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Assistive Technology Provision Module Part I

Models of application of AT. Human Activity Assistive Technology Model (HAAT)The Human PerformerThe ActivityThe Assistive TechnologyThe context for use. 1. The Human Performer. Impairment

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Assistive Technology Provision Module Part I

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    1. Assistive Technology Provision Module Part I Assessment Presented By: Lindsay Eubanks, Amy Fisher and Laurene Sweet HI. I’m Lindsay Eubanks. This is Amy Fisher and Laurene Sweet. Today we are talking to you all about AT assessment and the characteristics of technology for persons who are deaf and hard of hearing. As far as assessment goes, we will be talking about some of the main objectives of this module which are - compare and contrast the process by which AT is provided in different settings - describe the AT team and their respective roles - list the major steps in an AT assessment - describe how information gained in the interview and eval will effect selection of intervention - describe AT application principles and the impact they have on the success or failure of the intervention and create appropriate goals and outcome measures that relate to them. HI. I’m Lindsay Eubanks. This is Amy Fisher and Laurene Sweet. Today we are talking to you all about AT assessment and the characteristics of technology for persons who are deaf and hard of hearing. As far as assessment goes, we will be talking about some of the main objectives of this module which are - compare and contrast the process by which AT is provided in different settings - describe the AT team and their respective roles - list the major steps in an AT assessment - describe how information gained in the interview and eval will effect selection of intervention - describe AT application principles and the impact they have on the success or failure of the intervention and create appropriate goals and outcome measures that relate to them.

    2. Models of application of AT Human Activity Assistive Technology Model (HAAT) The Human Performer The Activity The Assistive Technology The context for use So, first, let’s look at the model that influences many of the AT decision. It is a human performance model which means that a system must represent a someone (person) doing something (activity) somewhere (within a context). The Human Activity Assistive Technology adds assistive technology to that human performance model and looks at someone doing some task with the HELP of something in a particular context. There are four components to this model The Human Performer The Activity The AT And the context for useSo, first, let’s look at the model that influences many of the AT decision. It is a human performance model which means that a system must represent a someone (person) doing something (activity) somewhere (within a context). The Human Activity Assistive Technology adds assistive technology to that human performance model and looks at someone doing some task with the HELP of something in a particular context. There are four components to this model The Human Performer The Activity The AT And the context for use

    3. 1. The Human Performer Impairment – loss or abnormality of a psychological, physical, or anatomical structure or function. Disability – is the inability to perform an activity in the manner or within the range considered normal for a human being. Handicap – is any resulting social disadvantage for an individual that limits the fulfillment of a normal role or occupation. (World Health Organization, 1980) The Human Performer component includes some terms defined by the World Health Organization They are impairment, disability and handicap. (READ OFF SCREEN THE DEFS)The Human Performer component includes some terms defined by the World Health Organization They are impairment, disability and handicap. (READ OFF SCREEN THE DEFS)

    4. 2. The Activity Activity – the thing the person wants to do; what needs to be accomplished Task – what needs to be accomplished to perform the activity Skill – the person’s ability to do the task Physical Ability – the person’s capacity to perform that skill The next defined term is the Activity The activity is (READ OFF SCREEN) The task is (READ OFF SCREEN) Following that is the Skill (READ) And finally the the physical ability (READ)The next defined term is the Activity The activity is (READ OFF SCREEN) The task is (READ OFF SCREEN) Following that is the Skill (READ) And finally the the physical ability (READ)

    5. 3. The Assistive Technology Assistive technology is any item, piece of equipment, or product system whether acquired commercially off the shelf, modified, or customized that is used to increase or improve functional capabilities of individuals with disabilities. USA PUBLIC LAW 100-407 TECHNICAL ASSISTANCE TO THE STATES ACT The assistive technology is defined as (read off screen)The assistive technology is defined as (read off screen)

    6. Assistive Technology Characteristics Low to high tech Hard or soft tech Minimal to maximal Augment or replace General or specific Commercial or custom Categories Aids to daily living Augmentative and alternative communication Computer access Environmental control units Home or work site modifications Job accommodation Seating and positioning aids Vision and hearing aids Wheeled mobility aids Vehicle modifications Recreational aids It’s important to remember that AT differs from rehab or educational equipment. It must be used to substitute for an impaired function. Rehab technology is used for remediation of impaired function. And educational technology is used to TEACH new knowledge or skills. Some other characteristics of AT are (READ OFF SCREEN) There are also categories of AT which include (READ OFF SCREEN)It’s important to remember that AT differs from rehab or educational equipment. It must be used to substitute for an impaired function. Rehab technology is used for remediation of impaired function. And educational technology is used to TEACH new knowledge or skills. Some other characteristics of AT are (READ OFF SCREEN) There are also categories of AT which include (READ OFF SCREEN)

    7. 4. Context for use of AT Service Delivery Models Medical Settings Educational settings (public or private) Vocational settings Retail settings (DME, ATS and RTS) Community based settings Residential or institutional settings Charities, societies, benevolent organizations Re-sale and recycle programs The last component is the context for the use of AT. It includes the physical environment and conditions, the psycho social and cultural environment, the lifestyle, and the setting or service delivery model. Service delivery models include (read off screen) Delivery of AT services will differ, depending on Purpose and mission Funding restrictions (must be medically necessary and appropriate in some settings) Population served Functional areas Geographic area served And administration and internal operations I’d like to get a show of hands of how many here work in a school setting. Where else are people working?The last component is the context for the use of AT. It includes the physical environment and conditions, the psycho social and cultural environment, the lifestyle, and the setting or service delivery model. Service delivery models include (read off screen) Delivery of AT services will differ, depending on Purpose and mission Funding restrictions (must be medically necessary and appropriate in some settings) Population served Functional areas Geographic area served And administration and internal operations I’d like to get a show of hands of how many here work in a school setting. Where else are people working?

    8. Teams and Collaboration (our favorite thing - right?) People involved Designer Fabricator Manufacturer Manufacturer’s representative Distributor Supplier Payer for funding source !!! ? As we know, many different people are involved in providing AT services. Some of those include (read off screen)As we know, many different people are involved in providing AT services. Some of those include (read off screen)

    9. Teams and Collaboration Designer Creates product’s functional and aesthetic feature Fabricator Actual construction of the product The Designer – conceptualizes and creates the product’s functional and aesthetic features. Sometimes they request input from potential users or via a manufacturer’s representative. Fabricator – is responsible for the actual construction of the physical product, often using drawings or instructions he receives from others.The Designer – conceptualizes and creates the product’s functional and aesthetic features. Sometimes they request input from potential users or via a manufacturer’s representative.

    10. Teams and Collaboration Manufacturer Producing and stocking the product Manufacturer’s representative Informs potential users, retail suppliers, or prescribers about the features and applications of the product The manufacturer is responsible for mass producing and stocking the product. The manufacturer’s rep informs potential users, retail suppliers, prescribers and others about the features and applications of the products made by the manufacturer that hired them. The manufacturer is responsible for mass producing and stocking the product. The manufacturer’s rep informs potential users, retail suppliers, prescribers and others about the features and applications of the products made by the manufacturer that hired them.

    11. Teams and Collaboration Distributor Obtains products and provides them to local retails suppliers Supplier “sells” the product to the consumer Assist the consumer in selection process The Distributor is the one who obtains the product, usually from several manufacturers, and provides the products to local retail suppliers. May keep stock on hand. The supplier “sells” to the consumer the products they carry, they may also assist the consumer in the selection process.The Distributor is the one who obtains the product, usually from several manufacturers, and provides the products to local retail suppliers. May keep stock on hand. The supplier “sells” to the consumer the products they carry, they may also assist the consumer in the selection process.

    12. Teams and Collaboration Payer or Funding Source Provides MONEY! Covers all or part of the cost of equipment And last, but certainly not least, is the payer or funding source. They provide money to cover all or part of the cost of the equipment, sometimes including the cost of evaluation, fitting, modifying, training, and other services. Usually work within strict guidelines for the prudent dispersing of funds.And last, but certainly not least, is the payer or funding source. They provide money to cover all or part of the cost of the equipment, sometimes including the cost of evaluation, fitting, modifying, training, and other services. Usually work within strict guidelines for the prudent dispersing of funds.

    13. When is a Team Needed? Preferred over a single assessor when The consumer’s situation is complex The issues are broad, crossing several disciplines’ scope of practice A single assessors skills are limited and he is unable to perform all the tasks of a thorough assessment by himself. It is almost always appropriate and desirable to form a team for an AT assessment. Having been on a team like this this past school year, I can see how important having input from multiple discipline’s can be. Each team member offers his/her unique knowledge and skills. I offered input on the positioning and motor aspect of the assessment since I was the OT. The Hearing Impaired teacher offered great insights to the student’s hearing abilities in the classroom. And the AT coordinator of the district offered the much needed technical support to operate different pieces of equipment during the assessment. Multiple disciplines working together is especially preferred when READ OFF SCREEN.It is almost always appropriate and desirable to form a team for an AT assessment. Having been on a team like this this past school year, I can see how important having input from multiple discipline’s can be. Each team member offers his/her unique knowledge and skills. I offered input on the positioning and motor aspect of the assessment since I was the OT. The Hearing Impaired teacher offered great insights to the student’s hearing abilities in the classroom. And the AT coordinator of the district offered the much needed technical support to operate different pieces of equipment during the assessment. Multiple disciplines working together is especially preferred when READ OFF SCREEN.

    14. Who can be on the AT team? Consumer Family and Caregiver Occupational Therapist Physical Therapist Special Education Teacher Speech Pathologist Physician Rehab Technology Supplier Rehab Engineer Others (i.e.school therapist, reg. Ed teacher, nurse, etc.) There are many different kinds of people who can make up an AT team. Some examples include: Consumer – the person who will use the AT. It’s important to keep this person as the central focus throughout the assessment process Family/Caregiver – daily support for the person using the AT Occupational Therapist – evaluates functional, perceptual, and cognitive performance, including sensory impairments, access and home modifications Physical Therapist – evaluates physical performance, including strength, balance, coordination, posture and mobility Special Ed teacher – evaluates educational performance, literacy and communication Speech Path – evaluates cognitive and language abilities, as well as oral motor function Physician – medical doctor who determines diagnosis and prognosis; prescribes treatments ad medications; may specialize in Rehab, Orthopedics, Surgery, or other fields. Many funding sources require Physician’s signature on prescriptions for AT equipment Rehab Technology Supplier – recommends technology options, procures the equipment including funding, fitting, training, maintenance and repairs Rehab Engineer – designs and fabricates modified or customized devices Other may include: school therapist, private therapist, classroom teacher, school staff, psychologist, nurse, respiratory therapist, counselor, employer, payer or funding agency, case manager, legal guardians, special friends or anyone else who has an interest in the consumer’s use of the AT. DON’T CHANGE SLIDES YET Next, we are going to brainstorm for a bit to come up with pros and cons of being on a team. As many of us have been for the past week or so. You shout them out slowly and I’ll write some of our ideas down. Then we’ll see what others are that we may have not thought about. AFTER FINISHED WITH liST>>> TURN SLIDE There are many different kinds of people who can make up an AT team. Some examples include: Consumer – the person who will use the AT. It’s important to keep this person as the central focus throughout the assessment process Family/Caregiver – daily support for the person using the AT Occupational Therapist – evaluates functional, perceptual, and cognitive performance, including sensory impairments, access and home modifications Physical Therapist – evaluates physical performance, including strength, balance, coordination, posture and mobility Special Ed teacher – evaluates educational performance, literacy and communication Speech Path – evaluates cognitive and language abilities, as well as oral motor function Physician – medical doctor who determines diagnosis and prognosis; prescribes treatments ad medications; may specialize in Rehab, Orthopedics, Surgery, or other fields. Many funding sources require Physician’s signature on prescriptions for AT equipment Rehab Technology Supplier – recommends technology options, procures the equipment including funding, fitting, training, maintenance and repairs Rehab Engineer – designs and fabricates modified or customized devices Other may include: school therapist, private therapist, classroom teacher, school staff, psychologist, nurse, respiratory therapist, counselor, employer, payer or funding agency, case manager, legal guardians, special friends or anyone else who has an interest in the consumer’s use of the AT. DON’T CHANGE SLIDES YET Next, we are going to brainstorm for a bit to come up with pros and cons of being on a team. As many of us have been for the past week or so. You shout them out slowly and I’ll write some of our ideas down. Then we’ll see what others are that we may have not thought about. AFTER FINISHED WITH liST>>> TURN SLIDE

    15. Pros and Cons of a Team Pros Draws on the knowledge and skills of experts in other disciplines Provides clearer view or lifestyle and psychosocial issues Varied backgrounds provide more solution options Shared decision making assures buy-in More Pros Shared goals the reinforce each other Produces more successful intervention Reduces abandonment Efficient when multiple opinions needed; eliminates duplication Established lines of communication. Here are some pros that we mentioned and may not have thought of. READ OFF SCREENHere are some pros that we mentioned and may not have thought of. READ OFF SCREEN

    16. Pros and Cons Of a Team Cons Expensive; poor funding ? Logistics of getting together Remote geographics Qualified experts not always available Requires an effective leader Powerful team can coerce consumer READ OFF SCREENREAD OFF SCREEN

    17. Teams and Collaboration Effective Collaboration requires Clear communication; limited use of jargon Respect of knowledge and skills of each other Willingness to listen and share decision making Specified coordinator or leader

    18. AT Provision Process (service delivery process) Phase A – Identify appropriate consumer by gathering preliminary information Phase B – Perform AT assessment Phase C – Develop a strategy and plan to ensure the intervention Phase D – Provide appropriate and timely implementation Phase E - Determine whether goals have been met The AT provision process can also be called the “service delivery process” IT usually includes the following phases (READ OFF SCREEN) The AT provision process can also be called the “service delivery process” IT usually includes the following phases (READ OFF SCREEN)

    19. Phase A – Identify Consumer by gathering information Determine need for and appropriateness of AT intervention Referral information (who and why?) Screening information (extent of disability, progressive nature, funding options, etc.) Determine if AT interventions should be deferred (i.e. after surgery, relocation, etc.) Phase A is identifying consumer by gathering information. One component of this phases includes determining need for and appropriateness of AT intervention by either referral information (who and why?), screening info (includes the extent of disability, progressive nature and age of onset, potential funding options), and determine if the AT interventions should be deferred (I.e. after surgery, change in meds, re-location, etc.)Phase A is identifying consumer by gathering information. One component of this phases includes determining need for and appropriateness of AT intervention by either referral information (who and why?), screening info (includes the extent of disability, progressive nature and age of onset, potential funding options), and determine if the AT interventions should be deferred (I.e. after surgery, change in meds, re-location, etc.)

    20. Phase A - continued Identify consumer’s preliminary goals and desired outcomes Make and initial statement of the needs and problems Determine if there is a match between the consumers needs and the service the AT Provision can provide Begin to collect appropriate background data. The next component to Phase A is to identify the consumer’s preliminary goals and desired outcomes. You should also make an initial statement of the needs and problems. Next is to determine if there is a match between consumer’s needs and the services the ATP can provide. If not, a referral may be appropriate. And the final component to Phase A is to Begin to collect appropriate background data. The next component to Phase A is to identify the consumer’s preliminary goals and desired outcomes. You should also make an initial statement of the needs and problems. Next is to determine if there is a match between consumer’s needs and the services the ATP can provide. If not, a referral may be appropriate. And the final component to Phase A is to Begin to collect appropriate background data.

    21. Phase B Perform an AT Assessment Eight Steps of the Assessment Process Gather Information Clarify the problems Produce a list of goals and desired outcomes Identify and describe the generic attributes the solution will need. List several intervention options that meet the desirable generic attributes Restate the preliminary goals Select the most desirable intervention option Make recommendations The next Phase is phase B – performing the assessment. This involves acquiring the necessary information to be able to evaluate, analyze, and assess the consumer, the tasks, the AT, and the environment. It usually includes one or more evaluations of the pertinent issues such as a Physical Performance Evaluation, a Functional Skills Evaluation, and Environmental Evaluation or perhaps an Alternative Access Evaluation. This process culminates with a recommended intervention. The steps in the Assessment process are (read off screen). Now try to remember these, because you will see them later. The next Phase is phase B – performing the assessment. This involves acquiring the necessary information to be able to evaluate, analyze, and assess the consumer, the tasks, the AT, and the environment. It usually includes one or more evaluations of the pertinent issues such as a Physical Performance Evaluation, a Functional Skills Evaluation, and Environmental Evaluation or perhaps an Alternative Access Evaluation. This process culminates with a recommended intervention. The steps in the Assessment process are (read off screen). Now try to remember these, because you will see them later.

    22. Phase C- Develop a strategy and plan to ensure the intervention Design a plan to implement the intervention Determine if intervention is commercially available Decide whether it is better to borrow, trial, rent, or outright purchase the device. Select a manufacturer or supplier Determine if a custom design is needed Select a rehab engineer to design and oversee the fabrication Ensure funding Phase C is developing a strategy and plan to ensure the intervention This includes components such as Designing a plan to implement the intervention Determining if intervention is commercially available Deciding whether it is preferable to borrow, trial, rent or outright purchase of equipment is preferred. This depends on the type of technology being considered, type and nature of disability, previous experience with technology, cognitive status, performance during evals and trials, support for trails and training, resources and again, FUNDING! The next component is to select a manufacturer or supplier. You should consider reputation, age in this business, are warranties honored, technical support offered, availability of repair parts and accessories, processing time. Next is to determine if a custom design will be needed Select a Rehab Engineer to design and oversee fabrication And Last, but very important is to ensure funding by identifying funding sources for the equipment, but also for installation or fitting, adaptations, training, service and other requirements to assure a complete and effective AT system. - is desired intervention within the guidelines of the funding agency? You will also need to determine the process, time frame, and paperwork needed to obtain funds And finally you will need to identify alternate and/or supplemental sources of funds.Phase C is developing a strategy and plan to ensure the intervention This includes components such as Designing a plan to implement the intervention Determining if intervention is commercially available Deciding whether it is preferable to borrow, trial, rent or outright purchase of equipment is preferred. This depends on the type of technology being considered, type and nature of disability, previous experience with technology, cognitive status, performance during evals and trials, support for trails and training, resources and again, FUNDING! The next component is to select a manufacturer or supplier. You should consider reputation, age in this business, are warranties honored, technical support offered, availability of repair parts and accessories, processing time. Next is to determine if a custom design will be needed Select a Rehab Engineer to design and oversee fabrication And Last, but very important is to ensure funding by identifying funding sources for the equipment, but also for installation or fitting, adaptations, training, service and other requirements to assure a complete and effective AT system. - is desired intervention within the guidelines of the funding agency? You will also need to determine the process, time frame, and paperwork needed to obtain funds And finally you will need to identify alternate and/or supplemental sources of funds.

    23. Phase D – Provide appropriate and timely implementation If commercially available, acquire the equipment or components Select a supplier Order the equipment Deliver, set up and fit the equipment - Start using the device! The next Phase – Phase D to provide appropriate and timely implementation to enable the consumer to achieve their goals. If commercially available, acquire the equipment or components This includes selecting a supplier or another person with expertise to set up, install, fit, adapt, customize, modify, maintain, update and repair the equipment Next is to order the equipment Next is to deliver set up and fit the equipment And last, it’s often helpful to have the evaluator attend when the final product is checked out to ensure that the intervention is meeting the goals as intended and to record the Outcome Measures.The next Phase – Phase D to provide appropriate and timely implementation to enable the consumer to achieve their goals. If commercially available, acquire the equipment or components This includes selecting a supplier or another person with expertise to set up, install, fit, adapt, customize, modify, maintain, update and repair the equipment Next is to order the equipment Next is to deliver set up and fit the equipment And last, it’s often helpful to have the evaluator attend when the final product is checked out to ensure that the intervention is meeting the goals as intended and to record the Outcome Measures.

    24. Phase D continued Design and fabricate the modification or custom equipment when this is the option of choice Assure that the intervention takes place in a timely, smooth and professional manner Assure that the intervention achieves the stated goals and objectives Resolve any poor outcomes Facilitate successful outcomes with performance aids and written instructions The next component of Phase D is to design and fabricate the modification or custom equipment when this is the option of choice. Next is to assure the intervention takes place in a timely, smooth and professional manner. Also assure that the intervention achieves the stated goals and objectives. This could include resolving any poor outcomes and providing performance aids and written instructions as needed. The next component of Phase D is to design and fabricate the modification or custom equipment when this is the option of choice. Next is to assure the intervention takes place in a timely, smooth and professional manner.Also assure that the intervention achieves the stated goals and objectives. This could include resolving any poor outcomes and providing performance aids and written instructions as needed.

    25. Phase D continued Provide training Include client, caregivers, support persons and team Training methods may vary with audience Include operation, maintenance and trouble shooting Include strategies to maximize device use and compensatory strategies Use a functional and practical context for practice and training Next is to provide training. This includes client, caregivers, support persons and team as appropriate. Training methods may vary with audience such as with an in-service demonstration, hands on trials, written materials, video tapes, group or one-on-one, phased training sequences. Also be sure to include operation, maintenance and troubleshooting information. Additionally be sure to remember to include strategies to maximize device use and compensatory strategies. Make sure to use a functional and practical context for practice and training. Next is to provide training. This includes client, caregivers, support persons and team as appropriate. Training methods may vary with audience such as with an in-service demonstration, hands on trials, written materials, video tapes, group or one-on-one, phased training sequences. Also be sure to include operation, maintenance and troubleshooting information. Additionally be sure to remember to include strategies to maximize device use and compensatory strategies. Make sure to use a functional and practical context for practice and training.

    26. Phase D- Continued Ensure follow-up Follow up if a tolerance program is needed Determine if consumer will be able to initiate request for assistance if equipment fails, needs maintenance or updating Identify the person responsible for checking to assure the goals are still being met Identify person responsible and the indications for initiating a reassessment or additional intervention And of course, we don’t want to do all this for nothing. So we need to do our best to ensure follow-up. If a tolerance program is needed to gradually allow the user to get used to the equipment, then repeated follow up will be required. Determine if the consumer will be able to initiate request for assistance if equipment fails, needs maintenance or updating. Provide instructions on how to re-access the delivery system if needed. You will also want to identify the person responsible for periodically checking to assure the intervention is still meeting the goals. And you’ll need to ID the person responsible and the indications for initiating a reassessment or additional intervention.And of course, we don’t want to do all this for nothing. So we need to do our best to ensure follow-up. If a tolerance program is needed to gradually allow the user to get used to the equipment, then repeated follow up will be required. Determine if the consumer will be able to initiate request for assistance if equipment fails, needs maintenance or updating. Provide instructions on how to re-access the delivery system if needed. You will also want to identify the person responsible for periodically checking to assure the intervention is still meeting the goals. And you’ll need to ID the person responsible and the indications for initiating a reassessment or additional intervention.

    27. Phase E – Determine whether consumer goals have been met Assess the efficacy of the intervention to achieve the goals Evaluate the effectiveness of the assessment, selection and recommendation process Recognize consumer dissatisfaction, equipment failure, and other poor outcomes The last phase is Phase E – determining whether consumer goals have been met This can be done by (read screen).The last phase is Phase E – determining whether consumer goals have been met This can be done by (read screen).

    28. Phase E – Determine whether consumer goals have been met Assure effective follow through and follow-up Periodically re-check the objective measures to ensure the goals continue to be met. Re-evaluate when indicated or if goals are no longer being met Provide maintenance, upgrades, and repairs as needed Prevent abandonment of equipment Also to assure effective follow through and follow up you may need to READ SCREEN And now, here is Amy Fisher to talk in more detail about the AT assessment steps and goal writing.Also to assure effective follow through and follow up you may need to READ SCREEN And now, here is Amy Fisher to talk in more detail about the AT assessment steps and goal writing.

    29. AT Assessment Steps Although the specifics may vary, all AT assessment usually follows the 8 steps mentioned earlier more or less in the same order Can you remember the order? ?

    30. Review of AT Assessment Steps Case Study Gather Information Clarify the problems Produce a list of goals and desired outcomes Identify and describe the generic attributes the solution will need List several interventions options that meet the desirable generic attributes Restate the preliminary goals Select the most desirable intervention option Make recommendations

    31. Information Required for an AT Assessment Personal Information Funding Diagnoses and Medical History Psychosocial Status Neuromusculoskeletal examination Skin condition Sensory function Speech, language and communication Function, skill and task performance Personal mobility Transportation Environment History of past equipment Present equipment

    32. Application Principles for Providing AT Keep the consumer and his goals as the central focus Do no harm Focus on functional abilities and potential Select from a hierarchy of preferred interventions Off the solution (intervention) that is simplest, but still effective

    33. Assessments with Special Issues Seating and Mobility Assessment Positioning and seating devices need to be checked and adjusted more often than others Assessment is very time consuming and is the most hands-on Computer Access Assessment Assessment usually includes trials of devices and software in a laboratory set-up Updating may be required as better technology becomes available

    34. Assessments with Special Issues Environmental Control Assessment Site visit is essential for the assessment to examine the environment that needs adapting Focus should be on the consumer’s lifestyles and routines Language and Cognitive Assessment Screening is important because potential consumers may not really need alternative and augmentative communication (AAC) Instruction and training on AAC devices can be lengthy, sometimes lasting years

    35. Establishing Goals for AT Interventions Ask the consumer what they want to do (which we call their goal) Ask why they can’t do that task now (which we call the problem) Suggest how they can fix the problem (we call this the solution)

    36. Guidelines for Goal Setting Include both short and long range goals Include quantity of life (health) and quality of life (happiness) benefits Funding sources prefer to focus on functional improvements, reduced disability, and reduced handicap Each member of the team may have different goals Goal should be prioritized Be realistic about what can be achieved

    37. Types of Goals for AT Goals for improved function Goals for improved health or reduced risk of pathology Goals for improved vocational and educational skills Goals for improved comfort Goals for improved safety Goals for progress of device mastery and appropriate use Goals for effectiveness of training/instruction

    38. Measuring Outcomes of the Person-Technology Match The assessment team should develop objective measures related to each goal so that data can be collected to the determine the effectiveness of the intervention An objective measure describes WHAT we are trying to accomplish, not HOW it was accomplished

    39. Examples of Goal with Objective Measure Mary will successfully activate the switch in 8 out of 10 trials during a 20 minute session Bob will increase his wheelchair tolerance to at least 6 hours a day for 5 out of 7 days

    40. How to Write an Objective Measure Clearly state the goal or desired outcome What do you intend to achieve? What is the desired outcome? Attach outcome measures to it How will you know you have achieved that goal? How can you measure that? Be very specific.

    41. Tips on Writing Outcome Measures Avoid vague opinions and vague summaries Use measures that can be quantified with numbers and concrete data Use objective rather than subjective terms In addition to measuring the user before and after, the user’s new performance can be compared to a known and accepted standard Let’s write some of our own goals!

    42. Now, get ready for Laurene and Module 7 Information provided by Fundamentals in Assistive Technology 3rd Edition

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