1User needs and goals:

The first part of any assistive technology assessment, involves a detailed assessment of the users needs and goals. The user himself or herself should be the most important part of the first date of this assessment. Before thinking of the technology, types of switches, or activities, it is essential to take a long hard detailed look at the types of challenges experienced by the user, the types of activities he needs to participate in, and also his strengths and skills. Only by identifying the areas in which improved function or participation is needed, can you go on to identifying the types of assistive technology equipment and applications which may assist.

A couple of excellent resources discussing the assessment process for assistive technology in detail, are the following: 
www.joyzabala.com
.This web site discusses the SETT Framework for assessment in detail.
www.qiat.org  The Quality Indicators for Assistive Technology Services web site provides extensive resources related to assistive technology and assessment.

2Determine type of access method:

Selection Methods for Input
It is important that a specialized assessment for adaptive switch input is only carried out following an overall assessment of the various options for adaptive input. There are an enormous number of different options in terms of input methods available to individuals with disabilities. Types of input methods can be generally placed into one of three different categories:

Direct select: this refers to any method that involves selection of an item with pointing of a finger, or any kind of pointing device such as a head stick or palm pointer etc. Direct select involves the choice of a specific focus or target point with a motor movement which is directed specifically towards the target point. Because of this immediate action selection, direct select is almost always the selection method of choice if it is possible for an individual, given a range of modifications and customized options. In almost every case, direct select will be the most efficient, quickest method of access for those who are able to cope with this access method. If an individual is able to actively select items through a direct point method, and is able to make selections accurately, this will in most cases we the method of choice for input. Pointing to make a choice, is one of the most normal and natural early developmental skills learned in a young child. As such, even for someone with a severe disability, pointing and reaching is one of the most natural and intuitive methods of making a selection.

Direct select, however, is not possible for all users. It is important to look at the many other types of input and selection methods available.

Directed selection: this refers to a method of making choices by moving and items or cursor around towards the selection choice. An example of this, is the use of a joystick, mouse pointing device, head mouse, or even some mouse control systems using directional switch control. As the cursor, or box / selection items on the screen is moved around towards the desired choice, the movement is a directed movement of a cursor to make the selection, hence the term directed selection.

Directed selection can be a very powerful and effective method of input for some users. In almost all cases it is not as quick as direct select, however for some users it may be significantly more accurate in terms of accurate item selection compared to direct select.

Indirect selection:  for individuals with significant physical disabilities, indirect select often offers a whole new way of participating in functional activities, producing work, and participating in communication and recreational activities which would not otherwise be possible.

Indirect select involves the use of hardware, which generally takes the form of adaptive switches, used in combination with a range of equipment such as computers and communication devices, running different types of programs for various functions. There are a number of different types of indirect select options and methods:

Single switch direct response
Single switch automatic timing scanning
Intermediate two switch step scanning
Two switch step scanning
    row-column, block, inverse
Encoding

3Assessment of biomechanics, joint movement and switch control sites:

See online, interactive information about joint movement and switch control sites.

Some important points to consider when selecting a joint movement and control site for switch placement:

SMALL, CONTROLLED MOVEMENT:  The movement should be as small and controlled as possible, using the least amount of energy and effort.  Only a small, controlled movement can be repeated many times without causing excessive stress on the joints or resulting in fatigue.

MOTOR LEARNING AND SKILL DEVELOPMENT:  Learning to activate and control switches is the same as any other motor skill learning - it requires time, many, many switch hits per day (in the hundreds...), repetition of the same movement, and perseverance as in learning any new physical skill.

LOW PROFILE AND UNOBTRUSIVE:  another reason for opting for smaller switches is that the switch itself should not be 'the activity'!  The switch should become 'transparent'.  It should be simply a means of 'making something happen', participating, communicating and being involved in other activities.  The switch should be out of the way of all activities, not interfere with placement of objects; it should not obscure visual contact with activities or communication partners.

VISUAL TARGETS!!!:  If at all possible, the switch should be set up so that the user can access the switch without looking for the switch.  If a user spends his time and effort looking for the switch and trying to access it, that means visual contact and attention is taken away from the communication partner or activity at hand, to find and activate the switch.

EXTENDED USE SETUPS:  For many switch users, switches are their means of access for many activities during their day.  If possible, switch control sites and types of movements and switches should be selected with keeping in mind the need for use at all times.  For those who need changes in switch setups, these should be quick and easy to set up and move.  For those who need access to a switch or switches all day, make sure those are accessible in all environments and positions. 

4.  Select type/s of switch/es:

5.  Applications - what are the activities and tasks for participation and communication?:

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