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-Some Tips, Information, and Examples
of Assistive Technology
Here are some basic descriptions of a few different types and uses of Assistive Technology.
This is not a complete list, rather it is an introduction for those
unfamiliar with the more popular types of A.T.
(Courtesy: Cybercil.com)
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Reaching and Mobility Aids for Independent Living
The freedom to move from place to place in your home and out in the
community is critical to independence. If you have problems with
movement, balance or coordination, there are a number of devices
that may help you get around and
accomplish everyday activities.
Here are some suggestions for devices to help with reaching, lifting and walking.
REACHING AIDS : Pushing, pulling, grasping, and turning are movements that
can be easier for you with a reaching aid.
The models discussed here have been designed to cover a wide range of activities
and will help people with a weak or painful grip, or a limited range of motion.
The most common reachers consist of a pair of jaws controlled by a trigger mechanism.
Made of lightweight aluminum and plastic, they are available in a variety of sizes and lengths.
The desk-sized model, about 24" long, is useful for retrieving objects on your desk, kitchen
counter, or bedside table. A mid-range length, about 28" long, is useful for everyday
activities such as picking up objects from the floor or reaching high storage areas.
An extra-long model (32") is also available if you need extended reach. Features
you'll find useful include a magnet for catching and holding metal objects, and a
projecting lug for pulling things toward you. Folding styles and reachers with toggle
(rather than trigger) closing action, swivel heads, or forearm extension are
also available. Prices vary widely, depending on the size and features. Reachers are
generally available at most medical supply stores.
WALKING AIDS : Mobility can be complicated by many factors, such as pain and
weakness in the legs or back, uncertain balance or dizziness, muscular tremors or
spasms, or paralysis. There are a variety of changes in your environment, as well as
canes and walkers, that can enhance your mobility in and out of your home.
MODIFYING YOUR HOME :
-Install grab bars in critical locations.
-Remove small rugs; avoid shag carpeting.
-Arrange furniture so that you can walk from solid piece to solid piece, using the
furniture for support
CLOTHING AND FOOTWEAR :
-Choose pants and tops that do not restrict motion, and do not trail behind
-Choose shoes with textured soles for better grip
-Removable cleats can give you better footing on ice or snow
CANES :
Although canes can be purchased at many drugstores, you should consult with
your doctor if you are having frequent or pronounced periods of weakness,
dizziness, or poor coordination.
Consider the following factors in selecting a cane:
Height: the handle should be the height of your hip joint
and you should have no trouble lifting the cane.
Handle: the grip should be comfortable and secure
Base: Canes are available with single tips, or 4-legged, wide bases
Other options available include a loop on the handle of the cane, to free your
hands for other activities, and a fold-down ice gripping tip, which can be
attached to the side of the cane.
WALKERS :
The walker is particularly useful for individuals with balance problems, since it affords support through both arms at a fixed distance. Walkers come in a wide variety of handle styles. Ask your doctor or physical therapist for help in making a selection.
GRAB BARS :
Grab bars make the most of your strength by giving you extra support when and where you need it, such as climbing in and out of the bathtub, your bed, or negotiating a flight of stairs. A grab bar looks like a towel rack, but that's where the similarity ends. A grab bar is designed to be strong enough to support your weight and more. Flanges on the ends of the bar have sturdy screws for installation, preferably into wall studs. There is room between the bar and the wall for you to get a good grip, and the diameter of the bar will feel solid in you hand. Made of plastic or rust resistant metal, the bar may have a rough surface to prevent slipping. Many shapes and sizes are available for different uses; most are wall-mounted, but some attach to the edge of your bathtub.
Some considerations in selecting a grab bar:
Evaluate your physical abilities; choose a bar and a location which lets you use your strongest muscles
most effectively. Make sure the bar you select is long enough to carry a movement through to its conclusion; if you run out of support before you're fully standing, you could lose momentum and fall back, or fall forward from too much force.
An occupational therapist can help you with decisions about where to place what kind of bar. Grab bars can be purchased at plumbing supply outlets, some department and hardware stores, and at
medical/surgical supply stores. If you can't find one to suit your needs, some companies will custom design a
bar for a somewhat higher price. Alternatively, you may be able to combine standard bars in sequence to
give you the support you need.
ASSISTIVE DEVICE MANUFACTURERS
- adaptAbility
1-800-266-8856
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- Can-Do Products
1-800-225-8446
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- Maddak, Inc./Ableware
Pequannock, NJ 07440
201-628-7600
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- Maxi-Aids
P. O. Box 3209
Farmingdale, NY 11735
1-800-522-6294
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- Mountain Aire Medical Supply, Inc.
2490 Patterson, Suite 5
Grand Junction, CO 81505
1-800-578-8986
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Low-Tech Devices for People with Visual Impairments
With all the attention being given to high-tech solutions these days, it is important
not to neglect the "low-tech" items that can also benefit people who are blind
or visually impaired. There are many important tasks that can best be done
quickly and simply by using a low-tech device. In this document, "low-tech"
refers to any device without a microprocessor.
Braille Hand Writing - Many low-tech and inexpensive devices are available to assist people with visual impairments
in writing, either in print or Braille. Braille users can employ a stylus and a variety of Braille slates for writing on index cards, labeling cassettes, making marginal notes as well as for writing more formal documents.
"Low-tech" hand writing aids include large print items and formats, such as large print check books and raised line notepaper, and writing templates which fit over standard documents, such as envelopes, checks, note paper and signature lines. These templates are made of metal, plastic or stiff cardboard, and provide spatial orientation for the user to handwrite critical information.
Magnifiers:
People who have some usable vision have a choice of magnification aids to use in all manners of situations. These devices include pocket sized magnification glasses, as well as devices for enlarging a line of print, or even an entire page of print at one time. Monocular and binocular devices can be used for magnifying items at a distance, such as street signs and marquees. Many magnification devices include attached lighting for enhanced visibility.
Kitchen and Household Items:
Many common kitchen and household devices are available with large print and/or Braille markings. These include measuring devices and replacement controls for appliances. Many gadgets have been designed or modified to produce audible cues or even limited speech. These include liquid level indicators, talking thermometers, and talking bathroom scales.
Labeling:
Many existing products for home school or office can be easily modified to make them more usable for people who have visual impairments. Various Braille and tactile tags can be obtained to mark clothing and canned or frozen food items. Braille and large print dymo-tape labeling guns, are available to assist with labeling. In some cases, however, careful application of masking tape or spots of glue may provide the needed tactile markings.
Watches, Clocks and Timers:
Time keeping devices have been designed in a variety of ways to make them more useful to people with visual impairments. Such devices typically involve large print displays, Braille markings, "speech" chips, or some combination. The range of such devices includes wristwatches, portable alarms, clock radios, kitchen and medication timers. Some of these devices, such as talking clocks, are readily available at retail stores such as Radio Shack and K-Mart.
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- Augmentative and Alternative Communication:
Augmentative & Alternative Communication (AAC) refers to any technique or aid that supplements, replaces, or enhances conventional communication methods, such as speech or writing. When a person is unable to communicate effectively with traditional methods of expression, these techniques are used to enhance (augment) or completely replace the individual's mode of communication. Most of us incorporate conventional AAC methods into our own communication, including hand gestures, facial expressions and head nodding. Telephones, TTYs, fax machines, computers, and typewriters are also used to communicate ideas and needs. These AAC methods are used by most of the general public. Many forms of AAC have been developed specifically for people with severe communication difficulties. These forms typically fall into two categories: aided techniques, such as communication boards & electronic devices, and unaided techniques, such as sign language and gestures. The most effective & functional AAC intervention for an individual is determined through an assessment, and should always use the team approach. The inter-disciplinary team traditionally includes a speech language pathologist, occupational therapist, the individual and his or her family members, an educator and rehab engineer. The age, disability and goals of each individual will determine the makeup of the assessment team. Physical therapy, vocational rehabilitation, psychology, social services, recreational therapy, vision therapy, audiology, and medicine are other disciplines which may be involved in the assessment. The individual and their family members are the most important part of the process, and should be included in all components of the intervention. This includes the needs assessment, defining goals, identifying characteristics or features that will best meet the individual's communication needs, and then matching these features to the most suitable or appropriate system. In addition, the assessment may provide information on funding sources, and make recommendations for training and follow-up services. All AAC assessments should be guided by the needs of the individual.The purpose of the team assessment is to determine the communication needs of an individual based on their physical, cognitive and language abilities, while also taking into account the environmental factors that will affect modes of expression. It is therefore very useful to perform the assessment in the environment or environments where the individual will be using the communication system. To enable the individual to communicate effectively, an AAC evaluation includes the following steps:
Assess the individual's abilities: cognitive, sensory and perceptual, motor, speech, and language. If needed, the assessment should also include seating and positioning , literacy, and emotional status.
> Determine communication needs in the individual's environments. For example: identify communication partners; does the individual need to speak face to face, in front of a group, use the telephone, or write messages?
> Set functional communication goals and prioritize them.
> Identify technology features that would provide the support necessary to reach goals.
> Select, purchase and set-up a customized system. This involves integrating the system and related technologies into the individual's environment or environments.
> Train and develop skills for the individual, family members, and other communication partners.
Communication Modes - Low-Tech Communication Devices:
This form of AAC typically refers to communication boards, displays, or wallets ("manual" indicating the use of the hands). Language is displayed using pictures, photographs, objects (e.g. soda can, cup, toy, candy bar), textures, letters of the alphabet, words, symbols, or a any combination of these. This type of system is accessed by pointing; using a finger, headwand or lightpointer, or eye-gaze to indicate needs and ideas. Typically, manual communication boards are used as an introduction to AAC and electronic devices, although they are not always a precursor to the use of high-tech devices. However, they have proven beneficial as a communication aid for individuals who are just beginning to recognize abstract concepts through pictorial representations; as a tool for emergent literacy; and for individuals who are functioning at a lower level, and/or are sensitive to, or do not respond well to auditory feedback. They are also a very important component for high-tech users, both as a complement to an electronic device and as a back-up system. These systems are fairly inexpensive and relatively easy to create.High-Tech Communication Devices:These systems typically fall into two broad categories: dedicated communication systems and computer based communication systems. Dedicated devices are stand-alone systems designed for communication. However, they incorporate voice and can include printers and other features. Computer-based systems are typically laptop computers that incorporate communication software and usually a speech synthesizer; and can be used for other applications as well as for communication. For the majority of high-tech AAC devices, language is generated through pictures, symbols, traditional writing, or a combination of these. Pictures or symbols may be used to represent a word, phrase, sentence or concept. These may be sequenced together, meaning two or more pictures are selected to create a phrase or sentence. Language is then "spoken" using either synthesized speech, digitized speech, or a combination. Synthesized speech uses a computer chip to generate spoken words from written text, based on phonetics. Digitized speech is an actual recording of an individual's voice, and requires more memory than synthesized speech. If digitized speech is the sole output method, however, it eliminates the ability to communicate spontaneously, since every word, phrase & sentence must be thought out beforehand and recorded into the device. Many devices allow language to be created on different levels. For example, the first level may be used to represent communication concerning activities at home; the second level for school activities, and the third level for church related activities. The amount of language created utilizing different levels, in conjunction with sequencing, is limited only by the amount of memory in the device. Other systems have a single level or overlay, and allow generation of unique messages by combining or sequencing pictures in different ways. When traditional orthography is used messages can be spelled, or rate enhancement techniques such as abbreviation expansion or word prediction can be used. These types of features increase the cognitive and sensory/perceptual demands of the user.Selection Technique:
Selection techniques for accessing communication systems are varied and often unique. With an appropriate access evaluation, a selection technique can be identified for anyone. Direct selection means the individual can access the device using their hands, a headstick, mouthstick or other typing aid, or an infrared or light-pointing device. Scanning is typically used by individuals who cannot direct select because of physical limitations. In visual scanning, the vocabulary on the communication device is "highlighted" in a predetermined manner (one cell at a time, by row then column). When the selection the individual wants to access is "lit up," speech is generated by activating a switch. Or, the switch may be held down until the appropriate selection is highlighted. When the switch is released speech will be generated. Auditory scanning is an option for individuals who are blind or visually impaired. With auditory scanning, selections are verbalized to the user through a small, external speaker. When the message they wish to express is heard, it may be verbalized to the communication partner by activating a switch. Communication systems may also be accessed through other indirect means, such as a joystick or trackball.ConsiderationsThe type of communication system selected for an individual will depend on their sensory, motor, language, and cognitive levels. Other considerations include the portability of the system, how it will be mounted and/or carried, and expected battery life. How well does it stand up to typical daily wear and tear (being dropped, exposed to fluids)? Does the manufacturer have a toll free number for service & technical assistance? Is the system easy to program and use? How easily can changes be made? What is the "growth potential?" That is; does the device have the capacity to grow as the user's needs change? It is important to look at the way the person is communicating now, and to try and modify or blend some of those methods into the AAC system.
AAC Resources
Information Resources:American Speech, Language, Hearing Association
10801 Rockville Pike
Rockville, MD 20852
(301) 897-5700
Augmentative & Alternative Communication
Journal Decker Periodicals
4 Hughson Street South, 4th Floor
P.O. 620, LCD 1 Hamilton, Ontario L8N 3K7
Augmentative Communication News
One Surf Way, Suite 237
Monterey, CA 93940
(408) 649-3050
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Direct Access - Electronic Aids to Daily Living:
Electronic aids to daily living, or EADLs, provide alternative access to electrical devices in the environment, such as audiovisual equipment, lights, doors, phones, and beds. This area of assistive technology used to be known as environmental controls, but the name was changed to more accurately define the area and to improve funding and reimbursement. Direct access typically means pressing a button or key with a finger, as on a remote control for a television. Splinting may facilitate finger isolation and stability for access. Some clients can get their hand over a specific key, but they (often the hand remains fisted). They may be able to hold a pointer or use a splint that has a pointer attached. Direct access can also be achieved with mouth sticks or head and chin pointers. Most direct-access EADLs were not specifically designed for persons with disabilities but rather as convenience items for the general population. As a result, this equipment is inexpensive and easily obtained. Direct-access EADLs require fairly good fine motor skills. Clients who can benefit from this technology include those with mobility impairments, muscle weakness, and fatigue. Think about it. When you are at home sick with the flu, using the remote control from the couch becomes more than a convenience. You need to conserve your strength. People who often use direct-access EADLs include those with spinal cord injury, multiple sclerosis, arthritis, stroke, muscular dystrophy, and mild to moderate cerebral palsy. If the client has a progressive disorder, direct-access EADLs may be an inexpensive stepping stone toward more sophisticated systems that offer alternative access.To better examine direct access EADLs, we will explore categories of the devices being controlled.
Audiovisual Equipment:
Most televisions (TVs), videocassette recorders (VCRs), and even stereos include remote controls. A remote sends an infrared signal to the device to control a specific feature, such as power, channel selection, or volume. Infrared signals have to be in line of sight, meaning you have to be in the same room and aim at what you are controlling. A variety of remotes are available. Some styles have very large and/or illuminated buttons. Other styles have very few buttons, which reduces choices (so they are cognitively more simple) and presents less to attend to visually. Universal remotes combine features of several devices, such as the TV and VCR, into one. Many of these remotes are available at large electronic stores and through Home Automation. Remote infrared control has recently made audio equipment more accessible. These remote controls usually do not include all of the audio commands. For example, the remote may turn on the power and change tracks for the compact disc (CD), but not change the radio station. Always check to see whether the remote includes the features your client wants to control. CDs have also revolutionized audio control for persons with disabilities. Only about 20 to 30 minutes of music is available to persons who cannot turn over records and audio cassettes. Many stereos can play multiple CDs, allowing the client to choose from several albums and to even play specific tracks (songs) on those albums. Lights and AppliancesX-10 is a company that took the remote control idea a step further to include on and off (and bright and dim) control of lights. They developed a remote control pad that sends radio signals to a receiver that plugs into a standard electrical outlet. This receiver then sends signals over the wiring in the home, looking for a module to turn on or off. For example, to control a table lamp in the living room by remote control, you can plug the lamp into a module (a small 2"x 2" box) which in turn plugs into the wall outlet. Each module is assigned a number. Pressing button #1 on the X-10 remote control activates module #1. This company took laziness seriously when they made a waterproof floating cover to let you control your lights from the hot tub! Of course, it took an occupational therapist to discover that this waterproof cover reduces the activation pressure of the buttons and protects against saliva, as well.Radio signals go through walls and ceilings, but they are subject to interference. Interference can result in modules being activated by outside radio signals or the X-10 radio signals triggering devices other than the intended module (like the neighbor's garage door!).
X-10 technology offers 16 distinct channels, or House Codes, that can be changed if interference is an issue on one or more frequencies. Modules can turn other devices on and off besides the lights. Appliances such as fans, blenders, and tape players can be controlled as well. I work with kids, and they always come up with the best and most creative things to control, such as electric train sets, Christmas tree lights, and tornado lamps. These modules function as though the device were being plugged in and out of the wall, so the controlled device needs to have a mechanical switch that can remain in the "on" position. For example, pressing down on a mechanical switch for "play" on a tape player into an outlet will result in the tape starting. If the tape player has an electrical switch (requiring electricity to activate), the tape will not start after being plugged in, but requires the play switch to be pressed while the power is on. Never plug a TV into a module! This will damage many sets because the module mimics the activity of repeatedly plugging that TV in and out. Universal Modules include an alert signal that can be activated to get someone's attention in the home, as needed. X-10 technology also controls thermostats and air conditioners. The Home Automation catalog features the full X-10 product line, which includes "automating" sprinkler systems, pet feeders, pet doors, and security features.
Telephones:
Directly accessing a telephone may not require any adaptations besides placing the phone within reach. To ease fine motor requirements, try a large-button telephone. To reduce effort, use a phone with speed/memory dial to reduce button hits and use speaker phones and wireless headsets so that the client doesn't have to sustain a hold on the receiver. Cordless and cellular phones can stay and move with clients, so reduced mobility is not an issue.
Doors:
Most door openers offer a variety of remote controls that are either radio or infrared based. These controls vary in button size and activation pressure required, but they are often similar to a garage door opener control. Most door openers incorporate a door lock as well.
Beds:
Most electric hospital beds offer a variety of remote controls. Ask to see each manufacturer's control options to evaluate which may be easiest for your client to use. Direct access EADLs aren't just for couch potatoes. Keep these easy-to-use, inexpensive devices in mind when assessing a client's self-care needs. A remote control can be just as essential as a sock aid!
Resources:
Home Automation Systems
800-762-7846
X-10 (USA), Inc.
800-526-0027
Follow this link for a listing of other technology vendors
INDEPENDENT LIVING TIPS TO ASSIST WITH HOUSECLEANING AND STORAGE
Choosing the right tool for the job and adapting the tools you have can make working in and taking care of your home a lot easier. These are some suggestions on how to do just that.
CLEANING :
-Floors: When purchasing a vacuum cleaner, think carefully about your upper body strength and don't buy a model that will be too heavy for you. As a rule, canister types are lighter than uprights; attachments to clean upholstery, drapes, blinds, and corners also make them more versatile. On the other hand, uprights help with balance and support. A rotating brush on the power head, though more expensive, gets down into a carpet and picks up ground-in dirt. A drawback is that the heads move independently and can get away from you. Electric brooms may be as useful as full-sized vacuum cleaners. They are lighter, less expensive, can be adapted for carpets or bare floors, and do not require vacuum cleaner bags. Practice emptying the dust compartment to make sure it is not more difficult than replacing a bag. When buying a broom, look for one with a slanted edge and feathered bristles. Wide push-brooms can provide support while sweeping. Long-handled dustpans can be bought at some stores, or insert a broom handle in the hollow handle of a regular dust pan and then angle the pan so that is lies flat to the floor. You can also purchase attachable extra handles to give better leverage and reduce bending over when using long-handled tools. Dust mops handily clean under beds and furniture and down steps. They also offer some help with balance and support. If you use a wheelchair, the handles of mops or brooms may be too long. Cut them off; you can then attach a bicycle-grip or D-grip handle to give yourself a better grip.
-Dusting: Dust frequently; dust combines with airborne cooking grease to make a sticky film that requires scrubbing to remove. A reaching aid holding a soft cloth can reach awkward surfaces. A dusting mitt can be modified to fit over a foot, allowing you to dust along mop boards and under cabinet edges without bending over. To save time and energy, make or buy an apron with plenty of large pockets to carry cleaning supplies, or attach a pocketed pouch to your walker or wheelchair. A small cart on casters can also be used to move cleaning supplies from place to place; sturdier models will offer some support when walking.
-Windows: A lightweight, car-sized squeegee can be mounted on a broom handle. Use the sponge side with a warm water/vinegar solution to scrub windows and mirrors; then wipe clean and dry with the rubber blade.
STORAGE:
Organization is the key to efficient, accessible storage. Most of the products referred to in this section are widely available at hardware and department stores. Be sure to take along accurate measurements and comparison shop to find the product that solves a storage problem most effectively for the least money.
Accessible storage defined:
-Bathrooms: Vertical towel bars, with rings to hang towels through, take up little space and are easily reached. Hanging racks, available in many bed and bath shops, can be very useful in the tub and shower. They can be attached to a wall, the side of the tub, or the shower fixture, and can hold shampoo, soap, brushes, etc. If you take baths instead of showers, a shelf across the tub can hold bathing items.
Closets: Stacking bins can create accessible storage at waist height on the floor of a closet; shelving units attached to the door can store cleaning, laundry, or kitchen supplies within easy reach. Full closet organizer "systems" are also available for $50 and up; look for a sturdy modular unit that allows you to set shelves at heights that you can reach easily. Lower the clothes bar if you use a wheelchair. Bifold doors will give easier access to the entire closet.
Abbreviated list of Vendors:
adaptAbility
1-800-266-8856
Beyond Sight
5650 S. Windemere
Littleton, CO 80120
303-795-6455
Can-Do Products
1-800-225-8446
Maddak, Inc./Ableware
Pequannock, NJ 07440
201-628-7600
Maxi-Aids
P. O. Box 3209
Farmingdale, NY 11735
1-800-522-6294
Below are some examples of 'Assistive Technology'.
The products on this page are just a few of the thousands available.
Have you ever thought; "I wonder if there is something out there that
can help me do this.." chances are there is such a product.
Contact bpritchett@tilinet.org if you would like more information about finding
a particular device.
The EZ-Flo water control valve lets you turn on the water by simply placing your hand under the faucet and moving the rod off-center. |
The Universal Turner is a unique aid designed to offer additional leverage for gripping and turning small knobs. |
Pill dispenser organizer features a locking mechanism and a loud alarm to help prevent medication errors. |
The Can Pop is a unique tool that uses a little leverage to easily pull back lids with pull-tabs! |
A blanket lift will let you sleep better at night by reducing painful pressure to your feet and ankles from the weight of your bedding. |
This Locking Reacher helps you maintain a secure grasp on objects without constant tension on the trigger! |
The Big Lamp Switch replaces smaller rotating knobs and offers more leverage when turning on the light! |
If it is hard for you to grasp and turn a doorknob, this lever handle is a great alternative without removing your existing doorknob. |
SuperTrapeze provides help for sitting and positioning support in bed with this unique handle. |
The UpEasy Seat Assist is a self-powered lifting cushion that provides that extra lift needed to help you get in and out of any armchair on your own. |
This 6 button universal remote control makes it easy to change the channel without fumbling over lots of buttons. |
 This amplified telephone makes dialing easy by identifying programmed speed dial buttons with pictures of your friends and family. |
This one-handed Knife and Fork Combination will easily cut your food with a simple rocking motion. |
If you have arthritis or a weak grip, this holder will handle the task for pens, pencils, toothbrush, crochet hook and more!
|
The SpaceSaverTM Foldable Commode is there when you need it and collapses for storage in seconds. |
Stop struggling to get in and out of the bathtub and use a Bath Transfer Bench with a sliding seat. |
Voice Amplifier-Rest your throat and minimize overall vocal cord strain and fatigue when physical conditions make talking tiring. |
Hip-Kit-if you've had hip surgery, you'll need this collection of helpful items that will help you accomplish daily tasks with less bending. |
If you are interested on learning more about the devices
or techniques mentioned on this page, please feel free to
contact the Assistive Technology Advocate here at
Tri-County Independent Living, 707-445-8404
Phone: 707. 445. 8404 Fax: 707. 445. 9751 / TDD: 707. 445. 8405 Toll Free: 1. 877. 576. 5000 |
Questions/Comments contact at
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