Assistive Technology and occupational therapy

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!