The document discusses assistive technology for individuals with cerebral palsy, detailing various devices and systems that support mobility, communication, and daily activities. It covers categories of technology, including no-tech, low-tech, and high-tech solutions, as well as specific aids for different bodily functions. Additionally, it emphasizes the importance of tailored adaptive equipment to enhance the independence and quality of life for users.

1. IO2 module 3
Assistive Technology and
CP
CP-CARE - 2016-1-TR01-KA202-035094
(01.12.2016 – 30.11.2019)

2. Unit 1 - Brief information on
assistive technology

3. Assistive technologhy is any equipment, appliance
or product that improves, protects or enhances the
functional capacities of persons with disabilities, is
sold on the market, or is designed, adapted or
adapted as necessary.
What is Assistive Technology?

4. - To be able to perform daily life
activities alone,
- To enable people without sight,
hearing, speech, and movement to
perform these functions,
- To support the growth and development
process,
- To facilitate the learning function,
- To provide security and convenience.
The effects
of assistive
technology in
Cerebral
Palsy

5. Assistive Technology In Cerebral Palsy And
Types Of Uses Of Technology

6. Technology Free Products
(Hardware)
Technology Products
(Software/Hardware)
Walking Assistants
- Walkers
- Sticks and crutches
- Wheelchairs
- Orthotics
- Prosthesis
Vision Support
- Screen Reader
- Touch Keyboard
- Screen Magnifier
- Accessibility software embedded in
Windows, Mac, IOS, etc.
Transfer Assistants
- Lifters
- Transfer Boards
Hearing Assistants
- Assistive Listening Devices
- Voice Enhancing Phones
- Loop Systems
Positioning
- Sitting
- Standing
Communication Aids
- Augmentative and Alternative
Communication(AAC)
Games, Recreation and Leisure Activities Learning Assistants
- Computer-aided Education (Educational
games)
House Adaptations
- Environmental Control (Domotics)
Vehicle Adaptations

7. No Tech
• Pencil Grip
• Post-it Notes
• Slanted surfaces
• Raised lined paper
• Covered overlays
• Tactile letters
• Magnifying bars
• Weighted pencils
Low Tech
• Buzzers
• Portable word
processors
• Talking Calculator
• MP3 players
• Electronic organizers
• Lights
High Techs
• E-Readers
• Touch screen devices
• Computerized
testing
• Speech Recognition
Software
• Word Processors
• Text-To-Speech
(TTS)
• Progress Monitoring
Software
 Examples of Assistive Technology

8.  No Tech Assistive Technology Products
Tactile Letters
Pencil Grips

9.  Examples of Low-Tech Assistive Technology
Products
Buzzers Switches

10.  High-Tech Assistive Technology Products
Computerized TestingTouch Screen Devices

11. References
 Assistive Technology Act, United States Congress
2004.
 http://istanbultip.istanbul.edu.tr/ogrenci/wp-
content/uploads/2016/10/asistif-teknoloji-resa-
ayd%C4%B1n.pdf

12. Unit 2 - Augmentative and
Alternative Communication (AAC)

13. What is
Augmentative and
Alternative
Communication?
How can someone
communicate with
AAC?
Examples such as PECS
(Picture Exchange
Communication
System), control
interfaces for the
computer, alternative
keyboards, touch
screens, head pointers,
mouth sticks.

14. AAC is various method of
communication that can help
people who are unable to use
verbal speech to communicate
AAC is a blanket term that
includes all forms of
communication except
«standart speech». AAC tools
allow children with cerebral
palsy to communicate more
effectively.
What is Augmentative And Alternative Communication?

15. Unaided Systems
Do not require special
materials or equipment
Rely only user’s body to
convey messages
Signing
and gestures
Aided Systems
Require the use of tools
and equipments
Devices that produce
voice output
Charts, books, assistive
technology
Types of Alternative And
Augmentative Communication

16.  It is an unaided system in which the individual does not
need anything other than his / her own body.
Unaided System
These include
gestures, body
language, facial
expressions, and
sign language.

17.  People use an aided AAC system when they are using their
body along with additional equipment or tools.
Aided System
High Tech
Touching letters
or pictures on a computer
screen that speaks for
individuals.
Low Tech
Pen,paper,
pointing to
letters,
words, or
pictures on a
board.

18. Eligibility For AAC
•Physically involved but cognitively able
•Multiply involved with unknown cognitive abilities
•Physically able but motor speech or language
delayed
•Pre-verbal or emergent-verbal
•Developmentally delayed
•Exhibiting behavior disorders related to inability to
communicate effectively
•Severe speech sound production difficulties
individuals
with complex
communication
needs who
are/have:
Who have difficulty accessing
their curriculum in the absence of
AAC support?

19. EXAMPLES OF AAC
Direct Selection
The person using AAC accesses a target by directly pointing to a
symbol, picture, or object with a body part (e.g. finger, hand, eye
gaze) or adapted tool (e.g. laser pointer, computer mouse).

20. EXAMPLES OF AAC
indirect Selection
The person using AAC selects a target from a set of choices as an
indicator scans each choice in the set.

21. References
 https://www.abclawcenters.com/cerebral-palsy-technologies-
augmentative-and-alternative-communication-aac/
 https://allaboutaac.wordpress.com/considerations/access-method/

22. Unit 3 – Assistive Technology For
The Lower Extremity

23. A. Positioning
• Sitting
• Standing
B. Mobility
• Orthotics
• Sticks and crutches
• Walkers
• Wheelchairs
• Others

24. A- Positioning;
• Allow active movement,
• Provide body support,
• Improve circulation and
bone health,
• Prevent soft tissue
contractures,
• Improve communication,
cognitive and personal-
social development.

25. Sitting
Sitting support many body
functions. Maintained
sitting is a goal achieved
by most typical infants
before 1 year age. There
are also significant social
benefits.

26. Seat
• Height
The height of the chair seat
should allow the feet to be
placed flat on the floor or foot
rest.
• Depth
The seat should be deep
enough to allow maximal
distribution of weight.
• Padding
Padding helps to limit pressure
which allows for increased
sitting tolerance.

27. • Backrest
Backrest should accommodate
adequate movement. Should also
provide adequate support of the
trunk to prevent muscular fatigue.
The shorter backrest allows great
mobility for general freedom of
movement.
• Seat to Backrest Angle
The angel formed between the seat
and the backrest of a chair is most
comfortable between 95 and 110
degrees.

28. Standing
The standing posture is the foundation for many
functional activities. Also can promote circulation, bone
mineral density, vertical access and social interaction
with others.

29. B- Mobility
Mobility is defined as the
ability to move in one’s
environment with ease and
without restriction. Problems
with walking, rolling over in
bed or transitioning
positions are examples of
mobility limitations.

30. Orthotics
Orthotic devices are braces worn externally that
improve and strengthen mobility.

31. Sticks and Crutches
Sticks and crutches are often used by those
with cerebral palsy who have the ability to
ambulate, or walk, but need extra help with
balance and stability.

32. Walkers
Walkers can assist
children with cerebral
palsy with their
mobility issues,
including problems with
balance and posture.
They also allow the
child to bear weight on
their legs.

33. Wheelchairs
Wheelchairs are common mobility aids for non-
ambulatory cerebral palsy patients. There are numerous
design options and features to choose from, but there
are two basic types: manual wheelchairs and electric
wheelchairs
Manual
Wheelchairs
Electric
Wheelchairs
https://www.youtube.com/watch?v=K-MTAe45cMo

34. References
 Raine S, Meadows L, Lynch-Ellerington M. The Bobath Concept: Theory
and Clinical Practice in Neurological Rehabilitation Çeviren: Karaduman
A,Yildirim SA, Yilmaz ÖT. Bobath Kavrami Nörolojik Rehabilitasyonda Teori
ve Klinik Uygulama. Pelikan Kitabevi., Ankara; 2012 s: 154-178
 www.drdenizdogan.com/2012/06/tekerlekli-sandalyeler.html
 www.theradapt.com
 https://www.nhs.uk/conditions/kyphosis/treatment/

35. Unit 4 - Assistive Technology
for the upper extremity

36. Functions of the upper extremity
The use of hands is important to be independent in
everyday life.
In daily life, a number of important activities are performed
using hands.
Activities range from ones that require more strenght and
less skill, such as carrying a heavy object, to ones that
require selective grip and skill, such as thread a needle.

37. Upper extremity problems
Involuntary
and jerky
movements
In-
coordinated
movements
Lack of
Sensation
Grasping
difficulties
Lack of fine
motor skills
Muscle tone
problems

38.  Orthotics/Splints
Orthotic devices are braces worn externally that
improve and strengthen mobility.

39. Technology support for upper
extremity
 Finger extension rehabilitation glove
https://www.youtube.com/watch?v=1bRkddWvyUM

40. References
 Raine S, Meadows L, Lynch-Ellerington M. The Bobath Concept: Theory
and Clinical Practice in Neurological Rehabilitation Çeviren: Karaduman
A,Yildirim SA, Yilmaz ÖT. Bobath Kavrami Nörolojik Rehabilitasyonda Teori
ve Klinik Uygulama. Pelikan Kitabevi., Ankara; 2012 s: 154-178
 Sveistrup H, Thornton M, Brvanton C, et al. Outcomes of intervention
programs using flatscreen virtual reality. Conf Proc iEEE Eng Med Biol Soc.
2004;7: 4856–4858
 A paediatric interactive therapy system for arm and hand rehabilitation.
in Virtual Rehabilitation, 2008
 Alamri A, Eid M, iglesias R, Shirmohammadi S, El Sadik A. Haptic virtual
rehabilitation exercises for poststroke diagnosis. iEEE Trans instrum Meas
2008;57:1876-84.
 Bouzit M, Burdea G, Popescu G, Boian R. The Rutgers Master ii—New
design force-feedback glove. iEEE Trans instrum Meas 2002:7;256-63

41. Unit 5 – Mobility And Transfer
Devices

42. Wheelchairs
• Wheelchairs are vital
mobility aids for cerebral
palsy patients with
ambulatory issues.
• There are numerous design
options and features to
choose from, but there are
two basic types: manual
wheelchairs and electric
wheelchairs.

43.  Things to watch out for the right
wheelchair:
Width of the selected wheelchair should be the child’s hip
width plus two fingers wide.
The length of the seating area of the selected wheelchair
should be from the hip to the back of the knee.
Arm height of the wheelchair should be from the seat to
the elbow.
if the child has a problem with head or body control, the
back support can be raised to the back of the head.

44. cm
Seat width 36 – 50,5
Seat height from the floor 40 - 46
Seat armrest height 25 - 47
Rear wheel rim hub width 38 - 52
Front pedal rear wheel height 38 - 80
• Persons who will use a manual wheelchair should have
sufficient strength and durability to push the chair on
various floors at home and in the community.

45. Arm Supports of the Wheelchairs
 Stable,
 Removable,
 Shaped like a
removable table,
 inclining backwards,
 Height adjustable,
 Tubular.

46.  Fixed arm support is part
of the frame and can not
be removed.
 This support prevents
approach to the counter
or dining table and side
transfers.

47.  Reversely raised and removable table-shaped
arm supports facilitate side transfers

48.  Tubular arm supports are available for
lightweight frames.

49.  The rotatable detachable
rungs can slide next to the
chair or can be removed
completely.
 These rungs allow you to get
closer to bed, bathtub and
counter
 Wheelchair length and
weight are reduced so that it
can be easily loaded into a
car when the rungs are
removed.
 Can be fixed to the chair
with a locking device

50.  Height adjustable
rungs are suitable
for patients with
lower extremity
oedema, changes
in blood pressure
and orthopedic
problems.

51. Base Plate of the Wheelchair
 it may have heel and toe straps to help secure
itself to the soles of the feet.

52. A calf strap can
be used when
additional
support is
required on the
foot support or
behind the calf.

53. Other accessories may include seat belts,
various brake styles, brake extensions, wheel
locks, and head restraints.
Brake Extensions Wheel Lock

54.  The electric wheelchair
is preferred if the
functional skill and
resilience of the user
are not sufficient to
push the manual
wheelchair
independently.
Electric
Wheelchairs

55.  To use an electric
chair, one's cognitive
and perceptual skills
must be sufficient.
 The house must be
suitable for use in an
electric wheelchair
users

56.  It brings
maneuverability and
performance with
other people's lives
become independent.
 Provides indoor and
outdoor use.
 Powerful engines offer
high performance.

57. Manual wheelchairs

58. Walkers
 Walker mobility aide allows
independent standing and
walking.

59.  It allows the
child's hands to
be free.
 The personalized
device provides
more participation
in daily activities.

60. Lifts
• There are a number
of lift options to help
those who have
difficulty transferring
positions and
supporting their
body weight.

61. Electric
Wheelchairs
Walkers Manual
wheelchairs
Possible to use
independently √ √ √
indoor and
outdoor use √ √ √
Needs strength
and durability to
use
× √ √

62. References
 www. madeformovement.com
 Berner TF: Overview of manual wheelchairs and what to consider when
making seating and positioning selections, OT Pract 12(19):CE1–CE8,
2007.
 www.drdenizdogan.com

63. Unit 6 – Virtual Reality in
Rehabilitation

64. What Is Virtual Reality?
 Virtual reality offers an
alternative and
attractive treatment
program to help
children with CP use
their arms and hands.
Go to: Module 5, Unit 10

65. It includes;
 Sensory Gloves
The system can be in
use with a child. Shown
are the monitor, table
with adjustable lighting
and wrap-around data
gloves.

66. • Various Games
These systems meet the
need for child-specific upper
arms rehabilitation with
multiple fun, game-based
trainings.

67.  Gloves are the most important part of using
virtual reality in hand and arm rehabilitation.
 These gloves, which are used to perform
skill-related activities of the hand in virtual
environment, can detect angles of motion
and positions of fingers and hand
movements through sensors.

68.  On the computer screen, in the games and their virtual
environment view, the patient can see the image of his /
her hand and can perform various activities such as
moving, holding (e.g. cupping), releasing, squeezing,
gripping, working with weight, maze game.
https://www.youtube.com/watch?v=Axj_wyGHhcg

69. Improve functional skills
Improve the quality of active
movement
Improve coordination
Motivate the client into repetitive
movements
Virtual reality can:

70.  With the virtual reality
application, the person
can see his / her own
movements on the
screen and also makes
desired movements by
trying to comply with
the commands given
by the screen.

71. References
 Weiss PL, Rand D, Katz N, Kizony R. Video capture virtual reality as a
flexible and effective rehabilitation tool. J NeuroEng Rehabil. 2004;1:12-
24.
 Virtual Reality in Pediatric Neurorehabilitation: Attention Deficit
Hyperactivity Disorder, Autism and Cerebral Palsy
 Pediatrik Rehabilitasyonda Oyun Konsollari ile Sanal Gerçeklik
Uygulamalari. Turkiye Klinikleri J Physiother Rehabil-Special Topics
2015;1(1):30-34

72. Unit 7 – Cerebral palsy
and therapeutic equipment

73. Therapeutic equipment
•helps to improve the functions of the individual and increases the
efficiency of the treatment applied.
•can support symmetry in the body, and provide equal load distribution to
the joints.
•improves mobility so as to be more independent in daily living activities.
What is Therapeutic Equipment?

74.  Therapeutic equipment, such as orthoses,
splints, corsets etc. are used to assist in
treatment.
An example of orthoses

75. • can make the child more mobile,
and improve communication with
peers, thus contributing to
emotional and social development.
• reduces the child's energy
expenditure. Thus, children with
cerebral palsy can develop more
effective functions with less
energy.
• helps to regulate muscle tone
(tension or looseness).
Therapeutic
equipments

76.  Therapeutic
equipment such
as orthoses and
splints can be
used for any post-
surgical support.
Orthosis Examples

77. • Age
• Functional Level
• Dexterity
• Severity of disability
• Family and child
expectations
For
selecting
therapeutic
equipment,
consider
the
following;
Selection of Therapeutic Equipments

78. Some examples of therapeutic equipment
Hand and wrist splints
Foot Orthosis Walker

79. •Auxiliary devices attached to the body to
enhance the performance of the limbs that have
partially or totally lost function and make them
more usable.
•Support specific body parts.
•Provide support for mobility.
•Prevent muscle imbalances.
•Improve the alignment.
•Prevent deformities.
•Reduce the energy consumption.
Orthosis

80. • Support or
immobilize the
limbs or the
spine.
• Can be used in
post-op
situations.
Splints

81. Corsets (soft and hard)
it can be
used for:
Stabilization
and
supporting
movement.
Treating
sensory
problems.
Therapeutic equipment
worn on the body when
there is moderate and
severe muscle tone
problems.

82. Orthosis Splints Corsets
Upper √ √ √
Lower √ √ √
Trunk √ × √

83. References
 Yalçin, S., Özaras, N., Dormans, J., & Susman, M. (2000). Serebral palsi
tedavi ve rehabilitasyon. Pediatrik ortopedi ve rehabilitasyon dizisi. Mas
Matbaacilik, İstanbul.
 Ehlert, R., Manfio, E. F., de Oliveira Heidrich, R., & Goldani, R. (2017).
Cerebral palsy: Influence of TheraTogs® on gait, posture and in functional
performance. Fisioterapia em Movimento, 30(2).
 http://www.cerebralpalsy.org/information/mobility/orthotics

84. Unit 8 - Adaptive
equipments/devices and
cerebral palsy

85.  Adaptive equipment is any device that helps increase
the functional capabilities of people with disabilities.
What is Adaptive Equipment/Devices

86. Adaptive equipments,
 Improve the function.
 Provide functional independence.
 Facilitate, develop and maintain a
specific function.
 Increase;
• the control over the environment of the
person.
• independence.
• motivation.
For example: the use of a
stand to maintain standing

87.  Adaptive equipments:
◦ Facilitate participation in
everyday activities in the
home, school and community.
◦ Improve communication skills.
◦ Develop social interaction
◦ Enhance visual attention and
perception.

88. Standing frames or positioning
equipment:
 it helps to protect the joints and
muscles.
 Prevents shortening and tension
in the muscles
 Increases muscle strength
 Improves lung function
 It can help the functions of the
digestive and excretory systems.

89.  Adaptive equipment
can facilitate the
skills a child can not
achieve, and thus
motivate motor,
sensory, cognitive,
perceptual,
emotional and social
development.

90. Indications of adaptive
device / equipment
Adaptive equipment /
equipment is used for
positioning, mobility,
participation in daily living
activities and interaction
with various media.

91. Positioning
 Equipment for
seating, standing,
lying positions.

92. Mobility
 Equipment such as
wheelchairs and
walking aids used to
improve the mobility of
the person.
An example of walker

93. Daily living activities
They are equipment used to facilitate activities such
as feeding, dressing, toilet, transfer, bathing and
personal hygiene.

94. References
 Dell AG, Newton DA, Petroff JG. Assistive Technology in the
Classroom:Enhancing the School Experiences of Students with
Disabilities. 2nd ed. Boston, MA: Pearson Education Inc; 2012.
 George Mason University. Assistive technology initiative. Equityand
diversity services. http://ati.gmu.edu/what_ati.cfm. Accessed July 11,
2013.
 Copley J, Ziviani J. Barriers to the use of assistive technology for children
with multiple disbilities. Occup Ther Inter. 2004;11(4):229–243.
 Angelo DH. Impact of augmentative and alternative communication
devices on families. Augmentative Alt Commn. 2000;16:37–47.

95. CP-Care project partners
 Gazi University (Turkey)
 PhoenixKM BVBA (Belgium)
 Bilge Special Education And Rehabilitation
Clinic (Turkey)
 Spastic Children Foundation Of Turkey
(Turkey)
 SERÇEV- Association For Children With
Cerebral Palsy (Turkey)
 Asociacion Espanola De Fisioterapeutas
(Spain)
 National Association Of Professionals Working
With People With Disabilities (Bulgaria)

96. CP-CARE curriculum, learning material,
handbook by www.cpcare.eu is licensed
under a Creative Commons Attribution-
NonCommercial 3.0 Unported License.
Based on a work at www.cpcare.eu
Permissions beyond the scope of this
license may be available at www. cpcare.eu
This project (CP-CARE - 2016-1-TR01-
KA202-035094) has been funded with
support from the European Commission.
This communication reflects the views only
of the author, and the Commission cannot
be held responsible for any use which may
be made of the information contained
therein.