Quiz 1 (weeks 1 & 2) Flashcards
o “any product, instrument, equipment, or technology adapted or specifically designed for improving functioning of a disabled person.”
WHO definition of assistive tech. 2001
“any item, piece of equipment or product system whether acquired commercially off the shelf, modified, or customized that is used to increase, maintain or improve functional capabilities of individuals with disabilities.”
US definition of AT.
US more inclusive of main stream technologies vs WHO
Video of Elle (14y/o) with CP
what tech did she use?
DynaVox
Video of Richard (man born w/ no arms or legs)
name some tech found in his home
- Electric razor holder,
- pencil/pen to push buttons
- special shorts
- chair w/ buttons
- rope on frigde
- lift for pool
- dressing hook made to fit in teeth
- special mouse
- Drago voice to text
Name some handwriting aides
Pencil grips
fidgets
weights
slant boards
cutting aides
loop scissors
self opening scissors
special grip scissors
safety blades
AT we saw in class
angled platform/binder
elastic shoelaces
foam for built up grip
What does HAAT stand for?
What are the 4 components that influence each other and are constantly changing?
Human Activity Assistive Technology model
- Activity
- The Human
- The AT
- The Context
HAAT model Implications
- Product research
- Product usability studies
- Client Assessment
- Outcome evaluation
What model states
“definition of AT is located within the environment component”
“Environmental factors are external to the person”
Why can this be a challenge?
WHO’s ICF (2001)
(International Classifications of Functioning)
AT is external, but often very personal to the client than other elements of the environment.
Is AT person or technology centered?
PERSON!
We are doing it to fit the person, not making the person suit the technology
5 Principles of AT
- Person centered
- participation in desired activities
- Evidenced informed process
- provided sustainably
refers to the actual, tangible device, such as computer hardware, an AAC device, a hearing aid, or a mobility device
Hard technology
refers to less tangible aspects that support the use of a device, including other people, written or auditory materials, and computer software.
Soft technology
refers to the most complex devices or equipment, that have digital or electronic components, may be computerized, multiple functions, will likely require training and effort to learn how to use and cost the most.
High tech AT device
AT devices that are often readily available, simple to operate and construct, often manually driven, and do not require extensive training.
Low tech AT device
Examples of No Tech AT
- Pencil grip
- post-it’s
- slanted surface
- raised line paper
- Colored overlays
- tactile letters
- Magnifying bar
- weighted pencils
Examples of Low tech AT
- Buzzer
- portable word processor
- talking calculator
- MP3 player
- electronic organizer
- switches/buzzers
- lights
Examples of High tech AT
E-readers
- Touch screens
- computerized testing
- speech recognition
- word processors
- text to speech
- progress monitoring software
(subset of AT) devices that are used to assist with completing activities of daily living. Bathing, dressing, grooming, toileting, and feeding are self-care activities that are including in the spectrum of activities of daily living (ADLs).
Adaptive Equipment
EADLs formerly called _______ But now stands for
Environmental control devices
Electronic aids to daily living
include X-10 functions, infrared functions, direct cable connections, telephone functions, and Z-wave functions, the hardware that is used for each function, and the end device that is being operated.
• Signals are sent through electrical lines, infrared waves, ultrasound, and radio waves depending on the functions in the unit.
Components of EADLs
- Direct Access
- Switch and Scanning Access
- Voice Activation
- Computer Activation
- Phone Activation
EADL Access
A form of assistive technology that provides an alternate means to control appliances or tools in the environment is known as
EADLs
“The constructed norms of internal consistency regarding what is right and wrong.”
-or-
“Moral principles that govern a person’s or group’s behavior.”
Ethics
4 principles of Medical ethics
Autonomy, beneficence,
non-maleficence, and justice
some may find having certain monitoring devices is a loss of privacy, while others see that the monitoring is the only direction toward independance
privacy
the right to self-determination and freedom from unnecessary constraints, interference, or loss of privacy
Autonomy
the interference of a state or individual in relation to another person, either against his will or when the interference id justified by a claim of better protection for the individual
What does this term assume?
Paternalism
o Assumes safety is more important than freedom of choice and that it is important to protect people from themselves
deals with the issue of fairness in individual, interpersonal, organizational, and societal contexts.
justice
Normative principles designed to guide the allocation of the benefits and burdens of economic activity.
Distributive Justice-
- What is subject to distribution (Income, wealth, opportunities, jobs, welfare,
- What is the nature of the subjects of distribution. (natural persons, reference classed e.g persons with disabilities.)
- What should the basis of distribution be (equality, maximization, free transactions)
3 principles of Distributive justice
the principle of not causing harm to others directly or through avoidance of actions that risk harming others. involves a balance b/w avoiding harm and respecting decision about dignity, integrity, and preferences.
• Non-maleficence
connotes acts of mercy, kindness and charity. Includes all forms of action intended to benefit or promote the good of others…helping them to further their important and legitimate interests
• Beneficence-
Obligation of _____ is to respond to the needs of others. this includes universal needs (life and limb, disease and disability, and the necessities of human sustenance
• Beneficence
requires faithful, loyal, honest, and trustworthy behavior, requires being loyal to the patient
• Fidelity-
Treat them with basic respect
Professional is competent, and capable of preforming duties required for their role
Adhere to professional code of ethics
Follow policies and procedures of organization and applicable laws
Agreements will be honored
o 5 expectations associated with fidelity in healthcare
- Sign of social unacceptability because there is shame or disgrace associated with something that is socially unacceptable. Can lead to discrimination and stereotypes.
Stigma
- indicates the promotion and preservation of the individuality of the client, by treating them with respect in all interactions. Dignity encompasses cultural sensitivity, cultural humility, and the need to be inclusive of all people
Dignity
RESNA stands for
What is it?
May be _____ across different professions
• Rehabilitation Engineering and Assistive Technology Society of North America
(Interdisciplinary professional association that focuses on AT) -
may be different across professions.
establish who is eligible to receive assistance for the purchase of devices, which devices are supported in the funding schemes, and which professional group serves as funding gatekeepers
Funding policies and regulations
o Program that provides grants to states for developmental disability councils, university-affiliated programs, and protection and advocacy activities for persons with developmental disabilities.
• The Developmental Disabilities Assistance and Bill of Rights Act
AT funding for illinois
Illinois assistive technology program (IATP)
federal program whose primary goal is to provide medical assistance to persons in need and to furnish them with rehabilitation and other services to help them “attain or retain capability for independence and self-care”
Medicaid
o joint federal and state responsibilities
o provides payment to providers, not the individual
o Largest funding source of AT services and devices
Medicaid
administered by the federal government with country wide rules. focused on needs of elderly (Over 65), people less than 65 with disabilities, disabled children of a person who was working but became disabled themselves, or people with end stage renal disease.
Medicare
DME stands for?
Medicare defines DME as 1. 2. 3, 4.
durable medical equipment
Equipment that
- Can withstand repeated use,
- Primarily used to serve a medical purpose,
- Generally is not useful for a person that does not have an illness or injury,
- appropriate for use in the home.
Medicare split into 2 parts
what is part A
What is part B
Part A – “hospital insurance” covers inpatient services, post-discharge care skilled nursing facilities, hospice care, and home health.
Part B – “supplemental medical insurance” covers DME, rehab, home health that is not covered in A
Private funding examples
- Private Health Insurance
- Private foundations
- Volunteer organizations (Kiwanis, Rotary Club)
- Specific groups (ASD, CP, RA, Lupus organizations)
Private health insurance is obtained 2 ways.
employment or direct purchase.
Other private funding options
- Private foundations
- volunteer organizations
- specific groups/service clubs
Rehab Act (amended) 1986 what changed?
- provision for AT was included
- requires provisions for AT be acquired and included in Individualized Plans for Employment (IPEs)
What Act
o prohibits discrimination on basis of disability
o indiv. Must meet requirement of disability
Americans with Disabilities Act (1990)
What does IDEA stand for
What does it entail?
_____ for all handicapped children.
___&____ public education.
_____ is the centerpiece.
Individuals w. Disabilities Education Act
- Education for all handicapped children
- “Free & appropriate public education”(FAPE)
- IEP = centerpiece of IDEA
What ACT Extends funding to the states that receive federal funding for AT
Assistive Technology Act (1998)
Devices that are used by the general public rather than being designed specifically for people with disabilities.
Mainstream technology
7 Principles of Universal Design
- Equitable Use
- Flexibility in use
- Simple & intuitive use
- Perceptible information
- Tolerance for error
- Low physical effort
- Size & space
The design is usable and marketable to people with diverse abilities
Equitable Use-
the design accommodates a wide range of individual preferences and abilities
Flexibility in use
use of design is easy to understand regardless of user’s experience, knowledge, language skills, or current concentration level.
Simple & intuitive use-
design communicates necessary info effectively to the user regardless of ambient conditions or the users sensory abilities
Perceptible information
Design minimizes hazards and the adverse consequences of accidental or unintended actions
Tolerance for error-
design can be used efficiently and comfortably and with a minimum of fatigue.
Low physical effort-
appropriate size and space is provided for approach, reach, manipulation, and use regardless of users body size, posture or mobility.
Size & space-
Steps to an AT Assessment/ evaluation (6)
- Referral & intake
- Evaluation
- Recommendation & report
- Implementation
- Follow up
- Follow along
an AT assessment should be _______.
the assessment team must be _______.
assessment is ongoing
Team must be multidisciplinary
Visual skills most important for AT
visual acuity, adequate visual field, and quality of vision.
• The clarity with which a person can see objects in the environment
Visual acuity
• Loss of peripheral vision or central vision
Visual field deficit
• Ability to track moving object
Visual tracking
• Ability to scan environment to gather visual information
Visual scanning
• Differentiates a figure from background, used during reading and in retrieval of info from a display
Visual contrast
The ability for the eyes to refocus when shifting attention
Visual accommodation
The process of giving meaning to visual information
Visual perception-
- involves the understanding that an object does not change despite being viewed from different perspectives
Form recognition or constancy-
Most important part of Visual perception for AT
- Depth perception
- spatial relationships
- form recognition or constancy
- Figure ground discrimination
the ability to discriminate between object in foreground and the background on which it rests
Figure ground discrimination-
- Enables individual to perceive info through touch either via actively touching something or passively receiving touch
Somatosensory or Tactile function
3 types of tactile functions included in protocol
- One-two point discrimination
- Perception of touch
- Temperature perception
evaluation that determines the physical capacity of an individual to perform an activity and the most functional position or positions in which to perform that activity related to gross motor function and manipulation, and device access related to fine motor function
Physical skills evaluation
Praxis
motor planning- Sequential steps that need to be completed in order to complete a task
important when determining whether the client will be able to learn how to use the tech as well as whether they have the capacity to use it effectively in the long term.
Cognitive evaluation
Cognitive evaluation includes… (4)
- Attention
- Memory
- orientation
- executive function
Higher order cognitive abilities. Judgment, insight, problem-solving, planning/organizing, and self-monitoring.
o Executive functions
Goal of assistive technology is to_______
Places focus on _____
enable activity performance
Places focus on functional outcomes
assigns a number to an attribute or characteristic. Can be measured in a specific way
o (ROM, MMT)
• Quantitative measurements
assume each individual has different experience. Purpose to describe and understand user’s experience with the tech
o include observations, interviews, captures experiences
• Qualitative measurements:
performance is ranked according to a sample of scores that others have achieved on the test. Produce a percentile rank, standardized score, or a grade equivalent
• Norm referenced –
rate performance according to specific level of mastery, assessing the persons own skill level
• Criterion referenced –
Common AT outcome measures can be
_______ or _____
General measures (Not specific to AT) or AT specific measures
Why may people abandon use of AT?
o Providers ignore users opinions o Obtaining the device (not easy) o Poor performance of device o Change in individuals needs/priorities o Cost vs. benefit o Disability does not define them as a person
