The need for assistive and adaptive technologies has increased with the return of wounded warriors from tours of duty.
Author: Mary Brintnall-Peterson, Ph.D., Owner of MBP Consulting & Professor Emeritus, University of Wisconsin-Extension
The need for assistive and adaptive technologies has increased with the return of wounded warriors from service during Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF) where blast-related injuries are the most common type of wounds (Shepard B., 2012). According to the Wounded Warrior Project, during OIF/OEF, 48,000 servicemen and women have been physically injured in military conflicts with an additional 400,000 living with combat-related stress, major depression, and posttraumatic stress disorder (PTSD). Another 320,000 have experienced a traumatic brain injury (TBI) while deployed. Many of these wounded warriors are learning to use various assistive technologies or tools so they can become independent.
Assistive technologies were legally defined in the Technology-Related Assistance Act of 1988, often called the Tech Act, which was reauthorized by Congress in 1994, 1998, and 2004. The term refers to “any item, piece of equipment (software) or product system, whether acquired commercially off the shelf, modified or customized, that is used to increase, maintain or improve the functional capabilities of individuals with disabilities” (Assistive Technology Industry Association (ATiA) & National Dissemination Center for Children with Disabilities).
Assistive technologies make life easier for a warrior by avoiding pain or stress and making it possible to accomplish a specific task. Assistive technologies help a service member hear, see, speak, and move and use different types of equipment. Assistive technologies range from gadgets such as a can opener, cane, or walker, which are relativity inexpensive, to an expensive and complex computerized system that helps a wounded warrior get around and even drive a car.
How Assistive Technologies Help Military Caregivers
In a recent study of 564 military caregivers of TBI patients, 33 percent listed one of their tasks as helping their service member with their assistive technology devices (Griffin et al., 2012). So the caregiver must understand how the assistive device functions to be able to assist with its use. The caregiver will be called upon as the wounded warrior learns how to use the device properly, and to help troubleshoot when it’s not working correctly. One way to learn about assistive technologies is to review educational resources and seek out information from various organizations or agencies that focus on disabilities. As a service member succeeds in using an assistive technology, he or she will recognize how valuable it is and be willing to try others.
Examples of Assistive Technology
Wounded service members are coming home looking for ways to return to a normal life as much as possible. Because every warrior’s injury is unique, it's important to have an assessment to so that possible assistive technologies can be matched to his or her specific needs. The following examples of assistive technologies, taken from the searchable database systems provided in the AbleData website resource section and the Computer/Electronic Accommodations Program website, are broken down by specific disabilities.
- Talking computer software uses talking and listening software to provide speech recognition, dictation and to turn text into speech. The software uses voice commands for hands-free computer operation to access MP3 music, weather maps, dictation, Internet browsers, to-do reminders, and email. This type of device is also helpful to warriors with a spinal cord injury and upper extremity, severe physical, mobility, or vision disabilities.
Traumatic Brain Injury
Cueing aids to help the wounded warrior remember appointments, medication schedules, and personal contact information.
Computer-related equipment and programs including screen readers and personalized keyboards.
Visual schedulers allow caregivers to customize a visual schedule to guide service members through daily events such as their morning routine or appointments, or provide step-by-step instructions to complete a specific task or activity. These schedulers are also helpful to wounded warriors with cognitive or communication disabilities.
Global positioning devices help prevent a warrior from getting lost and inform a caregiver when assistance is needed.
Magnification systems to enlarge text so it is easier to read.
Tracking programs to assist with mobility, tracking, cognitive aid, and voice output navigation system. These programs use voice and visual cues to help a service member travel independently via the bus or on foot. A caregiver can create specific travel route(s) and activate them from a GPS location. The wounded warrior receives customized audio and visual instructions to prompt him or her through the route. A caregiver is also able to send a text message, and the system will provide a map showing the warrior’s location. This assistive technology can be used to assist service members with a spinal cord injury, lack of upper extremities, or other mobility or vision disabilities.
An electric credit card uses a miniature scanner and fingerprint recognition software to verify the wounded warrior’s (cardholder’s) fingerprint as his or her signature. A Braille display allows the user to read the details of the transaction, and the card's built-in speaker says the name or type of the products being bought, thus giving a complete accounting of the transaction.
Medical information computer programs provide a simple template for recording and storing a warrior’s medical information on a personal computer. They record the service member's medical and surgical history, medications, emergency contacts, and allergies.
Money organizers have coin and paper compartments, credit card slots, a zippered pocket, an ID window, plus a checkbook pocket. They are also helpful to a service member with cognitive disabilities.
Personal digital assistants provide a calendar, contact list, notetaking, and access to text files through voice or a Braille keyboard.
Eye drop dispensers assist warriors in dispensing liquid into the eye using just one hand.
Spinal Cord Injury
Wheelchairs can be adapted for the service member's specific needs to allow him or her to be mobile. They can have other added devices to help with feeding, toileting, grooming, and bathing.
Remote-controlled speakerphones are voice-activated phones designed to provide hands-free operations. By using the voice, a service member can do remote dialing and automatic memory scanning and can save phone numbers. These devices are helpful to wounded warriors with fine motor, upper extremity, and severe physical disabilities.
Muscle sensors work with assistive technology programs that use a conventional switch to communicate in person, in a classroom setting or over the Internet.
Environment control computer programs enable the warrior to dial and answer the phone, control televisions, VCRs, DVDs, stereos, CD players, and appliances such as lights, fans, etc. using voice commands or switch input. Some allow for dialing, answering, and disconnecting. The programs can also dial from a directory, flash for call waiting, redial, and voice mail. They are also helpful to service members with other physical disabilities or a spinal cord injury.
Various tool adaptations help with specific tasks such as using a hammer, doing snow shoveling, carpentry, etc. They are designed to compensate for the lack of strength in the upper extremities, finger amputation, arthritis, or other grasping disabilities.
Home modifications allow warriors to function in their own home safely by adapting it for their needs such as ramps, wider doors, glow tape for hazardous furniture, lever door handles, lifts, or other adaptations.
Prosthetic devices such as hearing aids, glasses, artificial eyes, and limbs replace a missing or damaged body part.
Assistive listening devices improve auditory discrimination and attention by allowing service members to focus on the person speaking. They take out extraneous and distracting background noises, making it easier to communicate.
Amplification systems such as hearing aids or personal amplification systems raise the volume of surrounding sounds so wounded warriors can participate in conversations more easily.
Teletypewriter (TTY) help warriors with hearing or speech problems communicate using a phone with a teletypewriter.
Emergency response systems use electronic sensors connected to an alarm system to alert a caregiver that help is needed, such as when the service member falls.
Some assistive technology devices can be helpful to more than one disability because they are used differently. For example, a wounded warrior who is blind can use a voice-activated computer, another who has a TBI can take online classes, or a burn victim can stay connected with other burn victims using social media.
As you research the different types of assistive and adaptive technologies, you’ll discover there is no uniform categorization for them, so you may need to check more than one category to find what you need.
Selecting the Right Assistive Technology
Finding the right assistive technology is like purchasing any other piece of equipment. If you have consumer information, it will make the process easier, less confusing, and not so stressful. The following tips (Family Caregiver Alliance, 2005; Brainandspinalcord.org, 2009) should help you and your service member begin the exploration process:
- Remember different disabilities require different assistive technologies and devices.
- Consider the personal preferences of your warrior when selecting an assistive technology as it will help ensure its use.
- Select assistive technologies that address your wounded warrior’s specific needs, and don’t get carried away with the “looks” of the device.
- Observe the range of options from low tech to high tech so you are aware of what’s available.
- Learn about the support systems associated with the selected assistive technology so you can have it properly maintained, repaired, and provided with troubleshooting.
- Ask your wounded warrior’s doctor or other experts such as a rehabilitation specialist or physical or occupational therapist what type of technology would be best for his or her situation.
- Ask other service members with similar disabilities what assistive technologies they have found helpful.
- Select an assistive technology that is comfortable, functional, and simple to use. Because the purpose of an assistive technology is to make your warrior’s life better, select one that enhances his or her life rather than creating problems.
- Determine ahead of time how much maintenance or repairs will be needed for the assistive technology as it shouldn’t be more work than the assistance it provides.
- Test the assistive technology before purchasing to determine if it does what it’s supposed to do.
- Check to see if there is a rental or used equipment program that might have the needed assistive technology available. Some communities have equipment banks where unused equipment can be donated for use by someone else.
- Check out how long the seller will work with you in making the assistive technology workable for your wounded warrior.
- Insist on training on how to operate the assistive technology. Without proper training, the assistive technology will be used incorrectly or could be abandoned.
- Ask about return policies.
For more information on assistive technologies and resources, go to Assistive Technology Resources.
- AbleData. Products. http://www.abledata.com/abledata.cfm?pageid=19327&ksectionid=19327. (Accessed on April 11, 2013).
- Assistive Technology Industry Association (ATia). What Is Assistive Technology? How Is It Funded? http://www.atia.org/i4a/pages/index.cfm?pageid=3859. (Accessed on April 11, 2013).
- Brainandspinalcord.org. Assistive Technology (AT) for TBI. March 2009. http://www.brainandspinalcord.org/brain-injury/assistive-technology.html. (Accessed on April 11, 2013).
- Computer/Electronic Accommodations Program. Accommodation Solutions. http://www.cap.mil/Solutions/Index.aspx. (Accessed on April 8, 2013).
- Computer/Electronic Accommodations Program. Wounded Service Member Support. http://www.cap.mil/Programs/WSM.aspx. (Accessed on April 8, 2013).
- Cook, D. & Knue, A. May 2010. What You Need to Know about Assistive Technology. Center on Technology and Disability Studies at CHDD, University of Washington. http://depts.washington.edu/healthtr/documents/assistivetech.pdf. (Accessed April 15, 2013).
- Family Caregiver Alliance. Fact Sheet: Assistive Technology. Revised 2005. http://www.caregiver.org/caregiver/jsp/content_node.jsp?nodeid=1412. (Accessed on April 10, 2013).
- Griffin, J.M., G. Friedemann-Sanchez, A.C. Jensen, B.C. Taylor, A. Gravely, B. Clothier, A.B. Simon, A. Bangerter, T. Pickett, C. Thors, S. Ceperich, J. Poole, and M. van Ryn. 2012. The invisible side of war: Families caring for U.S. service members with traumatic brain injuries and polytrauma. Journal of Head Trauma Rehabilitation 27(1):3-13.
- National Dissemination Center for Children with Disabilities. Assistive Technology Act. http://nichcy.org/laws/ata. (Accessed on June 23, 2013).
- Scherer, M.J. (2012). Assistive Technologies and Other Supports for People with Brain Impairment. New York: Springer Publishing Co.
- Scherer, M.J. (2005). Living in the State of Stuck: How Assistive Technology Impacts the Lives of People with Disabilities, 4th edition. Brookline, MA: Brookline Books: ISBN-13:978-1571290984.
- Sellers, D.B. and Dittman, E.J. July 2008. Fashion an Easier Lifestyle with Assistive Technology. Fact Sheet MF-2837. Kansas State University Agricultural Experiment Station and Cooperative Extension Service. http://www.ksre.ksu.edu/bookstore/pubs/MF2837.pdf . (Accessed April 15, 2013).
- Shepard, B. October 5, 2012. UAB Program to Train Caregivers of Military Service Members with TBI. University of Alabama at Birmingham. http://www.uab.edu/news/latest/item/2802-uab-program-to-train-caregivers-of-military-service-members-with-tbi. (Accessed April 10, 2013).
- Wounded Warrior Project. Who We Serve. http://www.woundedwarriorproject.org/mission/who-we-serve.aspx. (Accessed on April 16, 2013).