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AT Final > Adaptive Recreation/ Driving > Flashcards

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
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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
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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
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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
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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
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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
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7
Q

Parts of a Comprehensive Driving Evaluation

A
  1. Clinical Evaluation: series of assessments pertinent to the client’s needs and diagnosis
  2. Functional On-Road Assessment of driving performance
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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

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9
Q

Clinical Evaluation (pt 1 of comprehensive driving eval)

A
  • Interview/medical history
  • Vision Assessment
  • Physical Assessment
  • Cognitive Assessment
  • Perceptual Assessment
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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
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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
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12
Q

Clinical Evaluation: Physical Assessment

A
  • Joint range of motion, Strength, Sensation, Coordination, Muscle tone, Endurance, Reaction time
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13
Q

Clinical Evaluation: Cognitive Assessment

A
  • Attention, Memory, Executive Functioning, Insight/Awareness of Deficit areas
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14
Q

Clinical Evaluation: Perceptual Assessment

A
  • Motor free visual perceptual skills, Visual Motor Integration, Apraxia, Inattention/Neglect
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15
Q

Clinical Evaluation: Adaptive Equipment Assessment

A

What adaptive equipment could this client safely use?

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16
Q

Adaptive Driving Equipment

  1. Spinner Knob
  2. Left foot accelerator with pedal block
  3. Hand controls
A
  1. instead of steering wheel
  2. if can’t use right foot
  3. that thing for pushing for gas and you had to keep it steady on the number 2 that was really hard
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17
Q

Adaptive Driving Equipment

  1. Secondary controls
  2. Adaptive Mirrors
  3. High tech adaptations
A
    • lifts
      - van adaptations
      - steering systems
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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)
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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
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20
Q

Driving: Primary Controls

A
  • brake, gas, and steering wheel
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21
Q

Driving: Secondary Controls

A
  • anything other than brake, gas, and steering wheel

- turn signals, windshield wipers, headlights

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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

  1. Work
  2. Movies
  3. Social Settings
  4. Home and Work
A
  1. 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)
  2. Movies: rear window captioning, sony caption glasses
  3. Social settings: choose well-lit areas for easier lipreading
  4. 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

  1. Fabricate
  2. Testing/Assessment
A
  1. Fabricate – identify materials & skills needed, making a prototype to scale
  2. 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)

AT Final (4 decks)

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