Thursday, 17 May 2012

Assistive Technology

Assistive Technology Stoller, 1998, defined Assistive Technology (AT) as “special devices or structural changes that promote a sense of self-competence, the further acquisition of developmental skills into occupational behaviours, and/or an improved balance of time spent between the occupational roles in an individual’s life as determined by the individual’s goals and interests and the external demands of the environment” (p. 6)

Basically put AT is something that increases, improves or maintains someone’s functional capability. This can be through methods such as computers, augmentative communication devices and environmental control systems.

One piece of AT that is commonly available is a switching device attached to a children’s toy. The child presses the switch and, depending on the toy, there will be a response (usually movement or music). This helps to teach the child basic cause and effect relationships. The game play and entertainment aspect is another very important reasoning behind switch activated toys. To a child play is meaningful occupation. Play is the arena for the development of sensory integration, physical abilities, cognitive and language skills, and interpersonal relationships (Knox, 2010). The switch activated toys can also promote social interaction between child, therapist, family and other children. The toys may provide a discussion point and the musical toys may provide an opportunity for a sing-along or dance/gentle movement.

Without the use of assistive technology children with physical disabilities may face occupational deprivation. This is the inability to engage in desired and appropriate occupations because of some external restriction (Parham, 2008). Through playing with switch operated toys children may be able to partake in otherwise unattainable activities.

Here is a video from AbleNet Inc demonstrating switch activated toys:

Switch Activated Toys

Here is information on one type of toy that is permanently switch adapted:

Train Conductor Bear

Here is information on one type of switch that is recommended for use with the above toy:

Jelly Bean Switch


Knox, S. (2010). Play. In J. Case-Smith & J. O’Brien (Eds.), Occupational therapy for children (6th ed.) (pp. 540-554). Missouri, USA: Mosby Elsevier.

Parham, L.D. (2008). Play and occupational therapy. In L.D. Parham & L. Fazio (Eds.), Play in occupational therapy for children (2nd ed.) (pp. 395-412). Missouri, USA: Mosby Elsevier.

Stoller, L.C. (1998). Low-tech assistive devices: A handbook for the school setting. Framingham, MA: Therapo, Inc.

Linking to blogs of interest and exchanging comments

This blog is to draw your attention to the right hand side of the page where I have added a live feed from five different blogs that relate to Occupational Therapy practice.

An example of comments exchanged are:

What a great demonstration of the concepts doing, being, becoming and belonging! Well done on choice of activity- nice to see the children doing the activity themselves- best way to learn. And of course having the end product would be very rewarding :)
Was there an emphasis placed on the importance of shared meals/food at the child care centre you were at?
Yes there was. It was to help with routine and what children were expected to do at meal times. The centre is one big family, it was so cool and so believes in like heaps of free play and kids discovery who they are

The internet and online communities

This blog post is about paediatric online communities. There are three online communties described and linked below. Following that are ethical considerations when using an online community discussion forum and benefits and limitations these have.

The intended purpose of this site is to provide a discussion forum for parents and carers of children with autism spectrum disorder (ASD). The blog is interactive however you do need to create an account and log in to contribute to discussions. An example of what people can contribute is evident through a recent post about a family whos son was recently diagnosed with ASD. They are asking for help interpreting some of the hospital results and asking ‘where to from here’. People are responding with kind messages and support.

This discussion forum is active with a range of people- people with cerebral palsy (CP), carers, friends and others interested in CP. There is a wide range of discussion about recent diagnosis, links to other resources and mobility tools. You need to create an account and log in to contribute to discussions.

This forum is designed for those where someone they love has Downs syndrome. There is a huge variety of forum topics to post in. These include general information, dual diagnosis, education for the person with Downs syndrome and a ‘Brags’ section to brag about how well your child is doing. You need to create an account and log in to contribute to discussions.

I believe that people contribute to an online community to find people who may be dealing with some of the same things in life. It is a reciprocal exchange of information. Ethical considerations that need to be taken into account are that the information is not from a medical source- it is a personal, subjective experience. This can provide very beneficial/useful information but may be contradictory to what the health professions say. With an online community/discussion forum there is also a lack of accountability due to being relatively identity free. While all of the sites will eventually remove any post that is malicious or hurtful, once something is on the internet it is hard to fully get rid of.

Benefits of online communities/discussion forums are that it allows people to talk to others who may be experiencing similar things. Some people may feel embarrassed or intimidated by their health professional and are unwilling to talk to them about issues they may be facing. It can provide a great deal of support for people.

Limitations could be the accuracy of the information and the relevance for one child to another. (As in what may work for one child may not for another).

All in all I believe that online communities/discussion forums are predominantly beneficial offering information, ideas and support.

Sunday, 13 May 2012

Paediatric Occupational Therapy - videos

This video shows a young girl speaking through her Tobii (assistive device).

This video is of an Occupational Therapist and the ways he works with children using sensory integration.

This video shows an Occupational Therapist working with children with autism.

This video shows an Occupational Therapy student displaying her "Paediatric toolbox" and the toys/objects that she used with the children.

This video is an Occupational Therapist showing the multiple uses for bubble wrap in paediatric Occupational Therapy.

Occupational Transition

Our video demonstrates occupational transition in the situation of moving from the workforce to becoming a student again. To make this short film our group of six discussed the differences that occurred in our life when we made the decision to study. For many of us this involved moving away from our home, to an unknown city with all new challenges. The new life and challenges involved new sights, events, environment, lifestyle and stressors. During this film we were reminded of the frustrating side of technology. When going to upload the film from camera the computer would not read or recognise the file type! After a long period of time we managed to get it on the computer only for the computer to crash and lose our work. . . Ahhh technology :) ...

Doing, being, becoming, belonging...

The concept of ‘doing, being, becoming and belonging’ is important in Occupational Therapy. Following are definitions:
Doing: “The concept of doing includes purposeful, goal-oriented activities; doing has been the traditional preoccupation of occupational therapy” (Hammell, 1998, p. 301).
Being: Hammell, 1998, defines this as “… time taken to reflect, be introspective or meditative, (re)discover the self, savour the moment... and to enjoy being with special people” (p.301).
Becoming: Hammell, 1998, describes this as the idea that “people can envision future selves and possible lives, explore new opportunities and harbour ideas…” (p. 302).
Belonging: “Belonging, within a network of social support can underpin both the ability to do and contribute to the pleasure and meaningfulness of doing” (Hammell, 2004, p.302)
I have attempted to demonstrate ‘doing, being, becoming and belonging’ through the slideshow using photos of craft (some of which are off the internet and some from my Fieldwork 2 placement). My Fieldwork 2 placement was at a day programme for adults with intellectual and physical disabilities. The focus was on meaningful occupation and they held a craft group once a week. I have not had a lot of involvement with craft- just completed small projects like basic scrapbooks.
It is difficult to separate which slide/image is which concept as many of the concepts are inter-related (e.g. group (belonging) working on project (doing)). The images show a variety of things ranging from group crafts, individual projects, equipment and craft in the community.
Ethical considerations I made in relation to this slideshow were to make sure no people from my Fieldwork 2 placement were shown in photo (as they have not consented to appearing), referencing all online sources appropriately, and choosing images that are appropriate for public viewing (no pieces of craft that would likely cause offense to an individual).
      Hammell, K. W. (2004). Dimensions of meaning in the occupations of daily life. Canadian Journal of Occupational Therapy, 71(5), 296-305.

Tuesday, 20 March 2012

Information Technology and Ethical Issues

As indicated in the title this posting will focus on Information Technology (IT) and the ethical issues surrounding IT use. Aksoy and DeNardis (2008) define information technology as “…systems of hardware and/or software that capture, process, exchange, store and/or present information, using electrical, magnetic and/or electromagnetic energy (p.8).  To me this includes, but is not limited to, things such as digital cameras, cell phones, internet, computers , televisions and external hard drives.
                Technology has become so common in society that a lot of people are dependent on it. Personally, before I even get out of bed in the morning the TV will go on and I will be on my laptop checking Facebook, emails, daily specials, weather and banking. Then I’m on my way to class, in my car with an electronic computer, passing through speed cameras (slowly!), CCTV cameras and traffic lights. I will stop at the supermarket to purchase an item through the self-checkout and will pay by EFTPOS. I will arrive in class where the lecturer will have the computer on projecting images, videos and audio to the class. Following class it is expected that we are back on a computer to do ‘self-directed learning’. I will check my cell phone, make a call, send an email, Skype my family and pay a bill online. This is all my own personal experience but I imagine there will be a lot of people whose days and routines are somewhat similar.
                The amazing changes that have been happening in technology and how these have penetrated into our society are demonstrated in the following Youtube video:

I can see the benefits and disadvantages of technology. For myself, the benefits include ease of access to information (news, weather), services (banking, booking, paying bills) and easy social interaction or communication with people you may not see on a day to day basis (Facebook, Skype, email). However, at the same time there are just as many disadvantages. There is the issue of security of information when using credit cards online or logging into an online banking service or personal security when putting personal information (name, age, location) online in places such as Facebook. There is the horror of realising the computer has frozen before document has been saved thus losing all of the hard work! There are also ethical implications when using technology- this will be discussed in further detail later.
Now to focus on IT in OT – that’s information technology in occupational therapy! In my Fieldwork 1(FW1) experience IT was not widely adopted. This may be due to being in a rural setting and the hospital not having the technology available. The notes were still handwritten and stored in a filing cabinet and faxes seemed more commonplace than emails. However I can envisage IT being a very useful tool of occupational therapy practice. For practitioners this can allow ease of information sharing. For the client this can be things such as memory aids (reminder on cell phone), online communities (for support and information) and interactive computer games such as the Nintendo Wii. Further information on IT in OT can be found in the following article:
Mainstream technology as an occupational therapy tool: Technophobe or technogeek?
            Last but not least I will briefly discuss the potential ethical implications that may arise when capturing, sharing and transferring information via IT devices (cell phone) or systems (Internet). When transferring information through a generally open system such as the internet there is a risk that information will end up in the wrong hands. This is of particular concern when it is something confidential such as an email between health practitioners discussing a client and their medical needs. Ethical implications may also arise when an image is captured and shared, possibly through a digital camera and uploaded onto a social networking site. Once something is uploaded onto the internet it is very, very difficult for it to be completely erased if the need arises. . . Speaking of which it is time to upload this (never to be successfully erased) post. J

Aksoy, P. & DeNardis, L. (2008). Information technology in theory. Boston, Massachusetts: Thomson Learning Inc.