Nau mai, haere mai! Welcome to my blog, a practical component of my occupational therapy degree paper, Participation in Occupation. This blog will be comprised of tutorial tasks relating toinformation technology and OT.
Assistive technology is defined by Christiansen and Townsend (2010, p. 417) as "technological inventions (devices) designed to enable active engagement or participation in occupation through energy conservation, accommodation for diverse physical disabilities, or compensation for functional limitations or disabilities". In layman's terms, this means any specially-designed gadget that helps someone do something by making the task easier. Some of the different types of objects that could be described as assistive technology include mobility aids like wheelchairs and walking frames, communication aids like speech recognition software or touchscreen communication devices, adaptive keyboards and telephones that have larger than standard buttons, prosthetic limbs, and systems like Teletext, just to name a few.
In this post, I'm going to look into the talking photo album, which is an album for photos, drawings, and practical elements like timetables, that contains a built-in microphone so that accompanying messages can be recorded onto it. Each page can have a new recording, and each page has a play button so that uses can listen to the message that goes with each image stored in the album. The albums come in three sizes, from a large A3, to a medium A4, and down to a small A5. They come with plain covers, or can also come with more interesting covers for kids. The pricing differs according to size, with the A3 costing $122, the A4 costing $115, and the A5 costing $98 (STAR Mobility, 2011). Here is a link to the STAR Mobility page for this device.
Talking photo albums could have a number of applications. The first application that is noted is the album's usefulness for dementia clients. Albums could easily be created for members of this user group of images and messages that remind the individual of a happy memory, or of a scene that represents something that the user finds relaxing, in order to return the user to a sense of calm if they become agitated. Below is a youtube video of a news story from Australia about the use of talking photo albums with dementia patients.
(dmcoles88, 2010)
Talking photo albums could also be used to help those with cognitive difficulties maintain order in their day, or create routines. The video below demonstrates just such an application. It shows a young boy who has his morning routine in a talking album, from getting dressed, to having breakfast, to getting his bag for school.
(Team4paws, 2010)
Occupational transition can be eased in the case of dementia clients with the use of talking photo albums. As individuals with a progressive disorder, dementia clients are in a constant state of transition as their condition slowly causes a decline in function. Talking photo albums containing images that hold meaning for the individual can assist in reducing this decline in function and occupational status, by providing the individual not only with the familiarity of photos, but also the familiarity of a friend or family member's voice. The novelty of the vocal component also promotes engagement for the dementia client.
Occupational justice is served well in the second video. The talking photo album allows the boy a degree of independence that he may not have otherwise had, and allows him the opportunity to participate more fully in his daily activities. He is capable of understanding the pictures and instructions contained in his album, and can therefore follow the album and ready himself in the morning, rather than having to rely on a parent or caregiver.
References
Christiansen, C.H., & Townsend, E.A. (2010). Glossary. In C.H. Christiansen & E.A. Townsend (Eds.), Introduction to occupation: The art and science of living (2nd ed.) (pp. 417-421).
dmcoles88. (2010, November 25). Talking books a helpful reminder - ABC News (Australia Broadcasting Corporation).flv [Video file]. Retrieved from http://www.youtube.com/watch?v=Kff-zf-6VUw
Here are links to some blogs of interest from an OT perspective.
http://otstudents.blogspot.co.nz/
This one I found interesting, as the blogger is a fairly recent graduate, and gives some great perspective all the way through study to entering the field, and the journey since.
http://otnotes.blogspot.co.nz/
Here's a blog that demonstrates just how much IT can be used in the field, it has certainly inspired me to branch out a bit more as far as communications technology goes at the very least.
http://recyclingot.blogspot.co.nz/
A really cool blog that recommends books for therapists to read, I was drawn by the links to Temple Grandin's work. I've encountered her other field of expertise, animal behaviour, in my previous career in the veterinary field, and it's fantastic to be able to get a better picture of her publishings on autism and advocacy. This blog primarily discusses how to make OT resources, and has some awesome ideas.
http://www.horseot.blogspot.co.nz/
This blog looks at one of my favourite topics, animal therapy in OT, in this case horses. Some great videos and ideas on how to create new tasks for hippotherapy.
http://kateloader.blogspot.co.nz/
Here's a link to a classmate's blog. Interesting and fun! Here's a comment I made on Kate's blog, and her reply.
In continuation from my second blog post, I'd like to focus on the use of animals in therapy. Prior to commencing my occupational therapy studies, I had a career as a veterinary nurse, and at one clinic had the chance to run puppy socialisation classes, which occasionally contained future guide dogs and hearing assistance dogs. My placement last year at Riding for the Disabled showed me a different way in which animals can prove therapeutic to people. I thought this blog task could expand my knowledge even further, in combining two different passions, animals and helping people, as well as exploring how they work from an occupational therapy perspective, as well as looking at ethical considerations regarding their pages.
Outreach Therapy Pets is a joint venture run by the Order of St John and the SPCA Auckland, which operates in Auckland, Kerikeri, Waihi and Thames, and involves volunteers and their animals visiting people in the community providing animal-assisted activity or animal-assisted therapy. AAA is an informal visiting service. AAT provides goal-based professional intervention. One common goal of AAT is to assist with occupational transition, which "can be defined as a major change in the occupational repertoire of a person in which one or several occupations change, disappear, and/or are replaced with others"
(Jonsson, 2010, p. 212). Such transitions can include retirement, and older people are a common user group for this service. The purpose of this page is to provide a brief introduction to the Outreach Therapy Pets service. It has been created by St John, a highly reputable organisation, and only St John can contribute to the page. Interaction is via one of two options, an enquiries email link, or an online volunteers request form, although the page also provides a toll-free telephone number. From an ethical perspective, this page contains one photographic image, in which neither the person nor the dog are identified.
This programme operates out of a women's correctional facility in Missouri, and involves prisoners working in one of two programmes, one which provides basic training for shelter dogs in order to make them more adoptable, or one in which prisoners train one specific dog in more advanced disability service skills. This programme looks not only at providing trained dogs for the community, but also tackles the issue of occupational deprivation caused by incarceration. Occupational deprivation occurs when "people are unable to participate in occupations due to structural as opposed to personal reasons" (Whiteford, 2010, p. 304). The page is controlled by C.H.A.M.P. Assistance Dogs, Inc, and provides basic information on how the prison programmes run, with a link to a volunteer's report on a visit to the prison programme, a PDF document with greater detail for viewers of the page who are considering a similar programme for their instution, and a link for visitors to the page to email the service. As with the Outreach Therapy Pets page, content contribution is limited to the page creators. Both the main prison programme page and the volunteer's report contain unaltered images of the interior of the prison, the dogs, and some inmates. No inmate is named on the main page, however one is named by first-name only. Informed consent from each individual would be needed for unaltered images to be uploaded to the internet, or published in any other pulic manner. As an NPO working in conjunction with a state facility, it would be fair to suggest that strict confidentiality protocols are in place.
This page provides an online forum for people who are training or using service or therapy dogs. Unlike the two previous sites, it is open to the public, and the majority of the contribution comes from registered members. The only restriction upon joining the community is that it is for private individuals only. There are some restrictions as to what content can be posted, and the discussion boards do have some moderation. Members may upload their own photos as ID, or include them in their posts, as well as create hyperlinks to other pages, but the sharing of any third party's information or material without consent is forbidden. This group is non-professional in its moderation, and as such, the advice given may not always be appropriate for users posing questions. Members create new threads to discuss elements of training or ownership, often seeking advice on becoming volunteers, the legal requirements of service/therapy pet ownership and management, and asking for tips on training. Members may reply to any thread, or on any of the other boards in the site. Some of the topics include training dogs to respond to events such as seizures, which can cause occupational disruption, which is "temporary and transient" (Whiteford, 2010, p. 305). With a forum this large and public, and with a small number of moderators, privacy could certainly be an issue.
References
Jonsson, H. (2010). Occupational transitions: Work to retirement. In C.H. Christiansen & E.A. Townsend (Eds.), Introduction to occupation: The art and science of living (pp. 211-230). Upper Saddle River, New Jersey: Pearson Education Incorporated.
Whiteford, G. (2010). Occupational deprivation: Understanding limited participation. In C.H. Christiansen & E.A. Townsend (Eds.), Introduction to occupation: The art and science of living (pp. 303-328). Upper Saddle River, New Jersey: Pearson Education Incorporated.
The purpose of this post is to link to videos relating to an area I've experienced on placement. In this case, I've chosen to look at my first placement, which was in an acute medical setting. The ward I spent the majority of my placement on was for people having abdominal surgery. Many presented with twisted bowels, or obstructions, although a large number were also there for cancer-related surgery for virtually any organ in the abdominal cavity. We also had a large number of referrals from the orthopaedic ward, where surgical patients had developed complications post hip or knee replacement. Here's a quirky look at abdominal surgery, don't worry, there's no real footage in this!
(AMICUSvisuals, 2011)
The most common piece of equipment I got to issue was a bed lever, as sitting up in bed requires use of the abdominal muscles, a task which proves to be very uncomfortable for someone who has had abdominal surgery. Here's a short video that shows how this simple but helpful device works.
(strokeeducation1, 2011)
We also issued a lot of walking frames, as many of our clients were older people with reduced mobility, which was further impeded by the discomfort they felt in the abdominal region. Here is a video demonstrating safe use of a walking frame.
(DoabilityukLtd, 2009)
Bathing and showering were also challenging tasks for many of our clients, particularly for those who were dealing with orthopaedic and abdominal surgeries. Shower assessments were completed for the majority of patients, and many were issued adaptive equipment for showering, both in the hospital, and to take home upon discharge. The following video shows images of transfers with equipment for shower/bath, which we issued regularly, as many homes have a shower over the bath.
(cracker2204, 2008)
As the majority of our clients were middle-aged or older people, we had a number that were living alone, being divorced or being widows/widowers. As it is becoming increasingly common for younger generations to travel overseas for work, a lot of these people had no close family living nearby to help them at home once they were discharged. This meant referrals to a variety of different services, depending upon the individual and their capabilities at the time of discharge. Some would receive referrals for assistance with personal care (ie showering and dressing, toileting etc...), others would be referred to home help agencies that assist with housework and tasks like grocery shopping. Most clients went home with meal replacements such as Sustagen, which provide adequate nutrition, but are very gentle on the gastro-intestinal tract, which is important for healing. Older clients living alone were also offered a referral to Meals on Wheels, which provides a meal delivery service for those who have limited abilities for cooking. Here's a video from a MoW client perspective.
Our task for this session was to create a video approximately 1 minute long relating to one of four chosen topics; occupational justice, occupational disruption, occupational transition, or occupational deprivation. We were assigned groups for this task, however I was absent the day of designation, and was given group members from the class that is on an alternative timetable to myself. This proved impractical, so I have made my video myself. After storyboarding a number of ideas, I went and checked out other blogs from my classmates, and discovered that people had already chosen the same or similar scenarios. So rather than looking outwards, I decided to look inwards for subject matter.
I chose to represent my own health issues, which have recently been causing occupational disruption, as you will see in the video. Occupational disruption is "a transient or temporary condition of being restricted from participation in necessary or meaningful occupations, such as that caused by illness, temporary relocation, or temporary unemployment" (2010, Christiansen & Townsend, p. 420). In my case, a change in the status of an ongoing condition, and the resultant change in medication, has created a situation where my primary occupation, that of student, has been severely disrupted, as have other daily occupations, such as housework, cooking and leisure activities.
In making this video, I used the built-in webcam on my computer. I had to take into consideration the limitations that a solo project incurs, such as filming whilst being in the frame, and being able to position my camera in a practical way. I edited the video using Windows Live Movie Maker. I chose not to use any soundtrack, to avoid possible copyright breaches. So here we go...
(emmelby, 2012)
References
Christiansen, C.H. & Townsend, E.A. (2010). Glossary. In C.H. Christiansen & E.A. Townsend (Eds.), Introduction to occupation: The art and science of living (2nd ed.) (pp. 417-423). Upper Saddle River, New Jersey: Pearson Education Incorporated.
Welcome to my post about Riding for the Disabled (RDA). Lasy year I spent my second semester placement with the Hamilton Group RDA, going one morning a week to work with children with a variety of disabilites being assisted in physical rehabilitation, emotional expression, and social inclusion, by horses and volunteers. I wanted to do a paediatric placement, and love horses, so it was a great fit for me. Here is a link to the Hamilton Group's web page:
This is a slide show with some images that will hopefully help you see just what the RDA can do for all sorts of kids.
Let's have a look at some concepts in occupational therapy that relate to this slideshow.
Doing is when we engage in "purposeful, goal orientated activities" (Hammell, 2004, p. 301). Being is "time taken to reflect, be introspective... savour the moment, appreciate nature... and to enjoy being with special people" (Hammell, 2004, p. 301). Becoming is described as "the idea that people can envisage future selves and possible lives, explore new possiblities" (Hamell, 2004, p. 302). Belonging is "the necessary contribution of social interaction, mutual support and friendship, and the sense of being included, to occupational performance and life satisfaction" (Hammell, 2010, p. 302).
Ethical considerations taken into account when creating this presentation were obtaining permission from the RDA coach to use photos from the website, as families of the children who use the service either consent or decline the right for photos of their children to be published. Consent was also obtained from those who appear in photos with myself, this being done prior to them being posted on my facebook page shortly after I first took them. I also chose not to resize the photos, so that the faces of individuals were for the most part concealed, and chose not to name any individual.
References
Here it is, my first post on my first blog. This post is all about defining information technology, discussing the use of technology in society and its prevalence, IT as it relates to occupational therapy (OT), and will end with some ethical considerations for the OT practitioner.
So let's kick off with a definition of "information technology". Oxford Dictionaries (2012) provides the following:
noun [mass noun]
the study or use of systems (especially computers and telecommunications) for storing, retrieving and sending information: [as a modifier]: information technology consultant
If I were to try and define "information technology" myself, I would probably say that it is a combination of devices and systems that allow information to be utilised, stored, and shared. With this definition, I would include no only the two most obvious elements of IT, computers and the internet, but also mobile phones, and other devices with internet connectivity like tablets, as well as digital devices with Bluetooth connectivity such as mp3 players. To make the connection between IT and OT, I would also be referring to a broad range of adaptive technology equipment, especially those that allow persons with disabilities to communicate, such as touch screens that are programmed with thousands of words and that speak for those who cannot vocalise. Below is an example of this kind of technology:
Moving on to the use of technology in society, and its prevalence. It is well-known that the internet is available globally, and that computers and other internet-capable devices are increasingly being used as a preferred means of communication. Leland's video above shows that IT is becoming of greater use not only to able-bodied people with few health problems, but also to people with a variety of disabilities. Possibly the most popular use of the internet as a communications medium outside of emailing is the use of social media. According to Facebook's (2012) Newsroom page, this social media giant had 845 million active users by the end of 2011, and at the same period, had 483 million active daily users worldwide.
As a means of communication, the internet is clearly extremely popular. Other methods of communication, such as cellular phones, are also commonly and regularly used. In the CIA's World Factbook (2012), New Zealand is noted as having 5.02 million cellular phones in circulation, which is more than one phone per person. This certainly shows that in this country at least, communication technology must be mobile and not just fixed in order to be popular.
Facebook. (2012). Newsroom: Fact sheet. Retrieved from
http://newsroom.fb.com/content/default.aspx?NewsAreaId=22
My own experiences with IT devices and systems are admittedly varied. Growing up, we had a dial telephone on a fixed line, our television set had tabs and sliding levers to control the channel options (there were only two) and volume, our stereo was composed of an AM tuner and and LP player, and even when I was at high school, I studied Typing on an electric typewriter, not IT on a computer. Looking around my house now, I have an Android mobile phone, a laptop with broadband and Bluetooth, an mp3 player, digital camera that connects to computers and televisions (whether digital or analogue), cordless telephones and the most common portable information storage device for students, a memory stick. I admit freely that I only learn about new technology when I have to learn, because it has become a requirement. I have no idea what a large number of the functions on my cellular phone are for, because I never need to use them. I don't use most of the functions on my digital camera either. I use my laptop daily for study purposes, including using Moodle and searching for information via the internet, as well as typing up assignments. I also use it for the purpose of connecting with people via social media and email, and have a number of mostly musical playlists saved on my youtube account.
I do not consider myself even remotely tech-savvy, and my reluctance to learn about new technology is mainly prompted by a lack of interest, at least as far as the ways in which I personally relate to IT. I am old-fashioned, I like to write pen and paper letters, put them in an envelope, put a stamp on them, and post them. I like to pick up a book and turn the pages. I like to manually highlight important points in photocopied readings for my course. One element of reading and writing that I do engage in from a more technologically advanced perspective however involves sharing poetry. I am a member of an international online writing group, and although I always compose my poems on paper first, I share them electronically on the internet with the group. I also read the poems of other members, which provide me with inspiration and enjoyment. Under these circumstances, IT provides a very efficient and effective service. Handwriting copies of each poem and mailing them, maintaining a list of members, and replying to the work of others, would all be very time consuming without the internet and computers. Poetry is a means of journalling and self-expression for me, and I enjoy sharing not only my own writing, but the writing of others. It is a meaningful occupation for me. I think that the application of technology towards others, to whom it would be of great benefit rather than just an interest, would prompt me to learn more. I do not feel that I need to be informed of every technological advance as it happens, as it is not a need for me, however, keeping track of improvements in technology for those that can be helped into meaningful occupations is something that I feel is more important. This paper is showing me that I do have a need for greater understanding of IT if I want to be able to more adequately contribute to the life adaptations of a potential OT client.
So, what kinds of observations have I been able to make thus far in my student career of IT being applied by OTs? Some of the applications I saw on my first placement in an acute setting include:
researching conditions online
researching assessment data online
sharing of information via email
use of cellular phones for communication within the department, and with other members of the multi-disciplinary team (MDT)
electronic storage and retrieval of various forms of information, such as client handouts pertaining to medical conditions, or equipment and its use
checking of patient information that is not stored in the handwritten file, such as digital radiography or ultrasound files
There are a multitude of different applications for IT, but those are the most common ones I saw.
With different applications of IT come different problems. Technology advances at a great rate, which can lead to a number of issues. Practitioners may find it difficult to keep up with new trends in both systems and devices, existing systems may no longer be compatible with newer variations posing problems for organisations that have strict budgets and cannot regularly afford to upgrade, clients who do not have the means or interest to keep up with technological advances may find IT intimidating or off-putting which can impair self-confidence. There is also the problem of access to IT products and services. They are very common, but it would be unwise to assume that everyone has access to IT devices and systems. Another big issue for practitioners is the safety of devices and the storage of files and communication. A cellphone is a small, extremely common device, that is easy to misplace or to have stolen. Sending client information via text message would leave that client open to a loss of confidentiality should the phone be lost or stolen. Much information is now stored on computer, and communications between team members regarding clients are often by email. Although the internet provides a wonderful platform for quick communication, it is also a playground for hackers. Hackers do not necessarily just steal information, they can also alter it, which could cause immense problems for the practitioner and their client. Regularly updated and high level security programmes for computers are a must for those working in fields where highly personal information is stored and shared online. Social media, which has already been mentioned previously in this post, is also a source of potential problems from an ethics perspective. Many countries now have legislation regarding social media and employment. Social media, even with high security settings, is still essentially a public forum, and confidentiality should be maintained in this format just as it is in the face-to-face world. To discuss a case, particularly to the extent where the client may be identifiable, can be classed as a breach of confidentiality, regardless of whether the practitioner is on the bus going to work, or posting on their Facebook wall. The biggest problem that I can think of with IT, beyond security and ethical considerations, is that sometimes it just DOES NOT WORK! This is frustrating and time consuming for practitioners who are already working with a heavy caseload.
I feel that the area in which IT is most likely to be applied is through the sharing of information and experience, both between practitioners, and between practitioners and clients. Although social media does not necessarily provide the best format for discussing cases, there are a variety of ways in which people of any profession can create private forums in which to bounce around ideas, share case studies, and submit observations. Forums like these can aid professional development in an informal way. Another way in which OTs have been using the internet is to post videos to sites like youtube for the benefit of clients. Below is an example of a hand therapy exercise.
A video like this could be useful to provide a visual reminder for a client on the technique to use with such an exercise. They can refer back to it, rather than having to rely just on memory. Video files can also be used specifically to educate about the OT profession. Here is a video that discusses OT and how the discipline can help with autism.
A video like this one could help a parent with a child newly diagnosed as autistic to consider what options there are in the health field that may help their child and their family as well.
IT is a constantly evolving, changing and growing field, and the advances in its application in a number of areas seem endless. Although there are some inherent problems with the use of IT, the benefits to me outweigh the issues. I definitely feel that the educational advantages that the internet can provide are of great benefit to both practitioners and clients. Google should not replace formal continuing education for practitioners, nor should it replace personal recommendations from a qualified professional for clients and their families, however as a secondary resource, I cannot think of any other format that can compete for variety and speed of access. As other forms of technology continue to improve, and provide devices like the DynaVox shown in the video above, they give a great range of clients a greater ability to participate in the world around them, to express their wants and needs, and to live fuller and more engaged lives. As a profession that values the right of clients to engage in the occupations that they both need and want to, the applications and progess of IT is something that I feel most OTs would welcome.
