Saturday, April 18, 2015

AT in the Classroom: SETTing the Example for using Assistive Technology

Sometimes I take for granted what I have learned about assistive technology, so let me start out by sharing and defining it before diving into examples...

Assistive Technology (AT) is defined in the Individuals with Disabilities Education Act (IDEA) as any item, piece of equipment, or product system, whether acquired commercially off the shelf, modified, or customized, that is used to increase, maintain, or improve functional capabilities of a child with a disability. It does not include medical devices that are implanted, such as cochlear implants.

As part of every Indvidualized Education Plan (IEP), Assistive Technology should be "considered" as part as the child's ability to have access to a Free and Appropriate Public Education (FAPE).

With all that in mind, in this alphabet soup of educational acronyms, how can parents, educators, and therapists search, select, and support children with complex needs?

Using the SETT Model, as developed by Joy Zabala who is a leader in Universal Design for Learning (UDL) concepts, it is recommended to look at four components: Student, Environment, Task and Tool.  First, you look at the Student: what are their strengths, needs, and motivating factors.  Then, look at the Envirnoment: where is the student going to be completing the task?  Third, name the Task: what does the student need to do or learn? Last is the Tools: how is this child going to access the task at hand, as independently as possible?

When I am working with students, I collaborate constantly with a group of amazing therapists and educators.  We try to look at all options from no tech to high tech. You don't want to jump to the iPad with ProLoQuo2Go if it's not going to work to the child's strengths and meet their needs.  Let me give you a few examples:

The Student: A preschool student with significant physical and cognitive disabilities. S/he is able to reach, grab and release with both hands.  S/he is motivated by sensory exploration, food and music.  
The Environment: Student will be completing tasks in the OT room, the classroom, and academic specials like gym, art, and music.  
The Task: develop a means of communicating needs and wants.   
The Tools: 
No Tech: Incorporating the use of gestures, eye contact and vocalizations into activities
Low Tech Option- pictures, like Boardmaker, SymbolStix, or downloaded pictures from the internet.  
Mid Tech Option- voice output single switch with a picture indicating what it says or a swtich activated toy (available through specialty vendors such as Enable Mart  or Able Net or potentially Amazon).
High Tech Option- iPad with Cause and Effect music based play apps such as Inclusive Tech, with a switch and Blue tooth switch interface for the iPad such as the Pretorian APPlicator

During therapy sessions, I use them all.  The combination of all approaches supports intent, initiation, persistence, and communication needs through motivating play. This student must request a turn using a picture exchange to then activate the cause and effect switch based toy/app, indicate more wanted time on the swing, or use of the rice box.  Notice, I haven't attempted to start an alternative and augmentative communication (AAC) app.  S/he is not ready for it yet.  Maybe in the future, maybe not.  

Example 2.
The Student: Student with significant physical mobility challenges. S/he is very bright but has difficult time keeping up with his/her peers during class activities. S/he can type on average at the same speed his peers write; s/he can write single letters and numbers recognizably but large.
The Environment: regular education setting
The Task: S/he needs to be able to complete math, reading, and writing worksheets independently.
The Tools
No Tech: scribing, however this involves an adult or peer to do the work, and the student is dysarthric. Reliability of answers should be considered.
Low Tech: Use a Slant board, built up pencil, and strategic positioning (and repositioning) of materials
Mid Tech:Lap top already available in the classroom with shortcut to a word processing application and a printer
High Tech: iPad with a PDF translation app that takes a photo, turns it into a PDF on which the student can type or draw on, access to email and/or printer

The student uses a combination of all four, again. Now that the student has access to the tech, the need for the scribing is lessened.   Sometimes the child wants to write. So with strategic positioning and his built up pencil, s/he can fill in the blank or draw the lines. But when the writing is more than a few letters or numbers, he can complete his work on either the iPad or the computer.  Is it perfect? Is it up to UDL? No, because in theory, the means of his expressing his knowledge wasn't explored before creating the lesson.  But does it work and give him improved access right now?  Yes.  

Example 3.
The Student: Elementary student with decreased strength and endurance to upper extremities and absent lower body sesnsation.  Also wears glasses.  Enjoys reading and music, but has a hard time comprehending and expressing what she knows.  S/he hunts and pecks on the keyboard.
The Environment: The inclusion classroom
The Task: Reading assignments, comprehension
The Tools:
No Tech: Provide modified educational materials like multiple choice questions
Low Tech: Highlighting strips to visually narrow the area the student needs to which s/he needs to attend. Access to read-aloud accommodations on the ePublished version of the reading program
Mid Tech: Access to laptop with a text to speech app/extension (Read and Write for Google, Readability, etc)
High Tech: iPad with PDF translation app to enlarge the print on the screen and limit visual clutter.  If student has a print disability, may qualify for Bookshare account and could use Voice Dream app on the iPad as well.

Combination of all four.

Notice the trend?  There is no end-all, be-all answer to access needs because depending on the strengths, needs, environment, and task, the tools required will be different.  And it is always a work in progress as the demands of the schoolwork change.  The important thing to take out of this is that you need to ask the right WH questions.  Who? Where? What? and How? Because if you don't know the answer, you can consult with your team or request an Assistive Technology Evaluation from your local AT group, in accordance with your district policies and procedures.  If you're not sure, refer!  

If you want to learn more about SETT, UDL, CAST, AIM, or any of the other Assistive Technology acronyms, there are amazing free and at cost webinars available on-line through AbleNet University, CDT Institute, and AOTA .  And don't forget to make friends with your local AT program!  They can be an amazing resource.

Saturday, March 28, 2015

OTMommy spOTlight on: IZ Adaptive, Where Fashion Meets Function

In the world of fashion, the needs of those with disabilities are overlooked.   But IZ Adaptive is working to change that.  
IZ Adaptive Logo
I was recently drawn to an advertisement for IZ Adaptive on social media.  It is a fashion line that focuses on the unique needs of those using wheelchairs, taking into consideration comfort, function and current fashion trends.   
Separating Biker Jacket for Men from IZ Adaptive
One of my favorite pieces is the Separating Biker Jacket for Men retailed at $449.   The way the cuts accentuate the shoulders while ensuring the ease of donning and doffing is gorgeous! 
Founder Izzy Camilleri is a well-established Canadian fashion designer, whose designs have been photographed on the likes of Meryl Streep, Kirsten Dunst, and Fergie.  But after meeting with Journalist Barbara Turnbull, who happened to be a high level quadripalegic, she began on a new venture that took her creativity rolling in a different direction. In 2009, she began to focus her talents on addressing and dressing men and women with disabilities.  In an email based interview, Ms. Camilleri took analysis of the unique needs of her new clients stating,"I had no idea that someone who used a wheelchair had different clothing needs.  It was a very eye opening experience on many levels."
Women's Tear Away Pant from IZ Adaptive
Women's Tear Away Pant retail $59 offer a a higher back and bulk-free front.
She had to consider topics that traditional fashion designers and people in general take for granted.  For example, skin integrity is an important issue for people with decreased or absent sensory awareness, such as in spinal cord injuries, multiple sclerosis, and Lou Gehrig Disease.  When fabric bunches and moisture build up, friction, heat, and sores can occur.   She also had to consider how the act of getting dressed and undressed can be helped or hinder by the type and placement of fasteners.
Open Back Jeans from IZ Adaptive
Open Back Jeans retail $79 offer easy donning wrap around panel with velcro strip.
With ideas in hand, IZ Adaptive was born. Ms. Camilleri uses fabrics that are soft to the touch and that have stretch to them allow for ease of donning and breathability.  In some of her designs she made zippers longer or used magnets instead of traditional buttons since standard buttons and zippers can be a significant struggle for those with fine motor difficulties.
Men's casual magnet shirt from IZ Adaptive
Men's Casual Magnet Shirt, currently on sale $29.99 uses magnets for easy fastening and an A line cut for a flattering fit.
There are pieces to fit every budget and need.  Her line includes informal apparel, work apparel and evening wear with prices ranging from $9.00 Knees Together Strap to a $650 Wedding gown.   Dress shopping in itself can be difficult, for any woman, physically and emotionally.  Women who use wheelchairs can visit the website and discover pieces in which they can feel beautiful and comfortable for the upcoming prom and wedding season.  Ms. Camilleri hopes to further expand the evening wear selection. Even browsing is made easier because each item is detailed with information tabs on fabric choices, care, and function.
Grace Strapless Gown from IZ Adaptive
Grace Strapless Gown retail $375
At this time, expanding the line to include other cut designs so that people with other physical impairments such as limited range of motion and limited strength is not in the works.  But that's ok since IZ Adaptive offers specific alterations through their website.  Custom designing is also available to those in the Toronto area and is priced according to the project and level of difficulty. 

Many of her other designs have been featured in international magazines like Vogue and Flare.  When asked about ever seeing IZ Adaptive designs in the spotlight, Ms. Camierelli said, "We have had our IZ pieces used in Fashion Magazines on high fashion models.  They were used in a different context of high fashion on able bodies models.  We are already seeing alternative models on runways during this past Fashion Week in NY, so I think we will see more and more exposure for fashion going to the next level."

So if you know someone who happens to use a wheelchair and is looking for clothing that fits their style and budget, as well as their seated posture, consider looking into IZ Adaptive, where fashion meets function.

Saturday, March 21, 2015

'Appy Hour Review: Mod Math

Gotta love social media for the free, fun, and functional finds.  I came across ModMath via Twitter and immediately downloaded it for my iPad to try it out.  This app may be a game changer for children who have difficulty writing and organizing basic math problems.
Available only on iPad, ModMath was created by a family whose son has dysgraphia and dyslexia.  He was struggling to his represent his math work on paper.  Now they are sharing their app for free on iTunes.

ModMath is fairly customizable.  You have the option to change the contrast, color of number font, and provide alternative row/column contrast.
When you open a new page, you are presented with a graph paper style grid.  Once you tap on a space, a number and symbol keyboard will appear.  But don't be fooled.  This is NOT a calculator.  It only provides the user with a means to clearly type numerals and symbols.
It took only a few tries to get how to use it.  For example, if you have to do long division, you first have to touch the paper, select the long division symbol, then touch the grid again where you want your numbers to create your equation, continuing this process as you solve the problem.
 As for carrying and cross outs, they have that covered too; they also included fractions.

The lines that differentiate between steps appear automatically if you place them in the box just prior to the number that you want to add, subtract, multiply or divide.

What I really like about this app is that you can see the work, the process, as well as the result, without it automatically giving the student the answer.  The ability to visually organize the numbers in clear columns and rows is a skill with which so many children struggle.  Bonus feature, the student can email the teacher, parent, tutor his/her work, or himself in case he wanted to print out a copy.  Just select how you would like to send it and it will create a PDF of each work session.  When the recipient receives the PDF file, it comes without grid lines.
A few things options I hope they consider in the next update: 1. to a direct print option and 2. the ability to type name and date at the top of the paper. (You can name the session/file).

ModMath creators are currently working on a KickStarter Campaign for an algebra version of this product too.  If you want to discover more about ModMath or its campaign, check out