General Session – Wednesday, July 20th

10:00 am – 11:00 am

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The Latest Advances in Technology and Research to Support  Return to Work & Productivity

Moderator:Michael J. Dunst, The Hartford 

Presenters:Oswald (Oz) Mondejar, Spaulding Rehabilitative Network; Partners 

HealthCare at Home

Paolo Bonato, Ph. D., Spaulding Rehabilitation Network 

Karrie A. Shogren, Ph. D., The University of Kansas

Cheri Blauwet, M.D., Spaulding Rehabilitation Network

Access to information and communications technologies, including the Web is a basic human right. 

‐ The UN Convention on the Rights of Persons with Disabilities 

Support diversity & inclusion efforts

Demonstrate corporate social responsibility

Enhance corporate image and reputation

Drive consistency and 

standardization of design

Increase customer research and satisfaction

Increase ability to attract and retain 

employees

Reduce legal exposure 

Source: ‘Developing a Web Accessibility Business Case’, W3C® Web Accessibility Initiative, http://www.w3.org/WAI/bcase/http://theweco.com/the‐business‐case‐for‐web‐accessibility/http://www.ssbbartgroup.com/reference/whitepapers/accessibility‐business‐case/

ACCESSIBILE TECHNOLOGY IS GOOD FOR BUSINESS

AN eRECRUITING SNAPSHOT

In 2015, The Partnership on Employment & Accessible Technology (PEAT)  surveyed people with disabilities nationwide who had recently applied for a job online.1 The results identified critical accessibility problems with typical eRecruiting practices—issues that may exclude 1 out of every 5 candidates from consideration. 

JOB APPLICATIONS

46%Rated their last  experience applying for a job online as “difficult to impossible.”

Of those 9% were unable to complete the application and 24% required assistance.

TECHNICAL ASSISTANCE

42%were able to complete the application

58%were not able to complete the application

Of those applicants using employer‐provided “technical assistance.”

TOP eRECRUITING ACCESSIBILITY ISSUES

• Complex navigation• Timeout restrictions• Lack of video captioning• No alternative text for images• Poor screen contrast• Inaccessible form fields• Mouse‐only input option

1eRecruiting & Accessibility: Is HR Technology Hurting Your Bottom Line? A Report on PEAT’s 2015 Research Findings , http://peatworks.org/content/erecruiting‐accessibility‐report

General Session – Wednesday, July 20th

10:00 am – 11:00 am

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Oswald (Oz) MondejarSpaulding Rehabilitation Network and Partners Healthcare at Home

Senior Vice President of Mission and Advocacy 

Spaulding Boston (SRH) 

Spaulding Cape Cod (SCC)

Spaulding Cambridge (SHC)

Spaulding W. Roxbury (SWR)

Spaulding North End (SNE)

IRFsLTAC SNFs Home Care 

Partners HealthCare at Home + Private Care (PHH)

PARTNERS CONTINUING CARE – WHO WE ARE

MISSION AND VISION Mission Partners Continuing Care is committed to delivering compassionate care across the health care continuum to improve quality of life for persons recovering from or learning to live fully with illness, injury and disability.

Vision Partners Continuing Care will be the nationally recognized leader in research and education achieving exceptional patient outcomes and known for delivering a broad range of innovative and integrated health care solutions.  We will exercise leadership to shape healthy policy and to advocate for our patients, their families and our staff.

General Session – Wednesday, July 20th

10:00 am – 11:00 am

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BUSINESS REASONS AND SUSTAINABILITY 

Quality and Outcomes

Customer Satisfaction

Market Share

Community and Political Support

Productivity

Satisfy Accreditation Standards

Grants and Funding

Public Relations

DRIVING GOALS BEYOND COMPLIANCE

Assistive Technology

Advocacy Empowerment Accessibility

Psychology Mental Health 

Therapy Wellness

Inclusive Design

Vocational Rehabilitation Community Engagement

Adaptive Sports and Recreation

Spaulding Rehabilitation 

Network

Rehabilitation Technology 

Paolo Bonato, Ph. D.Spaulding Rehabilitative Hospital

Department of Physical Medicine and Rehabilitation,Harvard Medical School, Spaulding Rehabilitation Hospital

MGH Institute of Health Professions, Harvard Medical School

Wyss Institute for Biologically Inspired Engineering, Harvard University

General Session – Wednesday, July 20th

10:00 am – 11:00 am

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REHABILITATION ROBOTS

Conor Walsh, Wyss Institute

B-Temia

Cyberdine

Myomo

Adaptive Equipment Demonstration 

Spaulding Motion LaboratoryBoston, MA

Applied Cognitive Technologies

Karrie A. Shogren, Ph.D.The University of Kansas

Professor, Department of Special Education

Co‐Director, Kansas University Center on Developmental Disabilities

Associate Director, Beach Center on Disability 

General Session – Wednesday, July 20th

10:00 am – 11:00 am

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WHO ARE PEOPLE WITH CONGNITIVE DISABILITIES?

• Cognitive disability is a broad term that describes people who have support needs in areas related to memory, problem‐solving, attention, reading, linguistic, verbal, math, or visual comprehension 

• People with cognitive disabilities may have diagnoses of intellectual disability, autism spectrum disorders, persistent mental illness, brain injury, stroke, and dementia

• An estimated 28.5 million Americans, more than 9% of the U.S. population have a cognitive disability

SUPPORTS CONGNITIVE DISABILITY

• Strengths‐based approaches to disability  suggest the importance of focusing on: 

−The demands of the environments in which people work and identifying the supports that are need for success when people are transitioning to employment or transitioning back to employment after an absence or injury

• Supports may take many forms, including education and training and adapted work environments and demands

• Supports can also be provided in many different mediums, including supports provided through technology 

APPLIED CONGNITIVE TECHNOLOGY

• The field of Applied Cognitive Technology provides: 

−Research and development on technology supports that enable people with cognitive disabilities to successfully function in environments, to increase participation in tasks and activities in environments, and to promote productivity and quality of life

−A framework for rapid research and development of technology supports that can be deployed to enable success across environments, including the work environment

General Session – Wednesday, July 20th

10:00 am – 11:00 am

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APPLICATIONS OF APPLIED CONGNITIVE TECHNOLOGY

• Cloud and app‐based technologies

• Social media and social networking technologies

• Self‐determination and personal autonomy supports (e.g., remote monitoring that is not invasive and supports independence)

• Mobile digital image communication applications

• Health‐related technologies

• Context aware and location‐based learning technologies 

SMART TRANSPORTATION SYSTEMS

TECHNOLOGY SUPPORTS 

• Smartphones, iPads, & Tablet PCs

• Cloud‐based apps

• The Internet of Everything

General Session – Wednesday, July 20th

10:00 am – 11:00 am

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ENDEAVOR CONNECT (ablelinktech.com)

VISUAL IMPACT (ablelinktech.com)

Sports and Employment:What is the Link?

Cheri  Blauwet, M.D.Spaulding Rehabilitative Hospital

Instructor in Physical Medicine and Rehabilitationat Harvard Medical School 

Disability Access and Awareness Director for Spaulding Rehabilitation Network.

General Session – Wednesday, July 20th

10:00 am – 11:00 am

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• Rates of employment for people with a disability lag• Why may this be the case?

• Introduction to our work – Am J PM&R, 2013

BACKGROUND TO THE TOPIC

BACKGROUND

• Great efforts have been made to increase rate of employment for individuals with disabilities 

• Despite this, employment for adults with SCI still lags− 5 years post‐injury, 21% are employed − 25 years post‐injury, 36% are employed − Similar across multiple other forms of disability 

• Lack of clarity regarding rehabilitative tools to stimulate employment− How about sports?

STUDY DESIGN

Exclusions: 46 people more than

65 years old

Boston SCI-Health StudyN=195

Aug 17, 2009 – Jan 14, 201122 years or older

one year post injury or moreno other neurological condition

not ventilator dependent

Employment Sub StudyAdults of employment age

N=149

General Session – Wednesday, July 20th

10:00 am – 11:00 am

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METHODS

• Outcome: Employment after SCI− Working full/part time

• Variable Selection/Definition− Age, gender, education− Duration of injury− Body mass index (BMI)− Participation in organized sports− Participation in individually planned exercise

• Multivariate logistic regression analysis 

RESULTSPARTICIPANT CHARACTERISTICS 

Variable Employed (n=64) Unemployed (n=85) Total (n=149)

Demographics

Age (Mean ± SD) 46.6 ± 9.8 51.6 ± 10.5 49.5 ± 10.5

Male (N) 51 (79.7%) 72 (84.7%) 173 (82.5%)

Duration SCI (Mean ±SD)

20.5 ± 10.8 18.0 ± 12.0 19.1 ± 11.6

BMI (kg/m2)

Normal (≤25) 34 (53.1%) 33 (38.9%) 67 (45.0%)

Overweight (>25 - ≤ 30) 17 (26.6%) 23 (27.1%) 40 (26.9%)

Obese (> 30) 13 (20.3%) 29 (34.1%) 42 (28.1%)

RESULTSSPORTS, EXCERSISE, AND EMPLOYMENT 

Variable Employed (n=64) Unemployed (n=85) Total (n=149)

Sports Participation

Participating 19 (29.7%) 14 (16.4%) 33 (22.1%)

Not participating 45 (70.3%) 71 (83.5%) 116 (77.9%)

Exercise Time (min/wk)

None (0) 16 (25.0%) 27 (31.8%) 43 (28.9%)

Minimal (≤180) 22 (34.4%) 20 (23.5%) 42 (28.2%)

Moderate (>180, ≤ 360) 14 (21.9%) 17 (20.0%) 31 (20.8%)

High (>360) 12 (18.8%) 21 (24.7%) 33 (22.2%)

General Session – Wednesday, July 20th

10:00 am – 11:00 am

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RESULTSCHARACTERIZATION OF ORGANIIZED SPORTS

• 33 participants reported participating in organized sports (yes/no) and several (n= 11) reported playing more than one sport− Basketball = 7− Tennis = 6− Snow skiing = 5− Sailing = 4

RESULTSMOBILITY MODE OF SPORTS PARTICIPANTS 

Most participating in organized sports were manual wheelchair users

Participating Not Participating Total

Power wheelchair

2 (6.9%) 27 (93.1%) 29

Manual wheelchair

28 (35.4%) 51 (64.6%) 79

Walk with aid 2 (9.5%) 19 (90.5%) 21

Walk independently

1 (5.0%) 19 (95.0%) 20

DISCUSSION

• In this study of 149 adults with SCI: − Participation in organized sports was associated with an 

increased likelihood of employment (~2.4↑)− Individual exercise did not show same impact− Independent of age and educational level

• Sports may be an effective tool to increase likelihood of employment

General Session – Wednesday, July 20th

10:00 am – 11:00 am

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FUTURE DIRECTIONS

• Consideration of a prospective study of a sports “intervention” with monitoring of outcomes − Physical, psychosocial, employment 

• Questions that remain: − Quantity/level/type of sport− Role of other factors – ex: urban environment − How these findings may vary for other categories of disability 

WHY SPORT?

Some ideas: • Informal mentoring outside of a “rehab” model

− Applies to peers, coaches− Example – independence in transportation, travel 

• Evolution of a positive self identity • Increase in sports opportunities at the collegiate level 

− Opportunities for the “student athlete” 

PERSONAL VIGNETTE 

General Session – Wednesday, July 20th

10:00 am – 11:00 am

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Thank You!