Kathleen Shanfield, OTR/L, MS, ATPRancho Los Amigos Rehabilitation Hospital

Center for Applied Rehabilitation TechnologyCART

Introduce uses of iPad with clients/patients in rehabilitation setting

Methods of alternative access App resources for a variety of therapeutic

goals

Skill attainment (fine motor, cognition, memory, visual scanning, etc) : Games, Typing, Skills Apps, Planners

Documentation Augmentative and Alternative

Communication (AAC) Method of Computer Access Research for Community Resources Research: data collection, feasibility studies,

etc. Recreation/Leisure: Games, reading books,

social networking, watching movies, etc.

Not much!! Lots of opportunities for YOU! Pub Med-7 articles AOTA- one Official Document and 5 Practice

Articles and various others

Can see lots of videos on You Tube and there are some blogs.

Very new and more research will emerge and is needed.

AOTA Official Documents: ◦ Specialized Knowledge and Skills in Technology and Environmen

tal Interventions for Occupational Therapy Practice

OT Practice articles: ◦ App Support: Mobile Applications for Individuals With Cognitive and Beh

avioral Challenges, by Lindsey Aftel, Mary Freeman, Jessica Lynn, & Whitney Mercer, in June 20, 2011, OT Practice

◦ Osteoarthritis, Video Games in Rehabilitation, and Fall Prevention, by Susan H. Lin, ScD, OTR/L, in February 21, 2011, OT Practice

◦ Electronic Engagement: Assistive Technology for Persons With Disabilities by Steve Van Lew, MS, OT/L; Holly Cohen, ATP, OTR/L; & Nandita Singh, MPH, OTR/L, in October 25, 2009, OT Practice.

◦ Technology Intervention, Using What Is There: Hidden Features and Functions of Operating Systems and Word Processing, by Kimberly D. Hartmann, PhD, OTR/L, FAOTA; Kathy Post, PhD, OTR/L, FAOTA; & Christine Gardner, BSHS, MOTS, in May 24, 2010, OT Practice. 

◦ ◦ Virtual Reality-Based Rehabilitation, by Salvador Bondoc, OTD,

OTR/L, BCPR, CHT; Courtney Powers, BSHS; Nathan Herz, OTD, MBA, OTR/L; & Valerie Hermann, MS, OTR/L, in June 28, 2010, OT Practice.

AOTA Quarterly Article: ◦ Writing Made Easier Through Technology by

Nancy Farley Stivers, MA, OTR/L in September 2011 Technology Special Interest Section Quarterly

◦ Advancing Your Knowledge and Skills in Assistive Technology by Katherine M. Post, PhD, OTR/L, FAOTA, in September 2009 Technology Special Interest Section Quarterly

Other Resource: ◦ Ethical Considerations Relevant to Emerging Tech

nology-Based Interventions by Paige M. Johns, OTD, OTR/L

http://otswithapps.wordpress.com/

www.apple.com/accessibility

www.aactechconnect.com

http://atclassroom.blogspot.com/2010

http://atmac.org/

http://lifekludger.net/

Chrystina Symanski on “Why I Chose the iPad”◦ http://www.youtube.com/watch?v=H85Lb8Pyu9U

◦ Adaptive Nicole !!! (USC OT student)◦ http://www.youtube.com/watch?

v=5agAdjsC9x0&feature=related

iPad and other tablet computers are just a tool to do what we already do in the clinic and at home.

The value is its portability, its popularity, ease of use, and ready access to the internet.

It is NOT for everyone. Really depends on what user wants/needs to do.

OT’s should use good judgment in recommending this product, apps, etc and be clear to patients about lack of evidence, etc.

Many touch screen devices now on the market. All have capacitive touch screen.

Touch screen must be accessed with skin contact or a stylus. There are great differences in styluses.

Can modify mouthstick/headpointers and splints using copper wire and/or aluminum foil, or purchase and modify capacitive stylus.

Non-Capacitive: These will require skin contact directly on the stylus for it to work.

Pogo Stylus: Available at Best Buy and other electronic stores for approximately $6-10.00

   Capacitive: Able to be used without skin contact or metal coupling. Most

sensitive and easy to adapt.iFaraday makes a variety of capacitive styluses with different tips for writing and drawing. They also have a line of styluses for the

disabled including a mouthstick, and a “wrap around” bendable stylus. www.ifaraday.com 

Touch Tec Capacitive Mouthstick: www.amazon.com $40.00

Resources to keep up with this changing world of devices:

http://www.imedicalapps.com/2012/02/ipad-stylus-pen-review-top-ipad-stylu/

http://graphicssoft.about.com/od/iphoneandipodtouchapps/ss/Best-Stylus.htm

Non-Capacitive, however will work when attached to a metal splint or mouthstick as long as skin is touching the metal. (i.e. stylus can be attached to a Wanchik Writer or a metal WHO or a metal mouthstick, and then skin is touching that splint)

 iHome Pen/Stylus: Available at many stores, however Best Buy,

Fry’s, Amazon.com will have it. They run $6-10.00. 

iPad Stylus Socks: Can be placed on the tip of any metal pointer, and they work as long as skin is touching metal. Available from: www.etsy.com/shop/shapedad for $16.00 for 4

 iPad Steady Stylus: Shaped like a “T”, and can be held in a fisted

hand. Available from www.etsy.com/shop/shapedad for $40.00. Junior size available for $16.00.

 iPad Mouthstick Stylus: Available from

www.etsy.com/shop/shapedad $40.00

Bluetooth Keyboards◦ Available at Best Buy, etc and online for about

$40-$70.00 Voice Control:

◦ Dragon Naturally Speaking App-free◦ New iPad has voice recognition for texting, emails and

other applications Switch Scanning Access

◦ Preliminary stage –not very good yet.◦ Ablenetinc.com◦ Rjcooper.com

Positioning/Mounting

Voice Over Zoom Large Text and Contrast Speak Auto Text Speak Selection Voice Recognition Assistive Touch

Important to try before recommending or using with clients/patients

Read reviews, blogs, use word of mouth for recommendations

Many games are too fast and therefore looking for those that are not timed is better.

Free or Lite versions often have a lot of ads. Many apps require wireless internet, which

patients/clients or even the hospital may not have.

Color Match Memory Matches Sound Match Memory Boost Find the Ball **** Balloons Tap and Learn Cut the Rope ***** Bubble Shooter Word Search HD Magic PuzzlesFrom Kimberly Gully, MS, CCC, CCM, CBIST

Dexteria-$4.99 (developed by an OT) Fun Bubbles TapTap Bubble Fruitie Tootie Cut the Rope Angry Birds Wipe and Learn Numerous apps for tracing, coloring and

handwriting. Just go to the App store and Search!

Rē Accessory turns iPhone into a universal remote

http://www.newkinetix.com/ $69.99

i-Got-Control iPhone Universal Remote www.thinkgeek.com $69.99

Control4myhouse App: Whole house audio, video, lighting & HVAC control from your iPhone or iPod Touch. This requires a Control4 home automation system

www.control4.com.

Apps for Kindle (Amazon), Barnes and Noble and iTunes Books, magazines and newspapers

iTunes-music, books, movies Netflix, TV networks (ABC, CBS) apps or websites

for watching TV shows Hulu Most of these downloads do cost $$$ and

user needs a credit card.

Usually difficult for those with limited hand function to use easily.

Fragile and easily lost or stolen. Clients/patients need internet access to

utilize all features ($$$) Does not usually replace a desktop or

laptop system Downloads can get expensive Small screen

Can you physically use the touchscreen easily and efficiently (with or w/o adaptations)?

What are you going to use the computer for?

Where are you going to use it? Do you have wireless internet in your home or

at a location you frequent? Do you have a credit card? Can you or a caregiver charge it when

needed? Is it useful at your school, work, or home?

iPad is a great TOOL to help OT’s and patients achieve therapy goals

It can be an easy method of computer access, recreation, and productivity for many patients

OT’s can make many adaptations using styluses, mouthsticks, head pointers, positioning, and settings to make it easier for patients to use.

OT’s can help patients and families sort out differences in methods and devices, and provide the right recommendation before making the purchase.