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Your weekly dose of information that keeps you up to date on the latest developments in the field of technology designed to assist people with disabilities and special needs.
Lynne Deese – Assistive Technologist & Media and Training Coordinator – North Carolina AT program
www.resna.org/certification/becoming-certified.dot
www.vimeo.com/116097680
www.ataporg.org/programs
www.ncatp.org
www.attraining.org/atdaily
Lynne Deese
Assistive Technologist/Media and Training Coordinator
Division of Vocational Rehabilitation, NC Assistive Technology Program
N.C. Department of Health and Human Services
919-859-8362 Phone
919-715-1776 Confidential Fax
Lynne.Deese@dhhs.nc.gov <mailto:Lynne.Deese@dhhs.nc.gov>
4900 Waters Edge Dr.
Raleigh, NC 27606
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——-transcript follows ——
LYNNE DEESE: Hi, this is Lynne Deese from the North Carolina assistive technology program, and this is your Assistance technology update.
WADE WINGLER: Hi, this is Wade Wingler with the INDATA Project at Easter Seals crossroads in Indiana with your Assistive Technology Update, a weekly dose of information that keeps you up-to-date on the latest developments in the field of technology designed to assist people with disabilities and special needs.
Welcome to episode number 283 of assistive technology update. It’s scheduled to be released on October 28, 2016.
Today we are starting a special series, a three-part series, all about assistive technology assessment. Today my guest is Lynne Deese who is with the North Carolina assistive technology act program. I’m going to have two other guests in the future to talk about assessment of assistive technology. Today Lynn is going to focus on independent living; next week we are going to focus on implement; and then the week after we are going to talk about assistive technology assessment in the school setting. It’ll be an interesting diversion from our normal format, and then we are going to come back after that with our annual holiday shopping episode. That’ll be released on November 25 which is known as black Friday here in the US.
LYNNE DEESE: Hi, this is Lynne Deese from the North Carolina assistive technology program, and this is your Assistance technology update.
WADE WINGLER: Hi, this is Wade Wingler with the INDATA Project at Easter Seals crossroads in Indiana with your Assistive Technology Update, a weekly dose of information that keeps you up-to-date on the latest developments in the field of technology designed to assist people with disabilities and special needs.
Welcome to episode number 283 of assistive technology update. It’s scheduled to be released on October 28, 2016.
Today we are starting a special series, a three-part series, all about assistive technology assessment. Today my guest is Lynne Deese who is with the North Carolina assistive technology act program. I’m going to have two other guests in the future to talk about assessment of assistive technology. Today Lynn is going to focus on independent living; next week we are going to focus on implement; and then the week after we are going to talk about assistive technology assessment in the school setting. It’ll be an interesting diversion from our normal format, and then we are going to come back after that with our annual holiday shopping episode. That’ll be released on November 25 which is known as black Friday here in the US.
In fact, we’d like to hear from you before the episode with any gift suggestions that you might have for folks with disabilities. And that show we gather up some of our friends, play some holiday music, and talk about what kind of Christmas gifts or holiday gifts might be helpful that fall in the category of assistive technology. You can call our listener line and tells about that at 317-721-7124. You can send us a note and link on Twitter at INDATA Project, or send us an email, tech at Easter Seals crossroads.org. Tell us all about the kinds of gifts that you would like to receive in the field of assistive technology or things you recommend. We might just include those in our annual holiday shopping episode.
Without further delay, here is my interview with Lynn Deese about assistive technology assessment for independent living.
***
WADE WINGLER: Today I’m starting a new series that I think ought to be interesting. It’s about AT assessment. Assistive technology assessment is an important component of what we do in the world of assistive technology. This is the first of three parts. This first one is going to be about independent living; the next one will be about employment; and then we are going to do one on education as well. I thought it made sense to invite some of my friends and colleagues to come on talk about their views and how they do assistive technology assessments in their area of expertise.
I’m super excited today to have my friend Lynn Deese from North Carolina, the assistive technology act program down there. We are going to talk about assistive technology assessment in the context of independent living. I have to warn you: being an Indiana farm boy, when I start talking to Lynn, if I slip into a southern drawl, it’s not something I do on purpose. It’s something I do when I talked to my friends from the South. I believe we still have Lynn on the line. Are you there?
LYNNE DEESE: I’m still here.
WADE WINGLER: Thank you so much for taking time out of your day today. I’m excited to talk with you a little bit about your take on assistive technology assessment as it applies to independent living stuff. I want to get into that, but before we start talking about AT assessment, I want to hear little bit about you. Tell my audience a little bit about yourself and your professional background and how you found yourself in the position to where you’re working with the North Carolina AT act program and you know about assistive technology and valuations.
LYNNE DEESE: Here at the North Carolina assistive technology program, I am an assistive technologist and also the media and training coordinator, which means I do a lot of the social media. I do various online webinars and demonstration videos, that kind of thing. My professional background is one of – my discipline is education, so I have degrees in special education and I sort of — I suppose you could say “backed in” to AT from the context. A great deal of assistive technology is used in special education.
I began the principal amount of that work when I work for the community college system, started doing things for the visually impaired, hearing impaired, that were students in the curriculum and continuing education. The assessment portion came when I joined the North Carolina assistive technology. I learned the evaluation process from colleagues in assistive technology throughout the country and by attending workshops, that sort of thing. We began – at the time that I came to the AT program here, we began to conduct our own fee for service evaluations, so it was really important for us to have a process that people could rely on and consistent results and outcomes.
WADE WINGLER: We’ve talked a little bit about your education and professional background. Before we jump into the AT assessment conversation properly, what about AT credentials? Do you feel there are credentials you feel are important? Are there credentials that you hold that are related to AT evaluation?
LYNNE DEESE: I do have a Masters degree in special education. I have a certificate in assistive technology. I think certificate programs are extremely important. Some of them are directed more towards school systems, more towards clinicians, but whatever your discipline to actually take some college-level courses in assistive technology is really essential to be able to conduct assessments. I have certificates in web accessibility, which we do a little bit of here as a pretty beefy topic but I do consult with other people on web accessibility. I also have a certification in vocational evaluation. We do a fair amount of workplace assessment here. Also in places like RESNA – and I’ve given you the link – offer certification assessments where you can actually receive some credentials you can add your name. I’m sure that acts your credibility.
WADE WINGLER: I agree. I think training and credentialing is super important. Like you, some of that we pick up informal settings and some of that is going to conferences and on-the-job training. I think one of the most important parts is always learning if you’re going to be doing this line of work, right?
LYNNE DEESE: Absolutely. In fact, yet to be an individual that’s a very comfortable with change. There’s always something new, always something to challenge you. There’s always a new manual to read. You have to be comfortable with that in the profession. We say here if you can survive the first two years of being an assistive technologist, then you are acclimated with what you have to deal with thereafter.
WADE WINGLER: That makes total sense. Let’s get into the part about the assistive technology evaluation for independent living. Tell me a little bit about what that looks like. When we are talking about an evaluation, for assistive technology in an independent living setting, what are some of the components of that?
LYNNE DEESE: I think the first thing we look at is the background documentation for the individual. It’s part of what we request in our referrals so that we can get an idea of how clinicians may you this individual. Independent living things like an OT evaluation, a PT evaluation, a speech and language evaluation would all be things we review in order to determine where this person’s functioning level is.
The second and most important thing, to me, is to incorporate the viewpoint of the individual. No matter what clinicians, no matter what educators tell me about a person, I sit down with that person and get me to tell me about themselves. Once we get to that point, there is an opportunity to take a look at a real eyeball level of what those physical limitations are. Sometimes that may involve taking a look at what their fine motor skills are really like, what their gait looks like when I get up and walk, that kind of thing, and maybe things like assessing things like tremors, those kinds of anomalies firsthand, getting a look at what that looks like. And then trying to pair a piece of equipment with that. That’s where the demonstration and loan portion of our program which is essential for us and all of the tech act programs. That’s where demonstration and loan comes in. You actually demonstrate the device, give them an opportunity to do some hands-on work to determine if it may feasibly be a good device for them to take into the environment where it’s going to be used and determine if it’s going to be effective. You then wait for anecdotal, for data feedback from the individual that gives you information on how well it did actually work. Sometimes that will take you back into another cycle of choosing another device and going at it again. Sometimes you’re not in a position to select the best device available, that is to say you either don’t have the equipment or you can’t get it from a vendor or there is no one piece of technology that will address the person’s need the best. Sometimes it is accommodation of several technologies. Sometimes you want to provide consumers with an array of options so that, as they grow, as they move through life, as they develop other needs, they have your list to look back on and determine whether or not one of these things might now be effective.
In some of the assessments we do, we not only see the kid in the elementary school, but he pops up again and high school as he is getting ready to transition to college. After college he is ready to transition into the workplace. We may follow these kids for years. We want to make sure that they know what their options are.
WADE WINGLER: We make a joke here in our program that our folks generally don’t go away. A lot of folks we see for assistive technology, we see them throughout the lifespan. It’s kind of like an old friend coming back when we’ve been done for a while but get to pick it up again.
LYNNE DEESE: Once you see what assistive technology can do for you, you are a devotee for life.
WADE WINGLER: That’s right. Talk to me a little bit about the outcome of a good assessment. When you’re done — and I understand it is a cyclical process – but when you are done with the assessment, what does that look like? What’s the outcome?
LYNNE DEESE: I think if a client is able to take something I recommend and apply it effectively in their life, for me that is the best outcome of assessment. I think if they can’t, then they should come back to me. Even if it is just an email where a clinician emails me and says, I have this person and he has this need, what do you think. I’m going to say what you think about this, is this what you think she needs? If it’s not, let’s discuss. Let’s figure out. You have to be willing to narrow down. When you get to that point, you’ll know that that individual can then take what you recommended and utilize it effectively in their environment. In the case of perhaps kids in school, and we are going to talk about a kid in a few minutes, it relates to their growth academically, that is they can take that modification and I should do well in school, then you know that’s a great outcome. If it’s a senior who has been stuck in his home for three weeks, and you make a modification that allows him to get out and go back to the senior center and have fun with his friends, you know that’s a good outcome. You know this by developing good relationships with these people and having them willing to call you back. Even in situations where we may assess a person’s need over the phone, and we seek out on the person to be their advocate, we make a call back that says, that person you talked to called me and offered to help me and I don’t think that would’ve happened without you. All of these things are great outcomes for us.
WADE WINGLER: Yeah.
LYNNE DEESE: And for the people we serve.
WADE WINGLER: That’s great. In the context of independent living, give me a few examples of things he recommended on a regular basis. What are some of the more common things that get recommended? I know it varies, but give me a few.
LYNNE DEESE: In terms of lender devices, wheelchairs, walkers. We’ve had a terrible hurricane down here, hurricane Matthew, and we are starting to get calls in from people who have lost items that they rely on every day, shower chairs, side of the bed and under the bed, commode chairs, things like that, that make living possible. We try to scrape those things together and get them to the people that need them. I think other things that have kind of a new and exciting are things like – I know I mentioned earlier assessing tremors. That’s because we’ve done a lot of modifications for people with Parkinson’s, things like Liftware, a device that is a spoon that has an algorithm built into the handle that compensates for tremor movement. Simpler things like weighted spoons, devices that help people in the kitchen every day. These are modifications that we make very commonly. Things for writing, all kinds of hand writing tools including braces and stabilization tools that we use not only for adults but for children as well. Those are some of the things we probably recommend the most often.
WADE WINGLER: Those are good examples. We see those here too. Those are pretty common things. We fit on it a little bit, but talk to me about the consumer’s role and involvement in the AT assessment, and then I’m going to ask you the same question but about the funding source, or the referring source. What are the roles of the people throughout this process?
LYNNE DEESE: I think it’s the role of the consumer – let me just preface that by saying it doesn’t matter to me what the consumers function level is. I always try to go through a process that elicits that person’s reaction to what I’m offering them. It’s not uncommon for me to listen to a child and not pay attention to the parent necessarily, because a child is given me more information about how they feel or what they think about the option that I’m offering them. I’m very driven that these things actually connect directly to whether or not children and adults abandon the devices you suggest. We all know that device abandonment can be a huge problem. You don’t want to recommend something, particularly expensive, that ends up on a shelf somewhere. Listening to that consumer is essential. Sometimes, like I said, you may have that background information from clinicians and teachers and other folks. It doesn’t mean you get the individual story about what they’ve been through in their entire life. It doesn’t mean that you don’t take an opportunity to look at it through their lands and see how they see it. I want them to know that I’m willing to do that.
I think they also have to be invested in the device trial process. I think it’s up to me to make the devices as attractive as possible. For example, if it is augmentative communication to make sure there are some games in there to play, make sure that the child or adult is communicating what they want to communicate the most. Those kinds of things help the individual and device trials. It’s essential for a positive outcome for the individual. I think there’s also a fair amount of folks who may have their own reasons for not being fully invested in the assessment process. I’m talking about something that is very common to assessment called malingering. People generally have motives for malingering, but I have to say – and I’ve been here 17 years — in the 17 years I’ve been here, I’ve maybe had two cases of what I can really call malingering. There were always reasons. At least one of those cases, a really good reason. I think when you sense what’s going on, it behooves the clinician, it behooves the assessor to get down to why that is going on.
WADE WINGLER: I’ve had similar experiences. It’s not been very often but every once in a while that happens. Good. Tell me a little bit about the potential pitfalls that can happen during an AT assessment. When things go wrong, what does that look like?
LYNNE DEESE: Of course if you forget to say your technology prayer in the morning and your equipment doesn’t work, that’s always discouraging. I think you have to be willing to have a sense of humor about it to say, okay, we are going to go at this again. I find the biggest pitfall, more than malingering, more than not having the equipment you need to do the device trial you want to do, more than both of those things is an environment that doesn’t support change. If you go into a school system and the teacher is not invested in this child using augmentative communication or using handwriting tools or using walkers or wheelchairs or any of those other kinds of things, or you go into – this is one of the biggest, I guess – nursing homes that aren’t invested in using power mobility. That kind of thing can be quite difficult. Environments that don’t support that kind of change can be the biggest barrier to actually implementing assistive technology in that environment. Whatever you assess, whatever you recommend, you won’t generate the outcome you want because that individual is not going to have an environment where people are willing to charge their device or willing to make sure that they have their hand splint whenever they want to use their computer. You just don’t have that kind of support you need that makes that modification successful.
WADE WINGLER: I’m sitting here smiling because one of the things we say here, some of the worst technology issues aren’t technology issues. They are just people issues.
LYNNE DEESE: I think these assessment protocols that you can certainly attach to over the Internet, and I’m sure you’re going to share with some other folks that are listening to this podcast, they actually do have sections that assess that environment, that is as the people in it, what they know about technology. As advanced as we become, there are still folks out there that are scared to death of technology. It’s still difficult to get them to accept it and to support the modification for the individual no matter how the individual may feel about it.
WADE WINGLER: Absolutely. We are getting a little tight on time, but I got some questions I want to make sure we get to hear. The first one is, we talk about pitfalls, tell me about a time you found just pure joy in doing an AT assessment.
LYNNE DEESE: A really easy question. The first that comes to mind is a young man named Logan. I’ve given you a link to a video called “Logan Is Present.” Logan is a child with spinal muscle atrophy that, because of a compromised immune system, could not attend school. What we did was to outfit him, thanks to the school system that he was in, with a robot that helps them attend school. It helps them attend summer activities, and in terms of outcomes it has contributed to a four out of five on his EOG’s. He got the principal award last year. A bright child who needed to be with his peers. The most gratifying thing, and you’ll see this in the video, from his wonderful occupational therapist that spearheaded this movement for the robot was that the children accepted the robot as Logan. I think that’s not also pure joy, it’s also absolutely gratifying.
WADE WINGLER: That’s amazing, and I’ll pop the link in the show notes as well as the other two shared so that people can check that out. Talking about robotics, this kind of leads into my next question. Anybody who has been doing assistive technology for more than a minute note that it changes all the time, and it has changed over time. Although assessment and technology are tied together, how has the training technology impacted the way you do assessments? Or has it? Is the process still the same?
LYNNE DEESE: Beside sterling me at every moment because I’m one of those people that love that change, it’s contributed to us doing more things like assessment in the field. There was no other way to complete that assessment on Logan. By the way, I wasn’t the only one involved in that. It has contributed to more team assessment. I did do this with my coworker Gloria Jinks in the East. We’ve moved more out in the field. There was no way to assess a robot without taking the robot to the school and seeing how it worked in the environment, how they work with wireless networks. We ended up moving to 4G so that he would get consistent coverage throughout so that he could go to the lunchroom and do other things that other kids did. Those kinds of changes take place. I do find that more families are coming to us for advice and being willing to implement their own technology. I certainly do credit cell phones and tablets and other forms of technology that are making people more comfortable with software or apps, and they are not so intimidated by technology as they used to be. Oh, yeah, I can put in that Bluetooth headset, they say, and I can make that modification. To show me how the switch access software works. If you demonstrations and they are off to the races on their own. Those are how advances have helped us the most.
WADE WINGLER: We see that here as well. We’ve got about a minute left in the podcast we going to pick up speed a little bit. If you had one piece of advice to give to somebody who is working in the field of assistive technology and is about to do assessments or just getting started doing assessments, what would your advice be to them?
LYNNE DEESE: Visit and develop a relationship with your nearest assistive technology center. These folks not only have a wealth of devices and information to offer you, but they can be a support as you learn to do assessments on your own.
WADE WINGLER: That’s great advice.
LYNNE DEESE: I have given you a link to ATAP on their programs page which will allow you to look for the assistive technology programs nearest you.
WADE WINGLER: We will include that in the show notes so that everyone here in the US can find the one closest to them. If people want to reach out to you directly and want to have conversations with you, what kind of contact information would you recommend?
LYNNE DEESE: The first thing of course since I’m such a gadfly is my email address. I can be reached through Skype, which we can certainly arrange if people need to talk to me face-to-face. I have given you my phone number, our confidential fax number, and the address of our assistive technology center here in Raleigh. I did want to make you aware that we have 10 centers throughout the state. I can certainly help you connect with another center if that’s your wish.
WADE WINGLER: Lynne Deese is an assistive technologist at the North Carolina AT program, has been doing assistive technology evaluations for a number of years now, a friend of mine and has been our guest today. Thank you so much for being on the show.
LYNNE DEESE: You’re welcome.
WADE WINGLER: Do you have a question about assistive technology? Do you have a suggestion for someone we should interview on Assistive Technology Update? Call our listener line at 317-721-7124, shoot us a note on Twitter @INDATAProject, or check us out on Facebook. Looking for a transcript or show notes from today’s show? Head on over to www.EasterSealstech.com. Assistive Technology Update is a proud member of the Accessibility Channel. Find more shows like this plus much more over at AccessibilityChannel.com. That was your Assistance Technology Update. I’m Wade Wingler with the INDATA Project at Easter Seals Crossroads in Indiana.
***Transcript provided by TJ Cortopassi. For transcription requests and inquiries, contact tjcortopassi@gmail.com***
In fact, we’d like to hear from you before the episode with any gift suggestions that you might have for folks with disabilities. And that show we gather up some of our friends, play some holiday music, and talk about what kind of Christmas gifts or holiday gifts might be helpful that fall in the category of assistive technology. You can call our listener line and tells about that at 317-721-7124. You can send us a note and link on Twitter at INDATA Project, or send us an email, tech at Easter Seals crossroads.org. Tell us all about the kinds of gifts that you would like to receive in the field of assistive technology or things you recommend. We might just include those in our annual holiday shopping episode.
Without further delay, here is my interview with Lynn Deese about assistive technology assessment for independent living.
***
WADE WINGLER: Today I’m starting a new series that I think ought to be interesting. It’s about AT assessment. Assistive technology assessment is an important component of what we do in the world of assistive technology. This is the first of three parts. This first one is going to be about independent living; the next one will be about employment; and then we are going to do one on education as well. I thought it made sense to invite some of my friends and colleagues to come on talk about their views and how they do assistive technology assessments in their area of expertise.
I’m super excited today to have my friend Lynn Deese from North Carolina, the assistive technology act program down there. We are going to talk about assistive technology assessment in the context of independent living. I have to warn you: being an Indiana farm boy, when I start talking to Lynn, if I slip into a southern drawl, it’s not something I do on purpose. It’s something I do when I talked to my friends from the South. I believe we still have Lynn on the line. Are you there?
LYNNE DEESE: I’m still here.
WADE WINGLER: Thank you so much for taking time out of your day today. I’m excited to talk with you a little bit about your take on assistive technology assessment as it applies to independent living stuff. I want to get into that, but before we start talking about AT assessment, I want to hear little bit about you. Tell my audience a little bit about yourself and your professional background and how you found yourself in the position to where you’re working with the North Carolina AT act program and you know about assistive technology and valuations.
LYNNE DEESE: Here at the North Carolina assistive technology program, I am an assistive technologist and also the media and training coordinator, which means I do a lot of the social media. I do various online webinars and demonstration videos, that kind of thing. My professional background is one of – my discipline is education, so I have degrees in special education and I sort of — I suppose you could say “backed in” to AT from the context. A great deal of assistive technology is used in special education.
I began the principal amount of that work when I work for the community college system, started doing things for the visually impaired, hearing impaired, that were students in the curriculum and continuing education. The assessment portion came when I joined the North Carolina assistive technology. I learned the evaluation process from colleagues in assistive technology throughout the country and by attending workshops, that sort of thing. We began – at the time that I came to the AT program here, we began to conduct our own fee for service evaluations, so it was really important for us to have a process that people could rely on and consistent results and outcomes.
WADE WINGLER: We’ve talked a little bit about your education and professional background. Before we jump into the AT assessment conversation properly, what about AT credentials? Do you feel there are credentials you feel are important? Are there credentials that you hold that are related to AT evaluation?
LYNNE DEESE: I do have a Masters degree in special education. I have a certificate in assistive technology. I think certificate programs are extremely important. Some of them are directed more towards school systems, more towards clinicians, but whatever your discipline to actually take some college-level courses in assistive technology is really essential to be able to conduct assessments. I have certificates in web accessibility, which we do a little bit of here as a pretty beefy topic but I do consult with other people on web accessibility. I also have a certification in vocational evaluation. We do a fair amount of workplace assessment here. Also in places like RESNA – and I’ve given you the link – offer certification assessments where you can actually receive some credentials you can add your name. I’m sure that acts your credibility.
WADE WINGLER: I agree. I think training and credentialing is super important. Like you, some of that we pick up informal settings and some of that is going to conferences and on-the-job training. I think one of the most important parts is always learning if you’re going to be doing this line of work, right?
LYNNE DEESE: Absolutely. In fact, yet to be an individual that’s a very comfortable with change. There’s always something new, always something to challenge you. There’s always a new manual to read. You have to be comfortable with that in the profession. We say here if you can survive the first two years of being an assistive technologist, then you are acclimated with what you have to deal with thereafter.
WADE WINGLER: That makes total sense. Let’s get into the part about the assistive technology evaluation for independent living. Tell me a little bit about what that looks like. When we are talking about an evaluation, for assistive technology in an independent living setting, what are some of the components of that?
LYNNE DEESE: I think the first thing we look at is the background documentation for the individual. It’s part of what we request in our referrals so that we can get an idea of how clinicians may you this individual. Independent living things like an OT evaluation, a PT evaluation, a speech and language evaluation would all be things we review in order to determine where this person’s functioning level is.
The second and most important thing, to me, is to incorporate the viewpoint of the individual. No matter what clinicians, no matter what educators tell me about a person, I sit down with that person and get me to tell me about themselves. Once we get to that point, there is an opportunity to take a look at a real eyeball level of what those physical limitations are. Sometimes that may involve taking a look at what their fine motor skills are really like, what their gait looks like when I get up and walk, that kind of thing, and maybe things like assessing things like tremors, those kinds of anomalies firsthand, getting a look at what that looks like. And then trying to pair a piece of equipment with that. That’s where the demonstration and loan portion of our program which is essential for us and all of the tech act programs. That’s where demonstration and loan comes in. You actually demonstrate the device, give them an opportunity to do some hands-on work to determine if it may feasibly be a good device for them to take into the environment where it’s going to be used and determine if it’s going to be effective. You then wait for anecdotal, for data feedback from the individual that gives you information on how well it did actually work. Sometimes that will take you back into another cycle of choosing another device and going at it again. Sometimes you’re not in a position to select the best device available, that is to say you either don’t have the equipment or you can’t get it from a vendor or there is no one piece of technology that will address the person’s need the best. Sometimes it is accommodation of several technologies. Sometimes you want to provide consumers with an array of options so that, as they grow, as they move through life, as they develop other needs, they have your list to look back on and determine whether or not one of these things might now be effective.
In some of the assessments we do, we not only see the kid in the elementary school, but he pops up again and high school as he is getting ready to transition to college. After college he is ready to transition into the workplace. We may follow these kids for years. We want to make sure that they know what their options are.
WADE WINGLER: We make a joke here in our program that our folks generally don’t go away. A lot of folks we see for assistive technology, we see them throughout the lifespan. It’s kind of like an old friend coming back when we’ve been done for a while but get to pick it up again.
LYNNE DEESE: Once you see what assistive technology can do for you, you are a devotee for life.
WADE WINGLER: That’s right. Talk to me a little bit about the outcome of a good assessment. When you’re done — and I understand it is a cyclical process – but when you are done with the assessment, what does that look like? What’s the outcome?
LYNNE DEESE: I think if a client is able to take something I recommend and apply it effectively in their life, for me that is the best outcome of assessment. I think if they can’t, then they should come back to me. Even if it is just an email where a clinician emails me and says, I have this person and he has this need, what do you think. I’m going to say what you think about this, is this what you think she needs? If it’s not, let’s discuss. Let’s figure out. You have to be willing to narrow down. When you get to that point, you’ll know that that individual can then take what you recommended and utilize it effectively in their environment. In the case of perhaps kids in school, and we are going to talk about a kid in a few minutes, it relates to their growth academically, that is they can take that modification and I should do well in school, then you know that’s a great outcome. If it’s a senior who has been stuck in his home for three weeks, and you make a modification that allows him to get out and go back to the senior center and have fun with his friends, you know that’s a good outcome. You know this by developing good relationships with these people and having them willing to call you back. Even in situations where we may assess a person’s need over the phone, and we seek out on the person to be their advocate, we make a call back that says, that person you talked to called me and offered to help me and I don’t think that would’ve happened without you. All of these things are great outcomes for us.
WADE WINGLER: Yeah.
LYNNE DEESE: And for the people we serve.
WADE WINGLER: That’s great. In the context of independent living, give me a few examples of things he recommended on a regular basis. What are some of the more common things that get recommended? I know it varies, but give me a few.
LYNNE DEESE: In terms of lender devices, wheelchairs, walkers. We’ve had a terrible hurricane down here, hurricane Matthew, and we are starting to get calls in from people who have lost items that they rely on every day, shower chairs, side of the bed and under the bed, commode chairs, things like that, that make living possible. We try to scrape those things together and get them to the people that need them. I think other things that have kind of a new and exciting are things like – I know I mentioned earlier assessing tremors. That’s because we’ve done a lot of modifications for people with Parkinson’s, things like Liftware, a device that is a spoon that has an algorithm built into the handle that compensates for tremor movement. Simpler things like weighted spoons, devices that help people in the kitchen every day. These are modifications that we make very commonly. Things for writing, all kinds of hand writing tools including braces and stabilization tools that we use not only for adults but for children as well. Those are some of the things we probably recommend the most often.
WADE WINGLER: Those are good examples. We see those here too. Those are pretty common things. We fit on it a little bit, but talk to me about the consumer’s role and involvement in the AT assessment, and then I’m going to ask you the same question but about the funding source, or the referring source. What are the roles of the people throughout this process?
LYNNE DEESE: I think it’s the role of the consumer – let me just preface that by saying it doesn’t matter to me what the consumers function level is. I always try to go through a process that elicits that person’s reaction to what I’m offering them. It’s not uncommon for me to listen to a child and not pay attention to the parent necessarily, because a child is given me more information about how they feel or what they think about the option that I’m offering them. I’m very driven that these things actually connect directly to whether or not children and adults abandon the devices you suggest. We all know that device abandonment can be a huge problem. You don’t want to recommend something, particularly expensive, that ends up on a shelf somewhere. Listening to that consumer is essential. Sometimes, like I said, you may have that background information from clinicians and teachers and other folks. It doesn’t mean you get the individual story about what they’ve been through in their entire life. It doesn’t mean that you don’t take an opportunity to look at it through their lands and see how they see it. I want them to know that I’m willing to do that.
I think they also have to be invested in the device trial process. I think it’s up to me to make the devices as attractive as possible. For example, if it is augmentative communication to make sure there are some games in there to play, make sure that the child or adult is communicating what they want to communicate the most. Those kinds of things help the individual and device trials. It’s essential for a positive outcome for the individual. I think there’s also a fair amount of folks who may have their own reasons for not being fully invested in the assessment process. I’m talking about something that is very common to assessment called malingering. People generally have motives for malingering, but I have to say – and I’ve been here 17 years — in the 17 years I’ve been here, I’ve maybe had two cases of what I can really call malingering. There were always reasons. At least one of those cases, a really good reason. I think when you sense what’s going on, it behooves the clinician, it behooves the assessor to get down to why that is going on.
WADE WINGLER: I’ve had similar experiences. It’s not been very often but every once in a while that happens. Good. Tell me a little bit about the potential pitfalls that can happen during an AT assessment. When things go wrong, what does that look like?
LYNNE DEESE: Of course if you forget to say your technology prayer in the morning and your equipment doesn’t work, that’s always discouraging. I think you have to be willing to have a sense of humor about it to say, okay, we are going to go at this again. I find the biggest pitfall, more than malingering, more than not having the equipment you need to do the device trial you want to do, more than both of those things is an environment that doesn’t support change. If you go into a school system and the teacher is not invested in this child using augmentative communication or using handwriting tools or using walkers or wheelchairs or any of those other kinds of things, or you go into – this is one of the biggest, I guess – nursing homes that aren’t invested in using power mobility. That kind of thing can be quite difficult. Environments that don’t support that kind of change can be the biggest barrier to actually implementing assistive technology in that environment. Whatever you assess, whatever you recommend, you won’t generate the outcome you want because that individual is not going to have an environment where people are willing to charge their device or willing to make sure that they have their hand splint whenever they want to use their computer. You just don’t have that kind of support you need that makes that modification successful.
WADE WINGLER: I’m sitting here smiling because one of the things we say here, some of the worst technology issues aren’t technology issues. They are just people issues.
LYNNE DEESE: I think these assessment protocols that you can certainly attach to over the Internet, and I’m sure you’re going to share with some other folks that are listening to this podcast, they actually do have sections that assess that environment, that is as the people in it, what they know about technology. As advanced as we become, there are still folks out there that are scared to death of technology. It’s still difficult to get them to accept it and to support the modification for the individual no matter how the individual may feel about it.
WADE WINGLER: Absolutely. We are getting a little tight on time, but I got some questions I want to make sure we get to hear. The first one is, we talk about pitfalls, tell me about a time you found just pure joy in doing an AT assessment.
LYNNE DEESE: A really easy question. The first that comes to mind is a young man named Logan. I’ve given you a link to a video called “Logan Is Present.” Logan is a child with spinal muscle atrophy that, because of a compromised immune system, could not attend school. What we did was to outfit him, thanks to the school system that he was in, with a robot that helps them attend school. It helps them attend summer activities, and in terms of outcomes it has contributed to a four out of five on his EOG’s. He got the principal award last year. A bright child who needed to be with his peers. The most gratifying thing, and you’ll see this in the video, from his wonderful occupational therapist that spearheaded this movement for the robot was that the children accepted the robot as Logan. I think that’s not also pure joy, it’s also absolutely gratifying.
WADE WINGLER: That’s amazing, and I’ll pop the link in the show notes as well as the other two shared so that people can check that out. Talking about robotics, this kind of leads into my next question. Anybody who has been doing assistive technology for more than a minute note that it changes all the time, and it has changed over time. Although assessment and technology are tied together, how has the training technology impacted the way you do assessments? Or has it? Is the process still the same?
LYNNE DEESE: Beside sterling me at every moment because I’m one of those people that love that change, it’s contributed to us doing more things like assessment in the field. There was no other way to complete that assessment on Logan. By the way, I wasn’t the only one involved in that. It has contributed to more team assessment. I did do this with my coworker Gloria Jinks in the East. We’ve moved more out in the field. There was no way to assess a robot without taking the robot to the school and seeing how it worked in the environment, how they work with wireless networks. We ended up moving to 4G so that he would get consistent coverage throughout so that he could go to the lunchroom and do other things that other kids did. Those kinds of changes take place. I do find that more families are coming to us for advice and being willing to implement their own technology. I certainly do credit cell phones and tablets and other forms of technology that are making people more comfortable with software or apps, and they are not so intimidated by technology as they used to be. Oh, yeah, I can put in that Bluetooth headset, they say, and I can make that modification. To show me how the switch access software works. If you demonstrations and they are off to the races on their own. Those are how advances have helped us the most.
WADE WINGLER: We see that here as well. We’ve got about a minute left in the podcast we going to pick up speed a little bit. If you had one piece of advice to give to somebody who is working in the field of assistive technology and is about to do assessments or just getting started doing assessments, what would your advice be to them?
LYNNE DEESE: Visit and develop a relationship with your nearest assistive technology center. These folks not only have a wealth of devices and information to offer you, but they can be a support as you learn to do assessments on your own.
WADE WINGLER: That’s great advice.
LYNNE DEESE: I have given you a link to ATAP on their programs page which will allow you to look for the assistive technology programs nearest you.
WADE WINGLER: We will include that in the show notes so that everyone here in the US can find the one closest to them. If people want to reach out to you directly and want to have conversations with you, what kind of contact information would you recommend?
LYNNE DEESE: The first thing of course since I’m such a gadfly is my email address. I can be reached through Skype, which we can certainly arrange if people need to talk to me face-to-face. I have given you my phone number, our confidential fax number, and the address of our assistive technology center here in Raleigh. I did want to make you aware that we have 10 centers throughout the state. I can certainly help you connect with another center if that’s your wish.
WADE WINGLER: Lynne Deese is an assistive technologist at the North Carolina AT program, has been doing assistive technology evaluations for a number of years now, a friend of mine and has been our guest today. Thank you so much for being on the show.
LYNNE DEESE: You’re welcome.
WADE WINGLER: Do you have a question about assistive technology? Do you have a suggestion for someone we should interview on Assistive Technology Update? Call our listener line at 317-721-7124, shoot us a note on Twitter @INDATAProject, or check us out on Facebook. Looking for a transcript or show notes from today’s show? Head on over to www.EasterSealstech.com. Assistive Technology Update is a proud member of the Accessibility Channel. Find more shows like this plus much more over at AccessibilityChannel.com. That was your Assistance Technology Update. I’m Wade Wingler with the INDATA Project at Easter Seals Crossroads in Indiana.
***Transcript provided by TJ Cortopassi. For transcription requests and inquiries, contact tjcortopassi@gmail.com***