Physical Characteristics Assessment

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Physical Characteristics Assessment

• Computer Access for Individuals with Cerebral
  Palsy

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What is Cerebral Palsy?

• What It Is.  Cerebral palsy, or CP, is a
  heart-breaking condition for the parents of
  children who are over-powered by an inability to
  control body movements.  CP is known as a static
  encephalopathy, meaning that once the condition
  has resulted in permanent brain injury, the
  number of brain cells lost does not change over
  time.  Approximately 500,000 people in the United
  States have cerebral palsy.  CP symptoms include
  unusually weak muscles or tight, spastic muscles.
  There may be difficulty with balance, poor
  coordination, abnormal reflexes, and delay in
  developing motor skills such as sitting, walking
  and talking.
• The name cerebral palsy refers exclusively to
  problems with movement, but the underlying brain
  injury often causes other neurological problems. 
  Many children with CP will also develop seizures,
  and some most unfortunate individuals will have
  severe mental redardation as well.  Cases of
  cerebral palsy can range from severe to mild and
  almost unnoticeable.

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Why was PCA Developed?

• Prior to the PCA, there wasnt any other AT
  assessment developed specifically for individuals
  with physical limitations of cerebral palsy.

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PCAs Purpose is to determine

• Body parts and movements that will enable
  computer activation
• The type of device that can facilitate computer
  activation
• Basic postural considerations related to computer
  access by individuals with cerebral palsy

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The PCA was developed with the following
presumptions

• An individual will activate a computer most
  effectively from a seated position, often from a
  wheelchair
• Persons undergoing evaluation are comfortably
  positioned in a therapeutically prescribed
  seating system
• Positioning devices depicted in this assessment
  are nonprescriptive common household items that
  may be used on a temporary basic to improve
  posture

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PCA Presumptions--Continued

• It is not possible to depict every example of a
  particular posture in this assessment
• It is not possible to depict every available
  device designed to improve sitting posture
• It is not possible to depict every computer input

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PCAs Design

• Body Parts for Activation
• This part is the most important, because it
  determines which parts to focus on or to omit
  from the PCA.
• Finger Activation
• Use of devices to facilitate finger-activated
  direct selection via a standard, adapted or
  alternative computer keyboard
• Activation via Head Pointers, Mouth Held Devices,
  or Voice
• Use of pointers to permit head-activated direct
  selection via a standard, adapted, or alternative
  computer keyboard or via voice activation

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PCA Design--Continued

• Activation via Hand/Arm Movement
• Evaluation of hand and arm movements in relation
  to switch placement for indirect (i.e. scanning)
  selection of input data
• Activation via Head Movement
• Evaluation of head movements in relation to
  switch placement for indirect (i.e. scanning)
  selection of input data
• Activation via Knee Movement
• Evaluation of knee movement in relation to switch
  placement (i.e. scanning) selection of input data

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PCA Design--Continued

• Activation via Foot Movement
• Evaluation of foot movements in relation to
  switch and joystick placement for indirect (i.e.
  scanning) selection of input data
• Basic Postural Considerations
• Identification of basic postural considerations
  designed to reduce fatigue and stress and
  facilitate computer use

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Equipment Needed for Evaluation

• Computer monitor
• Computer keyboard
• Mouse
• Trackball
• Key guard
• Light pointer (optical indicator)
• Switch Assortment
• Joystick
• Voice Recognition
• Enlarged Keyboard
• Mini Keyboard

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Positioning Equipment for PCA

• Utility holder
• Mitten
• Finger guard
• Wrist support
• Wrist rest
• Forearm support
• Head pointer
• Chin pointer
• Mouth pointer
• Cushion
• Foot stool

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PCA Results

• The Table where results are recorded looks like
  this (a picture will be inserted)

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PCA Results Summary

• The Summary Chart looks like this

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PCAs Critique

• To the question Did your method of computer
  activation change as a result of this
  assessment?
• 50 of respondents agreed
• PCA is a great assessment tool, so long as it is
  used in a greater framework, i.e. embedded in the
  SETT or Unifying Functional Model, where, except
  for the strict needs assessment, the specific
  environment in which an individual functions is
  also considered.

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References

• Fraser, Beverly, A., et al, Physical
  Characteristics Assessment Computer Access for
  Individuals with Cerebral Palsy. Don Johnston,
  Inc.
• (on cerebral palsy)

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Web Resources for Further Reading

• On Cerebral Palsy
• http//www.cp-information.com/main.htm
• http//www.about-cerebral-palsy.org/definition/spa
  stic-athetoid-ataxic.html
• On PCA
• http//trecenter.org/appendixA.htm
• http//fritschi.home.mindspring.com/offlipub.html