Michigan Assistive Technology (AT) Program Blog
A Feisty and NonCompliant View on AT!
By Aimee Sterk, LMSW, MATP Staff
I’m working on a trauma certificate and recently attended a symposium on Somatic Experience therapy for children who have experienced trauma. The presenter, Maggie Kline, LMFT, explained that for young children (birth to 18 months) who experience trauma, the body holds the memory and that therapy needs to focus on dissolving extra energy in the body, helping children find and feel safe, and helping the shock/trauma (reptilian) part of the brain heal.
According to Maggie, we are hard wired to overcome and release trauma. We are built to be resilient and there are tools to help children who have experienced trauma access that healing. These tools can help build from our innate resilience.
Maggie mentioned the Poly Vagal Theory developed by Dr Stephen Porges which explains that our nervous system has three modes:
- Connection mode—the state in which we can socially engage, interact and function;
- Fight/flight—our body’s immediate reaction to a threat that affects every part of the body to help us stay alive by either fighting the danger or fleeing as quickly as possible;
- Shutdown—when the fight/flight has not worked and we sense impending death, this system kicks in and causes freezing as a form of self-preservation
Maggie taught our group that children who have experienced trauma can have triggers that remind their body of trauma and then their body flips from fight or flight into shutdown mode. Somatic Experience therapy and other therapeutic models seek to help children become grounded in their bodies and come out of fight/flight or shutdown mode by activating the calming parts of the nervous system. The goal is to reorganize and rebalance the nervous system after being overwhelmed by trauma. Then, children’s bodies don’t respond to a trigger when they shouldn’t.
If a child you care about has experienced trauma, please consult a therapist to help them work through the trauma and prevent or treat PTSD. That therapist will likely use toys and tools you can use yourself at home to help with rebalancing the nervous system. These toys are things you can use yourself with a child but they should not be used as a sole means of treatment of trauma. Professional support is needed. These are listed here as ideas you can use in addition to the support of professionals.
Tools and Toys for trauma:
- Bubbles—help children extend their exhales longer than inhales which activates calming centers in the nervous system.
- Rocking horses and hammocks/swings– activate the vestibular (body positioning) system to help with grounding knowing where your body is in space.
- Drums—rhythmic, repetitive movements are soothing and activate the brain in ways that are therapeutic. This can also be seen in biking, running, yoga, and other rhythmic activities.
- Maracas and other toys that create a shaking movement when used—shaking off is a physical response that is seen in other animals too—discharging the fight or flight energy. I frequently know […]
By Aimee Sterk, LMSW, MATP Program Staff
In June I was paging through my copy of Woman’s Day Magazine and was impressed with an article on Veterans and AT use: How My Veteran Husband Copes with His War Injuries . The focus is on caregivers/family/friends of veterans’ views and support, but the AT used is directly helpful to the veterans themselves. I’m excited that the article is finally online and I can share it here. As someone who has had PTSD, I found the PTSD Coach app very helpful. The ideas in the article are especially helpful for veterans but are useful to anyone with PTSD or PTSD symptoms.
What did you think of the article? Have you used any of the apps or tools yourself? What are your experiences of the AT?
By Jen Mullins, BS, CTRS, MATP Staff
Renown Mexican artist Frida Kahlo has been one of my favorite artists since I was a young girl. A few years ago, I was excited to learn that Kahlo also had disabilities and she shared about them in her art and writing; in this way, she has inspired and emboldened me to do the same in my own artwork. Recently, I read an article that featured a photo of Kahlo using Assistive Technology (AT) to help her paint. While she was a young adult, Kahlo traveled on a bus that was in a terrible accident. “The accident broke Kahlo’s spinal column, collarbone, ribs, and pelvis, fractured her right leg in 11 places, and dislocated her shoulder. Those severe injuries left her racked with pain for the rest of her life, and she frequently [felt most comfortable in bed]. But during these times, Kahlo picked up her father’s paintbrush. Her mother helped arrange a special easel that would allow her to work from bed.” In this photo Kahlo is laying on her back, painting while in bed. She is situated with pillows behind her head, a paint palette resting on her stomach, a large, tilted easel at her waist, and a vase filled with paint brushes on a nearby side table. A young child is at her side (near the vase of paint brushes) watching her paint.
Kahlo’s story and this photograph of her made me interested to find out what other kinds of easels are available for artists with disabilities. Just like Frida Kahlo and her family discovered, I found that there are different types of easels available that may work as Assisitive Technology for some:
- Though I can’t say for certain, from the photograph it looks like Kahlo is using an adjustable drawing board. These boards can be placed on a variety of surfaces and the slant or tilt of the board is adjustable depending upon the needs of the artist.
- The Alvin Reflex Table was designed with wheelchair access in mind, The device has a semi circle cut out for accessibility of wheelchairs. The 30″ × 40″ top has a raised, black, PVC edge that prevents items from falling off. The base of the table is wide enough to allow wheelchairs to maneuver through and has telescoping legs to adjust the height.
- The Convert-able table is a large, multipurpose and adaptable table with 0º-90º of tilt. The optional Art Easel top keeps paper unwrinkled on a roll while horizontal guides hold the paper in place.
- Danette Smiths Rotating […]
“We never know how our small activities will affect others through the invisible fabric of our connectedness. In this exquisitely connected world, it’s never a question of ‘critical mass.’ It’s always about critical connections.” Grace Lee Boggs
This quote came up in my Facebook memories this week, posted by a friend and colleague some years ago. It provided a moment of synchronicity for me (a term my friend and teacher Jan Lundy uses often). Synchronicity is when two or more things happen that seem related but don’t have a causal connection that you can identify. For me, this quote from Grace Lee Boggs is related to the work we are looking at doing to address social isolation of people with disabilities in nursing homes. People residing in nursing homes are disconnected from their friends, families, pets, support systems, homes, belongings, interests and hobbies, their communities. Their fabric of connectedness is torn apart. Could assistive technology for computer/internet access be a tool that will help weave connection again?—repairing and building new critical connections for people who end up in nursing facilities.
A member of our board sent along a frightening article/news story on the social isolation, depression, and suicidal thoughts and actions of people in nursing facilities.
Having worked in nursing facilities and having worked as an ombudsman to improve conditions in nursing facilities, I can see where even very good nursing homes are places where people develop or return to deep depression and hopelessness. The online communities of my choosing have been huge sources of support for me when I have had strong depression symptoms—communities of peers, communities of neighbors, communities of nature lovers and book readers, communities of women who have experienced multiple pregnancy loss like myself. Having the internet, Facebook, Facebook Groups, email and other social media keeps me connected in ways that are meaningful and supportive for me.
What if people in nursing facilities could access communities that are important to them? While it would not solve the problem of being in a nursing facility if the person really wants to be in their home, it could provide an avenue for sharing stories, providing mutual support, learning and growth.
There is a digital divide. People with disabilities do not access computers and the internet at the rate that the general population enjoys. My guess is that nursing home residents have an even bigger gap in access.
Are there ways we can work together to bridge that divide?
What AT do you use for computer and internet access?
In what […]
by MATP Staff Member Laura Hall
The number of items in your home that can now be controlled remotely, by smartphone, or by voice is staggering and growing every day. I’ve been slow to upgrade my home to “smart home”, but now that I’ve been bitten by the bug there may be no stopping me.Over the holidays, I purchased a Nest learning thermostat, and when I enrolled in a peak energy program through my provider, it cost me almost nothing. The large print display lights up as you walk by the thermostat, and you can control the temperature using the ring along the side, your smartphone, or voice, using Amazon’s Alexa devices. I found this to be much easier than the small button you had to hold down on my old thermostat. You can also schedule when to turn the heat up or down, or the Nest also learns your favorite settings in about a week and you can enable it to auto-adjust. The”leaf” icon when you choose a setting that saves energy. For me, this is a good reminder that even a degree or two can lead to savings.
When we decided to get a security system for our home, I decided that I had to be able to manipulate the door locks, or else they would go unused. There are many assistive technology devices designed to help with holding and turning keys, but I always met them with varying levels of success. Initially, I was only considering a numeric keypad lock. I have several personal care staff that come in on different days and during different times, so I was looking for something that would allow me to program multiple unique access codes that I could easily change if there was turnover. However, when the home security company came to install the system, they showed me a smart lock that had both the numeric keypad and the ability to lock and unlock from my iPhone. The smart lock works with Z-wave technology to send a signal wirelessly from my phone to the lock. It’s also tied in with the app that controls my security alarm system, which means I can lock and unlock the doors, arm and disarm the alarm and monitor, who is coming and going all from my phone. I can’t get out of bed without the assistance of my personal care staff, so it’s been extra helpful to be able to disarm the alarm from bed from when they arrive (they can still unlock the door on their own using the keypad).
When it comes to environmental controls, lights are one of the easiest things to make hands-free. You can now buy many smart plug outlets for under $20. You simply plug any lamp into the outlet and it can be turned on using your smartphone (typically with an app that works with the outlet) or smart speakers […]
By Aimee Sterk, LMSW, MATP Staff
I’m a fairly accident-prone person. Add that to my recent age-related changes in vision and my already narrow field of vision and lack of depth perception due to one of my disabilities, and I’ve been getting burned in the kitchen even more lately.
I was sitting through a great webinar on kitchen safety this week and looked down at the matching burn marks across the base of both of my thumbs, snapped a picture and sent it to my colleague who was also on the webinar saying I needed the information for myself, not just for work.
Amanda TePastte, OTR, from Disability Advocates of Kent County was leading the webinar and shared some AT that I will be adding to my house to help keep me safe. Our partners throughout the state are now able to present this training on AT for Kitchen Safety. Connect with the site nearest you if you are interested in learning more yourself or a group you are affiliated with.
Tops on my list to prevent burns in my kitchen:
- Oven rack guards: The pair of silicone oven rack guards that Amanda showed in her presentation look so useful in preventing burns from my hands hitting the grates in the oven. I used to have a set of guards made of fabric that withstands high temperature that snapped on to my oven racks, but the snaps eventually rusted and wore out so the fabric protector was hanging off in spots. This silicone set doesn’t have any snaps and is easy to install.
- Oven rack push/pull: Most of my burns have come from getting things in and out of the oven, reaching into the oven and misjudging distance and hitting my hands on hot pans or the racks. I can use an oven rack push/pull to pull the oven racks out over the open oven door and put items closer in reach to more safely pick them up.
- Food Pod: Last year I sustained 2nd degree burns on my wrist after dropping half of a pot filled with boiling water and potatoes. A food pod allows you to boil food in a silicone pouch that you pull out of the boiling water instead of transporting pots of boiling water across the kitchen to drain. Sign me up!
These items are also available for demonstration from our partners around the state.
What AT needs do you have for kitchen safety? What AT has worked for you in the kitchen?
By Jen Mullins, BS, CTRS, MATP Staff
In my last two blog posts, Access Moves Fashion Forward! and Taking Steps Towards Access in Footwear!, I wrote about how the things that we wear are being designed with access in mind for more and more people. In this post, I share about how clothing, footwear, and accessories are shown & promoted. For a long time, there hasn’t been much representation of people with disabilities and the Assistive Technology (AT) they use in fashion. Jillian Mercado, a model who has spastic muscular dystrophy and uses a powerchair, shared: “Even as a very young girl and adolescent, I always knew that there was a hole in the fashion industry and that it wasn’t fair that I did not see myself reflected. I wanted to feel like I was a part of it, but there was nothing that was helping me see that.”
In recent times, representation has been changing. In Teen Vogue’s September 2018 issue, Vogue profiled three models with disabilities: Chelsea Werner, Jillian Mercado, and Mama Cax. The piece was written by journalist Keah Brown who has Cerebral Palsy. Brown writes, “Disabled people and disabled models are still left out of most campaign ads and runway shows. This lack of representation has implications: When you go so long without seeing yourself it is easy to interpret that lack of representation to mean you’re ugly and unworthy, that you deserve to be invisible or even worse, are grotesque. The erasure can have an impact on your mental health.”
In fall 2018, The Mighty published a piece that highlighted the growing representation in models: More models with disabilities are making their way up the ranks. One new face is Aaron Philip, who’s signed with Elite Model Management. Philip is a 17-year-old person of color, trans, disabled model — and now just one of two models who use Assistive Technology (wheelchairs) to sign with a major agency. “I enter the fashion world with intentions of making the industry more diverse, inclusive, and accessible,” Philip shared. “I have never seen a physically disabled supermodel or a Black transfeminine model heralded, celebrated, or even working in the way other models are — and I hope to change that.”
In the summer of 2018, Aerie, the lingerie brand from American Eagle launched a campaign that featured models with disabilities; some who are shown using their Assistive Technology and Durable Medical Equipment (DME). One model wears an Ostomy bag (a pouch is worn over the stoma to collect stool or urine), one model is photographed using forearm crutches, a model is shown wearing her insulin pump, another model is shown using her wheelchair and posing, and a model who has Down Syndrome is photographed with a huge smile on her face. President Aerie Jennifer Foyle shared, “Now, more than ever, we want to […]
Rachel Dancy posted this lesson in frustration on The Mighty. The problem Rachel describes with stuttering also occurs with disability “accents” where a disability characteristic makes speech less clear.
I decided to take a crack at coming up with some AT that could help reduce this kind of frustration. And I found some described later in the post.
Say Your Name #frustration #Stuttering By Rachel Dancy
There are times when phone technology is a blessing because of better service and quality, cute emojis and text messaging. All of that is fabulous. But the one thing that technology hasn’t improved is making phone automated prompts accessible to everyone. To a person who stutters, the automated phone prompts can be very frustrating. It doesn’t understand stuttering, only fluent speech. It prompts one to say your name. Sounds easy…but for most stutterers, saying your name is quite the hassle. You can’t replace it with another synonym, so you try.
“Please try again.”
“Rachel”. One barrier down, few more to conquer.
“Please state the reason for your call. Would you like to schedule an appointment, cancel an appointment, speak to a representative?”
More reasons than I can possibly want and all of them more than a word. Ugh. Silence.
“Please make a selection.” All of the choices are listed again as if I did not hear the first time. Hearing is not the problem; it is saying it. After thinking for a few seconds, I need to make an appointment. ” Make an ap-appointment.”
” Please try again.” I try to really enunciate and scream into the phone. “MAKE AN APPOINTMENT!”
“You selected ‘make an appointment’. Is that correct? Say yes or no.”
“Please try again.”
“Would you like an appointment for a haircut, manicure, pedicure, mani-pedi, wax or other? Say your choice.”
It’s a good thing I just need a haircut otherwise this would be an incredibly long phone call. Not to mention an incredibly expensive appointment too.
“Please try again.”
“Manicure.” Sometimes you have to go with what works, or comes out better. I suppose my nails could use some touching up. A hair cut will have to wait.
“Please wait while we connect you.” Elevator music plays. At least I am going to be connected to a human being instead of a computer. “Hello, this is Ruth. Thank you for calling; how may I assist you today?”
“I w-would like to make an ap-ap..”
“Appointment?” she finished for me, which is another pet peeve, but no point in biting her head off.
“Morning or afternoon?”
“How about afternoon?”
Now I have to pick a day. Looking at my calendar.
Ruth asks, ” Does Thursday at 2 work out?”
Crap. No, it doesn’t. On with the conversation.
“N-No, it doesn’t. Three O’clock? ” Please, please say yes.
“3pm is available. I will mark you down. Have a good day.” Ruth politely says goodbye and I breathe a sigh of relief. Technology might not be the greatest, but stuttering won’t get in the way of communicating with other people.
- 711: […]
By Jen Mullins, BS, CTRS, MATP Staff
While some designers are focusing on creating more accessible clothing, other companies are zeroing on footwear! For people who have limited mobility & dexterity and decreased stamina & balance, putting on traditional, lace up shoes can be difficult. Velcro laces have been popular and useful to many, but others share that they want better solutions. In July 2015, Nike release the FlyEase: “a shoe with a wrap-around zipper that opens the back of the shoe near the heel-counter, making it easier to slide the foot in and out. At the same time, the system provides sufficient lock down and eliminates the need to tie traditional laces.” Nike shared that they received a letter from Matthew Walzer, a customer of their shoes, requesting a shoe that he could put on himself. Walzer has Cerebral Pasly and told Nike that he needed daily assistance to put on his Nike shoes. Though they aren’t a perfect fit for everyone, the FlyEase is a great step in the right direction.
More recently, Nike released their shoes with E.A.R.L. (Electric Adaptable Reaction Lacing). “E.A.R.L’s technology makes self-lacing shoes possible. It electronically adjusts the lacing, pressure and fit to the contours of your foot. Once your heel hits the built-in sensor, E.A.R.L. automatically tightens until the fit is perfect.”
After a successful prototype creation, in 2015 BILLY footwear launched a fruitful crowdfunding campaign and today sell high top and low top styles of shoes for kids and a limited line for adults. “Smashing fashion with function, BILLY Footwear incorporates zippers that go along the side of the shoes and around the toe, allowing the upper of each shoe to open and fold over completely. Thus the wearer can place his or her foot onto the shoe foot bed unobstructed. Then, with a tug on the zipper-pull the shoe closes and secures over top the user’s foot.” Additional styles & options for adults are reportedly in the works, “We are actively working on adult designs for both men and women and are set to launch those designs in August 2019.”
It’s exciting that access is being built into footwear! But what do you do if you want to keep wearing your current shoes and need some help? Here are a few Assistive Technology (AT) devices that can make putting on, taking off, and wearing footwear more accessible:
- Long Shoehorn and Sock Remover with Non-Slip Handle: for people who have difficulty bending or reaching due to limitations in flexibility, mobility and dexterity in the fingers, hands and arms. Ideal for those suffering from neck and back problems.
- No Tie Elastic Shoelaces: laces are stretchy and held in place with a locking mechanism without having to tie them.
- Heavy-duty elastic shoelaces: for those who require or prefer better support.
- No Bend Shoe Remover: for people […]
By Aimee Sterk, LMSW, MATP Program Staff
People with barriers to community living who use supports through the Mi Choice Waiver Program (which provides services in the community instead of nursing homes) participated in a study that showed that accessing assistive technology, instruction, and home modifications decreased falls and hospitalizations and increased their ability to complete activities of daily living.
Sandra Spoelstra, RN, PhD, of Grand Valley State University, led a research program (Spoelstra et al, 2018) to implement and study CAPABLE (Community Aging in Place, Advancing Better Living for Elders) in four regions of the state.
During the 32 weeks of the study, participants worked with social workers, nurses, occupational therapists, and a handyperson to address activities that are challenging at home like meal preparation, medication management, bathing, and dressing. The team also looked at pain, mood, fall prevention, medications/interactions/side effects, communication with the doctor, incontinence management, sexual health and smoking cessation.
The occupational therapists conducted home visits, helped people access AT, and taught techniques to accomplish activities of daily living. Social workers addressed social and emotional needs, and the nurses conducted medication reviews. The handy person did home modifications like adding grab bars or made repairs to improve the home (these were required to be medically necessary).
This demonstration program is now being rolled out at all of the Mi Choice Waiver programs in the state. Soon, everyone will have access to these interventions and can use their person centered planning process to address needs for assistance and devices to help them live in the community.
The Michigan AT Program also offers one on one demonstration of AT devices, like the ones accessed through the CAPABLE Program, to support community living. If you would like a demonstration, please contact the closest local site and set up this free demonstration.
What AT devices do you use to help you live in the community? What is your favorite AT device for community living? What daily activities are hard for you? Could you use AT or techniques to make it easier for you to do them?
J Am Geriatr Soc. 2019 Feb;67(2):363-370. doi: 10.1111/jgs.15713. Epub 2018 Dec 13.
Dissemination of the CAPABLE Model of Care in a Medicaid Waiver Program to Improve Physical Function.