Telehealth: More Access to What We Need

Graphic of a hand holding a wrench. Text says, "Info, strategy"

By Jen Mullins, BS, CTRS, MATP Staff

Earlier this year, I had an experience that I think many of us have had: I was home sick with a cold/virus/etc. and couldn’t get an appointment with my regular doctor (not that I really felt up to leaving my home to drive to the doctor & sit in the waiting room anyway).  Thankfully, there was an accessible solution I hadn’t even considered:  a co-worker informed me that telehealth is a part of our health insurance and I could have a video call with a doctor to get checked out & get medicine if they decided to prescribe it.  Shortly after speaking with my co-worker, I had downloaded the app and was “on hold” waiting to video chat with a licensed physician; all from my phone! Hold screen featuring the image of a doctor. Text: You are the next patient to see Rebecca Beach-Beyer, Family Physician.

When a telehealth doctor was available, they greeted me, asked a few questions, looked at the brief medical history I had typed into the app, and prescribed me an antibiotic (she said she thought I had strep throat, but of course couldn’t do the test for it over the phone).  The telehealth doctor said that I should inform my regular physician if I didn’t get better within the next few days and book an appointment with them then.  That’s it!  The video portion took about 8 minutes and there was a prescription ready at my local pharmacy in about an hour.  My credit card was charged the price of a traditional office visit co-pay.  It was so easy & accessible to me, I remember feeling like I had cheated or something (but of course I hadn’t!)  It got me thinking: why isn’t more healthcare more accessible?  Assistive Technology can facilitate more accessible access to healthcare.

Illuminated light bulb

I’m an avid NPR/Michigan Radio listener and recently listened to a piece that talked about Telemedicine for Autism-related therapy.  The therapy mentioned in the piece traditionally requires a therapist to come to the individual’s home to provide An adult woman reading a book to a small child.support/assistance to person and the caregivers.  With Telemedicine, the therapist Skypes (does a video call) with the individual and their team/family to observe and provide those same ideas for support/assistance.  The family highlighted in the radio piece lives in a rural area and it’s not always convenient or covered by insurance to have therapists come to them; a video call is a great solution and reportedly works well for their family.

While doing some household chores recently, I turned on one of my favorite podcasts, The No Sleep podcast.  While I listened to the commercial introduction, I heard an advertisement for Talkspace: therapy via an internet connection.  My ears perked up and I smiled at hearing more about other applications of telehealth!  Talkspace’s website shares: “We created Talkspace so more people could benefit from therapy and overcome their day-to-day challenges in a stigma-free environment.  We are not trying to replace in-office therapy. Many people prefer that, which is fine. It can be difficult to wait days or weeks until your next appointment. With Talkspace, you can send your therapist a message whenever you’re near a laptop, tablet, or smartphone.  Talkspace has therapists that can help you with depression, anxiety, the challenges of being part of the LGBT Community or a Veteran, and more.”

Man texting on his phone.

The applications of telehealth I mentioned in this blog post are only a few of what’s available and more and more is being added/made accessible everyday.  Have you used telehealth before?  Would you consider using it?

Universal Design in Learning

by MATP Staffer Laura Hall

The term “universal design” has been around for quite some time.  Universal design refers to the idea that if structures are built to accommodate a particular group, say, people with disabilities, they also accommodate the rest of the population.  Power doors, for example, help people with disabilities navigate entryways, but they also help people with strollers, older adults, delivery people, etc.

This same idea is now being applied in education through Universal Design in Learning (UDL) Did you know that learning styles can be as unique to a person as their fingerprint?  The idea behind UDL is to make goals, methods, materials, and assessments accessible to every learner.

Pictures of different ways to express learning with pictures under each style. Includes: Interactive Writing, E-Book, Podcast, 5 profiles, visual narrating, narrated art, screencast, puppet video, quick edit video, Geo Map, Simulation Game and Digital StoryTaking into consideration diverse learning skills, this may mean that goals for a particular piece of the curriculum are expressly stated, written, or perhaps the student can develop his or her own goals.  Perhaps the method of teaching could vary with written instructions, verbal instructions, the use of pictures, video or other types of media, hands-on experience, etc.   The assignment a student turns in may not be something written.  A model or diagram, video or music, picture, podcast or oral story are just a few of the ways that learning can be demonstrated.

So how does this relate to assistive technology?  Just as power doors assist more than just people with disabilities, I believe that assistive technology in the classroom can assist all students, not just those with disabilities.  Photos that are described using alt-text, traditionally used by people with visual disabilities, could help any student who may be more of an auditory learner, as could audiobooks and textbooks.

Pen friend being used to identify cereal boxes
Pen Friend

I recently attended a conference session where the presenter was discussing UDL.  He gave an example of UDL in a college course.  For this course, the professor chose 4-5 students to submit their class notes to be scanned and uploaded to an online system that all of the students could access.  Some students took copious notes, some used outlines, some drew very detailed graphics, and another chose to highlight keywords.  All of these different styles of note taking could then be accessed by students with different learning styles.  Imagine if notes could also be taken with the Livescribe Pen, which records audio and synchronizes it with the text written, then accessed by all students. What if the Pen Friend, an audio labeling device, was used to help students learn the parts of the human body?  Test questions could be read with the labeler and answers given in writing, auditorily, or by demonstration.

It should be noted, however, that UDL should not replace accommodations or specific assistive technology need by students with disabilities in the classroom.  UDL provides the opportunity for AT to be used in a broader sense, but each student should be assessed for their individual needs and be provided accommodations or technology that meets those needs.

Personally, I know that I am an auditory learner, one that takes detailed notes, and expresses myself best through writing.  What type of learner are you?  What do you think of Universal Design for Learning?

 

 

 

Smart 911: Your Path to Safety in a Disaster

One of the enduring problems for people with disabilities who find themselves in an emergency or a disaster is the inability of the systems of emergency response to actually help them with the problems and threats they face. Once the emergency has occurred, it is too late to go through the complexities of your personal support system and health care needs. Response systems are largely operating on automatic during the early part of the emergency and they seem incapable of nuance.

Various registry approaches with, for example, power companies have been set up, but they all involve great practical difficulties in actual use not the least of which is the need for updating every time your needs in an emergency change.

There is a system out there that goes some way to reducing these barriers to safety in a disaster for our community. It is called smart911, and its purpose is to enable first responders to know what you need and want while they are responding. It is very flexible and allows for a wide variety of the kinds of preparation you can build with first responders. I would suggest that you work on it a little at a time so that you can more easily think through what you need.

You can start at the home site for smart911 at https://smart911.com/

I would scan the “How It Works” menu first. You can find out whether the service is part of your area by entering your zip code. You should also review the Security and Trust section, maybe several times over the period when you enter information. It can be daunting to fill out even if you know the information you are sharing could be crucial to your survival in an emergency.

I live in Ingham county and there is an active smart911 service here, so I have been working on filling our data in over the last week.

You can include just about anything you believe is important to your safety, even for pets and service animals.

Note that the information is only available after you call 911 during an emergency and only to first responders. Smart911 saves about 11 minutes per person in response, which is a lot of time in an emergency. And the info is only available for a short period of time. The service is very popular with users.

Take a look today. We all need support for emergency response.

hispanic female fire chief from Washington, D.C.

“One of the things we fail to think about is the fact that when a person is dialing 9-1-1, it can be a very chaotic environment and there could be a lot of panic involved. If they have preloaded a profile that automatically populates for our responders, we have useful information, even if the person cannot relay all needed information to us.”

Are You Spring Cleaning? Consider using the ATXchange.org!

skunk on snowy groundWhile the weather in this part of Michigan continues the long cold winter, there are some subtle signs of Spring, despite the snow coming the next few days! We were woken from a deep sleep last night at about 3 AM by an encompassing awful (!) aroma of skunk. I’ll take daffodils any day over that sign of Spring!

Blue bucket, pink mop and multiple bottles of cleaning products

One of the things many people do in the Spring is clean and clean out. As you delve into those closets and garages, you may find still usable assistive devices that have been outgrown, replaced or no longer needed. If so consider listing these on the Michigan’s Assistive Technology Xchange web site!

The AT Xchange is a web site where people can buy, sell, or give away assistive technology (AT). The AT Xchange is open to vendors who have used equipment for sale also don’t worry about cost, AT Xchange is a free service! Check out our article on safe online buying and selling using the ATxchange: Using the ATXchange: Buying and Selling Tips.

Did you know you can also check to see if someone has posted a want ad? One the site, select “Items” and then under Item Type, select “wanted”.

And if you need Assistive Technology to help with your Spring Cleaning, you can check out our webinar on AT for Spring Cleaning!

Spring will come (eventually). I can’t wait to open windows and see flowers! Happy Spring Everyone!

daffodils in snow

My Driverless Car!

Post Foreword: Driverless cars seem to be in the news more and more these days. The recent, tragic accident raises concerns and the potential benefits for people who can’t drive due to a disability.  Guest blogger, Cathy McAdam shares her desire for a driverless car in this blog post.

Car parked on the street. No one appears to be in the driver seat.

By Guest Blogger Cathy McAdam

Yes, I want one: Self-driving car, and have been asking family and friends if they will take a ride with me, (a driver who is totally blind)! Many have said yes, and some hesitate wondering as many do just how safe these cars (autonomous-vehicles) will be.

View of the inside of a taxi from outside of the vehicle. There are fuzzy dice hanging from the rear view mirror and a sign that says: taxiMy initial excitement has been a bit dampened by the reality of licenses needed and the current demand for a steering wheel and breaks and in most cases a backup driver.  However, I still feel for many of my low vision friends and others with disabilities that there is tremendous potential for driving, and adding to public transit options; such as a driverless taxi.

Technology is of course always changing.  A wheelchair user I connected with online expressed concern for maintaining his current adaptive equipment, and this of course is a valid concern. How many times do people make assumptions that something we love, use, and even need, is no longer a valid approach? And then it gets removed from the market (for example: simple, basic cell phones). For many others the increased support of warnings for backing up or changing lanes, and assistance for parallel parking may already be a welcome support. I choose to believe that somewhere on this winding trail there will be many benefits for those of us across the disability spectrum. Some with low vision now drive with the help of optical lenses, and surely will appreciate some of the progressive changes already in motion. Many who have difficulty concentrating or processing information under stress will also silently benefit as safety features increase.

Google seems convinced that a true driverless car without a steering wheel is possible.  View from the driver seat in a car behind the steering wheel.Some propose that the software is “the driver” leaving room for revising licensing.

One of the things I found when researching this topic was very exciting. The inventor of cruise control was an engineer who was blind. Fears of his invention parallel some of the concerns that drivers will day dream, not pay attention to their surroundings and lose control. (Maybe you were pulled into the hoax of a Stella award given to a woman/man who left cruise control on to go make a sandwich in the back of their Winnebago).

So I imagine we’ll hear many exaggerated stories about this awesome technology being developed for my driverless car. The more we include people with disabilities in the development, testing and real discussions about this technology the better the outcome! I’ll still be waiting to drive my real friends even if it takes 20 more years!

Will you come for a ride with me?

View from the passenger seat and the outside world is speeding by in a blur.

Panic Attack? There’s an app for that!

I had my first panic attack exactly 3 years ago, outside my doctor’s office. I’ve also had some PTSD flare ups recently so wanted to share this older blog post about my first panic attack as a reminder to myself and hopefully a help for others who have panic attacks.

In 2015, stress from recent health crises and triggers from childhood trauma culminated in a very scary experience–the panic attack in the parking lot of my doctor’s office. My friend was able to talk me through breathing /stopping hyperventilating and came to get me and take me home.

I later talked with my therapist about plans to prevent a future full-blown panic attack. She suggested noticing symptoms that came up as my anxiety increased. For me this is sweating, pounding heartbeat, and feeling trapped. Knowing this, she suggested using several interventions to prevent escalation and  breathing techniques to try to calm myself. This worked and helped for the next couple of days.

That is, until I was at an emergency preparedness conference and they were talking about critical incident stress management (CISM). I had recently run into a woman who I worked with when she/we were attacked and she was choked at our workplace. She could have been killed in the attack. After that incident, we had a critical incident debriefing. At the conference, the memories of that incident started to come flooding back, along with the feelings of guilt having recently run into my former colleague. Then, the conference presenter showed a video of workplace violence as an example—in a hospital setting (which was the setting of our attack). So, then I was done for. I hastily left the room and retreated to a quiet corner down a hallway.

I was breathing rapidly and tried to call a therapist friend immediately as my attempts at regulating my breathing were failing miserably. I got a voicemail. Not wanting to bother the friend that helped me last time, I decided I was going to try to go it alone until the therapist could call back.

the front page of the PTSD Coach App

I remembered that I had downloaded PTSD Coach, an app designed by the Veterans Administration, onto my iPhone and had been using it for anxiety and depression. The app has a tool for managing symptoms and one of the symptoms you can select is “Reminded of Trauma.” I selected that and rated my distress on a level from 1-10. I gave myself an 8 and the app suggested tools accordingly. It gave me the option of distracting and laughing/reading a comic book. I thought to myself ummm no, that isn’t going to work right now, so I gave that a thumbs down and asked for a new tool.

PTSD Coach then suggested Deep Breathing—putting on headphones and being led through a breathing exercise. Nice idea, but I left my headphones at home and I was at the end of a hallway where people could possibly hear me. New tool please!

Then we started to get somewhere—the app suggested slowly counting to 100. Yes, that helped me calm down some. Progress! After that, I asked for yet another tool, and it guided me through the RID Tool. R= relax. The app suggested breathing in and out slowly. As you breathe in think “let,” and as you breathe out think “go.” A 30 second timer started counting down.  You can then add 30 more seconds or move on. I took another 30 seconds.  The I=identify the trigger. The app suggested going over the last few minutes and hours and identifying what reminders of your trauma you encountered. I easily listed these in the space provided.  It then said once the triggers are identified, it is important to notice how it is just a reminder, and not the actual trauma happening again. At first I thought, “Well, duh, I know that,” but telling myself that did actually help. Then I filled in the box about how this experience was different from the actual trauma. In D, you decide what to do now, the app said you can try to decrease the trigger’s power by deciding to stick around and see that you can handle it and that your stress will actually go down the longer you stick it out. It also suggested if you are angry or in danger of harming yourself or others, you should take a time out and seek support. I decided to sit outside the meeting room for a little longer in peace and rejoin the conference at the next break. I did attend a few more sessions then found myself completely exhausted and decided to leave the conference early.

Meanwhile, I tried one more tool before going back to the conference. The app suggested a grounding exercise, “Walk slowly focusing your attention on what it feels like to take each step.” This was a great way to re-center and continue calming myself. I got outside for a walk and remembered that walking and being in nature always helps me. After my walk, the app asked me to again rate my distress level. I gave myself a 5. Much better than before.

***Note if you give yourself a 9 or 10 the app does suggest calling for help using people you have pre-loaded into the app and/or nationwide hotlines.

Have you tried PTSD Coach? Has it helped? Any other apps that help you?

Transitioning from School to Life: AT Considerations

By Laura Hall, MATP Staffer

Graduation cap, diploma, and books

Transitioning from school to life is an exciting time for any student.  Yet, accessing assistive technology once out of school can be a much different process.  In K-12, the Individuals with Disabilities Education Act (IDEA) requires that assistive technology be considered for all students during the IEP process.  If AT is determined to be necessary, the school district must provide it.  School districts also have access to ALT + Shift’s AT lending library.  The lending library allows schools to borrow devices for up to eight weeks, enabling the IEP team to evaluate the effectiveness of the AT before purchasing the product.

The process changes once a student transitions out of high school.  Students are no longer covered under the IDEA and schools are no longer obligated to provide assistive technology.  This means that students must be more proactive in advocating for the assistive technology they need whether they are transitioning to higher education or employment.  Students should be involved in transition and IEP meetings to discuss and prepare for their assistive technology needs beyond high school.  In K-12 education AT is considered the property of the school district, however, it may be worth asking if the student can take the assistive technology with them beyond high school or purchase it from the district.

In higher education, the student is responsible for pursuing the AT and accommodations they need in college.  Most colleges and universities have disability services offices that can help with this.   Professors may require a formal letter to request accommodations, like extra time on tests, or a notetaker in classes.  The Michigan Association of Higher Education and Disability (MI-AHEAD) has resources on transitioning from high school to secondary education, including a list of considerations related to AT and accommodations.

Green and white road sign reading "new job, just ahead"Michigan Rehabilitation Services can help students transitioning from school to work. through their Pre-Employment Services.  They can attend IEP’s and offer consultation services beginning at age 14, so becoming involved with MRS early may support the transition process.  The Youth Transition Services FAQ document through MRS contains a wealth of information about the services they provide.

For more information on transitioning from high school to life, check out the resources below:

The Michigan Assistive Technology program also has an archived webinar “AT and Secondary Education” and a resource document as well.

Have you transitioned successfully from school to life?  What was your experience?  Do you have any other resources to share?