Biomedical Engineering Reference
In-Depth Information
By the time he was admitted the second time for inpatient rehabilitation, John had
already been reinserted back into sixth grade at the school he had been attending. The
teachers asked for information and instruction about how to assess his learning process.
At that time, the rehabilitation focus was primarily on strategies for cognitive and writing
re-education. The SKM AT tool was added, with the switch John was already using,
but without the sound device. He was able to write by scanning, turning on the switch
with his right hand. A meeting was held with his teachers, at which modifications to the
curriculum were suggested to help his learning process and facilitate his interaction with
classmates, expand his communication, and master new content. Adaptations were also
made to John's way of communicating by using the SKM and alphabet cards to write his
answers or by pointing to the correct answer in multiple choice questions.
On John's third inpatient rehabilitation period, he was attending the same school and had
passed to the seventh grade. He was using the communication board with the alphabet and
months of the year on one side and days of the week and numbers on the reverse side. He
had better neck and trunk balance and improved manual function. During this time, new
boards were added, with ready words and phrases about the foods he ate, leisure activities
and places, activities of daily life, names of friends, and feelings. These new boards aimed
at speeding up and expanding his communication with other children. Improved manual
function allowed John to use a conventional keyboard with larger letters that was placed
on the same support as the boards on the left side within his field of vision. Figure 12.8
shows a rod affixed to his wheelchair to hold and better position the keyboard within his
field of vision. Because using a mouse was not functional, a table-board with joystick and
switch were made. Furthermore, the computer was reconfigured with new accessibility
options: repeatedly pressed keyboard keys that froze up, short cuts, and extra-large letters
on the screen. As his balance and manual function improved, John started training how
to feed himself, with customization of eating paraphernalia, such as dishes that affixed
to a table-board with raised edges to keep utensils from sliding off. A tubular bathing
chair was also added, ensuring greater safety during bathtime and allowing John to more
actively participate (he was able to soap up some parts of his body with his right hand).
FIgUre 12.8
(See color insert.)
Rod for holding a conventional keyboard for better positioning and viewing.
