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> Good morning, welcome to Assistive Technology (AT): Making a wise fit in integrated competitive employment. This is the one part, one-hour webinar. Once it is completed, we will make it available for those who request it. We are part of the College of Health & Public Service. For all of you joining us, I will do the same thing I do every time, I want to make sure you can hear me. Go to the dashboard and find the question box and say hello. Let me know that you can hear us this morning. Linda, thank you. Jason, appreciate it. If you go a little further down, you will see the one called handouts, that is the PowerPoint recitation that are instruct her has put together. Please feel free to grab that. If you have any questions or comments, please use that question box. Don't worry about misspelled words, just ask a question immediately and also possible in between each slide, we may stop the presenter and ask the questions. Make sure that everybody has the handout, and if there's any more than those three that have said hello, please say Hello. Please make sure you email us at you and TY for credit this morning. Right now, I want to introduce our speaker. Rebecca Cagle is an instructor for California State University Northridge. She is part of the ATH masters program. Within the University, she is Sr. Program Project Coordinator for UNTWISE . She has experience working in postsecondary disability services since 1976. She taught high school students with learning disabilities, worked in severe burn rehab research, and developed cognitive skills projects at a traumatic brain injury clinic. Rebecca received her Masters, and her bachelors from health sciences Allied. She is part of the I AAP. She is a professional core competencies previous certification in life care planning, she serves on the freedom scientific advisory committee, and the accessibility collaboration group. The professional groups include the national rehab Association. Welcome, Rebecca. The floor is yours.
> Thank you, can you hear me okay?
> Yes, ma'am.
> Hello everybody and welcome to our program on assistive technology. I want to start out with the objectives that we are going to cover today. We will deftly cover A-T technology -- terminology, and some considerations when we look at these matching customer and appropriate assistive technology, and identifying changes in legislation regarding AT. Today I will not cover anything on the blind low assistive technology very much, because the Texas the DS has a great resource for trainings. We have a lot of terms on the slide and I bet some of them are very familiar. With assistive technology, we want to look at taking a human centered approach to our AT considerations. At first, we want to look at the person. Then the environment, and then the activity. So we are not looking at assistive technology, we are looking at matching first. First I want to start here because I want to keep your mind on this focus. Especially because many people do this the other way around. They pick a piece of technology and assume that it will work without looking at things in a deeper level in these other areas. Sometimes, people pick a device and expect a customer to fit the device. There are times when there is only one device that is an option. But that seldom happens. Oftentimes, there is no text, or low-tech that is your best solution. So you boys want to look there first, not because you want to be cheap, but you want to look at all the options. A lot of times things are built into the computer these days or into a phone app. I had a customer who had asked workers that was having difficulty taking notes in the college arena, and they were willing to use a recording device. But I later found out, that they were violently opposed to anything that had the color red on it. So the two different devices that I had, the red recording button was there, and he refused to have anything to do with it. So my low-tech solution was to get some nail polish and paint over it. The follow-up for that, was that you had to make sure that nail polish date on their. I know that seems like a quirky thing, but those are some of the common things that come up with looking at a person first. The way I could've seen that happen, was he would've taken that device and never used it, because that red was so offensive to him. I might never have seen him again, and not known that it wasn't working. You might think about tracking for someone who has carpal tunnel or difficulties with typing. But again, if someone has low level English speaking skills, or their grammar is not good, that device is not going to be appropriate for that consumer. So there is another example of why you do not want to look at a device first. You need to get more information about the environment and the person. Another thing I would like for you to consider, is you don't want to make recommendations to a customer without first having a discussion regarding your ideas, for technology with their VR counselor. You do not know what kind of funding situation that person might be facing, and you don't want to set them up for disappointment if it's a device that is a going to be attainable. You might find it is attainable, but there is no one actually available to train. So with major life activities, caring for one self, eating, sleeping, these are the things that you want to run through in a quick checklist when you're looking at the environment that they are in, and they may be in a different environment in a work setting. Also, you will notice the column on the right, in that major life activities could include function. We are going to go over some of the ATA laws, but these got highlighted when they did the update to the ADA. We will cover those in a minute. You can see these are all things that you can't see of what is going on in someone's digestive system, or in their brain, or how they are breathing, but these are all things that we also want to consider in that environment. When you look at this column on the right, there are some specific disabilities that might come to mind when you think about a person. The one that comes to mind for me, right off, would be diabetes. Possibly, TBI, and then you want to look at a specific environment for the DAR 1612 assessment, these are great indicators on this page. As you read through that form, you will see that all of these are included in that form. What if you have, a consumer that may be on the autism spectrum, and you also know that they have high anxiety? Is there a technology to help with that? There are quite a few. Then, you will want to get your consumer better. Do they have a phone or an app that they would be agreeable to? One person told me he had a mood ring, I don't think that will work, but you have some high tech, and low-tech that might work. You might have a consumer that might be at the counter only when they're busy, so that would not be one of their primary duties. On the low-tech ends, you might use those natural supports that are built-in. I have a consumer that wears an insulin pump, and they are a checker at Walmart and her supervisor always make sure that she is getting her brakes on time. They check on her every hour, usually it is just a walk by to make sure that they look like they are functioning at their normal level. If not, they will pull her aside, and put someone else in and visit with her for a minute. Also, she is given permission for them to let the coworkers know. This is sadly, a unique situation, but she said it is very family oriented where she works. She loves knowing that there are people there to keep an eye out for her and make sure that she gets those important brakes to check her much sugar and have a snack. None of that has anything to do with technology, but it does tie into another customer might need to have a moment to self manage themselves more. Again, that is an example of knowing more about the environment that someone is working in. The central functions I mentioned ago, the EEOC, and that is where you want to have your focus if you're doing a job analysis. What are the primary functions of the job? You want to look at how technology my address those first, before you start looking at something further down in other duties. Let's look at accessibility for a moment. That Macy simple to most people, but it is more than just a wheelchair environment access that we are looking at. We are looking at axis IV things in the physical environment, in the sensory environment, and that communication, and the cognitive environment. I believe that as far as accessibility goes, we want our customers to have it all, just like anyone else. The federal definition for assistive technology is here on the screen and it is a boring thing to read. Most of you are probably familiar with it, but it can be anything as simple as a sticky note to a magnifying glass or complicated like a voice activated computer, or an electric wheelchair that may allow someone to navigate or get a drink of water. 80 services is also under the definition of assistive technology. This is where people tend to fall off, they get a device and say have a great day. But the service is as important as or more important than the device. If you don't have a good connection with follow-up, or follow through, then you may lose all the work that you put in. Let's look at the data a little bit, here. Who will benefit from the assisted technology? I think the data is shocking. It shows how many people there are with some kind of disability. There is a link in the notes part of the slide for you. Based off of the you and that -- U.S. census, there is 56 million. Look at high the percentage is. Here at the university, professors are shocked when they ask how many people we are talking about. If you look at the statistics, here, even coming down a little bit, it is still very high. Let's say have a classroom with 36 people, that is easily two or three people in a classroom. If you are in a corporate setting, there are people, mostly with invisible disabilities that would benefit from technology or better accessibility. Of course, we know there are a lot more people who are reaching retirement age, who are going to continue to work. We will have some form of disability that will -- we will see especially and hearing, and envision, and a reduction in dexterity. I would also like you to think about that AT benefits others as well. Not just the user, but their family, their work and school, and in the environment, it can also empower people to enhance their strengths, not only to compensate for the disability, but they can better allow communication, and it can decrease frustration. It can also increase frustration depending on the accessibility of the device. I find people are more that -- motivated when they are better trained in their technology. It increases their productivity, and there regular daily living we all want to have as much control over our environment as we can, and we want to see that people are able to contribute to society and have a good relationship with others, and adjust well to society. There are laws that surround assistive technology. If you look at the history of when the rehab act began in 1973, that was a big starting place for accessibility overall. With the ADA in 1990, there was more. Remember, with computer technology, we didn't have phones that had computer abilities built into them yet. So along this timeline, we see where the government is trying to play catch-up with how fast technology is changing and how well technology is actually creating more work environments for people that are accessible. I think the tele-commissions -- telecommunications act in .4 shows some big changes. You will see that in captioning, and audio description. If you are not familiar with audio description, if no one is talking, and you are only seeing a scene, if you can't see what it -- all of that is, it describes what is going on on the screen. It is quite an art, seeing people who are creating audio description. I have enjoyed seeing that. It makes you think differently about what is going on. It is also each person's interpretation of what you see, so it is quite an involved art. There specific assistive technology act, in 1998. That has been amended since. It was to try to catch up with technology and with the demonstration of technology for people. Moans of devices, and also funding were included. That was a big event there. Each state has its own assistive technology center. Ours is in Austin, Texas. If you never have anything to do with that center, I highly recommend you go to the website. It is in a link in the notes. It has where every states center is located. They all operate a little differently, and our grant funded. The autonomy for each state is so different in its needs. If you are in Montana, people live so far apart, that they can't get to and A-T center so they do a lot more virtual work. Texas has a AT center with the big bus that goes around and goes to different sites where people can work with the device to see if it is appropriate with them. The other thing I love about that state AT center, is that anyone can ask to have a loan of the device. To build -- typically, you can get a loan for a month. And you can try it out and see if it would work for your customer before you even bring it into their picture. You could show it to your DBS counselor, there are a lot of varieties with that. A family member can request it. You do not need to demonstrate that there is a disability involved. I think it is great that the government is giving us funding to allow us to learn more without having to spend our own money and have it set on the shelf. The last bullet on the slide, shows the UN convention, and international article. President Obama signed it. It hasn't been adopted by the U.S. A lot of it is based off of the ADA, it goes a step further and brings in the picture of the international classification of function. If you go back to the slide before, where we talk about the different movement in the body systems, it incorporates that a lot more. It also looks at the environment as a disabling condition, a lot of times. The 21st century communication video accessibility act is getting a lot of attention right now. You may not think about playing games as part of a work environment, but it could be used as a training environment. That could be in a game format. With the kids disabilities, a game environment can be a great teaching tool of memory skills, tracking, on and on. There will be a lot of attention given to that over the next few years. I want to touch on AT abandonment . The abandonment rate is very high. That is one reason why I want people to focus on how important it is to not think about device first. It's important to really get to know the customer and the environment that they will be in. My way of thinking, is that A-T selection shouldn't be the only's strategy, there should be a consisted -- consistent approach. 75% of assistive technologies are abandoned. On that, you want to look at surveys, and say who did the survey?Were these people using AT in a work environment, or were they in a nursing home and they had hip surgery and then they didn't really -- need a walker anymore after therapy. It still runs well over 50% for abandonment even in medical goods. I do believe we can do a better job on this. With assistive technology assessment, I have mentioned that we want to look at the environment, and also at the goals and future expectations of your customers. Also, we need to look at their employer. You want to be able to provide some support of how it is going to be implemented in the environment. You're going to evaluate -- evaluate feedback from the employer. Is are going to be a transition process? One of the hardest thing is a customer who is blind, they might need a job, it might be a week, or three weeks before jobs get installed, how are they going to use the calendar to do that kind of thing? Is there professional development set up where they have accessibility to that kind of thing?AT can get complicated. There is usually more than one disability and a person, and you may need more than one assistive technology for your solution. I like this saying, that the person who sweeps should pick the broom. I got this from one of the CEOs at Starbucks. In your work with assistive technology, if it worked -- involves a computer or I.T. support, you want to meet with them on the front and's, or someone in the employers arena to meet with them if that is going to interact well with the other components they already have going. This will save you a lot of time in dead end roads. The I.T. staff should be educated as much as possible. While that is not your responsibility, you want to encourage that. I have worked in places where there was only one I.T. person who knew anything about the jobs install, and it may be three weeks before they are able to set up a ticket. That is way too long for productivity, and is a set up for a potential lawsuit. One example, of more than one assistive technology might be Dragon NaturallySpeaking. That is where you have a microphone and speak, and it types what you talk. That can be a great tool. What if you also have a lot of responsibility being on the phone? You would need to have a different kind of microphone if you're going to be using the phone, or you may need to have a switch that will turn them on and off, so it can get complicated. You also want to know, with technology, if the person is allowed to install anything on their computer. If they're using some kind of technology that is computer-related, it may be that they have to have I.T. interact with them. Again, I.T. will need to come in and do upgrades. When browsers are updated, it can affect the technology as well. That's why it is important that you have a follow-up and follow-through plan with people available when the situations change. There may be other professionals involved in the life of the customer who are also involved in assistive technology. You may have a medical doctor who makes a recommendation or something specific. They may be working with an occupational therapist that is able to help with a communication device. In HR, some of them can get very involved in assistive technology, the training, the implement -- implementation. Not to take you out of the picture, but to find out who are the people who will help with the follow-up. Risk management is also one that you want to think about. You want to be able set up a environment for the customer where you feel fairly certain that you are not going to be setting them up with something that is going to make the condition worse. And ergonomic environment will be important. Follow-up will be important in that. Look at that, and see if that sit, stand desk is really doing what it should be doing. Did they get up Matt to help with -- to they get a map to help with the fatigue in the legs? There are a lot of things to think about.