Occupational Therapy Essay Research Paper We are

Occupational Therapy Essay, Research Paper

We are a group of occupational therapists and a new client has come to our office with the following case history:

Don is a 63 year-old amateur poet. He has several of his poems published in the local newspaper but has not yet been accepted by any literary journals. Three months ago, Don had a cerebellar cerebrovascular accident that has given him significant fine motor control limitations. He is not able to hold a pencil or a pen, and when one is taped in his hand, he can not produce recognizable printing. He is able to reach a range of nearly 5 feet from side to side but cannot pick up a 1-inch cube from the table. When asked to use a keyboard, he is as likely to strike two keys away from the target as the key he is aiming for. He is able to put his finger reliably into a square that is 2 inches on a side wherever it is located within his reach. He is not able to accurately place his finger into a square that is 1.5 inches on a side, however, unless it is located directly in front of him (Anson, 1997, p. 104).

Don is frustrated by his condition and needs some assistance to continue his writing. We used the decision tree to evaluate which computer adaptation would be best for Don. We determined that Don has physical limitations to the computer but has full range of the keyboard. Due to his trouble targeting specific keys, it would be increasingly difficult to simultaneously press more than one key at once. The client has frequent accidental keystrokes because of the size of the small keys. His inability to strike a single key on demand led us to expanded range of motion. Having assessed that Don could strike larger keys accurately; we reached the alternative of expanded keyboards.

Upon researching expanded keyboards, we found a great variety in what each keyboard offered. The 32 key layout with 2.5- inch keys did not provide an adequate selection for Don’s writing needs. Most of the standard expanded keyboards with 128 keys only have 1.5-inch keys. Some examples are Key Largo and Unicorn Expanded keyboards. Key Largo is an expanded keyboard, which works through Discover KENX. It is useful for one with coordination problems. Unicorn Expanded keyboard established the standard 128 key expanded keyboard design. We had the opportunity (in A.T. lab) to try and compare the different expanded keyboards. We appreciated that a client with difficulty reaching small keys would find these keyboards more beneficial.

All keyboards require an encoder, which interprets the key. When pressed it converts it to a keyboard code, that the computer could understand. Some computers come with a built in encoder and some without. These keyboards with encoders can be connected directly to the keyboard port of the computer. Therefore no internal adaptation is needed for the computer and it doesn’t interfere with any software in the computer. This is beneficial because it can be used with any operating system and software the client may need. A disadvantage to this is that the keyboard codes are not readily adaptable. This means that the keyboard layout is fixed and can’t be changed by the clinician. Another consideration is that this keyboard can not be connected simultaneously with the standard keyboard.

Since plugging and unplugging the keyboard is not recommended, this option is better suited for a client who would be the sole user of the computer. Expanded keyboards that do not have the built in encoder, require an external device that would interpret the codes to the computer. Although this keyboard has the disadvantage of an external device, it offers flexibility in the keyboard layout and allows for various overlays that change the layout. An example of the latter is the Key Largo keyboard mentioned above.

The problem with 1.5-inch keys is the client’s inability to accurately reach a key of that size unless the keyboard is positioned right in front of him. An option would be to position the client in front of the computer with the keyboard mounted close enough for him to access. Although this alternative was a possibility we preferred to find a keyboard with 2- inch keys.

After researching this alternative on the internet, we found a product that matched Don’s needs more efficiently. The name of the product is Expanded Keyboard for Apple II+ and IIE. This keyboard operates as a standard keyboard with the choice of 1.5 or 2-inch keys. With continued research, this was the only product with a two-inch key option. This is a perfect size key for Don’s needs. This keyboard can be connected at the same time as a standard keyboard. This would allow other family members to use the computer without having to constantly connect and disconnect his keyboard. Sticky key option is included in this keyboard. The flat surface of the keyboard will allow the use of overlays. In addition this keyboard allows all the same functions as a standard keyboard. This is an important fact considering Don’s interest in writing. The dimensions of the keyboard are 14 by 32 by 1, with the weight of six pounds. The pricing range is listed as 750 to 875 dollars. The manufacturer for this product is EKEG Electronics Co Ltd.

An additional way to address Don’s problem of accidentally striking untargeted keys is the option of delayed acceptance. With delayed acceptance the key must be pressed for a certain amount of time