strategies for documenting the need for assistive technology
DESCRIPTION
Strategies for Documenting the Need for Assistive Technology. Mark Schmeler, M.S., OTR/L, ATP . Center for Assistive Technology University of Pittsburgh & UPMC Health System. Problem List & Goals. Be Specific Relate to What Can’t be Done Relate to the User’s Goals - PowerPoint PPT PresentationTRANSCRIPT
![Page 1: Strategies for Documenting the Need for Assistive Technology](https://reader035.vdocument.in/reader035/viewer/2022062501/56815e79550346895dccfb5b/html5/thumbnails/1.jpg)
Strategies for Documenting the Need for Assistive
Technology
Mark Schmeler, M.S., OTR/L, ATP
Center for Assistive TechnologyUniversity of Pittsburgh &
UPMC Health System
![Page 2: Strategies for Documenting the Need for Assistive Technology](https://reader035.vdocument.in/reader035/viewer/2022062501/56815e79550346895dccfb5b/html5/thumbnails/2.jpg)
Problem List & Goals
• Be Specific• Relate to What Can’t be Done• Relate to the User’s Goals• Importance of These Goals
![Page 3: Strategies for Documenting the Need for Assistive Technology](https://reader035.vdocument.in/reader035/viewer/2022062501/56815e79550346895dccfb5b/html5/thumbnails/3.jpg)
Example 1
• The following specific problems have been identified related to JP's condition:
![Page 4: Strategies for Documenting the Need for Assistive Technology](https://reader035.vdocument.in/reader035/viewer/2022062501/56815e79550346895dccfb5b/html5/thumbnails/4.jpg)
Example 1 - Cont’d
1.He has no independent means of mobility due to severe muscle weakness and therefore needs full-time personal care attendants to push him.
![Page 5: Strategies for Documenting the Need for Assistive Technology](https://reader035.vdocument.in/reader035/viewer/2022062501/56815e79550346895dccfb5b/html5/thumbnails/5.jpg)
Example 1 - Cont’d
2. Due to a lack of postural support in the wheelchair, he has developed multiple orthopedic deformities which cause pain and difficulty with overall management of his activities of daily living. If not addressed, he will be at high risk for compromised vital organ capacity, pressure sore development, and increased pain.
![Page 6: Strategies for Documenting the Need for Assistive Technology](https://reader035.vdocument.in/reader035/viewer/2022062501/56815e79550346895dccfb5b/html5/thumbnails/6.jpg)
Example 2
• The following specific problems have been identified related to AH's condition:
![Page 7: Strategies for Documenting the Need for Assistive Technology](https://reader035.vdocument.in/reader035/viewer/2022062501/56815e79550346895dccfb5b/html5/thumbnails/7.jpg)
Example 2 - Cont’d
1.Due to decreased muscle strength and joint contractures in both upper extremities, AH is unable to write or access a computer effectively. These are necessary activities in order for him to engage in an academic program.
![Page 8: Strategies for Documenting the Need for Assistive Technology](https://reader035.vdocument.in/reader035/viewer/2022062501/56815e79550346895dccfb5b/html5/thumbnails/8.jpg)
Evaluation Procedures
• Clarifies Decision Making Process• Use Accepted Procedures• Standardized & Non-Standardized
• Physical Motor Assessment• Clinical Trials / Simulations• Natural Environments
![Page 9: Strategies for Documenting the Need for Assistive Technology](https://reader035.vdocument.in/reader035/viewer/2022062501/56815e79550346895dccfb5b/html5/thumbnails/9.jpg)
Example 1
• Following the completion of a comprehensive interview and physical motor assessment, JP was placed in a seating simulator which was adjusted to accommodate his postural deformities.
![Page 10: Strategies for Documenting the Need for Assistive Technology](https://reader035.vdocument.in/reader035/viewer/2022062501/56815e79550346895dccfb5b/html5/thumbnails/10.jpg)
Example 1 - Cont’d• Pressure mapping was
conducted to determine the most appropriate seat cushion to provide him with comfort, support, and pressure distribution. It was found that a custom modular foam seat and backrest was most ideal in addressing these needs.
![Page 11: Strategies for Documenting the Need for Assistive Technology](https://reader035.vdocument.in/reader035/viewer/2022062501/56815e79550346895dccfb5b/html5/thumbnails/11.jpg)
Example 1 - Cont’d
• It was also found that adjustable tilt in space provided him with good postural realignment and pressure relief. Adjustable recline did not work due his limited hip range of motion and spinal deformity.
![Page 12: Strategies for Documenting the Need for Assistive Technology](https://reader035.vdocument.in/reader035/viewer/2022062501/56815e79550346895dccfb5b/html5/thumbnails/12.jpg)
Example 1 - Cont’d
• JP had an opportunity to test drive three different power wheelchairs in the clinic and outside. He found that the heavy duty system was most ideal because it would be able to negotiate the rough terrain around his home yet still fit in his bathroom.
![Page 13: Strategies for Documenting the Need for Assistive Technology](https://reader035.vdocument.in/reader035/viewer/2022062501/56815e79550346895dccfb5b/html5/thumbnails/13.jpg)
Example 1 - Cont’d
• A loaner version of this power wheelchair and seating system was delivered to his home by a local supplier for a two week trial. JP reported he used the wheelchair on a daily basis and that it was very effective in meeting his needs.
![Page 14: Strategies for Documenting the Need for Assistive Technology](https://reader035.vdocument.in/reader035/viewer/2022062501/56815e79550346895dccfb5b/html5/thumbnails/14.jpg)
Example 1 - Cont’d
• He was satisfied with the performance and encountered no difficulties with accessibility in his home or transportation system.
![Page 15: Strategies for Documenting the Need for Assistive Technology](https://reader035.vdocument.in/reader035/viewer/2022062501/56815e79550346895dccfb5b/html5/thumbnails/15.jpg)
Example 2• Following a
comprehensive interview and complete assessment of AH's upper extremity function, he was provided with am opportunity to try several alternative keyboards, software, and other alternative inputs.
![Page 16: Strategies for Documenting the Need for Assistive Technology](https://reader035.vdocument.in/reader035/viewer/2022062501/56815e79550346895dccfb5b/html5/thumbnails/16.jpg)
Example 2 - Cont’d
• Through extensive clinical trials of various computer systems and software, it was found that a laptop computer with forearm and wrist supports was the most effective means for him to enter data into the computer.
![Page 17: Strategies for Documenting the Need for Assistive Technology](https://reader035.vdocument.in/reader035/viewer/2022062501/56815e79550346895dccfb5b/html5/thumbnails/17.jpg)
Function of the Equipment
• Describe Each Feature / Item• Relate Back to User’s
Disabilities• Reviewers Dispute Components• Use Chart or Grid
![Page 18: Strategies for Documenting the Need for Assistive Technology](https://reader035.vdocument.in/reader035/viewer/2022062501/56815e79550346895dccfb5b/html5/thumbnails/18.jpg)
Example 1
• A powered wheelchair is necessary in JP's case as he does not have the strength to propel a manual wheelchair. He needs an independent means of getting around in his home and community.
![Page 19: Strategies for Documenting the Need for Assistive Technology](https://reader035.vdocument.in/reader035/viewer/2022062501/56815e79550346895dccfb5b/html5/thumbnails/19.jpg)
Example 2
• A laptop computer with forearm and wrist supports is needed as he is unable to write, due to his decreased strength and upper extremity range of motion. He needs an efficient mode of computer access to assist with academic inclusion.
![Page 20: Strategies for Documenting the Need for Assistive Technology](https://reader035.vdocument.in/reader035/viewer/2022062501/56815e79550346895dccfb5b/html5/thumbnails/20.jpg)
Chart Example 1INTERVENTION and
SPECIFICATIONJUSTIFICATION
Seat - Sized to fit(name brand / type /means of attachment/ base / angle)
Provide appropriate baseof support and pelvicpositioning.
Provide appropriatepressure distributionover weight bearingsurface of the buttocksto reduce the potentialfor skin breakdown.
![Page 21: Strategies for Documenting the Need for Assistive Technology](https://reader035.vdocument.in/reader035/viewer/2022062501/56815e79550346895dccfb5b/html5/thumbnails/21.jpg)
Chart Example 2INTERVENTION and
SPECIFICATION JUSTIFICATION
Arm Support - full length/ desk length / heightadjustable / singleposted / double posted/ flip-up / removable /arm pad type / armtroughs / lap tray /mounting hardware
Provide appropriate armsupport and additionaltrunk stability throughweight bearing in theupper extremities.
![Page 22: Strategies for Documenting the Need for Assistive Technology](https://reader035.vdocument.in/reader035/viewer/2022062501/56815e79550346895dccfb5b/html5/thumbnails/22.jpg)
Chart Example 3INTERVENTION and
SPECIFICATION JUSTIFICATION
Back Support – Sized tofit add-on (name brand/ type / means ofattachment / base /angle), adjustabletension backupholstery, standardsling upholstery, lateralsupports (swing-away /fixed / size / location)
Provide appropriate trunksupport and spinalalignment to reduce thepotential for orthopedicdeformity.
![Page 23: Strategies for Documenting the Need for Assistive Technology](https://reader035.vdocument.in/reader035/viewer/2022062501/56815e79550346895dccfb5b/html5/thumbnails/23.jpg)
Alternatives
• What Alternatives Exist• Why Won’t they Work
![Page 24: Strategies for Documenting the Need for Assistive Technology](https://reader035.vdocument.in/reader035/viewer/2022062501/56815e79550346895dccfb5b/html5/thumbnails/24.jpg)
Example 1
• Without a power wheelchair, JP will continue to need around the clock attendants. Without the recommended seating system the power wheelchair would be of no use to JP and abandoned.
![Page 25: Strategies for Documenting the Need for Assistive Technology](https://reader035.vdocument.in/reader035/viewer/2022062501/56815e79550346895dccfb5b/html5/thumbnails/25.jpg)
Example 1 - Cont’d
• He would then be forced to remain in bed where he is at greater risk of developing pressure sores, further orthopedic deformities, and depression.
![Page 26: Strategies for Documenting the Need for Assistive Technology](https://reader035.vdocument.in/reader035/viewer/2022062501/56815e79550346895dccfb5b/html5/thumbnails/26.jpg)
Example 2
• Without the laptop computer, AH will have no means to produce written text and he will have difficulty engaging in an academic inclusion program, and therefore will be forced into an un-graded instruction program.
![Page 27: Strategies for Documenting the Need for Assistive Technology](https://reader035.vdocument.in/reader035/viewer/2022062501/56815e79550346895dccfb5b/html5/thumbnails/27.jpg)
Pictures and Videos
• Enhance Justification• Help Illustrate Need
• Before and After
• Help Describe Intervention
![Page 28: Strategies for Documenting the Need for Assistive Technology](https://reader035.vdocument.in/reader035/viewer/2022062501/56815e79550346895dccfb5b/html5/thumbnails/28.jpg)
Other Issues
• Length of Letter
• Author of Document
![Page 29: Strategies for Documenting the Need for Assistive Technology](https://reader035.vdocument.in/reader035/viewer/2022062501/56815e79550346895dccfb5b/html5/thumbnails/29.jpg)
The Process
• Time Consuming
• Not Reimbursable
![Page 30: Strategies for Documenting the Need for Assistive Technology](https://reader035.vdocument.in/reader035/viewer/2022062501/56815e79550346895dccfb5b/html5/thumbnails/30.jpg)
Strategies
• Find Out What the Reviewer Wants• Have the Reviewer Present during
Evaluation• physically present• via teleconference
• Dictation Systems• Intelligent Database / Automatic
Reporting
![Page 31: Strategies for Documenting the Need for Assistive Technology](https://reader035.vdocument.in/reader035/viewer/2022062501/56815e79550346895dccfb5b/html5/thumbnails/31.jpg)
Conclusion
• Important Part of the Process• Thorough Yet Concise• Appeal!!!!!
Review this lecture