Low Tech AT in the Classroom

Most elementary classrooms use low tech assistive technology without even knowing it. This blog will highlight some simple AT things that are commonly found in the classroom. Most of these items can benefit all students, not just students with disabilities!

(Reminder: Low tech assistive technology is not complex, does not require extensive training, is not battery or electrically operated, and is typically low cost.)

v  Holding a pencil can be a challenge to students who are just learning to write. Grasp progresses as we develop from a scribbling 3 year old to a writing kindergartner. Around age 5-6 a student should be using a mature tripod pencil grasp (see image below). However, the tripod grasp does not always develop on its own – see below for some AT tricks to facilitate development.   (Also visit this cool resource for more info on the progression of grasp patterns: http://www.ot-mom-learning-activities.com/support-files/pencil-grasp-development-2013.pdf)

Mature tripod pencil grasp for kindergarten age students 

Pencil grips can be used to facilitate appropriate finger placement

Clipping a clothes pin to a pencil is a great low cost way to facilitate tripod grasp! It also forces student's to tuck the remaining fingers to their palm.

Holding a small ball while writing is also a great tactile reminder for students to tuck their fingers to their palm.

Using a short pencil is a great way to facilitate the use of a tripod grasp because there is less room on the pencil for the other pesky fingers. You can buy shortened pencils or you can break them to be any length you want! (this technique also works great for crayons!) 

Why does it matter? The tripod grasp is the most efficient way to grasp a pencil while maintaining joint integrity, preventing hand fatigue, and maintaining writing energy for long periods of time.

v  Adapted paper can help students learn proper letter formation. For example letter “b” has a big line down that starts in the sky and ends on the ground. Letter “g” starts at the dotted line and ends in the basement (yes we have our own language J). Letter formation concepts can be very hard to learn in a limited amount of time, especially considering capital and lowercase letters can look drastically different. Adapted paper can provide explicit visual cues to assist with the learning curve. Adapted paper also comes in various sizes of triple-lined paper to progress handwriting from large to small in size.

Symbol paper provides great cues for letters that start in the sky and end on the ground. 

Highlighted paper is a great constant visual cue to break up the triple lined paper. This makes it east to see where all letters should begin and end.  

v  A lack of coordination can be seen when students are learning to write. In this case, letter formation looks choppy, lines look squiggly, and writing can be very faint. If motor coordination is the problem, a pencil weight or rubber band can be used to bring more awareness to the student’s hand. There is not a lot of research in this area but one article says 68% of occupational therapists are using weighted pencils in practice. This is definitely an area for more research!

o   Feder, K., Majnemer, A., & Synnes, A. (2000). Handwriting: Current trends in occupational therapy practice. The Canadian Journal of Occupational Therapy, 67, 197-204

Rubber-band being used to increase awareness and stabilization of pencil. 

Weighted pencil 

v  Class clown or sensory seeker? To work at our fullest potential we need to be in a comfortable sensory environment. Some kids have a really high tolerance to stimuli, they need more input to be comfortable…so they seek input in the wrong places. This can present anywhere from talking to friends, to squirming in their seats, to touching stuff on the desk, to getting out of their seat, chewing on pencils, and acting out in class. See the images below for some discrete things that can make a world of difference to the sensory seeking student. (Disclaimer: not all students who seek sensation or avoid sensation have sensory processing issues)

Quiet fidget's can be used discretely under a desk. ALWAYS have rules and make sure the classroom teacher is on-board with the use of fidgets.

Placing different textures (Velcro) under a students desk can give them a non-movable source of sensory input. They can feel it whenever they want to create their "just right" sensory environment.  

Wiggle disc's can be placed in a students chair to give them a dynamic seating system.

Thera-band can be tied around the legs of a chair for kids to bounce their feet on. Hopefully, this decreases the out of chair incidences and increases attention.  

v  Schedules with pictures placed on the board can be a great resource for students. On top of everything students learn in school they also have to time manage. A schedule is a great way to teach time management. This also makes students accountable and prepared for each step of the day.

Example schedule, add time frames to this and make is visible to all students 

****Note: There are MANY more examples of assistive technology, the ones mentioned in this blog are devices that I am becoming familiar with through my rotation.

All images in this blog were collected from Google images. 

Where there is a will, there is a way

When I think of school-aged children, my mind pictures little people who can run, play, sing, color, and leap into their parents’ arms. Unfortunately, this is not always the case. The prevalence of disability is much more common than one might think. 

Proof:

·         I am from rural Fremont County, nestled in the Loess Hills of Iowa. According to the Community Health Needs Assessment (2013) there are 54 (3.4%) children under the age of 18 in Fremont County that are diagnosed with a disability.

·         I am finishing my last rotation in a rural public school setting in Otoe County, Nebraska so I am also going to provide statistics for this region. According to the Community Health Needs Assessment (2013) there are 191 (5.6%) children under the age of 18 in Otoe County that are diagnosed with a disability. 

So what?

The United States Department of Education mandates that every child has access to the least restrictive learning environment: 

·         “In general.--To the maximum extent appropriate, children with disabilities, including children in public or private institutions or other care facilities, are educated with children who are not disabled, and special classes, separate schooling, or other removal of children with disabilities from the regular educational environment occurs only when the nature or severity of the disability of a child is such that education in regular classes with the use of supplementary aids and services cannot be achieved satisfactorily.”

·         More info: http://idea.ed.gov/explore/view/p/,root,statute,I,B,612,a,5,

In this blog, I want to address some AWESOME ways to use assistive technology to facilitate the least restrictive learning environment for medically complex students.

First, medically complex means a child may have medical fragility and intensive care needs, they may have a congenital or acquired multisystem disease, a severe neurologic condition with marked functional impairment, and/or technology dependence for activities of daily living (Cohen et al., 2011). (I could go on for DAYS about how this definition sings to my OT brain!)

How do you facilitate the least restrictive learning environment for a child who uses only their eyes to communicate?

Tobbi Eye Tracking software can be hooked up to a windows tablet or computer. It sends infrared signals to read the reflections in the user’s eyes (HOW COOL!). The individual’s eyes now work as a mouse pointer on the screen. With a few more modifications such as an on-screen keyboard, the user can now independently interact with their computer. This technology makes school, college, and employment a possibility for anyone who can use their eyes. For more information on eye gaze technology visit:   http://www.tobii.com/en/about-tobii/what-is-eye-tracking/   

Did you know that most new model power wheelchairs have Bluetooth capabilities?

A student (or anyone!) in a power wheelchair can drive right up to a computer and pair their wheelchair via Bluetooth. When this is completed, the joystick becomes a mouse and clicking functions can be enabled multiple ways. This grants an individual hassle-free computer access from the comfort of their chair. This feature paired with Dragon Naturally Speaking Voice Recognition Software, makes using a computer possible for anyone with limited to no arm function.  

*Note: sometimes Bluetooth capabilities need to be enabled on a power wheelchair prior to this working.

How do you facilitate the least restrictive learning environment for a child who uses only their voice/air to communicate?

A sip and puff switch is a type of control unit that allows users to suck in or push out air into a switch to activate a computer, wheelchair, environmental control system, etc. When a user sips or puffs air, the switch converts these commands into mouse button clicks, joystick button presses, or keyboard characters. The Sip and Puff Breeze (pictured below) plugs into a computer interface to convert the sip/puff signals into functional commands such as mouse clicking. This paired with an on-screen keyboard and voice recognition software can facilitate complete computer independence. For more information on using a sip and puff switch to interact with a computer visit: http://www.orin.com/access/sip_puff/

The job of an occupational therapist is to maximize the skills that an individual has. Using assisitive technology can make the opportunities endless!  

****Note: There are MANY more examples of assistive technology, the ones mentioned in this blog are devices that I am becoming familiar with through my rotation.

All images in this blog were collected from Google images.

References:

Cohen, E., Kuo, D. Z., Agrawal, R., Berry, J. G., Bhagat, S. K. M., Simon, T. D., & Srivastava, R. (2011). Children With Medical Complexity: An Emerging Population for Clinical and Research Initiatives. Pediatrics, 127(3), 529–538. http://doi.org/10.1542/peds.2010-0910

Community Health Needs Assessment. (2013). Health indicators report: Population with any disability, Otoe County, Nebraska. Retrieved from:  http://assessment.communitycommons.org/CHNA/report?page=1&id=617

Community Health Needs Assessment. (2013). Health indicators report: Population with any disability, Fremont County, Iowa. Retrieved from: http://assessment.communitycommons.org/CHNA/report?page=1&id=617