A short presentation on applying the HAAT model to ECU selection with a case study client with a C5 spinal cord injury. This was done as a final presentation as part of my BSc in Occupational Therapy.

1. ECUs
Environmental Control
Units: Selecting the
right one for your client
By Danielle I. Werner

2. 2
• COT Code of Ethics (2010) – the College is “committed
to client-centred practice” (COT 2010:v)
• Also see 3.3.2 (COT 2010:16)
• NSF for Long-term Conditions – „Quality requirement 1:
A person-centred service‟ (Department of Health (DH)
2005)
• Adoption vs. abandonment – influenced by perceived
relative advantage and involvement of client in
choice (Reimer-Reiss and Wacker 2000)
Personalised care –
why?
Danielle Werner - Assistive Technology

3. 3
• Assistive technology (AT) – any
device, service, strategy or practice that is used as an
aid in completing a task (Cook and Polgar 2008)
• Augmentative and alternative communication (AAC) –
AT used to overcome communication difficulties
(Cook and Polgar 2008)
• Environmental control unit (ECU) – a “device that
allows control of appliances” (Cook and Polgar 2008:
548); AKA:
• Environmental control system (ECS)
• Electronic aid to daily living (EADL)
Terms to know
Danielle Werner - Assistive Technology

4. 4
Human Activity
Assistive Technology
(Cook and Polgar 2008)
• Consider:
• What movements and
abilities are available
• What the client wants to
achieve
• The client‟s level of
expertise
• What environments the
client wants to have
control in
• The client‟s priorities!
HAAT model
Danielle Werner - Assistive Technology

5. 5
• Spinal cord injury at C5 due to skiing
accident
• Age 27
• Married
• Lives in a large ground floor flat with
ramp access, though currently in a
temporary residence until modifications
can be finalised
• Wants to be as independent as possible
in the home and needs a suitable ECU
• Also intends to work from home
Case study: Lorna
Danielle Werner - Assistive Technology
(Gille 2006)

6. 6
• Head, neck, some
Physical shoulder movements
Cognitive • Elbow flexion, not
extension (Cook and
Emotional Polgar 2008)
• Diaphragmatic
breathing, low stamina
• Assistance in coughing
and clearing secretions
(Apparelyzed.com 2012)
• Intact cognition
• Depression post-
accident, now motivated
What skills and
movements are available?
Danielle Werner - Assistive Technology

7. 7
• Important factor of human aspect
• „Novice‟ user first needs to grasp controls and learn
to cope with limited function
• „Expert‟ user can use unit creatively and
unconsciously (Cook and Polgar 2008)
What level of expertise
does the client have?
Danielle Werner - Assistive Technology

8. 8
• Direct selection When direct selection
• Remote is not ideal…
• Touchscreen
• Scanning
• Keyboard, modified
• Switch • Directed scanning
• Voice control • Row-column
• Joystick scanning
• Mouthstick • Coded access (e.g.
• Eyegaze Morse code)
• Etc. • Etc.
Human-technology
interface Test for
the best!
Danielle Werner - Assistive Technology
(Liberator 2012)

9. 9
• Lights?
• Doors?
• Phone?
Self-care
• TV?
• Computer? Productivity
• Chair? Leisure
• Etc.
• What are the client‟s
priorities?
What must the ECU
control?
Danielle Werner - Assistive Technology

10. 10
• Home?
Physical
• Office or school?
Social
• Layout of environment
• Number and position Cultural
of outlets Institutional
• ECU mounted on
wheelchair? Controls?
Display?
• Wheelchair controls?
• ALSO, what resources
are available?
In what environments
will the ECU be used?
Danielle Werner - Assistive Technology

11. 11
Signals
• Direct wiring
• X10 (via house
wiring)
• Wifi
• Ultrasound
• Infrared (IR)
• Radio frequency (RF)
Transmission
Danielle Werner - Assistive Technology

12. 12
Client‟s priorities! Ongoing support
• Aesthetics or • Progressive
function? condition?
• Speed, durability, batt • Novice  expert
ery life, reliability? • Change in priorities
• Which functions • Change in needs
should be at top of
list or first page
(depending on ECU)?
Other considerations
Danielle Werner - Assistive Technology

13. 13
(RSLSteeper no date)
• RSLSteeper‟s
evoassist and Remo
Phone
• Switch control using
available movements
(e.g. chin or mouth;
Cook and Polgar 2008)
• Typing stick for
computer use
(AbleData 2011)
(Apparelyzed.com
2012)
• Voice control (though
not as main control)
Choices for Lorna
Danielle Werner - Assistive Technology

14. 14
• Appropriate education can help prevent abandonment
• A „facilitator‟ should undertake training alongside client to
assist during the learning phase
• Information should be presented in small chunks so as
not to overwhelm the client (Cook and Polgar 2008)
• Ability to recall education also important indicator of
adoption vs. abandonment (Wielandt et al 2006)
• Education and support can come from other users who
have had similar experiences (Spinal Injuries Association
(SIA) no date)
(Apparelyzed 2012)
Education
and support
Danielle Werner - Assistive Technology

15. 15
TO CONCLUDE
• Selecting the best ECU requires a person-centred
approach
• Appropriate selection reduces abandonment
• Important considerations in selecting an ECU
include:
• Available skills and abilities of the client
• Possible ways of interaction with an ECU
• Desired functions
• Environment, and the limitations of certain signals
Danielle Werner - Assistive Technology