A U-shaped cutout table is an excellent way to facilitate this appropriate position of the upper extremities. Elbows should rest at a 90-degree angle with wrists flat. The student’s feet need to be flat on the floor or fully supported, the pelvis and trunk touching and supported by the back of the seat, and elbows and forearms resting on the desktop without extending outward or leaning forward. Stability in a chair is a prerequisite to success with a computer. (Be sure to specify whether purchases will be used with a Macintosh or Windows platform computer.) Seating and Positioning For Computer Activities A skills assessment by a specialist, and trials of hardware and software are highly recommended before purchases are made. RecommendationsĪlthough general guidelines for hardware and software can be made, specific recommendations are dependent on age, skill level, requirements for written communication and experience. Fortunately, it has been found that computer access may be quite beneficial when appropriate accommodations are made. The use of an aide to act as a scribe, although efficient, often encourages dependence upon others. However, unless adaptations have been made to the standard computer and keyboard, the results are often discouraging. Many patients with A-T have been encouraged to type as an alternative to handwriting. Sometimes patients are reluctant even to attempt a writing task because of the required effort and modest results. Many patients function below grade and age expectations in the area of written communication in part because of poor legibility and slow writing and typing speeds. Visual tracking is also often a factor adversely affecting reading ability. Together, these deficits create difficulty for completing reading and writing tasks. The typical patient with A-T has difficulty with eye movements, fine motor coordination of the hands, and trunk control. Software to enhance reading skills is then also reviewed. Typing trials are performed while manipulating hardware and software to find those combinations that optimize speed, accuracy, comfort, and quality of output. Visual ability is informally assessed to establish a comfortable font size for reading text. Next, the patient is provided with a standard computer and monitor. Legibility, fatigue, and speed of writing are evaluated (very young children may be observed while drawing a picture). Information regarding the benefits and obstacles associated with currently used assistive devices such as altered writing surfaces or adapted computer access is gathered. The evaluation process begins with an assessment of the patient’s home, school or work requirements, as well as current reading and writing skills. Keyboard access, mouse control, visual ability, and reading needs are explored. The primary focus of the Assistive Technology evaluation is computer access and use. However, the evolution of portable computers, scanners, highly adaptable hardware and software, and the World Wide Web have made computer access easier and an overall benefit for the A-T patient. Logistics of multiple classrooms, cost, and time restrictions continue to be a problem. To provide greater independence and continued educational growth, an adapted computer is often an effective assistive technology tool for the A-T patient.Ĭomputers, too, have their limitations. Scribes, although a favorite among students, may hinder the student from learning spelling, punctuation, capitalization, and organization of thoughts. Adapted pencils and slant boards do not typically ease fatigue or improve the speed and legibility of handwriting. Problems with legibility, time restrictions, and fatigue are common and adversely affect the ability of these students to participate in class and to demonstrate what they have learned. Yet for the patient with A-T, these simple tasks are much more difficult. Reports, spelling lists, journals, and exams are daily activities in the life of a typical student. 2008 originally published 2000 ASSISTIVE TECHNOLOGY FOR WRITTEN COMMUNICATION Loreta McPartland, Lynnley Moore, Nancy Inman
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