Occupational Therapy and
Assistive Technology:
A Vital Link
Molly Shannon, OTR/L, ATP
North Carolina Assistive Technology Program
Charlotte, NC 704-355-2703
mshannon@ncatp.org
www.ncatp.org
A Beginning…
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I drew it, the letter A. There it was on the floor
before me. I looked up. I saw my mother’s face for
a moment, tears on her cheeks. I had done it! It
had started, the thing that was to give my mind it’s
chance of expressing itself. That one letter,
scrawled on the floor with a broken bit of yellow
chalk gripped between my toes, was my road to a
new world, my key to mental freedom.
Christy Brown, 1954
My Left Foot, movie and book
Overview of Presentation
 Definitions,
compare and contrast
OT/AT
 OT Role
 Categories of AT and examples
 Resources
 Case studies
 Door Prizes
“Molly, Why Did You Stop Being
an OT?” WRONG!!
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I have never stopped being an OT.
I am an OT that specializes in AT.
AT professionals come from all
backgrounds, but OT is a logical choice.
Apple and AOTA in New Orleans years
ago, “AT and OT: Changing Lives One Day
at a Time”
Why Should O.T.s be Using AT?
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Why not? Hasn’t OT always dealt with adaptive
devices? AT is just an extension of this
Best practice! OT Practice Framework: ADL,
IADL, Education, Work, Play, Leisure, Social
Participation….AT touches all of these!
Different settings are demanding increased
knowledge of AT: schools and rehab
Increased media coverage of AT increases
knowledge base of consumers and families
Why Aren’t O.T.s Using AT?
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Lack of experience and/or confidence
Too little time for additional training
Little access to AT in particular settings
No mentors
Just don’t get it, no buy in yet or “ah-ha” moment
or client
Lack of institutional or supervisor support
Lack of resource information
Definitions of OT and AT

From AOTA website: Skilled treatment that helps
individuals with disabilities achieve independence in
all facets of their lives. It gives people the “skills for
living” necessary for independent and satisfying lives.
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AT Definition from PL 100-407:
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AT Device: Any item, piece of equipment or product
system whether acquired commercially off-the-shelf,
modified, or customized that is used to increase or
improve functional capabilities of individuals with
disabilities.
AT Service: Any service that directly assists an
individual with a disability in the selection, acquisition,
or use of an assistive technology device.
Compare and Contrast
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AT: goal is to increase function. If a person cannot
perform a required activity, then may need AT to
accomplish.
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OT: use functional tasks to increase
independence in self-care, work, school, play and
leisure.
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Do they overlap? Yes.
Terminology/Topics to Consider
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Least restrictive environment
No prerequisites to try AT! Continuum of access
concept across lifespan.
Universal Design.
Jargon: medical vs. educational vs. community.
For funding issues mainly.
No, low, and high tech: based upon cost or
degree of difficulty
Method vs. material accommodations vs.
accommodation technologies (seating, large print,
software for vision limitations)
Inclusion Levels
Tasks
Location
With peers
Examples or AT
Full: Level 1
Same
Eqpt for physical
Full: Level 2
Same with
With peers
accommodatio
ns
Increased time,
decreased
quantity, etc.
Full: Level 3
Same with
adaptations
With peers
Varied input/
output on CPU,
format shift
Moderate: Level 4
Same with
content shift
With peers
Books on reading
level, highlighted,
decreased grade
level
Moderate:Level 5
Same at
times:
Developmental
With peers or
separate part of
room
Ex: coloring map
and tracing
names of states
or name
Limited: Level 6
Functional
Separate
Functional words,
sorting,daily tasks
Limited: Level 7
Separate
Separate
Ex:IEP,cause
Settings for OT using AT
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Educational: all ages
Private, charter schools
Non-profit settings
Hospital or rehab
Private OT
Home Health, nursing homes or assisted living
Specific AT sites: Tech Act, school team, Voc
Rehab
OT Role in AT Evaluation
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Functional range of motion
Strength
Sensory
Cognitive, depending upon team
Coordination
Reach
Hand Strength and finger isolation or other
isolated access control
Functional skill levels
Typical OT Roles in AT vs.
Generalist in AT
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Assist in seating and positioning and ECU
integration possibly
Switch access
Mounting
Writing assistance tools and sottware
But as an OT gains more expertise in AT, the roles
between service providers blend. For example, I
do quite a bit of AAC consultation for low tech.
Assessment Assistance: few formal
evals out there
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Online typing tutor and AT assessment, $6 month
for individuals, free 4 wk trial at
www.customtyping.com
WATI free AT eval form (37 pages) and other
materials online, www.wati.org
SETT (Student, Environment, Task, Tools) online
form from Joy Zabala and Denham:
http://sweb.uky.edu/~jszaba0/ATConsidGuideADJ
Zcomp.doc Principles:
http://sweb.uky.edu/~jszaba0/Joyshandouts.ht
ml
Categories of AT
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Computer Access
Augmentative communication
Activities of Daily Living
Environmental Controls
Seating, Mobility and Positioning
Low or No Tech: Do Not Dismiss the
Importance!
Laptrays, adapted desks
 Typing aids, splints
 Book holders, 3 ring binders,
slant boards
 Built-up handles, grips, new
Crayon TwistUps, etc.
 Reachers, mouthsticks and
head/chinpointers
 Hand held magnifiers
 Raised line paper, writing guides
 Homemade devices! Client or therapist!
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Overview of AT Products
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Not meant to be all encompassing
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Just representative, novel products
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Trying to put a name to a product to help
with recognition later
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Sources listed on slides on handouts or
email for more info, some fav sources so
becomes resource list for you
Hierarchy of
AT Computer
Access
Least Restrictive Access
Keyboard
Mouse Technology
Proportional Joystick
Switched Joystick
4 switches
3 switches
Single switch scanning
2 switches
Single switch
Most Restrictive Access
Regular Keyboard Use
Slip-on Typing Aid, $16
Keyboard Labels or Keycaps,
~$20, various large print and
Braille,www.donjohnston.com,
www.beabletodo.com, various
Keyguards, $140
www.turningpointechnology.com,
various
Low Vision Keyboard, $60,
www.maxiaids.com
Regular Keyboard Use: Typing Aids
Lefthanded Keyboard,
various, $99, www.fentekind.com
Page Turners, $28, $18,
www.maddak.com
Mouthsticks,
www.wisdomking.com,
$62 and Headpointer,
$112
Portable Word Processors:
Alphasmart 3000 $199
with Co:Writer Applet add
$139 or DANA
www.alphasmart.com
PC6 from Perfect Solutions
www.perfectsolutions.com
$290 plus a text to speech
component available for $99
Alternative Keyboards: small, large, one hand, chorded,
Kid Keys Keyboards, $169
www.enablemart.com
Intellikeys Keyboard $395,
www.intellitools.com
Mini Keyboard, various, $60, Fentek
Half QWERTY keyboard, $595,
www.half-qwerty.com
Trackballs, Joystick or Mice Examples
Kid-Trac or PC Trac/Max
Roller II Joystick or
trax, $69-79 (Microspeed)
trackballs, $309
various sources and
www.enablemart.com
Infogrip, www.infogrip.com
Logitech
Trackman, $40,
Infogrip
Vertical Mouse, left or
right-handed,
www.sforh.com $72
HelpiJoy Mouse, $199, Infogrip
Mouse Emulation:
Magi-Mouse, www.magitek.com ,
wireless computer/AAC control
QuadJoy $540
www.quadjoy.com
IntegraMouse, $2200,
www.infogrip.com
Using Your Head:
Many Choices
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Infrared products: ex. Headmouse
Extreme, www.enablemart.com
$1000
HandiEye,
www.freedomofspeech.com, $699
Eye gaze systems, ex. Quick
Glance, www.enablemart.com
$4500-6500
Computer Software: Onscreen Keyboard Example:
REACH Interface Author (329 to 549.00) www.ahfnet.com, free 30 day trial, WIN
Word Prediction: (example) Co:Writer
$325 www.donjohnston.com. Great article
from LD Online about word prediction,
http://www.ldonline.org/ld_indepth/technology/word_prediction.html
Sorting Through Word Prediction and
Onscreen Keyboards
Onscreen Keyboards: physical issues, with or
without word prediction, variables
Word Prediction:
Applet for Alphasmart or software
Increases rate of writing as decreases number of
keystrokes required, >12 wpm may not be effective
unless need spelling/language support too
Have to visually monitor screen to be effective
Works nicely with onscreen keyboards or if keyboard
is mounted upright
Writing Support Software many choices!
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Kurzweil 3000, www.enablemart.com , $1100-1500,
new prod for Windows called ClaroRead for $395.
Read and Write, Enablemart, $695
Software: Talking Word Processors
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Example, Write:Outloud, $99,
www.donjohnston.com
More Writing software…
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Clicker 5, $199, www.enablemart.com
Writing Support Software
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Inspiration or Kidspiration, $55,
www.enablemart.com, 30 day free trial from
publisher www.inspiration.com
Voice Recognition:
Primarily using Dragon Naturally Speaking
Depends upon individual, yet many clients with
SCI depend upon VR
Students with LD, neurological like MD, some
CP
Doctors, lawyers, public safety
Bottom line: what tasks need to do? May use
VR for some and type via other methods for
others
Where to use in public school settings? What
grades? Cognitive load.
Switch Interfaces and Switches
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Have to have an interface to use
switches to operate computer
Several sources, including
www.donjohnston.com and others for
about $100
Switch software commercially
available or can do some
customization if needed
Hierarchy of Access Sites: Can Have
Multiple Sites for Access
Hands
Head/voice
Arms/elbow
Legs/knees
Feet
Top Tips for Switch Selection: compiled from Dr. Jennifer
Angelo source, Univ of Pittsburgh
Movement Issues: naturally occurring, volitional, social and
communication issues, motivation is key
Positioning and Environmental Concerns: team assessment
helps, space constrictions, reflexes, mounting, different
locales/times different access?
Performance Variables: Target size, Force,Timing, Accuracy,
Efficiency, Durability, Safety and Fatigue
User Input: Interest and acceptance, Fun for younger users, Increases
independence, Comfortable, Ease of use, Reliability, Cost issues
Professional or Family Support Pointers: Wait!, consider previous
attempts, try it yourself!, ease and reliability of set-up by staff/families
http://www.vard.org/jour/00/37/5/angelo.pdf#search='jennifer%20angelo%
Ideas for Feature Matching with
Switches: Varies with Clients!
Cerebral Palsy: coordination is
key
Pressure, rocker, wobble
switches. Mounting!
Neuromuscular (ALS, MD,
SMA): strength, ROM, fatigue
Spec, light touch, blink, P
switch, cup, microlite
Spinal Cord Injuries: high level
quads
DD/MR:
bright, big, sturdy
Visual Impairments:
Sip and puff, tongue, head
controlled
Big Red, Bass, wobble,
auditory
Texture switch, auditory
feedback
My Favorite Switches
Ultimate Switch, $95
www.enablingdevices.com
 Microlite Switch,
$59, www.tashinc.com
 MiniCup, $50, TASH
 Jelly Beamer, wireless
Switch, $129, www.ablenetinc.com
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Scanning: Techniques and Patterns
The most laborious and mentally straining
form of access is auditory scanning so is
usually a last resort for access! Visually
scanning is easier.
Scanning Techniques: Automatic, Step,
Directed or Inverse
Patterns: Linear, Circular, Group , Customized
Morse Code Issues
•Great if ham radio or military experience
•Expressive, not receptive
•Which devices or software: JOUSE,
EZ morse, DARCI, doublecheck
•Book, Modern Morse Code in Rehab and Education by
Thomas King
•Website of user and links: www.makoa.org/jlubin/morsecode.htm
•Book, Denis Anson,OTR: Alternative Computer Access
Speed is key, can get up to 30 wpm
Codes become automatic so reduces cognitive effort to write
and can concentrate on writing
Takes many hours to learn, audio learning best
Try at very early age; same age as peers learning to write
Voice Recognition
Example:Dragon Naturally
Speaking, various versions from $100-1000, various
sources including www.image-management.com/
 Powerful product that has replaced some other
methods for some clients
 Use a great deal with SCI and RSI
 Can be operated totally hands free if needed
 Source for resources for voice recognition:
http://atto.buffalo.edu/registered/ATBasics/Curriculu
m/Writing/speechRecognition.php
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Augmentative Communication
OT plays vital role as part of assessment team
 Become a generalist with experience!
 Should be using their devices in OT sessions,
not just in Speech or in class
 Linda Burkhart great resource site
www.lburkhart.com/
 Speech to Speech Relay service,state numbers
listed at website
http://www.fcc.gov/cgb/dro/sts.html
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10 things I wish my teacher knew about AAC
(insert AT or therapist, parents, etc) Callier Center/ ASHA
http://www.callier.utdallas.edu/ACT/res.html#C
1. I wish my teacher would joke with me.
2. I wish my teacher would learn how to work my communication
device.
3. I wish my teacher would stop shouting at me like I can’t hear.
4. I wish my teacher would remember that I don’t always spell very well.
5. I wish my teacher wouldn’t have a heart attack when my device
doesn’t work.
6. I wish my teacher would have more patience with me.
7. I wish my teacher wouldn’t hit my machine when it doesn’t workthat’s my mouth she’s hitting!
8. I wish my teacher would call on me for Share Day.
9. I wish my teacher would give me enough time to say what I’m
thinking.
10. I wish I could walk and talk like my sister and brother.
AAC with Environmental Controls
Dynavox and Prentke Romich products have
had infrared access for years with high end
AAC devices.
 Use for electronics in home or for operating
toys for children.
 No antennae or is radio
Controlled device or toy.
 AMDI Tech Talk ECU, $795
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Environmental Control:ECU
or EADLs
Simple large remotes,$39,various sources,
Wal-Mart or Large remote with
switch jacks, $119www.adaptivation.com
 Jumbo Universal Remote,
$189,www.enablemart.com
 Powerlink 3,$189,
www.ablenetinc.com
 More complex with scanning
Switch access start at $250-600 from
www.tashinc.com for Relax units and up to 5K15K for Quartet Simplicity voice/switch ECU
and components,
www.freedomofspeech.com
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Popular ADL Products
New products: Soap
Genie,$40 www.skymall.com
 Autoflip Spatula, $17,
www.independentliving.com
 Adapted Gardening, Fishing
and Hunting:
http://www.accesstr.com/
 Drink Aide, $39 from
www.gstsdesigns.com
 Half gallon carton holder, $8,
www.dynamic-living.com
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Various Newer
AT products
PDAs for augmentative communication and
cognitive support
 Bluetooth cellular phone for hands free
answering and calling
 Smartphones with Bluetooth and GPS and
alarms
 Infrared plumbing: Pros and Cons!
 Adjustable shelves and stovetops,
Approach Cooktop and Countertops, $1564
each
www.enablemart.com
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Self Feeders
Neater Eater,
www.sammonspreston.com,
$3796.00
Winsford Feeder, Sammons, $3746 or
www.activeforever.com at $2795!!
Steady Spoon, Sammons,
$40-50.00
Low Tech Toys and Learning
My Handout
 Great research summary article about using AT with infants
and toddlers:
www.asu.edu/clas/tnt/presentations/UsingAssisTechInfTodEB
P.pdf#search='toddlers%20AND%20power%20mobility‘
 Spice up use of switch toys by being creative, using in
units, cooperative activities, encouraging language and
motor skills
 Look wherever you shop for battery operated, current toys
can add a battery interrupter to. Cracker Barrel, $1 stores..
 Best sources of adapted switch toys remains
www.enablingdevices.com, but try Ebay as well!
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The Low Down on Battery
Operated Toy Adaptation
•Battery interrupters, $8-14 from
AAA-D battery sizes
•Make own, directions online. Cold solder
is now available
•Buying toys already adapted is more expensive, but
some benefits
•Adding own interrupters to cheap toys allows to increase
interest with current toys, like Curious George or
Dora
•Great holiday workshops to make switch, adapt toys
Single Switch Latch Timer, $75,
www.enablingdevices.com , adds control options
More Toy Tidbits…
•Some call adapters, but adapters are the way
to change from a 1/4 inch plug to a 1/8
plug or vice versa
•Note can buy both from Enabling Devices, just
not shown in catalog. Also from Radio
Shack and others
•Many toys have multiple operations and may
not be easy to adapt
•Some battery compartments are too tight to
place copper disk in
•Rasp to notch edge of cable
•Key! One adapter for one toy! Last much
longer, easily used…
Vision AT Examples
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Magnifiers, handheld, lighted
ADL aids:many talking ones
now for blood pressure, color
and money detection (Voice
It All, $250,
www.maxiaids.com ,
scientific calculators,hobbies!
CCTVs, ex. Quick Look color
portable, $745, Maxiaids
Software for screen
enlargement (Zoomtext) or
screen reading (JAWS,
$900-1100, Maxiaids) or
Braille input/output
Telephones and Cell Phones:
Ameriphone RC 200 Handsfree telephone, $400,
 Picture Phones, $60, www.101phones.com
 Bluetooth technology advances
 Amplification,Headsets
 TTY, Relay services,Speech to Speech/Sprint
 Alltel Disability Access cell phone reference:
http://www.alltel.com/phones/disability-access.html
 Engineer who specializes in adapted cell phones for
all disabilities, Ray Gonzales,
919-523-0205
http://www.etoengineering.com/quadriplegic.htm
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Mounting
Mounting Systems:
For Switches or AAC:
Cost varies with weight can hold, features
E-mount $99 or Magic Arm $190 from
www.adaptivation.com. Articulating
Arm from www.rjcooper.com $115.
Profiler-Lite $210, Slim Armstrong $191 ,
USMS $200 from Ablenet. MightyMount
$125 plus $90 for arm from TASH.
MAXESS switch mounting system, $55 from
www.inclusivetechnology.com
Early Positioning AT
Bumbo Seats, $40, www.bumbo.com
 Ladybug corner chairs, $770
www.adaptivemall.com
 Tomato, ~2K,
www.adaptivemall.com
 Giraffe standers,
~1500,

www.adaptive.mall.com
Upper Extremity Support
Powerboard, www.sforh.com, $115
Ergorest, www.infogrip.com, $119199
Zonco Mobile Arm Valet,
www.zoncoarm.com, $838 plus
for various attachments
Morency Rest, www.sforh.com,
$115
Electronic Page Turning: Worth it?
Book holders and mouthsticks easiest! Cheapest as well.
Electronic: GEWA (Winsford) and Touch Turner
www.touchturner.com $980
www.zygo-usa.com
Roberts Book Holder, $19,
www.activeforever.com
Low Tech Book Holders or Page Turning
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Handout: A-Z of Adapting
Books
Books on CD or tape, spiral
bound for SCI is easier
Book holders, nice ones from
Bible stores
Magnetic Page Turner, $60,
www.augresources.com
BookWorm, $239,
www.ablenetinc.com switch
access and voice output
I Love Cats!
Our Field Trip to Big Cat Rescue
Big or small…. I love cats!
Link to how to adapt Powerpoint for switch books,
various sites
www.everhart.leon.k12.fl.us/downloads/Powerpoint%20V3.
pdf
Power Mobility and Driving
These are true specialty areas.
 Karen Kangas, OT, great resource for
power mobility, 13 page article about
LMN for head access for power mobility
www.aslinc.com/PDFS/overallhead.pdf#search='
karen%20kangas%20AND%20assistive
 Peggy Barker, P.T. website with sources
for AT for power mobility www.atole.com/
 Adaptive Driving, An Introduction
www.infinitec.org/live/driving/dealers.htm
 Adaptive Driving and Vehicle
Modifications, sources
www.familyvillage.wisc.edu/AT/Driving.ht
m
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Melanie, from film
www.freedommachines.
com
Service Provision Setting and
Examples of Possible AT
•
•
•
•
•
•
•
•
•
CP
Autism
MD/ALS
SCI
CVA
Learning Disabilities
Visual Impairments
Arthritis
Traumatic Brain Injury
Cerebral Palsy and AT
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Varies with type of CP: spastic, athetoid, etc.
Athetoid connect most with AT with my experience
AT to support overall independence, community
skills, communication, work, leisure
CP: AT to Consider
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Adapted computer keyboards (mini, king,
keyguards, alternate, virtual onscreen)
Mouse emulation via trackballs
Head based controls
AAC
Environmental control/EADLs
Switch access for cause and effect, toys, leisure
Word prediction and talking word processors
Autism and AT
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Varies greatly with level of autism and
overall developmental level
AT to support learning and
communication, community skills, and
leisure.
Can assist with classroom behavior plan
and goals as a motivator.
Can work with perseveration and make it
a functional and motivating activity.
President Bush hugs
Jason McElwain, the
autistic basketball
manager who drew
national cheers by
scoring 20 points in
four minutes for his
high school team.
Autism: AT to Consider
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Talking word processors
Creative structured software for leisure: Ex: KidPix
AAC support: devices or software based
Possible touch screens initially
Electronic books (audiocassettes or CD-ROMs) Ex: Living
Books
Educational support via special needs software: example
Early Learning from Marblesoft www.marblesoft.com
Muscular Dystrophies, ALS and AT
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Various types: Duchenne’s, Spinal Muscular
Atrophy, ALS
Age and needs of clients vary of course
AT to support maintaining independence in
writing, computer access, environmental
controls/EADLs, feeding, leisure, communication
Funding is possible with ALS/MD Associations at
times
Stephen Hawking,
A Brief History of Time
“For a time after the tracheostomy operation
the only way I could communicate was to spell
out words letter by letter, by raising my
eyebrows when someone pointed to the right
letter on a spelling card. It is pretty difficult to
carry on a conversation like that, let alone
write a scientific paper.”
MD/ALS: AT to Consider
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Alternate keyboards: mini or Magic Wand
AAC devices
Switch access
Trackballs
Word prediction
Electronic page turners and feeders
Eye gaze systems
Environmental Controls
SCI: AT to Consider
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Head based or sip and puff mouse access via
QuadJoy, HeadMouse, SmartNav
Dragon Naturally Speaking
PC Trac trackball
Adapted desks
Voice activated telephones and environmental
controls/EADLS
Alternate keyboards: onscreen or mini
Keyboard trays, lapboards, forearm supports
Possible eyegaze computer access for highest level
of injury
www.scipilot.com
“I should be approached with the best [assistive
technology] that is available and find a way to get it
[funded]. And if I can’t, I can [downgrade], but I should
be able to see what’s available.”
- Marilyn’s story
SCI Functional Independence Guide
Activity
C1-4
C5
C6
C7
Para
Feeding
N
A
Y
Y
Y
Dressing:U
N
A
Y
Y
Y
Dressing:L
N
A
A
A
A
Bladder
N
Y*
A
Y
Y
Bowel
N
N
A
Y
Y
Transfers
N
N
Y*
Y
Y
Manual WC
N
Y*
Y
Y
Y
Power
WC
Y
Y
Y
X
X
Driving
N
Y*
Y
Y
Y
Key: N= Not independent, Y= Independent, A= Independent with assistive
devices, Y*= May be independent, but not expected, X= Not usually needed
SCI AT Products of Note
Quad Desk, $975 plus
Various components
www.enablemart.com

Quad Reacher,Vee-Zee C5
Reacher,$182,
www.allegromedical.com
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Psychosocial Aspects of
Recovery
I’ve often talked about the transition I have to make
almost every morning. I have to emerge from the
dreams in which I’m completely healthy and able to
do anything and adjust to the reality of paralysis.
Once that moment passes, I begin my day rationally
and hope returns.
Learning Disabilities and AT

Underutilized area for AT is with those with
learning disabilities

Usually can see the most opportunity for
improvement

AT allows to level the playing field or impact of
disability no matter what the age
LD: AT to Consider

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Handwriting aids
Software to support writing such as word
prediction or voice recognition
Outline or organizer software
Organizers (software or PDA)
Electronic or handheld spellcheckers
Reading support via OCR assistance such as
Kurzweil 3000
Visual Impairments and AT

Visual impairment vs. blindness

Different organizations and
professionals can really help us provide
best services

AT to increase independence in writing,
reading, vocational, community and
leisure skills
Stevie Wonder
Unveiled Breakthrough
Music Video Using
Description
Technology For Blind
And Low Vision Music
Fans
http://sev.prnewswire.c
om/entertainment/200
50514/NYF058130520
05-1.html
VI: AT to Consider

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Depending upon age and degree of visual loss
and Braille or not
Talking word processors
Screen reading programs
Screen enlargements
Portable Braille devices
Internet access
Arthritis and AT

Standard OT methods of energy conservation and
activity modifications

AT to improve independence in self-care, cooking,
writing, computer access, leisure

AT to consider: minikeyboards, trackballs, voice
recognition, ADL devices, leisure AT products
CVA and AT

Obvious left vs. right CVA
differences lead to different AT
needs

AT to increase independence in
functional upper extremity skills for
communication, writing, reading,
feeding, self-care, leisure

Big impact with augmentative and
written communication, return to
work or other life roles.
"My stroke changed me
into a better person — a
person whom I like. We
all want happiness. I've
learned we achieve
happiness when we
seek the happiness and
well-being of others."
from My Stroke of Luck
by Kirk Douglass
CVA: AT to Consider

AAC devices

One handed keyboards

Onscreen keyboard

ADL devices

Writing aids
Traumatic Brain Injury and AT

One of most complicated areas of AT provision as
there are so many different areas affected:
cognitive, motor, visual, sensory, communication
and psychological

AT to increase sensory stim and cause and effect,
motor control for writing, communication, cognitive
skills
TBI: AT to Consider

Switch access for toys/leisure/ECU/AAC

Augmentative communication

Computer access via mouse emulation with switches or
touch screen, etc

Cognitive supports via electronic reminders, software,
organizers
Orthopedic and AT

Temporary Injuries or Post-Surgery needs
for low tech ADL is standard.

One handed needs for keyboarding or self
care.
Case Study: Kelly, CP, age 11

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Home schooled now by mom who is a teacher
Using an AAC device to clarify speech
Using roller ball joystick and some regular and spec ed
software
Trying adapted cooking items already
Attempting to handwrite and cut, very motivated still
Using a book holder and magnetic page turner for a trial
now
Exploring various software
Case Study: Michael, CP, teen-adult,
transitions in life

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
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
Originally seen in middle school as school district OT,
computer access in school goals at that time and aide
training and support
When began college, called in for AT and accessibility
study by Voc Rehab
Two years later, CAP Medicaid Waiver case manager has
requested help
Has tried many types of AT for computer access, but
prefers head pointer. Uses laptop, hands-free Ameriphone
RC 200 with a headset, ordering an accessible/adapted
mobile phone with Bluetooth capability for hands free
calling and answering from wheelchair. NC contact:
Will have seen in public school setting, college and will
help transition into work world and independent living
settings in the future.
Case Study: Allen S, CVA, 19 years
old



Initially thought he was locked-in syndrome
Have seen him from ICU through getting him
ready for college
Areas assisted: augmentative communication
trials/ordering/loaner/training, computer access,
positioning of keyboard with lapboard, advocate
for helping him get going with college application
and coordination with other agencies for funding
Case Study: Carla, C6 SCI, 28 y/o




Initially saw in rehab for voice recognition
software which her family purchased along
with a laptop for her
Did work site eval for AT
Technology using now: Quad Desk, Dragon
Naturally Speaking, lapboard,
mike/headphone switch kit, slip-on typing
aid, mini-keyboard
Returned to work with DSS
Case Study: Jo, ALS, 52 years old,
former RN



Assisting ALS clinic with head based mouse
control and some environmental control
Very computer literate and participating in an
online research project with a doc for ALS
Technology using: laptop computer with Head
Mouse Extreme, REACH onscreen keyboard,
Ameriphone RC 200 Handsfree telephone,
Dynamyte AAC device and for environmental
control
AT Resources
•
•
•
•
•
•
RESNA Technical Assistance Projects, state
listing, www.resna.org
Alliance for Technology Access
www.ataaccess.org
Abledata www.abledata.com, major source of
AT info in a database
Family Center on Disability and Technology,
www.fctd.info/
Wisconsin AT Info, www.wati.org/ great
resources for educational AT, free eval and data
forms
Frticschi’s AT Tool Chart, great wealth of info!,
http://fritschi.home.mindspring.com/tools.html
More great resources…
•
•
•
•
•
•
AT Training Online Project, Univ of Buffalo,
http://atto.buffalo.edu/
Let’s Play Project, fantastic AT info for children
http://cosmos.ot.buffalo.edu/letsplay/AT/at.html
Boston Schools, Strategies and Tools for Adapting Books, 15
pages,
http://boston.k12.ma.us/teach/technology/emmanuel/Modifyin
gBks.pdf
JAN, Accommodation Guidelines by Disability,
http://www.jan.wvu.edu/media/atoz.htm
AAC resources http://aac.unl.edu/yaack/toc.html
Family Center on Technology and Disability
www.fctd.info/resources/
Disability or Age Specific Resources

•



Extra Hands for ALS, great website with AT and
other info http://extrahandsforals.org/mt/
SCI Pilot, www.scipilot.com
Chicago Lighthouse for the Blind has launched an
AT support line. Individuals who are blind,
teachers, and others can call (888) 825-0080 for
help in resolving issues
Brain Injury and use of PDAs resource
www.vcu.edu/partnership/pda/documents/Product%
20Reviews.html
LD and AT
www.ldonline.org/ld_indepth/technology/technology.
html
More…..






AT for young children www.abilitynetwork.org/links.html
Universal Design
www.extension.iastate.edu/Pages/housing/uni-design.html
College and AT Resource Guide
www.htctu.fhda.edu/publications/articles/cahe/cahe.htm
Home Modifications and other AT info
www.atnet.org/education/homemod.htm
PaTAN 13 pg guide “ AT: A Focus on Accommodations for
Learning” includes method and material accommodations and
accomodation technology ideas for various skill areas
including, writing, organization, etc.
www.westernwayne.org/instserv/resources/learningaccomodati
ons.pdf#search='accommodation%20Technologies
Baltimore Schools 500 books for which Boardmaker
communication boards have already been made (have to have
current version of BM)
www.bcps.k12.md.us/boardmaker/adapted_library.asp
Conferences, Trainings
CSUN, March, Los Angeles,California
www.csun.edu/cod
Handouts from previous conferences

www.csun.edu/cod/conf/proceedings_index.htm



RESNA, June, cities vary www.resna.org
Closing the Gap, October, MN www.closingthegap.com
ATIA, January in Orlando www.atia.org
Freebies!!!!
Click ‘n Type: free onscreen keyboard,
http://www.lakefolks.org/cnt/
 DASHER: unique text entry!,
http://www.inference.phy.cam.ac.uk/dasher/
 E-triloquist: free PC talking program,
http://www.etriloquist.com/
 ATA: We Can Play series,
http://www.ataccess.org/resources/wcp/endefault.html
 National Cristina Foundation: donated computers to nonprofits, schools or agencies, http://www.cristina.org/
 Learn to Type, free online typing test and tutor,
http://www.learn2type.com/
 Jim Mullen Foundation, free computers and software for
persons with disabilities,
http://www.jimmullen.com/ZoomSeq.asp?id=7948
 List of freeware and shareware on our website
www.ncatp.org/Celeste/west1.html#abbreviation

Top Ten Things to Not Say About AT/AAC










1. It’s not my job!
2. I don’t know anything about AAC or AT.
3. He’s just not ready developmentally for it.
4. It’s broken!
5. It costs too much.
6. It takes too much time.
7. He won’t use the device.
8. I am not a computer programmer!
9. Switch toys are so boring.
10. There is not training or support for me!
When we do the best that we
can, we never know what
miracle is wrought in our life, or
in the life of another.
Helen Keller
Door Prizes!