ASSISTIVE TECHNOLOGY:
TOOLS FOR THE OT TOOLBOX
Karen Dishman, OTR
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...
Physical Adaptations
Organize
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%20Techn
ology%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 Technology
Human Activity Assistive Technology (HAAT) Model
Four Components
1. Human
3. Assistive
Technology
2. Activity
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. Activity
The process of doing something!
1. Activities of Daily Living
2. Productivity and Work
3. Play and Leisure
3. Assistive Technology
Human/technology interface
Represents the boundary between
human and assistive technology
Processor
Translates information and forces
received from the human into
signals that are used to control the
activity output
The processor links the humantechnology interface and the
activity output
4. Contexts
the setting that the human carries out the activity in
Physical
Social
Cultural
Institutional
Seating & Mobility
Seating & 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/Ch2PositioningSeatingMobility.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 Communication
Everyone can have a voice!
Silly therapists, AAC is not just for kids!
AAC
1. No-Tech AAC systems
gestures, facial expressions,
and body movements, formal
signing systems (ASL)
2. Low-Tech AAC
communication simple
board, Picture Exchange
Communication (PECS),
visual schedules, choice
boards, token boards
3. High-Tech AAC
Speech Generating Devices
(SGD) such as keyboards,
switches, joysticks, pointing
interfaces, computers, iPads,
iPods
AAC Resources
http://www.adaptedstories.com/stories/index.cfm?session_id=C
CF0974B-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 Access
Involves the human-technology
interface
1. Control Interface
hardware by which human in
the AT system operates or
controls a device (input device)
2. Selection Set
items available from which
choices are made
3. Selection Method
Direct 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 EADLS
Electromechanical 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
Technology for Sensory Impairment
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)
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)
Sensory Aids for Auditory Impairment
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
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
Memory Aids
Prompting/Cueing/Coaching
• Medication boxes
• Fall alarms
• GPS watch
• Smart house (monitoring ,
communication, household
functions, physiological
measurements and medication
alerts.
Memory Aids
Time Management
• Electronic schedules (watch or
visual display)
• Visual schedules (written,
picture)
• Computer or internet based
schedule
• Alarm clocks and watches
Technology for
Cognitive Disabilities
Concept 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/PDS13648/Course_Wiki/SMART_Resources
(well organized teacher resources)
•
http://www.bvsd.org/assistivetechnology/Pages/AssistiveTechnologyInfo
rmation-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-speechon-the-ipad/
(text to speech and ibooks article)
• http://assistivetechnj.blogspot.com/2011/12/app-attack-switchaccessible-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-wouldyou.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 Resources
http://www.aota.org/Pubs/OTP/19972007/Features/2003/f-011803.aspx
https://www.disability.gov/home/i_want_to/assistive_tech
nology/assistive_technology_in_schools
http://atto.buffalo.edu/registered/ATBasics/Foundation/i
ntro/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