Changing role of OT: “E”nabling

Lynne Allsopp Highly Specialist Occupational Therapist

Access to Communication and Technology, West Midlands Rehabilitation Centre

ACT

•  Regional NHS Tertiary Assistive Technology Service: all ages and conditions

•  Mission statement – To work with patients/clients and their local

teams to assess and provide techniques and technologies which optimise the potential for communication and control

–  Staff: OT, SLT, Clinical Scientists, Workshop team, Administrators: about 30+ people

•  Other teams in UK are similar but each is unique

Starter for 10!

•  Do you/how do you use the internet in your current practice?

•  Where would you look on the web for OT resources?

•  Have you ever communicated with a OT colleague online (except email!)?

•  Have you ever “e”nabled a client, i.e. used a computer based occupation?

Professional resources

OT/As: knowledge sharing, developing resources, publicity and marketing, “lean” working

Occupational Media

ADL: shopping, banking Social activities: dating, connecting with friends Education/support: courses, peer support

groups Political/self advocacy: digital petitions,

consultations, comments, emails Leisure occupations: music and video, games Online work and volunteering Creative activities: writing, artwork, photography

Occupational Media

Computers play a part on almost every area of our daily lives in one form or another (Blain, McKeever, & Chau, 2010)

Chard (2007) acknowledges emailing, playing games online, editing pictures or music on a computer are some of the arts and crafts of our age

Digital Inclusion

A recent BBC World Service poll found that almost four in five people around the world believe that access to the internet is a fundamental right (BBC 2010).

In Finland access to the internet is a legal right (CNN 2009).

Digital Divide

“The gap between those who have access to, and use and control of the internet and digital media; and those who do not” (Goldfarb & Prince, 2008; Smedema & McKenzie, 2010).

Accessibility

The internet has been proposed as a liberating space for people who in offline life face many disabling barriers (Childers & Kaufman-Scarborough, 2009; Dobransky & Hargittai 2006; Guo, Bricout & Huang 2005)

Accessible? (DRC 2004)

I can’t afford it

I have no idea how to use a computer

I don’t know what you can

do on a computer!

I’m not good with

technology, I might break it!

I need help to understand how to

do new things

I don’t want to be a victim of identity

theft

I have trouble using a mouse and keyboard

I have a sensory

impairment

I have trouble using a keyboard and mouse

•  Customisation

•  Alternative Input

•  Software

Computer Customisation

•  Simple modifications available on the computer to make access easier.

•  Mouse, Display and Accessibility Options can be adjusted

Windows and Mac operating systems

Computer Customisation

•  Display Settings •  Keyboard Settings •  Mouse Settings •  Accessibility

This varies between operating systems and also between Windows and Mac.

Customisation: Keyboard

•  Adjust key repeat rate •  Filter out unwanted key presses •  Sticky keys- will automatically hold

Shift, Alt or Control keys down •  Keyboard shortcuts

Customisation: Windows Accessibility Options

Holds down Shift, Control, Alt or Windows key for one press to remove need for holding a key down.

Helps to reduce number of accidental key presses

Other Accessibility options are useful.

Customisation: Mouse

Switch left and right buttons over

Adjust the double click speed

Click Lock will hold down the mouse button while user drags curser across screen

BUTTONS

Customisation: Mouse

Change the pointer schemes from list

Can also import new cursors e.g. Priory Woods

POINTERS

Customisation: Mouse

Adjust sensitivity of the mouse curser

Snap to points on the screen automatically

Helps to locate mouse curser on screen

Customisation: Mouse

•  Adjustment of the Mouse and Trackpad •  Assignable Mouse Buttons

Customisation: Windows Accessibility Options

Also access Magnifier, Narrator & On Screen Keyboard through menus

Accessibility Options

•  Voice Recognition •  Screen Reader •  Screen Magnification

Accessibility Options

•  On screen keyboards

Input to the computer

What is an input to the computer?? •  Mouse •  Keyboard •  Something to control what you want to do on

computer •  Maybe start with wireless

Alternative Inputs to the computer

Physical Access •  Mouse/ Cursor Control

– Glide pad - USB – Tracker ball – Joystick – Head mouse – Eye Gaze –  Integra Mouse – USB Finger Mouse

Alternative Inputs to the computer

Physical Access •  Mouse/ Cursor Control

– Glide pad - USB – Tracker ball – Joystick – Head mouse – Eye Gaze –  Integra Mouse – USB Finger Mouse

Alternative Inputs to the computer

Physical Access •  Keyboard

–  Key guard, –  Single hand keyboard –  Keyboard size

•  Alternative to mouse / keyboard –  Switches, On-screen keyboard –  Touch screen –  Communication Aid

Alternative Inputs to the computer

Physical Access Voice •  Voice recognition software

Computer Access: Software

•  Freeware – On Screen Keyboards – Mouse Click Emulators – Dwell Click – Auto Hot Keys – Steady mouse – Mouse Wrap

Access to the computer: Switches

i.e. bypassing the mouse and keyboard completely

•  Attaching them to PC: – Joy Cable, Crick box – Switch driver

What next?

Page turners…… eReaders

More possibilities…

•  Texting via the computer •  Environmental control •  Communication

Further Training

•  Local Resources •  Ability Net – Skill sheets and fact sheets •  ITCH •  RNIB •  Aidis Trust

Practical next steps

•  Go and play on your computer! •  How you use a computer in your personal

life? •  How you use a computer in your work life? •  Reflect: what are my concerns? •  Discuss in your teams •  Find out about local IT training services •  Research relevant charities

Resources

www.actwmids.nhs.uk www.ace-centre.org.uk

www.abilitynet.org.uk/myway/

www.microsoft.com/enable/

www.apple.com/accessibility/ www.aidis.org/

References & Resources

•  www.keytools.co.uk •  www.qedltd.co.uk •  www.inclusivetechnology.co.uk •  www.lakefolks.org •  www.cameramouse.com •  www.wivik.com •  www.orin.com •  www.nuancestore.com •  www.smartboxat.com •  www.cricksoft.com •  www.microsoft.com •  www.apple.com

References

Blain, S., McKeever, P. & Chau, T. (2010) Bedside computer access for an individual with severe and multiple disabilities: A case study. Disability and rehabilitation. Assistive technology. Early Online 1-11

Chard, D. (2007) Computer games and karate: the arts and crafts of today. British Journal of Occupational Therapy. 70 (8) 329

Childers, T. & Kaufman-Scarborough, C. (2009) Expanding opportunities for online shoppers with disabilities. Journal of Business Research. 62 (5) 572-578

Disability Rights Commission (2004) The web: access and inclusion for disabled people. Available online at: http://www.ifap.ru/library/book427.pdf Accessed 14/05/2010

Dobransky, K. & Hargittai, E. (2006) ‘The disability divide in Internet access and use’, Information, Communication & Society, vol. 9, no. 3, pp. 313–334.

CNN Fast Internet access becomes a legal right in Finland. http://edition.cnn.com/2009/TECH/10/15/finland.internet.rights/index.html Accessed 14/05/10

BBC. Four in Five Regard Internet Access as a Fundamental Right: Global Poll http://news.bbc.co.uk/1/shared/bsp/hi/pdfs/08_03_10_BBC_internet_poll.pdf Accessed 15/05/2010

Goldfarb, A. & Prince, J. (2008) Internet adoption and usage patterns are different: Implications for the digital divide. Information Economics and Policy. 20 (1) 2-15

Smedema, S. & McKenzie, A.(2010) The relationship among frequency and type of internet use, perceived social support, and sense of well-being in individuals with visual impairments. Disability and rehabilitation. 32 (4) 317-25

Contact me

•  Lynne.allsopp@nhs.net