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Assistive Technology

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Title: Slide 1 Author: Amanda Last modified by: Amanda.Reinsfelder Created Date: 5/31/2011 10:41:04 PM Document presentation format: On-screen Show (4:3) – PowerPoint PPT presentation

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Title: Assistive Technology


1
Assistive Technology
  • and Traumatic Brain Injury

2
  • The views expressed in this presentation are
    those of the authors and do not reflect the
    official policy of the Department of the Navy,
    Army, or Air Force, the Department of Defense,
    nor U. S. Government.
  • This presentation does not imply any Federal /
    DOD endorsement.

3
Disclosure
  • VA Central Office Contract to the University of
    Pittsburgh to provide support to VA Polytrauma
    Centers for Assistive Technology

4
A ReviewAssistive Technology Device
  • any item, piece of equipment, or product
    system, whether acquired commercially, modified,
    or customized, that is used to increase,
    maintain, or improve functional capabilities of
    individuals with disabilities. (Assistive
    Technology Act of 1998)

5
The AT Team Includes
  • The Individual
  • Case Managers
  • Nurses
  • Occupational Therapists
  • Physical Therapists
  • Physicians
  • Psychologists
  • Speech Language Pathologists
  • Therapeutic Recreation Specialists
  • Vision Rehabilitation Specialists
  • and many more!

6
AT Pyramid
High
Mid
Low
Developed at Pennsylvanias Initiative on
Assistive Technology (Dolloff and Reinsfelder,
2010)
7
Examples of AT
  • Low tech
  • Pen and paper, Stylus, (Slim Jim or String
    Cheese?)
  • Mid tech
  • Pagers, Alarms, Simple vibrating watches
  • High tech
  • Automated systems / Reminders
  • Smart phones and Tablets
  • (Are these really high tech anymore?)

8
AT Services The Other Half
  • Evaluation for appropriate devices and selection
    of device.
  • Coordination with service providers (e.g.,
    therapists, engineers).
  • Training / technical assistance for the person
    and supporting individuals (e.g., personal
    assistants).
  • Follow up

9
HAAT Model
Cook and Husseys Assistive Technologies
Principles and Practice
10
HAAT Model(Simplified)
  • Human
  • Activity
  • Assistive Technology
  • AND
  • Environment (context)

11
Time Management / Organization
  • Low Tech
  • Sticky notes
  • Pre-organized books/folders
  • Data planners
  • Alarms / timers
  • Computer based reminders
  • Online Tools
  • Paging systems / services
  • PDA's / Cell Phones

12
Time Management / Organization
Paper Calendar
iPhone
Talking Watch
13
Thought Organization
  • Dragon Naturally Speaking
  • Windows Speech Recognition
  • (only available in Windows 7 and more recent
    versions)
  • WordQ / SpeakQ
  • Word Prediction

14
Thought Organization
  • Claro Read
  • DraftBuilder
  • Inspiration
  • Read and Write Gold
  • Kurzweil 3000
  • WYNN
  • Mindview

15
Information Processing / Comprehension
  • Text to Speech
  • Some magnification software programs also
    highlight as they read

16
Speech to Text
  • Examples

Real Time Captioning Photo from
http//webaim.org/techniques/captions/realtime
Captioned Telephone www.captel.com
17
Speech to Text
  • Example
  • Google Voicemail Transcription
  • Video
  • http//www.youtube.com/watch?vfHuai7-jVlYfeature
    player_embedded

Photo taken from http//www.google.com/support/vo
ice/bin/answer.py?answer115986
18
Memory
  • Internet Calendars
  • Color code and organize calendars and
    appointments
  • Can share with a caretaker using the same server
  • Task lists
  • Paper and pencil, or as an app
  • Recording devices
  • Zomm

19
Headsets for Concentration
  • Microsoft LiveChat Headset with microphone 
  • ATH-ANC27 QuietPoint Active Noise-cancelling
    Headphones 

20
Communication
  • Physical separate device dedicated to
    communication
  • Examples
  • Dynavox EyeMax
  • Tobii ATI C12

21
Communication
  • Using technology the person may already have
  • Examples

Proloquo 2 Go
NeoSpeech Paul or Kate
22
Vision
  • Apple Universal Access

Velcro Photo taken from www.velcro.com
Bump Dots Photo taken from www.maxiaids.com
23
Vision Examples
  • Copolillo A, Ivanoff SD. (2011) Assistive
    Technology and Home Modification for People with
    Neurovisual Deficits. NeuroRehabilitation 28
    211-220. DOI 10.3233/NRE-2011-0650
  • Neurovisual Deficits are different from
    progressive eye diseases (macular degeneration,
    etc)
  • Decreased control of eye movement, double vision,
    sensitivity to light, decreased cognitive skills
    and incorrect perception of the environment
  • Correct balance between independence and safety.

24
Vision Examples (cont)
  • Copolillo A, Ivanoff SD. (2011) Assistive
    Technology and Home Modification for People with
    Neurovisual Deficits. NeuroRehabilitation 28
    211-220. DOI 10.3233/NRE-2011-0650
  • Proper lighting in the home (incandescent)
  • Automatic lights (motion sensors)
  • Color filters
  • Contrast (furniture, rugs, walls, steps)
  • Magnifiers with lights or OCR
  • Read along highlighting
  • Talking Clocks

25
Magnification and Audio
Victor Reader Stream
Telesensory Desktop CCTV
26
Assistive Listening
LES 370 Personal FM System
Induction Loop ClipBoard
GPS Ranger
LES705 Amplification system
Noise Cancelling Headphones
27
Navigation Example
  • Lemoncello, R., Moore Sohlberg, M., Fickas, S.
    (2010). When directions fail Investigations of
    getting lost behavior in adults with acquired
    brain injury. Brain Injury, 24 (3)550-559. Doi
    10.3109/02699050903446807
  • 18 adults with acquired brain injury with 18
    matched controls
  • Problems impulsivity, lack of planning, memory
    lapses and anxiety
  • Aids written directions, standard cell phone
    connected to a helper

28
Navigation Example (Cont)
  • Those with brain injury had more errors, and used
    more vague descriptions of current locations when
    calling for help.
  • Cell phone was useful for reorientation and
    reassurance
  • Suggest navigational tools should also provide
    reassurance to travelers they guide

29
Universal Design
  • Universal design is the design of products and
    environments to be usable by all people, to the
    greatest extent possible, without the need for
    adaptation or specialized design.Ron Mace
    http//www.ncsu.edu/www/ncsu/design/sod5/cud/about
    _ud/about_ud.htm
  • Examples
  • Audio descriptions
  • Captioning
  • Simplified interfaces

30
Video -
  • GPII
  • http//www.gpii.net/

31
Newer Opportunities for AT
32
Time Management Organization
  • Paging systems - software
  • SMS short message service
  • MMS multimedia messaging service
  • Computer based
  • Send messages to cell phone
  • Google

33
Time Management Organization
  • General PDA's (soon to be outdated?)
  • Windows
  • Asus My Pal, Pharos, HP IPAQ
  • MAC
  • I-touch
  • Smart Phones
  • Windows, MAC, Android, Blackberry, Nokia Symbian
    OS, Palm Web OS

34
Time Management organization
  • PDAs / cell phones advantages
  • Alert/Prompts sound/vibration
  • Search
  • More information
  • Information carries over easier to change
  • Link calendar contacts
  • Notes / To-Dos
  • Link to PC/Internet 2 copies synchronized
  • Copy and paste from computer

35
Time Management Organization
  • PDAs / cell phones advantages
  • Looks Normal / the cool factor
  • Basic models serve many cognitive needs
  • PDA Software add-ons and Apps
  • Dictionary
  • Spelling / Irregular Verbs
  • Word prediction
  • GPS
  • Cameras
  • Messaging

36
iPad / Samsung Galaxy Pad
37
Zoom / Streak / Playbook
38
E-readers
  • E-Ink vs. Color screens
  • E-readers with text to speech on some books
  • E-readers with calendar feature

39
Examples of Evidence
  • Dowds MD, Lee PH, Sheer JB, ONeil-Pirozzi TM,
    Xenopoulas-Oddsson A, Goldstein R, Zainea KL,
    Glenn MB.(2011). Electronic Reminding Technology
    Following Traumatic Brain Injury Effects on
    Timely Task Completion. J Head Trauma
    Rehabilitation. 1-9.
  • 36 Adults with a Traumatic Brain Injury were
    asked to complete tasks using 4 memory strategies
  • Those who used an electronic Personal Digital
    Assistant (PDA) had a higher success rate of
    completing the task over using paper and pencil
    alone

40
Traumatic Brain Injury
  • May mean..

41
Other things to consider
  • Trauma can also affect other abilities
  • Vision
  • Hearing
  • Balance
  • Dexterity

42
Newer Technology
  • Home monitoring systems
  • Face Time can help to facilitate contact
  • In development
  • Simplified digital scanners for warehouses
  • Cell phones programmed with cognitive assistance
    and encouragement activated when shaken
  • Context aware devices
  • Ex. Voice prompts activated when entering a room

43
Other Technology
  • Signlink Studio - www.signlinkstudio.com

44
Wayfinding for Individuals with Dementia
  • Grierson, Lawrence E. M. , Zelek, John , Lam,
    Isabel , Black, Sandra E. and Carnahan,
    Heather(2011) Application of a Tactile
    Way-Finding Device to Facilitate Navigation in
    Persons With Dementia, Assistive Technology, 23
    2, 108 115
  • A belt is worn
  • Vibration cues occur in the direction the person
    needs to go
  • Found the design to be helpful
  • Current design may not work in community settings
  • Are there implications for people with TBI?

45
Key Things to Remember
  • No two people are alike
  • Each situation results in a unique solution,
    application, or combination of tools
  • Thinking outside of the box is good! ?
  • Include the individual in the process
  • Avoid the temptation of trends
  • Follow up, Follow up, Follow up!!

46
Three Key Points
  • Description of the desired activity (goals)
  • Individuals history at it relates to the desired
    activity (personal limitations)
  • Environment the task will most likely take place
    in (context)
  • Remember the HAAT?

47
Assistive Technology isCreativity!
  • No two individuals are the same
  • What works for one service member may not work
    for the others with similar barriers
  • There is no wrong way to use tools
  • If it was designed for one purpose but works to
    accomplish another great!

48
Resources
  • State AT Act Programs
  • www.ataporg.org
  • Professional Organizations
  • Ex. RESNA, ATIA
  • Your team!

49
Contact Information
  • Amanda Reinsfelder, ATP
  • Amanda.reinsfelder_at_amedd.army.mil
  • 202-257-5756
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