2002 Conference Proceedings

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ASSISTIVE TECHNOLOGY: SOLUTIONS THROUGH CASE STUDIES

Barbara Phillips, MS OTR
CART - Rancho Los Amigos National Rehabilitation Center
7601 East Imperial Highway
Downey, CA 90242
Phone: (562) 401-6805
Fax: (562) 803-8892
Email: bphillips@dhs.co.la.ca.us 

Carlene MacBride, MA CCC
CART - Rancho Los Amigos National Rehabilitation Center
7601 East Imperial Highway
Downey, CA 90242
Day Phone: (562) 401-6803
Fax: (562) 803-8892
Email: cmacbride@dhs.co.la.ca.us 

Bobbi Jean Tanberg, COTA
CART - Rancho Los Amigos National Rehabilitation Center
7601 East Imperial Highway
Downey, CA 90242
Day Phone: (562) 401 -6810
Fax: (562) 803-8892
Email: btanberg@dhs.co.la.ca.us 

Andy Lin
CART - Rancho Los Amigos National Rehabilitation Center
7601 East Imperial Highway
Downey, CA 90242
Day Phone: (562) 401-6811
Fax: (562) 803-8892
Email: alin@dhs.co.la.ca.us

The Center for Applied Rehabilitation Technology, CART at Rancho Los Amigos National Rehabilitation Center is an assistive technology center located in Downey, California. The population served at CART consists of individuals of all ages and with a wide range of physical disabilities. Clients are evaluated and treated in the areas of augmentative and alternative communication, computer access, electronic aids to daily living and seating, positioning and mobility. The CART team is unique because members from each therapy discipline work together in a dedicated building. If a client comes in for augmentative communication, but they are not seated properly, CART has the advantage of having a physical therapist present that can properly seat the client before moving forward with the evaluation. Many of the clients coming to CART have multiple technology needs.

Case study examples will reflect the benefit of the interdisciplinary team and on-going intervention when evaluating and making recommendations for assistive technology. Examples will include solutions for access to the computer, augmentative communication and electronic aids to daily living.

Examples of some of the types of case studies that will be reviewed are as follows. A 7-year-old child with Cerebral Palsy who attends school and needs independent communication technology. She has moderate hypertonicity and is taking medication that causes dramatic fluctuations in her motor control and attention. She was seen three times by the CART team before a trial device with reliable access method was determined.

A 21-year-old college student, who suffered a brain stem stroke and spinal cord injury, is paralyzed from the neck down. He was in and out of the hospital for a couple of years. Upon his last visit at Rancho, an access method for his computer was determined. He discharged to a facility where he received physical assistance. Several months later, he moved into his own apartment with part time attendant care. CART once again saw him for a method to control his environment. He currently attends college and is living independently with part-time attendant care.

A gentleman with a high level spinal injury who had never used a computer was evaluated for access while an inpatient. The initial recommendation was set up with a mouthstick and docking station and some adaptive software. Approximately one year later, he requested assistance from CART to be evaluated for electronic aids to daily living. He was doing well with the computer and realized the potential. Enrolled in college to take classes in order to be productive with his new situation, he had purchased speech recognition software and was successfully using it in conjunction with his mouthstick. With his new EADL, he is living in his new home and completing his degree in Psychology.

A young man in his 20's with Cerebral Palsy and difficulty communicating came to CART for an AAC evaluation. He is ambulatory and working part time as a landscaper. His access is direct selection and he is able to recognize familiar words, but is not a functional speller. He is presently attending college to study landscaping and needed a portable communication system. The system had to be programmed to meet his needs in the different environments where he spends his time.

A gentleman with ALS has had a great support network. He came to CART when all efforts were tried and the support network could not find a solution for access to his communication system. He is using a fiber optic switch at his eyebrow and is being evaluated for an eye-tracking system. His goal is to return to his work as a psychologist.

These are only some examples of the types of cases seen at CART. Often times, clients will return for several visits until the evaluation is completed. There are pros and cons to a center-based technology evaluation clinic. Clients come for a short period of time, they are out of their natural environment and often without the caregivers that spend time with them. The advantage to having a center-based clinic is that all the staff are readily available and any equipment needs can be immediately addressed.

There will be an opportunity for questions and answers after each case study presentation.

ENDNOTES: This will be an opportunity for individuals working in the area of assistive technology to see how a dedicated technology team problem solves more complicated cases.


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