Module 1 individual autonomy

I NDI VI DUAL AUTONOMY Sus t a i na bl eNe t wor k f ort hef a mi l i e s ofdi s a bl e dpe opl e t hr oughel e a r ni ng

MODULE 1

MODULE 1 INDIVIDUAL AUTONOMY

Table of content Table of content ............................................................................................................................ 1 Preamble ................................................................................................................................... 2 What is the individual and behavioural autonomy? ................................................................. 6 1.1. Capacity of people with disabilities to make a choice ..................................................... 10 1.1.1 What is important when person with disability make a choice? ............................... 11 1.1.2 Best Practice Examples – Personal Autonomy Promotion ......................................... 13 1.1.3.

Two exercises ...................................................................................................... 15

1.2 Capacity of disabled person to find resources .................................................................. 16 1.2.1 Four principles ............................................................................................................ 16 1.2.2. Assessing capacity and resources ............................................................................. 17 1.2.3 Relative’s best interest ............................................................................................... 19 1.2.4 Practical exercise ........................................................................................................ 20 1.3. Capacity to support disabled persons in usage of assistive technologies ....................... 21 1.3.1 What is assistive technology? .................................................................................... 21 1.3.1 The Assistive technologies inclusion into education, employment and daily life...... 25 1.3.2 Selecting the appropriate AT solution........................................................................ 28 1.3.3. Categories of ICT AT for the computer...................................................................... 31 1.3.4. PCs, smartphones, and tablets as communication devices ...................................... 33 1.3.5 Alternatives for standard keyboards .......................................................................... 41 1.3.6. Alternatives for standard mouse............................................................................... 44 1.3.8. Voice Recognition...................................................................................................... 48 1.3.9. Software facilitating general PC functions ................................................................ 48 1.3.10. Writing aid software................................................................................................ 51 1.3.11. Reading aid software............................................................................................... 52 1.3.13. Case studies ............................................................................................................. 55 Case Study 1 - AT accommodations for learning disabilities .......................................... 55 Case Study 2 – AT accommodations for upper limbs’ limited function .......................... 55 Case Study 3 – AT accommodations for daily communication (combined speech and mobility disabilities) ........................................................................................................ 56 Case Study 4 – AT accommodations for hard of hearing ................................................ 56 This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information 1 contained therein.

MODULE 1 INDIVIDUAL AUTONOMY Case Study 5 – AT accommodations for deafness .......................................................... 56 Case Study 6 – AT accommodations for chronic fatigue syndrome................................ 57 Case Study 7 – AT accommodations for low vision ......................................................... 57 Case Study 8 - Web Access for Student who is Blind ...................................................... 57 Case Study 9 – AT accommodations for employee with obsessive-compulsive disorder (OCD) ............................................................................................................................... 58 Case Study 10 - AT accommodations for a person with Autism ..................................... 58 1.3.14. Examples of reasonable adjustments (ICT and non-ICT based) .............................. 58 1.3.15. National databases with AT information ................................................................ 59 1.4 Active behaviour in terms of: personal hygiene, proper dressing and travelling ............. 60 1.4.1. Personal hygiene ....................................................................................................... 60 1.4.2. Suggestions for dressing............................................................................................ 66 1.4.2.1 First impression and image ................................................................................. 66 1.4.2.2. Suggestion for proper dressing for male............................................................ 68 1.4.2.3 Suggestion for proper dressing for female ......................................................... 69 Appendix 1 Hints while organising a trip ............................................................................ 70

Preamble

This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information 2 contained therein.

MODULE 1 INDIVIDUAL AUTONOMY This first unit consists of four learning objectives related to the parents of child with a disability namely: 1.1

Capacity of disabled person to

make a choice 1.2

Capacity of disabled person to

find resources 1.3

Capacity to support disabled

person

in

usage

of

assistive

technologies 1.4

Active behaviour in terms of:

personal hygiene, proper dressing and travelling.

Fig. 1.1 Autonomy sign

The main aim is to discover how to create opportunities of individual autonomy, by developing of competencies and support, based on the International Convention for the Rights of Persons with disabilities in the art. 19 – “Living independently and being included in the community” – recognize the equal right of all persons with disability to live in the community, with choices equal to the others, and shall take the effective and appropriate measures to facilitate full enjoyment by persons with disabilities of rights and their full inclusion and participation in the community including by ensuring that: a. Persons with disabilities have the opportunity to choose their place of residence and where and with whom they live on an equal basis with others and are not obliged to live in a particular living arrangement; b. Persons with disabilities have access to a range of in-home, residential and other community support services, including personal assistance necessary to support living and inclusion in the community, and to prevent isolation or segregation from the community;

This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information 3 contained therein.

MODULE 1 INDIVIDUAL AUTONOMY c. Community services and facilities for the general population are available on an equal basis to persons with disabilities and are responsive to their needs.

Fig. 1. UN Convention

There are as yet no universally accepted categorizations of disability. Commonly used disability terminology varies from country to country and also between different communities.

According to the Convention on the Rights of Persons with Disabilities disability results from the interaction between persons with impairments and attitudinal and environmental barriers that hinders their full and effective participation in society on an equal basis with others. Nowadays the term used is "people with disabilities". It is argued under the social model that while someone's impairment (for example mobility) is an individual property, "disability" is something created by external societal factors such as a lack of physical access to the workplace or whatever social service and goods that the person might use.

Abilities can vary from person to person or from disability organisation to similar one, and over time, for different people with the same type of disability.

People can have combinations of different disabilities, and combinations of varying levels of severity. Some people with various conditions would not consider themselves to have disabilities. They may, however, This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information 4 contained therein.

MODULE 1 INDIVIDUAL AUTONOMY have limitations of sensory, physical or cognitive functioning which can affect access to the services. These may include injury-related and aging-related conditions, and can be temporary or chronic. Also, the number and severity of limitations tend to increase as people age, and may include changes in vision, hearing, memory, or motor function.

Fig. 1.3 Self-directed child

On the other side, Whemeyer’s functional model of individual autonomy, that is the most widely used ones, is taken as reference. Actually, his theory remarks the importance of the “casual agency”, at the same time the opportunities of the environment are important for the quality of life (Whemeyer and Shalok, 2001).

Fig. 1.4 Whemeyer’s functional model

According to Whemeyer’s model, in terms of behavioural autonomy he means “acting as a causal agent in one self’s life, making choices, and making decisions on the one self’s life, free from undue external influences and interferences”.

The biopsychosocial model (abbreviated "BPS") is a general model or approach stating that biological, psychological (which entails thoughts, emotions, and behaviours), and social (socio-economical, socio-environmental, and cultural) factors, all play a significant role in human functioning in the context of disease or illness. Indeed, health is best understood in terms of a combination of biological, psychological, and social factors rather than purely in biological terms.

This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information 5 contained therein.

MODULE 1 INDIVIDUAL AUTONOMY

Fig. 1.5 The biopsychosocial model - diagram

What is the individual and behavioural autonomy?

Individual autonomy is a process in which people gradually acquire different skills and abilities, such as control, empowerment, experience, and making choices all along their lives. The decision making process is the expression of a person’s will, priorities and personality. In addition, the theory that everyone is able to make choices and decisions is the base of the behavioural autonomy as human right, and presupposes to respect individuals’ choices and to accept that they learn lessons from mistakes and taking into account available alternatives. In that sense, disable people have more difficulties in achieving autonomy.

This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information 6 contained therein.

MODULE 1 INDIVIDUAL AUTONOMY

Fig. 1.5 Autonomy

The development of the behavioural autonomy starts at an early stage and continues all along our lives. It is convenient evidence that the notion of behavioural autonomy gathers some erroneous meanings, which it could be suitable to remind in this section.

Behavioural autonomy is not

Behavioural autonomy consists in:

To make choices without guidelines, To make decisions based on conscious criteria, rules

needs, wishes, preferences, priorities and to

be

able

communicating

them

effectively To do only what someone likes, wants, To be conscious of preferences and prefers or expect from me

priorities

Acting and do not take responsibility for it To make actions based on preferences, interests, wishes, needs To make a choice on transitory pleasure

To evaluate the efficiency of decisions

This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information 7 contained therein.

MODULE 1 INDIVIDUAL AUTONOMY based on results of previous experience and reviewing future decisions To do things for oneself without help

Auto regulation of one self’s conduct and to establish personal goals

To solve problems without help

To consider multiples options and consequences of actions

Acting according to what other persons’ To start happenings in life and carry think

actions, when it is necessary

To have prejudice on the other person’s To have positive believes and selfpossibilities

confidence

To substitute what one self can do alone

To know and recognise between wishes and needs

Moreover, behavioural autonomy concerns aptitude as respect, appreciation, compassion, sympathy, listening, support, and look in different way. The term expresses opportunity, autonomy, dignity, selfknowledge, participation, help, hope, fears, dreams, and responsibility.

The disable person has to be recognised as “other” in front of me with who we can share learning and we can teach in the respect of his/her preferences, making he/she takes an active role in the traininglearning process and in the others spheres of his/her life.

Fig. 1.6 I love autonomy

Everybody can have limitations in the construction of one self’s autonomy, depending of different aspects, but people with disabilities might face more difficulties in order to achieve such independence in a natural way in their lives.

This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information 8 contained therein.

MODULE 1 INDIVIDUAL AUTONOMY

There are some advantages that make a person gain autonomy: 1. The social environment should recognise that a disable person can have control on his own life.

2. The

person’s

life

style

offers

the

opportunity of participation in different situations,

activities,

roles

and

relationships.

3. The

person

has

psychological

empowerment and self confidence in his own possibilities to make things different.

4. The

person

learns

the

necessary

competencies and receives the essential support.

Fig. 1.7 Autonomous person

To achieve a behavioural autonomy it is required direct and indirect experience. There are different way for sharing information and experience, through books, pictures, films, and similar. It is a critical part of the acquiring autonomy process, because, on one side, without experience there is not a real autonomy; on the other side, the selfconfidence comes from experience of large life lessons and lived situations, but sometimes it is limited.

Moreover, the kind of experience received (positive or negative) could affect a person’s autonomy capacity, and the level of self-confidence. On the other hand, it is important to stress that a disable person could not have sufficient experience uploaded in relation with skills and abilities. Therefore, he/she will need of more support in order to develop the adequate level required.

This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information 9 contained therein.

MODULE 1 INDIVIDUAL AUTONOMY 1.1. Capacity of people with disabilities to make a choice

Fig. 1.8 Make a choice

Choice making is an important skill for the definition of a behavioural autonomy. It can be distinguished among: 1. Making a choice among a lot of options. It should help to keep in mind preferences.

For

example,

about

nutritional

needs

and

independence,

experimenting different texture and colour of foods should provide variety which keeps in mind.

2. Making a choice between two options. Try to provide choice, for example in nutritional needs, for disable person this helps keeping in mind to limit the choices This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information 10 contained therein.

MODULE 1 INDIVIDUAL AUTONOMY to two options.

For example: “Would you like carrots or peas?� Choice should

keep in mind.

Fig. 1.9 Make a choice could be difficult

3. Accepting or refusing options.

4. Making decisions concerns to decide important things for our life.

Fig. 1.10 Decision making

1.1.1 What is important when person with disability make a choice?

Having choice is important in improving health, maintaining independence and retaining chosen identities. However, exercising choice can be hampered by lack of information or acceptable options.

Information is a precondition for choice; people are not always aware they have choices about services. People with gradually increasing support needs and no prior

This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information 11 contained therein.

MODULE 1 INDIVIDUAL AUTONOMY knowledge about services can be disadvantaged by their lack of access to relevant information at the pre-choice stage.

Fig. 1.11 choosing between solutions

The process of making choices creates some positive emotions. Try to avoid negative emotions which can lead to delays in making choices, thus also delaying any resulting benefits.

People revisit choices particularly after: changes in health or social circumstances; realizing the outcomes of previous choices is not satisfactory; People instigating revisions to choices of their own accord, and who have little contact with professionals, can lack support.

People learn from both the processes and the outcomes of making choices. They share their learning with other people and learn from the experiences of others. However, opportunities for learning can be restricted for some people by the complexity of their conditions, or by limited life opportunities.

Independence means different things to different people including being able to do things alone, make decisions, and be in control of one’s life. However, the relationship between choice and independence is not simple; choices that sustain independence in This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information 12 contained therein.

MODULE 1 INDIVIDUAL AUTONOMY one aspect of life can create dependency in other domains, or restrict the independence of other people.

The process of making choices is not simple. There is no “right” recipe for the “right” choices. Even when a person with disability makes all and the same steps these do not mean that the final result would be always successful.

Here are some important aspects of decision making process that the person with disability may take into consideration: 1. Provide all necessarily and relevant information.

2. Investigate and evaluate possible alternatives.

3. Be aware of existing limitations e.g. financial, environmental, social, behaviour etc.

4. Identify advantages and disadvantages of possible choice and see which ones predominate.

5. Be aware of consequences and impact that the choice may have on the person and his/her relatives.

6. Make the decision on time.

Fig. 1.12 Decision making II

1.1.2 Best Practice Examples – Personal Autonomy Promotion

In the social context to make choices, making decisions, defending one-self, construct objectives, and solving problems, lead to be more independent and are a challenge for people with disability. The social environment, family, friends, colleagues, can help disable people giving support in order to get experiences, because the learning starts from real opportunities and life experience, using the appropriate and necessary competences and skills for each specific situation. It is more important to people with This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information 13 contained therein.

MODULE 1 INDIVIDUAL AUTONOMY learning disability, who cannot think about situation in abstract and they need the sufficient repetition of facts and happenings in order to induce the successfully learning, suitable in the future.

Fig. 1.13 Parent and a child

Therefore, it is important to deliver practical moment along the daily life to improve their competences, as the following real cases:

When a person tries to do Pablo says “NO” when his In this case, it is such competences

mate asks him money.

important to strength positively the use of “NO”, in order to reproduce in the future

This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information 14 contained therein.

MODULE 1 INDIVIDUAL AUTONOMY the same situation When the person ask for help When Mary asks for help It is important to use to make an activity

because somebody insults support and her

reinforcement, in order she could do it alone in the future successfully

When somebody does things When Helen goes to a she has to decide what the same person could do

coffee-shop

she wants to take, and where she is going to seat

When there is a behaviour Before problem

the

problem We should teach how to

happens

front it, by the use of the most appropriate competence, skill

Benito has whims when he Professionals, family wants people helps him

members should indicate that he has to sign for help before his whims starts

1.1.3. Two exercises

1. Ask your relative with disability to choose how to present him/herself through illustration. Then comment together with him/her what was paint and why s/he decided to present in this way?

2. Having in mind the six important aspects listed above, please ask the relative to find a photo/image which illustrates each of the mentioned aspects. You can choose them from magazines, newspapers or from internet.

This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information 15 contained therein.

MODULE 1 INDIVIDUAL AUTONOMY

1.2 Capacity of disabled person to find resources 1.2.1 Four principles

The ability to make decisions and to find resources is sometimes called mental capacity.

We must begin by assuming that people including those with disabilities have capacity.

“A person must be assumed to have capacity.”

People must be helped to make decisions

on

their

personal

life,

education, training, employment, social life and social inclusion.

Fig. 1.14 Parents with the disabled child

“A person is not to be treated as unable to make a decision unless all practicable steps to help him/her to do so have been taken without success.”

Unwise decisions or non-utilized resources do not necessarily mean lack of capacity.

“A person is not to be treated as unable to make a decision and to find resources merely because he/she makes an unwise decision.”

Decisions must be taken in the person’s best interests.

Some people with learning disabilities have difficulty making a decision but can make it themselves with the right support. The family and professionals is usually best placed to know more about what kind of support is needed in these situations and can either provide it to the relative themselves or advise others about how to do so. This might be by providing the relative with information about potential consequences of the This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information 16 contained therein.

MODULE 1 INDIVIDUAL AUTONOMY decision, the options they have, the resources they have, by making information accessible, or helping them to “communicate” their decision.

The parents of persons with disabilities and their relatives should know that there is an option that a professional or paid worker may need to make a decision if they believe that they cannot decide on their own. In these situations they are known as the ‘decision-maker’ and it is their duty to ensure an assessment of the person’s capacity is carried out before any decisions are made in a person’s best interests.

If the decision is a major one, they may ask a specialist (such as a psychologist or a speech and language therapist) to help them assess the person’s capacity and the available resources.

Whoever carries out the assessment will often ask a family carer for advice and information to assist the person with disability, for example about the best way to communicate with the person.

1.2.2. Assessing capacity and resources

Anyone assessing capacity and resources has to answer a set of questions: •

Does the person who seems to lack capacity have a general understanding of what decision needs to be made?

•

Do they have a general understanding of the consequences of this decision?

•

Can they weigh up this information and use it to make a decision?

Fig. 1.15 Capacity and resources

This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information 17 contained therein.

MODULE 1 INDIVIDUAL AUTONOMY

•

Is there any way you could help them to make the decision for themselves?

•

Is there any way you can help them communicate their decision or their wishes and feelings?

•

Is the person able to evaluate and utilize the available resource while making a decision?

If an assessment has been carried out by someone else, you as a parent or relative may want to check that the following considerations have been taken into account where a major decision has been made: •

Was expert help with the assessment of capacity and resources required and was it sought? Such help might be provided by a psychiatrist, psychologist, social worker, or speech and language therapist.

•

Whether or not expert help was provided, responsibility for ensuring that an assessment is carried out remains with the decision-maker.

•

The health and care staff supporting your relative with disability should have received training to carry out assessments of capacity.

•

Health and social care services must be able to show how they carried out an assessment. Where a major decision is to be made, details of the assessment should be written down.

•

If your relative has a care plan, it should set out how issues of capacity and resources are dealt with.

It is important to establish whether your relative has expressed any views in the past that might affect the decision under consideration. This might be things they have written down, said to other people, or how they have behaved in similar circumstances in the past. Similarly, any beliefs or values that your relative is known to have held should be taken into account when considering their best interests.

This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information 18 contained therein.

MODULE 1 INDIVIDUAL AUTONOMY

1.2.3 Relative’s best interest

Fig. 1.16 putting children interests first

These are some other considerations that you as a parent may wish to bear in mind when considering a relative’s best interests: •

There are some decisions that you can never take on behalf of your relative.

•

These are usually to do with very personal issues such as entering into a sexual relationship, getting married, getting a divorce or adopting children.

•

If the decision is about life-sustaining treatment, the decision must not be motivated by a desire to bring about your relative’s death.

•

Some best interests’ processes happen very quickly by necessity because of a medical emergency or a potentially dangerous situation. In these situations it may not be possible for a decision-maker to follow every aspect of the process or consult with family carers before acting.

This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information 19 contained therein.

MODULE 1 INDIVIDUAL AUTONOMY

As with any decision, those relating to a person’s financial resources must each be considered on their own merits, since many people with learning disabilities will be able to make some decisions about their money.

A financial assessment or money plan may be drawn up, detailing a person’s capacity to make financial decisions on financial resources, and how decisions can be made by, with and for that person. These are particularly useful for people who support adults with learning disabilities living independently, or planning to live independently. Family want to be sure that good arrangements are in place to protect the best interests of a relative who may lack capacity to make decisions about their financial resources. These may range from day-to-day decisions about shopping for food or clothes, to opening a bank account, managing benefits payments and buying a house.

A family member can be the recipient of a direct payment on behalf of a disabled child.

To receive a direct payment themselves when they reach the age of 18, the disabled person must be able to consent to receive the direct payment (or the payment can be made to a third party).

1.2.4 Practical exercise

The parent initiate a discussion with his her child with disability on example how s/he cope with certain life situation using his/her own resources and strengths. The parent listed all mentioned resources and strengths and discuss with the disabled person how these resources can be utilized and how the strengths can be increased. They also discuss how their resources/strengths can be possible exploited in other life situations when the person with disability needs to find a solution. In case of need the exercise can be repeated after 10 days.

This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information 20 contained therein.

MODULE 1 INDIVIDUAL AUTONOMY 1.3. Capacity to support disabled persons in usage of assistive technologies

Fig. 1.17 Assistive technologies

1.3.1 What is assistive technology?

Fig. 1.18 what’s assistive technologies

The term “Assistive technology” device as “any item, piece of equipment, or product system, whether acquired commercially, modified, or customized, that is used to increase, maintain, or improve the functional capabilities of individuals with disabilities” (29 U.S.C. 3002). Assistive technologies can be subdivided to distinguish many kinds of products. For example, personal assistive devices—such as canes, scooters, hearing aids, and magnifying glasses—act, essentially, as extensions of a person’s physical capacities. They often move with the person from place to place.

This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information 21 contained therein.

MODULE 1 INDIVIDUAL AUTONOMY Adaptive assistive devices make an inaccessible mainstream or general use device usable by a person with a disability, although usually at additional cost. One example is the computer screen reader, which allows people with low vision to hear what is shown on a computer screen, for example, text documents.

Fig. 1.19 a child with disability is using assistive technologies for PC

Fig. 1.20 a child with disability is using assistive technologies for PC (2) This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information 22 contained therein.

MODULE 1 INDIVIDUAL AUTONOMY

Fig. 1.21 a child with disability is using assistive technologies for PC (3)

Fig. 1.22 a child with disability is using assistive technologies for PC (4)

This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information 23 contained therein.

MODULE 1 INDIVIDUAL AUTONOMY There is a growing literature on the role on information and communication technology (ICT), including social media, in improving the independence and social connectedness of people with disabilities. Potential of the assistive technology (AT) to promote independence among people with disability is directly linked to the improvement of the quality of their lives and their long-term care. Moreover, they can improve their social inclusion.

The United Nations Convention on the Rights of Persons with Disabilities 2008 (CRPD) addresses the issue of the provision and use of assistive technology, and requires states signatories to take measures to ensure that people with disabilities have access to it.

Autonomy and inclusion. Choice and control. Dignity and equality.

Fig. 1.23 a child with disability is using assistive technologies for PC (5)

Most people take these for granted as part of their everyday lives. However, for many people with disabilities, these are often everyday dreams, everyday challenges, and everyday struggles.

In the last decade disability rights has risen up the political agenda; problems were identified, data was collected and, most significantly, an international legal framework was put in place. The UN Convention on the Rights of People with Disabilities (CRPD) came into force in 2008. It is the first international human rights treaty signed by the EU itself. The EU as well as those Member States that have ratified the Convention are now bound to respect the rights enshrined in the Convention at both EU and at national level.

This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information 24 contained therein.

MODULE 1 INDIVIDUAL AUTONOMY The right to independent living signifies the following for persons with disabilities1: •

First, it represents increased autonomy and inclusion: o Being able to make decisions about one’s own life is fundamental o Equally important is to be part of the community, to feel accepted

•

Second, it also represents increased choice and control: o Being able to choose where to live and with whom

•

Third, it represents respect towards an individual’s dignity and equality: o Being given the same opportunity as others or having their voice heard so that specific issues are presented by them o Having a say in how to be treated

1.3.1 The Assistive technologies inclusion into education, employment and daily life.

Participating in education is a crucial element for people with disabilities and this can be made possible in a variety of ways: •

A student with hearing difficulties may wish to have access to the hearing loop/infrared system or for the lecturer to use a micro link to their radio aid.

•

A blind student or someone who deals with vision challenges may require hand-outs and course presentations in Braille/electronic/audio or large print format, or even use magnifying equipment.

•

Students with learning disabilities may need to record lectures and obtain official consent for this.

•

Some students could also use captioning/transcripts of video presentation (i.e. use closed or open captioned videos or have transcripts available) or FM systems with certain receivers (e.g. neck loop, ear bud) which allow direct sound from the microphone to the student without extraneous noises.

1

http://fra.europa.eu/en/speech/2012/autonomy-and-inclusion-people-disabilities

This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information 25 contained therein.

MODULE 1 INDIVIDUAL AUTONOMY •

Adjustable computer settings and peripherals for those with physical and mobility disabilities in order to access course materials, school/university announcements, lab material, etc.

Fig. 1.24 a child with disability is using assistive technologies for PC (6)

Employees with disabilities are responsible for initiating the process of identifying appropriate AT. They have to identify their disability to their employer when requesting AT as an accommodation on the job and negotiate it with their supervisor.

It is also important to remember that the need to find the right environment and set of job duties must match the individual’s interests, work habits, and skills in order to be productive and creative in relation to their strengths and limitations. There are many AT devices (also some portable ones) that can enhance a personal workstation and satisfy individualised needs: •

Portable spell checkers and word processors can take notes with the support of various editing features.

•

Talking calculators can assist with ordinary calculations with the addition of reading the numbers and functions aloud.

•

Smartphones have features such as alarms, calendars, calculators or global positioning systems. Tech support from the vendor is usually required to help customise the features and to demonstrate how to use them.

This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information 26 contained therein.

MODULE 1 INDIVIDUAL AUTONOMY •

If experiencing difficulty typing or writing there is text-to-speech software that reads electronic text and even proofreads an individual’s writing, as well as speech recognition software that converts dictation to text and/or word prediction programs that provide assistance in spelling and typing with a list of predicted words after a few letters have been typed.

•

Information management and communication software is useful in organising e-mail messages, schedules, tasks and contact information, and for alerting an individual to a meeting, appointment, or message received.

•

In order for the computer accessibility features to fit an individual’s daily work needs, they may have to adjust the contrast and enlarge print and graphics on the screen, adjust the contrast and background colour schemes and/or adjust keystroke and mouse controls settings.

Assistive technology is highly valued by users with various disabilities in performing daily tasks (from accessing a computer independently to using environments control systems). Additionally, it supports and reassures the carers, as they can be easily alerted by the user when their assistance is needed.

•

Access to computers and laptops whilst in a wheelchair or lying in bed, via adjusted keyboards, mice, trackballs, switches, and eye-tracking systems for those with severe physical and multiple disabilities in order to communicate, socialise, and/or work from home.

•

AT systems, like timers, remind the user to take their medication at the right time, help locate a lost item, or even orientate the person that it is day time or night time.

•

Quick calls via pre-programmed numbers or even a family member’s picture assists users with disabilities to phone a relative or friend.

•

Getting up at night time can be frustrating if the user’s disability doesn’t allow them to get out of bed without assistance; environmental control systems or devices with built in “wake-up” commands and speech recognition systems

This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information 27 contained therein.

MODULE 1 INDIVIDUAL AUTONOMY allows for the lights to be switched on or the curtains to be opened automatically.

•

Telecare assistive programs can also monitor the environment of the user and keep them safe by enabling immediate communication between the person with disability and the family or the telecare provider centre.

•

Hand-held GPS devices (or smartphones) help people with visual difficulties navigate busy city streets and use public transportation independently.

1.3.2 Selecting the appropriate AT solution

There are many AT products on the market today. The first step to narrowing down the search for appropriate AT tools is to analyse key factors, such as the individual needs, the specific tasks that must be delivered, and the type of AT equipment that will enhance the existing skills (given the disability’s nature and the limitations of the physical environment).

Fig. 1.25 select the appropriate AT

This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information 28 contained therein.

MODULE 1 INDIVIDUAL AUTONOMY Most users are interested in the quality, usability, and reliability of the AT tools and they want to know how user-friendly and reliable an AT tool is before they invest in it.

The best way to test the AT equipment’s functions is by using it in different settings.

For example, AT can help a student with a physical disability participate in activities at school/college as well as in other settings such as home, work, and social gatherings.

Portability has to be considered, as hand-held, pocket-sized and mobile tools are often very useful and light-weight. However, you need to remember that the right technology in one setting may be wrong for another.

Do assistive technologies have limitations? The truth is that AT may not be the answer for everybody. People with disabilities have different needs, skills, desires, habits, challenges, and insecurities. AT can be ineffective and even cause additional distress if it does not meet individual needs and preferences. For example, AT may not be useful when: •

It is not user-friendly (e.g. the number of keystrokes and mouse clicks necessary to operate the software/hardware can be extremely burdensome);

•

there has been a “mismatch” between the user’s needs and the AT tool’s capabilities during the assessment phase;

•

the user switches off or unplugs the devices (in cases of mental or cognitive disabilities);

•

the user is confused or panicked by any alarm sounds, lights, or synthesised voices;

•

there is need for single keystrokes to enter complex text (e.g. print page reference number formats, foreign language sentences and phrases, mathematical operations) which are not available on a standard keyboard;

•

assistive technology is expected to replace human contact and personal care.

AT can only act as a helpful addition to social life, not as a “remedy” for loneliness and social isolation.

This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information 29 contained therein.

MODULE 1 INDIVIDUAL AUTONOMY In most cases, the first stage in the use of a device concerns the installation of the input system and checking its compatibility with the system already in use: the hardware, such as alternative systems of pointing, may not be compatible with the PC (it might not run on the operating system installed on the machine) or associated software (drivers or virtual keyboard software).

Once possible issues regarding the installation of the input system have been resolved, the next step is personalisation. This involves maximising the usability of the device and ensuring it suits the needs of the user. The adjustments made at this point range from optimising the positioning of the hardware to the customisation of operating parameters; for example, increasing or lowering the speed of the pointing system or the scanning system or considering the modification of graphic features and the spatial organisation of menu elements.

Generally, with the help of experts and experience in using the AT device(s), there is a process of on-going customisation with a rising curve of operational efficiency.

It is often necessary to find solutions in situations in which the popular software on the non-specialist market cannot be accessed using the chosen input system. Adaptations of existing software products are then required. In cases like these, simple solutions for the user are usually identified involving, for example, the creation of a customised virtual keyboard with key functions capable of performing operations that would otherwise be too complex.

The support of experts (e.g. an AT Centre team) is essential. They can contribute to the evaluation of the individual case and commence a programme of support over time in order to guarantee the efficacy and real utility of the proposed solution. The primary aim of such an intervention is to guarantee the autonomy of the user, check the correct use of the assistive technology, and institute a process of progressive This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information 30 contained therein.

MODULE 1 INDIVIDUAL AUTONOMY customisation of the aid. Family members and professionals are also involved: they are offered guidance on methods, in-depth training on the aid concerned, and given access to online resources and user experiences.

Professionals of various kinds (educational, technical, health) are usually involved in the process of actuating the chosen solution. They each have their specific tasks both at the AT centre and in the everyday life contexts of the user, such as their school, home, and place of work.

External support can be valuable even after the user has started to use the aid, particularly in cases where: •

the user’s original caregivers are replaced by new staff members who require support and training in each AT aid within its environment ;

•

additional needs emerge which make it necessary to “review” the original evaluation and make changes and adjustments as appropriate. These additional needs may arise from the work--school transition, a change of employer, or the need to use new equipment etc.);

•

the progressive development of a disease leads to difficulties in the use of the chosen aid and makes changes necessary;

•

the aid becomes obsolete; this can occur quite frequently as the technological market is characterised by continuous improvement and innovation.

1.3.3. Categories of ICT AT for the computer

The following provides an overview of the main categories of ICT AT used while working with a computer, related to the different needs of individuals with disabilities.

The need to make an informed choice in choosing a technology is paramount. This involves the assessment of different factors, such as personal factors, including the needs and wishes of the user, technology related factors, and environmental factors.

In this unit we will delve a little deeper into appropriate AT assessment procedures.

This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information 31 contained therein.

MODULE 1 INDIVIDUAL AUTONOMY •

AT can help a person to function more effectively in various settings such as school, home, work, social gatherings, and recreational events. Here are some questions to consider: o In what settings will the AT tool be used (e.g. home, school, work and/or social settings)? The right technology in one setting may be wrong for another. Think about where it will be used, how it will be stored, and if the right furniture and electrical/electronic support is available. o If the AT tool will be used in more than one place, how portable is it?

Fortunately, hand-held, pocket-sized and mobile tools are often as useful as larger systems. A pocket-sized spell checker may work just as well as a computer with a spell-check program, and it's much easier to carry around.

•

Product Usability and Reliability: As with any device or piece of equipment, you will want to know how user-friendly and reliable an AT tool is before you invest in it. Here are some questions to ask about a product’s reliability, usability and quality: o How easy is it to learn about and operate? How user-friendly is the AT tool? Instructions should be brief and easy to read. Commands for operating should be clear and simple. Directions should include a logical, step-by-step process for setting up and installing the technology, basic and advanced operating instructions and tips for what to do when things go wrong. o What is the quality of its visual display and/or auditory output (if applicable)? Make sure the visual display and audio output are clear and easy for the user to see and/or hear. o How reliable is it? Ask past and present users how well the product performs and about its durability. Does it always seem to be breaking down or need frequent repairs? You may find it helpful to have a local

This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information 32 contained therein.

MODULE 1 INDIVIDUAL AUTONOMY technical-support system of people who are familiar with this AT tool or a similar one. This might include other users, parents, carers, local support groups, teachers, technical support staff and tutors. An internet search of customer reviews may also help answer your questions. o Does it need to work with other technologies? Make sure that the AT product is compatible with related technologies. For example, software designed to work on a personal computer may not operate on a Mac at home, in the classroom, or at work. Ensure that any accessory items, such as a microphone, are readily available. Consider the AT product's compatibility with the internet; for example, does a text-to-speech tool read certain websites aloud? o What technical support is available? Even with the most comprehensive and easily understood instructions, you may need technical support. Select products that offer online and toll-free support, readily available field representatives, and convenient service locations. Check the length, cost, and limitations of product warranties should you decide to buy one.

1.3.4. PCs, smartphones, and tablets as communication devices

AAC systems are diverse: unaided communication uses no equipment and includes signing and body language, while aided approaches use external tools and range from pictures and communication boards to speech generating devices. We focus here on this last group. •

AAC symbols sets: Some people with disabilities are not able to use speech as their principle means of communication. They may, however, be able to use an alternative method of communication such as symbols and symbolic languages.

It is important to understand that symbols are different from pictures. Pictures

This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information 33 contained therein.

MODULE 1 INDIVIDUAL AUTONOMY generally convey a great deal of information at once but their focus is often unclear. Symbols, on the other hand, are designed to convey a particular meaning. Symbols or symbolic languages can be used to represent many aspects of verbal communication. Symbols can be presented through visual, auditory, and/or tactile media and can take the form of gestures, photos, manual signs, printed words, objects, ‘reproduced’ spoken words, or Braille.

There are also different kinds of symbol sets; for example, Pictorial Communication Symbols, Minspeak and Makaton Symbols which can be helpful for people with a hearing impairment. Symbols can include simple body movements, such as nodding the head, shrugging the shoulders, and other gestures that are widely understood within a given culture. Symbol systems, such as single-meaning icons, can provide a means of basic communication ranging from simple, unambiguous responses like ‘Yes’ and ‘No’ to more complex concepts like feelings (‘happy’, ‘sad’, or ‘hungry’.) There are a variety of symbols and symbol-based languages that can be used to express more complex types of communication and that allow individuals to interact and convey cause and effect responses. These have generally been developed for users and listeners who have difficulty with understanding written or verbal language, for example for adults or children with autistic spectrum disorder.

Longer and more complex messages can be presented through different media of varying technical complexities, ranging from individual cards, paper charts and communication boards through to computer display programs and voice output devices. All of these systems have a common purpose: to provide an individual with the means to communicate more effectively regardless of disability. o Examples of abstract non-verbal symbol sets 2:

2

http://www.graphic-symbols.com/page.php?pageID=7

This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information 34 contained therein.

MODULE 1 INDIVIDUAL AUTONOMY 

Blissymbols: Blissymbols, originally called Semantography, were designed by Charles K. Bliss as an international symbol system to promote communication among cultures and nations and hopefully bring peace in a period of war (World War II). Although this vision proved unsuccessful, the symbol system was the first to be used as a visual communication system. In 1971, McNaughton began to use Bliss’ system in Canada as a means of communication with non-verbal physically disabled children; from this point on the system became known as Blissymbols. As the Blissymbol system requires the user to have a certain level of cognitive ability, it is mainly used with people with good cognitive skills. Blissymbols is a visual communication system that has a finite number of symbols. However, with the use of indicators and different strategies, the user can produce unlimited messages; any limitations thus reflect the limitations of the user.



Makaton Vocabulary Development Project (MVDP): The MVDP was formed in the UK in 1972 by Margaret Walker, who was working as a Speech and Language Therapist. The purpose of the project was to develop a sign language for adults with learning disabilities. A selection of symbols from the Rebus glossary were added in 1984 and additional symbols have been developed over time. The fact that Makaton symbols can be used as a part of a multi-modal communication approach distinguishes the set from the other symbol sets. According to the Makaton Charity, the Makaton Vocabulary is a unique language development programme because the vocabulary is divided into nine stages, based on a progressive sequence whereby students first acquire the core vocabulary and in later stages are able to communicate

This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information 35 contained therein.

MODULE 1 INDIVIDUAL AUTONOMY with others. If the user is able to manage a more advanced vocabulary, grammatical markets are added to the symbols. o Examples of picture symbol sets 3: Picture symbol systems provide more concrete representations of concepts than abstract non-verbal systems such as Blissymbolics. Some sets of pictures have been designed specifically for augmentative and alternative communication (AAC) use. 

Picture Communication Symbols (PCS) (Mayer-Johnson) http://www.mayer-johnson.com/category/symbols-andphotos/: PCS is an expanding set of symbols that use cartoonlike drawings. The Mayer-Johnson has 12.000 images in its PCS library. PCS are used in a wide range of Mayer-Johnson products.

One of these is Boardmaker, which allows users to create a variety of communication boards using PCS that can be printed out or used on a computer. A version of Boardmaker includes Speaking Dynamically Pro, which adds audio output capability.

Recently, Mayer-Johnson has been developing apps for the iOS platform that use PCS in games such as Bingo and Memory.



DynaSyms (Poppin and Company) http://www.poppinandcompany.com/dynasyms/index.shtml: DynaSyms uses realistic drawings for concrete concepts and combines these drawings with specific symbols to convey more abstract concepts; for example, “forget” is conveyed by a face with a solemn expression combined with a downward-pointing arrow. Colour is also used as a cue; a red circle is used to indicate that the icon is communicating a concept rather than a specific object. The basic vocabulary is 5.000 symbols. Sets of DynaSyms are available for use with DynaVox AAC devices and with Boardmaker.

3

http://atcoalition.org/article/picture-symbol-systems-aac

This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information 36 contained therein.

MODULE 1 INDIVIDUAL AUTONOMY 

Minspeak (Semantic Compaction Systems) http://www.minspeak.com: Minspeak uses a limited number of concrete symbols, each of which can mean more than one thing.

For example, depending on the other symbols it’s combined with, the picture of an apple can also mean “red,” “fruit,” “bite,” and so on. Minspeak is used in Prentke Romich AAC devices.



Widgit (Widgit Software) - http://www.widgit.com: Widgit symbols use cartoon-like drawings for concrete concepts and a combination of random and logical symbols for abstract concepts; e.g., a plus sign for “and” and a triangle for “the.” In some cases, similar abstract words have similar symbols, so that a circle inside a box means “in,” the circle atop the box means “over,” and so on. All parts of speech are represented and Widget users are expected to communicate using full English sentences. The Widgit library has 11.000 icons. A companion “Snaps” vocabulary has 1.000 icons as photographs rather than drawings. Widgit symbols are available for use with a variety of AAC programs and devices, including Boardmaker and Dynavox.



Arasaac - http://www.catedu.es/arasaac/: The portal offers ARASAAC graphic resources and materials to facilitate communication for those with difficulties in this area. 4



SymbolStix (SymbolStix Online) http://www.n2y.com/symbolstix/: SymbolStix uses a combination of realistic and cartoon-like drawings. Abstract concepts are represented by a series of related images; e.g., “What” is a question mark within a box, “When” is a question mark in front of a calendar, and “How much” is a question mark

4 This project has been financed by the Department of Industry and Innovation of the Aragonese Government (Spain) as part of the Development Plan of the Centre of Technologies for the Education (CATEDU), under the authority of the Department of Education, University, Culture and Sports of the Aragonese Government.

This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information 37 contained therein.

MODULE 1 INDIVIDUAL AUTONOMY next to a hand holding money. The library has over 12.000 icons.

SymbolStix pictures are used in a variety of AAC apps for iOS software, including ProLoquo2Go. 

Sclera (Sclera NPO) - http://www.sclera.be: Sclera was developed for the benefit of clients of a Belgian program for people with cognitive disabilities. The symbols are cartoon drawings presented mostly as white-on-black, which may be easier to see for some people with visual disabilities. Colour cuing is used in some instances; for example, a symbol may appear with a green background to indicate a positive association. Abstract concepts are represented by related images; e.g., “Who” is a question mark next to a person, and “Where” is a question mark next to a house.

Figure 1.26 Blissymbols (adapted from Jones and Cregan, 1986, p.64)

Figure 1.27: Picture Communication Symbols

This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information 38 contained therein.

MODULE 1 INDIVIDUAL AUTONOMY

Figure 1.28 Makaton symbols

Figure 1.29 Tobii symbol set on its communicator

Figure 1.30 Human System symbol set This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information 39 contained therein.

MODULE 1 INDIVIDUAL AUTONOMY

Figure 1.31 Widgit symbol set5

Figure 1.32 Boardmaker Communication 1 symbol set6

5

6

http://www.widgit.com/symbolupdates/symbols.jpg http://www.adelaideautismadventures.org/uploads/8/7/5/4/8754257/boardmaker_communication_pecs_1.pdf

This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information 40 contained therein.

MODULE 1 INDIVIDUAL AUTONOMY

Figure 1.33 Sclera symbols (adult concepts)7

1.3.5 Alternatives for standard keyboards

The standard 104-key Windows keyboard with the QWERTY layout has evolved from the early typewriter. It has changed relatively little over the years and it has remained the main input device for the personal computer. For some individuals the standard keyboard can be difficult or impossible to use. For example labels on keys may be difficult to see, a person may not have the fine dexterity to press on individual keys, or it may cause pain for the user after a period of use. Fortunately, a comprehensive range of alternative keyboards including large key, compact, wireless, high visibility, ergonomic, on-screen keyboards are available. These help people with disabilities to use a computer with greater ease and control. •

Simplified keyboards: The present arrangement of an AZERTY or QWERTY keyboard is not considered comfortable, logically arranged, or optimised for human efficiency. Character sets used in different tasks can be expected to yield different optimal key locations. New tasks are introducing new characters

7

http://www.photovoca.com/manual/4/1/

This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information 41 contained therein.

MODULE 1 INDIVIDUAL AUTONOMY and changing the frequency of selected old ones. An example is the Dvorak Simplified Keyboard. This is an alternative keyboard layout or key map that replaces the QWERTY keyboard layout. There are many ergonomic issues with the QWERTY keyboard and the Dvorak Simplified Keyboard remedies those.

Patented in 1936 by August Dvorak, the Dvorak Simplified Keyboard rearranges the layout of the keys to increase the productivity of the typist. Although it was developed for English, the Dvorak Simplified Keyboard has been adjusted to develop key maps for other languages. There is even a one handed layout. •

Different size keyboards: Depending on your need there are variations of the same keyboard in several different sizes. A good example is the BigKey Keyboard which has one inch square keys, making them much easier to see, find, and press. These are offered in 18 different models featuring different lowercase and colour keysets.

Figure 1.34 BigKeys keyboards

•

Braille keyboards: The most common type of Braille keyboard is the chorded keyboard used on the Perkins brailler and on electronic Braille note takers.

These keyboards do not have a separate key for each letter. There is one key for each dot of a Braille cell. To type one letter, all of the keys that correspond to the dots in that letter are pressed at the same time. The brailler or notetaker advances to the next letter after the keys are released. A spacebar is located below the main keys. On occasion a computer or typewriter keyboard may

This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information 42 contained therein.

MODULE 1 INDIVIDUAL AUTONOMY have been labelled with Braille letters. Most blind people do not use these as they learn to memorise the keyboard layout and type by touch.

Figure 1.35 Braille keyboard8

•

Flexible keyboards: Flexible keyboard are usually made from silicone material.

As they can be folded or rolled it makes them very portable. They are impervious to liquids and robust and thus can be used in harsh environments.

Figure 1.36 Flexible Ergonomic Keyboard9

•

Large print and High Contrast Keyboards: This is a standard keyboard with extra large print on the keys, making it suitable for users with a visual impairment.

8 9

http://cdn.shopify.com/s/files/1/0055/8312/products/kb-0164-large_grande.jpeg?0

http://www.kos.ie/input-devices/ergonomic-keyboards/flexible-keyboard/

This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information 43 contained therein.

MODULE 1 INDIVIDUAL AUTONOMY

Figure 1.37 Large print and High Contrast Keyboard 10

1.3.6. Alternatives for standard mouse

When you purchase a computer, it usually comes with a standard mouse. For many people, the mouse poses difficulties. They need to be rolled around a portion of the desk and held in one position while the button is pressed. As a result, they pose many problems for people with disabilities. The following list outlines some of the options that are currently available: •

Touchpad: These devices are often found built into laptops but are available as standalone input devices. They are stationary pads which are operated by sliding your finger across the surface. Clicking is achieved by tapping lightly on the surface or simply by clicking the raised buttons below the touchpad. They can be held in the hand or placed on a desk.

10

http://www.aramedia.net/aramedia/Large%20Print%20Keyboard%20White%20on%20Black1.jpg

This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information 44 contained therein.

MODULE 1 INDIVIDUAL AUTONOMY

Figure 1.38 Logitech touchpad11

•

Joystick: These types of devices work in a similar manner to joystick controls on a wheelchair. The mouse pointer moves fastest when the joystick is pushed fully forward.

Figure 1.39 Joystick12

•

Trackball: A trackball is basically an upturned mouse. With a trackball, the device itself remains static while only the ball on the top is moved using fingers, thumbs and palms. Larger trackballs are often suitable for operating by foot.

11 12

http://www.instablogsimages.com/1/2011/09/28/logitech_touchpad_2jmea.jpg http://liveimageserver.dlf.org.uk/mee//products/med/0105619.jpg

This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information 45 contained therein.

MODULE 1 INDIVIDUAL AUTONOMY

Figure 1.40 Trackball13

•

Foot-Controlled trackball: Some of the larger trackballs can be operated by foot, such as the BIGtrack.

Figure 1.41 BIGtrack14

•

Foot mouse: A foot mouse / control can be used by a person who has limited or no use of their hands or arms. The foot mouse can be used to navigate through software programs and select things in much the same way as a conventional mouse. Most foot mice consist of two segments. One segment will be used to control the cursor whilstthe second segment is used to click the mouse or to select shortcuts. Most foot mice include straps that help to hold the device in place on the foot during use. A long cable runs from the mouse and plugs into the computer via a USB port.

13 14

http://library.thinkquest.org/06aug/02177/Trackball.jpg https://assetlibrary.dstewart.com/ImageFolio43_files/gallery/Product_Images/Web/PNG/Zoom/26124.png

This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information 46 contained therein.

MODULE 1 INDIVIDUAL AUTONOMY

Figure 1.42 FooTime foot mouse15

•

Touch screen: Touch screens act in the same way as a standard screen but have sensitive surfaces. Selections and movements are made by pointing (and touching) at the screen surface. It is also possible to put a ‘Touch Window’ over the front of a standard monitor to give the same function. Touch screens are one of the key features of computer tablets such as the Apple iPad and many smart phones.

Figure 1.43 Samsung Galaxy Tab 2 (10.1) with touch screen16

15

http://bilila.com/yahoo_site_admin/assets/images/FM_Pic.194180943_std.jpg

This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information 47 contained therein.

MODULE 1 INDIVIDUAL AUTONOMY

1.3.8. Voice Recognition

•

Voice recognition software: Voice recognition software, also called speech recognition software, is the translation of spoken words into text. It is also known as "automatic speech recognition", "ASR", "computer speech recognition", "speech to text", or just "STT". The performance of speech recognition systems is usually evaluated in terms of accuracy and speed.

Speech recognition is a very complex issue. Vocalisations vary in terms of accent, pronunciation, articulation, roughness, nasality, pitch, volume, and speed. Speech is distorted by a background noise and echoes, electrical characteristics. Accuracy of speech recognition vary with the following: o Vocabulary size and confusability o Speaker dependence vs. independence o Isolated, discontinuous, or continuous speech o Task and language constraints o Read vs. spontaneous speech o Adverse conditions Good examples17 of voice recognition software are Dragon Dictate for Mac, Dragon NaturallySpeaking from Nuance Communications for Windows 7, eSpeaking – software for Windows XP, Vlingo for smartphones.

•

Voice recognition features integrated within operating systems: Most operating systems now have built-in voice recognition software (e.g. Windows Speech Recognition 18, Mac OS X Lion speech recognition).

1.3.9. Software facilitating general PC functions

16 17 18

http://www9.pcmag.com/media/images/289491-samsung-galaxy-tab-2-10-1-touch-screen.jpg http://en.wikipedia.org/wiki/List_of_speech_recognition_software http://windows.microsoft.com/en-us/windows7/set-up-speech-recognition

This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information 48 contained therein.

MODULE 1 INDIVIDUAL AUTONOMY What we address here are additional computer aids (not available as default software) that can make the interaction easier. As you will notice, most have been addressed in the previous sections.

•

Types of assistive technology products for a computer 19: o Alternative input devices allow individuals to control their computers through means other than a standard keyboard or pointing device.

Examples include: 

Alternative keyboards: featuring larger- or smaller-thanstandard keys or keyboards, alternative key configurations, and keyboards for use with one hand.



Electronic pointing devices: used to control the cursor on the screen without use of hands. Devices used include ultrasound, infrared beams, eye movements, nerve signals, or brain waves.



Sip-and-puff systems: activated by inhaling or exhaling.



Wands and sticks: worn on the head, held in the mouth or strapped to the chin and used to press keys on the keyboard



Joysticks: manipulated by hand, feet, chin, etc. and used to control the cursor on screen.



Trackballs: movable balls on top of a base that can be used to move the cursor on screen.



Touch screens: allow direct selection or activation of the computer by touching the screen, making it easier to select an option directly rather than through a mouse movement or keyboard. Touch screens are either built into the computer monitor or can be added onto a computer monitor.

o Braille embossers transfer computer generated text into embossed Braille output. Braille translation programs convert text scanned-in or

19

http://www.microsoft.com/enable/at/types.aspx

This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information 49 contained therein.

MODULE 1 INDIVIDUAL AUTONOMY generated via standard word processing programs into Braille, which can be printed on the embosser. o On-screen keyboards provide an image of a standard or modified keyboard on the computer screen that allows the user to select keys with a mouse, touch screen, trackball, joystick, switch, or electronic pointing device. On-screen keyboards often have a scanning option that highlights individual keys that can be selected by the user. On-screen keyboards are helpful for individuals who are not able to use a standard keyboard due to dexterity or mobility difficulties. o Screen enlargers, or screen magnifiers, work like a magnifying glass for the computer by enlarging a portion of the screen which can increase legibility and make it easier to see items on the computer. Some screen enlargers allow a person to zoom in and out on a particular area of the screen. o Screen readers are used to verbalise, or "speak," everything on the screen including text, graphics, control buttons, and menus into a computerised voice that is spoken aloud. In essence, a screen reader transforms a graphic user interface (GUI) into an audio interface. Screen readers are essential for computer users who are blind. o Speech recognition or voice recognition programs allow people to give commands and enter data using their voices rather than a mouse or keyboard. Voice recognition systems use a microphone attached to the computer, which can be used to create text documents such as letters or e-mail messages, browse the internet, and navigate among applications and menus by voice. o Text-to-Speech (TTS) or speech synthesisers receive information going to the screen in the form of letters, numbers, and punctuation marks, and then "speak" it aloud in a computerised voice. Using speech synthesisers allows computer users who are blind or who have learning This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information 50 contained therein.

MODULE 1 INDIVIDUAL AUTONOMY disabilities to hear what they are typing and also provide a spoken voice for individuals who cannot communicate orally, but can communicate their thoughts through typing. o Talking and large-print word processors are software programs that use speech synthesisers to provide auditory feedback of what is typed.

Large-print word processors allow the user to view everything in large text without added screen enlargement.

1.3.10. Writing aid software

It is possible to improve writing and reading skills for those that face challenges in understanding and/or using spoken language (e.g. people with aphasia) by using computer-based spell-checkers and programs for word prediction, similar to that used when writing SMS messages on mobile phones. •

Word processor for alternative access: o GRAFIS 20 is a word processing application specifically designed for disabled users. Target user groups of GRAFIS are users with motor impairments of upper limbs and users with learning disabilities. GRAFIS has been developed to provide the target user groups with an accessible, simple, and user-friendly word processing application that is still complete. It offers support for overcoming specific issues in addition to developing and enhancing writing skills. o CLICKER 5 is the software package that combines in one product the potential of a multimedia word processor (text, graphics and audio) and the flexibility of an authoring system for the creation of virtual keyboards customised and accessed by pointing and scanning: the result is a productivity tool accessible to people with limited motor skills.

20

http://www.ics.forth.gr/files/publications/antona/2000/Antona&Stephanidis.pdf

This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information 51 contained therein.

MODULE 1 INDIVIDUAL AUTONOMY o MULTITEXT is a suite of productivity applications designed especially for pupils with disabilities. It includes a word processing program, a program to edit arithmetical notation, a program for tackling geometrical problems, and a graphics program. The user can interact with the program using a mouse, keyboard, and external sensors.

•

Word prediction, grammar, and vocabulary support: o WordQ writing aid software is a writing tool used along with standard Windows word processing software to provide spelling, grammar, and punctuation assistance. It uses advanced word prediction to suggest words to use and provides spoken (text-to-speech) feedback. o Co:Writer 4000 adds word prediction, grammar, and vocabulary support capabilities to any word processor or email program. o Skippy is a word prediction program for faster typing, especially useful when combined with a virtual keyboard in scan mode. It can store and customise an unlimited number of word predictions. The program is fully configurable with regard to font size, text colour, background and other features beneficial for visually impaired users.

1.3.11. Reading aid software

•

OCR software: Optical character recognition (OCR) is the mechanical or electronic conversion of scanned images of handwritten, typewritten, or printed text into machine-encoded text. It is a common method of digitising printed texts so that they can be electronically searched and used in text-tospeech. This is especially appealing to blind and visually impaired users. A comparison of optical character recognition software is available here.

•

Synthetic speech system: A synthetic speech system is composed of two parts; the synthesiser that does the speaking and the screen reader that tells the synthesiser what to say.

This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information 52 contained therein.

MODULE 1 INDIVIDUAL AUTONOMY •

Speech synthesis: The synthesisers used with PCs are text-to-speech systems.

Their programming includes all the phonemes and grammatical rules of a language. This allows them to pronounce words correctly. Names and compound words can cause problems, as they often contain unusual spellings and letter combinations. The synthesiser is usually software that works via the computer’s sound card. Some synthetic speech sounds robotic, although some can sound almost human. Synthesisers are included when users purchase a screen reader. A comparison of speech synthesisers can be found here. One issue is that not all languages are currently available but solutions such as Nuance Loquendo offer most European languages.

•

Screen readers: Apart from the built-in screen reader support (see “1.2.1 ICT also usable by me and by others”), there are also other software solutions that can be run on a PC: o The most widely used screen readers are proprietary solutions: JAWS from Freedom Scientific, Window-Eyes from GW Micro, Dolphin Supernova by Dolphin (previously HAL), System Access from Serotek, and ZoomText Magnifier/Reader from AiSquared. The open source screen reader NVDA is equally gaining popularity through its improved functionalities. A comprehensive list can be found here. o A side note must be made here regarding the price (and hence affordability) of these screen readers. Most are in fact quite expensive and every new Operating System requires an update of the screen reader software which is again relatively expensive. As a result, in some countries cheaper software is preferred. This may explain the rise of NVDA which is completely free.

•

Screen magnifier: Apart from the built-in screen magnifier support, there are also other software solutions that can be run on a PC: o A screen magnifier is software that interfaces with a computer's graphical output to present enlarged screen content. It is a type of

This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information 53 contained therein.

MODULE 1 INDIVIDUAL AUTONOMY assistive technology suitable for visually impaired people with some functional vision; visually impaired people with little or no functional vision usually use a screen reader. Ranges of 1- to 16-times magnification are common. The greater the magnification the smaller the proportion of the original screen content that can be viewed, so users will tend to use the lowest magnification they can manage. Screen magnifiers commonly provide several other features for people with visual difficulties: 

Colour Inversion: Many people with visual impairments prefer to invert the colours, typically turning text from black-on-white to white-on-black. This can reduce screen glare and is useful for older people experiencing age-related macular degeneration.



Smoothing: Text can become blocky and harder to recognise when enlarged. Some screen magnifiers anti-alias or smooth text to compensate.



Cursor customisation: The mouse and text cursors can often be modified in several ways, such as circling it to help the user locate it on the screen.



Different magnification modes: Screen magnifiers can alter how they present the enlarged portion: covering the full screen, providing a lens that is moved around the un-magnified screen, or using a fixed magnified portion.



Screen reader: Some magnifiers come packaged with a basic screen reader, allowing whatever the user is pointing at to be read out.

o The most well-known screen magnifiers are: Dolphin Lunar, Magnifier (Windows), Virtual Magnifying Glass - Cross platform magnifier application, ZoomText.

This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information 54 contained therein.

MODULE 1 INDIVIDUAL AUTONOMY

Figure 1.44 ZoomText 9.1 in action21

1.3.13. Case studies Case Study 1 - AT accommodations for learning disabilities Situation: Young adult with a learning disability (dyslexia and dysgraphia). He can read but it takes him a very long time; he can write but writing is extremely slow and exhausting. Skills in reading print material and expressing himself in writing or using a keyboard are very slow.

AT solution: He uses taped texts and electronic text, as well as word prediction programs that suggest words based on the first few letters of a word and its context.

Case Study 2 – AT accommodations for upper limbs’ limited function Situation: A woman with quadriplegia that uses a power wheelchair and has very limited functional use of her arms and hands. Her new work position requires more typing which is exhausting and may cause chronic fatigue problems in the future.

AT solution: Her computer system was set up with trackballs and mouth pointers to make using a keyboard much easier, while she also tried a speech recognition system. This system was a highly developed, user-friendly speech-to-text program that recognised her speech patterns and stored vocabulary already input by her. The longer she uses the system, the more 21

http://www.softwareknowhow.info/portals/0/articleresources/images/48-assisted-technologies-3.jpg

This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information 55 contained therein.

MODULE 1 INDIVIDUAL AUTONOMY quickly and accurately it recognises her speech and word use. She was able to master the system with approximately two weeks of training.

Case Study 3 – AT accommodations for daily communication (combined speech and mobility disabilities) Situation: A middle-aged man with severe Amyotrophic Lateral Sclerosis (ALS) who receives assistance for most movement, uses a power wheelchair and he is unable to speak without the aid of a computer.

AT solutions: He uses a thumb switch and a blink-switch attached to his glasses to control the computer. When he blinks an infra-red switch is activated and he is able to scan and select characters on the screen in order to compose a URL and access the internet. He “speaks” through a voice synthesiser.

Case Study 4 – AT accommodations for hard of hearing Situation: Young woman hard of hearing with hearing aids in both ears who needs to participate in discussions during an educational workshop. She is unable to hear most of the discussion and the background noise reduces the effectiveness of her hearing aids.

AT solutions: She uses an FM amplification system during workshops to eliminate the background noise. With this system, the speaker is provided with a microphone, and the sound is transmitted through a receiver directly to her hearing aid. Whoever wears the transmitter unit repeats any question/answer taking place by others so she can hear it.

Case Study 5 – AT accommodations for deafness Situation: Young student with a severe to profound bilateral hearing loss; he uses hearing aids and lip-reading to maximise his communication skills and has some knowledge of English Sign Language but not enough to effectively use a sign language interpreter as an accommodation.

AT solutions: He usually uses an FM amplification system (via a microphone and transmitter worn by the instructor his or her words are sent directly to his hearing aid), but also real-time captioning which involves a stenographer who has a steno machine and laptop with This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information 56 contained therein.

MODULE 1 INDIVIDUAL AUTONOMY stenography software sitting next to him so he can see the monitor. Alternatively, the stenographer can be at a remote site; in this situation, the instructor wears a wireless microphone that transmits the voice back over the same phone line that is used to instantly send back the real-time captions to the student with a laptop in the classroom.

Case Study 6 – AT accommodations for chronic fatigue syndrome Situation: Journalist with chronic fatigue syndrome that affects her writing assignments and requires the use of a computer keyboard; she has chronic physical exhaustion and widespread muscle and joint/wrists pain.

AT solutions: She was introduced to speech input software which allows her to bypass the keyboard and participated in training sessions that provided her with extra skills on speech recognition systems and effortless computer access options.

Case Study 7 – AT accommodations for low vision Situation: Student with Stargardt's disease (legally blind, but with some peripheral vision). He is able to read some print material but for longer readings he needs a closed-circuit TV (CCTV) monitor that uses a camera to enlarge regular print material.

AT solutions: Since he can use CCTVs and monitors effectively, he used a video camera with a very powerful camera lens, with tripod and monitor, through which he can see the blackboard, overheads, and other visual aids used by his professors.

Case Study 8 - Web Access for Student who is Blind Situation: Blind scientist uses a refreshable Braille display to access text that appears on a computer screen. Some data she uses for her research is available on web pages that include plots of various graphical models that are not accessible to her, since neither refreshable Braille displays nor speech synthesisers are capable of reproducing graphics.

AT solution: Including short text descriptions of the plots; each description appears directly above or below the plot to which it applies and the student can access this text with her Braille output system, which is part of the standard computer configuration that she uses.

This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information 57 contained therein.

MODULE 1 INDIVIDUAL AUTONOMY

Case Study 9 – AT accommodations for employee with obsessive-compulsive disorder (OCD) Situation: Man with OCD with particular problems receiving, processing, and recalling information, especially during times of stress. The episodic and unpredictable onset and recurrence of OCD can also interrupt the working tasks due to an inability to block out sights and sounds, the limited ability to tolerate noise and crowds, and the difficulty in understanding or remembering verbal directions.

AT solution: The user preferred to run his browsers using special plug-ins like pop-up and animation blockers. He uses alarm notifications on timer devices that improve his ability to transition between tasks.

Case Study 10 - AT accommodations for a person with Autism Situation: Young autistic man with severe communication difficulties and language and developmental delays.

AT solution: Installation of the Board Maker, an assistive computer program which creates visual pictures that the user can use for communication, as well as the Picture Exchange Communication Systems (PECS) which creates symbol pictures and cards (and labels for them).

1.3.14. Examples of reasonable adjustments (ICT and non-ICT based) Impairment

Task/difficulty

Adjustment

Hearing impairment

Taking part in a meeting

Provide communication support palantypist or BSL interpreter.

Hearing impairment

Making a phone call

Provide a videophone or text phone

Hearing impairment

Contacting the office (for example, to find

Provide a mobile text phone that can be

out the time and location of their next

used with the Text Relay Service - e.g. a

meeting)

Nokia communicator

Visual impairment

New employee arriving at work

Colleague meets them at the bus stop

Visual impairment

Taking part in a meeting

Provide minutes and papers in advance,

This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information 58 contained therein.

MODULE 1 INDIVIDUAL AUTONOMY Impairment

Task/difficulty

Adjustment identify what format the employee requires (e.g. Braille, large print)

Dyslexia

Taking part in a meeting

Provide minutes and papers in advance and

Dyslexia

Writing a report

Provide mind mapping software

Dyslexia or learning

Taking minutes at a meeting

Provide a Dictaphone and allow extra time

in a user friendly format

difficulty

to type up minutes

Severe asthma

Travelling to a meeting using public

Provide taxis to and from the nearest public

transport

transport

Epilepsy

Long meetings, long days

Frequent breaks, cold drinks, and a fan

Lupus

Attending work full time all year

available Allow flexible working such as compressed hours Work related upper

Long day working on a PC

limb disorder

Allow rest breaks; provide timing software which will remind the employee to take rest breaks at regular intervals

Stammer

Taking part in a meeting

Provide awareness training for other staff

Severe back pain

Operating a checkout

Full ergonomic assessment and regular rest breaks

Autism

Starting a new job, fitting into a new team

Assign a 'buddy' to assist and explain office culture

Depression

Reception duties from 8am

Adjust shift to best part of day – after 11am

Anxiety

New employee arriving at work

Colleague meets them at the bus stop

Anxiety

Travel in rush hour

Allow flexible working so they can avoid rush hour

1.3.15. National databases with AT information Country (*

National databases

participates in eSUNET project) Austria

HANDYNET

http://handynetoesterreich.bmask.gv.at

France

Handicat – Handicaps et aides techniques

http://handicat.com

Germany (for

Rehadat

http://www.rehadat.de

German speaking community e.g.

Austria)

This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information 59 contained therein.

MODULE 1 INDIVIDUAL AUTONOMY Country (*

National databases

participates in eSUNET project) Italy

Siva - Servizio Informazione e Valutazione Ausili

http://www.portale.siva.it

Spain

CEAPAT - Centro Estatal de Autonomía Personal y

http://ceapat.org

Ayudas Técnicas UK (For English

DLF – Disabled Living Foundation

http://www.dlf.org.uk

speaking community e.g.

Cyprus)

1.4 Active behaviour in terms of: personal hygiene, proper dressing and travelling 1.4.1. Personal hygiene

During early adolescence most people have learned how to carry out basic hygiene activities such as washing and shaving. During late adolescence and early adulthood there is an increased expectation for a person to be more independent in their personal hygiene habits.

Fig. 1.44 Personal hygiene

We all like to have some choice and control of our regular activities, and to find meaning in them if possible. Control and choice in meaningful activities adds quality to our lives.

This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information 60 contained therein.

MODULE 1 INDIVIDUAL AUTONOMY It is important to consider how you might help the person you support to increase their level of choice and control about how and when they will carry out their hygiene activities.

A person may find particular hygiene activities more meaningful if they connect the activity to positive outcomes.

For example: • Looking and smelling good • Feeling healthy • Feeling accepted amongst peers and members of the community • Receiving praise and recognition for efforts.

Comments from relatives, friends, and parents/carers can help reinforce the connection between the hygiene activities and the positive outcomes.

As a parent you can be specific about the benefits of good personal hygiene habits.

Talk about what hygiene activities they may need to carry out in order to do what is important to them.

For example, if they say that going to the football with mates is important write down all the activities that need to be carried out to get ready for the football, for example: • Brush teeth • Wash hair • Put on footy clothing.

This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information 61 contained therein.

MODULE 1 INDIVIDUAL AUTONOMY

Figure 1.45 Personal hygiene cartoon

You may wish to use pictures/ photos to assist. This is a simple and effective way of making a clear link between hygiene habits and the ‘bigger picture’.

Personal hygiene activities such as showering are part of a daily routine. Getting into the habit of doing things at the same time each day can make personal hygiene habits much easier to learn.

This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information 62 contained therein.

MODULE 1 INDIVIDUAL AUTONOMY

Figure 1.46 Personal hygiene cartoons

Schedules are designed to bring routine and predictability to a person’s day. A written schedule may help the person understand and remember the planned activities.

Figure 1.47 personal hygiene in cartoons

Using pictures of activities in the order in which they occur during the day is a great way to promote independence and help the person learn routines.

Your regional office could help you develop a schedule if you wish.

A few praises you might like to try out: •

“Good on you for…(getting showered before work)”

•

“I know I don’t say this very often but I just wanted to say I’m proud of you for…(taking pride in how you look)”

This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information 63 contained therein.

MODULE 1 INDIVIDUAL AUTONOMY •

“I really appreciated the way you…(cleaned up the bathroom when you were finished)’

•

“I like the way you…(invited your friend over)”

•

“By the way congratulations on…(getting to the festival with your friends)”

•

“I thought you did a good job with…(choosing your clothes today)”

•

“By the way I have to say I was really impressed with…(how you and your mates had a great time at the football)”

Figure 1.48 personal hygiene in cartoons (Mayer, 2010)

You as a parent could use the following diagram which will help to train your child with disability on the elements of the personal hygiene.

This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information 64 contained therein.

MODULE 1 INDIVIDUAL AUTONOMY

Figure. 1.49 Eye and skin diseases (WEDC)

This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information 65 contained therein.

MODULE 1 INDIVIDUAL AUTONOMY 1.4.2. Suggestions for dressing 1.4.2.1 First impression and image

How long do you think it takes for someone to form a first impression of you?

•

At first glance

•

Within 30 seconds

•

Once you have started speaking

•

Within the first minute or so

•

As long as you are with the person in question

The answer is just 30 seconds. That’s all the time you have. You never get another chance to create a great first impression.

Image can be defined as: •

the impression we give to others

•

the perception that others have of us

•

the mental conception we have of another

•

the impressions we form when meeting someone new.

Image consists of : •

Facial expressions

•

Posture

•

Appearance

•

Speech

•

Actions

•

Attitude

People make assumptions based on limited information and when people observe a characteristic or behaviour in someone, they then tend to assume that the person has a number of other qualities.

Psychologist, Prof Meridian, carried out research into why we form first impressions.

He found: This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information 66 contained therein.

MODULE 1 INDIVIDUAL AUTONOMY •

55 per cent of a first impression formed about you consists of how your appearance is perceived

•

38 per cent consists of how you non-verbally communicate, and how it is perceived

•

Staggeringly only seven per cent of a first impression formed about you consists of what you actually say.

So 55 per cent of someone's first impression of us is based on our appearance, which consists of: •

height

•

weight

•

colouring

•

hairstyle

•

accessories

•

clothing

•

in the case of women this also includes make-up.

Image is also important because it affects how we feel about ourselves. When we feel we are presenting ourselves well, we gain in confidence and self-esteem. This process is called the cycle of success.

When selecting clothes and accessories for your child, consider the following: •

Quality – this indicates his/her status. Being well-made with good quality fabric is more important than brand or label.

•

Fit – choose something comfortable and smart that s/he can move about in confidently.

•

Care – is it a practical washable fabric that you will be able to keep in good condition

•

Clothing in harmony with his/her personal skin colouring, body size and shape, and personality

This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information 67 contained therein.

MODULE 1 INDIVIDUAL AUTONOMY •

Finishing touches - carefully chosen accessories demonstrate attention to detail.

1.4.2.2. Suggestion for proper dressing for male

The following tips are guidelines which are recommendable having in mind that your child with disability is visiting school, college, daily care centre etc.).

Please remember that you as a parent have responsibility just to transmit the information about proper dressing to your child with disability. After the processing of the information which is supposed to be done in collaboration with your child you should leave the final decision to him/her.

Suits •

When buying a suit think of your child’s age and the image you’d like to project.

If you like s/he to be smart but classic, opt for a traditionally cut suit. If s/he is younger combine his/her suit with modern pastel colour shirts.

•

Think about the colour. Navy blue is most versatile. Black is traditional and

formal, but be careful if you have a pale complexion, as black gives the illusion of draining colour from your child’s face. Grey suits appear more faceless, and again, depending on the shade and your child’s skin colour grey suits can drain colour from the face. Shirts with grey suits can be white, pale, or cream for an authoritative look.

Try to combine a grey suit with a brightly coloured tie to add warmth.

•

Look for a single-breasted cut, as this is more flattering on the stomach area;

double-breasted suits draw more attention to the stomach.

Plain shirts •

If you’re unsure what colours suit your child, always opt for light colours, as

these are easier to combine with ties.

Striped shirts •

Striped shirts are more prone to come in and out of fashion, and are also more

difficult to combine with a tie.

This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information 68 contained therein.

MODULE 1 INDIVIDUAL AUTONOMY •

Always wear your child with a plain tie with no pattern if you are wearing a

striped shirt.

Overcoat •

Too many men wear a totally inappropriate jacket over their suit, such as a

sports jacket or a jacket cut waist high allowing the bottom of the suit jacket to be visible.

•

Invest in an overcoat, woollen for winter and raincoat/trench coat for summer.

Accessories •

A belt is essential, in plain black, with a minimal formal buckle.

•

Shoes complete the look more so than any other accessories. If so opt for a

rubber-soled shoe but remember to retain a balance between comfort and formality.

Opting for leather soled shoes, if relevant, adds that subtle touch of class and therefore adds to his/her stature.

•

Socks should be dark colours. Try to match with the suit colour; so black with

black, navy with navy. Do not opt for bright colours, and never wear white.

1.4.2.3 Suggestion for proper dressing for female

The following tips are guidelines are recommendable having in mind that your child with disability is visiting school, college, daily care centre etc.): Suits, jackets and separates •

Stick to neutral colours for maximum flexibility; remember dark for authority,

lighter for approachability.

Blouses, shirts and tops •

Use these items to add colour and express your personality if you wish.

•

A lighter or brighter colour close to child’s face can lift a sober suit.

•

Avoid exposing too much flesh.

This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information 69 contained therein.

MODULE 1 INDIVIDUAL AUTONOMY •

In summer try a sleeveless camisole top with child’s jacket enabling him/her to

remain cool.

Dresses •

A dress has to be of a structured design to be suitable.

Accessories •

Keep jewellery simple and discrete.

•

Nothing dangly that is going to be impractical.

•

Choose accessories that suit the skin colouring, body shape and size, and

personality.

Hosiery and shoes •

Never wear light shoes with darker tights.

Successful dressing down Mastering the art of dressing down requires an understanding of: •

how you want your child wants to be perceived

•

what is acceptable and what isn’t in particular environment (school, college,

daily care centre etc.)

•

your own child’s colouring, style and personality

•

how to co-ordinate separate garments.

Appendix 1 Hints while organising a trip As a parent what you should consider:

Mobility is necessary for most of the activities in which we engage. For people with disabilities, travel by car is the easiest way to get about. It enables to carry mobility aids and any special equipment, as well as shopping, friends and colleagues, and necessarily materials.

Being able to drive a motor car is seen by many disabled people as the most important skill that they can acquire or re-acquire. Some young disabled people reaching the age This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information 70 contained therein.

MODULE 1 INDIVIDUAL AUTONOMY when they can obtain a driving licence, and newly disabled people who previously drove, are often eager to have the independence that having a car and driving brings.

Similarly, many older people want to maintain their ability to drive safely as long as possible.

Before going to the expense of obtaining a car, however, disabled people should take advice on what sort of adaptations might be necessary and whether specialist tuition or retraining should be undertaken, possibly in an adapted vehicle. The introduction of new technology and increased awareness of the needs of disabled drivers now make this possible for people with a wider range of mobility problems.

Driving is a possibility for most disabled people, given the range and diversity of adaptations now available. Conversions are available to allow a driver to drive from a wheelchair, and specialist equipment will aid steering and braking with a minimum of strength or dexterity. Disabled drivers must take the same driving test and demonstrate the same level of competence as any other motorist, although the conditions of the test can be varied to make allowances for particular difficulties.

The choice of which motor vehicle to have is an important one for every motorist and will depend on his or her own personal needs and circumstances. These include: price; manufacturer; availability; style (saloon, hatchback, estate, MPV, 4x4) and transmission type.

For the disabled motorist there are added considerations which will influence the choice of make and model. These may include: the width of the doors to allow room for pulling a wheelchair in, or for swinging legs in; the height of the sill on a boot or a hatch and the position and design of switchgear and controls for the fitting of adaptations.

Everyone in a moving motor vehicle is required by law to wear a seatbelt when they are fitted. This applies to disabled people, with some exceptions. Merely feeling uncomfortable when wearing a seatbelt is not accepted as justification for exemption.

If it is considered that a person should not wear a seatbelt for medical reasons, a

This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information 71 contained therein.

MODULE 1 INDIVIDUAL AUTONOMY doctor should be consulted. If the medical opinion is that an exemption should be made, a doctor or consultant can issue a certificate.

A lot of progress has recently been made in the provision of local bus routes and vehicles with increased access for disabled people. Local authorities are now taking steps to ensure that public transport in their areas comply with the best access standards and can often advise on which routes have accessible services. Many local authorities offer concessionary schemes on local buses for older residents.

As with other buildings and public places, bus stations have to conform to new regulations with regard to access, but it is still necessary for the disabled traveller to check with the appropriate operators that facilities are suitable and that help will be available when required. Changeover times on long-distance coach travel can be quite long and the availability of an accessible toilet and restaurant or cafeteria is very important. Some major bus stations will be able to arrange assistance and escorts, for instance for visually impaired people who need help to find facilities and to locate their onward transport.

Disabled people with sufficient mobility can use scheduled coach services, but the staff is not allowed to lift or give any other physical assistance with boarding. In addition manual wheelchairs can be carried, but only if folded and if there is sufficient room.

However, the conditions of carriage do not allow for the carriage of powered vehicles of any kind, including powered wheelchairs.

Many train companies now produce their own guides for disabled passengers and we recommend they be contacted prior to travel (ideally at least 24 hours beforehand), to establish the facilities available.

The assistance line operator puts in place a special booking arrangement to ensure that a disabled passenger gets assistance throughout the train journey. This starts from the arrival at the station with assistance with luggage, a wheelchair if required and, for those who require it, boarding assistance with a ramp. Accessible toilets are being provided on an increasing number of long-distance trains as well as on many regional rail services.

This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information 72 contained therein.

MODULE 1 INDIVIDUAL AUTONOMY Airlines make special provision for their disabled passengers, and most have departments dedicated to answering enquiries and making the arrangements for people who have special requirements. Some budget airlines may make a charge for providing assistance.

Wheelchairs, and in some cases pavement scooters, are carried as ‘non chargeable’ excess baggage and, as most such equipment is now powered by the more transportable dry-cell batteries, there are fewer restrictions or arrangements needed to prepare them for carriage. Some older wheelchairs still have acid batteries but these are now very unusual. They require special packing or may be banned altogether. As with all specific requirements, the travel agent or airline should be given prior notice of what is needed.

Such requirements may include: • special diets • the use of medical oxygen during a flight • escorting of wheelchair users or sensory impaired people • special seating arrangements.

These are some of the requirements that can probably be catered for if the airline is aware of them in advance. Passengers requiring extra leg room are advised to check in with such a request at the airport early, as these seats are limited, and those seats near emergency exits that have extra room cannot be used by passengers with mobility problems.

Getting to an airport can be a problem, but public transport services to and from airports are becoming more accessible to disabled people. Some airports have integrated railway stations, and most are well served by buses, coaches and taxis. For those travelling to the airport by car, special parking arrangements can often be made, and discounts are sometimes available for members of one of the disabled drivers’ associations.

Terminal buildings are generally wheelchair-accessible but access to the aircraft depends on the equipment available at each airport. All wheelchairs are carried in the This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information 73 contained therein.

MODULE 1 INDIVIDUAL AUTONOMY hold of the aircraft, the user having to transfer to an aircraft seat. At larger airports, air bridges or jet ways provide level or ramped access between the terminal and the aircraft. Elsewhere, wheelchair users may be lifted on to the plane by staff using a carry seat or by a high-lift loading vehicle. Transfer to the aircraft seat is by lifting or by means of a small aircraft aisle wheelchair. It is important to consider at the time of booking, any special transport arrangements that will be required at the destination airport for onward travel to the final destination.

You as a parent can use the following provided guide as a practical tool to plan a trip together with your child with disability.

TRAVEL PLANNING AND PREPARATION

Below we analyze the various tasks you must undertake while organizing a trip with the Internet help. If we choose this form of organization, we should: 1. Decide on the destination and purpose of the trip, either as a very precise plan or just a slight idea.

2. Determine the type of tourism chosen.

3. Do research on the destination: guidebooks, main sights, tips, social, economic and political situation, useful information, etc.

4. Choose the means of transport and prepare the route.

5. Learn about the health status of your destination: required and recommended vaccines, health insurance, travel insurance, etc.

6. Gather the necessary information about: personal documents (passport, visa), vaccination certificates, fees, expiration date of cards (student, hostellers, camper), location of embassies and consulates, etc.

7. Seek advice and information about baggage, personal safety and the method of payment (cash, credit card, travellers checks, etc.).

ISSUES TO CONSIDER FOR TRIP

This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information 74 contained therein.

MODULE 1 INDIVIDUAL AUTONOMY The choice of trip destination is personal and determined by specific circumstances.

When deciding where to go, numerous factors both internal and environmental should be taken into account by the traveller.

On the trip, especially in the case of older people, we must take into account the need to gather adequate information related to the health care and hygiene that we find at the destination. Basic precautions should be taken against any health problems that may arise later on. Some websites offer extensive information and advice on health during the journey and sanitary conditions at the destination.

Before travelling we should also get informed about current political systems, customs and weather of chosen destinations. When it comes to weather and climate we can check on the Internet the general weather forecast for different regions of the world.

You can check the weather forecast.

We must bear in mind that documentation cannot be left until the last moment before setting off our journey. The national identity card, passport or visa is the most important documents. Most governments maintain updated web pages of their Ministries of Foreign Affairs, which include information about required passports visas when travelling to certain countries.

There are browsers of embassies and consulates around the world such as http://www.embassyworld.com We recommend that you never travel without health insurance coverage and assistance which covers possible illnesses, accidents or other incidents. You can also obtain a Term Insurance Policy that includes insurance against robbery, loss of luggage, etc. The information and even the subscription of the contract are available directly on the Internet. Typing a "travel insurance" into Google browser you get a very extensive list of company products and procedures adapted to each situation.

THE AIRLINE TICKET

One of the most popular services online are those for booking airline tickets.

This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information 75 contained therein.

MODULE 1 INDIVIDUAL AUTONOMY There is nothing better than a practical example of how to book and buy an airline ticket online. For that, one of the most common websites specializing in finding and booking flights, hostels, cars, ferries, etc.

On the browser main screen there is a selection where the user can input information of his own particular case.

•

Departure city

•

Departure dates and destination

•

Number of adults, children, babies

•

Conditions: departure, round trip, multiple destinations, etc.

•

Time, which is important, because it is possible to opt for choosing the particular hour, time of the day (morning, afternoon, night) or, as an option, organize the results by price from the lowest to the highest.

Pressing the Search button (or another appropriate one) will begin finding flight offers, after a while you will get the results of the search operation.

This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information 76 contained therein.

MODULE 1 INDIVIDUAL AUTONOMY Figure. 1.50 Booking a flight

Later you will have to select the desired route on the proposed list and mark the flight corresponding box. It is common that, after requesting the flight details, the browser will ask you to pre-register on it’s own website, thus will provide identifying personal details, such as name, postal address or e-mail address. Once completed those details, the flight specification will be given.

Figure. 1.51 Booking a flight (2)

It is normal that, at the moment of the purchase, the server will offer another possibility such as trip cancellation insurance or travel insurance suitable for the elderly people. These insurances are optional, with some additional cost which will be specified.

The booking payment made with a credit or debit card will confirm the reservation, which will be sent by e-mail to the user’s account declared in the booking process.

This confirmation e-mail will include a booking reference number. It’s common to be given also further details about the following steps and to provide, together with reservation details, the contact information, budget, way of payment, etc.

This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information 77 contained therein.

MODULE 1 INDIVIDUAL AUTONOMY The booking confirmation is not equivalent to the e-ticket. It may happen that the ticket is not issued because of several reasons, even after the reservation has been confirmed.

Only after the booking feasibility is verified by the online travel agent, the airline ticket will be issued. It will be sent as an electronic ticket to the e-mail address supplied by the user and the previously specified credit card will be charged accordingly.

The e-ticket shows the reservation number to be used at the time of check-in at the airport, also useful to check-in at the automatic machines provided in the terminal.

There is also a possibility to make the seat reservation through online booking. This option speeds up some procedures at the airport. It should be accomplished a few days before the departure.

Some tips to get good flight offers: •

Flights should be compared among different companies to obtain the best prices and services

•

Flights should be booked well in advance

•

It is recommendable to avoid a peak time such as key dates for holidays

•

Sometimes prices in dates just before the flight show a significant reduction

•

An extreme case of the above situation occurs in so-called “last minute” offers

RAILWAY

The vast majority of the railway companies offer their services on the Internet. It is enough to know the name of the company, enter the website and select among its various options to book the ticket. There is no difference between booking railway or airline ticket. Europe, with a map of short distances between cities and not so significant geographical features, has a large railway network.

BY ROAD AND BY SEA

If you type in any browser “rental vehicles”, you will get many results where you can notice a huge variety of affordable options to rent motor vehicles. As a general recommendation it should be emphasized that it is better to turn to well-known and

This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information 78 contained therein.

MODULE 1 INDIVIDUAL AUTONOMY reliable companies with an appropriate data protection policy for their booking and payment system.

Bus transportation can be also coordinated through Internet consultation. However, since the availability of the tickets in this mean is usually simpler, often this part of the trip can be arranged directly at the counter or by telephone reservation.

The companies operating on different seas are advertised on the Internet and display their rates and offers. The most active ones are those which connect continents with the islands or those crossing the straits.

The browser of ferries across Europe: http://www.aferry.com/ and for cruises http://www.myphotographs.net/travelinformation/cruises.html BOOKING HOTELS AND ACCOMMODATION

Nowadays, every respected guest house must have an attractive and updated website.

Not only hotels, hostels, guesthouses, lodgings or campsites, but also individuals who offer their apartments for the holiday season use websites to publish their offers.

That is why servers, browsers and portals offering these services have expanded and centralized the offers, established price categories, quality and type of establishment according to the criteria provided by the bidders.

No wonder that online booking has become one of the most popular activities of the virtual tourism.

The information about hotels, apartments and hostels are endless on the Internet. Try typing the word Hotel in Google and more than 847 million results are found.

Therefore the search criteria must be adjusted, for example if one of the criteria will be Hotel in Rio de Janeiro, the result is reduced to 1,8 million references. If we add more search criteria such as Hotel in Rio de Janeiro, Copacabana, there are still many results, although among the first ones the correct website will be displayed.

Another possibility is to use a browser; a portal specialized in finding hotels, for example: http://www.booking.com/index.html and http://www.hotels.com/

This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information 79 contained therein.

MODULE 1 INDIVIDUAL AUTONOMY The accommodation browsers often provide lists of hotels, hostels, apartments and other classified by categories. These portals usually include additional useful information like maps or itineraries and offer an access to a booking database.

Finally, on the portal website or hotel website the convenient reservation can be preceded. Calendars of rooms’ availability are often provided in order to make this task easier. In other cases, the hotel network connected with the portal provides an intelligent search through price selection, category and other criteria. When it is not possible to satisfy the client’s request, alternatives of other similar hotels nearby will be provided.

Once selected, the user will make the reservation by completing the form and providing, usually, his credit card details. The booking formalization will make the centre send a message (usually by e-mail) to the address specified by the user, committing to keep the reservation and specifying accommodation, payment and cancellation conditions.

The message received from the accommodation centre will be valid and it is recommended that the user take it with him to his destination to enjoy the accommodation.

As usual, to avoid a surprise during card transactions made online, it is recommendable to work with a safe system and to check attentively bank documents confirming the payment and describing in detail the credit card balance.

This project has been funded with support from the European Commission. This publication reflects the views only of the author, and the Commission cannot be held responsible for any use which may be made of the information 80 contained therein.

" Thi spr oj ec thasbeenf undedwi t h s uppor tf r om t he Eur opeanCommi s s i on, t hr ought he Li f el ongLear ni ng Pr ogr amme–Leonar dodaVi nc i .

Thi sl ea etr e ec t st hevi ewsonl yoft he aut hor s , andt heEur opeanCommi s s i onandANPCDEFPc annotbehel d r es pons i bl ef oranyus ewhi c hmaybemadeof t hei nf or mat i onc ont ai nedt her ei n"