OT1025: DEVELOPMENT OF HUMAN OCCUPATIONS II  Regardless of the context, relationships are important.

Whether the
ASSISTIVE TECHNOLOGY assistive technologies are used in school (learning), at work (being
productive), at home (increasing independent self-care), or in the
community (accessing goods and services), they should promote
TECHNOLOGY positive relationships with family members
 Costly  Access to assistive technology should complement the removal of
 Simplifies the way you do things structural (e.g. providing curb cuts and ramps) and programmatic
 Can be a machine, process barriers (e.g. supplying assistive listening devices in theaters or
 Understanding the needs of disabled people providing written materials in large point
 Can be applied to work, leisure, ADLs, and etc.  Consumer choice and preference are critical to the successful selection
 As OTs, we fabricate some assistive technology of a particular assistive technology solution for a child or adult.
 As OTs, we design to match the need  Assistive technology is a means, not an end.
 It changes over time  The consumer knows best, what to do and how, when, where and with
whom they want or need to perform the task.
NOTE: PART OF THE TEAM  The device is only part of the equation.
 Engineers – understands the mechanical aspect of technology  Everything is not a “nail”
 OTs – involves the aspect of the person  The best is not all “high tech”
 The application of practical or industrial arts the help PWDs  The decision is not necessarily “either/or” --- merging the options
o In terms of OT, we call it industrial design instead of  Assistive technology should be a last resort.
industrial arts  Assistive technology is not a luxury.
o Both arts and science
COMMON MISCONCEPTIONS
ASSISTIVE TECHNOLOGY 1. Assistive technology is a means, not an end
 Application of practical or industrial arts that help people with  Purpose: functional goal
disabilities 2. The device is only part of the equation
 Enables individuals with disabilities to engage in or perform many  Need to educate, maintenance of the device
tasks.  Need training
o Have greater control over their own lives 3. Everything is not a nail
o Participate in and contribute more fully to activities in their  It is not descriptive
home, school and work environments and in their  Just because these symptoms are present, this specific
communities technology is the one needed
o Interact to a greater content with abled individuals  It varies to different clients
 Assistive technology is a multidisciplinary intervention that helps  Do not generalize
people develop compensatory techniques to engage in activities that  There is still a need of evaluation
are important to them. 4. The best is not all high tech
 Consider the poor community
AT DEVICE  It is all based on the context
 Any item, piece of equipment or product system, whether acquired 5. The decision is not necessarily either/or
commercially off the shelf, modified or customized, that issued to  There is no option A, B, or C = you can combine all
increase, maintain or improve functional capabilities of a person with 6. Assistive technology should not be a last resort
disability.  Match the needs to the client
o Commercially off the shelf – being bought, patented 7. Assistive technology is not a luxury

HUMAN TECHNOLOGY INTERFACE GENERAL AREAS

 The means by which the client interacts with the device – to either  Manipulation – more
input or receive information or both o The use of hands:
 Accessing technology
PROCESSOR  Seating intervention and Postural Control - the
 Acts on the user input and follows instruction or a program to produce use of limbs properly (e.g. adaptive seats)
an activity output  Upper Limbs Orthotic – also known as adaptive
(e.g. spoon and forks, bathing devices)
 Translate info and forces received from human into signals that are
 Prosthesis
used to control activity output
 Robotics – the potential area in the future
ACTIVITY OUTPUT  Mobility – shared with PTs
 For augmentation or replacement of human performance (from AT to  Communication – shared with SLPs
activity)  Cognition
 Communicating, moving self, manipulating objects
MANIPULATION
HAAT Model  Accessing Technology (switches)
 Human, Activity and Assistive Technology Model  Seating intervention and postural control
 Human technology interface: the means by which the client interacts o Seating devices
with the device – to either input or receive information or both o Adaptive seats
 Like PEO model  Upper limb orthotics (adaptive aids)
 Factors:  Prosthesis
o Human  Robotics
o Assistive Technology
o Activity ADAPTIVE SWITCHES
CONSIDERATIONS (OLSON AND DERUYTER, 2002)
GUIDING PRINCIPLES  3 parts of the switch: the connector plug, the cord and switch
 Focus should be on the functional goal that the individual wants to mechanism
accomplish, which may be increased independence with self-care at  Size and shapes: depend on type of movement to activate
home, enhance communication to increase classroom  Force needed for activation
  Range needed for activation  Specific goals for seating intervention:
 Feedback provided: auditory, visual and/or proprioceptive for accuracy o Improved head and/or trunk control
 Type of force needed for activation: from fingers/hand, puff n sip (air o Improved proximal stability
from mouth): single or dual or multiple o Improved gross motor abilities for better self-propulsion
 Number of controls needed: single or dual or multiple o Improved manipulation
 Switch amount: where would the switch be located and mounted o Improved visual motor skills
o Improved oral motor skills
ADAPTIVE TOY SWITCHES o Improved sitting tolerance or comfort
TYPE DESCRIPTION IMPORTANT o Improved physiologic function (e.g. respiration,
CONSIDERATIONS cardiovascular function, digestion, skin integrity)
Button Switch Simple pressure Easy to operate for o Improved endurance
switch; turns on/off a children with decreased o Improved psychosocial interaction and/or increased self-
device from a push of fine motor control esteem
a button Has audible click  Use of hands and upper limbs
feedback  Without postural control, you are not able to use your upper limbs
Lever Switch Simple pressure Modifiable to keep the  Maintain optimal control
switch that flips one device on when the lever
direction to turn is depressed and turned CUSHIONING
on/off device off when the lever is  To relieve pressure, distribute pressure, encourage postural control,
released provide comfort, increase function
Good for children with  Examples:
decreased UE ROM o Polyurethane / Latex foam
Has audible click o Gel cushions
feedback  Best choice
Pillow Switch Like button switch Good for poor grasp  Contours with the prominences, deformities
has cushy, soft-cloth control o Air cushions
casing; can squeeze, o Egg crate
grasp, push the  Least ideal, not effective
switch to activate  Do not distribute the pressure equally
Pneumatic Switch Air-pressure “sip n puff” switch-sip o Memory foam
“Sip and Puff” controlled switch (inhalation) for “on”  The closer the contour, the better the fit is;
while puff (exhalation) contours better than the rest
for “off” o ROHO cushion
 Inflated, machine operated
Sound/Voice Non-pressure switch No physical movement  Distributes the pressure, doesn’t have a
Activated Switch operated through need counteracting force
electrical sensors that  Can be adjust as needed
respond to sound o 3D Printer concept
stimuli (i.e. hand clap, o To fit the exact measurements for a certain person
oral/verbal words)
Tilt Switch Non-pressure, single Utilizes available body SIMPLE SEATING/POSITIONING DEVICES
switch usually part, but requires Wedge Seat For with low muscle, this seat will
attached to a body adequate range of encourage sitting upright by
part motion facilitating anterior pelvic tilt
It is composed of a
ball floating within
liquid inside a tilting Therapy Ball For squirmish children who likes
mechanism bouncing
Joystick Switch Multiple pressure Joysticks can be modified Pillows For infants or toddlers with delays in
switch; with different size balls gross motor development
can activate or even a “T” post for To support their sitting
directions like up, wrist/hand placements
down, left, right Requires fair amount of
control of UE ROM and Beanbag chairs For severely disabled children
control To contour their bodies while seating
Rocker Switch Pressure dual switch Similar to sip and puff Corner chairs Children with good head control but
Composed of 2 single switch poor trunk control
switches which pivots Promotes scapular protraction, aligns
at the center of both extremities to midline, better visual
switches scanning, more supported trunk
Wobble Switch This is a pressure Can use multiple body control
single switch that can parts, usually the head of
move and activate elbow ADAPTIVE SEATS
any four directions; Wedge To facilitate prone position, to
has flexible wand improve head control, stretches tight
with a ball attached hips and knees into extension
to it

SEATING DEVICES Bolster Stradding provides wider base of

 For a postural control – necessary for upper extremity function support for stability, promotes hip
 General goal: optimal functioning at home, school, work, community abduction and external rotation,
or leisure minimizes W-sitting (faulty sitting)
 Sidelyer For children with ATNR or extensor D. HYBRID
patterns, provides better position for o Mix of body-powered and myoelectric
midline reach for play, gravity- o Cable to elbow or terminal device and battery powered
eliminated position allows easier o Should be functional; not just open or close, spherical or
movement of limbs cylindrical grasp, etc.
Stander Allows alternative position for play,
allows weightbearing for bone ELECTRIC-POWERED PROSTHESES
density, may improve 1. Myoelectric prosthesis: uses muscle surface electricity to control the
breathing/digestive system, prosthetic hand function
psychological upliftment to be 2. No use of liner socks
“standing up” with peers 3. Usually self-suspending
4. Control mechanism
Feeder seats Head and trunk are in midline a. Digital control: operated at only one speed, allowing them
adequate support for proper and safe to turn on or turn off
feeding b. Proportional control: myoelectric signal (power) to the
hand is proportionate with the level of muscle signal that
the wearer generates so the wearer’s effort directly
controls the speed of the hand
c. Relies on the independent contraction of each muscle
ADAPTIVE AIDS FOR DAILY LIVING
 Sock aid, Reacher, Dressing Stick, Universal Cuff, Fork-Knife MOBILITY
 Mobile arm support, Suspended Equipment  Moving around
 Wheelchair attachment  Orientation and mobility (visually impaired)
 Environmental control units  LE prosthesis/orthotics
a. Ankle-Foot Orthosis (AFO)
UPPER EXTREMITY PROSTHESIS b. Ankle-Foot-Knee Orthosis (KAFO)
 Prosthesis = replace a missing limb c. Ankle-Foot-Knee-Hip Orthosis (HKAFO)
 Orthosis = aid a non-functioning impaired limb  Wheelchair mobility
 Driver evaluation and vehicle modification
TYPES OF UPPER LIMB PROSTHESES  LE Orthosis
A. COSMETIC  Ambulatory Aids
o No function, Just to look complete  Crutches
o Best cosmesis, less harnessing needed  Walkers
o Provides least function  Wheelchairs (standard, reclining, sports, electric, and scooter)
B. BODY-POWERED  Seat Orthotics
o Operate using other parts of body  Assistive Technology for Work Participation
o Most durable, highest sensory feedback, variety of
prehensors ORIENTATION AND MOBILITY
o Most body movement needed to operate, most harnessing,  Orientation: person’s knowledge of location/position in space relative
least pleasing appearance to locations/places in the environment such as destination a
EXAMPLES OF BODY-POWERED PROSTHESIS: pedestrian is walking toward
a. Prosthetic sock: knit wool, cotton, silicone  Mobility: person’s ability to move about safely, including negotiating
b. Socket: single or double wall and detecting obstacles and changes in elevation, street crossing
c. Suspension a. Tactile maps
i. Harness: figure-8, shoulder saddle and chest b. Talking signs
strap c. Long canes/dog guide
ii. Self-suspending d. Talking/audible signs
iii. Suction e. Etc.
d. Control Cable Mechanism
e. Terminal Device (TD) VEHICLE MODIFICATIONS
 Hooks, functional / active hand, cosmetic /  Pedal extensions
passive hand  Left-side accelerator pedals
TERMINAL DEVICE: HOOK OR HAND  Wheelchair storage device (top)
o Cosmetic Hand vs. Hook – Voluntary Opening or Closing  Mechanical hand controls (for paraplegics)
HOOK-VOLUNTARY OPENING HOOK-VOLUNTARY CLOSING  Steering spinner (spinner knobs, balls)
- Maintained in closed position - Closes by pulling with the  Quad grip mechanical hand controls
by rubber bands or tension cable on the harness system to
springs grasp an object AMBULATORY AIDS
 Placed 6 inches from the lateral border of the toes; top of the cane at
- Opens by pulling with the - Maximum prehensile force = the level approximately of the greater trochanter; with elbow flexed to
cable on the harness system in strength of the individual about 20-30 degrees
preparation to grasp  Single-point cane
 Four-point cane
- Maximum prehensile force =
number of bands
CRUTCHES
C. MYOELECTRIC
 Axillary crutches
o Activating movements of the hand
o 2 inches below the axillary till 2 inches lateral and 6 inches
o Moderate or no harnessing needed, least boy movement to
anterior to the foot, with elbow flexed at 20-30 degrees
operate, stronger grasp
flexion OR-16 inches from client’s height
o Increased energy expenditure, heaviest, most expensive,
 Forearm crutches
most maintenance
o As above except for cuff at approximately 1 to 1.5 inches
o Uses muscle surface electricity to control the prosthetic
below the elbow
hand function
WALKERS AUGMENTATIVE AND ALTERNATIVE COMMUNICATION
 Rolling walker  Integrated group of components, including symbols, aids, strategies
 Standard Walker and techniques used by individuals to enhance communication
 Symbols
WHEELCHAIRS o Representations of vocabulary or messages
 Standard  Aids
 Sports o Devices used to transmit or receive messages
 Reclining o Picture boards
 Powered  Techniques
o The way messages are transmitted
ASSISTIVE TECHNOLOGY FOR COGNITION o Sign language
 Are devices and services that compensate for deficits in cognitive
functioning FUNCTIONS OF AAC SYSTEM
 Sometimes called “cognitive prosthetics” or “cognitive orthotics”  An alternative communication system, substituting to some extent for
 Replace lost function or augment diminished function a vocal mode
 A supplement to vocal communication for the client who has difficulty
EXAMPLES with formulation or intelligibility
MEMORY AIDS  A facilitator of communication
 For clients with Dementia/memory problems as they cannot just rely
on plain memory UNAIDED COMMUNICATION
 E.g. calendar, sticky notes, picture boards, caregiver prompting, lists  Refers to communication system that does not involve the use of
external equipment or device use body parts to speak
PILL ORGANIZERS 1. Sign Languages
 Used for people to be reminded to take their medications 2. Educational Sign Systems
3. Gestural Language Codes
REMINDER DEVICES o Can be finger spelling or cued speech
 Examples: o American Manual Alphabet: most common finger spelling
o Names or pictures in contacts to know who to call, not just system
memorizing their phone numbers o Cued Speech: hand shapes, hand placements and
o Alarm attached to the key nonmanual signals to produce a visible code to help
supplement speech reading
ORGANIZATIONAL AID ON THE PC
 E.g. Emailing yourself, calendar, checklist, task list, sorting messages AIDED COMMUNICATION
 Use of equipment and/or devices to provide people with disability to
PERSONAL DIGITAL ASSISTANT (PDA) communicate
 Cognitively demanding  Symbol systems: forms the basis of aided system, non-electronic
 Both memory and organizational aid system and electronic system
 E.g. beeper, individual’s phone  Symbols: play a similar role as spoken words by representing ideas and
concepts
POPULATION FOR ATC  Symbols can vary from: level of abstraction, style and size
 Person with intellectual disability
 ASD SELECTION TECHNIQUES FOR AIDED COMMUNICATION SYSTEMS
 Learning disabilities  DIRECT SELECTION
 Alzheimer’s Disease  Require some form of directional movement as a means of pointing
 Acquired brain injury  For immature users
 Mental illness A. Head Pointing
 CVA B. Finger Pointing
C. Eye Gaze Pointing
WHAT WE NEED  SCANNING
 Devices that are multifunctional and multimodal  The user selects his or her choice when the scanner gets to the desired
 Capable of providing complex cognitive support icon in a row or column
A. Non-electronic system (e.g. velcro strips)
SKILLS DEMAND B. Electronic scanning system
C. Auditory scanning
 Mid-tech / Specific Task
o Items can be in the form of:
o E.g. camera
o Row-column
 High-tech / Specific Task
o Linear
o Globalized Positioning System
o Rotary
o Specialized or adapted software programs to facilitate
writing, reading, e-mail
NON-ELECTRONIC SYSTEMS
 Low-tech / Malfunction
 Often the first systems used with individuals who have severe speech
o E.g. sticky notes, voice mail, watch beeps, checklists,
problems because they are flexible and inexpensive
answering machine
 Use picture displays that are customized for the user’s needs and
o Appointment calendars
desires
o Car memo pads
 Mid-tech / Malfunction
TYPES OF NON-ELECTRONIC SYSTEM
o E.g. voice recorder / digital recorder, cell phone, pager, data
 Communication boards
watches (Timex data watch, Casio)
a. Traditional augmentative communication systems that are
 High-tech / Malfunction
convenient enough to be placed on wheelchair lap trays
o E.g. specialized task guidance systems, smartphone
b. Contain a single display of vocabulary words and phrases
(iPhone, Blackberry), personal digital assistants
c. Contain as many words and phrases as can fit onto the device
d. E.g. Picture Exchange Communication System
 Non-electronic Mini-Boards
a. Displays of vocabulary words and phrases that fit specific setting
or activities
b. E.g. A recreation mini-board
 Communication books
a. Help provide access to a large vocabulary compilation
b. Collection of mini-boards that occurs as chapters and pages
within the text
 Eye Gaze Displays
a. Composed of clear materials such as Plexiglas
b. Picture of objects are placed along the border of the display

ELECTRONIC DEVICES
 More expensive and involve unique considerations in their selection
 Involves increased independence and options of speech output
 Require periodic maintenance
 OT1025L: SPECIAL LECTURE
ASSISTIVE TECHNOLOGY IN EDUCATION
USES
 Designed to help students who have learning difficulties (physical,
cognitive, learning disorders)
o Physical: cerebral palsy
o Cognitive: intellectual disability
o Learning: dyslexia (reading), dysgraphia (writing),
dyscalculia (mathematics)
 Help them function in the classroom
 Tools and equipment to compensate for their learning difficulties
o Simple tools or sophisticated equipment
 Unable to eliminate the problems directly
o No, the diagnosis will still be there.
o But, we could that it would be eliminated indirectly by
maximizing their strengths.
 Capitalize on their strengths and minimize their weakness
 Audiobook
o For clients who are visually-impaired or blind clients
o Client with a visual field problem; can also see the left/right
 If there is no audiobook, mark the reading
materials with a red-glaring marker so that the
client can indicate if the line has already ended.
o Clients who have difficulties with reading
 It gives an additional feedback on how the text
is read
 Optical Character Recognition
o The entire page can be scanned by the very assistive tool;
right after, it can be translated into an auditory or audio file
(and it can be stored after).

COMMON TOOLS RECOMMENDED

 Electronic Worksheets
o If you have a client with dyscalculia, the ordering or
organization of numbers is difficult for them.
o To compensate, electronic worksheets can line up and align
words or numbers.
 Some of these worksheets have text to speech
features for additional feedback.
o Consider the resources of the family you are working with
 Phonetic Spelling Software
o Gives you an idea how to pronounce a word properly; you
can type something but if it is wrong, the software can use
the intended word
o Auto-feature gives an additional feedback how words are
being pronounced and how it could be spelled
 Talking Calculators
o Reads aloud the numbers;
 Single as you type, or
 Entire number typed
o Gives the learner additional feedback on what the figure is
 Variable Speed Recorder
o Recommended for clients who can’t hear (auditory
problem) and who have processing difficulties
 ADHD: difficulty in attention - if they do attend,
they wouldn’t be able to attend for a long period
of time; cannot sustain mental effort; cannot
see importance of smaller details
o To compensate and go back to the teacher’s lecture
o Before prescribing, talk to the school
o Variable: audio can be played back at a slower rate
 Abbreviation Expander
o Abbreviation Expanders benefits students who struggle
with writing
o The application is able to create, store and re-use the
abbreviations commonly used by the users. This can save
the user keystrokes and ensure proper spelling of words
and phrases he/she has coded as abbreviations.
o Long term recommendation: typing
 If the recommendation was given late, it
wouldn’t be plausible to focus on writing (i.e.
vertical lines)
 Alternative Keyboards
o Left:
 Ergonomics
 For a child with motor difficulties; positioning
the upper extremities appropriately
 Stabilization for children who also have trunk
difficulties
o Right:
 Alphabetically-arranged
 For a client to easily find the letters (since it is
sequential)
o Placement is necessary
 OT1025: DEVELOPMENT OF HUMAN OCCUPATIONS
LOCAL AND INTERNATIONAL TRAVEL GUIDELINES AND RESOURCES FOR
INDIVIDUAL WITH MOTOR AND BEHAVIORAL LIMITATIONS
INTRODUCTION:
TRAVELLING AS A VALUED OCCUPATION
 For parents and children
o Family vacations
 Taking care of children, bringing them with you
 For seniors and aging population
o Leisure and active ageing
o Seeking an experience, not just destination
 For adults TOURISM VALUE CHAIN
o See and experience the world through travelling
o More than the destination, it is creating stories
OCCUPATIONAL THERAPY AND TRAVELLING
 Travel as part of community mobility in the OTPF-3
ENABLING TRAVEL THROUGH ACCESSIBLE TOURISM
 Accessible tourism
o These include people with permanent and temporary
disabilities, seniors, obese, families with young children and
those working in safer and more socially sustainably
designed environments.
o Enabling PWDs or parents with special needs or senior
citizens to enjoy traveling
 Did you know that accessible tourism started it roots in Manila?
o In 1980, the Manila Declaration as the pioneering
statement on the right to tourism.
 Australia, Europe, the UK and the USA are leading the accessible
tourism revolution.
STAKEHOLDER COLLABORATION
 Stakeholder collaboration is a key factor for developing accessible
tourism solutions, recognizing the value of the market and capitalizing RESOURCES FOR TRAVELLING (CWD)
on it.
o Recognise the complementary nature of the different
paradigms
o Re-shape and transform the future of the accessible
tourism through influencing the tourism industry
 The dreams and aspirations of individuals play a fundamental role in
shaping the travel choices. EDUCATION AND TRAINING FOR CUSTOMER SERVICE
 Among people who live with a disability, the idea of leaving behind
one’s everyday surroundings and going on a journey can create
significant anxiety.
 People with disability often can design or influence their everyday
environment whilst they have routines to negotiate any difficulties and
thresholds that exist.
 This does not apply to new environments whilst travelling, where they
do not have prior knowledge, networks or influence on the design nor
the potential barriers that are to face and the way to overcome them.
 Accessible tourism futures destination managers must strategically
plan through the lens of UD.
 Designed in a way that allows for interaction between a person’s
abilities, their support needs and the assistive technologies to allow for
the enjoyment of all.
UNIVERSAL DESIGN (UD)
 Universal design is the design of products and environments to be
usable by all people, to the greatest extent possible, without the need
for adaptation or specialized design. The intent of the universal design
concept is to simplify life for everyone by making products,
communications and the built environment more usable by more
people at little or no extra cost.
 In order the facilitate people with differing abilities, of differing ages
and sizes within society, systems and building must be designed with
the user at the center of design process. A universally designed
environment promotes equality and makes life easier and safer for
everyone.
ACCESSIBLE TOURISM
 As a human right
o UN International Convention of the Rights of Persons with
Disability (UNCRPD)
 As a business care of niche marketing
o European Union: 80 million people with disabilities
o United states of America: 54 million people with
disabilities
o Asia-pacific: >400 million people with disabilities
o Latin America: 85 million people with disabilities
 The huge existing economic potential when considering the segment
of persons with disabilities as target customers in the market.
 Transport
o Canadian Transportation Agency: Take Charge of Your
Travel (A Guide for Persons with Disabilities)
 Hotel/Accommodations
o The Lonely Planet
 Airport
o Brochure - Manchester Airport: Airport Awareness
 Travel Advice for parents and carers of children
on the Autistic Spectrum
o Brochure – jetBlue airways
 Adventures with Autism: The Airport
Experience!
 Destination Experience
o Japan Accessible Tourism Center
o Museums
 Touching materials to appreciate the
architecture
 i.e. Prado Museum
o CWD-friendly
 Attraction Details for Guests with Cognitive
Disabilities
 Autism Speaks
 Autism On the Seas
o Cruise Trip dedicated for families who have Autistic children
o Families are oriented with activities, etc.
 PWDementia
 Accessible services offer should ensure disability awareness among
visitor service staff, and make sure that accessibility training is part.
 Education was also reported, and moving forward, there was seen to
be a necessity in replacing the current bits and pieces—