Attaching the AAC Device to a Wheelchair

Hey Tek-ninjas! In this post I want to talk about wheelchair mounting. This is often the bane of many speech therapists. A colleague from a large mounting company made the observation in regards to slps and mounts, that "those drawn to language, may not necessarily be drawn to building". Essentially, assembling a chair mount to a chair is like building with an Erector Set from my childhood.

So not everyone is drawn towards building, and your friendly neighborhood Physical Therapist or Occupational Therapist may be out of the picture, or have limited mounting experience themselves. None-the-less, wheelchair mounting is also a key factor supporting your end-users being able to consistently access their equipment, no matter their access modality. Unfortunately, there really is not an "industry standard" among wheelchair manufacturers for attaching AAC devices.

Often I sell the same chair mount, but there is an attachment piece necessary to join the mount to the chair. And those parts vary significantly. 

Regardless of which AAC vendor you are working with, your Sales Rep should be able to help you, but will be better able to do so with some specific information.

If the Rep has not been involved in choosing/selecting the appropriate device (because you are such a comfortable veteran AAC therapist) you will need to tell them what device your client wants, and what the access methods are.

Some wheelchair manufacturers are pretty cut and dry when it comes to recommending attachment parts. For example Permobil and Quickie Power Chairs have a version of channel nuts. Once I hear we are mounting to those chairs, I really don't need much other information or photos. Other manufacturers might require a 1 inch tube (side clamp, or tube clamp) and other manufacturers require different dimensions.

Photo Angles

The Rep may need pictures of the chair. I cannot tell you how many times I've asked for a picture, and received a lovely picture of a smiling child or adult suitable for a holiday card, but offering no insight regarding the chair! So, take a look at the "Photo Angles" picture to see what your Rep is likely looking for. Smiling pictures of your clients are always welcome, but not always helpful in this situation.

Other considerations may include: does the end-user have a lap tray? Is there a preference for which side the mount is on? This can be dictated by pre-existing equipment on the chair (ie: joy-stick). Or maybe a caregiver needs to do chair transfers to one side due to their own health/medical issues.

I hope this post facilitates acquiring the correct mount for your clients.

Happy therapy!

Welcome back!

Hey Tek-Ninjas! In the state of North Carolina school has been in session for at least a week . I'm

thinking about all of my colleagues who have returned to work after what was hopefully a restful summer vacation.

In my 18 years working for school districts, the first week or 2 back was generally chaotic, but not too painful. However, I found that the month of September felt as though it was unending! 

So this post is simply a shout out to our school based colleagues! Consider this encouragement to hang in there. You'll get through the month of September, October will run its normal course, and then the next 2 months will fly by like a rocket!

Thank you all for the work you do with our little ones! 

Reporting on your Therapy!

Hey Tek-Ninjas! Last blog I mentioned that I was excited by several of the offerings from Smarty Ears. Today, I'm blogging about their app Therapy Report Center (TRC). 

TRC seems to have been designed specifically with SLP's in mind, but I think it easily can be utilized by Occupational and Physical Therapists. If you are a clinician looking for a way to document your treatment and service delivery, this app may be the answer. TRC is compatible on your iPad. Incidentally, it's free. 

With TRC you can individually add each student you work with. You can include a photo of the student, and input the individualized goals into their profile.


The app is specifically designed to integrate with and collate data from other Smarty Ears apps, but I believe it could be used easily for tracking service delivery, and generating reports easily.  The interface is intuitive, and elegant.  Sending data via email and Airdrop is seamless. 

Per the Smarty Ears website: TRC is the perfect accompaniment for data collection in Response to Intervention (RTI). By allowing the professional to input all students (not just those on IEPs), the actual number of student’s being seen is tracked. In addition, each student’s goals are unique and individualized. Because data is tracked as often as the professional desires, TRC allows the professional to monitor interventions and the student’s progress over time. Data collection has never been easier!

So take a look at Therapy Report Center, it may simplify your work for you.

Hajimè! 

When To Refer, When Not To Refer

My inspiration to write today came from an email from a friend, and fellow Occupational Therapist from a nearby state. She wrote:

"Our Assistive Tech team keeps getting overwhelmed with referrals for an AT Eval or Consultation....How do you divide up the roles in your county? Any process tips you'd recommend to cut back on needless referrals or to put back some effort into the teams making the referrals? I've heard staff say, "Let's make an AT referral" as soon as a parent asks the team if the student might do better with keyboarding. I feel like the OT or teacher could answer that question without involving an AT referral. Any thoughts?"

We occasionally get referrals that don't require our expertise. When this happens, we follow up with a phone call to the referrer and try to get a bead on the situation. Are there questions that the team genuinely needs help with or are they simply looking for confirmation of their thinking. With newer staff, it is often an issue of sharing with them what our respective roles are. Occasionally, we may be faced with a potentially litigious situation, and so we are called in to be thorough.

In order to head off unnecessary referrals, we make a point to offer in-services to various staff groups (OT, SLP, PT, teachers) to really delineate what our respective roles are from our perspective.

For example, Occupational Therapists already have significant "Assistive Technology" as part of their domain. Consider adaptive eating utensils or cups, weighted vests, or pencil grips. An OT would never make a referral for such low-tech equipment, because they consider it a part of their domain. I posit that keyboarding software is a part of such equipment for most OT's. Similarly, many simple switches are part of a SLP's bailiwick as well.

Our Assistive Technology team considers our role as assessing need and prescribing technology interventions when the team "requires" such assistance. 

If the team already has a handle on the tools required to create an effective intervention, they probably don't need an evaluation, or possibly even consultation.

Assistive Technology teams are not here to replace your clinical reasoning. 

That being stated, I do have staff who will utilize their considerable knowledge, plan interventions, and then call or email to to see what we think regarding what they are doing, and whether or not we think they "missed" something. In my estimation, this is a great way to use available resources.

Other teams may handle such situations differently, and I'd be curious to hear from folks.

Thanks for reading, and happy therapy!

Engineering Students Making a Difference

Joystick Control Jeep

Recently I was asked to sit on a panel at UNC-Chapel Hill with faculty, a hospital based Occupational Therapist, a few parents of children with disability, and an adolescent with disability.  We were speaking with students who were beginning Rehabilitation Engineering Design Projects for their Applied Sciences and Engineering class. The purpose of our panel was to share with the students what they might expect in working with individuals with disabilities, and possibly demystify some of the process.The UNC class is taught by Dr. Rich Goldberg, and is paired with a similar class at Duke University which is taught by Dr. Kevin Caves.

Here is the description of the program from the UNC website:

"In this program, students develop custom assistive technology devices for people with disabilities. Project ideas come from therapists and clinicians in Durham and Chapel Hill, who serve as project advisors throughout the semester. Students spend the entire semester working on the design and development of a device. At the end of the semester, they deliver their device to the therapist and client at no charge. Lectures and discussions in the class focus on engineering design and communications; working with people with disabilities; ethical issues in assistive technology; patents; and other issues."

Also from the website, the program lists several objectives:
This program has several objectives:

• to provide a practical engineering experience as well as a personally rewarding experience to the student; this may also encourage them to use their specialized skills in the future to benefit individuals with disabilities.
• to help individuals with disabilities become more independent by designing and building custom assistive technology devices that address their needs.
• to facilitate learning and reflection about the daily life of an individual who has a disability, as well as the daily lives of the family members, therapists and teachers who are in close contact with them

The variety of projects and clients the engineering students work on is impressive. If you are local, and have a unique need, you may wish to contact Dr. Goldberg or Dr. Caves.

I wonder if other universities offer such classes?

Happy Therapy!

AT Lending Libraries in NC

Here in North Carolina we are blessed with some truly exceptional resources for our folks with special needs. Specifically we have a handful of agencies that offer lending libraries of unusual or expensive equipment.  This allows consumers to try equipment for free for a period of time, and for therapists/educators to augment there interventions. There are three agencies that come to mind: Tadpole, NCATP, and ATILL.

I have personally used the first two organizations. All three of them are free lending libraries. One offers free shipping (Tadpole), the others don't. You don't need a "school account" for any of them, you set up an individual account. Tadpole and ATILL have a great online library with photos. NCATP online library is nonexistent, but that's probably because they have so many centers throughout the state, and encourage folks to come in and put their hands on the equipment.

Generations-Tadpole

Where the Wild Things Are

Generations-Tadpole has over 1,300 items that have been selected for use with children and adults with developmental disabilities.  Their inventory includes both low and high technology.  Tadpole provides short term loans of both adapted and non-adapted devices to adults and children with developmental disabilities.  You may place your order on their website and they fill it, usually within a week.  Your order will include a packing list that includes the items that you borrowed as well as a ‘Due back the week of ________” date.  Prior to your due date, Tadpole will contact UPS to let them know to pick up your package.  UPS will arrive and bring a label and return the box to Tadpole.

Tadpole Inventory

All the above is a FOR FREE SERVICE. They pay shipping both ways. They provide batteries. Loan of the device is free. Amazing.

Tadpole's website is very user-friendly, though still under construction. It will be terrific when complete. That being said, there is tremendous value in taking a field trip there to see and hold all the different things they have to lend. It is a wonderful resource for therapists, teachers, and parents alike.

Assortment of SAT

Tadpole ships to a 22 county/school district region. Those counties/school districts include: Wake, Durham, Orange, Chapel Hill-Carrboro City, Chatham, Granville, Caswell, Person, Alamance, Franklin, Johnston, Wilson, Nash, Edgecombe, Moore, Lee, Harnett, Cumberland, Sampson, Wayne, Green and Clinton City Public Schools. Their operating hours are Monday, Wednesday and Friday from 9:00 - 11:45 a.m. You can reach them by phone at 1-888-288-7948. Their address is 205 W E St # G, Butner, NC 27509.

NCATP

The North Carolina Assistive Technology Program (NCATP) is a state and federally funded program that provides assistive technology services statewide to people of all ages and abilities.  A few blog-posts back I wrote about the AT Classifieds that are run by NCATP.


NCATP offers a device loan program to help individuals try out equipment in the location they will use it:  at home, work, school or recreational activities.  It’s a “try before you buy” approach which helps individuals and funding agencies make wiser choices. NCATP offers a wide range of assistive technology devices including augmentative communication ( for people with limited speech), computer access, low-vision aids, assistive listening, aids for daily living, switches, environmental controls, adaptive toys and recreational devices. 

Vantage Plus

Similar to Tadpole, the NCATP lending library is free.  Devices can be borrowed for a two week period.  Toys and other AT for young children (birth to 5 years old) may be loaned for longer periods of time.  

The NCATP library tends to be mid to high tech equipment, very current, and rather breathtaking. It's hard to find a place with a deeper selection and staff who are more knowledgeable.

The NCATP Centers are spread across the state of North Carolina with locations in Raleigh, Sandord, Winston-Salem, Greeensboro, Elizabeth City, Rocky Mount, Wilmington, Sylva, Morganton, and Charlotte.  

NCATP staff respond to individual requests about the benefits of AT, device options, information on funding resources, and the use of specific devices.  Staff research the inquiry and provide the information in person either on-site in the AT Center or in the home, school, work or community setting or via phone, email or U.S. mail.  Consumers or family members are not charged for this information.  However, if training on a device or formal evaluation is needed, there are fees for these services. 

Assistive Technology Initiative Lending Library (ATILL) 

ATILL Resources

Assistive Technology Initiative Lending Library (ATILL)  is a resource listing the assistive technology devices and software currently housed at the Watson School of Education. Like NCATP, they have many resources available for checkout providing you with an opportunity to "try before you buy."

Resources may be checked out for thirty days and must be picked up at the Assistive Technology Demonstration and Lending Site. Requests for devices may be made by you, a family member, a friend or advocate, or someone who is helping you with your assistive technology needs (e.g., a therapist, teacher, rehabilitation counselor).

ATILL is on the campus of Watson College of Education, in Wilmington, NC.  ATILL recently relocated into the Natural Sciences Building (NS) in room 1026. NS is located on the East Campus behind the McNeill Hall and can be accessed through Walton Drive. There are two parking spots with teal lines on the east side of NS in Lot T reserved for our AT Lending Library visitors. There is also a handicap parking spot on the south side of NS.


Of the three, I am least familiar with ATILL, and have not used them yet, but I was very excited to hear they are "in business"! The more the merrier. Tadpole is where I go when I need switch activated toys, or education supplements. NCATP is where I send families who are interested in test driving multi-thousand dollar devices.

I would wager that other states have similar programs.  If you not in North Carolina, but can speak to similar resources in your State I'd love to hear about it, with a web-link, and likely other readers would too!

Happy Therapy!

Hold the Date! 30th Annual NCACA Conference!

NCACA Conference

Alright North Carolinians! February 21-22 brings us the 30th Annual Augumentative Communication conference. And for those of us in the Piedmont, it's in Durham again!

Linda Burkart

The title for this year's conference is "We've Come A Long Way: 30 Years of AAC in NC".  And this year we have the pleasure of hearing Linda Burkhart  presenting on "Communication Strategies for Children Who Face Severe Physical and Miltiple Challenges".  Ms. Burkart is an internationally known pioneer of simplified technology for children with severe challenges.

This conference is designed for SLP's, OT's, PT's, Psychologists, Educators, Para-professionals, Families, and Consumers interested in increasing their knowledge of AAC and AT.

Every year I've attended this conference I have left with new knowledge, and fired up to try new tactics.  Don't miss it! You can find out more details here.