Monthly Archives: January 2017

The Amazon Echo as an Accessibility Support

By: Judy Gardner, MA, CCC-SLP, Speech Pathologist/Feeding Therapist

Amazon describes the Echo as a hands-free, voice-controlled device that uses Alexa (Amazon’s answer to Siri, Cortana and Google) to play music, control smart home devices, provide information, read the news, set alarms, and more.  It is exciting that people’s interactions with a computer device is much easier with no buttons to find and press.  The speech recognition still has some limitations but devices like the Echo show what the future may be around the corner.  The Echo works by constantly listening to a trigger word, by default, the trigger word is “Alexa” but you can change it in the Alexa app on your mobile device.    The communication devices we use in assistive technology allow a non-verbal child, or the child with some difficulty in oral speech to use the Echo independently.

Relationship Coordinator, Amy Liss, really enjoys this new device. “This is the most beneficial piece of technology I have ever received that can help me be completely independent.” Her favorite feature is playing daily Jeopardy trivia.

Some of these many uses:

Get quick answers for simple Web searches:  The most basic use of the Echo is to ask it questions it can answer by searching on the Web.  This ranges from simple math (Alexa what is 125 times 33?”) or spelling and definitions, etc.  The Echo is unique in that it will say the answers out loud  rather than requiring the user to read the responses.

Set alarms and timers:  So children with executive functioning is ability to self-regulate, including the ability to stay on task and manage and keep time.  For example, you can set a timer for someone to do an activity for one hour (“Alexa set a timer for one hour”) then set a second timer for each separate step that needs to be completed to accomplish the assigned task during that hour.  Just say “Alexa set a second timer for 25 minutes.  So you can have a 5 minute break.

Manage a to do list:  Just say “Alexa, add (name of to do item) to my to do list, or remind me to (name of task).”

Update your calendar:  “Alexa, add (event name) to my calendar.”  Gives the ability to stay organized.

Get your daily news fix:  (“Alexa, give me my Flash Briefing”)

Listen to Audible and Kindle books:  The Echo is a great way to listen to your books read aloud.  This can be a great way to use the Echo in the classroom setting.

wemoControl your lights:  Echo can be great way to control your home lighting using just your voice.  This can be especially helpful for those who have motor difficulties.  By installing the Hue Skill, you can get basic voice control of the lights in your home.

Control your appliances:  With a Wemo switch you can add voice control to any small appliance with an on/off switch (fans, lamps, etc.)

Listen to music and podcasts:  Echo supports a number of music services.

There are many more thing you can do with the Echo.  For more details go to www.luisperezonline.com for full details.  If you have a voice that is difficult to understand, have no fear- Alexa can use many speech generating devices to the rescue.

The Assistive Technology department at Easter Seals DuPage & Fox Valley has received a grant to install Amazon Echo in their department.  Once it is installed we hope that you all will come down and give it a try.  Learn more about our assistive technology department by clicking here.

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What is Occupational Therapy?

By: Laura Van Zandt, OTR/L

I’ve been an occupational therapist for seven years and it’s taken a long time to perfect the answer to the question “What is OT?” from people I just met. Today, I think I finally have a good answer.

To begin, occupational therapists see individuals across their lifespan and in a variety of different settings. We work closely with medical staff, parents, and educators. Typically there is some underlying problem that has initiated a meeting with an occupational therapist.

Depending on their training, there are a number of different approaches an OT may take to solve the problem.  One approach is the “Person, Environment, Occupation” (PEO) model. The PEO model (Law et al., 1996) is a well-known and established conceptual model of practice within occupational therapy. It offers a foundation for guiding assessment and intervention across all practice settings and client populations.
peos
This model of practice helps an OT consider the whole child…their roles, activities, where their performance may need help, areas of strength, and more. Since I work with children, I am going to define the person as a child. The environments are the places a child interacts (e.g. home, school, community) and the occupations are the things he/she does in those places (e.g. get dressed, feed themselves, learn to write/color/draw, play). It is an occupational therapist’s job to evaluate a child and determine what makes it hard for those occupations in all his/her environments. It could be strength, sensory, visual, etc. or a combination of all those areas. It could also require a team approach, short term services, or long term services.

Let’s look at an overview of the assessment process with a simple case study to make it easier to understand:

ASSESSMENT PROCESS (Person, Environment, Occupation)

Referral: A 7-year-old is referred by a doctor for occupational therapy services based on her parents’ concerns with difficulty sitting still at home and completing homework tasks. She also has difficulty focusing and getting ready for the morning.

Occupational Roles:
An OT would consider the child’s role as both a developing child, sibling, daughter, student, and friend. What is preventing her from participating fully in those roles? We would also consider the family’s values, interests and daily roles. We try to look at the client’s pattern of engagement in occupations (i.e. getting ready) and how they changed over time.

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Photo by Marita Blanken

In the example above, we would consider the entire family. This child has many roles. She is not only a child of a two parent working family, but she is also a sibling with a younger brother. She is also a first-grade student. In further conversations, we discover she also participates in gymnastics after school. In order to best support this child and her family, we would need to consider each of those roles and how they contribute to the overall profile of this child.

Occupational Performance Areas:
Then we consider the areas of occupational performance (e.g. activities of daily living, instrumental activities of daily living, rest and sleep, education, play and leisure, and social participation).

In the example above, this child is possibly presenting concerns with activities of daily living. Specifically, we might look at her ability to dress herself and completing grooming/hygiene tasks. Her mother, also mentions the child is having difficulties with staying focused and managing her assignments in school. Is this also impacting her social participation both at home, school and community where she does gymnastics?

Occupational Performance Components:
What components need to be addressed that may explain underlying difficulties?

Body Structure and Function – This may include muscle tone, range of motion, posture and alignment, postural control, strength, joint stability, endurance, fine motor skills, manipulation and dexterity, gross motor skills, coordination, bilateral coordination, etc. We may also evaluate her nutrition, respiration and gastrointestinal background to make referrals.

Sensory motor – This may include a child’s under or over responsiveness to touch, movement, sight, sound, taste and smell as well as their visual perceptual skills and body awareness. This may also include a child’s behavioral responses to activities.

Cognitive – This may include perceiving, understanding concepts, learning, and executive function skills (initiating, planning, organizing, sustaining, sequencing, flexibility, problem solving, managing emotions, etc.). We may make referrals to further understand the role cognition plays in your child’s abilities.

Social-Emotional – This may include self-regulation, self-esteem, as well as inner drive and motivation to participate in activities. It could also include the ability to relate to other children and adults.

TakeThreePhotography_05202010-102In the example referral above, we would need to determine what areas of occupational performance are making it difficult for her to participate to the best of her abilities. We could evaluate her strength by having her climb to see how she manages her body in space and uses her arms to support her body weight. We might also look at her core strength to see if she is weak and if that is causing her to feel unstable while sitting which impacts focus (e.g. if she is having to concentrate hard on keeping her body upright to be able to use her eyes and hands, then it will be hard for her to also concentrate on math facts).

We will also look at her hand skills. There might be concerns with weakness, grasp, manipulation, etc. that make it hard for her to use writing tools to complete tasks.

We can create a sensory profile, by asking questions, having a parent fill out questionnaires, and observing a child during activities. We would use our background in sensory integration too during our observations. For example, perhaps the feeling of clothing is too irritable to this child and she is having trouble focusing because she is needs to move to readjust how her clothing feels on her skin. We can evaluate vision to determine if we need to make a referral to another doctor. By planning some activities to do together, we can look at how her sequencing and planning behavior.

Finally, occupational therapists are mindful of the social-emotional development of children and how difficult things impact his/her daily function. We might ask the parent further questions if we notice that she is getting frustrated easily during a task and has trouble managing her frustration.

There are many hats that an OT wears in this therapeutic relationship….another adult, parent, teacher, friend, etc. When we begin, we often know very little about each other. However, we work together and figure out plans that best help a family address their wants for their child. In the process, we may not know all the answers yet and it may take time to figure them out. That is one of the hard parts of an OT’s job but also a fun aspect too. Wearing these different hats while at the core serving as an occupational therapist, is what I love about my job. To learn more about Easter Seals DuPage & Fox Valley’s occupational therapy services visit: http://www.easterseals.com/dfv/our-programs/medical-rehabilitation/occupational-therapy.html.