Tag Archives: occupational therapist

Adaptive Equipment Solutions To Help Arthritic Drivers and Others

People with severe arthritis, people with Muscular Sclerosis, Muscular Dystrophy and others with disAbilities can drive again with the help of a mobility equipment expert. To find the specific product solution for your driving challenges, consult with a Physical or Occupational Therapist, Driver Rehabilitation Specialist and a Mobility dealer. Here are just a few adaptive mobility devices that they may recommend to keep you on the road.

If your hands are too weak to turn the steering wheel, there’s a solution:

  • Joystick Driving Systems allow one-hand operation of brake, accelerator and steering and only require ounces of pressure to use.

If you can’t reach controls on your dashboard or steering wheel, there’s a solution:

  • Remote Wiper, Horn, Dimmer Switch, Signals and Headlight Controls. This control relocates these functions to a more reachable location. The driver uses a switch with the hand, elbow, head or knee.

If you have leg spasms, there’s a solution:

  • Pedal Block (for gas and brake) guards against inadvertent engagement of gas or the brakes due to a spasm.

Enabled By Design

Enabled by Design is a social business run on a not-for-profit basis for the benefit of its community.

It’s all about people-powered products and services:
Enabled by Design is a social business and community of people who are passionate about design for all. They believe that a good design can support people to live as independently as possible, by helping to make day-to-day tasks a little bit easier and in turn more manageable.

Enabled by Design’s work focuses on doing the following:

  • They provide their community with a space to share and talk about independent living products and services that are already available on the market, and to look at how they could be improved.
  • They are interested in exploring how people can “hack” or modify things to make them more accessible and easier to use.
  • They are working to develop relationships with designers, so that their community can help to improve the designs of the future with the aim of mainstreaming accessibility.

Enabled by Design was inspired by co-founder Denise Stephens’ experiences following her diagnosis of multiple sclerosis (MS) in 2003. Having suffered a series of disabling relapses and hospital admissions, Denise was assessed by an occupational therapist (OT) and given a range of assistive equipment to help her to be as independent as possible. Although this equipment made a huge difference to her life, she became frustrated as her home started to look more and more like a hospital. But Denise had an idea…

In April 2008, Enabled by Design was chosen to take part in the first ever Social Innovation Camp. A weekend long competition, Social Innovation Camp brings together people with ideas of how to solve specific social issues, with web developers, designers and those with business expertise to develop online solutions to real world challenges. At the end of the weekend after a Dragons’ Den-style pitching competition, Enabled by Design was awarded first prize as the ‘project with most potential’.

Since then Enabled by Design has been chosen to be part of the independent living stream of the Innovation Exchange’s Next Practice Programme, as well as a Level 1 and Level 2 Better Net UnLtd (Foundation for Social Entrepreneurs) award winner.

Denise and her co-founder, Dominic Campbell (also founder of government consultancy and social innovation incubator FutureGov), continue to work hard to spread the word about Enabled by Design and its goals, building a diverse community of people with an active interest in accessibility and design that supports independent living.

Driving Assessment Program: Spaulding Outpatient Centers

Driving Assessment Program

Man driving with evaluator New EnglandThrough their Driving Assessment Program, Spaulding Outpatient Centers offer evaluations for people experiencing functional changes due to trauma, surgery, a neurologic incident, or the aging process. It is an essential part of the assessment to address any deficits that may influence your safety and independence behind the wheel and as a licensed driver.
Medical conditions that may affect driving skills include stroke, Parkinson’s disease, dementia, Alzheimer’s disease, acquired or traumatic brain injury, macular degeneration, glaucoma, neuropathy, cardiac disease, arthritis and cerebral palsy. These conditions may affect your vision, memory, attention, and ability to problem solve and react quickly.
If you are unsure if your condition affects your driving abilities, or if you need a doctor’s order to medically clear you to drive, you may benefit from a driving evaluation. If you are concerned about the driving abilities of a family member or friend, you may want to recommend that they participate in a driving assessment.
We will assess your vision, spatial awareness, ability to shift attention, problem solving, sequencing, and awareness of others on the road. We also will assess your own strengths and weaknesses, ability to read traffic signs, ability to identify and safely respond to hazards, gas/brake/steering reaction time, and other physical and cognitive abilities. This evaluation may also examine the need for adaptive equipment to make driving easier for you. 

Our approach is to assess all of the abilities of a person who is driving – physical, cognitive, visual, perceptual, as well as driving behaviors. We start with a clinical assessment that takes one to two hours.  Following this, a person may be recommended for an in-vehicle assessment coordinated between the patient, their family/support, the occupational therapist, and one of our partner driving schools.
Following both assessments, recommendations are made to resume driving safely, pursue retraining on the road, pursue modifications/training for vehicles, pursue additional therapy to address areas of concerns, or refrain from driving. Alternative transportation options may be discussed as well. Reports are sent to the referring physician and may be sent to the Registry of Motor Vehicles.

A Driving Assessment is conducted by an occupational therapist at one of our six centers specializing in this evaluation. The occupational therapist has the opportunity to participate in training in the most advanced assessment tools and methods to ensure competent decision making both clinically and on the road.
The Spaulding occupational therapists who perform driving assessments have a unique benefit of being able to consult with each other as part of a team to allow the best quality of service for their patients. Our Spaulding occupational therapists are skilled in the assessment of vision, perception, cognition and mobility, as well as the complex interaction of all of these components during driving.

The Spaulding Rehabilitation Network is dedicated to researching innovative treatments for our patients who may need assistance with driving evaluations.


In-Vehicle Assessment

An on-the-road evaluation may be performed to determine your ability to drive safely in a closely supervised environment. This involves an in-traffic evaluation, helping to correlate the findings from the clinical tests with your on-the-road performance. This evaluation is performed in a vehicle that has an instructor’s brake, an occupational therapy, and a certified driving instructor. Results of both the clinical and road evaluations are sent to the referring physician along with specific recommendations, such as medical follow-up, outpatient therapy, driving lessons, or adaptations to your car to allow for safe driving. The evaluation is given on a self-pay basis and takes between two and three hours to complete.

Clinical Assessment
The clinical assessment utilizes evidence-based testing correlated to the skills required for driving. This includes vision, cognitive, and physical/reaction time testing.


Driving Assessments are offered at these Spaulding Outpatient Centers:

Spaulding Outpatient Center Sandwich
Spaulding Outpatient Center Wellesley
Spaulding Outpatient Center Braintree
Spaulding Outpatient Center Boston

Spaulding Hospital North Shore
Spaulding Rehabilitation Hospital Boston
Spaulding Rehabilitation Hospital Cape Cod


Assistive Technology Services

Image Goes HereIn the past decade, advances in computer technology and materials science have revolutionized the field of assistive and adaptive technologies. Assistive technologies can open new worlds for individuals with physical, communication, and cognitive limitations.
Technologies can help someone who is learning to live with a new disability compensate for his or her limitations. A new technology may also help someone with a chronic or progressive disabling condition maintain or improve his or her independence.
At Spaulding Rehabilitation Network’s (SRN) Assistive Technology Center in Boston, dedicated and experienced clinicians in physical therapy, occupational therapy, and speech-language pathology provide assessments and training with different types of assistive technologies.
Alternative Computer Access
 – People who are unable to use a standard keyboard or mouse due to physical, visual, or cognitive limitations may be able to operate a computer with alternative computer access technologies such as voice recognition, adaptive keyboards, a specialized mouse, or assistive software.

Assisted Memory and Information Processing
 – Electronic memory aids can benefit outpatients following brain injury, as well as individuals with dementia or other forms of memory loss. Small portable computing devices such as PDAs and smart phones can successfully aid individuals with memory loss.

 –  Spaulding’s Augmentative and Alternative Communication (AAC) program provides comprehensive evaluations and interventional strategies for those needing alternative or augmentative means of communication through use of a variety of different communication devices.  Augmentative and Alternative Communication is a set of strategies and methods to assist people who are unable to meet their communication needs through speech or writing. AAC strategies may include low-tech options (such as letter boards or communication books) or high technology devices that produce speech. These devices can be customized to meet the individual’s communication needs at home, at school, at work, and in the community. The goal is to provide communication skills that extend beyond simply conveying of basic wants and needs, and provides the means to allow each individual to be heard, and to express emotions.

Electronic Aids to Daily Living
 – People who have difficulty using their arms and hands to control objects during everyday activities can gain control through remote switches to operate household appliances and devices such as TV, stereo, lights, call bell devices, door openers, and thermostats.

 – Repetitive Strain Injury can make it difficult to use a standard computer set-up. Many people with wrist, shoulder, or neck pain may benefit from using ergonomic keyboards and mice, and from workstation modifications and body mechanics education.

Mobility, Seating, and Positioning
 – Wheelchair users may gain further independence through advanced wheelchair technologies. Some people may require modifications to a manual wheelchair; others may need a power wheelchair controlled by a joystick or a specialized switch, activated by sip and puff, or head movement.
Wheelchair users who have difficulty sitting upright, or who have postural abnormalities, may also benefit from customized seating and positioning systems. The systems use modified back supports, seating components, and tilt or recline features to meet an individual’s needs. The systems are designed so that users can achieve the best possible posture and can improve their performance of everyday activities.