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CUSTOMIZING ADAPTATIONS FOR JOB DEVELOPMENT: A CASE STUDY

Caren Sax, Julie Grant, and Jack Hanzlik San Diego State University Interwork Institute

ABSTRACT

This case study provides an example of how the consideration of assistive technology enhances the job development process. The customized job adaptations described in this study were developed by a transdisciplinary team. This "Tech Team" was led by a 59-year old woman with cerebral palsy, who was interested in leaving sheltered employment to find her first competitive job. She decided to pursue employment based on her data entry skills. The team designed and constructed an adaptive device to increase her accuracy and speed. Using this adaptation to demonstrate her skills, she applied for employment as a data entry clerk. After she was hired, subsequent modifications to further customize the device were necessary to meet the specific demands of her job. Success on the job has led to many positive changes in her life including increased wages, interaction with co-workers without disabilities and an ever-widening circle of friends.

BACKGROUND

Sonia was born with severe physical disabilities as a result of cerebral palsy. She requires support to do almost all daily tasks, e.g., eating, dressing and making phone calls. Sonia has had a number of surgeries throughout her life in order to alleviate tendon and ligament contractures and increase her range of motion. Her only volitional and consistent muscle control is located in her neck muscles. Sonia operates her "tilt-in-space" power wheelchair controls with her chin and uses a head wand to access her keyboard.

Sonia's family had few expectations for their daughter, based on her intensive medical needs. After living at home for a brief time, Sonia spent the next 57 years living in convalescent and group homes. In 1983, she entered a sheltered workshop with the goal of attaining employment. Sonia spent the next 10 years performing data entry and word processing duties in the workshop. In 1993, Sonia volunteered to participate in a collaborative project between SDSU Interwork Institute and United Cerebral Palsy-San Diego called "Project Real Move". The mission of the project was to support people in the workshop in finding competitive employment in the community. Before a job search was initiated, Sonia met with project staff and friends from her church to talk about her dreams for the future. After experiencing several of these person centered planning meetings, Sonia was ready to explore the use of customized assistive technology for marketing herself to potential employers.

A referral was made to Interwork Institute's Applications of Technology project. The first step when any referral is submitted for consideration is to pinpoint the targeted activity and ensure that the outcome results in increased participation in the community. Sonia's idea met these criteria so the next step was to complete an assessment of her skills and needs. Typically, a videotape is made of the individual, preferably in the environment where the adaptation will be used. The initial video in this case was filmed at the workshop where Sonia continued to perform her data entry responsibilities.

OBJECTIVE

The objective for the first adaptation was to enable Sonia to enter data onto her computer more accurately and quickly. Sonia's strength and coordination were in her head and neck muscle control. She had learned to enter computer data using a head wand but said that her greatest challenge was keeping her place on the data sheet as her attention shifted from the keyboard to the computer screen and back to the data sheet. A switch-operated "highlighter" was made to meet this need, which helped Sonia to increase her speed immediately. After acquiring a job at Road Runner Sports, Inc., additional modifications were made to this device plus the following adaptations were constructed: 1) a device to hold and process catalog request postcards; 2) a drink holder/dispenser; and 3) two wheelchair posts to stabilize her arm movements.

METHOD

A Tech Team was formed to brainstorm solutions to meet Sonia's identified needs. Her original team involved her supervisor at the workshop, SDSU mechanical and electrical engineering students and "Real Move" project staff. The composition of tech teams may change as the needs of the individual change. In Sonia's case, one team designed the original device and another group of people formed a second team to make the subsequent modifications. Teams follow a design process which includes interviewing and assessing the individual who requested the adaptation, researching assistive technology sources to locate commercially available items, designing a prototype, field testing the model and finally, building the adaptation (Sax & Kozole, 1994).

The development of Sonia's device began with the team modifying a free-standing clipboard to hold Sonia's data sheet. At the top of the clipboard, a 9 volt DC motor was used to advance a horizontally mounted drive shaft. The drive shaft was connected to a second shaft, located at the lower portion of the clipboard, by two vertical belts holding a single, horizontally mounted 2" x 10" piece of clear Plexiglasª. This Plexiglasª strip "highlights" the targeted line on her data sheet. The control logic allows Sonia to index the "highlighter" one line at a time by pressing a large switch with her head wand. When the highlighter reaches the last line of information, a trigger switch returns the highlighter to the top of the page, so that a new data sheet may be manually inserted. The highlighter guide was calibrated to accommodate various predetermined line settings. By selecting one of three settings, Sonia was able to customize the device to meet her changing data entry needs. The clipboard highlighter is designed to be free-standing, with an integrated keyboard and base that can be adjusted for different seating angles, thus maintaining the optimum placement. Sonia became adept at using the device and quickly increased her productivity and accuracy. Project staff involved in the job development search designed a "portfolio" to showcase Sonia and her new device to potential employers. The portfolio included a short video and pictures of Sonia using the device as well as a resume and samples of work.

After seeing Sonia's portfolio, the manager of Road Runner Sports, Inc. offered her a job entering information that was written on 3"x5" catalog request postcards into a database. A new device was required for Sonia to accomplish this job. Sonia's Tech Team reconvened with a new member, a representative from Road Runner who was familiar with the data entry requirements of the postcards. The new device was an oversized Plexiglasª copyholder, supported at an 45 degree angle with adjustable brackets, and fitted with three 3"x 3"x5" bins placed horizontally across the top. A stack of postcards ready for data entry were placed in the middle bin, against a spring-loaded surface. After entering the data, Sonia used her head wand to move the card to the bin on the right side. If she encountered a card that she could not read, she moved it to the left bin to be checked by a co-worker. Shortly after Sonia's starting date, the company temporarily ceased the postcard campaign and it appeared that Sonia's job was in jeopardy. With further discussion between Road Runner and Interwork staff, they realized that there seemed to be an endless supply of address changes to correct. The tech team convened once again to modify Sonia's original "highlighter" device according to the job requirements. The new, improved version accommodated 15" wide computer paper which was inserted horizontally. This device became the cornerstone upon which all of her job duties were assigned. Sonia thought that she might be able to improve her performance if the printout was enlarged. One of her co-workers volunteered to do this on an ongoing basis.

As Sonia became more comfortable with her new surroundings, she began to think of other adaptations that might make her time at work more accessible and comfortable. First, she asked for a device that she could use for drinking. As her arms were difficult to control, it was not feasible to secure anything to her laptray. Ongoing technology support was provided by one of the members of her team, a graduate student in biomechanics. He mounted a Camelbackª drinking system to the back of her wheelchair and attached a flexible copper lever to place the sipping spout within her reach. This system worked well, but required considerable effort to refill and clean. As the next, unrelated, modification was designed, a better solution was discovered for her drinking.

Due to the spasticity in Sonia's arms and the hyperextension in her fingers and wrists, she had difficulty maneuvering through doorways. This has led to the loss of fingernails, near sprains, and muscle strains. The simplest solution was to mount two vertically-oriented, curved posts to her laptray. She was easily able to place her hands inside of these restraining posts, away from the door frame, as she passed through the door. These posts were created using 1/2" x 12" PVC risers that were secured to the laptray via a 3/8" x 6" lag bolt. In the case of Sonia's right hand, the post was curved slightly by using a heat gun to soften the PVC. The PVC was covered with tube foam, and then wrapped with electrical tape. These posts served as a robust mount for Sonia's next drinking device.

The drinking adaptation was made from a standard cup holder, the type that attaches to the inside of a car window. The hook portion was cut away and the remaining frame was pop-riveted to a 6" length of 1" diameter PVC pipe. Two longitudinal cuts were made along the entire length of the pipe, effectively removing one-third of the PVC and creating a c-shaped clip, when viewed in cross-section. The c-clip was then warmed with a heat gun and spread open another 15% in order to increase its diameter. Sonia's large water bottle fits in this cup holder which then slides onto her left hand post. Twenty-four inch lengths of clear acrylic tubing were heated and bent to an appropriate angle for Sonia to use as straws.

Sonia's devices are not failproof and require occasional adjustment. Sonia, her co-workers, and her other support staff continue to notice items that can be improved by simply changing a fastener or relocating a component to a position that takes greater advantage of her muscle coordination. As Sonia increases her use of assistive technology, she demonstrates to others how much is possible with teamwork and creativity.

RESULTS

By developing a device that showcased Sonia's computer capabilities, the project staff was able to develop a rewarding job for Sonia in the field of her choice. The device was the lens through which potential employers could "see" past her disability onto what she was capable of doing. She has surpassed what anyone thought she would accomplish and much to her delight is now making a rewarding $5.00/hour compared to $3.00 a day at the sheltered workshop. By working 20 hours a week she now has enough money to purchase more than just the bare necessities and has achieved her dream of moving out of a group home and into an apartment of her choice. As Sonia recently stated, "Look how far I have come since I started this job! I feel like I am finally in the world and not in the institution." There has also been increased awareness by those around Sonia of her competence and emerging independence. She now feels that others take her opinions more seriously and can see past her limitations to the whole person she really is.

DISCUSSION

It is important to note that each successful device revealed more of Sonia's capabilities which led to the development of additional modifications and increased her independence at the jobsite. The following components were central to the success of this process. First, the transdisciplinary approach allowed for more creative brainstorming and utilized various types of available expertise. Second, with Sonia in the lead, the Tech Team was able to create a device that maximized her potential and was customized according to her needs and preferences. Third, the involvement and commitment of the manager and co-workers at Road Runner was critical in identifying the most essential aspects of her job. In addition, they provided feedback on prototypes so that Sonia would be performing duties important to the company, thereby making her a valued employee.

REFERENCES

Sax, C., & Kozole, K. (1994). Consumer-driven tech teams: Creating customized adaptations. Proceedings of the Ninth Annual International Conference of Technology and Persons with Disabilities, Los Angeles.

ACKNOWLEDGEMENTS

US Department of Education Grant Award #H235C30052 Program title: "Applications of Technology: A Community Model"

US Department of Education Grant Award #H128N20003 Program title: "Community Based Projects: Project Real Move"

Special thanks to Sonia, Road Runner Sports, Inc., and all of the engineering students who helped with the job adaptations.

Caren Sax Interwork Institute San Diego State University 5850 Hardy Avenue, #112 San Diego, CA 92182 619/594-7183 FAX: 619/59404208 csax@mail.sdsu.edu