Introduction to Assistive Technology Sarah Endicott Karen Milchus Work RERC, GA Tech November 3,...

Introduction to Assistive Technology

Sarah EndicottKaren Milchus

Work RERC, GA Tech

November 3, 2010

TACE Center: Region IV, a project of the Burton Blatt Institute.Funded by RSA Grant # H264A080021. © 2010 All Rights Reserved

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Agenda

• Introduction• Overview of assessment methodology• Video• Workplace accommodations for:

Mobility impairments Dexterity impairments Sensory impairments Cognitive impairments

• Workplace accommodation resources• Discussion, questions


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Learning Objectives

• Apply structured assessment methodologies to identify workplace accommodation needs

• Be able to list at least three workplace accommodations for multiple functional impairment categories including people with mobility, dexterity, sensory, and cognitive

• Demonstrate workplace accommodations that are applicable to a variety of work environments.

• Identify national, state, and local resources for workplace accommodations.


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• Focus is on whether or not the individual can perform the essential functions of the job

• Must achieve a certain performance baseline

• Implementation may be time sensitive

• Work area may be public / shared

• Different approaches if employee is new / returning / ongoing part-time / full-time telecommuting self-employed

Workplace Characteristics


5

Workplace Characteristics• Most private / public

employees Rights & responsibilities

under the ADA Cost / safety concerns Resources

• Workers’ compensation

• Federal employees

• Disabled veterans


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Reasonable Accommodation

“Any change in the work environment or in the way things are customarily done that enables an individual with a disability to enjoy equal employment opportunities.” (Source: EEOC)


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Follow Up

YesYes

Consider Confounding Factors

Family/Co-worker conflictsFunding restricts

Determine Solutions

Revise Solutions

Identify Goal

NoNo

Assess NeedsPerson

• Abilities/LimitationsActivity & Tasks

• Time/Quality/QuantityEnvironment

• Tools/Materials/Physical Space

Success?

The Accommodation Process


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• Upper Extremity

• Lower Extremity

• Voice & Speech

• Vision

• Hearing

• Cognition

Person


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• A process to identify the particular activities and tasks that a person performs as part of their daily routine and determine their relative importance

• Most activities can be broken into many smaller, discrete, singular, specific tasks

• Conducted on the activity, not the person doing the activity• Activity analysis helps to identify:

Tasks, tools, materials and equipment Necessary skill level / potential training needs Critical tasks and processes

Activity Analysis


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• Identifies environmental barriers so they can be removed

• Assessment team should be familiar with activity requirements

• Start with exterior aspects (e.g., entrance into building) and work inward (e.g., bathroom)

Environmental Assessment


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1. Modify or revise the activity, task, or location.

2. Creative use of commercially available consumer and industrial goods not typically used together.

3. Use standard, commercially available technology (AT / AD / UD).

4. Modify existing commercial devices.

5. Design and fabricate custom devices and make physical changes to the built environment.

Accommodation Hierarchy


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• Trial period may demonstrate whether accommodation works before investment made

• May need training on accommodation use

• May need multiple accommodations, change in accommodations (ongoing responsibility)

Implementation / Follow Up

Video

Youtube Video - Assistive Technology in the Food Service

Industry


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• “Richard”

• Paraplegia resulting from spinal aneurysm

• Difficulty with temperature regulation

• Good use of upper extremities

Photo courtesy of the Tampa Bay Hyatt

Regency

Video: Food Service


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• Work goal: continue working in food service.

• Hands-On Educational Program

• Partnered with Grand Hyatt Regency

• Stayed at the hotel with discounted rate while Hyatt helped secure an apartment for Richard

• Hyatt modified a basket to carry knives

• Built work platform to increase height 8”

Video: Food Service


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• Training program provided opportunity for prospective employer to observe the person’s skills and work ethic.

• Employer invested in employee by: Extending discounted hotel rate Provided modified basket and work platform Provided a loan for the apartment down payment

Video: Food Service


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Motor Difficulties (Mobility)


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• Accommodation Strategies Minimize effort Reduce distance Eliminate barriers Use aids and assists

Motor Difficulties


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Work RERC Accommodation Use Survey

Mobility Limitations

0102030405060708090

% under 55

% over 55


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Changing Levels


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Doorways

• Widen doorways

• Swing clear hinges

• Lever doorknobs

• Automatic door openers


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Restroom Modifications


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Mobility Aids• Cane

• Walker

• Wheelchair

• Scooter

• Seating


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Seating Systems

• Person can “age” into poor posture over time, which can easily be overlooked

• Proper posture can improve daily functioning and health Stabilization for task

performance Improve respiratory function Stimulate circulation

• Seating systems can be developed for use with almost any chair or scooter


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• Wheelchair backpack

• Wheelchair shelf

• Laptray

• Trolley

• Reacher

Carrying / Reaching Aids


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Accommodation strategies:• Accessible route to and

from

• Adequate maneuvering space

• Appropriate support surface

• Accessible work surface

• Accessible tools and materials

Workstations


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Support Surface

• Provides the necessary postural stability

• Maximizes efficiency and productivity

• Maximizes comfort

• Minimizes potential for injury


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Adjustable Seats

• Many office chairs offer adjustments to maximize support and comfort including: Seat height Seat depth Seat tilt Back height Arm rest height Arm rest width


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http://www.asd.co.uk/special_needs/splitseat/splitseat.htm

http://www.officeorganix.com/NPAbstool.htm

http://www.officeorganix.com/HA1.htm

Alternative Chairs


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Work Surfaces

• Matches the necessary job activities

• Provides adequate room for tools and materials

• Accommodates selected support surface

• Maximizes productivity Height Slope


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• Height adjustability Adjustment method W/C height req. differs by w/c

type

• Slope and positioning Adjustability based on job

duty Brings the work to the person

• Size and shape Customized systems

Work Surface Adjustments


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Motor Difficulties (Dexterity)


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Dexterity: Accommodation Strategies

• Reduce force required to operate Light touch controls Alternative controls (ex. trackball vs. mouse) Take advantage of leverage

• Enlarge gripping / target surface

• Use a different ability Use auditory (ex. voice input)


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Work RERC Accommodation Use SurveyUpper Extremity Limitations

0

10

20

30

40

50

60

70

80

% under 55

% over 55


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Gripping Aids


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Carrying / Reaching Aids


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Enlarged Target Surface


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Operating Systems:• Windows 2000, XP – Accessibility Wizard• Windows Vista / 7 – Ease of Access Center• Macintosh OS X

Included Features:• Adjust Keyboard / Mouse (e.g., ignore

repeated keystrokes, reverse mouse buttons)

• On-Screen Keyboard• Keyboard Control of Mouse

(MouseKeys)• Voice Input (Vista or higher)

Computer Access – Built-In Features


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Alternative Keyboards / Mice

• Maximize use of remaining motor abilities with devices which require a smaller range of motion, have bigger / smaller targets, etc.

Datalux SpaceSaver (compact) keyboard

Trackball &Touchpad


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Keyboards / Mice (Hands-Free)

• Other body parts can operate cursor control devices

• Onscreen / virtual keyboards allow a person to type with a mouse or other cursor control device

Head-controlled mouseOnscreen keyboard


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• Works with or without keyboard and mouse (but it is good to have a backup)

• Need to “train” the software

• Reasonably priced

Works best with: Consistent, fluid speech People comfortable with

computers People attentive to detail People not upset when

computer guesses a word wrong

Voice Recognition System


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Keyboard Trays

• Wireless keyboard and mice allow for less interference

• Keyboard trays offer multiple adjustments for changing postures


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Vision Difficulties


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Vision: Accommodation Strategies

Maximize use of remaining vision

• Change color / contrast to enhance visibility (ex: high contrast #s)

• Change size (ex: larger #s)

Use a different ability• Use auditory (ex: voice dialing)

• Use tactile (ex: tactile labels) Problem: Visibility of numbers when dialing


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Work RERC Accommodation Use SurveyVisual Limitations (N=57)

01020304050607080

altern

ate form

ats

built-in fe

atures

computer o

utput

reading devic

es

reloc/ mod devic

es

vision dev

ices

% under 55

% over 55


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• Adjust color / contrast for printed and electronic materials

• Lighting (and glare reduction)

• Stands to bring materials close

Enhance Visibility (Low Vision)


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Desktop & Portable CCTVs / Video Magnifiers

Screen Magnification Software

Standard Desktop Magnifier

Enlarge Information (Low Vision)


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Considerations:• Is vision functional?

• Familiar

• Minimal training

• Compatible w/ graphics; uses beyond print

• Don’t reformat docs

• See only part of doc. (navigation difficult)

• Desktop / portable, but portable versions have limited viewing area

Magnification


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Screen reader

Audio books

Digital recorder

Talking digital

caliper

Use Auditory Channels


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Screen Reading

• Software plus speech synthesizer (using built in sound card) reads lines, words or individual letters

• Reads icon and picture labels if tagged appropriately

• Keyboard commands used to control software, menus

• Significant learning curve

Related technology: talking word processors provide audio feedback along with visual cues for people with literacy issues (e.g., Write: Outloud)


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Optical Character Recognition (OCR)• Scanner takes picture of

document; OCR converts into electronic text

• Considerations: Used with “computer”;

(inc. smart phone) Once in e-format, have

many access options Different versions for blind

vs. learning disabilities

K-NFB Reader


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Adhesive bumps and tactile paint

Velcro tactile cues

Braille labels

Braille notetaker Braille labels

Braille notetaker

Adhesive bumps & tactile paint

Velcro tactile cues

Use Tactile Channels

http://images.google.com/imgres?imgurl=http://www.maxiaids.com/ProdImages/252715.jpg&imgrefurl=http://www.assistivetech.net/search/productDisplay.php?product_id=16612&usg=__aZ2Jfa1hzh8Qo4t4AUH1DjAHquE=&h=250&w=250&sz=7&hl=en&start=18&tbnid=ZomVjc5OkgSuTM:&tbnh=111&tbnw=111&prev=/images?q=dots+low+vision&gbv=2&hl=en


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Hearing Difficulties


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Hearing: Accommodation Strategies

• Maximize use of remaining hearing

Enhance sounds (ex: amplify, isolate)

• Use a different ability

Convey information visually (ex: text, sign language)

Convey information tactilely (ex: vibration)


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Work RERC Accommodation Use SurveyHearing Impairments (N=56)

05

101520253035404550

% under 55

% over 55


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Amplify or Isolate Sounds

Hearing Aid

Assistive Listening Devices

Amplified Stethoscope

Phone Ring AmplifierHearing Aid

Phone Ring Amplifier

Assistive Listening Devices

Amplified Stethoscope

http://facstaff.uww.edu/bradleys/radio/fm/


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TTY/TDD

Text/ Instant Messaging

Video Phone

Wireless Chat – Face-to-FaceText / Instant Message

Wireless ChatFace-to-Face

TTY/TDD Video Phone

Visual Communication


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Cognitive Difficulties


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• Perception: accurately senses & understands info. Aids similar to AT for sensory impairments

• Memory: stores and retrieves info. accurately Aids inc. recording systems and reminders

• Processing: correctly uses available information Aids inc. guides, checklists, simplified methods

• Expression: demonstrates thoughts or feelings through verbal/non-verbal means Aids similar to AT for communication, also behavior

training

Cognition & Cognitive Aids


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Cognition: Accommodation Strategies

• Minimize cognitive load Minimize competing info. Emphasize relevant info. Establish habitual patterns

• Minimize the need to read & understand language Supplement text with audio or other visuals Minimize calculations


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Work RERC Accommodation Use SurveyMental Function Limitation

0

10

20

30

40

50

60

70

% under 55

% over 55


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• Reminders at set times• Reminders for later recall

• Low to high tech• Consider info. format

Paging service

Paging serviceDigital recorder

(motion activated)

Reminders


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Sequencing AidsSequencing aids list task steps, sometimes providing picture and/or audio prompts Videos available to review

ahead of performing task (training tools)

Checklists as tasks are completed

Extra help if something falls outside normal pattern

High tech – PDA• Visual Assistant (AbleLink

Tech.)• Picture Scheduler (iPod app.)


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Software Features

• Simplified interfaces

• Picture cues for sender / recipient

• Talking: send recorded messages; software speaks incoming messages

Example Products

• ICanEmail (R.J. Cooper)

• Web Trek Connect (AbleLink Tech.)

Reduce Literacy Demand (Email)


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Other Strategies/ Accommodations

• Establish habitual patterns Keep materials in set location

(ex: Shadow board)

• Turn calculation/measurement tasks into visual tasks Hardware counters Container with fill line Jig for folding letters

Acknowledgements:• T.K. Martin Center for Tech. & Disability


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Additional Resources


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• assistivetech.net / ATWiki – AT and disability-related resources www.assistivetech.net

• RESNA – Rehab. Engineering & Assistive Technology Society of N. America www.resna.org

• Job Accommodation Network (JAN) – Free consulting service on worksite accommodation solutions http://www.jan.wvu.edu

• Computer / Electronic Accommodations Program (CAP) – AT services for some federal employees

www.tricare.mil/cap/

Researching Accommodations


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State AT Act Projects

www.resnaprojects.org/nattap/at/statecontacts.html

• In Georgia: Tools for Life - www.gatfl.org

• Common services include:

Opportunities to try out equipment (e.g., loan closets)

Assistance with finding funding (e.g., Georgia “Dollars & Sense Funding Guide”)

Promoting equipment exchanges, recycling


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AbilityOne Program: NIB & NISH

• Formerly Javits-Wagner-O’Day Act (JWOD) Provides for federal procurement of goods & services

from qualified non-profit agencies Direct labor force includes at least 75% people with

disabilities

• NIB & NISH develop employment opportunities for people with disabilities by assisting with process development on these contracts www.nib.org www.nish.org Funds available for accommodations


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• Employer! Required to pay for reasonable accommodations /

accommodations related to job tasks Work RERC research: employer paid for all or some of

accommodations 63% of time Tax Incentives

• Vocational Rehabilitation (33%)

• Employee (46%) PASS Low-interest loans

Work – Funding


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(PASS)• People on Supplemental Security Income (SSI)

• Set aside income for items needed to achieve a work goal (accessible vehicle, computer, work tools / uniforms)

• Those costs excluded from income calculations of whether person qualifies for SSI

• www.socialsecurity.gov/disabilityresearch/wi/pass.htm

Plan to Achieve Self-Support


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• Provides low-interest loans through participating credit unions to fund AT

• Available in several states: Georgia: Credit-Able www.resnaprojects.org/AFTAP/state/RESNA.html

• Doesn’t need to be linked to employment

• Examples: modified vehicles, home mods, computer equipment & software, hearing aids, recreational equipment

Alternative Financing for AT


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Question and Answer


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THANK YOU!


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TACE Center: Region IV Toll-free: (866) 518-7750 [voice/tty]

Fax: (404) 541-9002

Web: TACEsoutheast.org

My TACE Portal: TACEsoutheast.org/myportal

Email: [email protected]


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Education CreditsCRCC Credit - (1.5)Approved by Commission on Rehabilitation Counselor

Certification (CRCC) • By Friday, November 12, 2010, participants must

score 80% or better on a online Post Test and submit an online CRCC Request Form via the MyTACE Portal.

My TACE Portal: TACEsoutheast.org/myportal

**For CRCC credit, you must reside in the 8 U.S. Southeast states served by the TACE Region IV [AL, FL, GA, KY, MS, NC, SC, TN]. If beyond TACE Region IV, you may apply for CEU credit.


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Copyright Information

This work is the property of the TACE Center: Region IV. Permission is granted for this material to be shared for non-commercial, educational purposes, provided that this copyright statement appears on the reproduced materials and notice is given that the copying is by permission of the authors. To disseminate otherwise or to republish requires written permission from the authors.


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Disclaimer

This presentation was developed by the TACE Center: Region IV ©2010 with funds from the U.S. Department of Education, Rehabilitation Services Administration (RSA) under the priority of Technical Assistance and Continuing Education Projects (TACE) – Grant #H264A080021. However, the contents of this presentation do not necessarily represent the policy of the RSA and you should not assume endorsement by the Federal Government [34 CFR 75.620 (b)].

Introduction to Assistive Technology Sarah Endicott Karen Milchus Work RERC, GA Tech November 3,...

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