DOCUMENT RESUME ED 405 688 EC 305 389 TITLE TECH POINTS: Integrating Rehabilitation Technology into Vocational Rehabilitation Services. Training Manual. INSTITUTION South Carolina State Vocational Rehabilitation Dept., West Columbia. Center for Rehabilitation Technology Services. SPONS AGENCY National Inst. on Disability and Rehabilitation Research (ED/OSERS), Washington, DC. PUB DATE May 94 CONTRACT H133E20002-93 NOTE 212p. PUB TYPE Guides Non-Classroom Use (055) EDRS PRICE MF01/PC09 Plus Postage. DESCRIPTORS Adults; *Assistive Devices (for Disabled); Case Studies; Decision Making; *Disabilities; Job Placement; *Rehabilitation Counseling; Staff Development; *Technology; *Vocational Rehabilitation IDENTIFIERS *Rehabilitation Technology ABSTRACT This TECH POINTS training manuat and guide are intended to assist vocational rehabilitation (VR) agencies with staff training on the integration of rehabilitation technology services into the VR process. The TECH POINTS approach helps determine when and how to use rehabilitation technology with individual clients. The training manual covers: how to use the TECH POINTS approach, referral/application, extended evaluation, plan development, services, placement/follow-up, closure points, post-employment, and agency guidelines for rehabilitation technology. Sections provide a summary of main points, explanatory text, a place for notes, boxes with key points or implementation steps, and references: The TECH POINTS guide lists specific questions, considerations, and recommended actions to determine whether technology services are needed at each of the seven TECH POINTS stages from referral/application through post-employment. Other information in the guide summarizes components of rehabilitation technology; specific rehabilitation technology services, devices, and specialists; and cost considerations. There is also a list of rehabilitation technology information resources and databases, as well as space for listing local rehabilitation technology service providers and a summary of case studies of technology uses to modify the workplace in various environments. (DB) *********************************************************************** * Reproductions supplied by EDRS are the best that can be made from the original document. ***********************************************************************
182
Embed
ED 405 688 EC 305 389 TITLE TECH POINTS: Integrating … · DOCUMENT RESUME ED 405 688 EC 305 389 TITLE TECH POINTS: Integrating Rehabilitation Technology. into Vocational Rehabilitation
This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
Transcript
DOCUMENT RESUME
ED 405 688 EC 305 389
TITLE TECH POINTS: Integrating Rehabilitation Technologyinto Vocational Rehabilitation Services. TrainingManual.
INSTITUTION South Carolina State Vocational Rehabilitation Dept.,West Columbia. Center for Rehabilitation TechnologyServices.
SPONS AGENCY National Inst. on Disability and RehabilitationResearch (ED/OSERS), Washington, DC.
PUB DATE May 94CONTRACT H133E20002-93NOTE 212p.
PUB TYPE Guides Non-Classroom Use (055)
EDRS PRICE MF01/PC09 Plus Postage.DESCRIPTORS Adults; *Assistive Devices (for Disabled); Case
ABSTRACTThis TECH POINTS training manuat and guide are
intended to assist vocational rehabilitation (VR) agencies with stafftraining on the integration of rehabilitation technology servicesinto the VR process. The TECH POINTS approach helps determine whenand how to use rehabilitation technology with individual clients. Thetraining manual covers: how to use the TECH POINTS approach,referral/application, extended evaluation, plan development,services, placement/follow-up, closure points, post-employment, andagency guidelines for rehabilitation technology. Sections provide asummary of main points, explanatory text, a place for notes, boxeswith key points or implementation steps, and references: The TECHPOINTS guide lists specific questions, considerations, andrecommended actions to determine whether technology services areneeded at each of the seven TECH POINTS stages fromreferral/application through post-employment. Other information inthe guide summarizes components of rehabilitation technology;specific rehabilitation technology services, devices, andspecialists; and cost considerations. There is also a list ofrehabilitation technology information resources and databases, aswell as space for listing local rehabilitation technology serviceproviders and a summary of case studies of technology uses to modifythe workplace in various environments. (DB)
U S DEPARTMENT OF EDUCATIONOffice of Educational Research and Improvement
EDUCATIONAL RESOURCES INFORMATIONCENTER (ERIC)7,:ihis document has been reproduced as
received from the person or organizationoriginating it.
Minor changes have been made toimprove reproduction quality.
Points of view or opinions stated in thisdocument do not necessarily representofficial OERI position or policy.
IntegratingRehabilitationTechnology
intoVocational.
RehabilitationServices
BEST COPY AVAILABLE
Center for Rehabilitation Technology Services
SC Vocational Rehabilitation Department 2
TECH POINTSIntegrating Rehabilitation ec ogy grt
cational Rehabilitat on Sem c
Training Manual
Developed by the
Center for Rehabilitation Technology Services
Anthony J. LangtonProject Director
Judy L. HughesSpecial Consultant
Cynthia C. FlynnCoordinator of Research
Lydia S. GasterCoordinator of Technical Services
Valerie AugustineDesign and Graphics
Center for Rehabilitation Technology Services 3
Version 1.0 (Field Test Editi
The TECH POINTS Training Manual and TECH POINTS Guide are being field tested in selectedVocational Rehabilitation agencies beginning in Spring 1994. Field testing is being conducted as part of aNIDRR grant to determine the effectiveness of the TECH POINTS model as an approach to integrating theconsideration of rehabilitation technology services into the vocational rehabilitation process. Findings of theresearch will be available in Spring 1997.
Permission to utilize the TECH POINTS Training Manual, TECH POINTS Guide or other TECH POINTSmaterials should be obtained from the Center for Rehabilitation Technology Services. Comments on thesematerials or other aspects of CRTS activities are welcome.
Center for Rehabilitation Technology ServicesSouth Carolina Vocational Rehabilitation Department
1410-C Boston AveWest Columbia, SC 29170(803) 822-5362 Voice/TDD
(803) 822-4301 FAX
Joe S. DusenburyComissioner
South Carolina Vocational Rehabilitation Department
Funding for this project has been provided by the National Institute on Disability and Rehabilitation Research (NIDRR), U.S. Dept of EducationGrant # H 133E20002-93. Opinions expressed in the TECH POINTS Guide and TECH POINTS Training Manual are those of the authors andshould not be construed to represent opinions or policies of NIDRR or the South Carolina Vocational Rehabilitation Department.5/94
Center for Rehabilitation Technology Services
OUTLINE
FOREWORD
INTRODUCTION
TECH POINTSIntegrating Rehabilitation Technology into
at ion Rehabilitation ervi
The TECH POINT Concept
History of Rehabilitation Technology Services In VR
Just Exactly What Is Rehabilitation Technology?
Rehabilitation Technology Specialists: Now Tell Me Again Who They Are?
Applications Of Rehabilitation Technology
SECTION 1
REHABILITATION TECHNOLOGY AND THE VR PROCESS SECTION 2
Exploring Alternatives, What If .
Integrating Rehabilitation Technology
Working With Consumers
Changing Roles And Expectations
TECH POINTS SECTION 3
The TECH POINTS Process
Support And Resources Needed For TECH POINTS
TECH POINTS In Vocational Rehabilitation Services
What Will TECH POINTS Actually Do?
Utilizing Rehabilitation Technology Services
What We Haven't Included
Center for Rehabilitation Technology Services 5
HOW TO USE TECH POINTS SECTION 4
Getting Started
TECH POINTS As A Counseling Tool
TIPS For Considering Technology Interventions
Using the TECH POINTS Guide
TECH POINT I - REFERRAL/APPLICATION SECTION 5
Considering Rehabilitation Technology Options
Anticipating Accommodations For Individuals With Severe Disabilities
Identifying Rehabilitation Technology Needs
Developing A Rehabilitation Technology Needs Profile
Technology Intervention Preparation Steps (TIPS)
TECH POINT 2 - EXTENDED EVALUATION
A Closer Look At Rehabilitation Technology Needs
Incorporating Rehabilitation Technology Into Vocational Evaluation Services
Technology Intervention Preparation Steps (TIPS)
TECH POINT 3 - PLAN DEVELOPMENT
Rehabilitation Technology In The Individualized Planning Process
Anticipating "Reasonable Accommodation" Needs In Planned Services
Technology Intervention Planning Steps (TIPS)
TECH POINT 4 - SERVICES
Providing Services: Using Rehabilitation Technology Support
Changing Technology Needs: Making Amendments To The Plan
Technology Intervention Preparation Steps (TIPS)
6
SECTION 6
SECTION 7
SECTION 8
TECH POINTS Integrating Rehabilitation Technology Into Vocational Rehabilitation Services
TECH POINT 5 - PLACEMENT/FOLLOW-UP SECTION 9
Using The Rehabilitation Technology Specialist In Job Development
Placement Strategies Using Rehabilitation Technology Resources
Essential Job Functions: Determining What's Important
Reasonable Accommodations: Increasing Placement Success With Rehabilitation Technology
Follow-Up For Technology Interventions
Technology Intervention Preparation Steps (TIPS)
TECH POINT 6 - CLOSURE POINTS SECTION 10
Improving Successful Closures Through Use Of Rehabilitation Technology
Documenting Consideration And/Or Use Of Rehabilitation Technology
Technology Intervention Preparation Steps (TIPS)
TECH POINT 7 - POST-EMPLOYMENT SECTION 11
Maintaining Employment Using Rehabilitation Technology
Anticipating Maintenance And Replacement Needs For Assistive Technology Devices
Technology Intervention Preparation Steps (TIPS)
AGENCY GUIDELINES FOR REHABILITATION TECHNOLOGY SECTION 12
Agency Guidelines
Case Service Policies for Rehabilitation Technology Services
Funding Resources
Forms for Technology Service Activities
Center for Rehabilitation Technology Services7
REH 2 ILITATION TECHNOL GY RESOURCESAND TRraINING INFORMATION
Rehabilitation Technology Information Resources and Databases
Technology Resource Catalogs
Periodicals on Rehabilitation Technology Resources and Services
Organizations and Associations
Employment and Independent Living Resources
Local Technology Service Providers
Technology-Related Assistance Protects
Rehabilitation Engineering Research Centers
Training Information
Tech Reference Information
SECTION 13
CASE STULI IES SECTION 14
Case Study of the TECH POINTS Process
Examples of Simple Accommodations
Series of Successful Closures Through the Use of Technology
Other Case Study Information
TECH POINTS GUIDE SECTION 15
TECH POINTS Guide
8
TECH POINTS Integrating Rehabilitation Technology into Vocational Rehabilitation Services
Foreword
With a little help from our friends . . .
Response to the idea of identifying "points" where reminders about rehabilitation technology serviceswould be built into the vocational rehabilitation process has been positive. The simplicity of the TECHPOINTS concept may be its greatest attribute. We have attempted to layout a practical way for vocationalrehabilitation staff to incorporate and utilize the resources and services of rehabilitation technology. At thesame time we realized that the "specialists- who actually deliver the rehabilitation technology services; therehabilitation engineers, occupational therapists, speech pathologists and the other members of technol-ogy teams, needed to understand how the vocational rehabilitation process functions.
The development of TECH POINTS has followed a long, interesting road. As with most concepts, theexact origins can be traced back to many sources. The Center for Rehabilitation Technology Services isappreciative of the creative input of many people who saw the value of integrating technology into the VRprocess.
Leonard Anderson Kerry Mandeville
Poornima Attigupam Dawn Mangum
Cherie Clark Gayle Mason
Ben Dusenbury Charlie McBride
Cynthia Flynn Greg McGrew
Ron Fry Houston McMillian
Lydia Gaster Frank Puckett
Jane Gold Juan-Carlos Rivera
Pete Howell Marcia Scherer
Belinda Hudson Stephen Thomas
Lucerne Iseman Sandy Townsend
Paul Knight Krista Wooley
Charles LaRosa
Center for Rehabilitation Technology Services
At the time of publication, regulations for the 1992 Amendments to the Rehabilitation Act were just beingreleased for public comment. New regulations could result in changes to the vocational rehabilitationprocess, which in turn may require modification to the TECH POINTS structure. The concept of utilizing keypoints where technology should be considered for individuals served by VR agencies should not change.If it is determined that modifications are needed to remain compatible with the new regulations, an updatedversion of TECH POINTS will be made available.
TECH POINTS is more a training strategy than a planning or monitoring tool. The way that vocationalrehabilitation staff learn to think about technology resources and services will do more to integratetechnology resources and services into VR services than policies and regulations. Rehabilitation technologyresources and services are part of the unique capabilities which should be an integral part of vocationalrehabilitation services.
It is our hope that TECH POINTS will prove to be a useful resource for vocational rehabilitation agencies.Findings from the field testing and feedback from others using TECH POINTS will likely lead to modificationsand improvements in the original concept.
We welcome your comments and suggestions!
Tony Langton
Judy Hughes
Acknowledgements
Special appreciation goes to Cindy Flynn and Valerie Augustine for their extra efforts in helping to put thepieces and parts together!
10
TECH POINTS Integrating Rehabilitation Technology Into Vocational Rehabilitation Services
1111Introduction SECTION 1
11
TECH POINTS Integrating Rehabilitation Technology into Vocational Rehabilitation Services
e
In this section
Introduction SECTION 1
The TECH POINTS Concept
History of Rehabilitation Technology Services in VR
Just Exactly What is Rehabilitation Technology?
III V Rehabilitation Technology Specialists: Now Tell Me Again Who They Are?
Applications of Rehabilitation Technology
The TECH POINTS Concept
TECH POINTS is a rehabilitation technology management andtraining strategy for vocational rehabilitation agencies. TECHPOINTS is designed to provide rehabilitation counselors with aneasy-to-follow desk reference to help determine when and how touse rehabilitation technology with individual clients.
Integrating the consideration of rehabilitation technology at keypoints in vocational rehabilitation and similar service areas is ne-cessary if rehabilitation technology services are to be an effectiveresource (Langton, 1991). TECH POINTS can help a counselor con-sider simple, low cost rehabilitation technology interventions forthose clients for whom rehabilitation technology is sometimes over-looked. It should also help VR counselors deal more effectively withpersons with severe disabilities who present complex technology-related needs.
Center for Rehabilitation Technology Services 12
Applications of the TECH POINTS approach can be made invaried settings such as
vocational rehabilitation
education
business/industry
worker compensation
health care
independent living
other rehabilitation services
In vocational rehabilitation agencies TECH POINTS addressesseveral basic concerns:
Is rehabilitation technology use appropriate?
When should it be used?
Who should be involved?
What outcomes should be expected?
Making appropriate decisions about rehabilitation technologyapplications in the rehabilitation process is difficult even for experi-enced counselors. As with all VR services, the use of technology has
to be individually planned and matched with the needs and capabili-
ties of the individual. This requires not only knowledge and experi-ence but also a logical structure to follow. The concept of TECHPOINTS identifies key places in the rehabilitation process wheredecisions should be made and offers suggestions and questions forthe counselor and client to consider.
History of Rehabilitation TechnologyServices in VR
The value of rehabilitation technology in enhancing the capabili-ties of vocational rehabilitation agencies to serve individuals withdisabilities has been recognized for many years. Various types ofadaptive equipment, aids and devices have been a part of rehabili-
tation since its inception in the 1920s. Although not identified asrehabilitation or assistive technology, these resources have beenused to help with job function and independent living capability.
13TECH POINTS Integrating Rehabilitation Technology into Vocational Rehabilitation Services
The process of applying technological and scientific knowledge topractical purposes highlights rehabilitation technology's purposes.In the rehabilitation setting, it is the use of devices, techniques orstrategies to remove or reduce barriers to physical, behavioral, orcognitive performance (Galvin & Phillips, 1990).
The first official reference to rehabilitation technology was in the1986 Amendments to the Rehabilitation Act when rehabilitationengineering was included in the legislation (Phillips, 1993). Inclusionof rehabilitation engineering into VR regulations, mandated agen-cies to provide rehabilitation engineering services, as appropriate,during the evaluation phase and in the Individualized Written Reha-
bilitation Program.
One of the Institute on Rehabilitation Issues Study Groups in 1986also focused on "Rehabilitation Technologies" and their role in therehabilitation process (Corthell, 1986). Findings from a survey of VRagencies showed that most agencies were already very involvedwith technology-related services.
A policy directive issued by the Rehabilitation Services Administra-tion (RSA) in November 1990 reaffirmed the important role thattechnology-related services should play, emphasizing the needthroughout the rehabilitation process, from referral to post-employ-ment (Carney, 1990). VR agencies were also required to include intheir State Plan how they make these services available. Stressed inthis directive was the importance of using rehabilitation technologyresources when making determinations of eligibility.
The recent 1992 Amendments to the Rehabilitation Act furtheremphasizes the importance of rehabilitation technology resourcesand services. Significant changes have been made which includeincreased consumer responsiveness and accountability of VR agen-cies in the provision of services. Also included are new interpreta-tions of the potential of individuals with severe disabilities to benefitin terms of employability and the need for VR agencies to collect"clear and convincing evidence" to support eligibility decisions. Theentire Rehabilitation Act has been made consistent with the prin-ciples and language of the Americans with Disabilities Act (ADA) of1990 (Galvin, 1992). This has made it important that rehabilitationcounselors be familiar with essential functions, reasonable accom-modations, consumer empowerment and other concepts of theADA.
14Center for Rehabilitation Technology Services
1 -s
1986 amendments include
"rehabilitation engineering"
within VR regulations
1990 RSA Policy directive reaffirms
role of rehabilitation engineering
technology
1-4
Changes regarding "rehabilitation technology" result-ing from the new 1992 Amendments to the Rehabilita-tion Act:
13 Definition of "rehabilitation technology" from the Technol-ogy-Related Assistance for Individuals with Disabilities Act of
1988 (TECH ACT) replaces definition of "rehabilitation engi-neering."
(3 New reporting requirements about the type of rehabilitationtechnology services provided to individuals.
Et New requirement in the IWRP to include a statement of thespecific rehabilitation technology services to be provided toassist in the implementation of intermediate objectives andlong-term rehabilitation goals.
o Four new State Plan requirements: State agencies mustdescribe how a broad range of rehabilitation technologyservices will
be provided for each stage of the rehabilitation process
be provided on a statewide basis
enable VR counselors, client assistance personnel and
other related service personnel to train on rehabilitationtechnology
identify the manner in which devices and services will
be provided or worksite assessments will be made aspart of the assessment for determining eligibility and/orthe service needs of the individual
(Stafford, 1993)
Despite the growing awareness of the importance of rehabilita-tion technology, there remains a need to ensure rehabilitationtechnology resources and services are used consistently throughout
VR activities. Most rehabilitation counselors are uncertain how they
should integrate rehabilitation technology in their day-to-daycasework activities.
5
TECH POINTS Integrating Rehabilitation Technology Into Vocational Rehabilitation Services
Just Exactly What is Rehabilitation Technology?
A little background on the evolution of terminology common to the
application of technology resources and services may be helpful.Early reference to the use of "technology" to assist individuals withdisabilities began with work done in the orthotics/prosthetics areafollowing World War II. This eventually helped lead to the gradualdevelopment of "rehabilitation engineering," which was recognizedas a speciality of the engineering field in 1970 (McNeal, 1994)."Assistive technology" was introduced through the TECH ACT with its
emphasis on assistive devices and services. 'Rehabilitation technol-ogy" has been used as a general reference throughout this timespan.
Rehabilitation engineering, rehabilitation technology and assistive
technology represent aspects of technology service activities, andare now included together to define "rehabilitation technology."TECH POINTS will use these terms interchangeably in the TECHPOINTS materials.
The 1992 amendments to the Rehabilitation Act defines rehabili-tation technology as
"the systematic application of technologies, engineeringmethodologies or scientific principles to meet the needs ofand address the barriers confronted by individuals withdisabilities in areas which include education, rehabilitation,employment, transportation, independent living andrecreation. The term includes rehabilitation engineering,assistive technology devices and assistive technologyservices."
Within this broad definition, we will take a closer look at the three
components of rehabilitation technology:
rehabilitation engineering;
assistive technology devices;
assistive technology services.
16Center for Rehabilitation Technology Services
1 -6
UniqueDevice
Fabrication
Modificationsto
Commercially AvailableProducts
Commercially Availableoff the
Shelf Products
Estimates as high as 80 percent of
technology interventions utilize
assistive technology devices which
are commercially available with little
or no need for modification
Rehabilitation Engineering
Rehabilitation engineering is the branch of engineering that isconcerned with the application of science and technology to im-prove the quality of life of the physically disabled (McNeal, 1994).This involves applications of rehabilitation technology that dealprimarily with custom applications and accommodations requiringthe specialized expertise of a rehabilitation engineer.
The term "rehabilitation engineering" is identified with much of thework done in introducing technology services into VR agencies.Rehabilitation engineering and rehabilitation technology are termsused in many VR agencies to describe their technology-relatedactivities.
Assistive Technology Devices
The second component of rehabilitation technology is the equip-ment (i.e., aids and devices) that is often used to assist individuals inperforming tasks. These are referred to as assistive technologydevices.
The TECH ACT (Technology-Related Assistance for Individuals withDisabilities Act of 1988) defines AT devices as any item, piece ofequipment or product system, whether acquired
commercially off the shelf, or
modified or customized
that is used to increase, maintain, or improve functional capabilitiesof individuals with disabilities."
Assistive aids and devices such as hearing aids, eye glasses, andwheelchairs are some of the more common examples of rehabilita-tion technology "equipment: Since in most VR agencies technology-related devices such as cochlear implants or other devices fall intomedical or surgical categories, thesewill not be classified as assistivetechnology devices. For the most part though, almost all aids ordevices which "assist" an individual in performing tasks would beincluded.
The growing collection of aids and devices range from simple lowtech gadgets to high tech equipment. These devices have onegeneral purpose in common: to "assist" in accomplishing a task orbasic function.
17TECH POINTS Integrating Rehabilitation Technology into Vocational Rehabilitation Services
Low tech applications refer to easy-to-implement mechanical,structural or electrical solutions to problem areas. Examples include
simple daily living aids such as reachers, lever-style door hardware,custom designed hand tools, work station modifications or minorchangesto improvethe ability of a person with a disability tofunctionindependently.
High tech applications refer to applications of complex electricaland electronic devices. Examples include computers, augmentativecommunication devices and environmental control systems.
Selecting between a low or high tech solution to a problem is notalways possible. There are not always "appropriate" alternatives;identifying low cost solutions is a real need. It is often possible toidentify practical, low cost solutions to many problems with theassistance of rehabilitation technology specialists.
While there is no agreed-upon system of categorizing devices, thefollowing is one attempt to cluster them into logical groupings. Theadvantage of developing some type of a more detailed breakdownfacilitates coding and tracking of technology-related expenditures.
IAssistive Technology Devices
Major Categories
CI alternate formats
CI aids for daily living
CI architectural accommodations
CI cognitive/memory aids
CI communication aids
CI computer access
CI controls/switches
CI mobility/ambulation
CI orthotics/prosthetics
CI recreation
CI seating/positioning
CI sensory aids
CI therapeutic/health
maintenance aids
Cl transportation
CI vocational/training aids
Center for Rehabilitation Technology Services
18
1-7
AbleData currently has information
on over 19,000 aids and devices that
are commercially available. These
range from very simple mechanical
devices to complex electronic
equipment
i
Technology related services present
the most important part of
rehabilitation technology
0 Assistive Technology Services
The third component of rehabilitation technology addresses tech-nology-related services. Although discussed last, services represent
the most important part of rehabilitation technology.
The TECH ACT defined assistive technology service as
"...any service that directly assists an individual with adisability in the selection, acquisition or use of an assistivetechnology device."
This includes:
evaluation of the needs of an individual, including afunctional evaluation of the individual in the individual's
customary environment;
selecting, designing, fitting, customizing, adapting,applying, maintaining, repairing or replacing assistive
technology devices;
coordinating and using other therapies, interven-tions or services with assistive technology devices;
training or technical assistance for individuals withdisabilities;
training or technical assistance for persons involvedin the major life functions of individuals with disabili-
ties.
In TECH POINTS, assistive technology services are referred to as
"Rehabilitation Technology Services." These services are listed on the
following page.
19
TECH POINTS Integrating Rehabilitation Technology into Vocational Rehabilitation Services
TECH POINTS identifies the following rehabilitation technologyservices:
I Rehabilitation Technology ServicesJ-Th
0 technology consultation;
O rehabilitation technology evaluation /assessment;
O assistive device recommendation/prescription;
O assistive technology equipment procurement;
O device fitting/adjustment;
O device custom design;
O device fabrication/adaptation;
O device training for consumers/caregivers;
O device maintenance/repair;
O follow-up;
O equipment loan;
O product demonstration;
O funding assistance; and
O education and training.
These services are normally provided by rehabilitation technology
specialists who have specific training and expertise. Vocationalrehabilitation counselors familiar with these services will be able towork more effectively with rehabilitation engineers and other reha-bilitation technology specialists.
Center for Rehabilitation Technology Services
20
V Rehabilitation Technology Specialists:Now Tell Me Again Who They Are?
The previous information described the main components of reha-bilitation technology: rehabilitation engineering; equipment anddevices; and technology-related services.
The next obvious question is where do you find rehabilitationtechnology services? Vocational rehabilitation agencies differ inwhether they use internal VR staff or contract with externalservice providers for the technology services. Whether usinginternal or external resources, -rehabilitation technology spe-cialists" simply refer to
a person who provides rehabilitation technology servicesas one of their primary Job responsibilities. Specialistsinclude, but are not limited to, rehabilitation engineers,assistive technology specialists, speech pathologists, oc-cupational therapists or physicaltherapists.
For our purposes, we'll start by identifying the typical specialists aVR counselor might turn to for technology-related services. It may benecessary to use several specialists, forming a -technology team,- to
adequately address the needs of an individual.
Rehabilitation Technology Specialists1
0 rehabilitation engineer
O assistive technology specialist
O rehabilitation technologist
O fabrication technician
O occupational therapist
O physical therapist
O speech/language pathologist
O rehabilitation technology supplier/DME dealer
21TECH POINTS Integrating Rehabilitation Technology into Vocational Rehabilitation Services
V Applications of Rehabilitation Technology
One of the easiest ways to understand rehabilitation technologyis to look at actual applications of technology resources and ser-vices. Technology-related solutions to problems might deal with
CI the individual's functional capabilities, personality,attitude, etc.
CI the environments where the individual functions
home
community
vocational rehabilitation
school/training
work
0 tasks or work activities that the individual needs tocomplete
essential job functions
other concerns, such as transportation
Rehabilitation technology can be a versatile problem-solving tool
that rehabilitation counselors can utilize with many of their clients. It
won't solve all problems, but it can provide options for many clientswhich otherwise might not be possible. Integrating the consider-ation of rehabilitation technology into daily case management willenhance the benefit(s) that counselors and clients will be able torealize. TECH POINTS can help counselors make this integrationpossible. Looking at actual technology applications in work, schooland home, community and vocational rehabilitation environmentsshould help counselors see the scope of what can be expected from
rehabilitation technology.
Center for Rehabilitation Technology Services
22
References
Carney, N. (1990). Policy statement on rehabilitation engineering(Report no. RSA-PD-91- 03). Washington, DC: RehabilitationServices Administration.
Corthell, D.W. (1986). Rehabilitation Technologies: Thirteenth Insti-tute on Rehabilitation Issues. Menomonie, WI: University ofWisconsin-Stout Research and Training Center.
Galvin, J. (1992, November-December) Brief overview of the reha-bilitation act amendments of 1992. RESNA News pp. 1,5.
Galvin, J. & Phillips, E. (1990). What is Appropriate Technology?(Available from National Rehabilitation Hospital, AssistiveTech-nology Program, 102 Irving St., Washington DC 20010)
Langton, A.J. (1991). Utilizing technology in the vocational rehabilita-tion process. Proceedings of the 14th Annual RESNA Confer-ence. 11, 76-78.
McNeal, D. (1994). Rehabilitation Engineering. Manuscript submit-ted for publication.
Phillips, B., Bennett, J., & Galvin, J. (1993). Assistive Technology:Practical Intervention Strategies. (Available from National Re-habilitation Hospital, Assistive Technology Program, 102 IrvingSt., Washington DC 20010.
Stafford, B. (1993). The impact of the reauthorized rehabilitation act.ralle, 10(2), pp. 5-9.
r
23
TECH POINTS Integrating Rehabilitation Technology into Vocational Rehabilitation Services
1!,1Rehabilitation Technologyand the VR Process
24
SECTION 2
TECH POINTS Integrating Rehabilitation Technology into Vocational Rehabilitation Services
Rehabilitation Technologyand the Process
In this section
E x p l o r i n g Alternatives, What if . . .
Integrating Rehabilitation Technology
Working With Consumers
Changing Roles and Expectations
Exploring Alternatives, What If ...The resources and services of rehabilitation technology present
opportunities and alternatives for individuals with all degrees offunctional limitations. Selecting vocational goals or activities of dailyliving options without considering rehabilitation technology couldseriously limit choices. As a tool, rehabilitation technology can openup avenues and options that may at first seem unrealistic. Knowinga little about what is out there, employing some creative thinkingand taking some risks are necessary prerequisites for this to bepossible. Equally important is investigating new approaches andlistening to consumers as they describe how they think they can bestovercome their limitations.
Rehabilitation technology can be of assistance to a person with adisability only when it is applied appropriately. Most people withdisabilities would prefer to use as few aids and devices as possible.
Center for Rehabilitation Technology Services 25
2-1
SECTION 2
By using rehabilitation technology
resources, rehabilitation staff can
help individuals explore how
technology might enhance their
quality of life, independence and
offer job opportunities
1
2-2
Access to rehabilitation technology
depends on the counselor and client
recognizing that there could be
potential benefit from these services
It is extremely important that the person using the technology isthe lead person in deciding what and when assistive devices andmodifications are needed.
Many persons with disabilities, and even some professionals,impose limitations on career options by not considering wheretechnology could be used to "assist" with some of the essential tasksand activities of a job. Often tasks which at first seem unfeasible canbe made possible by looking at things from a different perspective.Inexpensive interventions such as changing how a switch operatesor using a simple over-the-counter adaptive aid can make all thedifference in the world in determining vocational potential.
Let's consider the example of a college student whodamaged his right hand severely in an auto accident. Theinjuries were so severe that he had eliminated pharmacyas a career option, basing this decision on the fact that hesaw no way he could open medicine bottles. A simple Jaropener placed under a counter allowed him to accom-plish this task. This even included opening childproof tops!
Integrating Rehabilitation Technology
Integrating the "consideration" of rehabilitation technology intoday-to-day case service practice must occur if benefits are to berealized. This must first occur with the rehabilitation counselor, thekey link to technology service delivery in VR agencies. Access torehabilitation technology depends on the counselor and client rec-ognizing that there could be potential benefit from these services.
The importance of this initial contact and the counselor' continu-ing role in coordinating all rehabilitation services makes it essentialthat counselors have a basic awareness of rehabilitation technologyand have direct access to rehabilitation technology resources andservices.
One of the major challenges faced by VR agencies in offeringrehabilitation technology services to clients is the inconsistency fromone counselor to another. Some counselors routinely include tech-nology considerations with most of their clients. Others rarely
26TECH POINTS Integrating Rehabilitation Technology into Vocational Rehabilitation Services
consider it and almost never refer clients for rehabilitation technol-ogy services. Most counselors fall somewhere between the twoextremes. Individuals applying for VR services with the same disabil-ity and almost identical functional limitations could find differentopportunities to try out technology-related solutions to problems.The only difference in many cases is the counselor's awareness leveland attitude toward technology resources and services.
A vocational rehabilitation counselor can be overwhelmed whenit comes to discussions about technology. A major part of theproblem is a need for training and increased awareness of whatexists. Emphasis has been placed on integrating technology into VRservices, but little information has been given to counselors to helpapplythis in a waythat is systematic and "user friendly" to the personwith a disability and to the counselor.
Many counselors are reluctant to discuss technology
What if the applicant wants something the agency can'tprovide?
What about budget constraints?
Where do I find out about the products available?
Who do I call for help?
What kind of questions do I ask someone when I don't knowanything about technology?
These are just a few of the things that often run through a counselor'smind when a person who might need technology applies for ser-vices.
Counselors have understandably been shy and reluctant to dis-cuss technology with applicants, fearing that talking about a certaindevice would obligate the agency to provide that device. This reluc-tance can be overcome by:
keeping technology concerns in the context of vocationalgoals;
sharing information about rehabilitation technology needswith clients;
emphasizing to clients that many options may need to beconsidered before final decisions can be made.
Center for Rehabilitation Technology Services 27
2-31
Technology is one of those areas
that can make vocational
rehabilitation counselors feel that
they are expected to be a "jack- of-
all-trades, but a master of none"
2-4
. . . if technology-related options are
not explored then it will never be
known what might have been
possible . . .
The person must be willing and
convinced that a device or a
modification will work for them or it
will not be used
Technology will not always be the appropriate solution to prob-lems. There may actually be times that technology could be useful,but it is either not necessary to achieve the vocational goal or notessential to the health or independence of the client.
Considering possible options is very important. Vocational reha-bilitation focuses on employment goals and helping individualsrealize their potential. Exploring appropriate use of rehabilitationtechnology to create better options should be a regular part of casemanagement practice. Early exploration of technology interventionsshould not be seen as a commitment to purchase specific equip-ment on the part of the VR agency or to require the individual to buyit on their own. VR counselors and consumers are very aware offunding as a real problem to address. There are no easy solutions tothe limited dollars available. However, if technology-related optionsare never explored then it will never be known what might have beenpossible.
V Working With Consumers
Empowerment has become a term frequently used to describewhat occurs with an individual in his or her rehabilitation program.When someone is "empowered," they are actively involved in keydecisions which result in several important outcomes:
O increased client motivation;
O greater likelihood that appropriate technology options willbe considered;
O reduced chances that equipment will be abandoned;
O alternative solutions can be found which otherwise mightnot have been considered.
Providing rehabilitation technology services or assistive deviceswithout extensive involvement of the individual as part of a technol-ogy team makes little sense, yet it occurs. The most knowledgeablesource of information about the functional limitations and problemsis the individual with the disability. Well-intentioned professionalsstill make the mistake of assuming that they "know what's best"when it comes to the selection of assistive technology equipment.The person must be willing and convinced that a device or amodification will work for them or they are less likely to use it. Time,
28TECH POINTS Integrating Rehabilitation Technology into Vocational Rehabilitation Services
equipment and money could all be wasted without the "user" beingthe quarterback of the team (Little,1991).
Working together as a team will not always be easy. The VR clientmust learn to be responsible in making decisions regarding technol-ogy needs. It is important that the client be aware of the realities thatvocational rehabilitation and other agencies have. Within their man-dates, VR agencies cannot provide for all of the technology needs foran individual. Identifying rehabilitation technology options, whenthey are appropriate, may require the counselor and client to worktogether to explore various ways to obtain all the assistance whichmay be needed.
V Changing Roles and Expectations
The expectations placed on VR counselors and other rehabilita-tion professionals are growing. To be effective in their duties, VRcounselors have to be "expert" in many areas, such as rehabilitationtechnology. This is difficult because most counselors have had little,if any, actual training in this area. The challenge of serving individu-als with more severe disabilities falls primarily on the VR counselor.
A review of major rehabilitation legislation places emphasis onpersons with severe disabilities being served by vocational rehabili-tation. Both ADA and the 1992 Amendments to the RehabilitationAct make it clear that persons with severe disabilities who want towork must be given the opportunity to do so. The RehabilitationAmendments Title 1 Part A Sec.100 states "...that individuals withdisabilities, including those with the most severe disabilities, havedemonstrated their ability to achieve gainful employment in inte-grated settings if appropriate services and support are provided.
This language speaks to the intent of The Rehabilitation Act andindicates that agencies must increase their efforts to serve personswith severe disabilites. Including technology in these efforts is clearlymandated. Counselors and VR agencies need to be prepared toprovide appropriate technology services for employment purposes.
The American with Disabilities Act (ADA) is also having an impacton the role of the counselor and VR agencies. Individuals withdisabilities are gaining greater access to community activities, pro-grams and employment opportunities. As with employers who arereviewing policies and procedures regarding "reasonable accom-modations," rehabilitation agencies must also make sure that
29Center for Rehabilitation Technology Services
2-5
Counselors and VR agencies need to
be prepared to provide appropriate
technology services for employment
purposes
2-6
Every rehabilitation counselor does
not have to become a technology
specialist
access to services are being provided in a manner consistent withthe ADA mandate. "Reasonable accommodations" for communica-tion or mobility limitations, as well as cognitive impairments, areexamples of what VR agencies must address at the initial referral.Rehabilitation technology should be considered at this and all stages
in the rehabilitation process.
What does this mean to the VR counselor?
Should every VR counselor become a specialist in rehabilitationtechnology? No. There are more effective strategies to consider.With TECH POINTS, it is not necessary for the counselor to be anexpert in technology or know all the equipment, devices or accom-modations that could be made. VR counselors are not prepared tobe "technology specialists." The demands already placed on coun-selors in most settings are extensive.
Should every VR counselor have a working knowledge of rehabili-tation technology resources and services? Yes. Counselors need the
array of resources that technology can provide. Expectations toeffectively serve individuals with severe disabilities, often with mul-tiple functional limitations, make it essential. Rehabilitation counse-lors need to
have a basic understanding of rehabilitation technology,
know what questions to ask, and
know who to contact to obtain the needed rehabilitationtechnology services.
The possibility of establishing a specialty role for rehabilitationtechnology is worth considering. An approach which has workedwell in many settings is designating a "technology specialist" role toone of the counselors in an office. This may be an unofficial desig-nation or one that is actually part of job expectations.
30
TECH POINTS Integrating Rehabilitation Technology into Vocational Rehabilitation Services
Some of the duties of a "technology specialist' counselor could
include
serving as a resource to other office staff,
collecting and maintaining information on rehabilitationtechnology,
being a liaison with rehabilitation technology service pro-viders, and
assisting with quality assurance and staff developmenttraining.
Some rehabilitation counselors have a natural interest in technol-ogy-related activities and would be valuable in helping other coun-selors. This arrangement would be most feasible for counselorswith caseloads where technology services are likely to be needed.Caseloads with large numbers of individuals with more physicalinvolvement needs would be best. Other speciality caseloads suchas deaf, blind or trust fund cases would also be possibilities.
110 While there would be advantages to establishing a "technologyspecialist" role for a counselor in field offices or regions, this is notrequired for TECH POINTS.
31
Center for Rehabilitation Technology Services
References
Jenkins, W.M., Patterson, J.B., & Szymanski, E.D. Philosophical,historical, and legislative aspects of the rehabilitation counselingprofession. In Parker, R.M. & Szymanski, E.D. Rehabilitation Coun-seling: Basics and Beyond. Pro-ed. Austin, TX pp. 1-34
Langton, Al & Hughes, J.L. (1994). TECH POINTS: Enhancing theuse of rehabilitation technology in vocational rehabilitation agen-cies. Accepted for publication in the Proceedings of the 17thAnnual RESNA Conference, June 1994.
Little, J. (1991). Rethinking rehabilitation: Are you a quarterbackor acoach? Team Rehab, 2(2), 23.
Phillips, B. (May, 1992). Perspectives on Assistive Technology Ser-vices in Vocational Rehabilitation: Clients and Counselors. (Avail-able from National Rehabilitation Hospital Assistive TechnologyProgram, 102 Irving St., Washington DC 20010)
32
TECH POINTS Integrating Rehabilitation Technology Into Vocational Rehabilitation Services
C!) TECH POINTS SECTION 3
33
TECH POINTS Integrating Rehabilitation Technology into Vocational Rehabilitation Services
SECTION 8
TECH POINTS
In this section
The TECH POINTS Process
Support and Resources Needed for TECH POINTS
TECH POINTS in Vocational Rehabilitation Services
What Will TECH POINTS Actually Do?
Utilizing Rehabilitation Technology Services
What We Haven't Included
The TECH POINTS Process
TECH POINTS offers vocational rehabilitation agencies a practi-cal, easy-to-follow guide on how to integrate rehabilitation technol-ogy into their activities. The goal was to develop a system thatoperates effectively within existing structures. This was made pos-sible by overlaying the concept of TECH POINTS on the existing VRcase management process. With the logical relationships of pro-gram elements already well laid-out, the task of identifying theimportant decision points and service areas was relatively easy(Langton, 1991).
Center for Rehabilitation Technology Services
34
3-2
Agency-wide strategic planning to
address how rehabilitation technol-
ogy services should be utilized is
essential for TECH POINTS or any
other approach to be effective.
TECH POINTS is based on the following premises:
TECH POINTS are integral parts of the VR case serviceprocess;
the rehabilitation counselor is the primary professional inidentifying and referring clients who have technology-related needs; and
clients are integrally involved in the identification of needsand the purchase of technology.
Support and Resources Needed forTECH POINTS
In order to appropriately implement the TECH POINTS system,VR agencies must:
issue policies and procedures concerning the provision andfunding of technology services;
provide staff with training in the TECH POINTS process;and
provide access to technology services for clients.
TECH POINTS in Vocational RehabilitationServices
Utilizing a series of points at critical junctures in the rehabilita-tion process, TECH POINTS provides the rehabilitation counselorwith a strategy to aid in determining if some type of technologyshould be considered. The seven "points" coincide with caseservice status tasks and activities that exist in some form in allagencies. The sequence of accepting referrals, conducting com-prehensive assessments, developing individual plans, arrangingfor necessary planned services, placing clients into employmentand conducting post-employment follow-up is basic to any em-ployment-oriented rehabilitation program.
35
TECH POINTS Integrating Rehabilitation Technology Into Vocational Rehabilitation Services
The TECH POINTS where consideration of rehabilitation technol-ogy should occur include:
TECH POINT O Referral/Application
Considers need for rehabilitation technology resources and services forall applicants. Decisions on vocational potential should include howtechnology resources/services could improve or enhance performance.
TECH POINT Extended Evaluation
Comprehensive assessment of the client's vocational potential includ-ing consideration of technology resources/services.
TECH POINT O Plan Development
Technology resources and services included in determination of voca-tional goals and objectives and all aspects of the IWRP planning process.
TECH POINT O Services
Use of technology-related resources/services to enhance performancecapabilities and address any accommodation needs in any plannedservice activities.
TECH POINT A Placement/Follow-up
Use of technology-related resources/services to enable a worker witha disability to perform essential job functions at their employment siteor improve the ability to obtain, maintain, or advance in employment
TECH POINT O Closure
Prior to closing any case, documents what, if any, use was made ofrehabilitation technology resources or services.
TECH POINT O Post-Employment
Reviews need for rehabilitation technology resources and services forclients to maintain employment, identifying those individuals who areat-risk of losing their job due to technology-related problems.
Center for Rehabilitation Technology Services36
9-3
Since TECH POINTS is based on an
existing process, it offers a system
that should easily integrate
technology services into regular case
service activities
3-4
TECH POINTS can provide a structure
for overall use of technology
resources and services.
Indicates primary access points
where technology services should be
considered
Offers a training strategy for staff
involved in technology services
o Provides, perhaps most importantly,
opportunity for consumers and
staff to see how the "technology"
really fits into the system
o Fosters a "what if .. altitude
about what people might be able
to do with the help of technology
What is a TECH POINT?
A TECH POINT is a place in the rehabilitation process where use oftechnology resources or services should be considered.
TECH POINTS are part of a continuous process which look atpotential rehabilitation technology needs of an applicant and thensystematically follow that individual throughout their rehabilitationprocess.
Some VR agencies may utilize status categories that differ fromthose illustrated earlier. In agencies where Order of Selection proce-dures are in effect, other status categories may be in use. In thosesituations, it may be necessary to incorporate additional categoriesinto the most appropriate TECH POINTS area.
Technology Intervention PreparationSteps (TIPS)
At each TECH POINT questions and consider-ations are presented which assist the counselor indetermining if technology services are actuallyneeded. These Technology Intervention Prepara-tion Steps, called TIPS, will help the counseloridentify the challenges and concerns needed toeffectively consider technology-related options.
Notes:
P
37
TECH POINTS Integrating Rehabilitation Technology into Vocational Rehabilitation Services
Referral/Applicant
general rehabilitationtechnology needs
technology impact onvocational potential
order of selectionconsiderations
accommodations forapplications process
ExtendedEvaluation
accommodations forvocational evaluationprocess
TECH POINTS in theVocational Rehabilitation Process
4K.,4m:44 "#%4,4. =4,44#.44449£22MR:M*44M
1104 PONT
NO A)111:...x.:44.sw444444444444,4.,,,
TECH PONT
Plan Development
rehabilitation technologyresources and services inthe IWRP
06FJOEND33
EVALUATION
(EVALUATON
55.433.42M1,.... ::335£2*LLT
..1,2{{6,5,5555
22222222222L144444441
U
Services
accommodations forplanned services
Placement/Follow-up
rehabilitation technologyresources in jobdevelopment
accommodations at theworksite
Flow chart taken fromRehabilitation Counseling:Basic and Beyond 11987)
Center for Rehabilitation Technology Services
[( KUM 41P
...222022:022,22,22,222342444403...
TTOFROINT
NAPSMI1TONN/
CLIEM
14
alc
16
r mm-AmyUgtK7.4.1*-,
NOT NO
YET LONGERLIKELY
.404404222P,POLON32K4S2"4_45=1ZSY, ^
20
REACITTOR
EMPLOYMENT
9-5
Closure
rehabilitation technologyservices for exit decisions
I
U TECHrite
Y. 2, ,,,W 4
ompens
ClosureOutcomes
08
26
28
14 3034
32 MSTEV4,3021/00
SEANCES
Post-Employment
rehabilitation technologyneeds for maintainingemployment
38
aoskfitE
EST COPY ORS BLE
V What Will TECH POINTS Actually Do?
TECH POINTS will help make technology resources and servicesa normal consideration throughout the VR process. This will offerpractical benefits for. . .
vocational rehabilitation staff
o rehabilitation counselorso vocational evaluatorso others
consumers
vocational rehabilitation agencies
rehabilitation technology specialists
Vocational Rehabilitation Staff
It is anticipated that utilization of TECH POINTS will assist reha-bilitation counselors and vocational evaluators by:
reducing the number of individuals they feel have limitedvocational potential;
expanding vocational placement and training options forclients;
increasing possibilities for direct job placements;
providing an easy-to-follow "tickler" management systemfor rehabilitation technology;
spending available funds for rehabilitation technology ap-propriately;
providing a tool for counselors to use wher. they feel over-whelmed in serving persons with severe disabilities; and
enhancing job development capabilities with employers.
39
TECH POINTS Integrating Rehabilitation Technology Into Vocational Rehabilitation Services
Consumers
Consumers will realize benefits from TECH POINTS through:
increasing involvement in the vocational rehabilitation pro-cess;
expanding understanding of technology and its impact onvocational decisions;
increasing opportunities to obtain appropriate rehabilita-tion technology services;
reducing likelihood of abandonment of aids and devices;and
improving opportunities for successful employment.
Agency
TECH POINTS will help VR agencies by:
providing a system to help comply with new rehabilitationtechnology requirements;
improving capabilities to serve individuals with severe dis-abilities;
utilizing available resources more effectively;
establishing more consistent state-wide utilization of reha-bilitation technology services;
providing a basis on which to improve tracking and ac-counting for technology-related expenditures;
offering a strategy for training field staff in how to userehabilitation technology resources and services; and
possibly reducing the purchase of inappropriate equip-ment.
40Center for Rehabilitation Technology Services
Rehabilitation Technology Specialists
TECH POINTS will help rehabilitation technology specialists by:
increasing utilization of rehabilitation technology services;
receiving more appropriate requests for technology ser-vices;
planning and coordinating technology service deliveryac-tivities;
increasing understanding of the vocational rehabilitationprocess.
V Utilizing Rehabilitation Technology Services
TECH POINTS emphasizes the need for a team approach inusing rehabilitation technology in vocational rehabilitation (Rice,1990). The VR counselor is the rehabilitation professional most likelyto become aware of the challenges that a client may face in seekingor maintaining employment or performing important independentliving tasks. The counselor, working with the client, is also likely torecognize concerns the client has about the use of technology. It isimportant for the counselor and client to determine if these chal-lenges and concerns could be addressed through use of technologyresources and services.
Notes:
41
TECH POINTS Integrating Rehabilitation Technology into Vocational Rehabilitation Services
Rehabilitation Technology Team
A technology team approach is essential to the use of rehabilita-tion technology. At minimum, the technology team will consist of thecounselor and client working together to consider possible rehabili-tation technology alternatives. Other members of the team will varydepending on the specific problems or questions being addressedand the stage in the vocational rehabilitation process.
The team of rehabilitation technology specialists could include:
O Rehabilitation Engineer
O Assistive Technology Specialist
O Occupational Therapist
O Physical Therapist
O Rehabilitation Technologist
O Speech Pathologist
O Rehabilitation Technology Supplier
O Fabrication Technician
O Others _J
TECH POINTS encourages the use of these and other rehabilita-tion technology specialists to address technology at appropriatepoints in the vocational rehabilitation process. Through the use ofTECH POINTS, the counselor should be able to determine:
who the technology team members should be;
what services may be needed;
what information is needed from the counselor and clientregarding technology needs; and
how to implement recommendations from the technologyteam.
Center for Rehabilitation Technology Services
42
3-9
A team approach is essential to
effective utilization of technology
resources and services
9 -10
Considering All Environments
Injured in an automobile accident on her way home from work, GLhas a spinal cord injury at the C-5 level which resulted in quadriple-gia. While still in the hospital, a physical therapist prescribed apowered wheelchair for GL. Compromises were made in the type ofwheelchair purchased because of limited funding by the insurancecompany.
GL wanted to live independently and return to her job as an officemanager so the hospital staff referred her to VR for services. Due tothe type and severity of her injury, her rehabilitation counselor soughtconsultation for technology services.
The first objective of the rehabilitation technology team was to helpher move back to her mobile home.The wheelchair caused problemsin terms of entry, safety, homemaking duties and accessibility to allrooms.
Getting home and using community services was also a chal-lenge. The team realized that she couldn't drive her vehicle using herpresent wheelchair. A different chair had to be purchased to achievethis goal.
To determine whether she could return to work, GL participated invocational evaluation services at the VR agency. In order to completethe evaluations, several devices were prescribed (e.g., hand splints,etc.).
To determine whether she could return to her job, assessmentswere made at the work site. It was discovered that if accessorieswere attached to her wheelchair it would eliminate challenges at thework site. Several changes were made.
As this case developed it became obvious that a team approachmay have improved the application of technology for this individual.It is also clear from Gl's story that every decision made regarding aperson with a disability has an impact on all environments in whichthe person interacts. A wheelchair chosen to help with mobilitycansolve one challenge while creating concerns in other aspects of theclient's life. If, in ordering the original wheelchair, the therapist hadconsidered Gi's HOME, movement in the COMMUNITY, servicesoffered at VR, potential SCHOOL/TRAINING environments andWORK, her transition back into the world might have been a littleeasier.
43
TECH POINTS integrating Rehabilitation Technology Into Vocational Rehabilitation Services
Rehabilitation technology services available from members of thetechnology team could include:
Rehabilitation Technology Services1
O Technology consultation
O Rehabilitation technology evaluation/assessment
O Assistive device recommendation/prescription
O Assistive technology equipment procurement
O Device fitting/adjustment
O Device custom design
O Device fabrication/adaptation
O Device training for consumers/caregivers
O Device maintenance/repair
O Follow-up
O Equipment loan
O Product demonstration
O Funding assistance
O Education and training}
These rehabilitation technology services can be used to addresstechnology needs throughout the rehabilitation process. If the reha-bilitation counselor is not certain what specific technology is neededafter problems or challenges are identified, they can consult with atechnology specialist to determine if technology intervention wouldbe appropriate.
Notes:
44Center for Rehabilitation Technology Services
3 -12
Applying Rehabilitation Technology Services
The following are examples of how technology interventions canbe applied within the environments discussed .Technology interven-tions can be a effective problem solving tool for rehabilitationcounselors.
Home
Technology can be used to address independent living accom-modations involving a person's residence including:
improving living accommodations such as design/con-struction of a ramp, widening of doors, etc.; and
determining the need for assistive aids to perform activitiesof daily living involving food preparation, eating, hygiene,dressing, etc.
Community
Activities of daily living involving persons with disabilities and theirinteraction with the community are enhanced through the use oftechnology by:
addressing issues such as curb cuts, ramps, public trans-portation, etc.; and
assessing and accommodating individual concerns involvedwith errands such as shopping, laundry, automobile main-tenance, etc.
Vocational Rehabilitation
VTRThe impact of technology in vocational rehabilitation facilities and
Assuring equal access to services is
an important consideration for VR
agencies
activities could involve:
technology consultation which can provide readily avail-able information on technology options;
rehabilitation technology assessment throughout vocationalrehabilitation process as needs are identified;
the rehabilitation technology specialist in assisting employ-ers with determining technology needs in the work settingto enhance employment opportunities; and
45TECH POINTS Integrating Rehabilitation Technology into Vocational Rehabilitation Services
Vocational Rehabilitation - continued
modifications to the vocational assessment setting tobroaden assessment options such as general accessibilityto the assessment site, computerized tests, reading/writingaids, etc.
School/Training
Technology can enhance the compatibility of the person with adisability and their school/training site by assessing and accom-modating:
general concerns such as accessibility, alternative formatsfor exams/instructional materials, note taking, etc.;
laboratory or work station modification needs; and
the need for mobility aids, communication devices, adaptedcomputer access, assistive listening devices, etc.
Job/Work Site
The use of technology services to enable a worker with a disabilityto perform essential job functions at their employment site or im-prove the ability to obtain, maintain, or advance in employment by:
accessing the overall work environment;
considering modifications, adaptations or adjustments toindividual work stations such as rearrangement of produc-tion lines or modification of tools or equipment; and
considering assistive devices which might enable the per-son with a disability to adequately perform job tasks.
Remembering to consider the client's activities in all environmentswill help address as many of the functional needs as possible.
Building on experiences in using rehabilitation technology spe-cialists will help the counselor become aware of other applicationswhere technology use could be beneficial. At each TECH POINT,additional suggestions on technology service applications are pro-vided. Recalling what proved to be effective with previous clientsand discussing cases with other counselors will be helpful.
46Center for Rehabilitation Technology Services
V What We Haven't Included
You have seen what TECH POINTS is, how it is designed tofunction, and suggestions of how it can be integrated into rehabili-tation services. This presents a partial picture of what is involved withrehabilitation technology applications in VR services. We haveomitted discussion on technology service delivery concerns such as:
where technology specialists can be found; and
exactly what technology specialists do.
This was necessary since service delivery structures differ mark-edly from state-to-state. There are "models" or similar approaches
used. Some are geographically determined (regional vs centralized)or setting-based (facility vs mobile). Others have rehabilitation tech-nology specialists employed by VR and those with whom VR con-tracts (internal vs external). Differences frequently exist within re-gions of a state. Details about technology services providers, wherethey are located, how they are best contacted and what servicesthey offer must be provided by the VR agency within each state.
47
TECH POINTS Integrating Rehabilitation Technology into Vocational Rehabilitation Services
References
Langton, AJ. (1991. Utilizing technology in the vocational rehabilita-tion process. Proceedings of the 14th Annual RESNA Confer-ence, 11, 76-78.
Mandeville, K.A., & Brabham, R. (1987). The state-federal vocationalrehabilitation program. In Parker, R.M., & Szymanski, E.M.(Eds.), Rehabilitation counseling: Basics and beyond Ipp.43-71). Austin, Texas: Pro-ed.
Rice, D. (Ed.. (1990. The Provision of Assistive Technology Services inRehabilitation. Seventeenth Institute on Rehabilitation Issues.Research and Training Center in Vocational Rehabilitation,University of Arkansas.
Center for Rehabilitation Technology Services
48
How To UseTECH POINTS
49
SECTION 4
TECH POINTS Integrating Rehabilitation Technology into Vocational Rehabilitation Services
HOW TO USE TECH;
In this section
4-1
Getting Started
TECH POINTS as a Counseling Tool
TIPS for Considering Technology Interventions
Using the TECH POINTS Guide
V Getting Started
The TECH POINTS system has been designed to use the normalVocational Rehabilitation (VR) case processing status system. There-
fore, the times that a counselor will use TECH POINTS are atapplication, during evaluation, acceptance, writing of the IWRP,amendments, employment and closure. This systematic approachwill assist in anticipating the needs of peoplewith disabilities through-out the rehabilitation process.
Knowing how to explain the agency's policies and proceduresregarding rehabilitation technology needs is important. Communi-cation about technology concerns and challenges should begin thefirst day a person applies for VR services. When VR clients complain
about services, it usually involves a breakdown in communicationbetween the counselor and client. Often, delays in service can bejustified. Frequent communication to keep the client involved andinformed is imperative when dealing with technology issues.
Center for Rehab /Nation Technology Services 50
Each TECH POINTS step will provide information to help thecounselor and client make appropriate rehabilitation technologydecisions. The TECH POINTS Guide will serve as a double-check ofinformation needed at different points to ensure that rehabilitationtechnology is given adequate consideration for each client. Everyeffort has been made to keep the process simple and to the point.
V TECH POINTS as a Counseling Tool
Rehabilitation counseling is goal-directed and vocationally-ori-ented from the first contact with a person with a disability. The onlyway some persons will become qualified for employment is by usingtechnology. Counselors who use the TECH POINTS process maywant to share the process with the VR client. This process will helpdecisions made about technology be more efficient and effective.
It is important that clear guidelines for utilization of technologyresources and services exist. Counselors should not be expected toset agency policies for rehabilitation technology as they exploreoptions with clients. Establishing effective counseling relationshipsis challenging enough without adding the uncertainty of a counselornot knowing if technology-related equipment and services wouldlikely be approved.
Through TECH POINTS, VR counselors should be able to maketechnology resources and services a regular consideration as theywork with clients. The interactive process of discussing challengesconfronting clients and exploring if technology interventions areappropriate will help enhance responsiveness to individual clientneeds.
V TIPS for Considering Technology Interventions
As mentioned in Section 3, several logical steps related to consid-ering rehabilitation technology have been developed. These Tech-nology Intervention Preparation Steps (TIPS) can be used at eachTECH POINT. These steps will help build the counselor's confidencein serving clients who may need rehabilitation technology services.TIPS offers a practical way of thinking about the need for technology.Many counselors will find the system to be very close to the processthat they have already used and found to work successfully in casedevelopment. The system is "user friendly" for counselors who arenot quite sure where to start when a person needs rehabilitation
5'TECH POINTS Integrating Rehabilitation Technology into Vocational Rehabilitation Services
technology services. TIPS should help organize thoughts concerningtechnology so that getting started is easier.
Although the questions and suggestions for TIPS vary for eachTECH POINT, they follow the same basic pattern:
First, general challenges and problems a client may faceand possible technology concerns should be identi-fied;
second, individualize the client's technology challenges andconcerns;
third, if technology intervention seems appropriate, priori-tize how to best proceed; and
fourth, identify specific steps and plan of action to arrangefor the technology services.
The following information outlines in more detail questions thatthe counselor and client should discuss. With individuals who havefew if any challenges about technology-related concerns, then theremaining questions may not be necessary. It is suggested howeverthat counselors quickly review these questions to be sure thattechnology services are included where needed.
TECHNOLOGY(Technology Concerns Identified)
Assists in identifying the general challenges a clientmay face due to his/her disability and the concernswhich he/she may have regarding technology.
0 What challenges does the dis- 0 Does the applicant/client haveabilitycreate in getting through concerns about the use or po-activities in this status? tential need for technology?
0 Would technology potentiallyassist in overcoming thesechallenges?
Center for Rehabilitation Technology Services
52
4-3
Consider all environments when
identifying what concerns and
challenges should be addressed:
home
community
vocational rehabilitation
school/training
work
General challenges and problems are
identified ...
. . . these challenges and concerns
are individualized . . .
. decides if technologyintervention seems appropriate
INTERVENTION(Individualize Technology Concerns)
Assists in individualizing the client's challenges andconcerns.
O Considering the challengesidentified at this status, whatimpact will technology have ineach environment (home; com-munity; vocational rehabilita-tion; school/training; andwork)?
O What other factors related toeach challenge must be con-sidered? (For example, cost vseffectiveness of vocational out-come, support systems neededto use the technology, etc.)
O What technology is needed tomeet challenges at this status?
O What technology concerns canbe identified?
O Does the technology currentlyused by the client meet thesechallenges?
PREPARATION(Prioritize Technology Concerns)
Assists in prioritizing technology concerns.
O Decide the order in which thetechnology concerns should beaddressed.
GI Are there deadlines?
O Other than the person with adisability and the counselor, are
others needed to help set prior-ities?
O What is the impact of settingthese priorities in terms ofpeople, health, money andagency guidelines?
53
TECH POINTS Integrating Rehabilitation Technology Into Vocational Rehabilitation Services
STEPS(Steps for AddressingTechnology Concerns)
Assists in identifying the process or steps to be takenin addressing these concerns and challenges (e.g.,who, what, where, when, etc.).
0 For each concern, identify themost appropriate way to seeksolutions and the most effec-tive steps if more than one pro-cess is indicated.
0 Determine which technologyservices are to be provided andwho should be involved in pro-viding these interventions.
O What is the applicant's/client'sinvolvement in the process?
O What is the plan for completingeach step?
O What is the plan for funding thetechnology?
WitThere is no right or wrong way to use these steps. Using the steps
to consider each technology concern and keeping each environ-ment in mind can reduce frustration. Involving a rehabilitationtechnology specialist at the appropriate time, should save time, andmoney, and improve service delivery. The TIPS process is simple andeasy-to-use.
V Using the TECH POINTS Guide
The Guide has been created to serve as a desk reference allowingcounselors to review rehabilitation-related issues at each TECHPOINT. The Guide explains how the TECH POINTS process func-tions, lists out the TIPS questions for each of the seven TECHPOINTS, and provides additional reference information.
Information in the Guide summarizes the most important ques-tions and considerations from the training manual that should beaddressed. The Guide is intended to be used along with the TECHPOINTS Training Manual by counselors who have had TECHPOINTS training.
Center for Rehabilitation Technology Services 54
4 -S
(13
. . . specific plan of action for
technology services
The Guide should be a convenient resource for the counselor indiscussing technology needs as they relate to the VR process. As the
Guide is used on a daily basis the process will become secondnature, and VR clients and counselors should benefit.
If you are looking for the TECH POINTS Guide try Section 15.
Notes:
55
TECH POINTS Integrating Rehabilitation Technology Into Vocational Rehabilitation Services
C11TECH POINT 1Referral/Application
TECH POINT
00
REFERRAL
02APPLICANT
EVALUATION
NO ELIGIBLE YES
(1-1-1.0TECH POINT
MAYBE
06EXTENDED
EVALUATION
( EVALUATION
/CLOSURE
asN
l0IWRP
DEVELOPMENT
/CLOSURE/
30
TECH POINT
NO 28LONGER CLOSURELIKELY
SERVICEINTERRUPTED
Flow chart taken fromRehabilitation Counseling:Basic and Beyond (1987)
. 26/CLOSURE/
AODLSERVICES
EEDED?
TECH POINT
32 POST I /34EMPLOYMENTS. SERVICES
SERVICES1 CLOSURE
SECTION 5
OTECH POINT
ClosureOutcomes
0826
28
30
34
5 6BEST COPY AVAILABLE
TECH POINTS Integrating Rehabilitation Technology into Vocational Rehabilitation Services
In this section
TECH POINT IR fern:II/Application
5-1
SECTION 5
Considering Rehabilitation Technology Options
Anticipating Accommodations for Individuals With Severe Disabilities
Identifying Rehabilitation. Technology Needs
V Developing a Rehabilitation Technology Needs Profile
Technology Intervention Preparation Steps
Considering Rehabilitation Technology Options
Vocational Rehabilitation (VR) counselors who have experience inworking with persons with severe disabilities realize the importanceof the first meeting with a person. This is the time that readiness forvocational rehabilitation services is often determined. Listening tothe person and deciding how the disability is dealt with on a day-to-day basis is important.
Discussing the ultimate goal of employment is tantamount tomaking eligibility decisions. Work must be a goal of the applicant orthe mandates of the counselor and VR agency cannot be met. If theperson is not interested in employment, but is someone who couldbenefit from technology services, then this is the time to advise theperson of other resources.
5?Center for Rehabilitation Technology Services
Vocational Rehabilitation has been criticized by consumers whowere turned down sometimes even before they had an interview.There are "horror" stories of potential applicants who were told,sometimes without even being seen, Your disability is too severe;you don't have transportation to get to the office so you obviouslycan't work: The rehabilitation act amendments clearly state thatpersons with severe disabilities who state theywant to work must begiven the opportunity to achieve this goal. Even people who are notconsidered to have a severe disability are sometimes turned downbecause technology was not considered.
At this point, counselors need to ensure that rehabilitation tech-nology considerations are included in decisions relating to theapplication process. This may include making sure that "reasonableaccommodations" are made for the interview process. For example,accommodations might be needed where there are communicationbarriers such as ability to give information. Applicants who havehead trauma, stroke, speech or hearing problems might fall into thiscategory. It is probably a good idea, when an appointment isscheduled, to ask if the applicant or referral source has any accom-modations that might be needed for the application process.
Rapid changes in the field of rehabilitation technology have madevocational goals possible that could not have been considered a fewyears ago. Changes brought about by passage of the Americanswith Disabilities Act (ADA) make it important for VR agencies andcounselors to create an environment where the same guidelinesused by employers are used with applicants for VR services. Be-cause VR is charged with assisting a person with a disabilityinobtaining em ployment, efforts must be made to ensure that theindividual is given every consideration for the goal of gainful employ-ment. ADA makes it clear that a person must be considered for aposition, if otherwise qualified, with or without a reasonable ac-commodation."
Anticipating Accommodations for IndividualsWith Severe Disabilities
When an individual with a severe disability is referred to vocationalrehabilitation, it is likely that some "reasonable accommodations"will be necessary to assist the person through the vocational reha-bilitation system. Anticipating where accommodation needs mayoccur can help to avoid frustration and problems.
55
TECH POINTS Integrating Rehabilitation Technology into Vocational Rehabilitation Services
The application and referral process is a time when it is importantfor a counselor and client to think about possible rehabilitationtechnology concerns that will make the goal of "qualified employee"obtainable. Using TECH POINT 1 for consideration of technologywill assist in determining if and when technology consideration isindicated. It is obvious to the counselor that many disabilities auto-matically require the use of technology for "major life activities."Sometimes a need for technology is not apparent at the time ofapplication, but, as the case process begins, it becomes apparentthat technology intervention is needed to help perform "essentialfunctions" of the job.
V Identifying Rehabilitation Technology Needs
As rehabilitation technology needs are discussed and solutionssought, it is important to remember that the same solution and/orequipment that is used with one person will not necessarily workwith another person even though the situation appears similar.Technology needs vary greatly in each situation.
More often than not, the person with the disability has ideas aboutwhat will work. It is essential to remember that the person with thedisability must be considered as a major part of any technologyteam. If a technology specialist tries to make recommendationswithout the person with a disability's involvement, there will mostlikely be problems.
It is not unusual for a counselor or even a person with a disabilityto be reluctant to discuss areas where rehabilitation technologymight be indicated. This is especially true in the early stages ofcounseling with a person.
Cost consideration is one reason that counselors may avoiddiscussing rehabilitation technology with an applicant or client. Thereality of limited case service budgets may cause a counselor toassume that a client's technology needs will be too expensive. AtTECH POINT 1 counselors are encouraged to explore options withan applicant without allowing budget considerations to rule outpossibilities. Counselors should explain to the applicant that explo-ration of technology is not a commitment to purchase equipment orarrange for services.
Center for Rehabilitation Technology Services
59
Careful consideration of technology options is a way for thecounselor to justify expenditures that are necessary for a successfulvocational rehabilitation plan. This careful consideration will alsohelp eliminate technology interventions that may not work for anindividual. A rehabilitation technology specialist can be helpful inproviding information to help make appropriate decisions concern-ing cost-benefits for a particular technology intervention. The coun-selor should emphasize that rehabilitation technology decisions aremade on the basis of vocational needs of each client. This shouldinvolve consideration of any concerns that the individual may haveabout using assistive technology, including how technology aids ordevices will be utilized in work or other environments.
V Developing a Rehabilitation TechnologyNeeds Profile
During the first session with a client, a Rehabilitation TechnologyNeeds Profile should be developed. This profile will be helpfulthroughout the case development. This will be especially true whena person is a technology user.
The profile can serve as a worksheet for the Technology Interven-tion Preparation Steps for TECH POINT 1. A suggested Rehabilita-tion Technology Needs Profile to use is included at the end of thissection.
Interaction with the applicant is the most important task at hand.While completing the profile is important, the primary focus shouldbe the interview, not the form. If clarification is needed for concernson the profile, these can be addressed the next time the applicant iscontacted. The profile should be completed by the end of the 60 dayreferral/applicant status (02). The counselor may find it helpful toconsult with a technology specialist to review potential technologyneeds for clients.
60
TECH POINTS Integrating Rehabilitation Technology into Vocational Rehabilitation Services
Technology Intervention Preparation Steps(TIPS)
The following -questions and suggestions were developed toassist a counselor in making sure that the possible need for rehabili-tation technology is discussed in the first contact and any subse-quent contacts with the applicant during the sixty-day period foracceptance decisions.
TIPS For Referral/ApplicationStatus 02
TECHNOLOGY(Technology Concerns Identified)
O Are there any reasonable ac-commodations indicated forthe VR application process?
O Does the applicant have con-cerns about performing any"major life activity"?
O Is the applicant presently usingtechnology to perform "majorlife activities"?
0 Is the main reason for VR appli-cation technology-related?
O Is the reason for VR applicationrelated to performing "essen-tial functions" of a job?
O Would technology enhance,create or eliminate the threatof job loss or affect health forthis applicant?
O Would consideration of tech-nology create an opportunityfor this applicant that wouldotherwise not be considered?
O Does the a pplicant understandthe relationship between tech-nology services and employ-ment?
O Does the applicant have a posi-tive and realistic outlook con-cerning technology?
Notes:
Center for Rehabilitation Technology Services 61
5-5
Are there challenges or problems
where technology concerns are
identified?
o YES o NO
5-6
Is use of rehabilitation technology
services appropriate?
o YES ONO
If technology intervention is needed,
what is the priority?
INTERVENTION(Individualize Technology Concerns)
O Separate each concern theapplicant has mentioned.Where and when does the con-cern for each task occur? Athome, outside the home suchas school, or work?
O Will more than one environ-ment be affected when thisconcern is addressed?
0 Other than assistive devices,what assistance does the ap-plicant have in performingtasks?
0 Does the applicant have orknow of financial resourcesthat can be used to addresstechnology concerns?
O Does the applicant appear tohave a workable knowledge ofrehabilitation technology?
O What has the applicant tried inthe past that did or did not workin attempting to solve this con-cern?
O Does the applicant appearcomfortable with consideringthe use of alternate ways ofaccomplishing tasks?
O Are counselor concerns notedregarding the use of technol-ogy that the applicant may notsee?
O Have all facts been obtainedand information reviewed?
PREPARATION(Prioritize Technology Concerns)
0 Is there a primary area of con-cern?
O If there is more than one con-cern, should any be addressedtogether? (For example, seat-ing and positioning in a wheel-chair might effect use of a com-puter switch; devices andequipment prescribed for mo-bility might affect equipmentneeds for adaptive driving, etc.)
0 In what order should the con-cerns be addressed?
0 Are there deadlines that mustbe considered in addressingconcerns?
O What agency guidelines mustbe addressed in consideringthis/these concern(s)? Has ap-plicant been advised of theseguidelines?
O Who is needed in addition tothe counselor and the appli-cant to help solve this/theseconcernIs)?
O What additional informationmight be indicated before ad-dressing this/these concern(s)?
62
TECH POINTS Integrating Rehabilitation Technology into Vocational Rehabilitation Services
STEPS(Steps for AddressingTechnology Concerns)
O What immediate technologyconcerns will be addressednow?
O What technology specialist(s)is/are needed to assist in as-sessment of technologyconcern (s)?
O Who is responsible for contact-ing the specialist(s)?
O Are time frames set to follow-upon steps that are indicated?
O Has the applicant been advisedof a time to check on progresstoward a solution?
O Has theapplicant been involvedto the fullest extent possible?
O Have alternatives been consid-ered?
O Is financial assistance neededto address any technology con-cerns?
Notes:
Center for Rehabilitation Technology Services
63
5-7
Reminder at TECH POINT 1 (02)
Are technology services needed?
Document on:
Application
Rehabilitation Technology Services
Profile
Case Notes
Rehabilitation Technology Needs Profile
Name Case #
Disability (primary) Code
(secondary)
VR Counselor
Review "major life activities" for which the applicant expresses/demonstrates concerns. Estimate level of
independence for activities where concerns are indicated.
Estimate Degree of independence
MOW' Life ActivitiesArea ofConcern
EmploymentConcern Related
Independentw/Assistive
Devices
RequiresAssistance and
Devices
UsesAssistance
OnlyRehab Technology
Assessment indicated
Self Care
Performing ManualTasks
Walking
Seeing
Hearing
Speaking
Learning
Breathing
Working
Transportation
Lifting/Pulling/Pushing
Memory
Are reasonable accommodations likely to be needed for the applicant to function effectively in any of thefollowing environments?
6,10 YES 0 NO Possibly
O YES 0 NO Possibly
0 YES 0 NO Possiblyint
0 YES 0 NO Possibly
0 YES 0 NO Possibly
EST COPY AVAILABLE
Accommodations/Strategies to Consider:
64
For the areas where problems or restrictions are encountered, does the individual utilize any type of technologyaids or devices? 0 YES NO
Check [1] what assistive technology aids/devices that the applicant uses or has used.
Aids for Daily Living
personal careeating/drinking/cookinghygiene/toiletingother
Flow chart taken fromRehabilitation Counseling:Basic and Beyond (1987)
SECTION 8
OTECH POINT
ClosureOutcomes
0826
283034
/CLO2S6UREF
ADDLSERVICES
CEDED?
TECH POINT
32 POST I
EMPLOYMENT7( SERVICES
SERVICES
34 I
CLOSURE'
66 BEST COPY AVAILABLE
TECH POINTS Integrating Rehabilitation Technology into Vocational Rehabilitation Services
TECH POINT 2Extended Evaluation
In this section
6-1
SECTION 6
A Closer Look at Rehabilitation Technology Needs
Incorporating Rehabilitation Technology into Vocational Evaluation Services
Technology Intervention Preparation Steps (TIPS)
A Closer Look at Rehabilitation TechnologyNeeds
TECH POINT 2 is important for the counselor and the client. All ormost preliminary evaluations have been arranged and are com-plete so that acceptability for VR services (status 06) is possible. It isimportant that the client understand the time frames for extendedevaluation. A decision regarding eligibility must be reached within18 months.
Some points to remember in TECH POINT 2:
For clients with severe disabilities, it is likely that the entire 18months for extended evaluation will be needed to ad-equately address needs.
A team approach is important in considering accommoda-tions or other rehabilitation technology.
Keeping the client informed and involved is critical to theprocess if the outcome is to be successful.
Center for Rehabilitation Technology Services 67
TECH POINT 2 is a documentation point as goals for the ExtendedEvaluation Plan will be written with and signed by the client. Theclient and counselor have together recognized possible concernsand needs for technology in the rehabilitation process. This is animportant time to use the resources available so that correct deci-sions are made. Many questions can and will arise.
In using the Technology Intervention Preparation Steps (TIPS) forvocational evaluation, the need for a pre-evaluation staffing toaddress technology issues may be identified. TIPS can help thecounselor decide if the technology concerns should be addressedprior to vocational evaluation, during or if it can wait until theevaluation is completed. This process will help the counselor and theclient deal with technology concerns in a systematic way, increaseefficiency, and reduce frustrations that often occur.
Sharing technology use and concerns with everyone associatedwith the technology and evaluation team is important. This will helpimprove the quality of the evaluation and reduce the time needed toreach vocational objectives.
Incorporating TECH POINTS into the extended evaluation pro-cess can provide the counselor and the client with time to makerational decisions based on facts. It will help avoid making poortechnology decisions such as if the solution worked with oneperson, it will work for another with the same disability.- It will alsohelp in dealing with clients with new disabilities who have read orheard about devices that "sound good," but in practical use have nomerit, or devices that will allow him/her to do a task then "recover."For example, a client may believe that a wheelchair that allows him/her to stand will help him/her to eventually stand on his/her own.TECH POINTS allows a counselor to discuss assistive technologywith a client in a reassuring way. Often a counselor will discoverunresolved conflicts suggesting the need for additional counselingand guidance.
68
TECH POINTS Integrating Rehabilitation Technology Into Vocational Rehabilitation Services
V Incorporating Rehabilitation Technologyin Vocational Evaluation Services
If TECH POINT 1 identified challenges in performing "major lifeactivities," then it is likely that some type of accommodation will beneeded in the vocational evaluation process. Inclusion of technologyresources will enable vocational evaluators and counselors betterprepare the client to perform at their fullest potential and exploreareas and career options through consideration of technologyresources.
Using assistive technology aids and devices for vocational evalu-ation will assist the vocational evaluator in accurately determining:
Client's strengths;
Extent of limitations;
Physical and mental capabilities; and
Learning and skill acquisition potential.
The same process employers use to accommodate workers withdisabilities should be applied to vocational evaluation activities.Employers are expected to consider a worker with or withoutreasonable accommodations," when making a decision about his/her ability to perform the "essential functions" of the job. This sametest should apply to the vocational evaluation setting.
Possible reasonable accommodations to discuss with the voca-tional evaluator include:
Lengthening or modifing the testing schedule;
Selecting alternative assessment instruments;
Deleting inappropriate tests or work samples;
Modifying administration procedures when necessary;
Having adaptive equipment available for try-out andloan;
Providing additional lighting;
Rearranging the assessment environment to provide aquiet, isolated work area; and
Utilizing an aide for one-on-one assistance.
Center for Rehabilitation Technology Services
89
6-3
All assessments, including vocational
evaluations, must consider
individual's ability to perform
essential functions of a job with
or without reasonable
accommodations
difference between essential
functions and physical demands
of a job
The Job Placement - ADA Connection,
(1993)
YR
Identifying a vocational objective that falls within the client'svocational goals and expectations is one of the most important tasksthat the vocational evaluator and counselor share. Technology re-sources and services can allow this to happen more effectively formany persons with disabilities.
Technology Intervention Preparation Steps
The following questions and considerations will help determine ifspecific rehabilitation technology services are needed.
Tips for Extended EvaluationStatus 06
TECHNOLOGY(Technology Concerns Identified)
0 Does a person with this type ofdisability generally need ac-commodations to complete avocational evaluation?
0 Is transportation a barrier? Ifso, is there a temporary solu-tion to allow completion ofvocational evaluation?
0 Would providing technology of-fer the opportunity to explorevocational goals that would notbe considered otherwise?
INTERVENTION(Individualize Technology Concerns)
0 What technology concerns, ifany, need to be discussed withthe vocational evaluator? Dothese concerns need to be dis-cussed prior to evaluation?
0 Is equipment presently beingused by the client adequate tocomplete vocational evalua-tion?
0 Is a technology assessmentneeded to help determineequipment needs and modifi-cations prior to vocationalevaluation (e.g., keyboard ac-
cess, communication devices,seating issues, etc.)?
0 Can equipment be borrowedor rented before a purChase ismade?
0 If any technology is recom-mended, what impact will ithave on the home, commu-nity, training or work environ-ments?
TECH POINTS Integrating Rehabilitation Technology Into Vocational Rehabilitation Services
PREPARATION(Prioritize Technology Concerns)
0 Would delaying a technologyintervention cause inadequateevaluation or a threat to healthof this client?
El Is there an order for address-ing the technology concernsidentified in this status?
0 Are there deadlines that needto be met?
0 Who else needs to be involvedin setting these priorities?
0 What is the impact of these pri-orities in terms of people,health, money and agencyguidelines?
0 Are VR services dependent onthis need being met and is thisconcern essential for employ-ability?
STEPS(Steps for AddressingTechnology Concerns)
0 Who will fund the technology?
0 Who will do what in address-ing concern(s)?
0 What is the time frame for ad-dressing concern(s)?
0 Has the client been involved?Does he/she understand his/her responsibilities?
Notes:
Center for Rehabilitation Technology Services
6-5
Reminder at TECH POINT 2 (06)
Are technology services needed?
Document on:
Extended Evaluation Plan
Review at 90 Day Intervals
References
Pimentel, R.K., Bell C.G., & Lotito, MJ.(1993) The job placement-ADAconnedion. Chatsworth, CA: Milt Wright & Assoc.
e
72
TECH POINTS Integrating Rehabilitation Technology Into Vocational Rehabilitation Services
TECH POINT 3Plan Development
TECH POINT
CO
REFERRAL
02APPLICANT
EVALUATION
NO ELIGIBLE YES
TECH POINT
MAYBE
06EXTENDED
EVALUATION
EVALUATION
8CLOSURE
24SERVICE
INTERRUPTED
Flow chart taken fromRehabilitation Counseling:Basic and Beyond (1987)
TECH POINT
S10
mapDEVELOPMENT
IWRPJWRITTEN w/
CLIENT
12
COMPjLETED
14 16 18
CEO PR T
sr
TECH POINT
NO 28LONGER CLOSURELIKELY
SECTION 7
111TECH POINT
ClosureOutcomes
Oa
262830
34
34CLOSURE
7 3BEST COPY AVAILABLE
TECH POINTS Integrating Rehabilitation Technology into Vocational Rehabilitation Services
In this section
TECH POINT 3PI n::C evel:op rnent
7-1
SECTION 7
Rehabilitation Technology in the Individualized Planning Process
Anticipating "Reasonable Accommodation" Needs in Planned Services
Technology Intervention Preparation Steps (TIPS)
Rehabilitation Technology in the IndividualizedPlanning Process
TECH POINT 3 implies that the client has been determinedeligible for services. At this point, goals of the Individualized WrittenRehabilitation Plan (IWRP) will be written with the client. Counselorswho use the TECH POINTS process write, with their client, anindividualized plan, in the strictest sense of the term. When writingplans for people with severe disabilities, it is often necessary toinclude one or more reasonable accommodations in order to beemployed and maintain independence. Accommodations will varywith the person and the task(s) the person will be completing.
By the time TECH POINT 3 is reached, many goals involvingassistive technology services will have been defined. TECH POINT3 is a good time to use the services of a technology specialist to makesure the needs of the client have been addressed appropriately.Client involvement should once again be emphasized. The client
Center for Rehabilitation Technology Services 74
should be gaining knowledge of technology services and realizinghow technology services can be beneficial to achieving their voca-tional goal.
TECH POINTS is a tool for counseling. Using TECH POINTS canenhance writing the rehabilitation plan by making sure consider-ation is given to writing goals that include:
Counseling the client on practicing and developing prob-lem-solving skills when technology assistance is needed;
The client's responsibility in their placement goal;
Increasing client's ability to discuss "reasonable accommo-dations" and -essential functions" in an interview, trainingor employment setting;
Counseling to assist the client's understanding of the costand care of equipment; and
Counseling to enhance client's self-esteem and confidencein using appropriate technology.
Before concluding the IWRP, a careful review of each goal by thecounselor and client will help ensure that all environments havebeen considered.
Anticipating "Reasonable Accommodation"Needs in Planned Services
VR counselors learn quickly that no matter how much planning isdone, people and events are always changing. However, by usingthe TECH POINTS system to serve as a review in preparing anindividual's plan, problems can be anticipated.
It is important to discuss "reasonable accommodations" with allclients. People with many types of disabilities can benefit fromrehabilitation technology use. By discussing how "major life activi-ties" affect employment, many concerns can be eliminated asbarriers.
75
TECH POINTS Integrating Rehabilitation Technology into Vocational Rehabilitation Services
Technology Intervention Preparation Steps
The following questions and suggestions will help to anticipateneed for technology in planned services:
Plan DevelopmentStatus (10) (12)
TECHNOLOGY(Technology Concerns Identified)
O What challenges does the dis-ability createinworking towardthe vocational objective?
O Review technology which theclient currently uses to deter-mine if it can be used in achiev-ing the vocational goal.
O Would technology potentiallyassist the client in overcomingthese challenges?
O Does the client have any con-cerns about the use of technol-ogy in working toward the vo-cational goal?
INTERVENTION(Individualize Technology Concerns)
O Have needs changed in trans- 0 Have technology needs beenportation, housing, equipment, appropriately documented toor communication? If so, have justify written goals on thenew technology needs been IWRP?
created in home, community,vocational rehabilitation, 0 Doestheclientunderstand howschool/training, or work envi- the technology goals relate toronments? the vocational goal?
O Is rehabilitation technologynecessary for the achievementof the vocational objective?
Center for Rehabilitation Technology Services
76
AIL
7-4
Reminder at TECH POINT 3
(10) (12)
Are technology services needed?
Document on: The IWRP
PREPARATION(Prioritize Technology Concerns)
O In what order will technologyconcerns identified in this sta-tus be addressed?
0 Other than the client and thecounselor, who else should beinvolved in setting priorities?
O How will the time needed toachieve technology goals af-fect the implementation of ser-vices (including accommoda-tion for job applications andinterviews) or achievement ofthe vocational goal?
O How much time will be needed CI Does client need time to adjustto carry out each technology to the technology or accom-goal? modation?
O Will the goal of employment bedelayed if technology concernsare addressed later in theprocess?
STEPS(Steps for AddressingTechnology Concerns)
O What steps are needed toachieve the technology goals?
O Who should be involved in pro-viding the technology servicesand what form should their in-volvement take?
El Is there a plan for completingeach step?
O Who will fund the purchase ofthe technology?
O Has the client been involved?Does he/she understand his/her responsibilities?
77
TECH POINTS Integrating Rehabilitation Technology into Vocational Rehabilitation Services
1!)TECH POINT 4Services
TECH POINT
00REFERRAL
02APPLICANT
EVALUATION
NO YES
06EXTENDED
EVALUATION
TECH POINT
EVALUATION
/CLOSURE
O8
TECH POINT 12
10/RP
COMPLETED
/CLOSURE/
30
TECH POINT
NO 28LONGER CLOSURELIKELY
24SERVICE
INTERRUPTED
Flow chart taken fromRehabilitation Counseling:Basic and Beyond (1987)
SECTION 8
11-1.0TECH POINT
ClosureOutcomes
08
26
28
30
34
26CLOSURE
ADDLSERVICES
EEDED?
32 POSTEMPLOYMENT SERVICES
SERVICES
34CLOSURE
7 8 BEST COPY AVAILABLE
TECH POINTS Integrating Rehabilitation Technology into Vocational Rehabilitation Services
TECH POINT 4Services
In this section
Providing Services: Using Rehabilitation Technology Support
Changing Technology. Needs: Making Amendments to the Plan
Technology Intervention Preparation Steps (TIPS)
Providing Services: Using RehabilitationTechnology Support
Following procedures that were established for TECH POINT 3,areas where a technology specialist is needed should have beenidentified in the IWRP. However, there will betimes when technologyassistance was not anticipated on the IWRP.
Identification of possible problem areas during the processshould cut down on the number of "emergency" needs. Withoutplanning, people who rely on assistive technology will run intoproblems. Planned VR service is an excellent time for the counselorto teach the client how to think through situations and learn toavoid problems. This may, at times, involve consulting with or usinga technology specialist to explain options with a client. The clientshould learn the importance of maintaining equipment so thatproblems can be prevented.
The counseling goal of being able to discuss "reasonable accom-modations" and "essential functions" on the job should continue tobe reinforced. A client can begin practicing this in the training
Center for Rehabilitation Technology Services 79
SECTION 8
8-2
"While it may, in fact, be tempting
to rely on more
technological solutions to
rehabilitation,
rehabilitation counselors
have so much more to
offer individuals with disabilities.
It seems that the
participants in the research were
saying, above all else, that they
needed, and would have
benefitted tremendously
from very early,
individualized rehabilitation
counseling."
(Scherer, 1990)
period. It is important that the client assume as much responsibilityas he/she can.
It is essential to provide counseling and guidance services aboutrehabilitation technology to clients with severe disabilities. By re-ceiving this service, clients tend to be more involved, more satisfiedwith services and more likely to use their technology.
Clients receiving physical restoration services often have an ob-vious need for technology assistance. Purchases such as wheel-chairs, prosthetic devices and hearing aids would automaticallysuggest using assistive technology and a technology specialist.Less obvious areas that would suggest consideration of technologyassistance may be VR services for persons with heart problems,diabetes, brain trauma and back problems. TECH POINTS shouldkeep the counselor and the client from overlooking areas wheretechnology could improve the outcome. For people who have dia-betes, devices such as glucometers can make a tremendous differ-ence in the control of diabetes. Lifting devices and/or carts may beconsiderations for people with lifting, pulling, and pushing limita-tions.
While technology is typically considered and provided for clients Swith severe disabilities receiving post-secondary training, personal,social and work adjustment is an area of training where technologyconsultation and use may be overlooked. Obviously, limitationshave been identified to determine a need for this service. Peoplewith cognitive problems resulting from head trauma or stroke,persons who are mentally retarded, or persons with learning dis-abilities can benefit from simple technology aids such as a spellinghelper, calculator, counter or even a watch with an alarm to remindthem to stay on task, look at a schedule or go to the next task.
Changing Technology Needs: MakingAmendments to the Plan
As a person becomes more independent and active, equipmentand assistive technology that was appropriate during earlier VRstages may no longer be adequate. A client may even find the needfor less technology assistance because of improved strength andendurance or actual improvement in their physical condition. Con-versely, the client may find that by using assistive technology theyare more productive and competitive. A counselor should help aclient learn to monitor changing needs and to be ready to consultwith a technology specialist when indicated.
80TECH POINTS Integrating Rehabilitation Technology into Vocational Rehabilitation Services
An excellent time to discuss with the client the importance oflong-range planning for anticipated technology needs is when aplan is amended for technology services, equipment repairs orchanging technology needs. This is also a good time to restate theagency's policy regarding purchasing and maintaining equipmentafter a case is closed. For technology users, it is imperative to havecontingency plans for emergencies. This is a must if employment isto be obtained and maintained.
The environments remain important. A client's living arrange-ment may change several times during training and each situationmay present a different problem. Training sites may have needsthat are constantly shifting because of the nature of the training.
v Technology Intervention PreparationSteps (TIPS)
The Technology Interventions Preparation Steps (TIPS) continuesto be a good method for solving technology problems as they arise.This method again keeps steps logical and timely so that needs canbe met and the plan not interrupted. Rehabilitation technologyconcerns should be reviewed when periodic reviews and amend-ments are completed. This gives the client and the counselor thechance to control events as much as possible.
TIPS for Planned ServicesStatus (141-Counseling and Guidence
Status (161-Physical Restoration
Status (181-Training
TECHNOLOGY(Technology Concerns Identified)
0 What previously unidentified 0 What is the client's comfortchallenges to receiving services level with technology?does the disability potentiallycreate?
0 What technology could poten-tially assist in meeting thesechallenges?
Center for Rehabilitation Technology Services 81
INTERVENTION(Individualize Technology Concerns)
O Does the client have any newconcerns regarding equip-ment, modifications, etc., sincethe last review?
O Have there been changes inany environment (e.g., home,community, school/training or,work environments)?
O Does the technology beingused have any unanticipatednegative impacts in these en-vironments?
0 Do others involved with theclient have any concerns abouttechnology the client is using(e.g., instructors, family, atten-dants, etc.).
0 Are assistive technology de-vices being maintained on aregular basis?
PREPARATION(Prioritize Technology Concerns)
O In what order should technol-ogy concerns be addressed?
O If a new technology concern isnot met or technology currentlybeing used is not updated, willthis cause a threat to the health
of the client or the achieve-ment of the vocational plan? Ifso, is immediate interventionneeded?
Notes:
TECH POINTS Integrating Rehabilitation Technology Into Vocational Rehabilitation Services
STEPS(Steps for AddressingTechnology Concerns)
0 For each concern identified,what technology specialistsmust become involved andwhat form must this involve-ment take?
0 What responsibility does theclient have in addressing con-cerns? Does he/she under-stand his/her responsibilities?
0 What is the time frame for ad-dressing concern(s)?
0 Who will fund the technology?
Notes:
Center for Rehabilitation Technology Services 83
8-5
I
T.... ....
97
Reminder at TECH POINT 4
(14) (16) (18)
Are technology services needed?
Document:
IWRP Amendments Periodic Reviews
References
Scherer, M.J. (1990) Assistive device utilization and quality of life inadults with spinal cord injuries and cerebral palsy two yearslater. Journal of Applied Rehabilitation Counseling, 21(4), 36-44.)
84
TECH POINTS Integrating Rehabilitation Technology Into Vocational Rehabilitation Services
TECH POINT 5Placement/Follow-Up
TECH POINT
NO
TECH POINT
00REFERRAL
02APPLICANT
EVALUATION
ELIGIBLE
MAYBE
06EXTENDED
EVALUATION
EVALUATION
YES
CLOSURE N
24SERVICE
NTER UPTED
Flow chart taken fromRehabilitation Counseling:Basic and Beyond (1987)
TECH POINT
S IWRP
DEVELOPMENT
IWRPWRITTEN w/
CLIENT
IWRP
COMPLETED
/CLO3S0URE/
14
COG
8 18
PR T
TECH POINT
NOTYET
20READY FOR
EMPLOYMENT
( PLACEMENT
NO 28LONGER'R' CLOSUREUKELY
22IN
EMPLOYMENT'
FOLLOW -UP
/CLO2S6URE
OTECH POINT
a
SECTION 9
TECH POINT
ClosureOutcomes
08
26
28
3034
TECH POINT
ADDLSERVICES
EEDED7SERVICES
34CLOSURE
8 5 BEST COPY AVAILABLE
TECH POINTS Integrating Rehabilitation Technology into Vocational Rehabilitation Services
TECH POINT 5Placement/Follow-up
In this section
9-1
SECTION 9
Using the Rehabilitation Technology Specialist in Job Development
Placement Strategies Using Rehabilitation Technology Resources
"Essential Functions" of the Job: Determining What's Important
Follow-up for Rehabilitation Technology Interventions
Technology Intervention Preparation Steps (TIPS)
Using the Rehabilitation Technology Specialist inJob Development
Placement, TECH POINT 5, is often the time when a counselor orclient will recognize a need for technology services. Job analysis isan area that is often overlooked where a technology specialist canbe helpful.
Counselors who work primarily with people who have severephysical disabilities realize the importance of staying alert aboutfuture job placements. Early exploration while a client is still intraining or receiving other services is important. A rehabilitationengineer or other rehabilitation technology specialist can be mosthelpful in deciding how -essential functions' on a job site can beaccommodated.
The ADA will become an excellent tool to gain acceptance at jobsites that were previously closed to many clients. While exploringpotential job sites, the employer's application and referral process
Center for Rehabilitation Technology Services66
must be analyzed. A technology consultation may be needed re-garding modifications or accommodations for the application pro-cess. Knowing these things ahead of time will help the client main-tain confidence and self-esteem. By preparing for the interview, theclient can concentrate on the actual interview and not worry aboutaccommodations that should have been made.
Vocational rehabilitation is unique in that it can offer employersaccess to rehabilitation technology resources and services. Using atechnology specialist to "consult" with employers can help withimmediate placement needs while also accomplishing job develop-ment for future placements. Utilizing technology consultation ser-vices to determine the feasibility of work site modifications or esti-mate costs can be a practical benefit to offer employers.
The concept of a "universal workplace . . . an environment incor-porating features useful to workers with and without disabilities"offers options for employers that can have other benefits (Mueller,1989). Applying principles of ergonomic design can help reduce theneed for accommodations and lessen the risk of work-relatedinjuries such as repetitive motion and lifting injuries. Using a rehabili-tation technology specialist familiar with work site accommodationsand industrial engineering principles can be a good resource for acounselor in approaching an employer who is reluctant to consideraccommodations.
v Placement Strategies Using RehabilitationTechnology Resources
VR data suggest many clients receive training but fail to obtainemployment. This may occur because the client and/or counselorbecome discouraged trying to address so many obstacles andbarriers in seeking employment. If the first few attempts at trying toresolve employment problems fail, it is hard to keep trying. Oftenthese failures can be attributed to minor problems which could havebeen resolved with a technological intervention.
Using TECH POINTS during the VR process will better prepareboth client and counselor for job placement activities. The Technol-ogy Intervention Preparation Steps (TIPS) approach that worked inapplying for and using VR services will work in an employmentsetting. Advanced preparation and anticipation of concerns will payoff! 87
TECH POINTS Integrating Rehabilitation Technology into Vocational Rehabilitation Services
Each job placement is unique and TECH POINTS will assist inidentifying how to approach job site modification and accommoda-tions. Unique problems such as transportation issues that wereresolved for training may need different considerations for jobplacement. Reviewing adaptive equipment needs will ensure thatequipment continues to work for a client at home and at work.
Placement may involve relocation for a client and this couldchange his/her ability to perform other "major life activities." Appro-priate VR services should include helping the client review presentneeds and again anticipate changing needs.
"Essential Functions" of the Job:Determining What's Important
In job placement, it is important to identify the "essential functions"of the job. Too often, persons with disabilities have been eliminatedfrom applying for a job because of the method by which a task istypically performed, not the accomplishment of the task (e.g., typingwith fingers as opposed to typing by voice input). ADA makes the VRcounselor's ethical role such that if a client is qualified for a job withor without reasonable accommodations: then a referral should bemade. The decision then rests on the employer and the client todetermine his/her ability to perform "essential functions" of the job.
To help determine if a job function is "essential" for a person witha disability:
Consider:
Whether employees in the position actually are required toperform the function
Whether removing that function would fundamentallychange the job
Center for Rehabilitation Technology Services 88
9-3
Sometimes consideration of a custom
made piece of equipment is neces-
sary, but most often there are
commercially available aids and
devices which will work.
Reasonable Accommodations
"any change in the work
environment, or the way things are
customarily done, which allow an
individual with a disability equal
employment opportunity"
The Job Placement ADA Connection
(1992)
Reasonable Accommodations: IncreasingPlacement Success with RehabilitationTechnology
Reasonable accommodations should be an interactive processinvolving client, counselor, employer and, when needed, the tech-nology specialist, working together as a team. Each member of theteam has a special role based on their expertise and interest.
The client is the most knowledgeable about the limitationsof their disability and the concerns and expectations theyfeel toward the use of technology resources. They are themost important member of the team since they will be theone using the aid or device on a regular basis.
The counselor is able to help all the team members focuson the common objective of successful employment. An-other responsibility of the counselor is assisting the clientand employer in understanding obligations and responsi-bilities concerning technology.
The employer understands the essential functions of thejob and needs within the overall work environment. UnderADA, most employers should be aware of their responsibil-ity to make reasonable accommodations for workers withdisabilities. Including the employer on the technology teamcan result in new ideas and may create options otherwisenot considered.
The technology specialist can help in identifying reason-able accommodations that the client and employer may nothave considered. A rehabilitation engineer will often look ata situation from a different perspective, suggesting how amodified hand tool or a re-arranged workstation couldsolve a problem.
Sometimes roles shift based on the skills and expertise of one ofthe team members. Often the "reasonable accommodations" canbe proposed by the client without extensive involvement from theemployer. For example, if the client is particularly skilled in makingaccommodations for their limitations, they may be able to suggesthow things can best be accomplished. When this occurs, the coun-selor should assume a supportive role permitting the client moreflexibility and freedom in making decisions about his/her employ-ment.
89,TECH POINTS Integrating Rehabilitation Technology Into Vocational Rehabilitation Services
If accommodations are found to be necessary, the involvement ofthe technology specialist to help problem-solve and suggest alter-natives is usually beneficial. A look at how this accommodationprocess usually occurs illustrates the perspective of most technol-ogy specialists.
The accommodation process that a technology specialist willgenerally follow:
O Identification of the capabilities and limitations of theindividual and the specific demands of the job.
O Determination of and which aspects of the job areproblems barriers for the individual in terms of:
specific tasks,the work environment.
O Determination of possible solutions to overcome thebarriers:
changing the job,changing the equipment,changing the capabilities of the individual.
O Initiation of the change and evaluation.
(Designing Jobs for Handicapped Workers, 1985)
This process illustrates how technology specialists approach theidentification of what the actual barriers are and then look atpossible solutions.
Follow-up for Rehabilitation TechnologyInterventions
Active follow-up by the VR counselor can make a difference for theclient and the employer. Offering technology consultation servicesis sometimes the very thing that can keep a client and employerworking together to solve a problem. Often small tasks seeminsurmountable. A job site visit or job analysis from a technologyspecialist can often suggest simple solutions to problems.
In conducting follow-up, the counselor should ensure that anyworkstation modifications or assistive technology equipment isfunctioning effectively. Follow-up on technology interventions can
Center for Rehabilitation Technology Services 90
be important since clients sometimes stop using assistive technol-ogy without informing the counselor or employer. The reasons forabandonment vary; improvement in client functioning, changes injob tasks, inappropriate equipment, etc. It is important for thecounselor to determine the reason and make changes if necessary.This will also help to increase the counselor's knowledge of howtechnology resources and services can be used most effectively.
Technology Interventions Preparation Steps
Technology Intervention Preparation Steps (TIPS) can serve as aquick check to see if technology concerns are being met duringplacement.
(TIPS) For Placement and Follow-up(20) (22)
TECHNOLOGY(Technology Concerns Identified)
O What challenges to searchingfor and obtaining work doesthe disability create for this cli-ent?
0 Would technology potentiallyassist this client in overcomingthese challenges?
CI Does the client have concernsabout the use or potential needfor technology in finding ormaintaining a job?
Notes:
91
TECH POINTS Integrating Rehabilitation Technology into Vocational Rehabilitation Services
INTERVENTION(Individualize Technology Concerns)
O Is the technology currently usedby this client adequate to meetapplication, job placement andjob maintenance needs?
O Will any reasonable accommo-dation be needed for the appli-cation process (e.g., interpreteraccessibility, writing aids,transportation, etc.)?
O With the present vocational ob-jective, what needs can be pre-dicted to perform the "essen-tial functions" of the job?
0 Will the present living arrange-ments change when place-ment is achieved? How? Willthis create new technologyneeds?
O What is unique a bout this place-ment (e.g., restrooms, worksta-tion and equipment needs)?Does this work situation createany new technology or accom-modation needs?
0 If the technology need is notmet, will this delay the place-ment of this client in employ-ment?
PREPARATION(Prioritize Technology Concerns)
O In what order should the tech-nology needs identified for thisstatus be addressed?
O Are there any deadlines?
O Other than the client and thecounselor, who else should beinvolved in setting priorities?
O What is the impact of these pri-orities on job application, jobplacement or job mainte-nance?
Center for Rehabilitation Technology Services
92
9-8
*Reminder at TECH POINT 5
(20) (22)
Are technology services needed?
Document on: IWRP Amendments
Annual Periodic
STEPS(Steps for AddressingTechnology Concerns)
O What technology specialistsshould be involved and whatform should this involvementtake?
O Can potential employer and/or client solve the technologyconcern?
O What steps are needed to ad-dress the technology con-cerns?
O Is there a plan for completingeach step?
O Who will fund the technology?
O Has the client been involved?Does he/she understand his/her responsibilities?
O Has the employer been in-volved? Does he/she under-stand his/her responsibilities?
Notes:
93
TECH POINTS Integrating Rehabilitation Technology into Vocational Rehabilitation Services
References
Pimentel, R.K., Bell, C.G., & Lotito, MJ. (1993). The job-placement -ADA connection. Northridge, CA: Milt Wright & Associates.
Mueller, J. (1989). Toward universal design. Proceedings of the 12thAnnual RESNA Conference. pp. 198-199. Washington, DC: RESNA
Press.
Mueller, J. (1990). The Workplace Workbook. Washington, DC: DoleFoundation Americans with Disabilities Act Handbook
Alexander, D. (1986). Designing Jobs for Handicapped Workers.Washington, DC: RESNA Press.
Center for Rehabilitation Technology Services
94
TECH POINT 6Closure
00REFERRAL
TECH POINT 02APPLICANT
EVALUATION
NO ELIGIBLE YES
MAYBE
06EXTENDED
EVALUATION
TECH POINT
EVALUATION
08CLOSURE
24
SERVICEINTERRUPTED
TECH POINT
IWRPWRITTEN wI
CLIENT
12
IWRP
COMPLETED
14 16 16
COG PR T
30CLOSURE
TECH POINT
NO 28LONGER CLOSURELIKELY
TECH POINT
ADDL I 32 POST I
SE
SERVICES
RVICES EMPLOYMENTFlow chart taken from CLOSURE
Rehabilitation Counseling:
... SERVICES
Basic and Beyond (1987)
SECTION 10
OTECH POINT
ClosureOutcomes
08
26
28
30
34
95 BEST COPY AVAILABLE
TECH POINTS Integrating Rehabilitation Technology into Vocational Rehabilitation Services
TECH POINT 6Closure Points
In this section
10-1
-c7-
SECTION 10
Improving Successful Closures Through Use of Rehabilitation Technology
Documenting Consideration and/or Use of Rehabilitation Technology
Technology Intervention Preparation Steps (TIPS)
Improving Successful Closures Through Use ofRehabilitation Technology
Successful employment is VR's goal for each person applying forservices. Successful closure is a time to celebrate the hours of hardwork that have taken place. TECH POINT 6 isan important time toreview what impact technology services had on the successfuloutcome. Even if the outcome was unsuccessful, it is important tosee if technology intervention at a different point would have madea difference.
TECH POINT 6 is a time to review with the client problem-solvingskills to enable him/her to resolve future technology needs. It iscertain that an assistive technology user will need intervention inthe future. This is going to happen because of the changes intoday's job market, transportation, adaptive equipment and possi-
ID bly the client's disability. Just the fact that the client will age oftenchanges the need for assistive technology.
Center (or Rehabilitation Technology Services 96
10-2
It is important to document
o rehabilitation technology services
provided
o assistive technology equipment or
devices purchased
o other technology related services
A review of technology needs with the employer may also beindicated. The counselor or client may want to share the Technol-ogy Intervention Preparation Steps process with the employer.This process could enhance the communication between the clientand employer concerning "reasonable accommodations." It alsoenforces a principle of ADA: First consult the person with a disabilitywhen there is a problem concerning his/her abilityto perform a task.
Documenting Considerations and/or Use ofRehabilitation Technology
Closure of a VR case requires documentation of the services andassistance provided to each client. For successful closures, it isimportant to record those technology interventions that had animpact on successful employment. Careful review of technologyintervention at closure can help a counselor learn what works bestin dealing with technology issues.
Unfortunately, there are times when well-intended use of reha-bilitation technology will not work for a particular problem or need.There are other situations when rehabilitation technology will im-prove functional capabilities, but still not result in employment. It isimportant to document all technology interventions for unsuccessfulclosures. Documentation helps collect information which can beused to determine if technology use had any impact on outcomes.This should help improve the counselor's judgement about whenand where to use technology services.
Certain types of unsuccessful closures are scheduled for "ineligi-bility reviews" within a year after closure. Sometimes it is determinedthat cases can be reopened and that the technology interventionspreviously used did make a difference. It is equally important toinvestigate changes in the client's disability to warrant reconsideringrehabilitation technology.
97
TECH POINTS Integrating Rehabilitation Technology Into Vocational Rehabilitation Services
Technology Intervention PreparationSteps (TIPS)
Technology Intervention Preparation Steps (TIPS) at closure serveas a quick check to see if technology concerns were appropriatelyconsidered throughout the VR process. This should be completedfor both successful and unsuccessful cases.
For clients who are successfully employed, counselors should usethe following questions and considerations to quickly review thecase to ensure that the closure is appropriate and that any technol-ogy-related considerations needed to maintain employment areaddressed.
TECHNOLOGY(Technology Concerns Identified)
O Review possible challengeswhich this disability may cre-ate in maintaining successfulemployment.
0 Would technology potentiallyassist the client in overcomingthese challenges?
O Does the applicant have con-cerns about using technologyin any environment?
O Does the employer have con-cerns about the client usingtechnology on the job?
Center for Rehabilitation Technology Services
98
10-4
INTERVENTION(Individualize Technology Concerns)
O Is the client meeting job expec-tations and performing the "es-sential functions" of the job? Ifnot, why not (e.g., speed, lackof skills, inability to use equip-ment, etc.)? Would technologyor accommodations help theclient meet performance re-quirements?
0 Can the employer and clientpinpoint the task which is cre-ating the problem? What solu-tions have been tried or con-
sidered? Would technology oraccommodations help the cli-ent overcome the problem?
O Does the company have otheremployees who may be able tomake the accommodation(e.g., a technical person on staff,in-house maintenance, etc.)?
O Are there any anticipated post-employment needs that mayinvolve technology?
PREPARATION(Prioritize Technology Concerns)
O In what order should the tech-nology needs identified for thisstatus be addressed?
O Are there any deadlines?
O Can the concerns be resolvedin a reasonable time frame?
O Is employment in jeopardy ifnot solved immediately?
O Is there a temporary solutionthat will work until a more per-manent solution is found?
0 Other than the employer, theclient and the counselor, whoelse should be involved in set-ting priorities?
O What is the impact of settingthese priorities in terms ofpeople, health, money, agencyguidelines or employment?
99
TECH POINTS Integrating Rehabilitation Technology Into Vocational Rehabilitation Services
STEPS(Steps for AddressingTechnology Concerns)
O What technology specialistsshould be involved and whatform should this involvementtake?
O Can the employer and/or cli-ent solve the technology con-cerns?
O What steps are needed to ad-dress the technology con-cerns?
O Is there a plan for completingeach step?
O Has the client been involved?Does he/she understand his/her responsibilities?
O Has the employer been in-volved? Does he/she under-stand his/her responsibilities?
For clients who have not been successful in obtaining or maintain-ing employment, counselors should carefully review the case todetermine if appropriate consideration was given to technologyresources and services.
TECHNOLOGY(Technology Concerns Identified)
O Review challenges which thisdisability created in consider-ing vocational rehabilitationpotential.
O Would technology potentiallyassist the client in overcomingthese challenges?
O Does the applicant have con-cerns about using technology?
O Were possible impacts of tech-nology on home, community,school/training and work envi-ronments considered?
O Has the use of technologybenefitted the client?
O Were all funding options con-sidered?
0 Did the client or counselor's at-titude toward technology af-fect the outcome for this client?Have all alternatives been con-sidered?
PREPARATION(Prioritize Technology Concerns)
O Were all people who neededto be involved, adequately in-volved in a timely and appro-priate fashion? If not, involvethe a ppro priate people prior toclosure.
0 Was the technology specialistconsulted in an appropriateand timely fashion? If not, con-sider this consultation prior toclosure.
STEPS(Steps for AddressingTechnology Concerns)
0 What steps can be taken at thispoint to prevent unsuccessfulclosure?
0 Has the applicant/client beeninvolved? Does he/she under-stand the reason for closure?
101
TECH POINTS Integrating Rehabilitation Technology into Vocational Rehabilitation Services
TECH POINT 7Post-Employment
OTECH POINT
00
REFERRAL
ENO
06EXTENDED
EVALUATION
EVALUATION
YES
/CLOSURE
24
SERVICEINTERRUPTED
Flow chart taken fromRehabilitation Counseling:Basic and Beyond (1987)
TECH POINT
S41.10
IWRP
DEVELOPMENT
IWRPWRITTEN w/
CLIENT__
12
IWRP
COMPLETED
/CLOSURE
14
CAD
16
PR
18
TECH POINT
NOT WORKVET READY?
28LONGERCLOSURELIKELY /
20READY FOR
EMPLOYMENT a
( PLACEMENT
22IN
EMPLOYMENT!
( FOLLOW -UP )
OTECH POINT
SECTION 11
OTECH POINT
ClosureOutcomes
08
2628
3034
OTECH POINT
32 POST
CLOSURE /~SE-/ 26
EMPLOYMENTEEDED?
SERVICES r( SERVICES34
I CLOSURE
BEST COPY AVAILABLE
TECH POINTS Integrating Rehabilitation Technology into Vocational Rehabilitation Services
TECH POINT 7Post Employment
In this section
SECTION 11
Maintaining Employment Using Rehabilitation Technology
Anticipating Maintenance and Replacement Needs forAssistive Technology Devices
V Technology Intervention Preparation Steps (TIPS)
V Maintaining Employment Using RehabilitationTechnology
Post-employment needs can sometimes be anticipated at thetime of closure. It is possible that a person's job site or the nature ofthe job is scheduled to change after several months on the job. It isreassuring for the client and the employer to know that assistivetechnology services are available should they be needed. This canbe an excellent tool for enhancing job placement.
If a client needs post-employment services, the TechnologyIntervention Preparation Steps (TIPS) should be applied todetermine if there is an immediate threat to employment or if theintervention will enhance opportunity. The TECH POINTS processwill help determine if post-employment services are indicated and/or if a new case should be opened. Rehabilitation technology ser-vices are one of the major reasons that post-employment servicesmight be indicated.
Center for Rehabilitation Technology Services 103
Change is unavoidable. lay-offs, promotions or any other factorsthat affect jobs can create major problems for persons with disabili-ties who rely on technology services and devices in the employmentsetting. Post-employment services are often needed to help analyzechanges and determine needs.
Anticipating Maintenance and ReplacementNeeds for Assistive Technology Devices
Persons who rely on technology know that their equipment willneed maintenance and repair. This is true of any technology, notjust that used for rehabilitation purposes. The person with a disabil-ity needs to know where and how equipment can be repaired andmaintained quickly and efficiently so that employment is not inter-rupted. It is imperative that the person with a disability learn his/herresponsibility for doing this on a periodic basis.
If a person uses specialized equipment, a list of distributors,vendors and technology specialist should be kept updated. He/sheshould know the name of the equipment and all information per-taining to repair or replacement.
It is important to discuss the "lifespan" and cost of assistivetechnology. Manual wheelchairs, for example, are expected to lastfive to seven years; other items such as crutches and walkers mayneed replacement every two to three years. Van modifications cancost $30,000 or more. Counselors should ensure that the client iseducated about employer benefits, savings, low interest loans andother options that may be available in the community. If a clientreceives Social Security or 551, discussing Work Related Expensesand Work Incentive Plans is necessary. Many clients do not takeadvantage of these benefits that have been written into law. Indi-vidual tax deductions and small business tax credits and deduc-tions are available and might be considered by the person with adisability or his/her employer. Responsibility for upkeep and main-tenance should not come as a surprise to the client after the case isclosed. A newly equipped van, a new power chair, etc., are largeexpenses and VR cannot be expected to always be responsible.
104
TECH POINTS Integrating Rehabilitation Technology into Vocational Rehabilitation Services
Technology Intervention PreparationSteps (TIPS)
Technology Intervention Preparation Steps (TIPS) in post-employ-ment will serve as a quick check to see if technology needs will be anongoing concern and if post-employment services are indicated.
Post-Employment(34)
TECHNOLOGY(Technology Concerns Identified)
O Have any "major life activities"or "essential functions' of thejob changed? If so, did this re-sult in a need for change intechnology?
O Would technology potentiallyassist in overcoming thesechallenges?
0 Does the client have concernsabout the use of technology?
0 Does the employer have con-cerns about the use of technol-ogy on the job?
INTERVENTION(Individualize Technology Concerns)
0 What are the client's technol-ogy concerns? Do they differfrom the employers concern?What caused this concern tobe an issue for employment?
O Are any of the technology con-cerns a direct threat to em-ployment?
0 If the health of the client is aconcern, would technology in-tervention be appropriate/use -ful?
Center for Rehabilitation Technology Services105
*Reminder at TECH POINT 7 (32)
Are technology services needed?
Document:
Post employment follow-up forms
Consider need to open as a new
case
PREPARATION(Prioritize Technology Concerns)
O In what order should the tech- 0 Is there a temporary solutionnology needs identified for this that will work until a more per-status be addressed? manent solution is found?
O Are there any deadlines?
O Can the concerns be resolvedin a reasonable time frame?
0 Is employment in jeopardy ifnot solved immediately?
O Other than the employer, theclient and the counselor, whoelse should be involved in set-ting priorities?
STEPS(Steps for AddressingTechnology Concerns)
O Can the employer and/or cli-ent solve the technology con-cern?
O Can employer and client solvethe technology concerns withreferral to other resources?
O What technology specialistsshould be involved and whatform should this involvementtake?
0 What steps are needed to ad-dress the technology con-cerns?
O Is there a plan for completingeach step?
O Has the client been involved?Does he/she understand his/her responsibilities?
O Has the employer been in-volved? Does he/she need tobe involved?
O Who will fund the technology?
O Will post-employment servicesbe needed or will a new VRcase be opened?
106
TECH POINTS Integrating Rehabilitation Technology into Vocational Rehabilitation Services
TECH POINTS Integrating Rehabilitation Technology into Vocational Rehabilitation Services
Rehabilitation TechnologyAgency Guidelines
In this section
Agency Guidelines
Case Service Policies for Rehabilitation Technology Services
Funding Resources
Forms for Technology Service Activities
Agency Guidelines
In order for TECH POINTS to be effective, counselors should be
kept informed of their agency's guidelines and policies for use ofrehabilitation technology. It is suggested that policies and proce-dures for referral to technology services, selection of technologyservice providers, funding considerations and other technology-related information be included in this section for easy reference.
Center for Rehabilitation Technology Services
108
SECTION 12
12-2
Case Service Policies for RehabilitationTechnology Services
109
TECH POINTS Integrating Rehabilitation Technology Into Vocational Rehabilitation Services
Funding Resources
Center for Rehabilitation Technology Services
110
1
12 -3
12-4
V Forms for Technology Service Activities
111
TECH POINTS Integrating Rehabilitation Technology Into Vocational Rehabilitation Services
11 Rehabilitation TechnologySECTION 13Resources and Training
112
TECH POINTS Integrating Rehabilitation Technology into Vocational Rehabilitation Services
Rehabilitation TechnologyResources and Training
In this section
SECTION 13
Rehabilitation Technology Information Resources and Databases
Technology Resource Catalogs
Periodicals on Rehabilitation Technology Resources and Services
Organizations and Associations
Employment and Independent Living Resources
Local Technology Service Providers
Technology-Related Assistance Projects
Rehabilitation Engineering Research Centers
Training Information
Center for Rehabilitation Technology Services
113
n
REFERENCEINFORMATION ...,
Rehabilitation Technology InformationResources and Databases
IERNIESERNMEEME
The following is a partial resource list for centers, national organizations, and information networks
related to applications of rehabilitation technology. Information on products, publications, and technology
related issues is made available through these centers.
Abledata ProductInformation DatabaseMACRO Systems, Inc.
Extensive collection of over 17,000 commer-cially available assistive technology aids anddevices.
Accent on InformationP.O. Box 700Bloomington, IL, 61702309-378-2961
Information on consumer products and ap-plications of technology from the consumer'sperspective.
Apple Office of SpecialEducation Programs
Apple Computer20525 Mariana Avenue, MS23DCupertino, CA 95014(408) 974-7910
This office is responsible for Apple computertechnologies appropriate to meet the Spe-cial Education and Rehabittation needs ofpeople with a wide range of disabilities.
Clearinghouse On ComputerAccommodation (COCA)
GSA Central Office18th and F Street, NWRoom 1213Washington, DC 20405
A demonstration and technical resource cen-ter providing information on frequently usedhardware /software and workstation furnish-
"
ings to accommodate individuals with dis-abilities. Provides ongoing consultation and/or technical assistance.
Cooperative DatabaseDistribution Network for AssistiveTechnology (CO-NET)
Trace R&D Center on ComputerAccessCommunications, and controlS -151 Waisman Center1500 Highland AvenueMadison, WI 53705608-262-6966 (voice)608-263-5408 (TTY)
Job Accommodation Network(JAN)
809 Allen HallWest Virginia UniversityMorgantown, WV 26506800-526-7234
Employment and placement resource sup-ported by the President's Committee on Em-ployment of Persons with Disabilities.
National Information Centeron Deafness
Gallaudet University800 Florida Avenue, NEWashington, DC 20002202-651-5052 (TTY)202-651-5000 (voice)
114
National Information SystemCenter for Developmental Dis-abilities
Benson Building, First FloorUniversity of South CarolinaColumbia, SC 29208803-777-4435800-922-9234 ext.301
U.S. Dept. of Commerce5285 Port Royal RoadSpringfield, VA 22161703-487-4600(general information)703-487-4650 (documents)703-487-4642 (searches)
RESNA1700 N. Moore StreetSuite 1540Arlington, VA 22209-1903703-524-6686703-524-6630 (fax)
RESNA is an interdisciplinary association forthe advancement of rehabilitation andassistive technology. Provides information,technical assistance, RESNA Press publica-tions, and resources.
REV. 5/94
1i?
REFERENCEINFORMATION ....
Technology Resource Catalogs
The following list represents a sample of the catalogs available on products for persons with disabilities.Most of these are available at no cost and offer "800" number telephone access. Establishing a collection ofcatalogs is an excellent way to obtain information on assistive technology products and equipment.
AIDS FOR DAILY LIVING
Abbey Foster4295 International Blvd., #0Norcross, GA 30093404-564-2224
Quickie Designs Inc.2842 Business Park Ave.Fresno, CA 93727-1328800-456-8168209-292-2171
The Med Group3223 South Loop 289Suite 600Lubbock, TX 79423800-825-5633806-793-8421
SEATING AND POSITIONING
Freedom Designs, Inc.2241 Madera RoadSimi Valley, CA 93065800-331-8551
Jay Medical, Ltd4745 Walnut StreetBoulder, CO 80301800-648-8282303-442-5529
Pin Dot Products6001 Gross Point RoadNiles, IL 60648-4027800-451-3553
Whitmyer Biomechanbc Inc.848 Blountstown Hwy. Suite FlTallahassee, Florida 32304904-575-5510
VISION AND HEARING AIDS
American Foundation for the Blind15 West 16th StreetNew York, NY 10011800-829-0500212-620-2000
Technology Resource Catalogs
Hear you are, Inc.4 Musconetcong Ave.Stanhope, NJ. 07874800-278-3277201-347-7662
Massachusetts Associationfor the Blind
200 Ivy StreetBrookline, MA 02146617-738-5110
Phonic Ear Inc.3880 Cypress DrivePetaluma, CA 94954-7600707-769-1110
AT&T Source Book15 West 6th Street3rd FloorCincinnati OH 45202800-451-2100
LaBac Systems8955 S. Ridgeline BlvdHighlands RanchColorado 80126303-791-6000
McDowell-Craig13146 Firestone BlvdNorwalk, CA 90450213-773-3451
Thomas Register510 Penn PlazaNew York, NY 10001212-290-7262212-290-7373 Fax
The Center for Rehabilitation Technology Services (CRTS) is part of the South Carolina Vocational RehabilitationDepartment. Support for this work has been provided through the National Institute on Disability andRehabilitation Research (NIDRRI, U.S. Department of Education, Washington D.C. as part of the rehabilitationengineering research center grant #H133E20002-93. Opinions expressed in this paper are those of thewriters and should not be construed to represent opinions or policies of NIDRR.
Center for Rehabilitation Technology Services
116
SC Vocational Rehabilitation Department 1410-C Boston Ave. West Columbia, SC 29170
REFERENCEINFORMATION"
Periodicals on Rehabilitation TechnologyResources and Services
This Tech Reference Guide highlights current information on assistive technology that can be found inprofessional journals, magazines and newsletters. An excellent source of current information on assistivetechnology can be found in the numerous professional journals, magazines and newsletters which areavailable. Many of these focus primarily on applications of rehabilitation technology. The following listingdescribes many of these periodicals, including several from the perspective of specific disability groups.Ordering information including cost and a short description is provided for each.
AADC NewsAmerican Association of DisabilityCommunicatorsSponsored by the National EasterSeal SocietyCommunications Department70 E. Lake StreetChicago, IL 606011312) 726-6200
Published quarterly. Cost: $25.00 withindividual membership per year. Newsitems for persons interested in assistivedevices for persons with disabilities.
Accent on LivingCheever Publishing, Inc.Gillum Road and High DrivePO Box 700Bloomington, IL 61702(309) 378-2961
Published quarterly. Cost: $8.00 per year.Articles, pictures and product advertisementsof interest to persons with disabilities.
ACS UpdateAdaptive CommunicationSystems, Inc.354 Hookstown Grade RoadClinton, PA 15026(412) 264-2288
Published quarterly. Cost: free. Conferenceannouncements and articles pertaining totechnical aids and devices used by non-speaking individuals. Also articles of interestto vendors and speech/language patholo-gists.
AFB NewsAmerican Foundationfor the Blind15 West 16th StreetNew York, NY 10011(212) 620-2029
Published quarterly. Cost: free. News andarticles about blindness and low vision.
AOPA AlmanacAmerican Orthotic and ProstheticAssociation1650 King StreetAlexandria, VA 22314(703) 836-7116
Published monthly. Cost: $24.00 per year.News and articles of interest to orthotic andprosthetic practitioners.
Published 6 times a year. Cost: $15.00 peryear. General news articles, announce-ments, and legislative updates relevant tothe field of mental retardation.
AbilitiesCanada's Lifestyle Magazine forPeople with DisabilitiesCanadian Abilities FoundationBox 527, Station PToronto, Ontario, Canada M5S 2T1(416) 588-8431
Published quarterly. Cost: $12.00 per year.News and articles of interest for personswith disabilities.
American Journal of OccupationalTherapy
The American OccupationalTherapy Association, Inc.1383 Piccard DriveP. O. Box 1725Rockville, MD 20849-1725(301) 948-9626
Published monthly. Cost: $25.00 per year.The official publication of the American Oc-cupational Therapy Association. Articlespertain to occupational therapy, new pro-grams and techniques of practice. Reportson research and educational activities andprofessional trends.
American RehabilitationRehabilitation ServicesAdministration330 C Street, SW, Room 3414Washington, DC 20202-2531
The official publication of the RehabilitationServices Administration. Published quar-terly. Cost: $5.00 per year. Articles of gen-eral interest to individuals employed in therehabilitation field.
TECH REFERENCE INFORMATIONREV. 5/94
Assistive Device NewsPennsylvania Assistive DeviceCenter150 South Progress AvenueHarrisburg, PA 17109(717) 657-5840
Published quarterly. Cost: free. Articles andannouncements of general interest to edu-cation professionals, consumers, famil ies andothers interested in the applications ofassistive technology to aid persons with dis-abilities. Focuses on augmentative commu-nication and computer applications.
Assistive TechnologyDemos Publications, Inc.156 Fifth Avenue, Suite 1018New York, NY 10010(212) 255-8768
Published quarterly. Cost: $37.50 per year.The official journal of RESNA. Research ar-ticles targeted for individuals working or in-terested in the field of rehabilitation engi-neering.
Published quarterly. Cost: Free. This news-letter was developed under a contract withthe National Institute on Disability and Reha-bilitation Research (NIDRR) and contains ar-ticles about assistive technology projectsaround the country.
Augmentative and AlternativeCommunication
Decker Periodicals, Inc.One James Street SouthP. O. Box 620, L.C.D.I.
Hamilton, Ontario, Canada L8N 3K7(416) 522-7017
Published quarterly. Cost: $95.00 per year.Research findings and articles in the field ofaugmentative and alternative communica-tion.
Periodicals on Rehabilitation Technology Resources and Services
Augmentative CommunicationNews
Sunset EnterprisesOne Surf Way, Suite 215Monterey, CA 93940(408) 649-3050
Published quarterly. Cost: $37.00 per year.Articles and news for consumers and clini-cians dealing with augmentative devices.
Breaking New GroundDepartment of AgriculturalEngineeringPurdue UniversityWest Lafayette, IN 47907-1146(317) 494-5988
Published quarterly. Cost: free. Articles,reports, and photographs of interest to farm-ers with disabilities.
BulletinNational Clearinghouseon Technology and AgingUniversity Center on AgingUniversity of MassachusettsMedical Center, 55 Lake AvenueNorth, Worcester, MA 01655(508) 856-3662
Published twice a year. Cost: $5.00 per year.Articles and general information on geron-tology.
CRT News UpdateCenter for Rehabilitation TechnologyGeorgia Institute for Technology490 10th Street, NWAtlanta, GA 30332-0156(404) 876-8580
Published approximately six times per year.Cost: free. News dealing with rehabilitationtechnology information in Georgia.
Careers and the DisabledEqual Opportunity Publications, Inc.44 BroadwayGreenlawn, NY 11740(516) 261-8899
Published three times a year. Cost: $10.00per year. Articles of interest to rehabilitationcounselors, individuals with disabilities andcorporate personnel recruiters.
Closing the GapClosing the Gap, Inc.P. 0. Box 68Henderson, MN 56044(612) 248-3294
Published six times a year. Cost: $26.00 peryear. A newsletter for individuals interestedin applying computer technology to meet theneeds of persons with disabilities.
Co-Net NewsNewsletter of the CooperativeDatabase Dissemination Networkfor Assistive TechnologyTrace R&D Center5-151 Waisman CenterUniversity of Wisconsin-Madison1500 Highland AvenueMadison, WI 53705(608) 262-6966
Published quarterly. Cost: free. A newsletterfor people interested in assistive technologyand individuals with disabilities.
Published quarterly. Cost: $19.00 per year. Afocal point for sharing the experiences andcommunication systems of non-speakingpeople, their families and the professionalswho work with them.
Communication OutlookArtificial Language LaboratoryMichigan State University405 Computer CenterEast Lansing, MI 48824-1042(517) 353-0870
Published quarterly. Cost: $18.00 per year.An international periodical for individuals in-terested in applying technology to the com-munication needs of persons with severedisabilities.
118Center for Rehabilitation Technology ServicesSC Vocational Rehabilitation Department 1410-C Boston Ave. West Columbia, SC 29170
Periodicals on Rehabilitation Technology Resources and Services
Computer Disability NewsThe National Easter Seal Society70 East Lake StreetChicago, IL 60601(312) 667-7400
Published quarterly. Cost: $15.00 per year.Focuses on computer products and services;includes interviews and new equipment in-formation.
Computer Use in Social ServicesNetwork
University of Texas at ArlingtonCUSSN Network CoordinatorBox 19129Graduate School of Social WorkArlington, TX 76019-0129(817) 640-7880
Published 4 times a year. Cost: $15.00 peryear. A network for professionals interestedin exchanging information and experienceson using computers in the human servicesfield.
Current ExpressionsPrentke Romich Company1022 Heyl RoadWooster, OH 446911212) 262-1984
Newsletter. Published quarterly. Cost: free.Articles and stories pertaining to the field ofenvironmental controls, augmentative com-munication equipment, public and privateprograms to aid those with severe communi-cation limitations.
Direct LinkCenter for Computer Assistance tothe Disabled617 Seventh AvenueFort Worth, TX 76104(817) 870-9082
Published quarterly. Cost: free. Newsletter.Provides updated information for personswith disabilities who have an interest in com-puters.
Electronic HouseElectronic House, Inc.56790 Magnetic DriveMishawaka, IN 46545(219) 256-2060
Published bi-monthly. Cost: $89.70 per year.The journal of home automation; articles andadvertisements related to remote control andhome computerization.
Exceptional ChildrenCouncil for Exceptional Children1920 Association DriveReston, VA 22091-1589(703) 264-9454
Published 6 times per year. Cost: $35.00 peryear. Articles focus on professional issues ofconcern to special educators and on theeducation and development of exceptionalstudents.
GA-SK NewsletterTelecommunications for the Deaf,Inc.814 Thayer AvenueSilver Spring, MD 20910(301) 589-3006
Published quarterly. Cost: free. Featuresnews, articles and advertisements of interestto persons with hearing impairments andprofessionals.
Published quarterly. Cost: $15.00 per year.A newsletter for professionals working in theallied health occupations field.
HPV NewsInternational Human PoweredVehicle Association, Inc.P.O. Box 51255Indianapolis, IN 46251(317) 876-9478
Published 6 times a year. Cost: $20.00 peryear. Articles of news and interest to indi-viduals interested in the creativity, design,and development of human powered ve-
., hicles.
Home Health Care DealerThe Journal of HME RetailingAllied Health Care Publications1849 Sawtelle Blvd., Suite 770Los Angeles, CA 90025(213) 479-1769
Published bi-monthly. Cost: free. Articlesand advertisements of interest to health caredistributors and users of their products.
ISTE
International Society for Technologyin Education1787 Agate StreetEugene, OR 97403-1923(503) 346-4414
Published 8 times a year. Cost: $46 a year.News updates about education and technol-
ogy.
inCider ,
Incider Subscription ServicesP.O. Box 58618Boulder, CO 80322-8618(800) 289-0619
Published monthly. Cost: $27.97 per year.Features news stories, advertisements andother special interest articles for individualsusing or interested in using Apple II comput-ers.
Independent LivingEqual Opportunity Publications, Inc.44 BroadwayGreenlawn, NY 11740(516) 261-9086
Published quarterly. Cost: $15.00 per year.News and articles related to physical disabil-ity. Advertisements are focused on adaptiveequipment for the physically challenged.
In The MainstreamMainstream, Inc.3 Bethesda Metro Center, Suite 830Bethesda, MD 20814(301) 654-2400
Published every two months. Cost: $60.00per year. News updates, analysis and re-ports of legislation pertaining to the disabled.
TECH REFERENCE INFORMATION 0
119 REV. 5/94
1 1
International Journal ofTechnology and Aging
Human Sciences Press, Inc.233 Spring StreetNew York, NY 10013-1578(212) 807-1047
Published bi-annually. Cost: $29.00 per year.Articles for researchers, academicians andhealth care professionals dealing with tech-nology and the aging community.
Issues In Science And TechnologyNational Academy of Sciences2101 Constitution AvenueWashington, DC 20418(202) 334-3305
Published quarterly. Cost: $36.00 per year.Research articles by noted scholars in a vari-ety of technology areas.
Journal of Prosthetics andOrthotics
American Orthotic and ProstheticAssociation, and the Academy ofOrthotists and Prosthetists717 Pendleton StreetAlexandria, VA 22314(703) 836-7116/8
Published quarterly. Cost: $50.00. Articlesare of special interest to practicingprosthetists and orthotists.
Journal of Rehabilitation Researchand Development
Office of Technology TransferRehabilitation Research andDevelopment ServiceVeteran's AdministrationProsthetics R&D Center103 South Gay StreetBaltimore, MD 21202-4051(410) 962-1800
Published quarterly. Cost: free. In addition toinformation related to rehabilitation andassistive technology research and develop-ment, this journal abstracts relevant technol-ogy information from other journals.
Periodicals on Rehabilitation Technology Resources and Services
Published quarterly. Cost: $17.00 per year.Information, research, and reports of inno-vative practices regarding the application ofeducational technology toward the develop-ment and education of exceptional children.
Long Cane NewsAmerican Foundation for the Blind15 W. 16th StreetNew York, NY 10011(212) 620-2000
Published twice a year. Cost: $8.00 per year.A newsletter for professionals working withindividuals with visual impairments in thearea orientation and mobility training.
Macintosh Lab Monitor (The)Richard WandermanP. O. Box 1386Litchfield, CT 06759(203) 567-4307
Published quarterly. Cost: free. A publica-tion of interest to individuals using aMacintosh computer in special educationapplications.
MainstreamExploding Myths, Inc.2973 Beech StreetSan Diego, CA 92102(619) 234-3138
Published monthly, except January and June.Cost: $20.00 per year. Advertisements, ar-ticles, and stories of interest to persons withphysical disabilities and rehabilitation per-sonnel.
Published quarterly. Cost: free. This is anewsletter for those involved with isslefinnrehabilitation and disability. 4
SC Vocational Rehabilitation Department 1410-C Boston Ave. West Columbia, SC 29170
NASA Tech BriefsAssociated Business PublicationsCo., Ltd.41 E. 42nd StreetNew York, NY 10017-5391(212) 490-3999
Published monthly except July/August andNovember/December. Cost: $75.00 per year.A magazine dedicated toward transferringNASA technology to American industry andgovernment.
National Rehabilitation NewsletterNational Rehabilitation Association633 South Washington StreetAlexandria, VA 22314-4193(703) 836-0850
Published 8 times a year. Cost: $10.00 peryear. News of general interest to all rehabili-tation professionals.
NewsNational Library for the Blind andPhysically Handicapped Library ofCongressWashington, DC 20542(800) 424-9100
Published quarterly. Cost: free. News andarticles of interest to persons with visual im-pairments.
0 & P AlmanacOrthotics & Prosthetics NationalOffice1650 King St., Suite 500Alexandria, VA 22314(703) 836-7114
Published monthly. Cost: $35.00 per year.This magazine for the Orthotics & Prostheticsprofessional contains articles on the latestdevelopments in products and services inthe industry.
Periodicals on Rehabilitation Technology Resources and Services
OSERS News in PrintOffice of Special Education andRehabilitative ServicesU.S. Department of EducationWashington, DC 20202-2524(202) 732-1723
Published quarterly. Cost: free. Articles onrehabilitation programs supported by theDepartment of Education.
Occupational Therapy NewsThe American OccupationalTherapy Association, Inc.1383 Piccard DriveP. O. Box 1725Rockville, MD 20849-1725(301) 948-9626
Published monthly. Cost: $15.00 per year.News and articles of interest to occupationaltherapists and related personnel.
OnlineWest Virginia Research & Training
CenterOne Dunbar Plaza, Suite EDunbar, WV 25064(304) 766-7138
Published quarterly. Cost: free. Articles andnews updates for rehabilitation profession-als who use technology in their jobs.
Orthotics and ProstheticsAmerican Orthotic and ProstheticAssociation717 Pendleton StreetAlexandria, VA 22314(703) 846-7116
Reports of research, techniques in the field,advertisements and conference announce-ments.
PAM RepeaterPAM Assistance Center601 W. Maple StreetLansing, MI 48906(517) 371-5897
4111)Published approximately nine times a year.Cost: $10.00 membership fee for subscrip-tion. Articles of interest to persons with dis-abilities.
PalaestraThe Forum of Sport, PhysicalEducation, and Recreation for theDisabledChallenge PublicationsLtd., 549 Meadow DriveP. 0. Box 508Macomb, IL 61455(309) 833-1902
Published quarterly. Cost: $18.00 per year.A magazine of general interest to individualswith disabilities interested in sports, recre-ation, and leisure activities.
Paraplegia NewsParalyzed Veterans of America5201 North 19th AvenueSuite 111Phoenix, AZ 85015-2994(602) 246-9426
Published monthly. Cost: $12.00 per year.News, legislative updates and product ad-vertisements of interest to individuals withdisabilities.
Pin Dot NewsPin Dot Products3001 Gross Point RoadNiles, IL 60648-4027(800) 451-3553
Published twice a month. Cost: free. A newspublication for people interested in seatingand positioning of people with disabilities.
Positively SpeakingPRAB Command, Inc.5140 Sprinkle RoadKalamazoo, MI 49002(616) 383-4400
News and information on enhancingproductivity through technology.
121
Rehab USANational Rehabilitation Association633 South Washington StreetAlexandria, VA 22314-4193
Published Quarterly. Cost: Free to members.This magazine was created to facilitate therelationship between science and people,and to magnify the role of people in therehabilitation process.
RESNA NEWSRESNA Association for theAdvancement of RehabilitationTechnologySuite 1540Arlington, VA 22209-1903(703) 524-6686
Published quarterly. Cost: $25.00 per year.News and special articles of interest to indi-viduals working in the field of assistive tech-nology.
Published quarterly. Cost: $16.00 per year.News related to government programs,medical research and other resources forpersons with disabilities.
Spinal Cord Injury LifeNational Spinal Cord InjuryAssociation600 West Cummings ParkSuite 2000, Woburn, MA 01801(617) 935-2722
Published quarterly. Cost: call for informa-tion. News of concern to persons with spinalcord injuries caused by trauma or disease.
REV.5/94
Spinal Cord Society NewsletterSpinal Cord SocietyWendell RoadFergus Falls, MN 56537(2181739-5252
Published monthly. Cost: $30.00 per year.Articles and medical research updates ofinterest to individuals with spinal cord inju-ries, their families and medical researchersworking in the area of spinal cord regenera-tion.
Sport and SpokesParalyzed Veterans of America5201 North 19th AvenueSuite 111Phoenix, AZ 85015-2994(6021246-9426
Published bi-monthly. Cost: $9.00 per year.News, product advertisements, announce-ments and articles of interest to individualswith disabilities interested in wheelchairsports and adaptive recreation.
Teaching Exceptional ChildrenCouncil for Exceptional Children1920 Association DriveReston, VA 2209 1 -1 589(7031620-3660
Published four times a year. Cost: $25.00. Amagazine for parents and teachers of chil-dren with developmental disabilities.
Team Rehab ReportMiramor Publishing Company6133 Bristol ParkwayCulver City, CA 90230(2131337-9717
Published bi-monthly. Cost: $24.00 per year.Articles and news items on assistive technol-
Published quarterly. Cost: free. Informationfor persons interested in assistive technol-ogy.
Periodicals on Rehabilitation Technology Resources and Services
Technology UpdateSensory Aids Foundation399 Sherman AvenueSuite 12Palo Alto, CA 94306(4151329-0430
Published bi-monthly in print, large print andaudiocassette. Cost: $47.00 per year. Newsof technology devices to aid persons withvisual and hearing impairments.
USSAAC Newsletter (The)United States Society forAugmentative and AlternativeCommunicationMedical School Wing ECB# 7120UNC-Chapel Hill, Chapel Hill, NC27599-7120(919) 966-2343
Published quarterly. Cost: free. Addressesthe communication needs of people who donot speak.
UpdateNational Library Service for the Blindand Physically HandicappedLibrary of CongressWashington, DC 20542(800) 424-8567
Published quarterly. Cost: free. News andarticles of interest to persons with visual im-pairments.
Window on TechnologyMinistry of Community and SocialServices12th Floor5140 Yonge Street North YorkOntario, Canada M2N 6L7(4161730-6470
Published 6 times per year. Cost: free. Anewsletter on assistive tec hnology for peopleworking in human service programs.
Word from WashingtonUnited Cerebral Palsy Association1522 K St. NWSuite 1112Washington, DC 20005(2021842-1266
Published monthly. Cost: $25.00 per year.Short news articles reporting on the legisla-tive activity in Congress with regard to dis-abilities.
The Center for Rehabilitation Technology Services (CR1S) Is part of the South Carolina Vocational RehabilitationDepartment. Support for this work has been provided through the National Institute on Disability and Rehabilita-tion Research INIDRRI, U.S. Department of Education, Washington D.C. as part of the rehabilitation engineeringresearch center grant #H133E20002-93. Opinions expressed in this paper are those of the writers and shouldnot be construed to represent opinions or policies of NIDRR.
Center for Rehabilitation Technology Services122
SC Vocational Rehabilitation Department 1410-C Boston Ave. West Columbia, SC 29170
Organizations and Associations
REFERENCEINFORMATION
.........
This Tech Reference Guide provides information on national organizations and associations with aninterest in rehabilitation technology and individuals with disabilities. Utilization of technology resources andservices has been recognized by many organizations and associations as an excellent resource. The
following is a representative listing of some of the national organizations and associations that have
developed specialized expertise in the application of technology to assist persons with disabilities.
AMERICAN FOUNDATION FORTHE BLIND (AFB)
National Technology Center15 West 16th StreetNew York, NY 10011212-620-2080
Center for Technology in HumanDisabilities2301 Argonne DriveBaltimore, MD 21218301-554-3046
INTERNATIONAL SOCIETY FORAUGMENTATIVE ANDALTERNATIVE COMMUNICATION(ISACC)
c/o Barry Romich1022 High RoadWooster, OH 44691216-262-1984
NATIONAL ASSOCIATION OFMEDICAL EQUIPMENT SUPPLIERS(NAMES)
625 Slaters Lane, Suite 200Alexandria, VA 22314703-836-6263
NATIONAL EASTER SEALSOCIETY
70 East Lake StreetChicago, IL 60601312-726-6200312-243-8888, TDD
NATIONAL REHABILITATIONASSOCIATION (NRA)
633 South Washington StreetAlexandria, VA 22314703-836-0850
PARALYZED VETERANS OFAMERICA
801 18th Street, NWWashington, DC 20006202-872-1300
123
PRESIDENT'S COMMITTEE ONEMPLOYMENT OF PEOPLE WITHDISABILITIES
1111 20th Street, NW, Room 600Washington, DC 20036202-653-2088
RESNA, an Association for theAdvancement of Rehabilitationand Assistive Technology
1700 N. Moore Street, Suite 1540Arlington, VA 22209-1903703-524-6686703-524-6630 (fax)
UNITED CEREBRAL PALSY66 East 34th StreetNew York, NY 10016212-481-6300800-872-1827
The Center for Rehabilitation Technology Services(CRTS) is part of the South Carolina Vocational Reha-bilitation Department. Support for this work has beenprovided through the National Institute on Disabilityand Rehabilitation Research ( NIDRR), US. Depart-ment of Education, Washington D.C. as part of therehabilitation engineering research center grant#H133E20002-93. Opinions expressed In this paperare those of the writers and should not be construedto represent opinions or policies of NIDRR.
TECH REFERENCE INFORMATIONREV. 5/94
REFERENCEINFORMATION
Employment and Independent LivingResourcesMERIESSEREEMEMBEMBEELMENEEMERIEMEMENEN
The following organizations represent some of the available resources which may be able to assist withrehabilitation technology-related concerns with employment and independent living activities.
American Foundation for the Blind15 West 16th StreetNew York, NY 10011(212) 620-2000(212) 727-7418 (fax)
An information and referral service for pro-grams and information on blindness.
American with Disabilities ActTechnical Assistance Manual,(Title 1)
Superintendent of DocumentsP.O. Box 371954Pittsburgh, PA 15250-7954Order processing code 6196
American with Disabilities ActHandbook
Equal Employment OpportunityCommission and the U.S.Department of JusticeU.S. Government Printing OfficeSuperintendent of DocumentsMail Stop: SSOP
Washington, DC 20402-9328
American Institute ofArchitects (MA)
c/o Information Center1735 New York Avenue, NWWashington, DC 20006(202) 626-7493
Bibliographies of material on barrier-freedesign.
Architectural and TransportationBarriers - Compliance Board
Association of Persons inSupported Employment (APSE)
50001 West Broad StreetSuite 34Richmond, VA 23230(804) 282-3655
Provides support and information to jobcoaches, enclave and mobile crewsupervisors, small business entrepreneurs,and program managers.
Innovations in Rural IndependentLiving
Research and Training Center onIndependent LivingInstitute for Life Span Studies4089 Dole Human DevelopmentCenterUniversity of KansasLawrence, KS 66049913-864-4095
124
Job Accommodation Network(JAN)
West Virginia University809 Allen HallP. O. Box 6123Morgantown, WV 26506(800) 526-7234(304) 293-7186(800) ADA-WORK(304) 293-5407 (fax)
JAN is an international information networkand consulting resource which provides in-formation about employment issues to em-ployers, rehabilitation professionals, andpersons with disabilities. Sponsored by thePresident's Committee on Employment ofPeople with Disabilities, the Network is oper-ated by West Virginia University Rehabilita-tion Research and Training Center. Printedmaterials are available free of charge.
Job Opportunities for the BlindNational Federation of the Blind1800 Johnson StreetBaltimore, Maryland 21230(301, 659-9314(800) 638-7518
JOB is a nationwide job listing and job refer-ral system of the NFB, a service availablewithout charge. Among JOB's 40+ free pub-lications are: Blind People at Work, andTechnical Assistance Guide for Employers.The Recorded Bulletin is sent to registeredapplicants and includes articles about ca-reers and employment, as well as job listing.
TECH REFERENCE INFORMATION
REV. 5/94
National Center on Employmentof the Deaf (NCED)
National Technical Institutefor the DeafRochester Institute ofTechnology (RIT)
One Lomb Memorial DriveRochester, NY 14623(716) 475-6834(716) 475-6205 (TDD)
NCED is designed to promote successfulemployment of RIT's deaf graduates and otherqualified deaf people nationwide. The Cen-ter offers a range of services to employers,professionals serving deaf persons, andqualified deaf persons. Staff members meetwith employers on compus and on site toassist in recruiting, hiring, accommodatingand promoting qualified deaf people. In-depth employer training programs are alsooffered.
National Council on IndependentLiving (NCIL)
310 South Peoria StreetSuite 201Chicago, IL 60607
Non-profit organizations designed to helpdisabled persons live as indendently as pos-sible.
National Organization on Disability(NOD)
910 16th NWSuite 600Washington, DC 20006(202) 293-5960 (Voice)(202) 293-5968 (TDD)
The National Organization on Disability oper-ates an information clearinghouse, directingpeople to resources that can answer theirspecific questions.
Employment and Independent Living Resources
President's Committee onEmployment of People withDisabilities
1331 F Street, NWSuite 300Washington, DC 20004-1107(202) 376-6200 (Voice)(202) 376-6205 (TDD)(202) 376-6219 (fax)
Provides information, referral, and technicalassistance to employers as well as employ-ees with disabilities and other interested inthe employment of persons with disabilities,including information on tax incentives forbusiness, and rights and responsibilities ofemployers and employees.
U.S. Department of JusticeCiv0 Rights Division
Coordination & Review SectionP.O. Box 66118Washington, DC 20035-6118(202) 514-0301
125
The Center for Rehabilitation Technology Services ICRTS) is part of the South Carolina Vocational Rehabilitation Department. Support for this work has been provided throughthe National I nstitute on Disability and Rehabilitation Research INIDRR), U S. Department of Education, Washington D.C. as part of the rehabilitation engineering research centergrant #1-1133E20002-93. Opinions expressed in this paper are those of the writers and should not be construed to represent opinions or policies of NIDRR.
Center for Rehabilitation Technology ServicesSC Vocational Rehabilitation Department 1410-C Boston Ave. West Columbia, SC 29170
REFERENCEINFORMATION
... .
Rehabilitation Technology ServicesProviders
Name Address Phone/fax Rehabilitation Technology Services
126
REV. 5/94
REFERENCEINFORMATION
Technology-Related Assistance Projects
REERR,,,
This Tech Reference Guide provides information on Technology Related Assistance projects, hereafterreferred to as Tech Act Projects. The following states have been awarded Technology Related Assistancegrants. Funded by the National Institute on Disability and Rehabilitation Research (NIDRR) through P. L. 100-
407, Title I, the purpose of the projects is to develop and implement a consumer-responsive, comprehensivestatewide program of technology-related assistance for individuals with disabilities.
Assistive Technologies of AlaskaDivision of VocationalRehabilitation400 D Street, Suite 230Anchorage, AK 99501800-770-0138907-274-0138, voice907-274-0517, TDD907-274-0516, FAX
Applied Science and EngineeringLaboratoriesUniversity of Delaware/A. I. DuPontInstitute1600 Rockland RoadWilmington, DE 19899302-651-6834, voice/TDD302-651-6895, FAX
Florida Department of Labor& Employment
Division of Vocational RehabilitationBureau of Client ServicesRehabilitation EngineeringTechnology1709-A Mahan DriveTallahassee, FL 32399-0696904-488-6210
Georgia Assistive TechnologyProgram
Department of Human ResourcesDivision of Rehabilitation Services878 Peachtree Street, NE, Room702Atlanta, GA 30309404-894-7593404-853-9059, FAX
Hawaii Assistive TechnologySystem (HATS)
Department of Human Services677 Ala Moana Blvd., Suite 403Honolulu, HI 96813808-532-7110808-599-5443, FAX
19,
Idaho Assistive Technology ProjectUniversity of Idaho
Idaho Center on DevelopmentalDisabilitiesProf. Building, 129 W. Third StreetMoscow Latah, ID 83843208-885-6849
Illinois Technology-RelatedAssistance Project
411 E. Adams StreetSpringfield, IL 62701800-852-5110 (IL)217-522-7985, voice/TDD217-522-8067, FAX
Indiana ATTAIN Project (AccessingTechnology Through Awareness inIndiana)
Department of Human ServicesTechnology Assistance UnitP. O. Box 7083Indianapolis, IN 46207-7083800-545-7763317-233-3394317-232-1240, FAX
Iowa Program for AssistiveTechnology ppm)
IA University Affiliated ProgramUniversity Hospital SchoolIowa City, IA 52242800-348-7193 (IA)319-353-6386, voice/TDD319-356-8284, FAX
Coordinating Center427 Versailles RoadFrankfort, KY 40601800-327-KATS (KY)502-564-4665502-564-3976, FAX
Louisiana Assistive TechnologyProject
State Planning Council onDevelopmental DisabilitiesDepartment of Health & HospitalsP. O. Box 3455 - BIN 14Baton Rouge, LA 70821-3455504-342-6804504-342-4419, FAX
Maine Consumer Information andTechnology Training Exchange(CITE)
Assistive Technology CoordinatingCenterUniversity of Maine at AugustaUniversity HeightsAugusta, ME 04330207-621-3195, voice/TDD207-621-3193, FAX
Maryland Technology AssistanceProgram (TAP)
Governor's Office forHandicapped Individuals300 W. Lexington Street1 Market Center, Box 10Baltimore, MD 21201410-333-4975410-333-6674, FAX
Michigan Department of EducationRehabilitation Services
P. O. Box 30010Lansing, MI 48909517-373-4058517-373-0565, FAX
Minnesota STAR ProgramGovernor's Advisory Council onTechnology for People withDisabilities300 Centennial Building685 Cedar StreetSt. Paul, MN 55155612-297-1554612-297-3698, FAX
Mississippi Project STARTDivision of Rehabilitation ServicesP.O. Box 1698Jackson, MS 39215601-354-6891601-354-6678, FAX
Missouri Assistive TechnologyProject
UMKC, School of Education5100 Rockhill RoadKansas City, MO 64110816-235-5337816-235-5270, FAX
MonTechRural Institute on Disabilities
The University of Montana52 Corbin HallMissoula, MT 59812800-732-0323406-243-4597, voice/TDD406-243-2349, FAX
Nebraska Assistive TechnologyProject
Department of Education301 Centennial SouthP. 0. Box 94987Lincoln, NE 68509-4987402-471-0735, voice/TDD402-471-2701, FAX
128
Technology-Related Assistance Projects
Nevada Assistive TechnologyProject
Rehabilitation Division, PRPD505 East King Street, Room 501Carson City, NV 89710702-687-4452, voice/TDD702-687-5980, FAX
New Hampshire TechnologyPartnership Project
Institute on Disability#14, Ten Ferry StreetThe Concord CenterConcord, NH 03301603-224-0630603-228-3270, FAX
New Jersey Department of LaborOffice of the Commissioner
Raymond L. Bramucci,CommissionerLabor Building, CN 110Trenton, NJ 08625609-292-3604
New Mexico Technology-RelatedAssistance Program (MMTAP)
Department of Education435 St. Michael Drive, Bldg. DSanta Fe, NM 87503800-866-ABLE (national voice/TDD)505-827-3533, voice/TDD505-827-3746, FAX
New York State TRAID ProjectOffice of Advocate for the DisabledOne Empire State Plaza, 10th FloorAlbany, NY 12223-0001800-522-4369 (NYS)518-474-2825, voice/TDD518-473-6005, FAX
North Carolina Assistive.Technology Project
Department of Human ResourcesDivision of Vocational Rehabilitation1110 Navaho Drive, Suite 101Raleigh, NC 27609919-850-2787, voice/TDD919-850-2792, FAX
Center for Rehabilitation Technology ServicesSC Vocational Rehabilitation Department 1410-C Boston Ave. West Columbia, SC 29170
Technology-Related Assistance Projects
Ohio Rehab Services CommissionDivision of Public Affairs400 E. Campus View BoulevardColumbus, OH 43235-4604614-438-1474
Oklahoma Department ofHuman Services
Rehabilitation Services DivisionDJS. RS # 24
P. 0. Box 25352Oklahoma City, OK 73125405-424-4311
Oregon Technology AccessThrough Life Needs (TALN)Project
Department of Human ResourcesVocational Rehabilitation Division2045 Silverton Road, NESalem, OR 97310503-378-3830, Ext. 386503-378-2756, FAX
Institute on Disabilities/UAPTemple University13th Street & Cecil B. Moore AvenueRitter Hall Annex 433Philadelphia, PA 19122215-787-3861
South Carolina AssistiveTechnology Program
Vocational RehabilitationDepartmentP. O. Box 15
1410-C Boston AvenueWest Columbia, SC 29171-0015803-822-5404, voice/TDD803-822-4301, FAX
DakotalinkSouth Dakota Department ofHuman ServicesDivision of Rehabilitation ServicesKneip Building, 700 Governors DrivePierre, SD 57501605-773-3195
TECH REFERENCE INFORMATION
REV. 5/94
Tennessee Technology AccessProject (TTAP)
Department of Mental Health &Mental RetardationDoctor's Building, Suite 300706 Church StreetNashville, TN 37243-0675615-741-7441615-741-0770, FAX
Texas Assistive TechnologyPartnership Project
The University of Texas at AustinUAP of Texas, Department ofSpecial EducationEDB 306
Austin, TX 78712512-471-7621
Utah Assistive TechnologyProgram
Utah State UniversityDevelopmental Center forHandicapped PersonsUMC 6855Logan, UT 84322-6800801-750-1982801-750-2044
Vermont Assistive TechnologyProject
Department of Aging andDisabilitiesAgency of Human Services103 South Main Street, WeeksBuilding, First FloorWaterbury, VT 05671-2350802-241-2620, voice/TDD802-241-3052, FAX
Virginia Assistive TechnologySystem (VATS)
Department of RehabilitativeServicesOffice of Planning4901 Fitzhugh AvenueP. 0. Box 11045Richmond, VA 23230800-552-5019804-367-2445/voice804-367-2445/TDD804-367-2440, FAX
West Virginia Assistive TechnologySystem
Division of Rehabilitation ServicesCapital ComplexCharleston, WV 25305-0890304-766-4698
Wisconsin Assistive TechnologyProgram (WisTech)
Division of Vocational RehabilitationP.O. Box 78521 W. Wilson Street, Room 950Madison, WI 53707608-267-6720, voice608-267-9599, TDD608-267-3657, FAX
Public Law 100-407, Title II, includes acontract with RESNA, an interdisciplinaryassociation for the advancement of re-habilitation and assistive technologies,to provide technical assistance togranted states of Public Law 100-407,Title I as described above. The technicalassistance provided includes aidinggranted states and others in reaching abetter understanding of consumer re-sponsiveness, systems change andfunding for assistive technology. In or-der to obtain these goals, the RESNATechnical Assistance Project holds train-ing sessions, produces information prod-ucts, publishes newsletter articles andholds teleconference sessions. TheRESNA TA Project can be contacted at the
address below.
RESNA TA Project1700 N. Moore Street, Suite 1540Arlington, VA 22209-1903703-524-6686703-524-6630 (FAX)
The Center for Rehabilitation Technology Services (CM)is part of the South Carolina Vocational RehabilitationDepartment. Support for this work has been providedthrough the National Institute on Disability and Reha-bilitation Research ( NIDRR), U.S. Department of Educa-tion, Washington D.C. as part of the rehabilitationengineering research center grant #H133E20002-93.Opinions expressed in this paper are those of thewriters and should not be construed to representopinions or policies of NIDRR.
441
a
REFERENCEINFORMATION
Rehabilitation EngineeringResearch Centers
............
This Tech Reference Information Guide highlights selected resources related to Rehabilitation EngineeringResearch Centers. The National Institute on Disability and Rehabilitation Research (NIDRR) supportsapproximately 15 rehabilitation engineering research centers covering a wide spectrum of technologyapplications for persons with disabilities. These centers are excellent resources for current information onresearch and development in rehabilitation engineering and the entire field of assistive technology. (Thecenters, formerly known as RECs, are now called RERCs in accordance with the Rehabilitation Act of 1973, asamended in 1992.1
Adaptive Computers andInformation Systems
Gregg Vanderheiden, Ph.D.The University of Wisconsin750 University Ave.Madison, WI 53706(608) 262-6966(608) 262-8848 (fax)
Focus: Research will focus on assistingpeople with disabilities in activities of dailyliving; enhancing capacities for productionand access to information to help the dis-abled perform competitive work in the high-technology future; and increasing the avail-ability of affordable adaptations to com-mercial electronic information services.
Assistive Technology andEnvironmental Intervention forOlder Persons with Disabilities
William Mann, Ph.D.State University of New Yorkat Buffalo515 Kimball TowerBuffalo, NY 14214(716) 829-3141(716) 829-3217 (fax)
Focus: Current research projects involve:assessing the abilities and needs of olderpeople with disabilities and their caregivers;environmental design; and developing andevaluating assistive technology devices forretaining or regaining functions. The centeralso has three dissemination and utilizationprojects: assistive device training for older
people and their caregivers; professionaleducation for physicians, nurses, therapists,counselors, product developers and re-searchers; and reporting and technical as-sistance for consumers, service providersand researchers in the field.
Augmentative and AlternativeCommunication Devices
Richard Foulds, Ph.D.,Patrick Demasco, M.S.The University of Delaware/A.I. duPont InstituteP.O. Box 269Wilmington, DE 19899(302) 651-6830(302) 651-6895 (fax)
Focus: This center will develop corn munica-tion technology and facilitate the transfer ofthese devices into commercial production.Projects include: language facilitationthrough graphics and graphical animation;the application of natural language process-ing to MC; a prototype speech prosthesisfor filtering dysarthric speech; automaticdiphone extraction for individualized syn-thetic voices; and MC systems based onpersonal computers.
130
Employability for Persons withLow Back Pain
Malcolm Pope, Dr. Med. Sc., Ph.D.The University of VermontOne S. Prospect St.Burlington, VT 05401(802) 656-4582(802) 660-9243 (fax)
Focus: Among the center's intended out-comes are to: develop and test assistivedevices that will help people with low backpain remain on the job, create occupation-specific adaptations to allow people to re-turn to their old jobs, and establish occupa-tion-specific preventive measures to avoidlow back pain. The center will also test theeffectiveness of rehab engineering interven-tion for early return to work by employeeswith back injuries.
Hearing Enhancement andAssistive Devices
Harry Levitt, Ph.D.The Lexington Center Inc.30th Ave. and 75th St.Jackson Heights, NY 11370(718) 899-8800(718) 899-9846 (fax)
Focus: Research projects include develop-ment of: a prototype device for early detec-tion of hearing loss in infants; cost-effective,improved hearing aids and fitting systems;new types of hearing aids for people withsevere to profound hearing loss; job-sitemodifications for employees with hearing
TECH REFERENCE INFORMATION
REV. 5/94
RFST COPY AVAILABLE
loss; improved hearing aid devices and pre-scriptive systems for older adults with hear-ing loss; devices to assist employers in meet-ing ADA requirements; and technological in-novations for people with both hearing lossand visual impairments.
Personal Licensed Transportationfor Disabled Persons
John Thacker, Ph.D.The University of VirginiaP.O. Box 1885University StationCharlottesville, VA 22903(804) 924-6294(804) 982-2037 (fax)
Focus: Ongoing projects include: establish-ing a lending library to identify and catalogvehicle safety, access and exit systems; as-sessing deficiencies in assistive technologyfor personal transportation; developing amethodologyfor checking device compliancewith existing federal and state standards;and creating a methodology for evaluatingequipment to be used when assessing indi-vidual needs for vehicle modification andadaptive equipment. The center is also de-vising methods to: evaluate vehicle accessand exit systems for safety and effective-ness; assess wheelchair tie-downs and oc-cupant restraint systems; and estimate thestructural integrity of modified vans.
Prosthetics and Orthotics
Dudley Childress, Ph.D.Northwestern University345 E. Superior St.Room 1441Chicago, IL 60611(312) 908-6502(312) 908-6526 (fax)
Focus: Ten projects are planned in three ar-eas: ambulation, mobilityand measurement;interface mechanics (tissue stresses) duringwalking, CAD/CAM assistance with upper-limb prosthesis design and socket materialsfor upper limb amputees; and manipulation,design and fabrication of a high-level ampu-tee upper-limb prosthesis.
Rehabilitation Engineering Research Centers
Quantification of PhysicalPerformance
Sheldon Simon, M.D.The Ohio State UniversityN389 Doan Hall410 W. 10th St.
Focus: Projects include: assessingambulation motion parameters for evalua-tion and clinical decision-making; develop-ing a new technique for foot pressure mea-surement and assessing risk of foot ulcer-ation; establishing new diagnostictechniquesfor motion disorders; and developing anddisseminating a system for cerebral palsygait analysis for diagnosis and treatment.The center will also use virtual simulation todetermine environmental accessibility andwheelchair user proficiency, create a moresensitive test for low back pain, and developprotocols for ergonometric evaluation of in-dustrial jobs to comply with the Americanswith Disabilities Act (ADA).
Anthony Langton, M.S.Center for RehabilitationTechnology ServicesSouth Carolina VocationalRehabilitation Department1410-C Boston Ave.West Columbia, SC 29170(803) 822-5362(803) 822-4301 (fax)
Focus: Studies are focusing on: a generalprofile of rehab technology services; clientassessment and evaluation practices; job re-sponsibilities of rehab engineers; links be-tween VR and other agencies in providingtechnology services; job success and tenurefor employees using assistive technology aidsand devices in the workplace; the efficacy ofcurrent approaches to the delivery of rehabtechnology services: a model "Tech Points'strategy to integrate technology in the rehabprocess; and the consumer's role in the deliv-ery of rehab technology services in the VRprocess.
X31
Robotics to Enhance theFunctioning of Individuals withDisabilities
Richard Foulds, Ph.D.,William Harwin, Ph.D.The University of Delaware/
duPont InstituteP.O. Box 269Wilmington, DE 19899(302) 651-6830(302) 651-6895 (fax)
Focus: Among the center's plans are increas-ing knowledge of the efficacy of rehabilita-tion robots, develop innovative solutions toimprove manipulation and mobility, and es-tablish criteria for the interface and control ofa powered upper extremity orthosis. Thecenter will also focus on assistive robotics ina vocational setting; develop and market ofrobot-aided science education environmentfor students with severe disabilities; investi-gate the use of a mobile robot in independentliving; and adapt a wheelchair-mounted ro-bot to a general environment.
Technological Aids forBlindness and Low Vision
Arthur Jampolsky, M.D.,John Brabyn, Ph.D.Smith-Kettlewell Eye ResearchInstitute2232 Webster St.San Francisco, CA 94155(415) 561-1619(415) 561-1610 (fax)
Focus: Projects include: clinical field trial ofa photo refractive vision screener for earlydetection of visual impairment in infants;design of a low-cost, ten-message voice re-corder for non-vocal people; a new nystag-mus tester for early detection of disruptedbinocular vision; a study on alternate occlu-sion as an early rehabilitative technique; thestudy of a reader for the universal productcode; a design to improve computer graph-ics and broil le text access; and improvementsto consumer products for universal design.
Center for Rehabilitation Technology ServicesSC Vocational Rehabilitation Department 1410-C Boston Ave. West Columbia, SC 29170
Rehabilitation Engineering Research Centers
Technology Evaluation andTransfer
Joseph Lane, M.B.P.A.,William Mann, Ph.D.State University of New Yorkat Buffalo515 Kimball TowerBuffalo, NY 14214(716) 829-3141(716) 829-3217 (fax)
Focus: Focus is on direct technology evalu-ation and transfer of new devices, with 5-10devices expected to be commercialized eachyear. The overall plan stresses developmentof an ongoing business primarily operatedby disabled consumers. Proposed activitiesinclude a multiphased evaluation, need sur-vey and market research. Interdisciplinaryteam research is planned involving univer-sity engineering with technology applicationtrials by participating consumer groups, in-cluding a research and development group.
Technology for Children withOrthopedic Disabilities
Mark Hoffer, M.D.,Donald McNeal, Ph.D.Ranchos Los Amigos MedicalCenter12841 Dahlia St., Building 306Los Amigos StationP.O. Box 3500Downey, CA 90242(310) 940-7994(310) 803- 6117(fax)
Focus: Projects include a biomechanicalstudy to improve grip in children's terminaldevices; a lightweight, cosmetic, articulatingankle-foot orthosis; orthotic management ofcongenitally dislocated hips; advancecontracture reduction orthosis; assistive tech-nology usage outcome; and cognitive pre-dictors of successful powered wheelchaircontrol with the very young child. The centeris also involved in determining the appropri-ateness of integrated control of assistivedevices; mainstreaming children withassistive technology into general education;developing a consumer's guide to fundingassistive technology; and creating resourcematerials for assistive technology laborato-ries.
Technology to ImproveWheelchair Mobility
Douglas Hobson, Ph.D.,Clifford Brubaker, Ph.D.The University of Pittsburgh107 Pennsylvania HallPittsburgh, PA 15261(412) 826-3138(412) 826-3143 (fax)
Focus: Seventeen projects are proposed inwheeled mobility, seating and transporta-tion. These include: developing more appro-priate prescription practices; evaluating cush-ion technologies; examining the systematicmeasurement of changes in spinal defor-mity; focusing on the development ofsecurement and transport of wheelchairs;and gathering information to develop stan-dards.
Worksite Modifications andAccommodations
John Leslie, Jr., Ph.D.Cerebral Palsy ResearchFoundation of Kansas2021 N. Old ManorBox 8217-0217Wichita, KS 67208(316) 688-1888(316) 688-5687 (fax)
Focus: The center will create a user-friendlyPC computer system to guide full use ofrehabilitation technology, and develop a par-ticipatory worksite accommodation processthrough assessment, design and evaluationthat could provide a standard for undue hard-ship determination. Also planned is a multi-media workstation design for inspection andcontrol tasks.
For further information, contact the resources listed, or the Center for Rehabilita-tion Technology Services. Information for this resource guide was taken from TheNext Wave of Rehab Technology", Guy Hammer, BSEE, Team RehabilitationReport, September 1993.
The Center for Rehabilitation Technology Services ICRTSI is part of the South Carolina Vocational RehabilitationDepartment. Support for this work has been provided through the National Institute on Disability and Rehabilita-tion Research (NIDRRI, US. Department of Education, Washington D.C. as part of the rehabilitation engineeringresearch center grant #H133E20002-93. Opinions expressed in this paper are those of the writers and shouldnot be construed to represent opinions or policies of NIDRR.
Center (or Rehabilitation Technology Services
132
SC Vocational Rehabilitation Department 1410-C Boston Ave. West Columbia, SC 29170 0.)
Training Information
Need for training
Do I Need Training? You bet! TECH POINTS is primarily a trainingstrategy for vocational rehabilitation staff on effective ways to inte-grate technology. Effective use of rehabilitation technology re-sources and services require an agency-wide training initiative.Training is critical because most VR staff have had little or no realexposure to rehabilitation technology in their pre-service training.TECH POINTS is only one aspect of what is needed.
Agencies will need to implement training for all staff involved withrehabilitation technology. This would include rehabilitation counse-lors, vocational evaluators, supervisory and management person-nel, quality assurance staff, rehabilitation technology specialistsand others. Field staff should receive training on various applica-tions of rehabilitation technology on a planned, ongoing basis.
The TECH POINTS Training Manual and TECH POINTS Guideare designed to be implemented with a minimum of one day oftraining. Although the manual is a self-study training resource,participation in the initial training is essential.
Some considerations for staff development and training shouldinclude
closely linking any technology-related case service expecta-tions with training activities,
offering regional and statewide training on technology-re-lated topics,
incorporating technology training as a regular part of all newemployee orientation,
encouraging periodic in-service training sessions on technol-ogy concerns at the office level,
and offering more in depth training for any counselors whoare designated as "technology specialists".
Rehabilitation technology specialists in the VR agency or thoseunder contract to provide technology services should be included inthe training activities whenever possible.
1 3TECH POINTS Integrating Rehabilitation echnology into Vocational Rehabilitation Services
11 Case Studies SECTION 14
134
TECH POINTS Integrating Rehabilitation Technology into Vocational Rehabilitation Services
In this section
Case Studies...........................
Case Study of the TECH POINTS Process
Examples of Simple Accommodations
Series of Successful Closures Through Use of Technology
Other Case Study Information
Case Study of the TECH POINTS Process
Injured in an automobile accident in 1986 on her way home fromwork, GL was soon confronted with questions she had never consid-ered and a confusing array of decisions and options. Facing thischallenge was made easier thanks in part to intervention from hercounselor with the VR Department and the availability of technologyresources and services. As with most people who suddenly findthemselves disabled, GL knew little about quadriplegia and evenless about what we now refer to as assistive technology.
In many ways GL's situation is typical of people served by voca-tional rehabilitation agencies. Could she return to her previous jobas an office manager? Could she live independently? These werequestions without easy answers. When she was referred to VR lessthan three months following her accident, GL admittedly was fearfulof assistive technology and uncertain about what she could do.
Center for Rehabilitation Technology Services 135
14-1
SECTION 14
14 -2
Referral/Applicant
Identifies rehabilitation
technology needs
assists in accurately estimating
vocational potential
Evaluation/Assessment Aidentifies reasonable
accommodations which could
be needed in vocational
evaluation
describes what rehabilitation
technology assessments could
provide
In her case, access to technology resources and services helpedpave the way to retraining and a successful return to work.
Throughout her rehabilitation process, assistive technology wasused as an important "tool" in regaining functional capacity, explor-ing new options and achieving independence. Decisions on whattechnology to consider were made jointly by GL and her vocationalrehabilitation counselor. This use of technology occurred at most ofthe TECH POINTS that have been identified in the TECH POINTSmodel and illustratesthe importance of utilizing technologythrough-out the rehabilitation process.
Referral (TECH POINT 1)
Since GL had been involved with therapists at her rehabilitationhospital, prescriptions for wheelchairs (power and manual) werealready in process at the time of referral. The private insurancecompany had agreed to limited funding on a power chair, and,unfortunately, a compromise had been made because of funding.This would later result in compatibility problems with positioning andtie-downs for vehicle adaptations.
When additional factors such as transportation were considered,the power chair purchased by the insurance company did not meetGL's needs. To a VR counselor working within budget constraints, a"technology team" approach could save additional expenditures.
Although GL had lived independently prior to the accident, theneed for attendant care and accessibility issues dictated that shereturn to live with her family. It became immediately apparent thattheir mobile home would need adaptations.
Extended Evaluation (TECH POINT 2)
The plan for extended evaluation was written to assist with homemodifications . A visit was made to her living site by the VR counselorand an occupational therapist from the hospital to determine neededhome accommodations. Changes necessary included ramping,providing access to the bedroom and bathroom, bathroom equip-ment, grooming aids and adaptive devices for use in the kitchen.Further equipment needs for increasing her independence wereidentified that included both low tech and high tech" solutions. Anelectric hospital bed with adapted switch controls and a number ofADL items such as button hooks, reachers, dressing aids and otheritems were identified.
136TECH POINTS integrating Rehabilitation Technology into Vocational Rehabilitation Services
Her family was very resourceful in making most of the low tech"modifications such as controls for the stove. Funding was coordi-nated from several sources including insurance, VR, family andfriends.
Evaluation for driving and identification of vehicle adaptationsnecessary were also completed at this stage. Vehicle consider-ations were provided through a VR specialist in van conversion. Itwas found that the power wheelchair that had been purchased byher insurance company presented problems when adaptive con-trols for the van was being considered. At this point GL stated, I wasnot ready to deal with adaptive driving,- and, therefore, elected tohave only a wheelchair lift installed.
Eventually GL adapted her van for driving and obtained herlicense, but not until after she became employed. VR assisted her inadaptive driving equipment so she could use her van independently.
Plan Development/IWRP (TECH POINT 3)
After modification to GL's van and home, Glwas readyto enter theplan development phase. GL decided to return to her previousemployer to help determine her ability to work and if she couldtolerate a full day. Her employer was more than willing to accommo-date. GL, therefore, worked briefly in telemarketing. Counseling,guidance and other goals were identified to assist GL. A head-setwas the only job modification needed for the telemarketing position.GL and her VR counselor discussed that this work experience wouldhelp her identify if additional training would be needed to help herreach vocational independence.
Counseling GuidanceTraining /Physical Restoration Services (TECH POINT 4)
GL briefly worked in the telemarketing position. She needed todetermine how difficult work would be from a powered chair. Shealso realized that additional training would be needed to upgradeemployment if she was to become self-supporting. It was after thisbrief experience that GL felt she was ready for additional vocationalevaluation. This evaluation included the rehabilitation engineer withthe VR department.
A decision to enter a computer training program was made. Forthis she moved into the training center's dormitory in August 1987.Assistance with hand splints from an occupational therapist and
Center for Rehabilitation Technology Services 137
14-3
Planning
shows how to include
technology resources and
services into IWRPs
Services Aexplores need
for rehabilitaiton technology
support for planned services
such as physical restoration
and training
Placement
addresses work site accommo-
dation needs
includes rehabilitation technol-
ogy resources in job-develop-
ment
Closure Outcomes
monitors any exit point from
VR services
documents consideration and
use of rehabilitation technology
could be used to monitor Order
of. Selection decisions
Post-Employment Areviews need for rehabilitation
technology to maintain employ-
ment
minor keyboard modifications from the rehabilitation engineer tookcare of immediate technology needs.
Follow-up during training indicated a need for a seating consulta-tion from the rehabilitation engineer. Adaptations for independentliving activities in her dormitory were addressed. GL also was inter-ested in adaptive clothing, and was provided information andcontacts on who could answer these important questions.
Placement (TECH POINT 5)
A position was identified with a community bank as a computerprogrammer. GL applied for and obtained the job in July1989. GLconsulted with her VR counselor and the rehabilitation engineer assoon as an offer of employment was extended. A survey wascompleted of her working environment and the issues of access forentering a secure work area, workstation accommodation andbathroom modification were addressed. With consultation andrecommendations from the VR counselor and rehabilitation engi-neer, the bank was willing to make the needed recommendations.
In July1990, GL had her van modified. She was now able to driveindependently.
Closure (TECH POINT 6)
Close follow-up to ensure GL was meeting job expectations and"essential functions" of the job was provided by her VR counselor. Atthe time of closure GL and her employer were extremely satisfiedwith her performance.
Post Employment (TECH POINT 7)
After working for about eight months, GL began asking questionsabout apartment adaptations. She mainly wanted to be sure that inlooking for independent living she was asking the right questions.
She also asked about the appropriateness of her present typingsplints as they had broken. The rehabilitation engineer was con-sulted, and it-was decided that GL have extra splints made by anoccupational therapist. These would serve as back-up should asplint break. The VR counselor and GL did not feel post-employmentServices were needed for this purpose.
138
TECH POINTS Integrating Rehabilitation Technology into Vocational Rehabilitation Services
GL's case history is typical of VR procedures for people who needassistive technology. GL stated that "a person with a disability isdependent on their counselor for information on what technologycould do to help with independence and being able to go back towork." She added that without her counselor knowing technologyresources, she might not have been able to have it all work out aswell.
Center for Rehabilitation Technology Services 139
Examples of Simple Accommodations
The following accommodations are extracted from The Ameri-cans with Disabilities Act: Making The ADA Work for You MiltWright & Associates, Inc. and Jackson, Lewis, Schnitz ler & Krupman
Copyright 1990. As they are reviewed, it should be noted that theywere actual job accommodations; however, they are accommoda-tions which could be considered for any TECH POINT.
A plant worker who was hearing impaired was able to use atelephone amplifier designed to work in conjunction with hearingaids, allowing him to retain his job and not be transferred to a lower-paying job within the company. Cost: $85
A clerk with limited use of her hands was provided with a "LazySusan" file folder for her desk. This prevented her from having toreach across her desk and allowed her to remain in her job asbefore. Cost: $85
An individual with the use of only one hand needed to be able touse a camera as part of his job. A tripod had proven to be toocumbersome. By providing a waist pod (such as is used in carryingflags), he was able to manipulate the camera and keep his job.Cost: $50
A seamstress diagnosed as having carpal tunnel syndrome dueto repetitive wrist motion purchased a pair of spring-loaded, ergo-nomically designed scissors. Cost: $19.95
A desk layout was changed from the right to the left side for avisually impaired data entry operator. Cost: $0
An individual with an eye disorder where glare on the computerscreen caused increased fatigue was accommodated by the pur-chase of an anti-glare screen to minimize the glare. Cost: $39
A receptionist who was blind was provided a light-probe whichallowed her to determine which lines on the telephone were ringing,on hold, or in use. Cost: $45
A light was installed at the door of a company to alert the securityguard of an approaching employee who used a wheelchair andneeded assistance with the high-security door. Cost: $0
A headset for a phone was rented that allowed an insurancesalesperson with cerebral palsy to write while talking. Cost $49.95
140
TECH POINTS Integrating Rehabilitation Technology Into Vocational Rehabilitation Services
A one-handed individual working in a food service position wasable to perform all of the tasks in her position except opening cans.A one-handed can opener enabled her to perform that one remain-ing task. Cost: $35
A groundskeeper who had recovered from a stroke had limiteduse of one arm and needed to be able to rake grass to maintain hisposition. The use of a detachable extension arm on the rake allowedhim to grasp the handle on the extension with the affected hand andcontrol the rake with his functional arm. Cost: $19.80
A timer with an indicator light allowed a medical technician whowas deaf the capability of performing the laboratory tests requiredof her. Cost: $26.95
A person who used a wheelchair could not use the furniture in theoffice provided for her because the desk height was too low for thewheelchair to fit into it. Raising the desk with wood blocks allowedthe proper amount of space for the wheelchair to fit in, thus savingthe expense of purchasing a special desk. Cost: $0
An individual with dyslexia working as a police officer had troublefilling out forms at the end of the day. Providing him with a taperecorder and allowing a secretary to type out his reports allowedhim to continue his job. Cost: $30 - $69
141Center for Rehabilitation Technology Services
14-81
V Series of Successful Closures Through Use ofTechnology
The following case study examples of technology interventionsand their role in successfully placing individuals on jobs were takenfrom the VoRTECHS newsletter. VoRTECHS is published quarterly bythe Center for Rehabilitation Technology Services.
1 4 2
TECH POINTS Integrating Rehabilitation Technology Into Vocational Rehabilitation Services
WAS
Isss,e:
Modifications for Working inthe Library
Greg McGrew, Rehabilitation Engineer, SC Vocational Rehabilitation Department
J is a 36 year old who has moderate-to-severe cerebral palsy. He.11. currently works as a librarian assistant at a small college thanks
to the help of a custom assistive device. This device allows him to performhis work in an accurate and proficient manner.
J.H. is able to walk but has difficulty with his balance due to spasticityand spinal curvature. Reflex activity also makes it difficult forhim to use his hands and arms for fine motor tasks. He oftenmust compensate for this problem by using two hands tostabilize tools and work pieces that would normally onlyrequire one hand to use.
When J.H. started his job in the library, his VR counselorfound that the set of tasks involved in performing the job weretoo difficult for him to do in a timely manner. His jobincluded taking new books and installing labels on thespines. It was very difficult for J.H. to get labelson straight without wrinkles and bubblesunder the tape. An evaluation by therehabilitation engineer revealed that the s
demands of this task meant that J.H. couldperform the job only if both hands were free \\\to manipulate the tape and labels when applyingthem to the book spine. This suggested the need forsome simple device to hold the book for J.H.H. This device
z
14-9
This device uses a spring-loadedplate to support the book in astable, spine-up position. Thisdevice allows J.H. to use bothhands when applying labels. Thebook holder is made of aluminumplates which "sandwich" pieces ofTEFLON, allowing them to slidefreely. This, in conjunction with theangled design of the holding plates,allows J.H. to easily slide in booksof a wide variety of thicknesses,using one hand. J.H. was alsosupplied with a Dycem-coatedwork surface which helped keepwork items from sliding when laidflat.
J.H. has worked with the libraryfor over a year now. He continuesto use the custom designed bookholder to perform his job everyday. *
Book
would have to hold the book in a stable position that wouldallow him to accurately install the book labels on a variety of sizesof books. It would also have to be easy to place the books in and out ofthe book holder. These design criteria led to the construction of the bookholder shown in the picture.
Center for Rehabilitation Technology Services 143
Aluminum platesthat hold thebook.
1'111;161.--.0
Spring-loadedTEFLON plate thatsupports thebook
Wooden base
14-10
The Counselor and Client:Achieving Together
Lillian Ackley and Robert KennedyPennsylvania Blindness and Visual Services
'Ns\ if.1
Ass;v.'s\
After retiring from a 24-year career as an executivesecretary at a local medical centers Lillian Ackley wasenjoying life very much. She worked two part-time jobswhich she loved, one as a feature writer for the county'slargest daily newspaper, and the other as an employee ofan economic development agency. All of that changedwhen she lost her vision during treatment fora pituitarytumor, The following is Lillian's account of her journeyback into the world of work
Two years ago I was plunged into the world of the blind during two
operations to remove a pituitary tumor. The social worker at themedical center referred me to Pennsylvania Blindness and Visual Services
(BVS). My counselor, Robert Kennedy, explored my thoughts about my
future. Since I was 65 years old, it would seem that retirement would be a
satisfactory plan. However, I was not ready for that, so Mr. Kennedy worked
out a plan more to my liking. BVS sent me to the Greater Pittsburgh Guild
for the Blind. There I was enrolled in the Personal Adjustment program
which included training in touch-typing and computer skills using adaptive
equipment.144
Upon completion of the basicGuild program, I was accepted fortheir Access Technology Centerwhich provided intensive, moreadvanced training in computer use.It was recommended that I have anIBM-compatible computer with amodem and telecommunicationsystem, Vert Plus speech softwarewith a DECtalk synthesizer, and aclosed circuit television for minimalreading and bookkeeping tasks. Allitems of equipment recommendedfor me by the Guild were providedby BVS, through contributions fromlocal and regional Lions Clubs.
I was offered a position asadministrative assistant with theRural Development Administration(RDA). The equipment provided byBVS was adequate to meet theneeds of the new position.However, there were someproblems with the speech software.BVS arranged for Brenda Loughrey,
my instructor at the AccessTechnology Center, to come in for aworksite assessment. She installed anew speech system furnished by theoriginal supplier and she providedadditional training for my newposition.
Since beginning my job we havefound a need for a scanner (opticalcharacter reader) which wasprovided by the FederalGovernment, a recording device towork with the government's digitaltelephone system, and a twochannel headset.
The use of technology in helpingthe disabled to a level playing fieldin the real world of employment
TECH POINTS Integrating Rehabilitation Technology into Vocational Rehabilitation Services
must be a continuing process. Mr. Kennedy has worked with the RDAInformation Resource Manager and the engineers to provide additional support.
The Counselor's CommentsThe case of Lillian Ackley demonstrated persistence in pursuit of a
vocational goal and in resolving the inevitable frustrations that occur infinding the right mix of technology and technique to achieve practicalresults.
This unconventional lady brought to the process a valuable networkof contacts, a strong work history and ethic, computer experiencebefore losing her sight, and extraordinary motivation to return to workat her age. This counselor's role was often that of "getting out of herway."
Options and alternatives available through the VocationalRehabilitation process were discussed, and she readily chose thoseservices needed to meet her goals. She had the advantage of hands-ondemonstration of various types of equipment and training at aresidential center. Local service clubs contributed financially in theform of "comparable benefits" for adaptive equipment. She also hadthe good fortune of a supportive, understanding employer whoappreciated the skills and expertise she brought to the organization.Simply put, she is able to help meet the employer's needs.
For this counselor, Lillian's case reinforced the need for ongoingproblem-solving when working with technology. Also important isdefining the problem objectively, preferably in writing, so that allparties can reach a consensus on what needs to be donewhere wewant to go. This makes "how" we go about it more focused. In thiscase, a combination of high technology and low technology solutionsseems to have worked.
Her achievements are an inspiration the human spirit dealingwith loss/adversity. *
Center for Rehabilitation Technology Services
145
14-11
14-12
I
sz.
, sv.
Adapted Cooking Utensils in aResturant Setting
Glenn Hedman, Rehabilitation Engineer, University of Illinois at Chicago.
K. eith is an individual who is mentally retarded and works at acommunity agency in a workshop setting. In an effort totransition Keith to competitive employment, his vocational
evaluator placed him in a local fast food restaurant. Initially his dutiesincluded clean-up of the storage area. Later they were increased to assist incooking hamburgers at the grill and relish station. The owner agreed to atrial period at the grill but was reluctant as Keith had shown some anxietyregarding the heat generated by the grill.
The vocational evaluator requested a worksite modification evaluationfrom the Assistive Technology Unit at the University of Illinois at Chicago'sUAP. The evaluation resulted in identifying three problems: the position ofthe client's hand relative to the hot grill surface during the cooking of
burgers and bacon, the amount of seasoning applied toburgers while cooking and the stability of the
client's hand while scraping the grill surface aftereach batch of burgers and bacon had been
cooked.The first problem was solved bymodifying a stainless steel spatula to
give Keith a surface to holdapproximately 2" farther from the
grill. Stainless steel tubing andend fittings usually used for
handrail applications wereused to modify the
spatula. This adaptivehandle was clamped
FIGURE A
146
to the spatula's wooden handlewith stainless steel screws, nutsand washers, as shown in FigureA.
To regulate the amount ofseasoning applied to the burgers, aseasoning shaker was adapted. Aone-inch diameter disk wasinstalled on the perforated cover ofthe shaker to block some of theholes and reduce the amount ofseasoning coming out during eachshake.
The single blade of the scraperdid not provide much stability andan additional point of support forthe utensil was needed. The onlysurface that would not damage thegrill surface was that of anotherscraper blade. The handle ofanother scraper was shortened andwas bolted underneath the originalscraper. The scrapers wereseparated enough to provideproper angling of the blade withrespect to the grill surface, therebymaking it a more stable utensil forKeith to use.
With the owner confident ofKeith's cooking abilities during hisafternoon shift, he plans toincrease his work hours to includea few evening shifts each week. *
TECH POINTS Integrating Rehabilitation Technology Into Vocational Rehabilitation Services
jL
Help Me Find A Way!By Judith Hughes, CRCSouth Carolina Vocational Rehabilitation Department
"Please help me, I want to style hair.I'm willing to stand on my head if
that's the only way to do it!"
When a VR counselor hears a client make a statement thisemphatic, even in a joking manner, you have to believe thatthis individual is serious about not considering other vocational
choices. But what does a counselor do when the client's disability involvessevere injuries to the feet and ankles caused by a fall?
This client had received a vocational evaluation. Listed among herfunctional limitations was the inability to stand or walk for long periods oftime. Her only work history involved working as a successful hair stylist. Thevocational options considered were sales of cosmetic and beauty supplies,instructor in a beauty school, manicurist, etc. However, this individualneeded at least a GED to consider many of these options. She tried for ashort period to make efforts toward these goals but found her interest andconcentration hard to channel.
This client was concerned about long term goals as she was a singleparent of two small children. She had therapy and several surgicalprocedures during the first year after her injury and had becomeoverwhelmed with the idea of these long term goals.
Without promises that her goal of returning to hair styling would work,the client and counselor decided to discuss her dilemma with therehabilitation engineer to see if there might be a way that a hair stylist couldsit and still reach her customer. Research into various beauty supply
Center for Rehabilitation Technology Services147
14-13
products resulted in finding "anew, unique product designed toextend your career!" This productwas called a ROLSEAT. Thestool-type seat on rollers allowsthe user to move easily and freelyaround the customer while restingon the stool. The ROLSEATattaches to the shaft of the salonchair so that the hair stylist isclose to the customer whilemoving around to all sides. Aperfect solution for this client!
Other modifications were madefor this individual as it wasnecessary to try to minimize anystrain on her ankles. For instance,a power hydraulic base waspurchased for her salon chair toeliminate the pumping action shehad to do with her ankles.Other minor modificationsincluded a rubber mat to decreasethe impact of standing andwalking on a concrete floor and acart with wheels to keep hersupplies close to her. This clientstill must pace herself in the worksetting, but she is doing exactlywhat she wanted to do. In thefuture she plans to complete herGED and to pursue othervocational options. *
14-14
148
TECH POINTS Integrating Rehabilitation Technology into Vocational Rehabilitation Services
TECHNICALLYSPEAKING
Gerald Weisman, M.S.
Vermont Rehabilitation Engineering Center
Manual Material Handling:Accommodating Workers forPushing Tasks
People with back pain oftenrequire workplace
accommodations for performingmaterial handling tasks. Materialhandling may include lifting,carrying, pulling and pushing.Appropriate accommodationscan often help prevent backinjuries on the job.
Adding a powered unit to amanually-operated cart can greatlyreduce or eliminate the amount ofpushing force required. Peoplewith functional limitations thatprevent them from applyingsufficient pushing force can thenperform many material-handlingtasks. This kind of modification canalso help minimize risk of backinjury among other workers.
A tape reel cart was modifiedwith a simple power unit consistingof the front wheel drive and steeringcolumn from an Amigo wheelchair.Two bushings were fabricated andmounted to the back of the cart
Center for Rehabilitation Technology Services
14-15
with welded angle iron brackets.The steering column was supportedand free to rotate in the bushings asshown in the figure below. Abattery, mounted to the lowest shelfof the cart, supplies power; fingercontrols mounted on the handlebarscontrol the motor, and thehandlebars are used for steering.
These modified carts areextremely useful when poweredcarts are unavailable orinappropriate and when materialup to 500 pounds has to be movedon level surfaces or on ramps forlongdistances. *
Modified Tape Reel Cart
149
HandleBars
FingerControls
SteeringColumn
14-16
V Other Case Study Information
ci
El
CI
Notes:
150TECH POINTS Integrating Rehabilitation Technology Into Vocational Rehabilitation Services
11 TECH POINTS Guide SECTION 15
151
TECH POINTS Integrating Rehabilitation Technology into Vocational Rehabilitation Services