Case Studies Karten s C T E C Centre-

Case Studies Karten’s C. T. E. C Centre- Petach Tikva November 2010

Merav & Michal- Background • Meirav, 30 years old • BA in political science from Tel Aviv University, and MA in International Relations from the Jerusalem University. • Works at public relations office -full time.

Merav & Michal- Background • Michal, 38 years old • BA in Aerospace Engineering and MA in risk management. • Worked at the Security project at Athens Olympics as analyst at Financial consultant • Since 2002 due to her medical conditionworking with her mother- owned translation office. Working from home

Diagnosis Hereditary neuropathy with liability to pressure palsies • A disorder that affects peripheral nerves. These nerves connect the brain and spinal cord to muscles as well as sensory cells that detect touch, pain, and temperature. • In people with this disorder, the peripheral nerves are unusually sensitive to pressure.

Hereditary neuropathy with liability to pressure palsies • Recurrent episodes of numbness, tingling, and/or loss of muscle function (palsy) • An episode can last from several minutes to several months. • Repeated incidents can cause permanent muscle weakness or loss of sensation. This disorder is also associated with pain in the limbs, especially the hands. .

Diagnosis • Pains- constant sense of tingling throughout the body. • Drug treatment- Coordination impairment • Decline in lung function - assisted respiratory support when needed at night. • Breathing difficulties- Memory impairment, confusion and Insomnia.

Diagnosis- cont’ • • General weakness & fatigue Mobility - difficulty performing transitions Uses crutches Adjustment processes motorized wheelchair. (Michal)

Objectives • Directed by Rehabilitation worker from Rehabilitation Departments of the social security bureau • Assistance Technology (AT) Assessment • Workstation evaluation and adjustment

Operational objectives: • Maximum utilization of the energy invested • Emphasis on diversification pressures during use of the input environment (seating). • Efficient use of computer input device.

Difficulties and solutions Work environment: • Prolonged sitting causes- pain, hyper sensation and discomfort. • Difficulty performing transitions sitting and standing Adjustable chair, built according to customer's measurements. Allows changes of position at the touch of a button

Work environment: cont’ • Difficulty at working over time • Telephone grip difficulties • Adjustable Mobile Table • The hand supported by the armchair handles • Cordless phone with built-in speaker / wireless headset use.

Difficulties and solutions. Keyboard • Fatigue • Repetative movements cause pressure and fingers loss of sensation. • Using the laptop keyboard- reducing range of motion • Connecting an external numeric pad. • "Sticky Keys“- using shift, alt, ctrl & win logo key by pressing one key at a time. • Using voice recognition programmer Dragon Naturally Speaking.

Difficulties and solutions. Mouse • Fatigue caused by moving the mouse. • Difficult to press the mouse buttons. • Trackball with programmable buttons • Location- thigh or the arm chair • Pointer option- Snap to

Background- Iris • Iris 42 Years old • Marital Status- married with one child two years old • Interpreter- Video Editor

Diagnosis • in October 2003 - she lost consciousness, following an asthma attack, for 10 minutes. • Unconscious for two months. • Metastatic brain damage • Cortical vision impairment • Motor skills- fine motor skills activities

Objective • Directed by Rehabilitation worker from Rehabilitation Departments of the social security bureau • Assistive Technology Assessment- part of her vocational rehabilitation options • Training Program – Touch typing – Shortcut Keys

Operative objective • Writing a book about her experiences from the coma.

limitation factors • Vision– Flickering vision – Seeing shadows and colors • Motor – Joint stiffness – Tremor – Difficulties performing activities that require fine motor skills – Transitions – Unstable walking

Solutions- Keyboard Limited range of motion and tremor Difficulty In Identify letters on keyboard Using a standard-sized keyboard and pasting embossed stickers or velcro Using filter Keys- ignoring brief or repeated keystrokes Training Program - Touch typing

Solution-Mouse: Difficulty locating the mouse cursor. Partial mouse control • Using a standard sized mouse. • Reducing the use of mouse by Learning to use keyboard shortcuts. • large mouse cursor, colors opposite of Windows, showing pointer trails • Activation function "snap to"

Solutions- Work environment • Difficulty performing transitions between sitting and standing and vice versa. • Difficulty connecting portable memory • Tremor and joint stiffness • Table with cut off • Chair with hand brake • USB connection extension that will allow convenient connection • Familiar and permanent environment

Solutions- Vision Difficulties in locating objects and identifying letters. Glare sensitivity. Display adjustments: 21 “ screen size Desktop background - blue, reduce icons. Fonts- Arial font, 200 pts. Software: Using Text to speach software ש

Individualized learning program Touch typing Keyboard space orientation Shortcut Keys Using Speech to text software

Builds palaces with spoon • Iris studied for about a year: – Word Processing – E-mail • 2 month ago Iris book was published • The book describes her experiences when she was in a coma

Builds palaces with spoon Using the computer seems to be impossible because of bad eyesight and hands paralyzed. . .

Builds palaces with spoon Then I started to learn touch typing. . . We went to Petach Tikva to Karten CTEC, the Institute that provides IT solutions for the handicapped like me, where I learned to use a computer voice software. .

Builds palaces with spoon Two fingers stiff and trembling wading the computer keyboard, I’m writing this book. Headphones on my head from the screen reading software can helping to achieve the goal. My fingers stiff as Jelly sticks groping between the marks and Scotch on the keyboard. . .