Assistive Technology Use

ASSISTIVE TECHNOLOGY USES: EXAMPLES

Assistive Technology uses people's capabilities to enable them to do things that they previously could not due to their needs not being addressed by standard technology. AT should always increase the user's independence.  Like Telecare it can be used as part of the health and social care system to support people to live in the community.

Below are examples of some scenarios of Assistive Technologies being used to support people:

(The scenarios are realistic but ficticious and should not be used to work out what might be suitable for you or someone you know. Please remember if you have a health problem you should contact your GP or health professional. If you are having daily living problems you should contact your local social services. )


SCENARIOS:

School Pupil gets Access to Computers

Scenario

Sam, who is aged 10, lives at home with his family. He uses a powered wheelchair to move around indoors. Mostly his family support his daily living needs around the house for him. He attends a special needs school.

Sam has Muscular Dystrophy, MD for short. His MD has recently changed and he can no longer use any computer keyboards at his school. He has lost much more of his range of movement of his arms and fine motor movements in his hands. His education is suffering and his teachers want him to be able to use the computer again. Sam is bright and the only thing stopping him is his physical inability to be able to use the keyboard, he can still drive his wheelchair.

Possible Solution

The school calls for help from the local AT service. The AT assessor comes to the school armed with information that the school staff gave her and possible alternative choices of AT. After talking with and observing Sam, she suggests using an on-screen keyboard, word prediction and a small handheld pointer.

The AT assessor installs the software on Sam's computer that gives him the on-screen keyboard and word prediction. She explains and demonstrates that instead of having a physical keyboard in front of him he will now have the keyboard drawn on the computer screen and just has to point and click on the letters he needs. Then she shows him that as he types out a word the 'word prediction' starts to offer him possible words and if it offers the right word it saves him time. Sam likes the idea and says that his friend Karen uses something similar.

The AT assessor then gets Sam to try to use the alternative to the mouse, that is the small handheld pointer. It's new and so strange to Sam, but he shows some success. They all agree he will practice with it for a few days and then they will all see how it goes.

When the AT assessor returns Sam has made progress, but clicking isn't always easy. Sam admits that after an hour or two he begins to tire. The school teacher present comments that he seems to be able to operate his wheelchair joystick much more easily and with less effort. The AT assessor after observing Sam driving around, and Sam confirming that he finds it easier and less tiring using his wheelchair joystick, suggests that the wheelchair joystick could be used for the computer too. But also pointing out a switch will be needed for Sam to be able to click.

They try a bright red switch about 5 cm across in various places that Sam finds easy to reach. Sam chooses the best location and asks can he have a green switch instead. This is agreed and it is decided to buy the new wheelchair joystick control that will also provide pointing on the computer. After the meeting the teacher arranged for the school physiotherapist to check that they didn't foresee any potential for long term physical harm to Sam from the positioning and effort associated with the new controls.

A week later the AT assessor is back again. She has brought the new joystick.  She removes the old one from Sam's wheelchair and sets-up the new one. Sam learns how to switch the joystick between driving his wheelchair and pointing on his computer. One week later Sam is back in business and fully integrated in his education.

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Young Adult Living Independently

Scenario

Graham is 20 and has recently decided he wants to live independently in his own home. He has a ground floor flat which is designed for someone who uses a wheelchair.

The local social services have already organised a team of five part-time personal assistants to help him with his daily living needs. Graham already has some AT equipment he was provided with for living at home. By strapping his limbs to his wheelchair his uncontrolled movements no longer disturb his head movements which he uses to point (using some AT called a headpointer) and press switches. So he can control equipment that way.

But, he and his carers will still need help with getting him in and out of his wheelchair for bathing, toileting and getting up or going to bed. As much as possible he wants to open and close windows, doors etc. And to get some times when he can be on his own so he will need to have a way of calling for assistance when it's needed - probably using the phone, which he wants to do anyhow because his parents used to handle that for him.

Possible Solution

Graham and his parents arrange a visit from his AT assessor from the NHS. They meet at his new flat. Graham had already chatted with the AT assessor over the phone, so she came knowing what Graham needed and what AT should be considered. The council social services sent Graham's lead care worker to the meeting too.

The AT assessor told them her first thoughts of what would be ideally needed. The list included :


The social services representative said that their Occupational Therapist largely agreed with what the AT assessor had just listed. But that at least initially they would like to introduce only the essential elements first and see how it went. So the door opening would be restricted to the main door and the bedroom door; the windows that Graham would have control of would be limited to the bedroom and the living room. And apart for TV and the HiFi each room would have just one socket that Graham would control.

Slightly disappointed Graham agreed to what was offered but hoped that everything went well, and that either it would prove that some of the AT equipment left out wasn't really needed or that quite quickly any needed extra equipment would be offered.

The AT assessor and social services lead care worker went away with an agreed plan of who was going to provide what. The AT assessor needed to make some detailed plans and get back to Graham and social services to make sure that the right environmental controls were purchased.

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Stroke Patient Talking and Using their Upstairs Floor Again

Scenario

Lydia who is 68, had a stroke six months ago. Its left her almost paralysed on her left hand side and she still has difficulty speaking. She can make David, her husband, understand what she says or wants but other people find it really difficult. She feels so frustrated that she can't chat with her grandchildren. Life at home is difficult because of Lydia's continuing paralysis, only David uses the upstairs rooms. Lydia for ease lives in the ground floor of their home, most times she has to make do with a wash from a basin when before she would have had a shower or a bath upstairs.

Possible Solution

David contacted the council social services and after a wait they managed to be seen by an Occupational Therapist. He recommended the installation of a stair-lift, and a further meeting with a Speech & Language Therapist to assess whether more therapy could help and/or a voice output communication aid was needed.

A few weeks later they heard they were going to get the stair-lift, and they went to see the Speech & Language therapist. Her assessment was that some therapy might help, and she also explained some communication strategies that might help Lydia and David in the short term. But she said it would take time and there was no guarantee that things would improve. A few months later Lydia's language problems had greatly diminished, but her paralysis and ability to produce intelligible speech had shown very limited improvement.

Lydia could type text and construct sentences and so the Speech & Language Therapist began to think in terms of a voice output communication aid(voca) for Lydia.  Lydia, David and the therapist discussed it. Using a voca wasn't going to be like talking, it wasn't as quick. But in those situations where Lydia couldn't make herself understood by other people she could use it to talk clearly for her. An application was made to get it funded but was rejected - losing out to other requests. The therapist said they could try again next financial year or try some charities. But Lydia and David decided to spend their own money and got one straight away.

Lydia found she learnt how to use the voca quickly. She did find it useful although sometimes she felt very self conscious about using it with complete strangers.

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