Assistive Technology for Children with Disabilities

Assistive Technology

• Assistive technology (AT) is defined as any item, piece of equipment, or product system that increases, maintains, or improves an individual's functional status.
• AT is used to promote the development and acquisition of skills that a client lacks due to illness or injury.
• AT aids in performing socially acceptable activities.

Objectives

• Define Assistive Technology and associated team members
• Discuss the equipment selection process
• Define a Letter of Medical Necessity
• Describe types of seated mobility and adaptive standers
• Describe types of walkers
• List adaptive commodes and hygiene systems
• Describe switches, controls, and access sites
• Define augmentative and alternative communication
• List computer technology and electronic aids

Assistive Technology Team

• The team includes community members (family, transportation, architecture, etc.), funding specialists, social workers, and medical/health professionals (doctors, specialists, nurses, psychologists).
• The core team includes physical therapists, occupational therapists, speech therapists, rehabilitation engineers, and rehabilitation technology suppliers.
• School/work personnel are also part of the team (teachers, supervisors, vocational counselors, therapists, administrators).

Assistive Technology Professionals

• RESNA: Rehabilitation Engineering and Assistive Technology Society of North America
• ATP: Assistive Technology Practitioner
• ATS: Assistive Technology Supplier
• NRRTS: National Registry of Rehabilitation Technology Suppliers
• RTS: Rehabilitation Technology Supplier (specializes in seating and mobility)
• CRTS: Certified Rehabilitation Technology Supplier (certified by NRRTS and RESNA trained).

Role of Assistive Technology/Adaptive Equipment

• Equipment allows for safe positioning in home, school, and free time.
• Reinforces positions and movements during treatment, reducing atypical movements and postures.
• Encourages interaction and daily management of the child.
• Provides safe transportation.
• Wheelchairs and strollers must have approved tie-down systems.

Precautions with Assistive Technology/Adaptive Equipment

• Poor planning, improper choice, and lack of environmental matching can hinder usage.
• Misuse of equipment can be a problem along with how easily the caregiver can handle it Equipment and movement restriction must be considered.
• Restraints must be used cautiously and with proper guidelines in preventing the individual from using the device.

Parents and Caretakers

• Parents and caretakers need information about the benefits of AT for the child.
• They must be taught to perform the task involved with the device including how to use and maintain it.
• Psychosocial considerations must be accounted for as children with disabilities may experience difficulties relating to their differences—parents may have as well. 

Selection Process

• Collect data (client, environment, previous equipment).
• Construct a problem statement that identifies needs, and problems experienced.
• Establish reasonable goals and outcomes, considering funding.
• Conduct physical examinations for device selection.
• Generate working hypothesis based on clinical impression and device selection, including components.
• Plan the intervention strategy, matching products to the client and considering growth.
• Implement the strategy by selecting components/interfaces, securing funding, assembling/constructing assistive technology package, delivering the system, and providing training.
• Conduct follow-up and reassessments.

Areas to Assess for Assistive Technology

• Physical (ROM, deformities, medical interventions, muscle tone, control, strength, reflexes).
• Sensory deficits, perceptual skills, cognitive deficits, and functional disabilities.

Assessing the Home and School Environment

• Entrance accessibility (elevator/walkup).
• Home storage and device placement.
• Doorway clearance.
• The number of home occupants, and if the child has their own room.
• Device needs for home vs school.

Equipment Selection

• Dimensions
• Availability of adaptations.
• Is the device cost-effective, durable and easily adjusted?
• Reputation of the manufacturer.
• Delivery time.
• Cost and alternative options.
• Aesthetics considered for child and family.
• Manageability.
• Ease of use

Letter of Medical Necessity

• Demographics
• Diagnosis
• Functional abilities and disabilities (postural control, ambulation).
• Description of current equipment.
• Description of requested equipment and its benefits.
• Trial of equipment.
• Reason(s) why other equipment is not appropriate.
• Equipment type, parts, and components, and why child needs them.
• Accessibility to location where equipment will be used.
• Trial of the equipment.
• Instructions to help parents/caregivers to use the equipment.
• Estimated lifespan.
• Beneficiary information (name, injury, condition and diagnosis, current functioning level).
• Describe why the device is medically necessary.
• Show how the equipment will result in a functional improvement for the individual.

Knowledge Check

• Assistive technology is defined as any piece of equipment that maintains or improves individual functional status, is used to promote the development and acquisition of skills, and improves socially acceptable activities.
• The most appropriate answer for a 5-year-old child with Cerebral Palsy and limited head/neck extension is a prone stander.

Standing Walkers

• Standers and walkers are categorized as adaptive equipment for upright postures.
• Functionalities of upright postures (weight-bearing health benefits).

Commodes and Bathers

• Free standing systems may be needed for some individuals with altered mobility for personal hygiene.
• Handheld showers, water driven lifts, Hoyer lifts, and tub transfer benches are examples of assistive equipment for bathing.

Switches, Controls, and Access Sites

• Special switches, controls, and communication aids that are required for use of computers, wheelchairs, or other devices.

Augmentative and Alternative Communication

• AAC systems provide communication for individuals with limited or absent verbal skills.
• Communication tools include body language, gestures, facial expressions and written output as well as technology such as computers and keyboards.

Computer Technology

• Keyboard adaptations can aid in accessibility for individuals with impairments.
• Mouse alternatives such as joysticks and touchscreens aid in computer and other digital device functionality.

Electronic Aids to Daily Living

• EADLs are devices and technology systems that enable operation of electrical appliances and other equipment.
• EADLs may be controlled directly or remotely via varied technological components.
• EADLs aid people in gaining independence and participating in society.

Examples of Communication Devices

• Technology like Bliss Boards aid in communication for students with reduced verbal skills.
• Adaptable technology for toys, computers, home access devices allows users to continue normal routines.
• Voice-activated components and adapted keyboards are also available to increase functionality for the individual.

Other Adaptive Equipment

• Assistive technology equipment, including examples like infant positioners, car seats, and tricycles.

Examination & Evaluation

• Examination and evaluations are needed for the use of specific assistive technology. 

Successful Technology Use Requirements

• Functional movements must be voluntary, reliable, and repeatable.
• Effective collaborative efforts for professionals (therapists, teachers) and the individual involved with a clear understanding of the child's cognitive development and learning.
• Sensory skills like visual input, auditory discriminative input, and kinesthetic proprioceptive inputs for selection, access, feedback, and training.

This quiz explores critical aspects of seating assessments and assistive technology for children, particularly those with disabilities. It covers essential factors in selecting equipment and developing strategies to enhance comfort and usability. Test your knowledge on how optimal seating can benefit children and specific considerations during assessments.