The Case of Shane

Anna Anderson, OTS; Kara Iverson, OTS; Robin Schmid, OTS; Stacy

Weber, OTS; &Kendra Wolff, OTS

Introduction to the Case

• Meaning occupations give individuals a sense of purpose in life.– ADL’s, Work, and Leisure

• Assistive Devices can help one become more independent following an impairment.

HAAT Model of Practice

• Four components– Human – the person being assessed – Activity – the task performed– Assistive Technology – the devices used during an

activity– Context – the place the activity is taking place and

under what conditions

Shane

• Age: 52 Years• Shane’s Occupation: Works in the cooperate

office of a major regional sporting goods store chain– Organizes and provides training for sales associates

• Wife’s Occupation: Educational aid at an elementary school

• Children: Two young adults sustaining careers locally.

Injury• Injury: Hunting accident resulting in a gunshot wound

to the head• Impairments– Broca’s aphasia– Right sided hypertonicity of the arm and leg– Cognition – Vision deficit in the upper quadrants of his visual field– Limited Range of Motion– Slow Movements– Poor Fine Motor Control

• Currently uses a Hemiwalker with minimal assistance

Further Analysis

• The Home– Shane and his wife live together– Ranch style home

• Three steps to enter the home• Walk out basement to the hot tub and fire pit in the backyard• Kitchen• Computer Workstation

• Meaningful Occupations– Biking, Kayaking, Pheasant hunting, hot-tubing, and

relaxing by the camp fire– He also enjoys following professional baseball and football

Goals

• Independent Self-care• Return to light work duties• Improved Communication• Accessing the Telephone independently• Continue Outdoor activities as able.

Major Tasks Affected

ADLs

• Bathing, dressing, and grooming• Affected by:– Limited ROM– Poor fine motor control– High tone in Right UE– Cognitive impairments

Work

• Organize and provide training to associates at his store

• Affected by:– Broca’s Aphasia– Impaired cognition

Social Participation

• Community mobility and communicating with others

• Affected by:– Slow movements– Impaired cognition– Broca’s aphasia– Limited vision

Play/Leisure

• Biking, Kayaking, hunting, and following major league sports

• Affected By: – Limited ROM in UE– Slow movements– Impaired vision– Impaired cognition– Poor fine motor control

ADL

Communication Aides:

CatrikeVillager

www.catrike.com

ComputingLarger Mouse

Logitech Wireless Trackball Mouse

http://www.fentek-ind.com/logitech.htm

ComputingBig Keyboard

Big Key Plus Keyboard

www.fentek.com

Leisure4’ Hot Tub Steps

www.rhtubs.com

LeisureHunting

Trigger Adapter

www.rjbowers.com

Funding Process

• Select an insurance company or private organization– Public agencies– Private agencies – Insurance companies– Service organizations– Private contributions

• Write a justification letter

Components of a Justification Letter

• Be professional• Identifying information about client• Current abilities• Prognostic abilities with the use of the device• Description of the device • Benefits of the AT to the user• Evaluation team• Contact information for further questions

Primary Assistive Technology

• Apple iPad 2 32 GB with Wi-Fi capability– www.apple.com– $599.00

• Proloquo2Go version 1.5– iTunes store– $189.99

• Communication device that is portable so Shane can use at home, in the community, and when he returns to work

Apple iPad 2 32 GB

Proloquo2go

• Cost effective solution• Text to speech capability• Can be purchased through the iTunes store• $189.99

iPad Features

• Occupation based activities that Shane enjoys• Speak Auto-Text• Audible and visual alerts for incoming and

outgoing mail and calendar events

iPad Features

• Zoom In and Out• Intelligent Onscreen Keyboard with Predictive

Text Entry• Street and geographic maps• Notepad• Calendar organizer• Contact lists