Handwriting for Heroes – Learn to Write with Your Non-dominant Hand

Hanwriting for Heroes image

Learn to Write with your Non-dominant Hand in Six Weeks

Loosing hand dominancy after injury or a medical condition is a daunting task after years of developing manipulative skills of one’s preferred hand. A recent assessment of a vocational rehabilitation client in her late twenties who sustained a spinal stroke identified the need for compensatory tools and interventions to overcome barriers due to loss of her preferred hand. With continuing education the vocational goal to retrain her in a profession compatible with her mobility impairment, identifying compensatory tools as well as interventions to support use of her non-dominant hand was required. As a student, producing written communication to support coursework were among the goals identified by the client. In the area of written communication, efficient production of word-processed information as well as hand writing notes were identified client goals.

While several high-tech tools were identified to support access to the computer and written production, handwriting was also a concern for this client. While electronic tools for note taking are readily available, experience with assessing post-secondary students continues to find handwriting the most typical and familiar method of notetaking for students. A survey of students enrolled in Information Science post-secondary program found only 37% used electronic note taking (Fox, 2005) with 63% used hand writing when note taking. In the study, the use of electronic note taking further reduced when drawing figures or numbers were required during note taking (diagramming, math, chemistry, etc.) (Fox, 2005). Identifying compensatory methods of word processing were important for this client as well as low tech tools and interventions for re-training handwriting with her non-dominant hand.

Handwriting for Heroes, a systematic program to learn to write with your non-dominant hand, is a method of instruction for adults who need to “re-learn how to handwrite for individuals sustaining injury and loss of skills in their dominant hand. Written by experienced VA Occupational Therapists working with adults who sustained injuries to their dominant hand, the series of 6 weeks of graded lessons provides practice in development of in hand manipulation skills, visual motor and handwriting practice. Within the sequence of lessons, mindful exercises and positive affirmation embedded in the functional handwriting lessons are also provided to the user. In its 3rd, edition, this user manual provides daily guided practice to regain both cursive and manuscript handwriting skills in the six-week lesson format. For this client being assessed, Handwriting for Heroes seemed to be a great resource given the high interest in learning to handwrite with her non-dominant hand.

Purchase of the Handwriting for Heroes 3rd Edition manual allowed a more thorough review of the program. Over view of the program showed a well-developed manual offering six weeks of lessons and activities with the following writing and fine motor components:

  • Warm-ups (visual motor warm-ups)
  • Practice writing a sequence of single and series of letters
  • Range control, stretches (translation)
  • Writing and copying words and sentences with increasing neatness
  • Tracing word/letter formation within lines or pathways
  • Dot to dot, coloring within lines
  • Application of skills to functional tasks (writing lists, personal information, within blanks for sizing, money management tasks, recipes, e.g.)
  • Mindful activities

Lessons are functional, varied and progress with repeated practice throughout the program. Tips for therapists are also provided including posture, grasp patterns, lighting, and other positioning suggestions.

Adaptive equipment recommendations, like what pediatric therapists use for handwriting instruction, positioning and tool use are also provided:

The Handwriting for Heroes website offers several resources related to their program:

In addition to the recommended pens identified by the OT’s of Handwriting for Heroes program above, experience with evaluating vocational rehabilitation clients with mobility impairment (arthritis, reduced strength, pain, neurological disorders, Ehlers Danlos, e.g.) have found the following preferred adaptive pens/pencils and grips for handwriting tasks:

PenAgain image

Big fat arthritis pen image

Dr. Grip gel pen image

pencil grips

Conclusion

The Handwriting for Heroes 3rd Edition program is a well-organized manual providing sequential lessons for individuals interested in retraining handwriting with their non-dominant hand. The program offers lessons in the physical task involved in retraining as well as emotional guidance. The authors of Handwriting for Heroes also offer additional support when using the program including low tech equipment, positioning and intervention strategies. The Handwriting for Heroes website offers additional information on their program.

Regarding the vocational rehabilitation client assessed, she was motivated to use this program to learn to write with her non-dominant hand. After trial of different pens that would aid writing with decreased strength of her non-dominant hand, she chose the Super Big Fat Pens for Arthritis, a frequent low tech writing choice of clients I service with upper extremity strength and pain challenges.

H/T to the Occupational Therapist authors who dedicated their time in creating and publishing Handwriting for Heroes, offering a valuable resource to our OT Tool Kit.

More for your OT Tool Kit!

Carol – OT’s with Apps and Technology

References

Fox, J. (2005, November). A Survey of Electronic Note-Taking Behavior in Information and Library Science . Chapel Hill, NC, USA.

Posted in Adults, Assistive Technology, Fine Motor Development, Handwriting, Mobility Impairment, Notetaking,, Rehabilitation, Writing | Tagged , , , , | Leave a comment

Call Scotland – Android Apps for Learners with Dyslexia / Reading and Writing Difficulties

 

CALL Scotland, a service of the University of Edinburgh shares information and resources on assistive technology. They produce wonderful visual app wheels of apps and tools to support individuals with disabilities. They are a quick glance of tools or apps categorized within separate subcategories in their app wheels. One of their recent posters updated in 2018 presents Android Apps for Learners with Dyslexia / Reading and Writing Difficulties. This recent app wheel visually presents the already curated apps by subcategories that will support learners with reading and writing challenges.

image of Android apps for reading and writing for dyslexia

I love these app wheels and the subcategories to help identify new and old apps available. Check out the complete poster on their website: Android Apps for Learners with Dyslexia / Reading and Writing Difficulties.

Check out CALL Scotland posters and leaflets at their website.

H/T to CALL Scotland for their diligence with curating apps for special needs. Not an easy task when there are thousands of apps available!

More for your OT / AT Tool Kit!

Carol – OT’s with Apps and Technology

Posted in Android, Apps for OT's, Apps for Special Needs, Assistive Technology, Dysgraphia, Dyslexia, eBook Creating, Reading, Uncategorized, Writing | Tagged , , | Leave a comment

Livescribe Echo Pen Sound Stickers

picture of Echo pen with sound sticker on note cardsThe Livescribe Pens have been around since about 2010 offering a ink pen that scans what you write and records audio. It uses Livescribe’s specialized dot matrix note paper to synchronize the audio recorded with the handwriting notes you are writing. Nine years later this pen has undergone some model changes but essentially is the same pen and paper as from it’s inception. It is also still one of those handheld technologies that amazes student and parents often with comments “I wish I had that when I was in school”. The Livescribe Echo Pen continues to be a frequently chosen assistive tech tool  to support note taking for students with disabilities who may have mobility, learning or cognitive challenges due to its typical handwriting method used by most students I meet.

The Livescribe Echo Pen has a variety of type of paper and accessories. While the accessories have been around for quite some time (and some have come and gone, e.g. dictionary app), I haven’t taken the opportunity to utilize one of the accessories such as the Sound Stickers. I am not sure why, since I have had some leftover stickers supplied to me several months ago. Recently an online classmate inquired about the Sound Stickers and their potential use for individuals with low vision. It was time to check out the stickers to see how well they worked and consider application to the variety of clients services as well as individuals with low vision.

Livescribe Sound Sticker Trial

The asynchronous online class I am enrolled in uses video presentations within the assigned modules. Power Point slides of the video content is provided which I print out on hard copy paper due to my preference for handwriting notes when reviewing the videos. Applying the Sound Stickers (3/4” circle stickers) to the PPT slide handouts was a simple process as well as starting the audio recording requiring tapping the pen on a paper based recording icon then tapping the sound sticker to record for an individual with vision. Taping the sound sticker a second time stopped the audio recording on the sticker. I then could immediately tap the sound sticker to listen to audio message recorded. Visual information on the Echo Pen’s LCD screen provided guidance to using the Sound Stickers. The process to complete the recording and viewing the stickers and icons require vision, at least with initial use due to the low contrast stickers and recording icon and small print LCD screen.

As a functional application for identification of objects I used the sound stickers on   products around the house (different types of hair spray bottles, other hygiene and grooming items, canned goods, etc. ) to identify similar items or products using audio labels. While I could feel the stickers with careful tactile scanning and consistent placement, identification of these sticker by feel they would require adaptation for individuals with visual impairment using puffy paint or other tactile marking for ease of locating the stickers. Use of the recording icon would also need to be adapted with a tactile or high contrast marking to aid identification. Over all when locating the sticker and tapping with the pen, I was able to easily hear the recorded information identifying the object.

The Livescribe Sound Stickers comes in a pack of 1000 for approximately $20-25 and can be re-recorded. They are a great accessory if you own a pen, allowing recording of information when taking notes on standard paper such as handouts, study cards or even talking books. Multiple stickers can be placed on a paper/handout allowing recording or marking separate topics on a handout. The sound stickers also worked well to record information on real objects to aid identification, however if used by individuals with low vision, tactile markers and training on its use would aid locating the stickers, recording icon and sequence to record and play.

Image of sound stickers and recording icons

Alternatives to the Sound Stickers are Livescribe Sticky Notes offering small sticker notes that can be applied and recorded on.

Livescribe Sticky Notes

If using this with individuals with low vision providing high contrast or tactile marking to them would be important. Although this pen would work for identifying objects (with tactile or high contrast adaptation), purchasing this pen for the sole purpose, might not be the most accessible tool as you need an additional icon to start the recording and the need to charge it using a micro USB, difficult to plug in for individuals with visual impairment.

Other tools for labeling are available for individual with low vision which provide tactile buttons for operations (recording, sound, etc.), are battery operated, have stickers with tactile qualities and may be less expensive. A few of the talking label tools to consider might include:

Reizen Talking Label Wand – Voice Labeling System ($88.74) A handheld device with tactile buttons/controls that are also high contrast. Labels which also are washable are included with the purchase of the device. The device stores 2 GB of recorded information.Reizen label voice readerAdditional labels are available for the Reizen wand Reizen labels

PenFriend2 Voice Labeling System (149.75). A handheld device with tactile buttons/controls. Simple on/off system of recording is easy to use. Labels are provided with purchase of the pen. The device stores 4 GB of recorded information.

image of Penfriend2 talking labeler

Additional labels for the Penfriend2 can be purchased separately.

Conclusion

The Livescribe Echo Pen and Sound Stickers can be good tools for recording audio on paper handouts,  create talking labels for books and objects or used for non-writers to record answers on worksheets or handouts. The Sound Stickers were found to be best  suited to individuals with normal or near normal vision due to the low contrast stickers and recording icons, limited tactile quality and small, LCD screen providing instructions.  With adaptations and training, the Echo Pen, Notebook and Sound Stick could be used by individuals with visual impairment  however, other talking label devices are available that offer better accessibility to individuals with visual impairments such as the Reizen Talking Wand or PenFriend2 Voice Labeling System or  PenFriend2 Voice Labeling System

Have you used Livescribe Sound Sticker for other than note taking?

More for your OT / AT Tool Kit!

Carol, OT’s with Apps and Technology

Posted in Accessibility, Accessories, Assistive Technology, Learning Disability, Low Vision/ Blindness, Note Taking, Notetaking,, Uncategorized | Tagged , , , , | 2 Comments

New Emoji to Feature People with Disabilities — Assistive Technology at Easter Seals Crossroads

Easter Seals Crossroads shares the new Emoji’s  that will feature people with disabilities that Apple is proposing!

Emojii's for disabled proposed

There will be twelve new emoji released later on this year depicting the experiences of people with disabilities. The Unicode Consortium released 59 new emoji this week; among them are several images portraying various aspects of the disability experience. The Unicode Consortium is a “nonprofit corporation devoted to developing, maintaining, and promoting software internationalization standards…

via New Emoji to Feature People with Disabilities — Assistive Technology at Easter Seals Crossroads

H/T to the AT at Easter Seals Crossroads for sharing the new proposed emoji’s.

Carol

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Echo Show Accessibility Features — Assistive Technology at Easter Seals Crossroads

Echo Show pic

I received an Amazon Echo Show as a gift for Christmas and I love it! I set it up in my kitchen so recipes, news, music, and so much more are easily accessible. If you’re unfamiliar with the Echo Show, it is an Amazon Echo device optimized “for visuals and room-filling sound.” The device is jam-packed…

Read more about the accessibility features of the Amazon Echo as posted by the folks at Assistive Technology at Easter Seals Crossroads

H/T to AT at Easter Seals Crossroads for their adaptive tech review!

via Echo Show Accessibility Features — Assistive Technology at Easter Seals Crossroads

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Technology for Sound Sensitivity

image of distressed child covering ears

Sensitivity to sound, often referred to as auditory defensiveness or hyperacusis, can be a socially isolating condition hindering social participation for many of our clients or students. The Friendship Circle identifies different types of noise sensitivities as described in the online post, “Noise Control: 11 Tips for Helping your Child with Autism Deal with Noise” (Wang, 2014). Causes of hyperacusis are varied and may be due to neurological, otological. congenital, endocrine, medication among others (Hyperacusis Focus – Causes, 2019). As an occupational therapist, we often have many students exhibiting the symptoms of sensitivity to sound requiring intervention to assist with reducing isolation, avoidance or behavior challenges.

Treatment of hyperacusis is varied with severe cases requiring medical intervention and counseling (Hyperacusis Focus – Ear Plug Use, 2019). Other treatment methods can include desensitization, avoiding exposure, use of electronic hearing devices or noise cancelling ear protection as well as alternative treatments for stress reduction and symptom management (Hyperacusis Focus – Causes, 2019) (Wang, 2014).

As an occupational therapist in the school system a typical method of intervention is using noise cancelling ear muffs. Noise cancelling ear muffs are readily available, low cost, and can be independently applied by the student on demand. A wide variety of noise cancelling ear muffs are available that are affordable (see list or link below). Noise cancelling ear muffs however are not discreet in appearance, especially when used in the classroom where peers are not permitted use.

Student Case Study

A middle school student I work with has a long-standing history of sound  sensitivity. Ear muff continue to be needed for him to comfortably participate in assemblies and join peers in the cafeteria. Results of a sensory processing assessment indicated he still falls in the “more than most people” range in sensory sensitivity and avoiding,  with noise a major factor. As a middle school student transitioning soon to high school, exploring other discreet options that will continue to allow him to participate in school activities with his peers. Exploring options of noise reducing tools was discussed with his teacher and the student for self esteem and social acceptance as he transitions to the secondary level.

Noise Reduction Ear Plug Trial

One solution immediately trialed was providing him with a set of Vibes High Fidelity Noise Reduction Ear Plugs previously purchased and identified as a noise reduction tool used by individuals with autism (Lamb, 2018). While high fidelity noise reduction ear plugs are used by musician and employees who work with equipment or environments with loud and continuous noise, these noise reduction ear plugs also are known to support individuals with noise sensitivity. Noise reduction ear plugs decrease sound levels (dB), filter specific frequencies while maintaining the ability to hear and the quality of the sound. High fidelity noise reduction ear plugs each have different levels of sound reduction identified by the manufacturer and are just one of many types of sound reduction ear plugs available (sleep, work, shooting, flying, music, etc.) (Banks, 2018). Noise reduction HF ear plugs for musician are generally recommended for individuals with hyperacusis. The Vibes HF Ear Plug offer noise reduction up to 22 dB and come with different sized replaceable ear tips. Use of these types of noise filtering earplug, depending on the user, could also help grade exposure to sound, allowing some noise but filtering out louds sounds to help individuals with sound sensitivities increase their tolerance as recommended (Hyperacusis Focus, 2019).

The trial of the Vibes with the student was successful. He was motivated in using the low-profile ear plugs and applied them consistently during his school day to join peers at lunch time in the cafeteria. On a rare occasion he sought out eating in the resource room due to high noise and a report of “whistling sounds” with the noise level. This may be the result of a poor fitting ear tip or certain noise levels particularly challenging to his auditory processing. Although the Vibes have successful for the student, additional research on options for this student continued for this trial period.

Resources on Hyperacusis and Ear plugs

Helpful information about sound sensitivity and ear protection  was found at in the following articles and websites:

  • Lindsey Banks, Au.D. ‘s online article “The Ultimate Guide to Wearing (and Choosing) Ear Plugs”, (Banks, 2018). Her updated post provided great information on different kinds of ear plugs, purposes and a listing of “Best” earplugs in each category.
  • Hyperacusis Focus.org provided an excellent overview of the condition of hyperacusis. The concept of discouraging overprotection or over use of hearing protection was presented with evidence that it will lower loudness thresholds over time (the more you protect, the greater the sensitivity over time) (Hyperacusis Focus – Ear Plug Use, 2019). This evidence is similar to the recommendations for light sensitivity, the more you protect the greater the sensitivity and anxiety about exposure. Slow, graded exposure to sound is important to improve tolerance generally. This is typically evidenced with our students as they age.
  • “Noise Control: 11 Tips for Helping your Child with Autism Deal with Noise”, written by Karen Wang provides types of sound sensitivities, strategies for the condition, interventions as well as alternative treatments for the condition.

This general information provided good background information from a general viewpoint.

Ear Protection Options

Research and experience with noise cancelling ear protection identified the following ear protection options. There are many options on the market with the following being just a few gleaned from research:

Ear Muffs: Over the ear headsets or ear muffs are a handy, durable solution for individuals with sound sensitivities. A wide variety of headphones are readily available for children and adults in stores with sporting goods and sound equipment. Here are just a few ear muff recommendations:

High Fidelity Ear Plugs:

Livemusic earplugs image

  • Etymotic HF ER 20 Earplugs – (12.95) One pair, available in two sizes available (Large and standard) with 20 dB NNR.Etymotic earplugs
  • Etymotic HF Earplugs (ER20X; $19.95) High fidelity noise reduction ear plugs. Reduces nose by 20 dB. Available in large and standard size.

Some noise reducing earplugs comes with a case. strap or neck cord to help with maintaining and locating these small earplugs.

High Tech Noise Reduction Earplug Option

Other options for noise reduction include high tech active noise cancelling earplugs which have a microphone and a processor that produces anti-noise to cancel sounds. These earplugs are expensive with costs in the $300 range. An option to explore include the active noise cancelling earplug technology produced by QuietOn.

Summary: Low profile ear plugs are available to reduce noise levels for individuals with sound sensitivity, however, may be dependent on the users sound sensitivity, fit motivation and safety with use. Many options are available for ear protection, with standard ear muffs readily available and high-fidelity noise reduction earplugs which reduce certain levels of sound. High tech active noise cancelling ear plugs are also available at a much higher cost. Recommendations were found suggesting limiting overuse of noise cancelling ear protection which may contribute to reduced sound tolerance when used for a long period of time. A variety of intervention methods and strategies including medical, counseling, therapies and devices are available for individuals with sound sensitivities.

What other experience and recommendations do you have for noise cancelling headsets or earplugs?

More for your OT and AT Tool Kit!

Carol

References:

Banks, L. (2018, May 8). The Ultimate Guide to Wearing (and choosing) Ear Plugs. Retrieved from Everyday Hearing: https://www.everydayhearing.com/hearing-technology/articles/ear-plugs/

Hyperacusis Focus – Causes. (2019, February 3). Retrieved from Hyperacusis Focus : http://hyperacusisfocus.org/research/causes/

Hyperacusis Focus – Ear Plug Use. (2019, February 3). Retrieved from Hyperacusis Focus: http://hyperacusisfocus.org/other/

Lamb, E. (2018, February 19). Vibes High-Fidelity: EarPlugs for Autism and Sensory Processing Disorder. Retrieved from The Autism Cafe: https://theautismcafe.com/high-fidelity-earplugs-people-sensory-issues/

Wang, K. (2014, May 6). Noise Control: 11 Tips for Helping your Child with Autism Deal with Noise. Retrieved from Friendship Circle: https://www.friendshipcircle.org/blog/2014/05/06/noise-control-11-tips-for-helping-your-child-with-autism-deal-with-noise/

 

Posted in Activities of Daily Living, Assistive Technology, Hearing, Occupational Therapy, Self-regulation, Sensory Processing, Special education | Leave a comment

OrCam MyEye 2.0 – “A Game Changer”

orcam156-780x382A recent AT assessment with a client with low vision explored both computer based and handheld magnification tools as well as text to speech tools that would help her access print required of her online classes. Reading hard copy print (textbooks) is also a need with quantity of material required for her to consume for her classes. She also experiences visual fatigue and experiences unforeseen periods when her vision declines causing additional challenges in her functional vision.

One of the assistive reading tools, the OrCam MyEye 2.0, a wearable scanner with text to speech was trialed by the client as a low vision tool for accessing print with text to speech. This wearable device was described by the client as “a game changer”, allowing her access to her hard copy textbooks, computer print, some environmental print as trialed. Further discussion about the OrCam’s capabilities such as facial recognition and barcode scanning astonished her with immediate identification of ways this device could support her independence throughout her daily life.

OrCam

This new OrCam MyEye 2.0 is a small, discreet wearable computer that attaches to a glasses temple with magnets and offers gesture and  touch controls to activate scanning of text and barcodes to generate voice output. The scanning process is fast and amazingly accurate with a high quality text to speech voice.  As aforementioned, it can also be used for reading text on the computer,, reading restaurant menus as well as signage and articles, identifying colors, dollar bills as well as reading barcodes on goods at home and in the community. As the client almost instantly recognized, it’s functionality extends beyond just reading course textbooks.

For the client I was working with, of all products explored, the OrCam MyEye 2.0 was identified as the “game changer” that would support her academically but also aid her in many functional daily tasks. It’s discreet, mainstream appearance is also appealing for individuals who are concerned about how others may perceive them. .

The new OrCam MyEye 2.0 provides significant improvements when compared to the flagship model sold in 2016. The new OrCam MyEye 2.0 improvements offer:

  • Wireless model with battery life of 1-2 hours
  • My Eye 2.0 has been streamlined, now measuring approximately 2-3 inches in length with magnets used to easily attach the unit to glasses temple(s).
  • Size and positioning do not interfere with hearing aids or glasses frames.
  • Easy access controls on the exterior of the device (touch or tap) to activate scan and reading print.
  • My Eye 2.0 can now be positioned on the right or left side to accommodate handedness.
  • Improvements in facial recognition, product scanning, dollar bill identification make it easier to use.

Here is a video describing more of the OrCam MyEye 2.0

Where can you get the OrCam My Eyes 2.0 and receive training?

Check out the MyEyes 2.0 at Adaptive Technology Resources, a supplier with certified trainers!

As stated by the client, this wearable assistive technology tool is a “game changer” for some individual. Do you have clients who have used OrCam MyEye? It is an awesome product for the right client.

More for your OT, AT or LV Tool Kit!

Carol

 

Posted in Accessibility, Activities of Daily Living, Artificial Intelligence, Assistive Technology, Learning Disability, Life Skills, Low Vision/ Blindness, Uncategorized, Wearable technology | Tagged , , , , | Leave a comment