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Essentials of Assistive Technologies - E-Book

Essentials of Assistive Technologies - E-Book

Albert M. Cook | Janice Miller Polgar

(2014)

Additional Information

Book Details

Abstract

Master the assistive strategies you need to make confident clinical decisions and help improve the quality of life for people with disabilities with this new essentials text. Based on the Human Activity Assistive Technology (HAAT) model developed by Dr. Cook, the book provides the most important coverage of the devices, services, and practices that comprise assistive technology and focuses on the relationship between the human user and the assisted activity within specific contexts. Case studies, illustrations of assistive devices, review questions, and well-developed learning objectives help you focus on the most important areas of assistive technology application.

  • UNIQUE! OTA focus provides you with the specific information occupational therapy assistants need to know to implement and utilize assistive technologies.
  • Comprehensive coverage includes all areas of assistive technologies.
    • The AT industry
    • A historical perspective on the industry
    • Relevant legislation
    • Issues of professional practice
    • Service delivery in assistive technologies
    • General purpose assistive technologies
    • Specific areas of application for assistive technologies
    • And more
  • Content derived from market leader gives you similar chapters and organization to the Principles text, but has more of a focus on the practical skills and knowledge needed for the implementation of AT.

Table of Contents

Section Title Page Action Price
Front Cover Cover
Essentials of Assistive Technologies v
Copyright vi
Dedication vii
Preface ix
Acknowledgments xi
Contents xiii
Chapter 1: Introduction and Overview 1
Assistive technologies: a working definition 1
Definition of Assistive Technology Devices and Services 2
Characterization of Assistive Technologies 3
Assistive versus Rehabilitative or Educational Technologies 3
Low to High Technology 3
Hard and Soft Technologies 3
Appliances versus Tools 3
Minimal to Maximal Technology 4
General versus Specific Technologies 4
Commercial to Custom Technology 4
Universal Design 4
Commercial Assistive Technologies 5
Modified Devices 5
Custom Devices 5
Summary 6
The assistive technology industry 6
The Consumer and Direct Consumer Services 6
The Consumer 7
Characteristics of Direct Consumer Service Programs 7
Basic Research 8
Applied Research 9
Product Development 9
Manufacturing 9
Distribution of Hard Technologies 9
Information and Referral 10
Education 12
Professional practice in assistive technology 12
Who's on First?—Providers of Assistive Technology Services 12
Ethics and Standards of Practice 14
A Code of Ethics for Assistive Technologies: The RESNA Code of Ethics 14
Standards of Practice 14
Quality Assurance 14
Overview 16
Standards for Service Providers 16
Standards for Devices 17
Outcomes of Assistive Technology Delivery 17
Summary 18
References 18
Chapter 2: Framework for Assistive Technologies 20
Human performance and assistive technologies 20
Foundation for a Human Activity Assistive Technology Model 21
A Human Activity Assistive Technology Model 22
The activity 23
The human 23
Skills and Abilities 24
Novice versus Expert User 25
The contexts 25
Physical Context 26
Social Context 27
Cultural Context 28
Institutional Context 28
Extrinsic enablers: the assistive technologies 29
Human-Technology Interface 30
Processor 30
Activity Outputs 31
Environmental Interface 31
Soft Technologies as Extrinsic Enablers 31
Assistive Technology Devices for Specific Applications 31
Application of the haat model: designing assistive technology systems for successful outcomes 32
Assistive Technology System 32
Define Key Activities 32
Consider the Perspective of the User 33
Consider the Environment 34
Selecting the Assistive Technology 35
Allocation of Functions 35
Application of the haat model: a case study 36
Define the Key Activities (The Activity) 37
Consider the Perspective of the User (The Human) 37
Consider the Environment (The Context) 37
Physical Context 37
Social Context 37
Chapter 3: Delivering Assistive Technology Services to the Consumer 41
Principles of assistive technology assessment and intervention 42
Assistive Technology Assessment and Intervention Should Consider All Components of the HAAT Model: Human, Activity, Assisti ... 42
Assistive Technology Intervention Is Enabling 43
Assistive Technology Assessment Is Ongoing and Deliberate 43
Assistive Technology Assessment and Intervention Require Collaboration and a Consumer-Centered Approach 43
Assistive Technology Assessment and Intervention Require an Understanding of How to Gather and Interpret Data 44
Overview of service delivery in assistive technology 44
Referral and Intake 45
Initial Evaluation 46
Quantitative and Qualitative Measurement 46
Norm-Referenced and Criterion-Referenced Measurements 46
Needs Identification 47
Skills Evaluation: Sensory 48
Evaluation of Functional Vision 48
Evaluation of Visual Perception 49
Evaluation of Auditory Function 50
Evaluation of Tactile Function 50
Skills Evaluation: Physical 50
Skills Evaluation: Cognitive 51
Skills Evaluation: Language 52
Past Experience with Assistive Technology 52
Evaluation of the Context 52
Matching Device Characteristics to the User's Needs and Skills 53
The Human/Technology Interface 54
The Processor 54
Activity Output 55
The Environmental Interface 55
Physical Construction 55
Evaluating the Match between Characteristics and the Consumer's Skills and Needs 56
Decision Making 56
Recommendations and Report 57
Implementation 57
Ordering and Setup 57
Delivery and Fitting 57
Facilitating Assistive Technology System Performance 58
Training 58
Performance Aids 59
Instructions 59
Follow-up and follow-along 60
The Effects of Errors in Assistive Technology Systems 61
Evaluating the effectiveness of assistive technology services and systems 62
Assistive Technology Abandonment 62
Formal Evaluation 62
Informal Evaluation 63
A final word about funding 64
Public Funding 64
Private Funding 64
Other Sources of Funding 65
Determining Eligibility for Funding 65
Summary 65
References 65
Chapter 4: Seating Systems as Enablers of Function 67
The role of the rehabilitation assistant 68
Overview of Needs Served by Seating 68
Evaluation for Seating 68
Overview of Assessment Process 69
Human Factors 70
Physical Skills or Mat Assessment 70
Musculoskeletal Factors 70
Postural Control 70
Tissue Integrity 71
Respiratory and Circulatory Factors 71
Sensory and Perceptual Skills 71
Cognitive Skills 72
Psychosocial Factors 72
Environmental Considerations 72
Physical Context 72
Social Context 72
Institutional Context 72
Matching Device Characteristics to a Consumer's Needs and Skills 73
Biomechanical principles 74
Kinematics: Study of Motion 74
Kinetics: Forces 74
Types of Forces 74
Pressure 75
Newton's Laws of Motion 75
Friction 76
Sitting Posture and Center of Pressure 76
Principles of seating for postural control 77
Guidelines for Postural Control 77
Pelvis and Lower Extremities 77
Trunk 80
Head and Neck 82
Upper Extremities 82
Principles of seating for tissue integrity 83
Incidence and Costs of Pressure Ulcers 83
Origins of Pressure Ulcers 83
Other Factors That Contribute to Pressure Ulcer Development 84
Mobility 84
Spinal Cord Injury 85
Body Type 85
Nutrition 85
Infection 85
Age 85
Sitting Posture 85
Microclimate at the Seat/Buttock Interface 85
Transfers and Handling Techniques 85
Pressure Measurement 86
Principles of Seating for Comfort 87
Technologies for seating and positioning management 87
Design and Construction of Seating Systems 87
Planar 87
Prefabricated 88
Custom Fabricated 88
Standard Contoured Modules 88
Custom Contoured 88
Prefabricated Adjustable Backs 89
Properties of Materials used to Construct Seating Systems 90
Classification of Cushion Technologies 90
Cushion Covers 90
Technologies that increase comfort for older adults 90
Summary 94
References 95
Chapter 5: Making the Connection: User Inputs for Assistive Technologies 97
Anatomic sites for control of assistive technologies 97
Connecting the user to the technology 99
Control Interface 99
Selection Set 99
Selection Methods: Direct and Indirect Selection 99
Scanning 100
Directed Scanning 100
Selection Techniques for Scanning 100
Selection Formats for Scanning 101
Coded Access 103
Rate enhancement 104
Development of skills for the use of control interfaces 106
Training and Practice to Develop Motor Control 106
Developing Scanning Skills 107
Summary 109
References 111
Chapter 6: Control Interfaces for Assistive Technologies 112
Characteristics of control interfaces 112
Spatial Characteristics 113
Activation and Deactivation Characteristics 113
Sensory Characteristics 114
Is it working? evaluating the effectiveness of a control interface 115
Enhancing control: proper positioning and arm supports 116
Head Pointers, Hand Pointers, and Mouthsticks 117
Mobile Arm Supports 118
Positioning the Keyboard for Use 118
Control interfaces for direct selection 118
Keyboards 118
Standard Keyboards 118
Ergonomic Keyboards 119
Expanded Keyboards 120
Contracted Keyboards 121
Special-Purpose Keyboards 121
Touch Screens and Touch Tablets: Laptops, Pad Devices, and Smart Phones 121
Concept Keyboards for Users with Cognitive Limitations 122
Eye-Controlled Systems 122
Pointing Interfaces 123
Light Pointers 124
Modifications to Keyboards and Pointing Interfaces 124
Keyboard Layouts 124
Keyguards, Shields, and Templates 126
Technologies for Reducing Accidental Entries 126
Control interfaces for indirect selection 126
Types of Single Switches 127
Mechanical Control Interfaces 128
Proximity Switches 128
Pneumatic Control Interfaces 129
Switch Arrays, Discrete Joysticks, and Chord Keyboards 129
Control-Enhancing Joystick Templates 130
Mounting the Control Interface for Use 130
Multiple versus Integrated Control Interfaces 132
Summary 133
References 134
Chapter 7: Computer Access – Augmenting the Keyboard and Mouse 135
Keyboards – typical and unique 135
On-screen Keyboards 135
Built-in Software Adaptations to the Standard Keyboard 137
Automatic Speech Recognition as an Alternative Keyboard 137
Mouse 139
Touch Screen Mouse Emulation 139
Keypad Mouse 140
Trackball 141
Continuous Input Joysticks 141
Head-Controlled Mouse Emulators 141
Connecting an external control interface to the computer 142
USB Switch Connectors 143
Customizing the Emulator – The Use of “Setups” 144
General Purpose Emulators 146
Using Scanning to Substitute for a Keyboard or Mouse 147
Communication devices as alternative computer inputs 148
Accessibility for mobile devices 148
Internet use by persons with physical disabilities 149
Speech output 150
Digital Recording 150
Speech Synthesis 150
Audio Considerations 150
Summary 151
References 151
Chapter 8: Sensory Aids for Persons with Visual Impairments 153
Visual function 154
Common visual disorders 155
Age-Related Macular Degeneration (ARMD) 155
Glaucoma 155
Cataracts 155
Diabetic Eye Disease 155
Fundamental Approaches to Sensory Aids 155
Augmenting the Visual Pathway 156
Use of Alternative Sensory Pathways 156
Tactile Substitution 156
Auditory Substitution 157
Reading aids for persons with visual impairments 157
Magnification Aids 157
Optical Aids 158
Nonoptical Aids 158
Electronic Aids 158
Braille as a Tactile Reading Substitute 160
Limitations of Printed Braille 160
Refreshable Braille Displays 161
Speech as an Auditory Reading Substitute 162
Recorded Audio Material 162
Devices That Provide Automatic Reading of Text 163
Portable Braille Note Takers and Personal Organizers 164
Making mainstream technologies accessible for individuals who have low vision or are blind 165
Graphical User Interface 165
The GUI and the Blind Computer User 166
Access to Mobile Telephones for Individuals with Low Vision or Blindness 166
Computer Adaptations for Visual Impairments 167
Access to Visual Computer Displays for Individuals with Low Vision 168
Access to Computer Output for Individuals Who Are Blind 169
Visual access to the internet 171
User Agents for Access to the Internet 171
Web Browsers 172
Evaluating Web Sites for Accessibility 172
Mobility and orientation aids for persons with visual impairments 172
Mobility Aids Compared to Reading Aids 173
Long Canes 173
Electronic Travel Aids for Obstacle Detection and Orientation 173
Electronically Augmented Canes 173
Hand-Held and Body-Mounted Obstacle Detection and Orientation Devices 175
Navigation Aids for the Blind 176
User Preferences for GPS Systems 176
GPS-Based Mobility Aids 176
Navigation Aids Based on Environmental Adaptations 177
User Preferences for Sensory Aids for Mobility 177
Special-purpose visual aids 178
Devices for Self-Care 178
Devices for Work and School 179
Devices for Play and Leisure 180
Summary 180
References 181
Chapter 9: Sensory Aids for Persons with Auditory Impairments 182
Auditory function 182
Hearing loss 183
Fundamental approaches to auditory sensory aids 183
Augmentation of Existing Pathway 183
Use of Alternative Sensory Pathway 184
Tactile Substitution 184
Visual Substitution 184
Aids for persons with auditory impairments 184
Hearing Aids 184
Types of Hearing Aids 185
Hearing Aid Accessories 186
Cochlear Implants 186
Telephone Access for Persons Who Are Deaf 187
Telephone Devices 187
Visual Telephones 188
Access to Mobile Phones 189
Technology for Face-to-Face Communication Between Hearing and Deaf Individuals 190
Alerting Devices for Persons with Auditory Impairments 190
Assistive Listening Devices (ALDs) 191
Captioning as an Auditory Substitute 192
Closed-Captioned Television and Movies 192
Real-Time Captioning for Education and Business Applications 192
Computer Adaptations for Auditory Impairments 193
Built-in Options to Increase Usability by Persons Who Are Deaf 193
Access to the Internet when Auditory Information Is Difficult for the User 194
Aids for persons with both visual and auditory impairments 194
Devices for Face-to-Face Communication with Individuals Who Are Deaf and Blind 194
Summary 195
References 195
Chapter 10: Assistive Technologies to Aid Cognitive Function 197
Cognitive skills 198
Perception 198
Attention 198
Memory 201
Orientation 201
Knowledge Representation 201
Problem Solving 201
Language and Learning 202
Disorders that may benefit from cognitive assistive technologies 202
Congenital Disabilities 202
Intellectual Disabilities 202
Learning Disabilities 202
Attention Deficit Hyperactivity Disorder (ADHD) 203
Autism Spectrum Disorder (ASD) 204
Acquired Disabilities 204
Dementia 204
Traumatic Brain Injury (TBI) 204
Stroke 205
Cognitive skills related to specific disorders 206
Addressing cognitive needs through assistive technologies 206
Considerations for Individuals with Mild Cognitive Disabilities 206
Considerations for Individuals with Moderate to Severe Cognitive Disabilities 207
Considerations for Individuals with Acquired Disabilities 209
Characteristics of Cognitive Assistive Technologies 209
Assistive Technologies to Aid Cognitive Function 211
Memory Aids 211
AT for Time Management 211
Devices that Provide Prompting/Cueing/Coaching 214
Stimuli Control 216
Language Tools 216
Alternative Input 217
Alternative Output 218
Tracking and Identification 219
Summary 221
References 222
Chapter 11: Augmentative and Alternative Communication 224
Disabilities affecting speech, language , and communication 226
What Is Augmentative and Alternative Communication? 227
Approaches to Alternative and Augmentative Communication 227
No-Tech AAC Approaches 227
Low-Tech AAC Systems 227
High-Tech AAC Systems 227
The AAC Team 228
The Importance of Augmentative Communication in the Lives of People with Complex Communication Needs (CCN) 229
Partners of People with CCN Who Rely on AAC 230
Attitudes About and Acceptance of AAC 230
Communication needs that can be served by AAC 230
AAC for Individuals with Developmental Disabilities 232
Cerebral Palsy 232
Autism Spectrum Disorder (ASD) 235
AAC for Individuals with Acquired Disabilities 235
Traumatic Brain Injury (TBI) 235
Aphasia 236
AAC for Individuals with Progressive Neurological Conditions 238
Als 238
Dementia 239
Overview of the AAC assessment 240
The Social Networks Inventory : Who Are the Partners? 240
The Participation Model: Identifying Barriers and Opportunities 240
Gathering the Data 241
Relating Goals and Skills to AAC System Characteristics : Developing the Implementation Plan 242
Components of current assistive technologies for AAC 242
Ways of Representing Language in AAC 242
Options for Making Selections in an AAC Device 244
Static Communication Displays 244
Dynamic Communication Displays 244
Visual Scene Displays (VSDs) 245
Outputs from AAC Devices 246
Speech Output 246
Written Output 247
Outputs to Control Assistive Technologies 247
Access to Mainstream Technologies 247
Vocabulary Storage and Retrieval Techniques 248
Vocabulary Programs for Language Development 249
Configurations of Commercial SGDs 250
Putting augmentative communication systems into use—the implementation process 252
Vocabulary Selection 252
Motor Skill Development 254
Setting Up an AAC System for Use 255
Mounting SGDs to Wheelchairs 255
How to Choose Parts for a Mounting System 256
Training System Use: Developing Communicative Competence 256
Follow-up: Measuring Short- and Long-Term Outcomes 261
Summary 262
References 263
Chapter 12: Technologies That Enable Mobility 265
Mobility needs served by wheelchairs 266
Disorders Resulting in Mobility Impairments 266
Functional Limitations of Mobility 267
Mobility Issues Across the Lifespan 267
Evaluation for wheeled mobility 268
Needs Assessment 268
Evaluation of the Human Factors 268
Environmental Factors 269
Physical Context 269
Social Context 269
Institutional Context 269
Characteristics and current technologies of wheeled mobility systems 270
Supporting Structure 271
Frame Types 271
Accessories 273
Frames for Recline and Tilt 274
Frames for Standing 276
Frames That Provide Variable Seat Height 277
Frames that Accommodate Growth 277
Propelling Structure: Manual 277
Tires 277
Wheels 278
Casters 279
Hand Rims 279
Propelling Structure: Powered 280
Drive Wheels 280
Control Interfaces for Powered Mobility Systems 281
Controllers 282
Batteries 283
Ventilators 283
Specialized Bases for Manual Wheelchairs 284
Stroller Bases 284
Transport Wheelchairs 284
Wheelchairs for Use by Older Clients 284
Wheelchairs for Bariatric Clients 285
Specialized Bases for Electrically Powered Wheelchairs 285
Customizable Electrically Powered Wheelchairs 285
Scooters 285
Power Assist Mechanisms 287
Wheelchair Standards 287
Implementation and training for manual and powered mobility 288
Fitting of Mobility Systems 288
Maintenance and Repair of Personal Mobility Systems 289
Developing Mobility Skills for Manual and Powered Systems 289
Summary 290
References 292
Chapter 13: Technologies for Transportation and Driving 294
Safe transportation for children 294
Vehicle Restraint Systems for Children 295
Location in the Motor Vehicle 297
Vehicle Restraint Systems for Children with Disabilities 297
Safe transportation of individuals using wheelchairs 298
Crashworthiness of Wheelchairs and Seating Systems 298
Wheelchair Tie-Down and Occupant Restraint Systems 299
Evaluation and technologies for transportation and driving 301
Evaluation for Driving 301
Pre-driving Rehabilitation 301
Vehicle Selection 301
Vehicle Access 303
Modifications for driving 304
Primary Driving Controls 304
Secondary Driving Controls 307
Summary 307
References 308
Chapter 14: Technologies That Aid Manipulation and Control of the Environment 310
Manipulation 311
Low-technology aids for manipulation 311
General-Purpose Aids 312
Specific-Purpose Aids 312
Self-Care 312
Work and School 313
Play and Leisure 314
Specific-purpose electromechanical aids for manipulation 314
Electrically Powered Feeders 314
Electrically Powered Page Turners 315
Electronic aids to daily living 316
Functions of Electronic Aids to Daily Living 317
Transmission Methods 318
Direct Connection 318
House Wiring—X-10 318
Infrared Transmission 318
Radio Frequency Transmission 319
Selection Methods 321
Trainable or Programmable Devices 321
Phone Control 322
Configuring Electronic Aids to Daily Living 323
Assessment for EADL Use 323
Activity 324
Human 324
Context 324
Technology 325
Studies of EADL Users 325
Implementation of EADLs for Manipulation 325
Summary 328
References 328
Index 331