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ECUsEnvironmental ControlUnits: Selecting theright one for your clientBy Danielle I. Werner
2• COT Code of Ethics (2010) – the College is “committed  to client-centred practice” (COT 2010:v)   • Also see 3.3.2 (COT...
3• Assistive technology (AT) – any  device, service, strategy or practice that is used as an  aid in completing a task (Co...
4Human ActivityAssistive Technology(Cook and Polgar 2008)• Consider:    • What movements and      abilities are available ...
5• Spinal cord injury at C5 due to skiing  accident• Age 27• Married• Lives in a large ground floor flat with  ramp access...
6                                         • Head, neck, some          Physical                         shoulder movements ...
7• Important factor of human aspect• „Novice‟ user first needs to grasp controls and learn  to cope with limited function•...
8• Direct selection                       When direct selection    • Remote                             is not ideal…    •...
9•   Lights?•   Doors?•   Phone?                      Self-care•   TV?•   Computer?        Productivity•   Chair?         ...
10• Home?                                           Physical• Office or school?                                           ...
11Signals• Direct wiring• X10 (via house  wiring)• Wifi• Ultrasound• Infrared (IR)• Radio frequency (RF)TransmissionDaniel...
12Client‟s priorities!                     Ongoing support• Aesthetics or                          • Progressive  function...
13                                         (RSLSteeper no date)• RSLSteeper‟s  evoassist and Remo  Phone• Switch control u...
14• Appropriate education can help prevent abandonment• A „facilitator‟ should undertake training alongside client to  ass...
15    TO CONCLUDE•     Selecting the best ECU requires a person-centred      approach•     Appropriate selection reduces a...
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Using the HAAT model to select an appropriate ECU for your client

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A short presentation on applying the HAAT model to ECU selection with a case study client with a C5 spinal cord injury. This was done as a final presentation as part of my BSc in Occupational Therapy.

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Using the HAAT model to select an appropriate ECU for your client

  1. 1. ECUsEnvironmental ControlUnits: Selecting theright one for your clientBy Danielle I. Werner
  2. 2. 2• COT Code of Ethics (2010) – the College is “committed to client-centred practice” (COT 2010:v) • Also see 3.3.2 (COT 2010:16)• NSF for Long-term Conditions – „Quality requirement 1: A person-centred service‟ (Department of Health (DH) 2005)• Adoption vs. abandonment – influenced by perceived relative advantage and involvement of client in choice (Reimer-Reiss and Wacker 2000) Personalised care – why? Danielle Werner - Assistive Technology
  3. 3. 3• Assistive technology (AT) – any device, service, strategy or practice that is used as an aid in completing a task (Cook and Polgar 2008)• Augmentative and alternative communication (AAC) – AT used to overcome communication difficulties (Cook and Polgar 2008)• Environmental control unit (ECU) – a “device that allows control of appliances” (Cook and Polgar 2008: 548); AKA: • Environmental control system (ECS) • Electronic aid to daily living (EADL)Terms to knowDanielle Werner - Assistive Technology
  4. 4. 4Human ActivityAssistive Technology(Cook and Polgar 2008)• Consider: • What movements and abilities are available • What the client wants to achieve • The client‟s level of expertise • What environments the client wants to have control in • The client‟s priorities!HAAT modelDanielle Werner - Assistive Technology
  5. 5. 5• Spinal cord injury at C5 due to skiing accident• Age 27• Married• Lives in a large ground floor flat with ramp access, though currently in a temporary residence until modifications can be finalised• Wants to be as independent as possible in the home and needs a suitable ECU• Also intends to work from homeCase study: LornaDanielle Werner - Assistive Technology (Gille 2006)
  6. 6. 6 • Head, neck, some Physical shoulder movements Cognitive • Elbow flexion, not extension (Cook and Emotional Polgar 2008) • Diaphragmatic breathing, low stamina • Assistance in coughing and clearing secretions (Apparelyzed.com 2012) • Intact cognition • Depression post- accident, now motivatedWhat skills andmovements are available?Danielle Werner - Assistive Technology
  7. 7. 7• Important factor of human aspect• „Novice‟ user first needs to grasp controls and learn to cope with limited function• „Expert‟ user can use unit creatively and unconsciously (Cook and Polgar 2008)What level of expertisedoes the client have?Danielle Werner - Assistive Technology
  8. 8. 8• Direct selection When direct selection • Remote is not ideal… • Touchscreen • Scanning • Keyboard, modified• Switch • Directed scanning• Voice control • Row-column• Joystick scanning• Mouthstick • Coded access (e.g.• Eyegaze Morse code)• Etc. • Etc.Human-technologyinterface Test for the best!Danielle Werner - Assistive Technology (Liberator 2012)
  9. 9. 9• Lights?• Doors?• Phone? Self-care• TV?• Computer? Productivity• Chair? Leisure• Etc.• What are the client‟s priorities?What must the ECUcontrol?Danielle Werner - Assistive Technology
  10. 10. 10• Home? Physical• Office or school? Social• Layout of environment• Number and position Cultural of outlets Institutional• ECU mounted on wheelchair? Controls? Display?• Wheelchair controls?• ALSO, what resources are available?In what environmentswill the ECU be used?Danielle Werner - Assistive Technology
  11. 11. 11Signals• Direct wiring• X10 (via house wiring)• Wifi• Ultrasound• Infrared (IR)• Radio frequency (RF)TransmissionDanielle Werner - Assistive Technology
  12. 12. 12Client‟s priorities! Ongoing support• Aesthetics or • Progressive function? condition?• Speed, durability, batt • Novice  expert ery life, reliability? • Change in priorities• Which functions • Change in needs should be at top of list or first page (depending on ECU)?Other considerationsDanielle Werner - Assistive Technology
  13. 13. 13 (RSLSteeper no date)• RSLSteeper‟s evoassist and Remo Phone• Switch control using available movements (e.g. chin or mouth; Cook and Polgar 2008)• Typing stick for computer use (AbleData 2011) (Apparelyzed.com 2012)• Voice control (though not as main control)Choices for LornaDanielle Werner - Assistive Technology
  14. 14. 14• Appropriate education can help prevent abandonment• A „facilitator‟ should undertake training alongside client to assist during the learning phase• Information should be presented in small chunks so as not to overwhelm the client (Cook and Polgar 2008)• Ability to recall education also important indicator of adoption vs. abandonment (Wielandt et al 2006)• Education and support can come from other users who have had similar experiences (Spinal Injuries Association (SIA) no date) (Apparelyzed 2012)Educationand supportDanielle Werner - Assistive Technology
  15. 15. 15 TO CONCLUDE• Selecting the best ECU requires a person-centred approach• Appropriate selection reduces abandonment• Important considerations in selecting an ECU include: • Available skills and abilities of the client • Possible ways of interaction with an ECU • Desired functions • Environment, and the limitations of certain signalsDanielle Werner - Assistive Technology

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