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Easy & FUNctional Solutions! AT for Children with Severe Disabilities

Elaine Finkelstein, MS, OTR/L
Jennifer Bilyew, MS, CCC-SLP
The Hospital for Sick Children
Washington, DC

This exciting session will reveal simple Assistive Technology strategies and solutions for children with severe to profound cognitive and/or physical limitations.

Evaluating the AT needs of children with severe to profound cognitive and/or physical limitations can be an overwhelming and frustrating experience. The very idea of starting an AT evaluation may seem like a daunting task when faced with the unique challenges of this population.

Some of the specific challenges that we have faced with this population will be discussed. Challenges that will be highlighted are organized into the following 4 categories:

AT Challenges related to

Lack of Identified Access Site (secondary to sensory impairments, cognitive limitations, or movement disorders) Evaluating the Medically Fragile (vents, tracheas) Inconsistent Responsiveness Rejection/Abandonment of Assistive Technology

The majority of the session will be devoted to discussing the strategies/solutions we have found to help during AT evaluations, training, and implementation. Solutions revealed will be tied to challenges discussed to help empower evaluators. Some solutions to be discussed are as follows:

Performing a multidisciplinary evaluation (OF, PT, SLP, Education) Specifically addressing all sensory, cognitive, motor, and positioning needs Complete a parent questionnaire with personal information and how the child responds to strangers (family-centered approach) Achieving a good baseline through observations (with family and peers in various settings) Objectify what you are looking for Using non-conventional access sites (cheek, palm, knee) Acknowledge "windows of opportunity", and effects of medications Using an entire continuum of AT options (spelling boards, simple voice output devices, call bells) Consider the barriers to AT acceptance/performance; consider the nature of the child's condition and their reason for needing AT (i.e. trauma vs. developmental delay)

The last part of the session will target easy and FUNctional ways to implement Assistive Technology in various settings (hospital, school, home). Ways to adapt activities using technology will be discussed. Examples are as follows:

• Hospital: tape recorders, adapted call bells, Winsford Feeder, remote controls
• School: calling out attendance, sending messages to the principle, washing the blackboard, circle time leader
• Home: drying dishes, cooking, pouring ingredients, blender, vacuuming, blow drying hair
• The final portion of the session will provide the audience with some time to share/problem-solve their largest challenges and most exciting solutions.

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