. This is the slogan for the National Disa-
bled Veterans Winter Sports Clinic, and has been
for the past 30 years. For one week in Snowmass,
Colorado, the Disabled American Veterans charity
(DAV) and the Department of Veterans Affairs
partner to host the largest rehabilitative event that
aims to teach Veterans how to ski and the chance
to participate in other sports and leisure activities.
Over 400 military Veterans with qualifying disabili-
ties including traumatic brain injuries, spinal cord injuries, orthopedic amputations, visual impair-
ments, and other certain neurological disorders,
gathered this year to learn new skills, develop
friendships, and renew a sense of adventure. For
these individuals, it wasn’t just about the extreme
outdoor adventure, it was about breaking down
walls, shattering barriers, overcoming obstacles, and
transforming their life to prove that disability
doesn’t define them. More than 200 certified disa-
bled ski instructors aided in providing each Veteran
an exhilarating, life-changing experience. The clinic
offers instruction and support for all sports (skiing,
snowboarding, sled hockey, snowmobiling, scuba
diving, curling to name a few) to everyone, no mat-
ter their skill level. The program is developed for
the novice, first time Veteran all the way to the
Paralympic, seasoned athlete.
As a member of the Assistive Technology and
P r o s t h e t i c s
team this year,
our goal was
to provide an
optimal seat-
ing environ-
ment and
improve the
Veterans fit
i n t o t h e
sports equip-
ment. This
not only helps
to prevent
skin break-
down, but can
also be important in enhancing their performance
while participating in the sport. Prosthetists were
on hand to provide adjustments to prosthetic limbs
in preparation for skiing and snowboarding. It is a
collaborative team effort to ensure each Veteran’s experi-
ence is safe, effective, and enjoyable.
Since 1987, the Winter Sports Clinic has been leading the
way for adaptive sports programs around the country, and
this year was no exception. Developed through the Univer-
sity of Utah, the Tetra Ski made its debut on the white pow-
der of Snowmass. Developed for low-level tetraplegic and
high-level quadriplegic patients, the Tetra Ski allows individ-
uals to use a joystick or a sip & puff to control the skis and
direct them down the mountain. An innovative device that
proves, anything is possible if you’re willing to try. So put
your hands together and help me congratulate the 430+
Veterans that proved this year that any obstacle is conquer-
able!
Miracles on the mountainside… by: Erin Brandon, PT
I N S I D E T H I S
I S S U E :
TeleRehab Site
Visit
2
Meet AT Staff 2
Veteran’s Story 3
AT Expanding into
Mental Health
4
VACO AT WEB-
SITE: VA ATECH
5
Nuts & Bolts 6
D E P A R T M E N T O F
V E T E R A N S A F F A I R S
PM&R Assistive Technology S P R I N G 2 0 1 8V O L U M E 7 I S S U E 3
When: 1st Friday of
the month
Time: 1pm EST
Continuing Education
is offered for AOTA
and ASHA.
Registration is always
through TMS.
P A G E 2
Richmond, VA and Clarksburg, WV are working
closely to enhance access to specialized rehabilitation
services through a hub/spoke model for TeleRehabili-
tation. As a spoke site, Clarksburg has teamed up
with Richmond for assistance specifically in serving
their Veterans within the amputation system of care
and Veterans with TBI. After several teleconferences
discussing our upcoming site visit, we decided Clarks-
burg would visit the Richmond VAMC to determine
what other specialized services we could offer. We
completed our site visit about a month ago, where
we were able to review our existing programs and
develop an action plan for our future programs. In
addition, Richmond was able to provide individualized
trainings with the Clarksburg staff with our AT, OT
and Speech therapy departments focusing on what
specialty services Richmond could provide to Clarks-
burg Veterans via telehealth.
.
P M & R A S S I S T I V E T E C H N O L O G Y
Clarksburg Visits Richmond
Overall, our site visit was a huge success! Not only were
we able to create a strategic plan moving forward, we
were also able to provide several trainings to the Clarks-
burg TREWI staff in an effort to work toward enhancing
Veteran’s access to assistive technology in Clarksburg.
The Clarksburg staff are planning to consult assistive tech-
nology specifically for specialty wheelchair seating evalua-
tions, AAC for ALS, EADLs and adaptive sports equip-
ment. A special thank you to Melissa Oliver and the AT
team for helping us grow our TeleRehabilitation initiative
forward!
MEET AT STAFF… Brittany Reed, CCC, SLP Brittany Reed joined the AT Program at the
VA in January 2018. She earned her Bachelors in Com-
munication Disorders in 2010 and her Masters in Speech
Language Pathology in 2012 from UVA. For the past 5 ½
years her clinical interest have been the management of
dysphagia, treatment of Neuro disorders (ex: TBI, CVA,
PD) and the integration of technology in therapy. Learn
more about Brittany from her interview,
What do you like about working at the VA?
Of course our Veterans. I love hearing theirstories. It is
such a rewarding experience to have a role in their
rehab experience and to give hope when all hope may
have been lost.
What areas of AT are you interested in and like
working with? And Why?
AT is an umbrella term that covers many types of assis-
tive technology. I am most interested in technologies
that improve cognitive abilities—this could be something
as simple as medication reminders with timers to more
complex systems such as an intelligent personal assis-tant (Alexa).
I also really enjoy working with communication devices
to help provide a mode of communication to some-
one who otherwise doesn’t have a voice or a way of
expressing themselves. It’s tough to imagine a world
where you can’t express yourself or can’t remember
conversations you have had with a loved one. AT
allows us a chance to change that.
Why are you passionate about AT?
It’s my duty to give back and be a blessing to our
Veterans. We live in a world full of evolving technolo-
gy. It is important to me to help others in ways that
extend beyond traditional therapy techniques. The
use of AT enhances what we are already doing and
bring ideas to life. We can use AT to help someone
communicate, move, manage their personal affairs.
With AT opportunities and possibilities are endless. It
is imperative to use every tool we have to better
serve our veterans.
Tell us about other interests outside of the VA.
I am the ultimate foodie and dog lover. Most days I
am exploring new places in RVA with my husband or enjoying nature. I am also a HUGE basketball fan; I
coach a local high school girls basketball team.
Brian Burkhardt, Rehab
Engineer in Richmond VA, provided training to Brianna Cain and Cara
Damn (both OTs from Clarksburg) regarding Electronic Aids to Daily Living (EADLs).
Melissa Oliver, Assistive
Technology Program Director, and Stacy Gross, SLP, in Rich-
mond provided training
to Cris Irwin, Clarks-burg SLP, regarding AAC devices for pa-
tients with ALS.
P A G E 3 V O L U M E 7 I S S U E 3
bridge on the pool stick. It is awesome!”
Where did the idea come from? According
to Seth Hills, one of the AT rehab engi-
neers, “Nicole Shuman, one of our adaptive
sports recreational therapist, came up with
the concept by putting a toy train on the
pool stick to see if it would work and it
did. So, she asked us to further develop the
idea.” There is something similar on the
market, but it is too narrow to get on and
off the pool stick. Seth took approximately
8 hours to design the concept, and approxi-
mately 5 hours to print in nylon using the
AT Program’s 3D Printer. “We went
through three versions before finally com-
ing up with the one that Malik is using.”
Jennifer stated, “Malik is really excited to
play again.”
Motivated to move forward with his life,
Malik is doing more than playing pool,
working hard with staff of the Polytrauma
Transitional Rehabilitation Program to re-
gain his lost strength and skills. Malik is
making regular taking trips into the communi-
ty for both leisure and community reintegra-
tion, and he recently enrolled in the VA’s
Driver Rehabilitation Program so that he can
regain the skills to drive a car again.
“I am so happy with the progress that I see
with Malik Jones”, said Mrs. Vass. “His speech
and comprehension are great, and he is walk-
ing every day. He has made tremendous phys-
ical progress and, maybe more importantly, he
is far more outgoing and happy these days.
Working hard with the right attitude makes all
the difference in the world – for all of us.”
Shooting pool is a pastime many people
enjoy playing including Veterans and
Servicemembers. Navy Corpsman Malik
Jones is definitely one of those individu-
als. For years he played pool every
weekend with his friends and that all
changed, as with most everything else in
his life, on July 29, 2017 when he suf-
fered a traumatic head injury while Malik
was stateside in Virginia Beach, Virginia. Malik suffered a traumatic brain injury
and was left paralyzed on the left side of
his body as a result of this injury.
Malik, who enlisted at 19 years old and
is currently 22, is still active duty Navy,
however his treatment and rehabilita-
tion is being coordinated in partnership
with the Department of Veterans Af-
fairs. When he arrived at McGuire VA
Medical Center’s Polytrauma Rehabilita-
tion Center in Richmond, VA, Jennifer
Vass, a Certified Therapeutic Recreation
Specialist, immediately started working
to engage him back into recreational
activities he enjoyed. He wanted to play
pool, but trying to manage a traditional
pool bridge and the pool stick was next
to impossible. Jennifer had heard about
the 3D Printed rolling pool bridge the
Assistive Technology (AT) Rehabilitation Engineering team had developed, so she
tried it with Malik. “He picked up on it
really quickly and immediately had strat-
egy on how to use it,“ according to
Jennifer. Malik stated that “Depending
on how far away the cue ball is will de-
termine where I place the rolling pool
Small things making a BIG impact on quality of life!
P A G E 4
In 2008 Legislation funded the establish-
ment of four Assistive Technology (AT) Labs. In
2010, The Richmond VAMC opened and began pur-
suing The AT Programs mission, which is “to en-
hance the ability of Veterans and Active Duty mem-
bers with disabilities to fulfill life goals through the
coordination and provision of appropriate interdisci-
plinary assistive technology services and to serve as
an expert resource to support the application of
assistive technology within the VA health care sys-tem.”
The AT program at McGuire VA, continues
to expand and has recently opened an OT/AT Satel-
lite clinic located in the Mental Health Department.
The primary role of the AT Program in Mental
Health, is to evaluate, develop and implement the use
of appropriate assistive technology services, strate-
gies, devices and/or practices to improve the func-
tional challenges faced by service members and vet-
erans in their daily life roles. The AT program in
Mental Health primarily provides evaluation and
treatment for three areas of AT, including: adaptive
computer access, electronic cognitive devices and
learning technologies.
Adaptive Computer Access is a specialized
group of hardware and software designed to enable
individuals with a wide range of disabilities to use a
personal computer. The service members and veter-
ans who would benefit from adaptive computer ac-
cess are those who have experienced a traumatic
brain injury, stroke, multiple sclerosis, amyotrophic
lateral sclerosis, an upper extremity amputation,
upper extremity orthotic injuries/disease, spinal cord
injury and/or those with documented learning disabil-
ities. Some factor’s that are considered when evaluat-
ing someone for adaptive computer access are first
the veteran’s diagnosis/prognosis, and the veteran’s
current cognitive abilities. Other factors that are
considered are, the veteran’s goals (i.e. to return to
school or work…etc.), whether or not the individual
owns a computer/has access to a computer, type
and/or brand of computer they plan to utilize and
what environment they plan to use the computer (i.e.
at home, at work, at school…etc.). Some examples
of adaptive computer access are an adapted mouse
(i.e. Trackball Mouse, Rollerball Mouse, SpaceMouse),
alternative keyboards (LearningBoard, large key key-
board, large print keyboard, etc.), ZoomText, voice
control (i.e. Dragon NaturallySpeaking Software), eye
control technologies, adaptive switches…etc.).
Electronic Cognitive Devices (ECD) are
products or systems that are used by an individual to
compensate for cognitive impairments and support
his or her ability to participate in activities of daily
living (ADLs) or instrumental activities of daily living
(IADLs). The service members and veterans who
P M & R A S S I S T I V E T E C H N O L O G Y
The Assistive Technology Program at Richmond VAMC
Continues to Expand...by Mandy J. Freeman, MS, OTR/L
would benefit from ECDs, are those who have experi-
enced a traumatic brain injury, stroke, multiple sclerosis,
dementia, PTSD, schizophrenia, autism, etc. Typical cogni-
tive issues that these individuals experience are decreased
attention spans, difficulty remembering to do things (i.e.
taking medications, remembering appointments, etc.), de-
creased memory/difficulty remembering name, faces, plac-
es, etc.), difficulty with task sequencing and multi-tasking,
problems with organization, time management, and difficul-
ty with adapting to changes in their routines. There are
several factors/symptoms to consider, when determining if
an individual would benefit from an ECD and to assist in
determining which device would be most appropriate,
including: balance, visual impairment, speech impairment,
auditory impairment, behavioral changes, initiating and
perseverating, and safety awareness. Some examples of
ECDs are an iPad or iPod Touch, smart phones, Livescribe
Smart Pen, smart watches, Ablelink, Personal Information
Manager (PIM) Software…etc. There are a multitude of
different applications (Apps), that can be uploaded to these devices that can assist individuals with time management,
money management, medication management, education,
health management, behavioral management, communica-
tion & visual & hearing
impairment, etc.
Learning technologies are the
broad range of communication,
information and related technologies that can be used to
support learning, teaching, and assessment. Learning Tech-
nologies can assist individuals in many ways, at work or in
school. At work, learning technologies can help an individ-
ual with word finding, word prediction, recalling infor-
mation from meetings/conversations, with document accu-
racy & with reading comprehension. At school, learning
technologies can help an individual with word
P A G E 5 V O L U M E 7 I S S U E 3
If a provider has a patient that has
an identified loss of function, due to illness
or disability and the patient may benefit
from an AT evaluation, then a consult to
the Physical Medicine and Rehabilitation
(PM&R) AT program must be placed. Of
note, the consult must be entered by a
physician, physician assistant or a nurse
practitioner. Once the PM&R AT consult is
received, the service member/veteran will be evaluated by an AT Team Member.
After a veteran is evaluated by an
AT Team Member, multiple factors are
considered when selecting the appropriate
AT device. First, the patient
and caregiver’s goals are
considered. After the pa-
tient and caregiver’s goals
are determined, the AT
team member assesses and
determines what is the least
invasive device available to
meet the patient’s needs.
The patients physical, mental,
and cognitive strengths and
challenges, the setting in which
the device will be used, the
veteran and/or active duty
member’s current knowledge
and usage of devices, the pros
versus cons of the AT device,
the Prosthetic and Sensory
Aids Services’ (PSAS) Clinical Practice Recom-
mendations (CPRs) and the necessary training
time and follow through needed for the pa-
tient to learn to use the device, are all taken
into account and have an impact on which
device is selected.
While the AT Program is designed
to address various needs, to improve the
functional challenges faced by service mem-
bers and veterans in their daily life roles, the AT program does not provide basic computer
skills training, have an open computer lab for
veteran or staff use, or address basic job skills
training. Although this article provides a gen-
eral overview of the AT services that can be
offered to active service members and veter-
ans, in the Mental Health Department, it is by
no means a comprehensive list, of services or
devices. For further information regarding AT
services, at the Richmond VAMC, please visit
the Richmond VAMC AT website at https://
www.richmond.va.gov/services/AT.asp. Also,
another great resource for information on the
different AT categories and AT device re-
views, is the VACO Rehabilitation & Prosthet-
ics Program Office’s Website called VA
ATECH at https://www.vaatech.org/.
finding, word prediction, recalling infor-
mation from class & groups, assignment
accuracy, completing assignments &
reading comprehension. Some examples
of learning technologies are voice recog-
nition software such as “Dragon Natu-
rally Speaking,” word finding software,
such as “Word Q/Spell Q,” document
accuracy software such as “Ginger Soft-
ware,” reading comprehension software such as “Read & Write Gold”,
“WYNN” and/or “Kurzweil 3000,” and
thought processing software such as
“Inspiration.”
AT continues to expand, cont.
VISIT THE NATIONAL ASSISTIVE TECHNOLOGY WEBSITE ...VA ATECH
VACO Rehabilitation & Prosthetics Program Office
launched a new website specific to Assistive Technology
(AT) called VA ATECH: https://www.vaatech.org/
The website provides information about different
AT categories such as electronic cognitive devices, com-
puter access to name a few. In addition, the AT device
reviews are posted on this website which provides an objec-
tive view of the newest AT devices offered to our veterans.
Other tabs include: resources, access to educational webi-
nars and VA AT Connect and VA AT locator which are
ways to locate an AT provider.
remote was inserted into a box and servo
motors controlled by Arduino could press
the buttons for the user. If necessary, the
remote could be removed from the box.
Otherwise the user could control the bed
controller using IR, which could subse-
quently be accessible to the user via an
environmental control unit or adaptive
remote.
Another example is the Sip’n’Puff
Air Rifle. Many veterans enjoy participating
in recreational air rifle, but some veterans
with fine motor deficits may have difficulty
aiming and pulling a trigger in succession.
AT engineer Seth Hills developed an Ar-
duino circuit that controls a servo motor,
which pulls the trigger when activated by a
sip’n’puff switch once the veteran aims.
Seth also created an adjustable mounting
system for the circuit and components so
that it could be positioned correctly on the
air rifle.
A different application of Arduino
can be found in the Gateway Remote, a
project developed by AT engineer John
Miller. Veterans with a traumatic brain
injury may find it difficult to control house-
hold items like a television due to perseve-
In the Assistive Technology Pro-
gram, our aim is to serve veterans by always
solving problems presented to us rather
than giving up. Custom electronics fabrica-
tion is one of the tools we use to create our
best solutions for the most complex prob-
lems. We rely on Arduino, an open-source
computer hardware and software platform
that offers ready-made components for
building circuits and programming them to
perform tasks. Arduino allows novice/
intermediate users to build their skills in
electronics by providing tutorials online, an
online community forum to discuss projects
with other Arduino users, and lots of exam-
ples of programming code with which to
control a circuit. The only costs associated
with Arduino are components and time.
The bed controller is a good ex-
ample of an Arduino project created by AT
staff. Hospital bed controls are usually acti-
vated with low-profile pushbuttons on a
remote, which are inaccessible for people
with quadriplegia or deficits in upper ex-
tremity movement. However, modifying the
bed control remote voids the warranty of
the hospital bed. AT engineer Brian
Burkhardt developed a solution where the
ration, so he created a simplified TV remote
that will turn off a button temporarily after a
user has pressed it until a different button has
been pressed. The circuit designed must read in
IR commands to learn them during set-up, and
it controls when to send the correct IR com-
mands to a TV as intended by the user.
Projects involving Arduino stretch our
skillset and require a large breadth of engineer-
ing knowledge, but they are solutions for when
nothing else exists to help veterans access their
environment. It is a great tool for the AT Pro-
gram that expands our capabilities many times
over.
1201 Broad Rock Blvd
Richmond, VA 23249
Melissa Oliver, OTR/L
AT Program Coordinator
Phone: 804-675-5000 x2134
Fax: 804-675-6134
E-mail: [email protected]
Assistive Technology Program Mission
• To enhance the ability of Veterans and Active Duty members with disabilities to fulfill life goals
through the coordination and provision of appropriate interdisciplinary assistive technology services.
• To serve as an expert resource to support the application of assistive technology within the VA health
care system.
Department of Veterans Affairs
Assistive Technology Center of Excellence
Nuts and Bolts…Creating our own custom electronics with Arduino!... John Miller, AT Rehab Engineering
P A G E 6