1. Changing role of OT: “E”nabling
Lynne Allsopp
Highly Specialist Occupational Therapist
Access to Communication and Technology,
West Midlands Rehabilitation Centre

2. ACT
• Regional NHS Tertiary Assistive Technology Service: all ages
and conditions
• Mission statement
– To work with patients/clients and their local
teams to assess and provide techniques
and technologies which optimise the
potential for communication and control
– Staff: OT, SLT, Clinical Scientists, Workshop team,
Administrators: about 30+ people
• Other teams in UK are similar but each is unique

3. Starter for 10!
• Do you/how do you use the internet in
your current practice?
• Where would you look on the web for
OT resources?
• Have you ever communicated with a OT
colleague online (except email!)?
• Have you ever “e”nabled a client, i.e.
used a computer based occupation?

4. Professional resources
OT/As: knowledge sharing,
developing resources,
publicity and marketing,
“lean” working

5. Occupational Media
ADL: shopping, banking
Social activities: dating, connecting with friends
Education/support: courses, peer support
groups
Political/self advocacy: digital petitions,
consultations, comments, emails
Leisure occupations: music and video, games
Online work and volunteering
Creative activities: writing, artwork, photography

6. Occupational Media
Computers play a part on almost every area of
our daily lives in one form or another (Blain,
McKeever, & Chau, 2010)
Chard (2007) acknowledges emailing, playing
games online, editing pictures or music on a
computer are some of the arts and crafts of
our age

7. Digital Inclusion
A recent BBC World Service
poll found that almost four in
five people around the world
believe that access to the
internet is a fundamental
right (BBC 2010).
In Finland access to the
internet is a legal right (CNN
2009).

8. Digital Divide
“The gap between those
who have access to, and
use and control of the
internet and digital
media; and those who do
not” (Goldfarb & Prince,
2008; Smedema &
McKenzie, 2010).

9. Accessibility
The internet has been proposed as a
liberating space for people who in
offline life face many disabling barriers
(Childers & Kaufman-Scarborough,
2009; Dobransky & Hargittai 2006; Guo,
Bricout & Huang 2005)

10. Accessible? (DRC 2004)
I have trouble
I can’t afford it
I don’t want to be a using a mouse
victim of identity and keyboard
theft
I need help to
understand how to I have a I don’t know
do new things sensory what you can
impairment do on a
computer!
I have no idea how I’m not good
to use a computer with
technology, I
might break it!

11. I have trouble using a keyboard
and mouse
• Customisation
• Alternative Input
• Software

12. Computer Customisation
• Simple modifications available on the
computer to make access easier.
• Mouse, Display and Accessibility
Options can be adjusted
Windows and Mac operating systems

13. Computer Customisation
• Display Settings
• Keyboard Settings
• Mouse Settings
• Accessibility
This varies between operating systems
and also between Windows and Mac.

14. Customisation: Keyboard
• Adjust key repeat rate
• Filter out unwanted key presses
• Sticky keys- will automatically hold
Shift, Alt or Control keys down
• Keyboard shortcuts

15. Customisation: Windows
Accessibility Options
Holds down Shift,
Control, Alt or
Windows key for
one press to remove Helps to reduce
need for holding a number of
key down. accidental key
presses
Other
Accessibility
options are
useful.

16. Customisation: Mouse
Switch left
and right
buttons over
Adjust the
double click
speed
Click Lock will
hold down the
mouse button
while user drags
curser across
screen
BUTTONS

17. Customisation: Mouse
Can also
Change the import
pointer new
schemes cursors
from list e.g. Priory
Woods
POINTERS

18. Customisation: Mouse
Adjust sensitivity
of the mouse
curser
Snap to points on
the screen
automatically
Helps to locate
mouse curser
on screen

19. Customisation: Mouse
• Adjustment of the Mouse and Trackpad
• Assignable Mouse Buttons

20. Customisation: Windows
Accessibility Options
Also access Magnifier, Narrator & On
Screen Keyboard through menus

21. Accessibility Options
• Voice Recognition
• Screen Reader
• Screen Magnification

22. Accessibility Options
• On screen keyboards

23. Input to the computer
What is an input to the computer??
• Mouse
• Keyboard
• Something to control what you want to do on
computer
• Maybe start with wireless

24. Alternative Inputs to the
computer
Physical Access
• Mouse/ Cursor Control
– Glide pad - USB
– Tracker ball
– Joystick
– Head mouse
– Eye Gaze
– Integra Mouse
– USB Finger Mouse

25. Alternative Inputs to the
computer
Physical Access
• Mouse/ Cursor Control
– Glide pad - USB
– Tracker ball
– Joystick
– Head mouse
– Eye Gaze
– Integra Mouse
– USB Finger Mouse

26. Alternative Inputs to the
computer
Physical Access
• Keyboard
– Key guard,
– Single hand keyboard
– Keyboard size
• Alternative to mouse / keyboard
– Switches, On-screen keyboard
– Touch screen
– Communication Aid

27. Alternative Inputs to the
computer
Physical Access
Voice
• Voice recognition software

28. Computer Access: Software
• Freeware
– On Screen Keyboards
– Mouse Click Emulators
– Dwell Click
– Auto Hot Keys
– Steady mouse
– Mouse Wrap

29. Access to the computer:
Switches
i.e. bypassing the mouse and keyboard
completely
• Attaching them to PC:
– Joy Cable, Crick box
– Switch driver

30. What next?
Page turners…… eReaders

31. More possibilities…
• Texting via the computer
• Environmental control
• Communication

32. Further Training
• Local Resources
• Ability Net – Skill sheets and fact sheets
• ITCH
• RNIB
• Aidis Trust

33. Practical next steps
• Go and play on your computer!
• How you use a computer in your personal
life?
• How you use a computer in your work life?
• Reflect: what are my concerns?
• Discuss in your teams
• Find out about local IT training services
• Research relevant charities

34. Resources
www.actwmids.nhs.uk
www.ace-centre.org.uk
www.abilitynet.org.uk/myway/
www.microsoft.com/enable/
www.apple.com/accessibility/
www.aidis.org/

35. References & Resources
• www.keytools.co.uk
• www.qedltd.co.uk
• www.inclusivetechnology.co.uk
• www.lakefolks.org
• www.cameramouse.com
• www.wivik.com
• www.orin.com
• www.nuancestore.com
• www.smartboxat.com
• www.cricksoft.com
• www.microsoft.com
• www.apple.com

36. References
Blain, S., McKeever, P. & Chau, T. (2010) Bedside computer access for an individual with severe and multiple
disabilities: A case study. Disability and rehabilitation. Assistive technology. Early Online 1-11
Chard, D. (2007) Computer games and karate: the arts and crafts of today. British Journal of Occupational Therapy. 70
(8) 329
Childers, T. & Kaufman-Scarborough, C. (2009) Expanding opportunities for online shoppers with disabilities. Journal of
Business Research. 62 (5) 572-578
Disability Rights Commission (2004) The web: access and inclusion for disabled people. Available online at:
http://www.ifap.ru/library/book427.pdf Accessed 14/05/2010
Dobransky, K. & Hargittai, E. (2006) ‘The disability divide in Internet access and use’, Information, Communication &
Society, vol. 9, no. 3, pp. 313–334.
CNN Fast Internet access becomes a legal right in Finland.
http://edition.cnn.com/2009/TECH/10/15/finland.internet.rights/index.html Accessed 14/05/10
BBC. Four in Five Regard Internet Access as a Fundamental Right: Global Poll
http://news.bbc.co.uk/1/shared/bsp/hi/pdfs/08_03_10_BBC_internet_poll.pdf Accessed 15/05/2010
Goldfarb, A. & Prince, J. (2008) Internet adoption and usage patterns are different: Implications for the digital divide.
Information Economics and Policy. 20 (1) 2-15
Smedema, S. & McKenzie, A.(2010) The relationship among frequency and type of internet use, perceived social
support, and sense of well-being in individuals with visual impairments. Disability and rehabilitation. 32 (4) 317-25

37. Contact me
• Lynne.allsopp@nhs.net