ABCs of OT

I know we are a little behind on this, but April was Occupational Therapy Month!

Every year on Instagram, Shannen Marie (@shannenmarie_ot) hosts an ABCs of OT challenge to advocate for our profession. The idea is that you post an OT word everyday that starts with each letter of the alphabet to educate on all the wonderful things an OT can do. I participated this year on my Instagram (@hamlinconsulting) with an assistive technology twist! I wanted to compile all the posts in one place, so here it is!

A is for Assistive Technology

 Luckily, we get to start off with “A” and define assistive technology right away. From the Assistive Technology Industry Association: “Assistive technology (AT) is any item, piece of equipment, software program, or product system that is used to increase, maintain, or improve the functional capabilities of persons with disabilities.” Personally, I would also extend this definition to include any training, education, strategies and techniques used for the same purposes. AT isn’t always tangible!

B is for Bluetooth

Bluetooth has changed the game for a lot of AT. With wireless connectivity, Bluetooth has increased accessibility and independence for such a wide range of individuals – from physical disabilities to sensory impairments to aging, and even makes life easier for those without disabilities! #UniversalDesign
Here’s some of my favorite Bluetooth AT:
– Blue2 Switch: Gives users single or dual-switch access to mainstream technology while providing auditory, visual, and tactile feedback
– Bluetooth Mouse Simulator: For individuals to utilize a wheelchair joystick to control their computer – we love integrating technology!
-Smartpens are amazing for many students and professionals to organize their notes and receive auditory feedback.

C is for Control Sites
Simply put, control sites are the body sites that can be used to control a device (Cook & Polgar, 2015). This changes based on a person’s physical abilities. Hand and fingers are typically the most preferred control sites, but if these are unavailable the head, upper extremity, feet, knees and even eyes, mouth and chin can be used as control sites! An Occupational Therapists involvement in choosing a control site is so important – we need to measure range of motion, fine motor skills, determine best positioning, consider environmental and social factors, as well as how positioning of AT could influence transfers and ADLs.

D is for Dragon Naturally Speaking
Dragon Naturally Speaking is a comprehensive speech recognition software. Individuals with impairments that limit their ability to manipulate and coordinate typical computer use, can utilize this software to navigate their device with their voice. DNS allows them to dictate documents, send emails, search the web, and use social media. There are several versions of the software for professional, home and mobile use.

E is for Electronic Aid to Daily Living (EADL)
An EADL is a device that allows control of appliances (TV, phone, fan, etc.) through the use of switches (Cook & Polgar, 2015). This allows for those with physical or sensory impairment to access and independently control their environment. This is so important for many reasons – mostly safety. As a lot of us know, there is a pattern of Personal Care Assistant shortages. In this instance, individuals need to be able to independently access the phone, be able to open doors, etc. EADLs also play a huge role in independence, confidence, and self-worth, which are vital for the mental health of our clients. With devices like Alexa and Google Home, EADLs are becoming more mainstream and easier to obtain/use.

F is for Function Allocation
Function allocation is determining which functions of the task will be done by the user, which ones will be done by the AT, and which tasks will be done by a Personal Care Assistant. Why is this important to OT? Well, as Occupational Therapists it is always our goal to keep our clients both as independent as possible and as safe as possible. Putting all task requirements on the AT, would likely be greatly underestimating and devaluing the client. At the same time, AT enables people to continue doing what they love and often does this by increasing the safety of that task. Remember – many conditions fluctuate and change over time, so expect function allocation to also change and use good clinical reasoning!

G is for Guided Access
Guided Access is an Apple feature that allows users to limit access to one app and be in control of available features. Once activated in your settings, all you have to do is press the home button or side button (depending on which model you have!) three times quickly and the guided access feature will pop up. From here, you can limit the device to stay in the current app, block portions of the touch screen, put time limits on the app and device use and much more. This is helpful for a variety of individuals. It helps a lot when using the iPad as a reward as it keeps people engaged and focused on one app with clear expectations. For people with motor impairments, guided access limits the number of accidental activations on a touch screen. I’ve even used it with my 2-year-old nephew when he kept accidentally exiting the game app we were playing while he figured out how to manipulate a touch screen! #UniversalDesign

H is for High Tech
High tech AT is used to describe those fancy, digital, complex AT devices. These are usually more expensive and harder to obtain, but have many more capabilities. They are also harder to use and train individuals on, so even though they are cool, make sure you are using good clinical judgement to match your client to an AT! Examples include power wheelchairs, voice recognition, electronic aids to daily living (remember those from day 5?!)
You can find more information on Georgia Tech Tools for Life website (where they also host a ton of great AT webinars FYI!)

I is for Information and Communication Technology (ICT)
ICT is a term used to describe all communication based technology. This encompasses everything from the internet, cell phones, software, social networking and more! With ICT so mainstream, and a lot of that ICT having built-in accessibility features, it has become much more available and affordable for people with disabilities to use ICT to access and interact with the world. #UniversalDesign

J is for Jouse
No, that’s not a typo and no, I didn’t make it up! Jouse is an assistive technology manufactured by Compusult that allows joystick operation for your computer or AAC device by using your mouth, cheek, chin, or tongue! Remember when we talked about control sites? Well, this is a perfect example of using your face as a control site! This is helpful for a wide range of individuals with very limited motor abilities as it doesn’t require large movements to manipulate.

K is for Kitchen Modifications
One of my favorite areas of AT as an OT is home safety and home modifications. I think that’s because, personally, I have a strong sense of home and attribute a lot of meaning to home and as OTs, we understand the impact the environment has on functioning and wellbeing. The kitchen is one of the most important rooms in a house and is essential for individuals to be able to access for their health. Some ways we can modify the kitchen to make it more accessible and safer are: raising counters to fit wheelchairs underneath, placing visual cues as memory aids for kitchen safety, adding tactile cues to microwave buttons, placing frequently used items lower and within reach and adjusting lighting.

L is for Low Tech
Low tech is cheaper, easy to obtain, sometimes even DIY assistive technology. Now just because it’s cheaper and not as fancy as high tech AT, don’t underestimate its power in making someone’s life easier! Examples of low tech AT include using calendars as a memory aid, using color-coded high lighters, pencil grips, sensory fidgets and so much more.

M is for Monitoring Devices
Controversial AT alert!
Monitoring devices can be the difference between staying at home and having to live in a facility, but it also comes with hefty ethical and autonomy considerations. While the main idea is to promote safety, monitoring devices need to be used in a way that we are still honoring client’s freedom and privacy. Monitoring devices include medication dispensing units, GPS tags, door alarms, video monitoring and smart homes.

N is for Notability
Notability is a great alternative note taking app that lets you utilize highlights, audio and PDF annotation to keep your notes organized! This is a game changer for a variety of students including those with fine motor impairments, executive functioning deficits and auditory learners.

O is for Optical Character Recognition
Optical Character Recognition (OCR) is an AT that has been created mainly to help individuals with vision impairments. This technology translates characters into either speech or Braille output to make the information accessible to those with vision loss.

 P is for Pressure Mapping
Wheelchair users are at an increased risk for pressure sores from prolonged sitting – especially if they don’t have effective pressure relief either independently or through tilt! One way to help identify problem areas and compare wheelchair cushions is through pressure mapping. This is a mat that is placed on top of the seated surface in question, then the person can sit on top and the screen will portray high pressure areas. Seating for comfort is essential for participation in daily occupations and pressure mapping is a great preventative measure!

Q is for Quha
Quha is a manufacturing company for all things computer access! They have a variety of devices for a variety of individuals including contactless puff switch, head mouse, switches, dwell software and more. You can check them out at Quha.com!

R is for Ramps
A ramp may seem like a simple install project, but there is actually quite a bit that goes into it in order for it to be as safe and functional as possible. To meet ADA guidelines, the slope must be no greater than 1:12, have a width of 36 inches and have landings at the top and bottom. While we try to meet ADA guidelines everywhere, they aren’t required in private homes. Adding ramps onto homes poses additional challenges when considering access to garage/driveway, the impact of the weather, emergency exits and aesthetics (it’s important to a lot of clients to have a pretty home!)
Please tell me I’m not the only one who slows down and checks out a ramp when I’m driving!

S is for Screen Readers
Screen readers are a software application that allows users who are visually impaired access technology. They translate text on the screen to either speech or Braille output. The American Foundation for the Blind has a great resource for more information.

T is for Touch Accommodations
Touch accommodations is an Apple feature that allows the user to decide and customize how the touch screen reacts to gestures. For example, you can adjust Hold Duration to customize how long you have to hold a selection before it is inputted. This helps reduce accidental selections for those with tremors and other fine motor impairments.

 U is for Universal Design
Universal design is such an important concept to consider with any environment (physical or virtual), or product. It’s the idea that these things should be accessible to all people without exceptions. My favorite example: a curb cut is helpful to both a wheelchair user and a mother pushing a stroller. It benefits everyone and harms no one!

V is for VoiceOver
VoiceOver is Apple’s screen reader (remember those from day 19?!) It provides auditory descriptions of what’s happening in your screen. It even is compatible with a refreshable Braille display!

W is for Word Prediction
Word prediction is a software that suggests words as the user types and will give guesses as to what the next word will be. The cool thing about word prediction is that it has become fairly universal with mainstream technology! I’m actually using it right now to type out this caption.

X is for X10 Minitimer
The X10 Minitimer is a device that is a timer and home automation system. It controls lights and appliances, turning them on/off at certain times throughout the day.

Y is for Yellow
We are talking low tech today! Yellow (or colors in general, really, but y is hard so give me a break!) can be used to highlight and provide contrast. Highlights are helpful for those with executive dysfunction/learning disabilities to organize information. There are high tech reading programs that provide highlights with text-to-speech to provide visual feedback for sustained attention. Contrasting colors are essential for anyone with a visual impairment as well. You can do this by printing on different colored paper and providing a solid background for activities. AT doesn’t have to be complicated!

Z is for Zoom Magnifiers
Zoom magnifiers enlarge all or part of an object. There are high tech ways to do this for a screen through apps and accessibility settings and low tech ways through magnifiers. It’s a game changer for those with low vision!

Did you learn about any new AT with the ABCs of OT challenge? Tell me below!

If you think you or a loved one could benefit from assistive technology, contact Hamlin Consulting at 603-460-5958 or lhamlin@hamlin-consulting.com.

Lilly Hamlin and Hamlin Consulting, LLC have no affiliation with any products discussed in this post.