Adaptive Recreation/ Driving Flashcards
(54 cards)
1
Q
Adaptive Recreation: Understand potential impact of participating in adaptive recreation on the client
A
- Engage participants
- Enhance independence
- Empower clients
- Provide appropriate challenge: opportunities to success and fail
- Avoid disabling: work with the individual to understand how they will engage with the sport
2
Q
Adaptive Recreation: Understand how sport and recreation can be adapted for the user
A
- Implementation: safety first, fun, success, challenge
- Be creative
- Have a toolbox: know what exists and come up with new ways to bring adaptations to the individual
- Sports that can be adapted: cycling, track and field (have a guide), kayaking (never attach someone to a boat in a water sport), golf, court sports, skiing, hockey
- Adding dump: bring up the seat (decrease angle of your hip)
- Negative dump: extend angle
3
Q
Adaptive Recreation: Understand how an OT may get involved in adapted recreation (schools, clinic)
A
- Create access
- Understand barriers to access
- – Physical, Transportation, Emotional, financial
4
Q
Driving: Role of the OT generalist
A
- provide rehab for all IADLs
- assure patient that their therapy program is designed to optimize all goals, including driving
- be aware of state laws about driving
- have knowledge about driver rehab programs in the area
- – talk about why referral to specialist is important and what they can expect, address fears
- identify activities impacted by driving
5
Q
Self-Assessment Tools for Driving
A
- help older adults gain insight
- limitation: client must have capacity for honest/accurate self-reflection
- are only a screening tool
6
Q
Role of OT Driving Specialist
A
- optimal knowledge base: training in the field of driver education and traffic safety, knowledge of medical conditions and disabilities and their impact on driving.
- familiar with personal-use vehicles, adaptive equipment, and options for vehicle modification.
- perform a comprehensive driving evaluation
7
Q
Parts of a Comprehensive Driving Evaluation
A
- Clinical Evaluation: series of assessments pertinent to the client’s needs and diagnosis
- Functional On-Road Assessment of driving performance
8
Q
The purpose of the Clinical Evaluation (Pt 1 of comprehensive driving eval)
A
to develop a profile of the client’s strengths and limitations in the basic performance skills required for driving
9
Q
Clinical Evaluation (pt 1 of comprehensive driving eval)
A
- Interview/medical history
- Vision Assessment
- Physical Assessment
- Cognitive Assessment
- Perceptual Assessment
10
Q
Clinical Evaluation: Interview
A
- talk with client and family
- about issues to be addressed
- about performance skills
- driving habits, routines, and roles
- history of driving experience
- characteristics of client’s driving: distance from home, frequency of trips, time of day
- consideration of types of vehicle
11
Q
Clinical Evaluation: Vision Assessment
A
- Visual acuity
- Peripheral vision
- Depth perception
- Contrast Sensitivity
- Color recognition
- Oculomotor skills
- Requirements in MA: Visual acuity and Peripheral vision
- – 20/40 for night driving
- – 20/70 for day driving
- – 120 degrees VF in both eyes
12
Q
Clinical Evaluation: Physical Assessment
A
- Joint range of motion, Strength, Sensation, Coordination, Muscle tone, Endurance, Reaction time
13
Q
Clinical Evaluation: Cognitive Assessment
A
- Attention, Memory, Executive Functioning, Insight/Awareness of Deficit areas
14
Q
Clinical Evaluation: Perceptual Assessment
A
- Motor free visual perceptual skills, Visual Motor Integration, Apraxia, Inattention/Neglect
15
Q
Clinical Evaluation: Adaptive Equipment Assessment
A
What adaptive equipment could this client safely use?
16
Q
Adaptive Driving Equipment
- Spinner Knob
- Left foot accelerator with pedal block
- Hand controls
A
- instead of steering wheel
- if can’t use right foot
- that thing for pushing for gas and you had to keep it steady on the number 2 that was really hard
17
Q
Adaptive Driving Equipment
- Secondary controls
- Adaptive Mirrors
- High tech adaptations
A
- lifts
- van adaptations
- steering systems
- lifts
18
Q
Behind the Wheel Eval (pt 2 of comprehensive driving eval)
A
- Road testing performed by a driving instructor and/or an occupational therapist
- On road driving performance to include local/busy streets, expressway driving, parking
- If necessary, geographic evaluation to determine someone’s ability to drive locally (can drive self to supermarket, but shouldn’t go unfamiliar places)
19
Q
Recommendations after Driving Eval
A
- Safe to drive without adaptive equipment
- Safe to drive with restrictions/adaptive equipment
- Not safe to drive
- Need more therapy in preparation for return to driving
20
Q
Driving: Primary Controls
A
- brake, gas, and steering wheel
21
Q
Driving: Secondary Controls
A
- anything other than brake, gas, and steering wheel
- turn signals, windshield wipers, headlights
22
Q
AT Primary Control Options: Mechanical Brake and Gas
A
- Push: go, right angle: stop
- Push: go, rock: stop
- Push: go, pull: stop
- Push: go, twist: stop
- Left foot accelerator, Brake extenders (longer pedal so you can reach it)
23
Q
AT Primary Control Options: Steering Wheel Orthotics
A
- Spinner knob
- Palm grip (no need to grasp)
- V grip: attaches to steering wheel, still need to stabilize wrist, but stabilizes hand, minimizes grasp
- Single pin: hold with hand, still minimize grasp
- Tri pin: holds the wrist steady
24
Q
AT secondary control options
A
- Cross over bar: right hand operation of turn signals and headlight dimmer
- Single function buttons: position for operation by finger, elbow, head or knee
- – Turn signals, Headlight dimmer, Wiper, Cruise control set, Horn, Windshield Wash
- Single control for multiple functions:
- – button positioned for operation by finger, elbow head, knee
- – Pin switch: Mounted on brake/gas orthotic
- – Tri-pin rocker switch
- Spinner knob with switches
- – Turn signal, headlight dimmer, wiper, windshield wash, horn
- Manual handles or fabricated extensions
- – Ignition/start, gear selection, driver/passenger windows
- – Parking brake, door locks, heat/AC, rear wiper, rear defogger, lights
- Single electronic controls and/or console
- – Ignition/start, gear selection, driver/passenger windows, door locks, lights, parking brake, rear wiper, rear defogger
25
Evaluator/Trainer Controls
- Mechanical brake and Electronic brake
- Dash buttons
- -- Engine Kill, Left turn, Right turn, Horn
26
SETT Framework
- Student
- Environment
- Task
- Tools
- -- AT, training, accommodations, environmental modifications
27
Low and High Tech Solutions: Reading - Motor Skills
- Low: rubber thumb, mouth stick, headpointer, cookbook stand
- High: electric page turner, e-book
28
Low and High Tech Solutions: Reading - Cognitive Skills
- Low:
- High tech: educational software (programs that present very simple stories, programs with multiple output modes i.e. interactive stories)
29
Low and High Tech Solutions: Reading - Sensory Skills
- Low: contrasting colors for letter and background, large print, incorporate colors for page orientation
- High: computerized reading programs, text-to-speech programs, screen-reading programs, reading scanner: OCR
30
Low and High Tech Solutions: Writing
- Low tech:
- -- positioning chairs for stability
- -- Writing surfaces: stabilize paper with a clipboard, add self-stick rubber feet, provide an angle with a slant board
- -- Writing tools: built up grips for pencil, weighted pencil
- -- Spelling: Handheld, speaking and nonspeaking devices
- High tech:
- -- word processing software with spell-checker
- -- Word prediction programs i.e. Word-Q: support the writing process, help students generate sentences with correct grammar and spelling
- -- Voice detection software
- -- Composition: comprehensive concept mapping software for your computer; iPad Apps, many apps online
31
Low and High Tech Solutions: Mathematics
* High tech: computer spreadsheets and databases, electronic math worksheets enable students to do multistep problems on the computer with walk-through solutions, talking on-screen calculators, calculator apps
* Low tech: speaking and nonspeaking handheld calculators
32
Low and High Tech Solutions: Social Activities/Communication
* Low tech: manual communication board (pictures and symbols)
* High tech: AAC devices
33
Understand when common high tech devices may be used: graphical organizers, word prediction, speech recognition, reading & literacy assistants
(there is no question)
iPad now more commonly used
• support for classroom links
• apps just for education
• topics: communication, emotional development, seeing & hearing, language development, literacy, diagnostics, organization, life skills
34
Communication access is dependent on the needs and preferences of the individual. There is no one- size-fits-all solution. Factors that influence access:
- The etiology of the individual’s hearing loss
- Communication preference – always best to ask
- Amount of residual hearing and speech discrimination
- Availability of assistive technology
- The individual’s comfort level in understanding, and advocating for, their own needs
35
Culturally Deaf Individuals
- do not see themselves as having a disability
- Cultural view, not pathological
- Use a distinct language, practice a distinct culture
- Will require ASL interpreters for communication
- ASL interpreters must be screened and certified
- May need to use Certified Deaf Interpreters (CDI) in some situations
36
Hearing Aids
- Digital hearing aids amplify where you need it, don’t where you don’t need it.
- -- the microphone with the speaker thing, can turn on and off as needed, adjustable
- Many manufacturers claim to have successful noise reduction programs on their hearing aids - a claim that is only partially true. (pick up on background noise, can't filter out)
- Small hearing aids often present challenges to people with poor vision or fine motor control (old people lose them)
37
Hearing Aids and Blue Tooth
- Bluetooth is a wireless digital transmission standard. Almost all hearing aid manufacturers have implemented it in ways that allow hearing aids to receive sounds from a linked source, usually a remote microphone or audio device interface.
- Bluetooth can provide an easy link between a hearing aid, cochlear implant and cell phone, avoiding feedback and ambient noise
38
Hearing Aids and Telephones
- feedback you get when you put a microphone and a speaker too close together
- can't hear clearly
39
Telecoil
- Telecoil is a magnet built into a hearing aid that receives signals from a telephone or other electronic device. It is used to connect to a large variety of listening devices, particularly audio induction loops. Some are manual, some are automatic.
- -- A big problem today is that many people who wear hearing aids don’t even know if they have telecoils in their hearing aid, or know how to use them.
40
Personal Sound Amplifiers
- not hearing aids
- Not intended for treatment of hearing loss, not to be marketed or sold to anyone with a hearing loss
- old people tend to buy them because they look like hearing aids so they think they are hearing aids
41
Cochlear Implants
- for individuals who, even with hearing aids, do not derive much - if any - benefit from sound amplification.
- There is extensive pre-testing involved before someone is approved as a CI surgery candidate. The ideal candidate is someone who has post-lingual hearing loss, has consistently worn hearing aids, and is a candidate for general anesthesia.
- Age alone has nothing to do with candidacy. An otherwise healthy senior who is a good audiological candidate and has no adverse reactions to general anesthesia is a very viable CI prospect.
- Most insurances including Medicaid pay for CI's in full.
42
Assistive Listening Systems
- wireless and hardwired systems
- For someone who has a mild hearing loss and may not need a hearing aid
- Amplifies the sound in one area
- Personal systems: like headphones, can be used for TVs
- Amplified phones
- captioned phones (show text of what other person is saying)
43
AT for Hard of Hearing In Different Settings
1. Work
2. Movies
3. Social Settings
4. Home and Work
1. Work: can use CART for those who do not use ASL
(super speedy typers who type as fast as people speak so you can read along, use shorthand)
2. Movies: rear window captioning, sony caption glasses
3. Social settings: choose well-lit areas for easier lipreading
4. Home and work: environmental alerting systems, Captioned smoke detectors (or lights), Vibrating alarms under your bed
44
Creating Custom Solutions: Advantages and Disadvantages
Advantages:
- custom solutions are needed when companies discontinue the sale of a certain AT
- Depending, may also meet the needs of many clients
- The function currently is not made by any other company
- Can use simple materials that were already available (splint scraps)
- Can be low-tech or high-tech
Disadvantages
- may only meet the need of an individual client
45
Does the person need a custom device?
- Understanding how to adapt the task, can the task be done with equipment?
- Researching mainstream devices or rehab tech/AT that already exists
- Can existing devices be adapted or modified
- What is the need for designing a new device
- If there is nothing available, person may need a custom solution
46
Planning and Design
- Understanding design consequences & design choices
- Sketch out solutions
- Collaborate
- Incorporate design factors
- Consider HAAT Model
- think about universal design
47
Prototyping
1. Fabricate
2. Testing/Assessment
1. Fabricate – identify materials & skills needed, making a prototype to scale
2. Testing/assessment – testing to see if it works, taking into account the individual, activity, and context, and safety of use
48
Implementation/Follow-Through
- Identify who is going to support equipment: client, caregiver, staff
- Will the client be able to direct staff, how will they be best supported to perform the task
- Identifying equipment maintenance, malfunction, troubleshooting
- Developing sufficient manufacturer instructions – creating manuals
- Making sure it’s billable to 3rd party payer
49
Available Evidence for AT and Assessments
- Theory: HAAT, PEO, MOHO
- lack of quality evidence
- active engagement of clients in AT assessment process leads to better outcomes
- Assessment measures should be client centered, work in multiple contexts, valid and reliable, user friendly
50
Matching Person and Technology Scale: Purpose
- Purpose: understand present environments, individual, and technology to determine appropriate technology to meet goals
51
Assessments: Student Environment Task and Tools Framework
- SETT
52
Task Based Assessments
- Protocol for Accommodations in Reading (PAR): Great for comparing silent reading vs. RA vs. synth speech
- Written Productivity Profile (WPP): Determine if an alternative or supplement for handwriting is necessary
- Functional Assessment for Cognitive
Assistive Technology (FATCAT)
- Time Management Questionnaire (TMQ)
53
Matching Person and Technology: Advantages
- “organization-wide” license print and use, type directly into fields on PDF,
- validation studies,
- use in multiple environments,
- Good for comprehensive evals looking at multiple domains
- Can pick and choose checklists/modules
- -- Has a nice sub-scale for getting info regarding impression around tech use– predict success with using technology tools?
- Initial worksheet useful for starting an eval
54
Matching Person and Technology: Disadvantages
- Manual is extensive and overwhelming
| - does not track outcomes well (though encourages users to repeat specific measures to track qualitative changes)
