Developing Clinical Skills in Assistive Technology
Originally published in Advance for Occupational Therapy Practitioners
Written By Michelle L. Lange OTR, ABDA, ATP www.atilange.com
This regular Assistive Technology series has now included 26 articles, spanning topics
such as seating, mobility, speech generating devices, computers and electronic aids to
daily living. I often hear from readers who have questions about a recently covered topic.
However, I have been hearing from many people who are interested in learning more
about assistive technology to develop their clinical skills and ultimately provide these
services to clients.
Occupational Therapy educational curriculums are covering more assistive technology
than ever before. That’s great if you’ve gone to school recently or if any of that great
information really sunk in prior to seeing actual clients. When I went to OT school, over 20
years ago now, we didn’t learn anything about assistive technology, not that there was
much to learn at that point. Assistive Technology was an emerging field and everyone was
learning by the seat of their pants. That’s how I started in this area. My first job as an OT
was with California Children’s Services in the Los Angeles area. I saw many children with
significant physical limitations. I could evaluate them and tell you age levels for gross and
fine motor skills. I could provide therapy. For these kids, however, evaluation and
traditional mat therapy was not increasing their function. They still couldn’t sit up by
themselves, move around the environment, write or speak. Which meant that no one
really knew their potential because no one really knew what was going on inside that little
person.
Most of the kids I treated were already in a wheelchair. The therapists were not overly
involved in the evaluation for seating and mobility, however. We relied on the equipment
supplier to order the best equipment and to fix it when things went wrong. If a child had a
communication device, it was because they happened to work with a savvy speech
language pathologist and the OT was generally not a part of that process, either. So what
changed? I did. I was not satisfied with the status quo and so I tried hard to make it better
and learned as I went along.
A big part of getting started in the assistive technology practice area is having a passion
to see your clients become more functional. We all want our clients to be more functional,
right? Clients who can benefit from assistive technology often present initially as a client
who cannot benefit from traditional therapy. This requires us to change our perspective.
Even clients who would not make significant functional improvements with ongoing
traditional therapy techniques may become much more functional through assistive
technology. As Occupational Therapy Practitioners, we need to work as a part of a team
to meet client needs. We work with the supplier as an active participant to match product
to specific client parameters which are determined through a clinical evaluation. We work
with the speech language pathologist to develop functional communication through
speech generating devices. We work with the teachers to use the computer to meet
educational goals.
Ok, so you are working with a client who you know needs AT, where do you start? I
suggest a number of options: mentoring, reading and continuing education.
- Mentoring The best way to learn new clinical skills is to observe someone who
works in a practice area and then practice new skills under their supervision. That’s
why OT students have to complete clinical internships after taking all those classes.
Some educational programs offer a third specialty internship or an advanced
degree focusing on assistive technology. But let’s face it, most of us don’t have the
time and money to pursue those options. I suggest finding a clinician specializing in
AT in your area and asking if you can hang out with them periodically to learn these
skills. It is important to follow HIPPA guidelines when observing and to get
permission from the client(s). Don’t know any specialists in your area? Contact the
Rehabilitation Engineering and Assistive Technology Society of North America
(RESNA) at www.resna.org where you can look up Assistive Technology
Practitioners in your area. There are still a few Assistive Technology programs out
there. When you plan your next vacation, see if there is a program in the area and
ask if you can visit for a few hours or a day just to observe and have the
opportunity to see what services models are being used.
- Reading Reading is another way to increase knowledge. As much as I write,
reading is my least preferred method of learning. It is not interactive and often does
not focus on practical information that I can directly use with my clients. That is why
I strive to write material that is practical. Here are some periodical suggestions.
Interested in a subscription? Look up the periodical on the internet and subscribe.
Most are free! ·
- Advance for Occupational Therapy Practitioners – technology articles and all
for free! ·
- OT Practice – occasional technology articles, typically practical. Free if you
keep up your AOTA membership. ·
- Tech SIS quarterly newsletter – provided to AOTA members who also are a
member of the Technology Special Interest Section. ·
- Mobility Management – good articles on seating and mobility. It is free.
- Rehab Management – you don’t have to be a manager to benefit from the
technology articles in this periodical. The articles mostly address seating and
mobility issues. It is free. ·
- Closing the Gap newspaper –this publication is packed with information
about computer hardware and software as well as communication. It is
available for a fee. ·
- Journals - there are several very good journals out there, though the
information is not as practical. Research and evidence based practice is the
foundation we work from however, even if it can be dry to read.
- Technology & Disability by Elsevier Press, Assistive Technology by RESNA
Press, and the Journal of Rehabilitation Research & Development of the
Department of Veterans Affairs are three to consider.
- Books about assistive technology are tricky. The field changes so quickly
that books that are more practical tend to get out of date fast. Here are a few
of my favorites at the moment: ·
- Cook & Hussey’s Assistive Technology, 3rd Ed., Mosby Elsevier, 2008.
- Clinician’s Guide to Assistive Technology, Mosby, 2002.
- Fundamentals in Assistive Technology, 4th Ed., RESNA Press. 2008.
- Continuing Education Continuing education is available at inservices, courses and
conferences, on the internet and, occasionally, by reading text.
- Inservices: We used to have regular inservices at The Children’s Hospital of
Denver. A local equipment supplier or an equipment manufacturer
representative would come in, often with pizza and tape measures, and
provide an inservice on new equipment. I loved inservices because they were
easy (I was already at work, after all), they were free and I got to see, touch
and try out new equipment in a small group and ask all the questions I
wanted. If you don’t have regular inservices now, contact your local
equipment dealer and ask for a specific inservice topic. This type of
continuing education typically covers seating and mobility areas of AT.
- Courses: Courses often cover a specific AT topic in a full day format. The
course may come to your area, so that a hotel and flight is not necessary. As
the topic is focused, you can take away a lot of information in a day,
compared to going to several one hour sessions on varied topics. Look for
announcements in periodicals and flyers in the mail. If you want to hear me
talk about something, you can take a gander at my website to see upcoming
courses. A good basic AT course that travels around and is offered at the
RESNA conference is Fundamentals in Assistive Technology.
- Conferences: One huge advantage of conferences is networking
opportunities. This allows you to develop a support network to share ideas
and learn. I learn so much from my peers. Conferences can be expensive to
attend, especially if the conference is a distance away. My average cost,
between tuition, hotel (usually sharing with people to save money), flight and
food (conferences can be a great diet plan!) is $1000. Employers don’t cover
such expenses as much as they used to, either. Conferences often offer
general sessions and pre-conference sessions. Pre-conference sessions are
a half or full day course on a specific topic and usually require an additional
fee. Here are some great AT conferences: ·
- ATIA (Assistive Technology Industrial Association) – offered in the
Orlando area in January, this conference covers a variety of AT,
specifically computers, augmentative communication and EADLs.
Great exhibit hall. ·
- California State University at Northridge (CSUN) – offered in
Northridge, CA each March, this conference covers a variety of AT,
specifically computers and augmentative communication for higher
education and vocation and has a lot of information on technologies
for people with vision or hearing deficits. ·
- Canadian Seating and Mobility Conference – offered in Toronto in
September, this conference focuses on seating and mobility and has a
great exhibit hall. ·
- Closing the Gap – offered in Minneapolis in October, this conferences
focuses on computers and augmentative communication for children in
schools. ·
- Heartland Conference – offered in Waterloo, IW each June, this
conference covers primarily seating and mobility topics. ·
- International Seating Symposium – offered in Orlando and Vancouver
on alternate years (Vancouver this year) in March, this is my favorite
conference for seating and mobility. The topics are intermediate to
advanced and the exhibits and networking are great. ·
- MedTrade – offered in Atlanta in October, this is primarily a trade
show. Picture a football field sized exhibit hall with all the latest and
greatest in seating and mobility products, along with a lot of ancillary
equipment such as bathing and toileting equipment. Bring good
walking shoes! ·
- RESNA – offered in varying locations each June, this year in
Washington, DC. This is a professional organization meeting and
conference in one which offers pre-conference Instructional Courses,
as well as general sessions on a variety of AT topics. This is my
favorite conference for covering the gamut of AT in one place. As I
work with all areas of AT, it is nice to go to a conference that offers
information across the board. Some sessions address overlapping
issues between AT areas. The conference also includes loads of
meetings as a part of the professional activities. You do not need to be
a member to attend the conference or most of the meetings. Internet
courses
- Several institutions offer courses over the internet for a fee. Internet
courses provide less interaction, but do allow you to work at your own
pace. Since you can work from home or office, you don’t have to pay
travel expenses. Some of these courses provide a certificate of
completion or CEUs (as with courses and conferences). ·
- University of Pittsburgh’s Home Study Course is designed for
assistive technology suppliers, but provides a very
comprehensive assistive technology foundation. ·
- University of Buffalo has some online training opportunities,
Assistive Technology Training Online (ATTO) ·
- CSUN offers a 100 hour certificate program ·
- AOTA’s Assistive Technology and Occupational Therapy: A Link
to Function (self-paced clinical course)
- Another resource to keep in mind is the state Tech Act
programs. Each state has a Tech Act program. You can find a
complete list at www.resna.org. Stop by and give them a visit.
They may even offer free or low cost classes.
These can also be great places to volunteer with to gain more experiences. A long time
ago… I used to make a great splint. I can’t anymore. If I see someone who needs a splint,
I refer them to an OT who specializes in this area. If I wanted to start making splints again,
I would get some training to improve my skills. It’s the same for any specialty area,
including assistive technology. If you aren’t seeing a client who needs or uses AT now,
one thing is certain: you will!
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