Adaptive Recreation/ Driving Flashcards
1
Q
Adaptive Recreation: Understand potential impact of participating in adaptive recreation on the client
A
- Engage participants
- Enhance independence
- Empower clients
- Provide appropriate challenge: opportunities to success and fail
- Avoid disabling: work with the individual to understand how they will engage with the sport
2
Q
Adaptive Recreation: Understand how sport and recreation can be adapted for the user
A
- Implementation: safety first, fun, success, challenge
- Be creative
- Have a toolbox: know what exists and come up with new ways to bring adaptations to the individual
- Sports that can be adapted: cycling, track and field (have a guide), kayaking (never attach someone to a boat in a water sport), golf, court sports, skiing, hockey
- Adding dump: bring up the seat (decrease angle of your hip)
- Negative dump: extend angle
3
Q
Adaptive Recreation: Understand how an OT may get involved in adapted recreation (schools, clinic)
A
- Create access
- Understand barriers to access
- – Physical, Transportation, Emotional, financial
4
Q
Driving: Role of the OT generalist
A
- provide rehab for all IADLs
- assure patient that their therapy program is designed to optimize all goals, including driving
- be aware of state laws about driving
- have knowledge about driver rehab programs in the area
- – talk about why referral to specialist is important and what they can expect, address fears
- identify activities impacted by driving
5
Q
Self-Assessment Tools for Driving
A
- help older adults gain insight
- limitation: client must have capacity for honest/accurate self-reflection
- are only a screening tool
6
Q
Role of OT Driving Specialist
A
- optimal knowledge base: training in the field of driver education and traffic safety, knowledge of medical conditions and disabilities and their impact on driving.
- familiar with personal-use vehicles, adaptive equipment, and options for vehicle modification.
- perform a comprehensive driving evaluation
7
Q
Parts of a Comprehensive Driving Evaluation
A
- Clinical Evaluation: series of assessments pertinent to the client’s needs and diagnosis
- Functional On-Road Assessment of driving performance
8
Q
The purpose of the Clinical Evaluation (Pt 1 of comprehensive driving eval)
A
to develop a profile of the client’s strengths and limitations in the basic performance skills required for driving
9
Q
Clinical Evaluation (pt 1 of comprehensive driving eval)
A
- Interview/medical history
- Vision Assessment
- Physical Assessment
- Cognitive Assessment
- Perceptual Assessment
10
Q
Clinical Evaluation: Interview
A
- talk with client and family
- about issues to be addressed
- about performance skills
- driving habits, routines, and roles
- history of driving experience
- characteristics of client’s driving: distance from home, frequency of trips, time of day
- consideration of types of vehicle
11
Q
Clinical Evaluation: Vision Assessment
A
- Visual acuity
- Peripheral vision
- Depth perception
- Contrast Sensitivity
- Color recognition
- Oculomotor skills
- Requirements in MA: Visual acuity and Peripheral vision
- – 20/40 for night driving
- – 20/70 for day driving
- – 120 degrees VF in both eyes
12
Q
Clinical Evaluation: Physical Assessment
A
- Joint range of motion, Strength, Sensation, Coordination, Muscle tone, Endurance, Reaction time
13
Q
Clinical Evaluation: Cognitive Assessment
A
- Attention, Memory, Executive Functioning, Insight/Awareness of Deficit areas
14
Q
Clinical Evaluation: Perceptual Assessment
A
- Motor free visual perceptual skills, Visual Motor Integration, Apraxia, Inattention/Neglect
15
Q
Clinical Evaluation: Adaptive Equipment Assessment
A
What adaptive equipment could this client safely use?
16
Q
Adaptive Driving Equipment
- Spinner Knob
- Left foot accelerator with pedal block
- Hand controls
A
- instead of steering wheel
- if can’t use right foot
- that thing for pushing for gas and you had to keep it steady on the number 2 that was really hard
17
Q
Adaptive Driving Equipment
- Secondary controls
- Adaptive Mirrors
- High tech adaptations
A
- lifts
- van adaptations
- steering systems
- lifts
18
Q
Behind the Wheel Eval (pt 2 of comprehensive driving eval)
A
- Road testing performed by a driving instructor and/or an occupational therapist
- On road driving performance to include local/busy streets, expressway driving, parking
- If necessary, geographic evaluation to determine someone’s ability to drive locally (can drive self to supermarket, but shouldn’t go unfamiliar places)
19
Q
Recommendations after Driving Eval
A
- Safe to drive without adaptive equipment
- Safe to drive with restrictions/adaptive equipment
- Not safe to drive
- Need more therapy in preparation for return to driving
20
Q
Driving: Primary Controls
A
- brake, gas, and steering wheel
21
Q
Driving: Secondary Controls
A
- anything other than brake, gas, and steering wheel
- turn signals, windshield wipers, headlights
22
Q
AT Primary Control Options: Mechanical Brake and Gas
A
- Push: go, right angle: stop
- Push: go, rock: stop
- Push: go, pull: stop
- Push: go, twist: stop
- Left foot accelerator, Brake extenders (longer pedal so you can reach it)
23
Q
AT Primary Control Options: Steering Wheel Orthotics
A
- Spinner knob
- Palm grip (no need to grasp)
- V grip: attaches to steering wheel, still need to stabilize wrist, but stabilizes hand, minimizes grasp
- Single pin: hold with hand, still minimize grasp
- Tri pin: holds the wrist steady
24
Q
AT secondary control options
A
- Cross over bar: right hand operation of turn signals and headlight dimmer
- Single function buttons: position for operation by finger, elbow, head or knee
- – Turn signals, Headlight dimmer, Wiper, Cruise control set, Horn, Windshield Wash
- Single control for multiple functions:
- – button positioned for operation by finger, elbow head, knee
- – Pin switch: Mounted on brake/gas orthotic
- – Tri-pin rocker switch
- Spinner knob with switches
- – Turn signal, headlight dimmer, wiper, windshield wash, horn
- Manual handles or fabricated extensions
- – Ignition/start, gear selection, driver/passenger windows
- – Parking brake, door locks, heat/AC, rear wiper, rear defogger, lights
- Single electronic controls and/or console
- – Ignition/start, gear selection, driver/passenger windows, door locks, lights, parking brake, rear wiper, rear defogger
25
Q
Evaluator/Trainer Controls
A
- Mechanical brake and Electronic brake
- Dash buttons
- – Engine Kill, Left turn, Right turn, Horn
26
Q
SETT Framework
A
- Student
- Environment
- Task
- Tools
- – AT, training, accommodations, environmental modifications
27
Q
Low and High Tech Solutions: Reading - Motor Skills
A
- Low: rubber thumb, mouth stick, headpointer, cookbook stand
- High: electric page turner, e-book
28
Q
Low and High Tech Solutions: Reading - Cognitive Skills
A
- Low:
- High tech: educational software (programs that present very simple stories, programs with multiple output modes i.e. interactive stories)
29
Q
Low and High Tech Solutions: Reading - Sensory Skills
A
- Low: contrasting colors for letter and background, large print, incorporate colors for page orientation
- High: computerized reading programs, text-to-speech programs, screen-reading programs, reading scanner: OCR
30
Q
Low and High Tech Solutions: Writing
A
- Low tech:
- – positioning chairs for stability
- – Writing surfaces: stabilize paper with a clipboard, add self-stick rubber feet, provide an angle with a slant board
- – Writing tools: built up grips for pencil, weighted pencil
- – Spelling: Handheld, speaking and nonspeaking devices
- High tech:
- – word processing software with spell-checker
- – Word prediction programs i.e. Word-Q: support the writing process, help students generate sentences with correct grammar and spelling
- – Voice detection software
- – Composition: comprehensive concept mapping software for your computer; iPad Apps, many apps online
31
Q
Low and High Tech Solutions: Mathematics
A
- High tech: computer spreadsheets and databases, electronic math worksheets enable students to do multistep problems on the computer with walk-through solutions, talking on-screen calculators, calculator apps
- Low tech: speaking and nonspeaking handheld calculators
32
Q
Low and High Tech Solutions: Social Activities/Communication
A
- Low tech: manual communication board (pictures and symbols)
- High tech: AAC devices
33
Q
Understand when common high tech devices may be used: graphical organizers, word prediction, speech recognition, reading & literacy assistants
(there is no question)
A
iPad now more commonly used
• support for classroom links
• apps just for education
• topics: communication, emotional development, seeing & hearing, language development, literacy, diagnostics, organization, life skills
34
Q
Communication access is dependent on the needs and preferences of the individual. There is no one- size-fits-all solution. Factors that influence access:
A
- The etiology of the individual’s hearing loss
- Communication preference – always best to ask
- Amount of residual hearing and speech discrimination
- Availability of assistive technology
- The individual’s comfort level in understanding, and advocating for, their own needs
35
Q
Culturally Deaf Individuals
A
- do not see themselves as having a disability
- Cultural view, not pathological
- Use a distinct language, practice a distinct culture
- Will require ASL interpreters for communication
- ASL interpreters must be screened and certified
- May need to use Certified Deaf Interpreters (CDI) in some situations
36
Q
Hearing Aids
A
- Digital hearing aids amplify where you need it, don’t where you don’t need it.
- – the microphone with the speaker thing, can turn on and off as needed, adjustable
- Many manufacturers claim to have successful noise reduction programs on their hearing aids - a claim that is only partially true. (pick up on background noise, can’t filter out)
- Small hearing aids often present challenges to people with poor vision or fine motor control (old people lose them)
37
Q
Hearing Aids and Blue Tooth
A
- Bluetooth is a wireless digital transmission standard. Almost all hearing aid manufacturers have implemented it in ways that allow hearing aids to receive sounds from a linked source, usually a remote microphone or audio device interface.
- Bluetooth can provide an easy link between a hearing aid, cochlear implant and cell phone, avoiding feedback and ambient noise
38
Q
Hearing Aids and Telephones
A
- feedback you get when you put a microphone and a speaker too close together
- can’t hear clearly
39
Q
Telecoil
A
- Telecoil is a magnet built into a hearing aid that receives signals from a telephone or other electronic device. It is used to connect to a large variety of listening devices, particularly audio induction loops. Some are manual, some are automatic.
- – A big problem today is that many people who wear hearing aids don’t even know if they have telecoils in their hearing aid, or know how to use them.
40
Q
Personal Sound Amplifiers
A
- not hearing aids
- Not intended for treatment of hearing loss, not to be marketed or sold to anyone with a hearing loss
- old people tend to buy them because they look like hearing aids so they think they are hearing aids
41
Q
Cochlear Implants
A
- for individuals who, even with hearing aids, do not derive much - if any - benefit from sound amplification.
- There is extensive pre-testing involved before someone is approved as a CI surgery candidate. The ideal candidate is someone who has post-lingual hearing loss, has consistently worn hearing aids, and is a candidate for general anesthesia.
- Age alone has nothing to do with candidacy. An otherwise healthy senior who is a good audiological candidate and has no adverse reactions to general anesthesia is a very viable CI prospect.
- Most insurances including Medicaid pay for CI’s in full.
42
Q
Assistive Listening Systems
A
- wireless and hardwired systems
- For someone who has a mild hearing loss and may not need a hearing aid
- Amplifies the sound in one area
- Personal systems: like headphones, can be used for TVs
- Amplified phones
- captioned phones (show text of what other person is saying)
43
Q
AT for Hard of Hearing In Different Settings
- Work
- Movies
- Social Settings
- Home and Work
A
- Work: can use CART for those who do not use ASL
(super speedy typers who type as fast as people speak so you can read along, use shorthand) - Movies: rear window captioning, sony caption glasses
- Social settings: choose well-lit areas for easier lipreading
- Home and work: environmental alerting systems, Captioned smoke detectors (or lights), Vibrating alarms under your bed
44
Q
Creating Custom Solutions: Advantages and Disadvantages
A
Advantages:
- custom solutions are needed when companies discontinue the sale of a certain AT
- Depending, may also meet the needs of many clients
- The function currently is not made by any other company
- Can use simple materials that were already available (splint scraps)
- Can be low-tech or high-tech
Disadvantages
- may only meet the need of an individual client
45
Q
Does the person need a custom device?
A
- Understanding how to adapt the task, can the task be done with equipment?
- Researching mainstream devices or rehab tech/AT that already exists
- Can existing devices be adapted or modified
- What is the need for designing a new device
- If there is nothing available, person may need a custom solution
46
Q
Planning and Design
A
- Understanding design consequences & design choices
- Sketch out solutions
- Collaborate
- Incorporate design factors
- Consider HAAT Model
- think about universal design
47
Q
Prototyping
- Fabricate
- Testing/Assessment
A
- Fabricate – identify materials & skills needed, making a prototype to scale
- Testing/assessment – testing to see if it works, taking into account the individual, activity, and context, and safety of use
48
Q
Implementation/Follow-Through
A
- Identify who is going to support equipment: client, caregiver, staff
- Will the client be able to direct staff, how will they be best supported to perform the task
- Identifying equipment maintenance, malfunction, troubleshooting
- Developing sufficient manufacturer instructions – creating manuals
- Making sure it’s billable to 3rd party payer
49
Q
Available Evidence for AT and Assessments
A
- Theory: HAAT, PEO, MOHO
- lack of quality evidence
- active engagement of clients in AT assessment process leads to better outcomes
- Assessment measures should be client centered, work in multiple contexts, valid and reliable, user friendly
50
Q
Matching Person and Technology Scale: Purpose
A
- Purpose: understand present environments, individual, and technology to determine appropriate technology to meet goals
51
Q
Assessments: Student Environment Task and Tools Framework
A
- SETT
52
Q
Task Based Assessments
A
- Protocol for Accommodations in Reading (PAR): Great for comparing silent reading vs. RA vs. synth speech
- Written Productivity Profile (WPP): Determine if an alternative or supplement for handwriting is necessary
- Functional Assessment for Cognitive
Assistive Technology (FATCAT) - Time Management Questionnaire (TMQ)
53
Q
Matching Person and Technology: Advantages
A
- “organization-wide” license print and use, type directly into fields on PDF,
- validation studies,
- use in multiple environments,
- Good for comprehensive evals looking at multiple domains
- Can pick and choose checklists/modules
- – Has a nice sub-scale for getting info regarding impression around tech use– predict success with using technology tools?
- Initial worksheet useful for starting an eval
54
Q
Matching Person and Technology: Disadvantages
A
- Manual is extensive and overwhelming
- does not track outcomes well (though encourages users to repeat specific measures to track qualitative changes)
