AT/OT/PT Collaborative Problem Solving AT/OT/PT Collaborative

AT/OT/PT Collaborative
Problem Solving
By Cricket Rizzo, MS, OTRL, ATP
Westmoreland Intermediate Unit
&
Kendra Bittner, MEd,
MEd, SoSE,ATAC
Allegheny Intermediate Unit
Housekeeping
• Feel free to ask
questions as they
come to you
• We will take a
break mid-session,
but feel free to
move around
“Technology is a tool that serves a set of
educational goals, and if we don’t think
about what we want the technology for
first, we end up with technology-driven
solutions that have very little impact in the
lives of children and in our educational
system.”
Dr. Linda Roberts, former director of the Office of Educational Technology, U.S. Dept.
of Education
1
AT Definition
IDEA defines Assistive Technology as
both a “device” and a “service”.
AT Device
“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 the functional capabilities
of individuals with disabilities.”
(34 C.F.R. §300.5)
AT Service:
“Any services that directly assist in
the selection, acquisition, or use of
an assistive technology device.”
These services (e.g. acquiring, customizing,
coordinating, training) imply many tasks
for team members in the implementation
of AT.
2
Assistive Technology
Legislation
• IDEA 2004 (34 CFR Parts 300 and 301 )
• Early Intervention Act (PL-99-336)
• Technology-Related Assistance for
Individuals with Disabilities Act of 1988
(PL-100-407)
• Americans with Disabilities Act (PL-101336)
• Entitlement Legislation:
– Rehabilitation Act of 1973 (PL-93-112, as
amended)
– Rehabilitation Act Amendments
When to consider AT
• During the IEP/IFSP process
• When the need arrives for physical access,
communication assistance, and cognitive
support
• When a disability impacts the performance
or potential of a person in any of several
areas:
–
–
–
–
–
Play
Accessing environments
Communication
Writing
Accessing print and auditory information
When to consider AT
• When progress is flat or negative in
direction
• Upon team request
• As early as possible
• If someone is asking this question in
the first place
3
When to consider AT
• IDEA does not require a formalized
implementation plan outside of the
IEP.
• Best practice is considered when it is
systematic and collaborative.
• Refer to your local entity to discuss
the procedure and to gain additional
guidance.
AT Assessment is…
a flexible, collaborative decisionmaking process in which teams of
families, professionals, and friends
repeatedly revise their decisions and
reach consensus about the everchanging abilities, needs, and
expectations of the person with a
disability.
(Adapted from S. Bagnato – Children’s Team Work)
How is the AT assessment
conducted?
• Dynamic
• Multimodal
–
–
–
–
–
Inventory
Interview
Observation
Formal Testing
Informal Testing
• Assessment should focus on features and
strategies rather than on a specific device
• Matches abilities, needs, and expectations
to AT features
4
Feature Match: Abilities,
Needs and Expectations
•
•
•
•
•
•
•
•
Daily needs
AT history
Individual & family input
Cognition
Language
Sensory issues
Motor issues
Life transitions
Multidisciplinary
Evaluation
In the collaborative team approach,
it is assumed that no one person or
profession has an adequate
knowledge base or sufficient
expertise to execute all functions
associated with providing services.
(S.W. Blackstone, 1992)
SETT Framework
• Student
What are the student’s needs?
• Environment
Where are the needs noted? Who teaches
or supports the student in these
settings?
• Task
What must the student do to meet lesson
or IEP goals? What do peers do in
comparison?
• Tools
What no-tech, low-tech, and high-tech
tools have been used or considered?
5
Multidisciplinary Evaluation
Information about the student in regards to
the SETT framework includes:
• What we know
• What we need to know
• What are the barriers
• What are the areas of concern
• What level is the student participating
educationally, physically, socially, and
technologically
AT Assessment Determination
• Determination and implementation of
assistive technology is based on data.
– Formal and informal assessment data guide
initial decision-making and planning for AT
implementation.
– Student performance is monitored while the
assistive technology is integrated into the
students daily and curriculum activities.
AT – Written Plan
Following IEP development and the
determination that AT is being
considered, all those involved in
implementation work together to
develop a written action plan that
provides detailed information about
how the AT will be used in specific
educational settings, what will be
done and who will do it.
6
AT - Written Plan
• AT is a not a goal in and of itself
• AT is a tool that can be used to assist an
individual to access and achieve functional
goals and objectives
• Emphasis should be placed on the needs of
the individual and the features that are
required, not on specific names of
equipment
(J. Marquette, PennTech)
• AT should be considered for the current needs,
developing skills, and future
academic/communicative demands.
Trialing of assistive
technology is suggested
to determine if the
technology supports
student progress.
Equipment Trials
• Team Consensus –
Equipment trials
and timelines
• Emphasis on
meaningful,
motivating
activities
– Activities should
reflect key
environments
– Use should be
consistent
• Careful collection
and review of data,
outcomes, &
recommendations
• Closure through
team decisionmaking
7
Acquisition of Trial
Equipment
• District or IU
inventory
• PaTTAN Short Term
Loan
• Device lending
libraries
–
–
–
–
• Manufacturer lease or
rental
• Purchase with a trial
period agreement
• Purchase of less
expensive items
PIAT
CIL
Organizations
Schools
• Low-tech and no-tech
solutions
AT Assessment Integration
Assistive Technology…
• is adjusted to support student progress.
• spans environments.
• is used when and where it is needed to
facilitate the student's access to, and
mastery of, the curriculum.
• may facilitate active participation in
educational activities, assessments,
extracurricular activities, and typical
routines.
AT Assessment –
Responsibility
• Persons supporting the student across all
environments in which the assistive
technology is expected to be used
• All persons working with the student
should know their roles and
responsibilities, be able to support the
student using the assistive technology
• All persons should share the
implementation of the plan.
• Bottom Line:
Share the wealth!
8
AT Implementation
AT is a process that is on going through out
the student’s life.
AT is used via:
• In-house equipment
• Low-tech and no-tech solutions
• District purchase
• Family purchase
• Insurance/Medical Access
Areas for Evaluation
• Seating and Positioning
• Augmentative Alternative
Communication (AAC)
• Computer Access
• Electronic Aids to Daily Living
Seating and Positioning
9
Seating and Positioning
• The PELVIS is “where it’s at…”
– Proximal stability leads to distal
mobility
Seating and Positioning
• What to consider during a seating and
positioning assessment
– How will the wheelchair be transported?
– Where will the wheelchair be charged?
– Accessibility for the wheelchair within the
educational environment
• Environment is which the mobility device will be utilized
– Entrances, surface materials, doors and doorways, path of
clearance, turning radius, location in the classroom, work
space (height, space needs for books, etc.), bathrooms,
cafeteria, elevator (key), chair lift
– Use/develop a “Mobility Checklist”
• Fire Drill/Emergency Plan – Notify local authorities
Seating and Positioning
– Is there or could there be a need for
integrated controls?
– Is there or could there be a need for
mounting a device?
– Is there a need for changes in positioning?
• Seating/positioning in different locations i.e.
WC, chair, stander, beanbag, floor
• Tilt and/or recline for weight shifts, cathing,
autonomic dysreflexia, etc.
– Wheelchair evaluations are usually not done
through the schools but through outside
agencies/service providers
10
Seating and Positioning
– Need for collaboration between school
therapists and outpatient/inpatient
therapists and vendors/manufacturers
representatives (NRRTS)
• Parent permission to contact/communicate
with other professionals
• What is possibility for attending “outside”
evaluations i.e. The Children’s Institute ?
Evaluation of Student’s
Skills
• Cognitive Skills (attention, concentration,
ability to follow directions, potential for
learning, frustration tolerance)
– Do these skills vary depending on the environment
i.e. 1:1, small group, classroom
• Perceptual Skills
– Depth perception, figure ground, fitting through a
space width
• Sensory Skills (vision, touch, hearing)
– Visual/auditory stimulation/distraction
– Tactile interaction with the control interface (CI)
• Motor Skills (AROM, coordination, strength)
– With a power wheelchair, kids will be “driving”…
Evaluation of Student's
Skills
• Motor Skills
– If unable to use hands, identify
alternate anatomic site for control and
evaluate that site
• Hierarchy of control sites:
–
–
–
–
–
Hands
Head, forehead, eye, mouth, chin
Feet
Elbow/arm
Knee/leg
11
Control Interfaces for AT
• Select candidate control interfaces
(i.e. joystick, head array) matching
the anatomical site available for
access (i.e. hands, head to control
the interface)
• Control interfaces vary in terms of:
– overall size
– how activated: movement, respiration,
voice
– whether or not they give feedback i.e.
auditory, tactile/kinesthetic, visual
Wheelchair Cushions
Control Interfaces for
Powered Mobility
12
Positioning Devices
Evaluation of Student's
Skills
• Cognitive Skills (attention,
concentration, ability to follow
directions, potential for learning,
frustration tolerance)
• Perceptual Skills
• Sensory Skills (vision, touch, hearing)
• Motor Skills (AROM, coordination,
strength)
– Look at seating first!!!
Evaluation of Student's
Skills
• Motor Skills
– If unable to use hands, identify
alternate anatomic site for control and
evaluate that site
• Hierarchy of control sites:
–
–
–
–
–
Hands
Head, forehead, eye, mouth, chin
Feet
Elbow/arm
Knee/leg
13
Control Interfaces for
AT
Control Interfaces for
AT
• Select candidate control interfaces
i.e. various keyboards matching the
anatomical site available for access
i.e. hands to control the interface
• Control interfaces vary in terms of:
– overall size
– how activated: movement, respiration,
voice
– whether or not they give feedback i.e.
auditory, tactile/kinesthetic, visual
Direct Selection vs.
Indirect Selection
• At this stage, you can determine if
the student will use:
– direct selection
– indirect selection
14
Direct Selection
• user can randomly choose any output
directly
• user identifies a target and goes
directly to it
• at any one time, all outputs are
equally available for selection
• physically -- requires refined,
controlled movements, most difficult
• cognitively -- intuitive, easier
Indirect Selection /
Scanning
• intermediate steps involved; thus
slower access
• at any one time, all outputs are not
equally available for selection
• physically -- requires very little
motor control
• cognitively -- requires significant
cognitive skills, visual tracking,
attention, ability to sequence
Directed Scanning
• hybrid of direct and indirect
selection
• user activates the control interface
to select the direction of the scan,
when a desired choice is reached, the
user sends a signal to select
15
Communication
AT and the Purpose to
Communicate
• Communicative functions:
– Rejection
– Request for social interaction,
object, action
– Comment
(Gleason, 1997)
Communication
Considerations
• Does the student have access to
communication across environments
to convey intentions?
• Is the communication system
functional?
• Does it take changing communication
partners into consideration?
• Is the language system flexible?
16
AAC - Definition
"Augmentative and alternative
communication (AAC):
1) The supplementation or replacement of
natural speech and/or writing using aided
and/or unaided symbols...The use of aided
symbols requires a transmission device.
2) The field or area of clinical/educational
practice to improve the communication
skills of individuals with little or no
functional speech."
(Lloyd, L.L., Fuller, D.R., & Arvidson, H.H. (1997)
Augmentative and Alternative Communication: A handbook
of principles and practices. Boston: Allyn and Bacon. pg 524)
AAC - Determination
How is the use of AAC determined?
• Assessments
• Student’s interaction with the world
• Student’s language level
• Input from all members of the team
• Goals, needs, wants to communicate
Pragmatic Intent
How the need to communicate is being
demonstrated?
– What is the behavior in the absence of
language: Eye gaze, vocalization,
grabbing, leading, hitting, screaming,
drooling, blinking, gesturing
17
Pragmatic Intent
• How are the needs or message being
expressed:
–
–
–
–
–
–
Single sounds/signs
Single words/signs/photos/symbols
Multiple words/signs/photos/symbols
Phrases
Sentences
Timely manner – in context, establish the
amount of time, wait time (clock resets at 0
every time someone interrupts); how long it
takes to get the message across to the
communication partner
Language Mode
• Manual
– Sign language – formal, home sign, gesture
• Verbal
– Speech
– Vocalizations
• Written
–
–
–
–
Symbols
Letters
Words
Sentences)
Language Level
• Developmental Language Level
– Emergent
– Phonological (sounds & sound patterns)
– Semantic (relates words to referents &
meanings)
– Morphological/Syntax (putting words
together)
– Pragmatic (Competent)
18
Cognitive Development and
Communicative Symbolic
Use
Cognitive Development – Jean
Piaget
• Sensorimotor Stage – The
child is beginning the process
of learning how to think. She
experiences her surroundings
through her senses and
actions with objects but does
not yet have a functional
representation of the object.
• Object Permanence – The
child is beginning to learn that
things exist even when they
are not being experienced.
• Means-Ends – The child begins
to solve problems in different
ways other than trial and
error.
Language Development
• Pre-symbolic – Reactive
behavior, Proactive behavior,
intentional, and conventional
pre-symbolic language
•
Concrete Symbolic –use of
concrete 1:1 correspondence
with symbol and the referent
•
Abstract Symbolic/formal
symbolic communication
(Rowland and Shweigert, US
office of Special Education
Programs)
Building the Language
System
• Functional language in the
environments that is meaningful to
the student
• Build language for communication
needs by building a solid foundation
• Generalization of language is
impacted by the familiarity of the
systems by the professional collaboration
Building the Language
System
• Using common, functional words to build
core vocabulary (no, low, mid, high tech
options)
• Moving beyond yes and no and I WANT.
• Expand core language to use more rich
words and messages (two word level –
agent + action; MOMMY GO, I GO),
phrasing (pre-recorded or invented),
sentence building
19
Low Tech AAC
Single recordable
switch, sequencing
switch, paper
communication
book, talking
photo album
Mid Tech AAC
Icon sequencing or exchange
voice output communication
aid, paper overlay voice output
communication aids
Hi Tech AAC
Dynamic display
voice output
communication
aids
20
AAC - Features
•
•
•
•
•
Access
Portability
Voice output
Operating system
Display
Access – How will the student get
the message across?
Direct Selection – one
step to get the
message across:
• touch enter
• touch exit
• Stylus
• switch with one
choice
• eye gaze selection
Indirect
Selection/Scanning
• Indirect selection
through directed
scanning – joystick,
mouse, multiple
switches
• Switches – single, dual
• Visual
• Auditory
• Step scanning
• Inverse scanning
(release when your
choice is highlight)
• Row/ Column
Portability Features
• Weight
• Handle
• Where is it being transported and by
whom?
• Mounted – wheelchair, table, bed,
tray
– How will it be mounted ?– apparatus,
Dual Lock, Dycem
21
Voice Output
• None
• Digitized (recorded by a person)
• Synthesized (computerized)
Operating System
Features
•
•
•
•
•
•
Communication software
Paper grids
Linguistic organization
Core word
Semantic compaction
Single word/phrase/sentence
building with or without a message
window
Display Features
•
•
•
•
•
•
•
•
One hit area to a multiple hit area
Visual Scene
Number of grids, windows, keys
Static or removable
Paper or computerized
Outerware – Knobs, buttons, and latches
Power button
Computerized screen – quality of back light
(CVI)
• Pressure to activate
• Keyguards
22
Computer Access
Keyboards
• Standard
– QWERTY
– Alphabetic
– Dvorak
• Portable
• Large Print/Button/
Expanded
• Miniature/Contracted
• Keytop Overlays &
Keyguards
• Coded/Alternate
Entry
• Programmable
• Onscreen
• Word prediction
Standard Keyboards
• Features
– Readily available
– Commonplace and
familiar
– Plug-and-play or
freely convertible
via operating
system
•
•
•
•
• Considerations
– Specialized layouts
impact
generalization of
skill on non-adapted
computers
– Plug-and-play
versus programmed
QWERTY
Dvorak
Alphabetic
Miniature
23
Optimizer Keyboard
• Optimize key to
reduce movement
away from
keyboard
– Mouse control
– Number pad
• QWERTY format
Tactile Pro 2.0
• Replicates the feel
of the old
Macintosh
keyboard
• Available in Mac
and PC versions
• USB 2.0 port built
into the device
• Available with a
pre-programmed
Optimizer button
(see previous slide)
Trackball Keyboard
• Standard
QWERTY keyboard
• Integrated
pointing device
• PS/2 keyboard
• PS/2 or USB
trackball
24
Versa Point RF Keyboard
• Wireless
configuration
– 100 foot range
– Line-of-site not
required
• Integrated
pointing device
• Available as a
combo with
wireless cursor
control unit
Portable Keyboards
• Features
– Most are standalone
word processors
– Reduce distractions
– May offer add-in
functionality
• Pre-programmed
• Download
• SD card
– Text shared with
computer via wire or
wireless connection
– Durability
– Low power consumption
• Considerations
– Inexpensive in
comparison to a
laptop
– Screen size
– Brightness and
contrast limits
– Limited display fonts
and sizes
CalcuScribe
• Portable keyboard
• Built-in calculator
• Text display
options
– 4-line
– 8-line
• File management
system
– Folders
– Menu structure
• Wireless beaming
to other
CalcuScribes for
collaboration
25
Dana Portable Keyboard
• Palm-based
– Organization tools
– Downloadable
software
– Laptop-like
functionality
• Large screen
• Backlight for use in
dark rooms
• Send or Sync
Flexible Keyboard
• Water resistant
• Low pressure to
activate
• Rollable for
storage and
transport
• Available in two
heights
– Standard (19.6 in)
– Short (16.2 in)
Folding Keyboard by Matias
• Full-sized
keyboard
• Integrated number
pad with Tab key
feature
• Function key
access
– Arrow keys
– Page navigation
– Delete
• Volume control
keys
26
Fusion Keyboard (The Writer)
• Text-to-speech
output
• Word prediction
• Split screen
vocabulary word
lists
• Pre-programmed
writing prompts
• Rubrics
– Basic
– Perfect Paragraph
– Multi-Paragraph
Essay
– Six Traits of
Writing
– Persuasive Essay
– Response to
Literature
– Creative Writing
– Build-your-own
Neo & Neo 2
• Six font choices
• Capable of running
applets
– Typing tutor
– Word prediction
– Quiz software
• Wired or wireless
transfer of text
• Saves automatically
in 8 locations
• Option for
Text2Speech
QuickPAD IR & QuickPAD Pro
• Integrated typing
tutor
• Built-in thesaurus and
word prediction
• Infrared connection
via dedicated receiver
• Password-capable
portfolio filing system
to organize writing
files
– Up to 70 pages in
10 separate folders
(QuickPAD IR)
27
Large Print/Button
(Expanded) Keyboards
• Features
– Color schemes for
ease of viewing or
identification
– Large “target”
– Clearer separation
between letters on
large keys
• Considerations
– Larger footprint
– Reduced key set
– Visually distinct
from traditional
keyboards
BigKeys LX & Keyboard
Plus • Standard keyboard
footprint
• One-inch keys
• LX model
– 60 keys
– Black and white keys
• Plus model
– 48 keys
– Color keys
– Black and white keys
• Variety of layouts
– QWERTY
– ABC
Clevy Keyboard
• Vertically aligned
keys
• Keys are four times
larger than standard
keys
• Keys colored by
function
• Fewer keys than a
standard keyboard
• Durable – keys are
switches, not
membranes
28
Large Print Keyboard
• Standard-sized
keyboard
• Enlarged key font
(roughly 3 times
standard size)
– Black on yellow
– Black on ivory
– Yellow on black
• Hot keys for
common commands
and applications
ZoomText Keyboard
• High-contrast keys
– White on black
– Yellow on black
• 16 programmable
buttons
Miniature (Contracted)
Keyboards
• Features
– Reduce “travel” for
users with small
hand spans or
fingers
– May be useful when
• Considerations
– Key face often
features a smaller
font than a
standard keyboard
• Fatigue is common
• Range of motion is
limited
• Only one hand is
used for key
activations
29
EZ-Reach Keyboard
• Flat profile
• Vertically aligned
keys
• Backspace and
Enter are
repositioned for
access by the
forefinger (rather
than the little
finger)
Frogpad
• Wired and wireless
(Bluetooth)
configurations
• Wearable version
– PDAs
– Handheld devices
• USB version
– Handhelds
– Laptops
– Desktops
• Left and right hand
models
• Non-standard key
configuration
(frequency-based)
Half Keyboard
• Palm-sized
• Left-hand only
• Allows user to type
with left hand and
navigate pointer
with right hand
30
Half QWERTY Keyboard
• Full-sized
keyboard
• QWERTY
arrangement
– Two-handed typists
– Left-handed
typists
– Right-handed
typists
Low Profile Keyboard
• 101 keys
• Integrated pointer
available
– Joystick
– Trackball
• Laptop-like feel
• Lightweight
• Flat profile
(approximately one
inch high)
• Small frame (less
than 6”x12”)
Magic Wand Keyboard
• Built-in mouse
– 11 speeds
– Left, right, & double
click
– Click-drag
• Accessible with slight
head or hand
movement
– Handheld wand
– Mouthstick
• No force required for
activation
• Small profile (7” x 6”
x 0.5”)
31
Space Saver Keyboard
• 100 keys
• Narrow design
(10.8”x6”)
– Keypad, function, and
arrow keys above
standard
alphanumerics
• Two models
– Desk (weighted,
2.55”)
– Flat (unweighted,
0.75”)
• Available with or
without integrated
touch pad
USB Mini Keyboard by Tash
• Membrane surface
• Keys less than ½inch square
• QWERTY layout
• Auditory feedback
• Mouse Mode key
for positioning and
click functions
• Adjustable
features
– Response rate
– Key repeat rate
– Mouse tracking
rate
Ergonomic Keyboards
• Features
– Increasingly
available (and
standard) in school,
home, and work
environments
– Reduce repetitive
stress injuries by
supporting more
natural hand
positions
– Some models are
adjustable
• Considerations
– Not conducive to
one-handed typing
– May not fit into
built-in keyboard
trays
32
Contoured Keyboard by Kinesis
• Two models
– Advantage
– Classic
• Concave key
arrangement
– Accommodates
differing finger lengths
– Prevents wrist
extension
• Central positioning of
common “weak finger”
keys
– Backspace
– Enter
• Foot switch compatible
Freestyle Keyboard by Kinesis
• Adjustable, split
keyboard
– Pivot Tether
connects both
modules
• Driverless Hot
keys (not
supported on Macs)
• Optional accessory
packages for
increased
functions
Goldtouch Keyboard
• Splits into two
sections for
adjustment
between 0 and 30
degrees
– Horizontal
– Vertical (tenting)
• Integrated
numeric keypad
• External numeric
keypad available
33
Maltron Ergonomic Keyboard
• Concave key wells
to accommodate
differing finger
lengths
• Centralized number
keys
• Vertical alignment
of key rows
• Thumb keys
– Return
– Space
– Backspace
• Shift Lock feature
Maxim Keyboard by
Kinesis
• Low-force keys
• Horizontal and
vertical
adjustments at 0,
8, or 14 degrees
• Removable palm
supports
• Embedded numeric
keypad
• External numeric
keypad available
Natural Keyboard Elite by
Microsoft
• Keys aligned for
natural wrist and
arm alignment
34
Tru-Form Keyboard
• Split keyboard in
an integrated unit
• Built-in wrist
support
• Dual keys
– PC – Alt, Shift,
Control, & spacebar
– Mac – Command,
Shift, Option,
Control, & spacebar
• Option of built-in
touchpad
Keytop Overlays &
Keyguards
• Features
– Adapt keyboards
for moisture-prone
use
– Provide color cues
to emerging typists
– Retrofit an existing
keyboard
inexpensively
– Provide support for
users unable to
support wrists or
isolate keys easily
• Considerations
– Adhesives may
leave a residue
when removed
– OS settings may
need to be
adjusted (in cases
where a keyboard is
being changed to a
non-QWERTY
layout)
Keyboard Skins
• Protect keyboard
from moisture and
dust
• Conforms to
keyboards for a
secure fit
• Requires model and
FCC# at time of
order (to ensure
proper
configuration)
35
Keyguards
• Available in plastic or
metal versions
• May be easily
removed, if necessary
• Conforms to specific
keyboard arrangments
(specified at time of
order)
• Keyguards are often
available for
specialized keyboards
(through the
keyboard
manufacturer)
Keytop Overlays
•
•
•
•
•
Braille
Early Learning
Finger Position
High Contrast
Large Print
• Uppercase/Lowercase
Coded/Alternate Entry
Keyboards
• Features
– Utilize chords,
codes, or preprogrammed
settings
– Reduce keystrokes
– Reduce hand
movement (travel)
• Considerations
– Learning curve is
typical
– Non-intuitive
36
BAT Keyboard
• Left and right hand
models
• Single-handed keying
– Can be used in addition
to a standard
keyboard
– Free hand for Braille
reading
• Seven keys to
perform all standard
keystrokes
– Chord-based entry
– Programmable macros
Darci USB
• Adjustable, stored
settings
– One to three
switches
– Timing
– Code set
• Plug-and-play (no
specialized
drivers)
• Bus-powered for
convenience and
portability
• Audio feedback
EasyLink Braille
Keyboard
• Bluetooth Brailler
– 6 Braille keys
– 3 function keys
• Compact design
• Highly portable
• 10 hours of
continuous use on
battery
37
EZ Keys XP
• Multiple layouts/entry
methods for adapted
computer access
– Mouse
– Switch access
• Single
• Multiple
– Keyboard
– Mouse emulation
software
– Morse Code
• Built-in features
– Text to speech
– Word prediction
– Abbreviation
expansion
Jouse2
• Morse code joystick
– Control movement
with mouth, chin,
cheek, or tongue
– Perform mouse
clicks with the
integrated sip and
puff switch
• Emulates mouse and
keyboard activations
• Four user-selectable
versions of Morse
Code
Lomak
• Light operated mouse
and keyboard
– Handheld pointer
– Head pointer
• Plug-and-play
• Requires little physical
effort
• Reduces accidental
input through dual
input
– Selection confirmed
by illumination
– Confirm key to use
• Equidistant, circular
key arrangement
38
Programmable Keyboards
• Features
– Allow macros to be
programmed
– Allow computer input
via traditional and
non-traditional means
•
•
•
•
Letter-based
Word-based
Phrase-based
Picture-based
• Considerations
– Time and planning is
often required prior
to use
– Typically require
specialized drivers
(not plug-and-play)
– Highly customizable
• User requirements
• Activity requirements
DX1 Keyboard
• 25 repositionable
keys
– Useful when vision,
dexterity, or range
of motion hinder use
of other devices
• Scalable – add keys
when needed
• Macros
– Programmable
– Pre-built
– Recordable
IntelliKeys Keyboard
• Built-in stand for flat
or angled use
• Wide variety of
overlays
– Pre-programmed
– Printable
– Customized (with
separate Overlay
Maker software)
• Keyguards available
• Dual-switch inputs
• Compatible with
IntelliTools software
and activities
39
X Keys Stick
• Programmable
software
– Macro Works (PC)
– iKey (Mac)
• Sixteen keys
• Repositionable
• Backlight illumination
for low-light use
• Legends
– Pre-cut for
handwrite
– Microsoft
Templates
X-Keys Keypad
• Programmable
keypad
• Works as an
auxiliary keyboard
• Two configurations
– 20 keys (39
macros)
– 58 key (115 macros)
Onscreen Keyboards
• Features
– Keyboard and text
are on the same
plane
– Ability to change
layout
– Alternate input
• Mouse – click or
dwell
• Switch
• Touchscreen
• Considerations
– Loss of “real
estate”
– Fatigue and
repetitive stress
– May require
assistance with
programming/setup
– Integrated word
prediction and
abbreviation
expansion
40
Clicker 5
• Support or develop
writing skills in “non
writers”
• Allows for high level of
structure
• Option for textless
composition
• Universal Design
• Quick, on-the-fly
changes to cell content
• Free, content-sharing
site
CubeWriter
• Customizable
interface
–
–
–
–
Letters
Words
Numbers
Punctuation
• Personalized word
lists
• Three modes of use
– Type
– Write
– Teach
Discover:Screen by
Madentec
• Text-to-speech
• Point and click
access
– Letters
– Words
– Phrases
• Adjunctive (works
with all applications
on a computer)
41
IntelliTools Classroom
Suite
•
•
•
•
Fully customizable
Switch-ready
Scanning available
Compatible with
IntelliKeys USB
– Pre-made overlays
– Overlay Maker
software is
required for
custom overlays
KeyStrokes
• Macintosh
software
• Five resizable
layouts
–
–
–
–
–
Number pad
Function keys
Navigation
QWERTY
Alphabetic
• Modifiable keys
and background
• Resizable
• Dwell selection
Onscreen by IMG
• Built-in supports
–
–
–
–
–
Word prediction
Calculators
Macros
Numeric layouts
International layouts
• Dwell selection
• Verbal Keys Feedback
• Show/Hide key
function
• Smart Window
repositioning
• Scanning option
available
42
REACH Interface Author
by Applied Human Factor
• 140 preprogrammed
layouts
– Customizable
– Create-your-own
• Key Size Button for
quick resizing
• Built-in supports
– Word prediction
– Scanning
– Word use learning
– Dwell selection
• Smart Keys
– Removes or
deemphasizes
unlikely
combinations
– AutoType for
single-result
combinations
ScreenDoors 2000 by
Madentec
• Built-in features
– Word prediction
– Abbreviation
expansion
• Three keyboard
layouts
– QWERTY
– Alphabetic
– Frequency of Use
• Dwell selection
SofType
• Five layouts
–
–
–
–
–
–
QWERTY
Alphabetic
Frequency of use
Numeric
KidKeys
Create-your-own
• Resizable
• Built-in features
–
–
–
–
Word prediction
Dwell selection
Jitter control
Dragger – single
switch control of
mouse functions
– Macro programming
– Size
– Font
– Spacing
43
WiVik by Prentke Romich
• 50 layouts in 22
languages
• Fully customizable
• Repositionable
• Built-in features
– Word prediction
– Abbreviation
expansion
– Dwell selection
– Scanning
• Automatic
• Step
• Direct
Word Prediction
• Features
– Rate enhancement
to reduce
keystrokes
– Real-time display of
choices
• Vertical
• Horizontal
• Dynamic
• Considerations
– Adjunctive versus
self-contained word
prediction
– Phonetic versus
sequence based
– Access to
specialized word
lists as needed
– Text-to-speech
capability
Co:Writer
• Intelligent word
• Neo version
prediction
available
• Flexible spelling
• Adjunctive use
(may be used with
• Collected words
a wide range of
• Predict Ahead
applications)
• eWord Banks
• Basic, personal, and
topic dictionaries
• Text-to-speech
44
Cloze Pro
• Type or paste prepared text
• Remove words automatically
or manually
– Word or letter recurrence
– Sequence
– Pattern
• Present words in a grid or
pop-up list
• Prompt with word shape, word,
exposed letters
• Useful when etext is available
• Suitable for assessment and
cloze-style tasks
Writing With Symbols
2000
• Four writing
environments
– Symbol Processor
– Word Processor
– Grids for Printing
– Grids for Writing
• Customizable word
lists
• Useful as a teacher or
student tool
Soothsayer
• Text-to-speech
• Adjunctive word
prediction
• AutoType Feature
• Abbreviation
Expansion
• Sentence
completion
• Automated
correction of
common spelling
errors
45
WordQ
• Text-to-speech
• Adjunctive word
prediction
• Usage examples
for confusing
words
• Accommodates
phonetic spelling
attempts
• Offers the option
of speech
recognition via
SpeakQ
Other Input Devices
•
•
•
•
•
•
•
•
Mice
Trackballs
Joysticks
Number Pads
Switches and switch interfaces
Touchscreens
Head mice
Microphone and speech recognition
Other Input Devices
• Mouse options
– Switch adapted
– Ergonomic
– Handheld
• Trackballs
• Joysticks
– Gaming
– Roller Joystick
– Roller Joystick Plus
• Number Pads
• Switches and
Switch Interfaces
– Crick USB
– Don Johnston
Switch Interface
Pro
– IntelliKeys USB
Keyboard
• Touchscreens &
monitors
• Head Mouse
– Tracker Pro
46
Speech Recognition
• Utilizes a microphone to input
text
• Requires adequate speech skills
• Requires significant executive
functions to maintain a topic and
perform corrections/training
• May allow for reduced use of the
hands when controlling the
computer
• Consider environment and task
when implementing
Dragon Naturally Speaking,
IBM Via Voice, Mac Dictate
• Continuous recognition
• Allows for keyboardfree text input
• Support for adult and
teen voices
• Analyzes existing
documents for
vocabulary and style
• Noise-cancelling
headset or array
microphone is
recommended
• Skip Training option
• Accuracy tool set
• Works in an adjunct
capacity to other
software
• Not suitable for
discrete recognition
• Specialized versions
available (Dragon
NaturallySpeaking)
SpeakQ
• Customizable training
• Discrete and continuous
prediction modes
• Speech feedback of
recognized text
• No verbal commands for
control or correction
• Integrated word
prediction capability
• Text-to-speech
feedback
• Allows for both
keyboard and speech
input
• Server-level storage of
student voice files
47
Scan and Read/Write
Programs
•
•
•
•
Kurzweil 3000
Read and Write Gold
SOLO by Don Johnston
WYNN
Kurzweil 3000
• Reading, writing, studying,
and test taking software
• Grades 3-12
• Assists students who are
unable to read fluently at
grade level
• Multisensory access to
virtually any text or
curriculum
– Print
– Electronic
– Web-based documents
• Helps develop study skills for
independent learning
• Used at all tier levels for RtI
• Supports principles of (UDL)
Universal Design for Learning
• Web Licensing for access at
home
Read and Write Gold
• Reading, writing, studying,
test taking software
• Improves reading fluency and
comprehension
• Encourages independence and
inclusion
• Multisensory access to
virtually any text or
curriculum
– Print
– Electronic
– Web-based documents
• Used at all tier levels of RtI
• Supports the Principles of
UDL
• Concurrent user licensing
accessed from school or
home
48
SOLO by Don Johnston
• Literacy Suite combining 4
tools
–
–
–
–
Word Prediction
Graphic Organizer
Talking Word Processor
Text Reader
–
–
–
–
Comprehend
Synthesize
Expand ideas
Edit
–
–
–
–
Compose
Organize
Revise
Publish
• Assists in developing reading
skills
• Assists in developing writing
skills
•
•
•
•
•
•
WYNN Wizard
Reading, writing, studying, test
taking software
Improves reading fluency and
comprehension
Encourages independence and
inclusion
Color-coded, rotating toolbars
– File management
– Visual and auditory presentation
of text
– Study Tools
– Writing Aids
– Internet Use
Multisensory access to virtually
any text or curriculum
– Print
– Electronic
– Web-based documents
Used at all tier levels of RtI
Electronic Aids to Daily
Living (EADL)
49
Electronic Aids to Daily
Living (EADL)
• Basic EADLs
– Provide alternative
access to:
• Multifunction EADLs
• Battery operated
devices i.e. toy
• Simple electronic
devices i.e. fan
– Provide limited control
of an infrared receiving
device
• i.e. TV “volume up”
– Access almost always
by a switch
– Provide control of a
variety of devices such
as:
• TV, DVD, Stereo, CD
• Lights
• Appliances i.e. blender,
fan
• Heating and AC
• Door Openers
• Electric Hospital Beds
• Telephone
Electronic Aids to Daily
Living (EADL)
• Basic EADLs
– Operated by direct connection via battery adapter
• Individual can notch battery cover and insert battery adapter
between battery and contacts
– Operated by direct connection via pre-adapted device
• Ablenet
• Adaptivation
• Enabling Devices
– Can have intermittent control via:
•
•
•
•
Switch latch
Switch latch and timer
Dual switch latch and timer
Choice switch latch and timer
How can EADLs be used?
•
•
•
•
•
To provide play
To meet educational goals
To increase independence
To increase social interaction with peers
To prepare/train for more advanced
assistive technology
50
Electronic Aids to Daily
Living (EADL)
•
Integrating into the curriculum
–
Play and Learn
•
•
•
•
http://www.ablenetinc.com/Store
/tabid/205/Default.aspx?ItemCo
de=200PAL
A 12-month motor-based
preschool curriculum specifically
developed for children of All
abilities!
More than 300 pages of themebased activities that are highly
engaging, and relevant to young
children.
Each activity includes a "Try
Another Way" option that utilizes
simple assistive technology so all
students can participate,
communicate and learn.
Case Studies
• Case 1
– Seating/positioning, mobility, accessibility
w/classroom and different chairs, AAC,
Intellitools, EADL i.e. games for recess,
inclusion for class activities i.e. fan, blender
• Case 2
– Seating/positioning, AAC, access to curriculum,
peer relations, EADL for computer and AAC
access
Case Studies
• Case 3
– Kurzweil 3000, Fusion
• Case 4
– AAC, Clicker 5
51
Resources
• Ablenet Presentations
– Positioning for Access by Michelle Lange, OTR, ABDA,
ATP
• http://www.ablenetinc.com/Default.aspx?tabid=241&Suppo
rtDocId=191
– Classroom Applications by Michelle Lange, OTR, ABDA,
ATP
• http://www.ablenetinc.com/Default.aspx?tabid=241&Suppo
rtDocId=193
– Switch Access and Assessment: determining type and
location by Michelle Lange, OTR, ABDA, ATP
• http://www.ablenetinc.com/Default.aspx?tabid=241&Suppo
rtDocId=192
Resources
• Closing the Gap
– http://www.closingthegap.com/
• DynaVox Technologies Implementation Toolkit
– http://www.dynavoxtech.com/training/toolkit/
• Enabling Devices Communicator Comparison Chart
– http://enablingdevices.com/files/content/ComparisonCh
art.pdf
• Scott A. Dougherty, AIU #3
– http://www.aiu3.net/Level3.aspx?id=3822
Websites
• Abledata http://www.abledata.com/
• Adaptivation Photo Gallery of Ideas
http://www.adaptivation.com/Adaptivation
_Website/Adaptivation_Photo_Album.html
• Georgia Project for Assistive Technology
http://www.gpat.org/Index.aspx
• Techmatrix
http://www.techmatrix.org/
52
Contact Information
Cricket Rizzo
MS, OTR/L, ATP
Occupational Therapist
Westmoreland Intermediate Unit
#7
102 Equity Drive
Greensburg, PA 15601
[email protected]
(724) 836-2460 x 2193 (VM)
Kendra Bittner
MEd, SoSE, ATAC
IDEA Training and Consultation
Coordinator, Assistive
Technology
Allegheny Intermediate Unit #3
475 East Waterfront Drive
Homestead, PA 15120-1144
[email protected]
412-394-5872 ● 412-394-5992
(Fax)
AIU Assistive Technology Home Page
http://www.aiu3.net/Level3.aspx?id=1220
53