2006 Conference General Sessions

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Douglas Rakoski
Center for Applied Rehabilitation Technology (CART) – Rancho Los Amigos National Rehabilitation Center
7601 East imperial Highway
Downey CA 90242
Day Phone: 562-401-6815
Fax: 562-803-8892
Email: drakoski@ladhs.org

This session will include an evaluation of current EADL devices and their features, operation and price.  In addition, how to assess for EADLs will be discussed.

The Center for Applied Rehabilitation Technology (CART) at Rancho Los Amigos National Rehabilitation Center enables individuals with physical disabilities to lead more independent lives through the use of assistive technology.   CART's interdisciplinary team provides a full range of services including evaluation, recommendations, equipment set up and instruction.   Many individuals seen at CART are unable to control their environment.   A proper assessment helps determine the types of electronic aids to daily living (EADLs) that best match a client’s needs and goals.

As technology advances so do the choices for EADLs. New technologies can offer many choices in EADL’s and deciding what options are truly needed can be a difficult task. An EADL provides independent control of lights, appliances and devices. Anything that is electrically powered can be operated by an EADL. Common devices that are controlled by an EADL are: light, fan, radio, TV, VCR, DVD, telephone, fan, alerting systems, electric bed, door opener, and more. EADLs can control one electrical device or many devices based on the needs of the client. These devices are controlled by a remote control (transmitter and receiver) through ultrasound, infra-red or radio waves.

An evaluation is required to identify what the client wants to control in the environment and to prioritize their needs. The purpose of the evaluation is to identify individual goals of the client and their expectations of technology, vocational and educational goals, family/agency goals and recreational interests. The assessment includes the client’s daily routine within the different environments, location of devices in the home, number of devices to be controlled, layout of home, and compatibility with other equipment in the client’s daily life.

The functional abilities of the client are assessed to determine the access method, type of feedback required, and the number of steps the client can follow. Physical evaluation includes the assessment of motor control, strength, range of motion, endurance and voice quality. Sensory evaluation includes assessment of touch and proprioception, hearing and vision. A vision assessment includes visual attention, acuity, fields and the ability to track a moving target. If an EADL is needed in more than one environment, each environment will need to be explored. Other people that share the same living space as the client will need to be kept in mind. They may need to control some of the same items (TV, DVD, lights) without affecting the client’s ability to be independent. Where the client will be using the device from also needs to be determined (wheelchair, bed, other seating areas).

EADLs are typically accessed through direction selection or switch scanning. Direct selection includes the use of a keypad, voice or joystick. Scanning includes the use of single, dual, or multiple switches. These switches vary in size, sensitivity, travel distance, feedback, and durability. Switch feedback includes tactile, visual and auditory cues. Optimal position for the device and switch needs to be determined.

When selecting an EADL, device features also need to be evaluated. These options include the number and types of devices to be controlled, transmission (ultrasound, infrared or radio waves), access methods, setting changes (scan rate, switch latched or momentary), feedback provided (auditory, visual, or tactile), sequence to operate, training requirements, flexibility and/or expandability, reliability, ease of maintenance, local support, and price.

Another consideration to keep in mind with all of the EADL devices on the market today is the ability to integrate with other technologies such as computers, communication devices, and wheelchairs.  

This session will explore low technology to high technology options currently available. Evaluation of these devices will include access methods, basic features, options, feedback, operation and price.  Results from a retrospective review will be shared regarding trends in the types of EADLs recommended for clients with various physical disabilities. Information regarding long-term use of EADLs will also be discussed.

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