluated by an

AT Team Member, multiple factors are

considered when selecting the appropriate

AT device. First, the patient

and caregiver’s goals are

considered. After the pa-

tient and caregiver’s goals

are determined, the AT

team member assesses and

determines what is the least

invasive device available to

meet the patient’s needs.

The patients physical, mental,

and cognitive strengths and

challenges, the setting in which

the device will be used, the

veteran and/or active duty

member’s current knowledge

and usage of devices, the pros

versus cons of the AT device,

the Prosthetic and Sensory

Aids Services’ (PSAS) Clinical Practice Recom-

mendations (CPRs) and the necessary training

time and follow through needed for the pa-

tient to learn to use the device, are all taken

into account and have an impact on which

device is selected.

While the AT Program is designed

to address various needs, to improve the

functional challenges faced by service mem-

bers and veterans in their daily life roles, the AT program does not provide basic computer

skills training, have an open computer lab for

veteran or staff use, or address basic job skills

training. Although this article provides a gen-

eral overview of the AT services that can be

offered to active service members and veter-

ans, in the Mental Health Department, it is by

no means a comprehensive list, of services or

devices. For further information regarding AT

services, at the Richmond VAMC, please visit

the Richmond VAMC AT website at https://

www.richmond.va.gov/services/AT.asp. Also,

another great resource for information on the

different AT categories and AT device re-

views, is the VACO Rehabilitation & Prosthet-

ics Program Office’s Website called VA

ATECH at https://www.vaatech.org/.

finding, word prediction, recalling infor-

mation from class & groups, assignment

accuracy, completing assignments &

reading comprehension. Some examples

of learning technologies are voice recog-

nition software such as “Dragon Natu-

rally Speaking,” word finding software,

such as “Word Q/Spell Q,” document

accuracy software such as “Ginger Soft-

ware,” reading comprehension software such as “Read & Write Gold”,

“WYNN” and/or “Kurzweil 3000,” and

thought processing software such as

“Inspiration.”

AT continues to expand, cont.

VISIT THE NATIONAL ASSISTIVE TECHNOLOGY WEBSITE ...VA ATECH

VACO Rehabilitation & Prosthetics Program Office

launched a new website specific to Assistive Technology

(AT) called VA ATECH: https://www.vaatech.org/

The website provides information about different

AT categories such as electronic cognitive devices, com-

puter access to name a few. In addition, the AT device

reviews are posted on this website which provides an objec-

tive view of the newest AT devices offered to our veterans.

Other tabs include: resources, access to educational webi-

nars and VA AT Connect and VA AT locator which are

ways to locate an AT provider.

remote was inserted into a box and servo

motors controlled by Arduino could press

the buttons for the user. If necessary, the

remote could be removed from the box.

Otherwise the user could control the bed

controller using IR, which could subse-

quently be accessible to the user via an

environmental control unit or adaptive

remote.

Another example is the Sip’n’Puff

Air Rifle. Many veterans enjoy participating

in recreational air rifle, but some veterans

with fine motor deficits may have difficulty

aiming and pulling a trigger in succession.

AT engineer Seth Hills developed an Ar-

duino circuit that controls a servo motor,

which pulls the trigger when activated by a

sip’n’puff switch once the veteran aims.

Seth also created an adjustable mounting

system for the circuit and components so

that it could be positioned correctly on the

air rifle.

A different application of Arduino

can be found in the Gateway Remote, a

project developed by AT engineer John

Miller. Veterans with a traumatic brain

injury may find it difficult to control house-

hold items like a television due to perseve-

In the Assistive Technology Pro-

gram, our aim is to serve veterans by always

solving problems presented to us rather

than giving up. Custom electronics fabrica-

tion is one of the tools we use to create our

best solutions for the most complex prob-

lems. We rely on Arduino, an open-source

computer hardware and software platform

that offers ready-made components for

building circuits and programming them to

perform tasks. Arduino allows novice/

intermediate users to build their skills in

electronics by providing tutorials online, an

online community forum to discuss projects

with other Arduino users, and lots of exam-

ples of programming code with which to

control a circuit. The only costs associated

with Arduino are components and time.

The bed controller is a good ex-

ample of an Arduino project created by AT

staff. Hospital bed controls are usually acti-

vated with low-profile pushbuttons on a

remote, which are inaccessible for people

with quadriplegia or deficits in upper ex-

tremity movement. However, modifying the

bed control remote voids the warranty of

the hospital bed. AT engineer Brian

Burkhardt developed a solution where the

ration, so he created a simplified TV remote

that will turn off a button temporarily after a

user has pressed it until a different button has

been pressed. The circuit designed must read in

IR commands to learn them during set-up, and

it controls when to send the correct IR com-

mands to a TV as intended by the user.

Projects involving Arduino stretch our

skillset and require a large breadth of engineer-

ing knowledge, but they are solutions for when

nothing else exists to help veterans access their

environment. It is a great tool for the AT Pro-

gram that expands our capabilities many times

over.

1201 Broad Rock Blvd

Richmond, VA 23249

Melissa Oliver, OTR/L

AT Program Coordinator

Phone: 804-675-5000 x2134

Fax: 804-675-6134

E-mail: melissa.oliver@va.gov

Assistive Technology Program Mission

• To enhance the ability of Veterans and Active Duty members with disabilities to fulfill life goals

through the coordination and provision of appropriate interdisciplinary assistive technology services.

• To serve as an expert resource to support the application of assistive technology within the VA health

care system.

Department of Veterans Affairs

Assistive Technology Center of Excellence

Nuts and Bolts…Creating our own custom electronics with Arduino!... John Miller, AT Rehab Engineering

P A G E 6