Using Assistive Technology to Optimize Occupation MARLA ROLL, MS, OTR JACOB SUNDER, OTS ANDREW FLINT, OTS Teiyko Japanese OT Students September 8th, 2015

What is Occupational Therapy at CSU? The mission of the Occupational Therapy department at CSU is to optimize human performance and participation in everyday occupations and contexts across the lifespan. OT Curriculum Design: http://ot.chhs.colostate.edu/students/curriculum-design.aspx Google image from: uscmarketplace.com Google image from: blythedale.org

Definition of Assistive Technology A broad range of devices, services, strategies and practices that aid in assisting individuals with disabilities. An AT device is any item, piece of equipment, or product system that is used to increase, maintain or improve functional capabilities of individuals with disabilities. -Cook & Hussey

Types of Assistive Technology Assistive Technology examples: Access to Computers and Electronic Information ( ATRC focus) Augmentative Communication Systems Environmental Controls Technology to enhance mobility There are many different areas within assistive technology for example: We focus on providing equal access to technology and electronic information for students

What is the Assistive Technology Resource Center (ATRC)? Mission of ATRC is to ensure equal access to technology and electronic information for CSU students and employees with disabilities. Disability groups served Physical (congenital & acquired) Sensory (vision & hearing) Non-Apparent impairments ( TBI, LD, ADD, ADHD, Mental health) as defined by the Americans with Disabilities Act and Sections 504 and 508 of the Rehabilitation Act. Physical – Neurological (SCI), ortho, communication challenges Sensory – Blind, low vision, deaf, HOH Non-Apparent – learning, cognitive (TBI), Austism Spectrum Disorders AT for OT students- providing labs, case studies, and other activities that are integrated into the curriculum

Scope of ATRC services: Staffing: 3 full time Occupational Therapists 1 full time Technical Support/ IT position 2 OT graduate students 1 OT teaching assistant 1 student hourly IT support Providing services to entire campus: 30,000 students ( 10 % have a disability) Employees 1700 faculty 2850 administrative professionals

ATRC Services Services Direct ( Students & Employees) : Assessments, Training, Equipment Loans, Resources, Accommodations Consultation and Education ( faculty & campus units): regarding ergonomic, ADA, and universal design considerations in technology environments Assistance with making programs, information and course material accessible for students Assistance with making web content accessible Experiential learning of AT for OT Students ATRC hires OT students to work in the center Provides assistive technology content/ labs in the overall curriculum Provides Level I and II fieldwork opportunities Today we will mainly focus on and describe the student services piece.

ATRC Occupational Goals The ATRC’s goal is: to increase student participation in school-related activities and enhance academic performance. to increase employee participation in work related tasks and enhance work related performance.

ATRC and Occupation Occupational Therapy Role Occupations Assessment - Interview Intervention – Equipment recommendation & training Occupations Reading Writing Note-taking Test-taking Accessing computers and technology

AT for Physical Impairments AT for Typing and Accessing Computer: Alternative Pointing Devices (Mice) Head tracker Sip and puff Switches Alternative Keyboards One handed keyboards Chorded keyboards On- screen keyboards Positioning Adjustable tables and monitors Devices, e.g. mobile and static forearm supports AT for Writing: Alternate Input Voice recognition software Word completion and word prediction software Alt. pointing device - way to navigate computer screen, provides full mouse control but with alternate input, examples… Alt. keyboards Chorded keyboards – enter data using combination of keystrokes On-Screen keyboards – such as WiVik, allow for word processing or other text entry Word completion/prediction software – predicts word = reduces amount of keystrokes

AT for Students Who Are Blind AT for Reading: Braille and Tactile Graphics Refreshable Braille Keyboard Braille Embossers Text to Braille converting software Thermo Pen PIAF (Pictures in a flash) Audio Talking Web Browsers Talking Digital Book Players Audio Formatting Software Scanners with OCR to convert text to audio format AT for Accessing Computer: Screen Readers Tactile Key Indicators AT for Calculating: Talking Scientific Calculator Braille Keyboard – instantly translate screen content into refreshable Braille Embossers- creates raised Braille dots on Braille paper Thermo Pen – creates raised image on Flexi-Paper PIAF- instantly produces tactile graphics using heat sensitive capsule paper Talking Web Browsers convert web pages directly into speech Screen readers – audio output of all screen data including commands and text Tactile Key Indicators - sticker keys with raised bump in the middle PacMate - portable accessible PC Talking Scientific Calculator - standard calculator with voice output

AT for Students with Low Vision AT for Reading: Large Print Digital Book Players/ Electronic Texts Built in Accessibility Options Software Magnifier and Reading Software Scanning and Reading Software Magnifiers Portable Video AT for Typing: Labels for keyboard Video Magnifiers - A video magnification device that allows a user to view any document or object with enlargement in 3 dimensions Magnifier and Reading software- software that allows user to visually manipulate text and hear it read aloud Scanning and Reading software - Program which allows user to scan items and then read the image aloud Built in Accessibility Options - Windows XP has built-in accessibility features such as: magnifier, narrator, accessibility wizard, and an on-screen keyboard.

AT for Students with Hearing Impairments AT for Note Taking and Classroom Participation: FM Systems: Portable, wireless listening system for classroom use. The teacher wears a compact transmitter and microphone. Students use a portable receiver with earphones. Captioning Communication Access Realtime Translation (CART): instant translation of speech to text via advanced, remote or onsite real-time translation software Student activities such as listening to lectures and videos, are affected for students with hearing impairments AT can support those students by Augmenting the auditory output – example FS systems that amplify the sound Visual substitution Captioning for video content – note UD CART

AT for Students with Non-Apparent Disabilities – Writing Aids AT for Writing: Spelling and Word Selection Phonetic Spell Checker Word Completion and Word Prediction Talking or Visual Dictionary Word Wizard Homophone Checker Thought Organization Thought Mapping Outline Format Other Aides Speech recognition: Dictation vs. typing Text to speech AT for Note Taking: Digital Recorders Smart Pen Apps for mobile devices A number of different AT programs available to support success in occupations like writing, note taking, reading, and organizing material. Note UD Software programs have different features to support Spelling and word selection Organization Thought = graphical Outline = word outlines, easy to organize topics and move text Alt Typing is distracting/slower than thoughts – dictation T2S = for proofing Note taking Digital recorders – audio recording so student can go back and listen Smart pen – combine written notes with audio recording

AT for Students with Non-Apparent Disabilities – Reading Aids AT for Reading: Converting Printed Material to Electronic Format Scanning with OCR Learning Ally (human voice recordings) Auditory Output Portable Book Reading Devices: Digital book players and MP3 players E-text Reading Computer Software: Text to speech Options: synthesized or human voice, audio only or audio + text Apps for mobile devices Visual Layout Size of text and line spacing Color of text and background Masking Highlighting words as they are read Speed Reading Portable Miscellaneous Reading Aides Scanning and Reading Pens Portable dictionary AT to support reading can be customized based on the user’s needs. First, get book/printed material into electronic format Options for listening Visual modifications Other task specific aides

AT for Students with Non-Apparent Disabilities - Organization AT for Organizing Assignments: Low Tech Checklists, day planners, task sequencing lists, alarms and timers on watches and cell phones High Tech Devices: Computers, tablets, smartphones, PDAs Software or Apps: Planning: calendars and “to do” Audio notes to self Multimedia prompting system

AT for Students with Cumulative Trauma Disorders Hardware Ergonomic keyboards Ergonomic mice Wrist pads Adjustable tables Document holders Adjustable monitors Mobile devices/touch screens Software Word completion and word prediction software Dictation software Apps Cumulative trauma disorder: are "injuries of the musculoskeletal and nervous systems that may be caused by repetitive tasks, forceful exertions, vibrations, mechanical compression (pressing against hard surfaces), or sustained or awkward positions".[1] RSI is also known as cumulative trauma disorders, repetitive stress injuries, repetitive motion injuries or disorders, musculoskeletal disorders, and [occupational] overuse syndromes. Software – reduce the amount of keystrokes

Augmentative and Alternative Communication AT for Classroom & Social Participation: Augmentative and Alternative Communication (AAC) Devices Low-Tech Picture Boards DynaVox, Tango, Toby Lightwriter Software with Communication Boards Apps on mobile devices Devices to facilitate communication and language

Mobility Technology Low-tech: cane, walkers, manual wheelchair, etc. High-tech: power wheelchairs Direct Control: use body part or extension to directly interact Fastest control method More intuitive Requires refined, control movements Indirect Control: requires an interface between user and the wheelchair; switches and scanning Slow control method Requires less motor control, but higher cognitive demand than direct control

Environmental Control Units (ECU) Control interface that enables people to control various devices in their environment independently Lights Electrical Appliances Heating/Cooling Systems Stereo TV Computer

Mobile Devices Apps for iOS & Android to support: Life Organization Scheduling /Time Management School Organization Note taking/Audio Recorders Financial Organization Work Organization AAC Reading Community Mobility and Accessibility And on and on…..

Questions? ATRC Website: http://atrc.colostate.edu Hands On Time Questions? ATRC Website: http://atrc.colostate.edu