2004 Conference Proceedings

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WORKSITE COMPUTER ACCOMMODATIONS FOR INDIVIDUALS WHO MUST WORK FROM A RECLINED POSITION

Presenter(s)
Taylor McConnaughhay, MS
Workforce and Technology Center-Maryland
Division of Rehabilitation Services
2301 Argonne Drive
Baltimore, MD 21218
Phone: 410 554-9212
Email: tmcconnaughhay@dors.state.md.us

Ann Reed, OTR/L
Workforce and Technology Center-Maryland
Division of Rehabilitation Services
2301 Argonne Drive
Baltimore, MD 21218
Phone: 410 554-9551
Email: areed@dors.state.md.us

Through the use of case studies, this presentation will provide lessons learned and considerations applied in providing computer access accommodations for an individual who must work from a semi-reclined or reclined position.

Background

The Rehabilitation Technology Services (RTS) is a program of the Workforce and Technology Center (WTC), Maryland Division of Rehabilitation Services, Maryland State Department of Education. The WTC is one of nine state-operated comprehensive vocational rehabilitation centers in the United States and is accredited by the Commission on Accreditation of Rehabilitation Facilities (CARF).

The RTS assists workers with disabilities select, acquire and use accommodations to succeed in the workplace and live independently using an interdisciplinary approach. This assistance is provided through assistive technology and workstation ergonomic assessments, consultation, equipment setup, and training. The team providing worksite accommodations consists of a wide variety of professionals including rehabilitation technologists, Occupational Therapists, Physical Therapists, and case managers. Because the RTS is a part of the comprehensive rehabilitation center, the full staff of the WTC including physiatrists, Speech Language Pathologist, Vocational Evaluators, design and fabrication, and others are available as needed for ancillary services.

Individuals are referred to the RTS for services through the state vocational rehabilitation field program, Veterans Administration, worker's compensation, other state agencies, and directly from employers wishing to provide appropriate accommodations to their employees.

Problem

In recent years, the RTS has received an increasing number of requests for work site accommodations for computer access for individuals who must spend significant amounts of time in a semi-reclined or reclined position. In some cases the individual must be in a reclined position for a certain portion of their day, while others spend the entire time in that position. These cases have included individuals with spinal cord injury, multiple sclerosis, rheumatoid arthritis, fibromyalgia, chronic pain, morbid obesity, lower back problems, psychiatric disabilities, and lymphedema. There have been other cases where the individual needs these accommodations intermittently, for example an individual with sickle cell anemia.

Solutions

When determining appropriate computer access methods for these individuals, best practices for providing accommodations are followed by the RTS as with any other individual. However, working from the reclining position amplifies some common issues and considerations while introducing some unique concerns.

We have determined the following important issues and considerations when working with individuals working from a reclining position.

  1. Depending on the individual's functional limitations, job responsibilities, and other factors, a range from simple adaptations, to complex modifications to exorbitantly expensive commercial reclining workstation solutions may be appropriate.

  2. Frequently modifications must be made to commercial reclining workstations to enable an individual to operate it independently and to make it functional.

  3. Safety issues need to be addressed. Frequently equipment must be suspended over the individual. Selection of appropriate monitor, workstation, seating, and access methods must be made to ensure the safety of the individual.

  4. Individuals often need or want to vary their position in the chair or bed. It may be necessary to encourage the individual to select only one or two positions for maximum use of the computer.

  5. Equipment may need to be mounted in such a way that the individual can reposition it independently and safely.

  6. Consideration must be made for a person's motor and sensory abilities when evaluating a reclining workstation. These skills may be affected when the person is reclined

  7. Different tasks may require different positions. It is not always feasible to accommodate every job task in the reclining position.

These issues, considerations, and lessons learned will be illustrated through case studies of successful and unsuccessful worksite accommodations. Discussion on these issues will be encouraged.


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