References

American Occupational Therapy Association (2018). The reference manual of the official documents of the American Occupational Therapy Association, Inc (23rd ed.). Bethesda, MD: Author.

Luna Language Services (2020). Video Remote Interpreting Services (VSI) [Online Image]. https://luna360.com/services/interpreting/video-remote-interpreting-vri/

rich vibrational patterns.”

Buzz user’s account on the device: https://youtu.be/t12AMOTJ6S4 
Website: https://neosensory.com/

Patricia Inacio, P. (2019, October 25). Tobii Dynavox Launches New Speech Tablet with Eye-tracking. Retrieved September 07, 2020, from https://cerebralpalsynewstoday.com/2019/10/25/tobii-dynavox-launches-next-generation-i-series-speech-tablet-eye-tracking-integration-system/

AssistiveWare. (n.d.). What is AAC?  Retrieved from https://www.assistiveware.com/learn-aac/what-is-aac

Fairfax County Public Schools [Fairfax Network - Fairfax County Public Schools]. (2019, June 5). Augmentative and alternative communication (AAC) devices [Video file]. Retrieved from https://www.youtube.com/watch?v=qB2Fk0KdUuo

High-tech: Proloquo2Go on the iPad and light-tech: A  young boy using a book made from Proloquo2Go screenshots [Online image]. (n.d.). AssistiveWare. https://www.assistiveware.com/learn-aac/what-is-aac

Proloquo4Text: AssistiveWare's text-based solution [Online image]. (n.d.). AssistiveWare. https://www.assistiveware.com/learn-aac/what-is-aac

Reference
Doise, M. (2016, December 21). Is the BrailleNote touch the Notetaker of the future? iAccessibility. https://iaccessibility.net/braillenote-touch-review/ 

Electronic Notetakers (Braille). (n.d.). American Foundation for the Blind. https://www.afb.org/assistive-technology-products/braille-notetakers

References

Meaghanwalls. (2017, July 31). AT for Independence in the Kitchen Part 2: Adapted Measuring. Retrieved September 09, 2020, from https://assistologyomaha.com/2017/07/31/at-for-independence-in-the-kitchen-part-2-adapted-measuring/

Assistive Technology Australia. (2018). Assistive Technology Guide - Mouth/Head Sticks/ Pointers. Retrieved September 09, 2020, from https://at-aust.org/items/2899

Resources

GLASSOUSE ASSISTIVE DEVICES. (n.d.). Retrieved September 09, 2020, from https://glassouse.com/

GlassOuse. (n.d.). Retrieved September 09, 2020, from https://www.zygo-usa.com/usa/index.php/our-products/assistive-technologies-at/alternative-and-computer-access/glassouse

GlassOuse v.1.2 - Head Mouse Control. (n.d.). Retrieved September 09, 2020, from https://www.westminstertech.com/products/glassouse-v-1-2-head-mouse-control

“This resource has a lot of different articles and resources not only for therapists or educators but also for parents and other caregivers. It gives a lot of different tips and tools to access where to start or can pinpoint with a certain diagnosis and then see what options are available for different symptoms of the diagnosis! What I like most about this website is the vast majority of options for different types of people in the AT process - clients, therapists, caregivers, parents, educators and others.” 

https://www.massmatch.org 

“Though this is based out of Massachusetts, Massmatch gives a great list of assistive technology options for safety and mobility,  personal care, aid with cognition and memory tasks, home management, communication, and community/leisure activity involvement. I really like the list of items they gave and the different "ADL" or "performance skill" categories they put each of the devices under.  In addition, most of the hard technologies listed include links to where you can find and buy the device. The massmatch website also includes helpful information about what AT is, programs, and resources for where to get help in buying or borrowing these devices.” 

“This website is a good resource for researching how AT is utilized in the workplace. It provides information about different types of common ATs within the workplace. There is a podcast link available that focuses on the future of accessible solutions in the workplace. It also provides various accessibility toolkits and resources to explore. I like how easy the website is to navigate and how informative it is!”

“This website is a great place to find out about new and emerging AT around the world.” 

“This Assistive Technology (AT) & Accessible Educational Materials (AEM) Center website provides a wide variety of informational resources on AT and AEM. The website provides resources to understanding the AT basics, assessments, tools, implementation, and new and upcoming AT. In addition to AT resources, the website also outlines an understanding of AEM and how to obtain educational support through alternative forms of educational materials such as print, digital, graphics, audio, video, or braille resources for textbooks, educational content, and test taking. Lastly, the website provides professional development resources and links to upcoming events, modules, and AT conferences or vendor fairs.”

“Do-it; or the Disabilities, opportunities, internetworking, and technology Center is an organization with the mission to empower individuals with disabilities through the power of education and technologies. On their website that have a whole resource page with a lot of links to information regarding AT, universal design, and AT guidelines.”  

“The Assistive Technology Industry Association (ATiA) offers education programs of 150+ live sessions that focus on various AT topics.  ATiA has many alliance partners that include Accessibility Solutions and Research Center, Alliance for Technology Access, State Leaders of Assistive Technology in Education, and many, many more.”  

“This is a great source that goes over the different types of AT and what equipment might fall within that type of AT. It also has clickable links within the reading that expand on the type of AT.  It also has a few other suggested resources for AT and helpful readings.”

“This website offers up free and low-cost assistive technology resources for accessible education and student support. On this website, it is organized into different categories such as reading, writing, and communication making it easy to manage and navigate. Along with this, it offers programs for all different types of computers and devices, making it readily available for students of any kind. Highly recommend checking this out!“

“This website contains various pieces of AT ranging from mobility to visual impairments. It seems to be a very straight forward website and easy to search for specific equipment one would be interested in finding. There was also a sale section with some discounted items which I think is great for those who may be on a budget!”

“This resource offers a lot of information for not only therapists and educators, but also for parents on assistive technologies (AT) in relation to children with Learning Disabilities.  The website discusses what learning problems can be addressed with AT and further provides some examples of the types of AT available. This website further offers a wide variety of research, guides, and resources. I like how easy this website is to navigate and how it addresses educators and parents in separate sections. The website also offers videos to help facilitate understanding of the material being presented.” 

“This website provides information regarding different devices for vision impairments and blindness. It includes resources to available screen reading software programs, assistive technology software for mobile devices, screen magnifiers, voice recognition software, optimal character recognition (OCR) scanning software, and many others. In addition, a list of contact information and websites are provided to find these devices an additional resources to support those with vision impairments.” 

“This is a link to Move United.  On this website there are many links to all different Assistive Technologies to help people in wheelchairs get around in an area without a road.  There are different kinds of manual and power wheelchairs along with chair accessories, handcycles, and other off-road accessories.  These devices can help a person go on a hike or manage their farm.  Great ideas for clients who like the freedom to explore beyond the given trail for those in a wheelchair!”

https://scisexualhealth.ca/mobility/ 

“Both of these resources are related to adaptive technology for improving sexual engagement for clients with disabilities. The first resource is a more general guide for implementing sex and adaptive devices into practice. The second resource is specific to spinal cord injuries with additional resources at the bottom of the page. I think it's easy to forget that sexuality is within our scope of practice but sex is an ADL! It's important that we all have a basic understanding of how to address sexuality and intimacy in practice regardless of the setting or population.” 

“This is a great resource to suggest to a family member if they are becoming the sole caregiver for a loved one.  It provides links on where to find devices, gives quick synopsis on types of AT, how to pay for them and certain devices that are used for deaf, dementia or communication impaired.”

“Here is a resource from Department of Administration Assistive Technology-STAR. Through this resource, you can choose a resource and occupation topic such as Leisure, Home, Education, etc. Once you choose a topic, click on it and it will bring you to a page where there are examples of AT devices and facts. In addition, there are links to local, state, and legislative resources that people can access! This is definitely something that we can explore as professionals, encourage clients to explore, and explore it together!”

5 High Tech pieces of AT for Children & Youth:
1. High tech version of AAC or Alternative and Augmentative communication device

2. Portable Keyboard - Alphasmart, Dreamwriter, and Quickpad

3. Word processors & Talking word processors - Write: OutLoud, Intellitalk 

4. Word Prediction - Co:Writer

5. Graphic Organizers - Kidspiration, Inspiration
6. Alternate Keyboards - Intellikeys, Discover: Board
7. On-screen Keyboard - Discover: Screen

5 Low Tech pieces of AT for Children & Youth:
1. Low tech version of AAC is PECS, picture exchange communication 

2. Multi sensory raised line ruled paper 

3. Varied pencil grips of different shapes, sizes, and weights

4. Slant board for writing on

5. Foot stool for proper positioning

Further Resources: 
- https://www.aota.org/about-occupational-therapy/patients-clients/childrenandyouth.aspx

- https://www.aota.org/About-Occupational-Therapy/Professionals/CY.aspx 

- https://www.massmatch.org/resources/children.php 

5 High Tech pieces of AT for Productive Aging:

1. Smart showers that can sense the presence of an individual and accordingly adjust the timing, water flow, and/or temperature to meet the person’s specific needs. Showers could include sensors that time water flow and water direction, regulate water temperature, and control soap dispensing.

2. The use of smart textiles to augment natural sensation in individuals with neuropathy. For example, prototype optical-fiber-based smart socks have been demonstrated that can measure plantar pressure and temperature in shoes.8 Adoption of such technology could reduce the occurrence of diabetic foot ulcers and other conditions that may progress and result in amputation.

3. Advance technologies that automatically monitor existing wounds and infections, such as “smart bandages” that detect movement, deliver drugs, monitor healing, detect infection, and transmit results directly to the physician.

4. Automated food preparation systems, such as robotic systems - https://www.moley.com

5. Safety devices or security devices that enable client to remain in their home

5 Low Tech pieces of AT for Productive Aging:

1. Advance systems of reminders, alerts, and real-time feedback to patients on their at-home oral care. These would replace and improve upon current patient education materials. These active, personalized dental care systems may include smart toothbrushes or embedded devices in mirrors.

2. For example, inexpensive, disposable electrochemical sensors that can immediately reveal or correctly identify the type of bacteria within a specific location and simple image analysis can both be effective at monitoring wounds.

3. Medication pill organizers and/or modifications to these organizers such as enlarged text, color contrasts, puff paint, etc. to provide sensory input to client with low vision or other conditions

4. Mobile phone-based daily reminders to take medication or when to make financial payments

5. Wearable technology such as smart watches, rings, or wristbands to monitor things like activity, sleep, or vital signs.

Further Resources: 
- https://www.aota.org/About-Occupational-Therapy/Professionals/PA.aspx 
- https://www.aota.org/-/media/Corporate/Files/AboutOT/Professionals/WhatIsOT/RDP/Facts/HomeMod-Occ-Therapy.pdf 
(And here: https://www.aota.org/About-Occupational-Therapy/Professionals/PA/Articles/HomeMod.aspx)  
- https://www.researchgate.net/publication/30815948_Assistive_Technology_for_Successful_Aging_Perspectives_from_Developmental_Behavioral_and_Neuroscience
- https://www.whitehouse.gov/wp-content/uploads/2019/03/Emerging-Tech-to-Support-Aging-2019.pdf

5 High Tech pieces of AT for Mental Health:

1. Blocking or managing auditory hallucinations with music or audio files

2. Telehealth so that clients can receive care from their own homes 24/7. This is especially important for those who feel suicidal or are having an anxiety attack

3. Virtual reality - eg. exposure training for PTSD

4. Apps for meditation & emotions - What's up?; Stop; Breathe & Think; Calm; Head Space; Mind Ease; Clear Fear; Happify; Mindshift; Wysa; & Woebot

5. Medication management reminder pager, watch, or cell-phone

5 Low Tech pieces of AT for Mental Health:

1. Noise canceling earbuds or headsets

2. Digit devices

3. Sun boxes and lights

4. White noise or sound machines 

5. Weighted blanket

Further Resources: 

- https://www.aota.org/About-Occupational-Therapy/Professionals/MH.aspx
- https://www.explorevr.org/sites/explorevr.org/files/files/AT%20MH%20Part%201%20FINAL.pdf
- https://askjan.org/disabilities/Depression.cfm

5 High Tech pieces of AT for Rehabilitation and Disability:

1. Customized wheelchair such as a tilt in space or standing wheelchair

2. Standing frame 

3. Switches - Discover switch, Gumball switch on flex mount, jelly bean switch, etc.

4. Hearing aids

5. Memory aids or orientation aids to help the client keep track of time/day/month

5 Low Tech pieces of AT for Rehabilitation and Disability:

1. Walkers

2. Manual Wheelchairs

3. Sock aid

4. Dressing stick

5. Reacher
6. Bra Angel (https://www.4mdmedical.com/index.php/catalog/product/view/id/230129/s/buckingham-bra-angel-angel?CAWELAID=120141310000056386&CAGPSPN=pla&gclid=Cj0KCQiAy579BRCPARIsAB6QoIYKnuVgmwyCe5aVpaKbC9NBeZy2LbJQf1D2jkBrjQaJv94Nh2FvbvQaAj6AEALw_wcB)

Further Resources: 

- https://www.aota.org/About-Occupational-Therapy/Professionals/RDP.aspx 

5 High Tech pieces of AT for Health and Wellness:

1. Custom designed wheelchairs for Paralympic Games/Sports that can be used on all terrains

2. Beeping sports balls, such as for basketball, tennis, soccer, etc.

3. Wireless In-ear headphones for exercise

4. Robot feeding and dinning assistant 
- these devices promote and support the clients to age in place or stay in their home

5. Amazon Alexa or Google Assistant to help with ADLs and IADLs

5 Low Tech pieces of AT for Health and Wellness:

1. Apps for health & wellness - Presently (gratitude); SuperBetter (builds resilience); Lightening Bug (sleep clock); Plant Nanny (helps you drink more water); etc.

2. Mobile phone-based daily reminders to drink water, exercise for 30 minutes, 5 times a week, and eat healthy!

3. Alarm clocks either on your phone or a separate device to make sure one has a solid bed routine every night to maintain sleep-wake circadian rhythm.

4. Assistive devices for leisure activities such as one-handed fishing rods for those with limited mobility and bowling balls with hand grips 

5. Weights with straps on them somewhat like a universal cuff to help the client hold onto the weights if they have fine motor difficulties

Further Resources: 

- https://www.aota.org/About-Occupational-Therapy/Professionals/HW.aspx 
- https://www.gulphmillstennis.com/single-post/2017/05/23/5-Assistive-Devices-for-Extreme-Sports-and-Tennis

(Plus ergonomics: https://www.aota.org/-/media/Corporate/Files/AboutOT/Professionals/WhatIsOT/WI/Facts/ergonomics.pdf)

5 High Tech pieces of AT for Work and Industry:

1. Screen Reader for those with vision loss which prevents them from seeing screen content or navigating with a mouse. (example: https://www.freedomscientific.com/Products/software/JAWS/) 

2. Modifications for your work vehicle can include lifts and hoists to help you get into and out of your truck if you have a lower limb mobility disability. There are many commercially available, or you can check out a do-it-yourself wheelchair lift.

3. Outdoor mobility aids, including outdoor wheelchairs designed for rugged terrain, are essential in getting around if you work in an agricultural setting.

4. Automatic doors can be beneficial for people with poor motor skills who may be unable to open doors with ease.

5. A frequency-modulated (FM) system is an ALD that makes it easier for people with hearing loss to hear what others are saying in noisy environments, like a theater, school, church, museum or other public places. This wireless system, also called a personal FM system, uses radio waves to deliver speech signals directly from the speaker's mouth to the listener's ears. (example: https://www.babyhearing.org/devices/fm-systems)

5 Low Tech pieces of AT for Work and Industry:

1. Ergonomic key boards - designed to minimize strain and discomfort in your hands, wrists, shoulders and back. Alternatively, an adapted keyboard can be designed to meet your specific needs, such as a one-handed keyboard if you only have the use of one hand.

2. Screen Magnifiers to make screen text larger if you have low vision. You could also use a larger computer screen.

3. Screen clips hold paper in place to decrease neck strain while you type information from printed documents.

4. Microphone headsets help to reduce neck strain and back pain while talking on the phone by allowing you to hold your head in an upright, neutral position.

5. Voice recognition software can be great if you have limb loss, limited muscle control or hand-use, or conditions like carpal tunnel syndrome. This software allows you to speak commands to operate your computer.

Further Resources: 

- https://www.massmatch.org/resources/work.php 

- https://www.aota.org/About-Occupational-Therapy/Professionals/WI.aspx 
- https://choosework.ssa.gov/blog/2017-08-21-using-assistive-technology-in-the-workplace
- http://www.ldonline.org/article/11908/
- https://abilityunlimited.net/top-5-assistive-technology-tools-in-the-workplace/

5 High Tech pieces of AT for Advocacy and Research: 

1. The latest Artificial Intelligence (AI) devices being found in recent literature and research propose that these devices or robots can assist clients in their daily needs and potentially saving their lives.

2. Computer databases with evidence based practice (EBP) articles and research

3. Camera or video surveillance - Which documents any violations or misconduct and advocate for those being mistreated

4. Video teleconferencing - Zoom, Skype, Facebook video chat, etc.

5. Closed captioning and voice recognition (speech-to-text or text-to-speech) softwares to be accessible to all and used in mainstream devices.

5 Low Tech pieces of AT for Advocacy and Research:
1. Websites such as AOTA with Factsheets and Handouts - Spreading the word about the latest research

2. Online Client/ Caregiver Education - Providing them with knowledge on how to advocate for themselves (this can be done through teletherapy or websites)

3. Social Media Platforms - Such as Facebook, Instagram, Snapchat, etc.

4. Writing and emailing letters of necessity to whom it pertains (such as insurance companies or representatives) to advocate for AT device. 

5. Online fundraisers - GoFundMe, Fundly, Bonfire, Double the Donation, DonateKindly, Crowdrise, Razoo, Kickstarter

Further Resources: 

- https://www.aota.org/About-Occupational-Therapy/Professionals/EBP.aspx 
- https://www.aota.org/Advocacy-Policy/Congressional-Affairs/Take-Action.aspx

          A way to adapt making a phone call for someone with Alzheimer’s an occupational therapist can assist this process by making a list of steps on how to make a phone call using their landline phone with a list of numbers that the individual and family approve of.  This information will be placed next to their phone in large and bright lettering so the individual will hopefully see it and recognize how to go ahead with this process.  

          In order for individual to make a phone call with Alzheimer’s, there are memory picture phones available to purchase.  There are photos of the individuals the client might want to call and so they don’t need to dial number.  The client will be less likely to become frustrated and confused.  This also eliminates the individual calling the wrong people and never completing the task they started.  They are about $50.00 with some brands in lower price ranges.

      The Occupational therapist can help a client with low vision make a phone call by making the keys bigger. The OT can write big numbers and cut them out, they can then glue these numbers to the phones existing keys.

      The OT could provide the client with bigger buttons built in. These landlines are readily available on Amazon and are reasonably priced. These adapted phones can be found anywhere from 29 to 45 dollars. Providing the client with a phone with bigger buttons can help them better see the keys and more accurately dial the right numbers.

Adapting this activity doing low tech could be adding colorful and bold stickers with the corresponding numbers to the phone, another could have a handheld magnifying glass to use, or putting the telephone is a better lit area of the house. In my opinion these options would be better because you can continue to adapt and change these as their vision continues to negatively progress.

Adapting this activity doing high tech could be utilizing an audio feedback when typing the numbers, utilizing a braille phone instead of having to depend on seeing the numbers, or using a screen reader. Another could be utilizing a new phone with enlarged numbers and buttons as well.

The low-tech device I chose is a LoopyCase. This case has a loop on the back to provide more stability. It also eliminates flexion of the MCP, PIP, and DIP joints while holding the cell phone. Here is the website link for the cases: https://www.loopycases.com/ (Links to an external site.) 

The high-tech device I chose is teaching the client to utilize the accessibility options in their phone. Some of the options can include talk to text, Siri / voice commands, and switch control. Each of these settings can decrease the amount of finger movements required to make a phone call. 

Historically, occupational therapy has used technologi­ cal devices in the provision of assessment and intervention services. The Association recognizes that continuing technological advances have a significant impact on the use of these devices in occupational therapy practice. Professional and technical education prepares the occupational therapy practitioner to assess the individual's need for technological assistance. However, the rapid change in the availability and complexity of technological devices necessitates that practi­tioners pursue continuing education so that they can apply new technology and new devices to the needs of persons with disabilities.

The occupational therapist assesses a person's sensori­motor, cognitive, and psychosocial abilities to determine the assistive technology that will enable him or her to safely perform activities of daily living, work/school activities, and play; leisure activities. During the assessment process, the therapist also considers the person's environmental con­straints and life-style to ensure a useful and appropriate application of technology. The occupational therapist's unique ability to analyze the person's capabilities, the task, and the environment ensures compatibility between the person and the assistive technology used to meet that per­son's needs.

The occupational therapy practitioner provides a broad range of services in the application of technology, including identification, evaluation, recommendation, procurement, fit, modification, training, and follow-up. The occupational therapy assistant works under the su­pervision of the occupational therapist in specified serv­ice provision tasks. The occupational therapy practition­ er's understanding of the disabled person's everyday functional needs and abilities enables the practitioner to provide input into the design, development, and clinical application of new technological devices.

It is important that information and knowledge from many areas be coordinated in the application of technol­ogy. The occupational therapy practitioner routinely col­laborates with individual team members (e.g., rehabilita­tion engineer, rehabilitation technologist, speech­ language pathologist, teacher) to assess each person's unique needs and to apply the appropriate technology. The occupational therapist's orientation toward the pro­vision of adaptive solutions, coupled with an understand­ ing of the person's impairments and the task's demands, places the occupational therapist in the unique position of coordinating the application of technology services. Training and follow-up are coordinated with the person, the family or caregiver, and other professionals involved in the person's care.

Decisions regarding technological assistance are guided by ethical considerations such as the person's values and needs, long-range cost-effectiveness, and use­ fulness. The application of technology is not an end in itself, but is part of an ongoing therapeutic process. Tech­nology and the new tools it offers to simplify work and extend human performance serve occupational therapy in its most traditional and enduring dimension-helping humans toward independence by assisting them in the process of adaptation."
Reference
Deterding, C., Youngstrom, M. J., & Dunn, W. (1991). Position paper: Occupational therapy and assistive technology. American Journal of Occupational Therapy, 45(12), 1076. https://doi.org/10.5014/ajot.45.12.1076

1990 passive of American Disabilities Act - everywhere must be accessible

Low technology:  devices that are inexpensive, simple to make and easy to obtain

High technology: devices that are expensive, difficult to make and take longer to obtain

Universal Design: products, communications, and the built environment made more useable by as many people as possible at little or no extra cost

EADL:  electronic aids to daily living- allows the child to interact with and manipulate one or more electronic appliances (CD, radio, TV, fan, etc.)

AAC: Alternative and augmentative communication= defined as communication that does not require speech and that can be individualized to the unique needs of the child                                                                                                                             (low tech = PECS picture exchange communication system to high tech computer devices)

Input: device for accessing computers (e.g., standard keyboard)

Output:  product or outcome that is produced when using a computer (e.g., braille, voice output)