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ENABLING TECHNOLOGIES:

Tony Gentry, PhD OTR/L

Leveraging the Miracle Machines

Virginia Commonwealth University

The largest university in the Commonwealth

Located in Virginia’s capital city

Historic Richmond

On the banks of the James River

Ongoing Work

¨  NIDRR DRRP iTouch in Job Support research trial in collaboration with DARS

¨  NIDRR RRTC developing customized employment model for people with “most severe” disabilities (P. Wehman)

¨  TATRC physiological monitoring for sleep in PTSD research trial

¨  Smart Homes for state vocational rehabilitation center and McGuire VAMC

¨  Pilots exploring handheld devices for people with mental illness and sleep hygiene cueing for adults with autism.

VCU Autism Center of Excellence Facebook: “Assistive Technology for Cognition”

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The Age of Technology What is Disability?

Person

Task

Place

21st Century Rehabilitation How do we get there?

What is AT?

¨  Any item, piece of equipment or product system, whether acquired commercially off the shelf, or modified, or customized, that is used to increase, maintain, or improve the functional capabilities of individuals with disabilities.

¨  Any service that directly assists an individual with a disability in the selection, acquisition, and use of an assistive technology device.

¨  Tech Act, 1988

Everyday AT - mobility

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Everyday AT – Wheelchairs, etc. Johnny Kelley

¨  IT Engineer ¨  Inspirational Speaker

Now & Soon

iBot

Magicwheels

Whii e-wheels

Puma by Segway

Everyday AT - Cars Toney Lineberry, Esq.

¨  Law Professor ¨  Road Safety Lecturer ¨  Inspirational Speaker and Author ¨  Graduate of University of Virginia School of Law ¨  Father of twins

¨  All achieved after an auto accident caused a C-6 spinal cord injury at age 17

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New & Soon…

Kenguru e-car

Google Self-Driving Car

Everyday AT – in home & out

Now & Soon

RI-Man

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Computer Access

¨  Mouse control & Pointers ¨  Alternative keyboards ¨  Speech Recognition ¨  Software adaptations

¤ Spell Check ¤ Sticky Keys ¤ Word prediction ¤ Screen readers ¤ Task Organization

Task Adaptations

¨  Computer skill is the strongest indicator of competitive employment for people with mobility impairments

¨  Develop skills ¨  Focus on computer access

technologies ¨  Opportunities for home-

based employment/telecommuting

Internet socializing

¨  www.facebook.com ¨  www.myspace.com ¨  www.disabilities-r-us.com/

community/ ¨  www.inspire.com/groups/

paralysis-resource-center/ Chris and Diana Reeves Foundation-sponsored site

¨  www.disaboom.com

COMPUTER ACCESS – Now & Soon

Everyday AT - Cognition iPod Touch 4g/5g

¨  Organization apps ¨  Still/video camera ¨  Face Time video-calls ¨  Built-in microphone ¨  Voice-over accessibility ¨  Background-running program

capability ¨  Application Folders ¨  Highly portable ¨  All-day battery

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Functional Cognition

¨  Remembering to do things (medications, appointments)

¨  Memory for names/faces, locales ¨  Task Sequencing ¨  Multi-tasking ¨  Dealing with Distractions ¨  Adapting to transitions and changes in

routines ¨  Dealing with frustration

Impact on Everyday Life

¨  Inconsistent medication: ¨  Hospitalization, decline in health ¨  Missing appointments: ¨  costs money, jobs and friends ¨  Missing bills: ¨  Eviction from your home, bill collectors ¨  Spatial orientation problems: ¨  Getting lost, traffic accidents ¨  Task-Sequencing Problems: ¨  Job failure, need for supervision ¨  Problems multi-tasking or dealing with

distractions: ¨  Home and community safety, difficulty at

work

¨  Remembering to do things/forward planning

¨  Task-Sequencing

¨  Wayfinding

¨  Managing Problematic Behaviors & Situations

¨  Health Management

¨  Safety

¨  Communication

¨  Home & Money Management

¨  Academics

¨  Sensory ability accommodations

How ATC Can Help: Patient Services Representative Assistant at Doctor’s Office

§  Filing patient charts

alphabetically

§  Checking shelves for

alphabetical order

§  Scanning new patient

information

§  Sorting and delivering faxes

to the 7 doctors

VoCal Task Analysis in Notes

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Hack Story Kit

¨  Free app ¨  Picture sequences ¨  Captioning and

drawing ¨  Audio cues ¨  http://www.youtube.com/watch?

v=RSWQkUS4kXk

Story Kit

Story Kit cont. Before Story Kit prompts

With Story Kit prompts Cognitive AT – Now & Soon

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Everyday AT - Vision

SENSORY AT - other The Service Side of AT

Team Approach

¨  Client – The Expert ¨  Caregiver ¨  Employer ¨  Co-workers ¨  Rehab Counselor ¨  Occupational Therapist ¨  Job Coach/Supported

Employment Specialist ¨  Assistive Technology

Practitioner

Person-Centered Collaborative Problem-Solving

¨  Assessment of Skills and Needs in the Workplace ¨  Not just what jobs am I good at, but what activities

on the job require supports, which do not ¨  Costs and Benefits of various adaptations ¨  Rent or borrow AT – trial and error ¨  Work with employer, job coach, coworkers, too ¨  Who will act as team facilitator/leader? ¨  Follow-along and revision

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Heirarchy of AT provision:

1.  Modify the task parameters 2.  Use commercially available products 3.  Combine technologies not typically

used together 4.  Modify existing commercial devices 5.  Use rehabilitation-specific products 6.  Fabricate new devices

Employer & Co-worker concerns

¨  He’s got an easier job than I do.

¨  She’s not safe here. ¨  Our insurance costs will go

up. ¨  Now everyone will want this

accommodation. ¨  Expect sub-par work. ¨  I don’t want outsiders

making accommodations here.

Questions for Vendors

¨  What service is provided? ¨  Do you loan or trial AT with

users? ¨  Do you provide training? ¨  What happens if it breaks? ¨  Repair and return time? ¨  Get a statement of charges

for services & repairs

Formative and Summative Evaluation

¨  Assess on-site ¨  Reassess ¨  Try something else ¨  When do you know it’s

working? ¨  When do you check back in? ¨  How do you build on success? ¨  Don’t forget the

interpersonal.

Worksite Social Issues

¨  Communication ¨  Sharing ¨  Collaboration ¨  Management ¨  The importance of the interpersonal ¨  Socializing

What does it mean to be an Assistive Technology practitioner?

¨  You are a therapist ¨  But you are also a technician ¨  Follow-along and maintenance ¨  Collaboration and “Buy-in” ¨  Transparency ¨  Not too new ¨  Not too weird ¨  Seek help and share.

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FUNDING

¨  Early Intervention Programs (IDEA) ¨  Head Start ¨  Public Schools (IEP or Section 504 of Rehab Act) ¨  Vocational Rehabilitation Services ¨  Social Security Administration (PASS and IRWE) ¨  Medicaid ¨  Loans ¨  Non-Profit Disability Associations ¨  Foundations ¨  Civic Organizations ¨  Charities and Fund-Raisers ¨  Used Equipment Sales ¨  Leasing

Issues with Technology

¨  It breaks ¨  It requires maintenance ¨  It evolves ¨  Liberating and

confining