It's
do-able

Technology comes to the aid of those with disabilities in state-of-the-art center.

by Maridith Geuder

The youngest client so far has been one month old. The oldest has been 97.

They may have relatively simple needs, such as a way to hold an over-sized cup steady. Their needs may be more complicated, requiring highly technical electronic systems that allow someone with a severe spinal cord injury to regulate his environment. They may require visual or audio augmentation devices that allow them to communicate effectively, or special mobility devices that allow freedom of movement.

The T.K. Martin Center for Technology and Disability at Mississippi State is serving the needs of disabled citizens around the state. Now 20 months old, the 22,000-square-foot center adjoining the Longest Student Health Center is a one-of-a-kind facility on a college campus.

With primary funding from the Mississippi Department of Rehabilitation Services, the center works to remove the barriers experienced by those who have physical or cognitive impairments. Its primary tool, as the name suggests, is the technology that enhances and expands lives.

"The current status of technology and the ability of new technology allow us to do things for people with disabilities that weren't possible before," said Harry F. (Bud) Rizer, director of the center.

"Here we focus on the concept of accommodation," he explained. "We make things convenient for people. We make tasks do-able. We don't remove an imperfection; instead, we change the environment or modify the task to make it convenient for the person."

Those who seek the services of the center are referred by state agencies such as the Mississippi Department of Rehabilitation Services, by hospitals and home health agencies, and by private rehabilitation companies.

Clients find assistance in areas that include augmentative and alternative communication, adaptive computer access, adaptive driving, assistive technology for visual impairments, assistive technology for hearing impairments, assistive technology for learning disabilities, assistive technology for brain trauma, seating and mobility, home accommodations, and job accommodations.

Since the center opened in 1996, more than 1,100 clients have been referred, but Rizer says that the need in Mississippi is greater than those numbers suggest.

"Mississippi has one of the highest rates of unemployment among its citizens with disability," he noted. "We also have a high incidence of disability in the state. We want to see our service to Mississippi continue to expand."

A recent report from the university's Social Science Research Center indicates that Mississippi leads the region in the proportion of its working-age population who have a work disability.

Among staff members at the T.K. Martin Center are rehabilitation engineers and therapists who consult with clients to determine their specific needs and who match needs with the appropriate assistive technology. Design and fabrication laboratories allow engineers to make an assistive device if one doesn't exist commercially.

I have to communicate my needs

Andrew Whetstone, left, coordinator of seating and mobility services, talks with Walt Shinault of Tupelo, a T.K. Martin client.

In February 1980, Walt Shinault, in top physical shape, took a misstep that changed his life. A sophomore and cheerleader at the University of Mississippi, he had an accident on a mini-trampoline that resulted in paralysis. He spent six weeks in a Memphis hospital before being transferred to Mississippi Methodist Rehabilitation Center in Jackson.

By August, he was back at school. Now, 17 years later, he's an assistant vice president of Merrill Lynch, working in the Tupelo office and managing about $40 million in accounts.

"I first heard about the center from Bud Rizer," he said. Because Shinault's job demands a high level of computer work, he needed assistance converting from a DOS to a Windows format. With the assistive technology recommended at T.K. Martin, he can accomplish the conversion by voice command or by using an infrared signal from a telephone headset.

"I can type letters, and go in and out of programs more quickly," he said. He was at the center last summer for the final fitting for a new wheelchair. "I've had my current wheelchair for five years, and I knew I needed a new one," he said.

The process of matching the technology to the need is sometimes lengthy, said biomedical engineer Andrew Whetstone, who coordinates the seating and mobility area.

"We did two consultations with Walt to determine exactly what he needed," he explained. The staff also did a mock-up for customized seating tailored especially for Shinault.

"I have to convey to Andy my concerns," Shinault said. "The process of working through exactly what I need is lengthy, but if I don't communicate my exact needs, there is no benefit."

Shinault, who says that he and companion Jeff Covington will replace the new chair's joystick with something easier to use, likes the "can-do" attitude at the center. "The people are always positive," he said. "If there's no standard solution, they'll find a creative, innovative way to do the job."

State chairman of Easter Seals, Shinault also serves on the T.K. Martin Center's advisory board.

We want the system to fit the life as well as the body

Adaptive computer technologies can improve the lives of those with disabilities. Specialists at the center can help select and configure entire systems.

Whether the client is an adult who has special needs or a youngster who needs specialized car-seats or strollers, Whetstone says everyone gets a thorough evaluation. "We ask questions about equipment, about environment, about transportation issues. We do a literature review. We want the system to work for the client and for the caregiver. Even a beautiful system can be counterproductive if it's not used."

The T.K. Martin Center works with a wide range of seating and mobility issues and with a range of ages, he explained. There are manual chairs for those who are able to self-propel. Chairs that may do double duty as sports chairs. Chairs that have a seat elevator to bring the user to eye level. Powered chairs that allow independent control for pressure relief or chairs that help the user stand, if a job requires that.

There are "standers" -equipment primarily for children and adolescents who must be in a standing position for periods of time to give their bodies the cues for growth.

And Whetstone can provide very specialized seating, designing cushions molded specifically for a client's body. "We want the chair to fit the life as well as the body," he said.

One of the most gratifying recent cases was a young client, about to turn three years old, who has cerebral palsy. She was not mobile, depending on her parents to move her from one point to another. The family turned to the T.K. Martin Center, where Whetstone was able to set up a powered mobility system. "She's now able to go out to the playground and zoom around with her friends," Whetstone said. "She'd never before had that freedom of movement."

Looking at 'how' and finding 'what'

Sometimes accommodations for homes and jobs can involve minor adjustments, said Dr. Gary McFadyen, the biomedical engineer who coordinates these areas at the center.

Someone who has difficulty holding kitchen utensils may benefit from ergonomically designed knives and forks. Or, someone with impaired motor skills may need a range of assistive devices available commercially, from a tool to help pull socks on to a tool that will help wash their backs. There are chairs for showers and tubs for the mobility impaired. There are amplified telephones and alarm clocks that flash instead of ringing for the hearing impaired. McFadyen will help match these devices to the individual's needs.

He also helps evaluate and design specific solutions for problems that can't be addressed with available assistance.

One client who lost an arm to an accident works at a factory job in which safety procedures require he hit two buttons simultaneously. McFadyen designed and is fabricating an extender bar that allows him to hit both buttons with one hand.

In a similar case, he is making a device that allows a client to loosen and tighten a bolt with one hand. For a client who is a quadriplegic and breathes by using a respirator, the center has designed an environmental control system. The client can turn his head to activate a menu of options that allows him to use the television, radio, and telephone.

"Sometimes our job is to ask what the client needs to accomplish and to find the 'how,'" McFadyen said.

Driver's education

Disabilities don't necessarily have to restrict a person to a lifetime without driving, says Christina Haake, rehabilitation engineer who coordinates adaptive driving.

The center provides evaluations and recommendations for clients who can benefit from adaptive driving technologies.

For those who wish to consider driving as an option, the center assesses visual-perceptive abilities, reaction times, judgment, and physical skills to determine if the person is a candidate for driving with adaptive aids.

"If they're a candidate, we want to determine what they would need to drive safely," Haake explained. The center can prescribe equipment and modifications for clients who can benefit.

Three assessment vehicles help Haake and others at the center determine the technology best suited to individual clients. Vehicles include a sedan with hand controls and a left foot accelerator, a modified minivan that will accommodate a wheelchair driver, and a full-size van with electronic control systems.

If the client is determined to be capable of driving, Haake said, the center provides training in the use of the adaptive equipment. She currently is working with a hearing impaired client who is learning to use visual cues for sounds such as turn signals, horns, and sirens. Other clients may make use of sophisticated electronic equipment that permits voice activation of secondary systems such as turn signals.

Driving tests assure that they're ready to be on the road.

"Recently, we modified a pick-up truck for a client who was unable to lift herself into the seat," Haake said. "We were able to work with her to acquire a truck lift, and she's now going to schooland will be able to finish her degree," she said.

For those who qualify, adaptive equipment ranging from hand controls and steering devices to electronic driving controls can allow the independence to pursue interests or careers, she said. "We're happy when we can help those who have been sitting at home and are now able to do other things."

Reaching out around Mississippi

The T.K. Martin Center for Technology and Disability adjoins the John C. Longest Student Health Center on the Mississippi State campus.

Its location at Mississippi State allows the T.K. Martin Center to benefit from collaborations with faculty members and students, center director Bud Rizer said. Reporting through the Office of Research, the center seeks grants and outreach opportunities to enhance the lives of those on and off campus.

Recently, the center designed remote assessment units for field offices of the Mississippi Department of Rehabilitation Services. Using phone lines, a briefcase-size carrying case, a laptop computer, and a video camera, field staff can have two-way communication with professionals at the T.K. Martin Center. Currently, Mississippi is the only state with such a system in place.

"In a rural location such as our state, the system lets us screen and be better prepared to provide services," Rizer said. "It eliminates travel on the part of the person with a disability for screening and helps us get ready for a client before the first visit."

The center also is working with the Mississippi Cooperative Extension Service and Easter Seals in the Agrability for Mississippians project. One of 19 such efforts nationwide, it provides information and suggests modifications for those with disabilities who are involved in agricultural pursuits.

"Agriculture is one of the most hazardous professions," Rizer noted. "This program extends the services of rehabilitation to those agriculturally employed."

As the T.K. Martin Center for Technology and Disability expands its efforts, Rizer envisions touching the lives of even more Mississippians. "In Mississippi, the center has allowed us to create a central source of expertise. We want to do even more of what we do well."

For more information about the center, contact Bud Rizer at (662) 325-1028 or TDD (662) 325-0520; or access the center's World Wide Web site at www.msstate.edu/dept/tkmartin/.