Ask the Scholar
Document scope · 1 page
Scholar
Ask about this object, its catalog metadata, its source description, or the page inventory.
For page-specific OCR and visual context, open one of the page chats.
Scholar Source Context
Document identity
localId
351002215
label
"Rehabilitation Engineering Sourcebook" [1979]
core
doc
dtoType
document
citationUrl
pageCount
1
Source metadata
id
351002215
contentType
document
title
"Rehabilitation Engineering Sourcebook" [1979]
citationUrl
collections
Lex Frieden Collection: Records on Disability Rights
Printed Materials
imageCount
1
hasImages
yes
source
import
hasTranscription
no
Source extras
naId
351002215
levelOfDescription
fileUnit
recordType
description
ocrSource
nara-archive
Single page context
seq
1
pageIndex
0
type
document
mediaId
d50c6f418f52d5ae
ocrText
Originally Processed With FOIA(s):
FOIA Number:
S
S
FOIA
MARKER
This is not a textual record. This is used as an
administrative marker by the George Bush Presidential
Library Staff.
Record Group/Collection:
Donated Historical Materials
Collection/Office of Origin:
Frieden, Lex, Collection
Series:
Printed Materials
Subseries:
Manuals
OA/ID Number:
52104
Folder ID Number:
52104-003
Folder Title:
"Rehabilitation Engineering Sourcebook" [1979]
Stack:
Row:
Section:
Shelf:
Position:
REHABILITATION ENGINEERING SOURCEBOOK
©
Copyright 1979
Institute for Information Studies
400 N. Washington St.
Falls Church, VA 22046
Library of Congress Cataloging in Publication Data
Institute for Information Studies (Falls Church, Va.)
Rehabilitation engineering sourcebook.
1. Vocational rehabilitation. 2. Rehabilitation.
I Title.
HD 7255. I56
1979
326.8'5
79-24747
ISBN 0-9 35294-02-3
This publication was made possible in part
by Grant #22 P-59236/3-01 from the
National Institute of Handicapped Research
Department of Health, Education and Welfare
Washington, D.C.
PREFACE
The topic for this document was selected by a nominating panel of rehabilitation service
providers including:
Robert Lusin
Jacequeline Sanchez
Vocational Rehabilitation
1265 Race Street
Eastern Area Office
Denver, Colorado 80206
P.O. Box 30010
Lansing, Michigan 48909
Dr. Eugene Murphy and
Tammy Sowell
Eric Lucero, Supervisor
Assistant to the Director
Division of Vocational Rehabilitation
Office of Technology Transfer
Southern District
Veterans Administration
631 Lake Avenue
252 Seventh Avenue
Pueblo, Colorado 81004
New York, New York 10001
The Panel suggested several topics of urgent concern, but gave "potential and actual
contributions from the field of rehabilitation engineering" their clear top priority rating. The
Final Selection Review Board endorsed this choice without reservation, and stressed that the
document should be a practical aid to providers rather than an expository work. Dick LeClair,
Chief, Office of Research Utilization and Training, National Institute of Handicapped Research,
deserves the credit for the initial suggestion that the main body of the text consist of case
examples - paired statements describing actual problems encountered by people with
disabilities and the specific technological solutions which were brought to bear.
This suggestion was followed up by a telephone survey of nearly three dozen rehabilitation
practitioners - with state vocational rehabilitation agency counselors and "sheltered" workshop
personnel being most heavily represented - seeking opinions on the desirability of such an
approach. The idea was met with resounding enthusiasm. Next it quickly became evident that
many excellent sources of suitable data existed in the various rehabilitation engineering projects
throughout the country.
Participating Projects
A program ideally suited to generating the type of information sought was discovered in
Project IMPART (Innovative Matching of Problems to Available Rehabilitation Technology),
established by the Texas Rehabilitation Commission in collaboration with the Southwest
Research Institute with funding assistance from the Rehabilitation Services
Administration. IMPART acts as a clearinghouse in that it receives rehabilitation problems and
searches for individualized solutions. It is a public service available to anyone living in Texas and
neighboring states who has a work related rehabilitation problem. Dr. Carol Whitcraft, Project
Director, expressed the opinion that information sharing such as planned for this document was
"an idea whose time has come" and became the first rehabilitation engineering project director
to participate in its development.
The problem/solution format was quickly dubbed a "Dear Abby" approach, which brought
to mind another source of information, one long appreciated by counselors in the California
Department of Rehabilitation. For more than five years, A.G. Garris, Assistive Device Consultant
with the California agency, has written a column in the departmental newsletter titled "Dear
A.G." Questions are submitted by counselors with problems relating to some aspect of their
clients' performance capabilities in the hope that A.G. might know of some technological
solution. The column has been greatly appreciated over the years because he often did know of a
workable solution. When he did not, he was available to evaluate the situation and could
frequently devise one. A.G. too, was pleased by the opportunity to see wider dissemination of the
fruits of his labors, and those of Charles Eckles, a consultant with whom he often collaborates.
A total of 15 different agencies (centers, projects) or individuals contributed to the
production of this document. In addition to the IMPART and "Dear A.G." files, other sources of
problem/solution statements are described below.
Since 1976, the Rehabilitation Engineering Center of The Cerebral Palsy Research
Foundation in Wichita, Kansas, has published a series of technical briefs titled "Problem Solving
with Rehabilitation Engineering - Tech Brief". Each brief describes specific problems
experienced by clients and employees of Center Industries. Center Industries operates under the
same administration as the Foundation, and is a job shop which predominantly hires workers with
disabilities. Innovative jigs and fixtures created for use there are well represented in the
briefs. John Jonas, Executive Vice President of the Foundation, provided the needed materials for
abstracts of selected briefs to be included here.
Jerry Kuns, Vocational Specialist for the Sensory Aids Foundation of Palo Alto, California,
provided materials describing work and training related problems experienced by blind or
partially sighted individuals and the technological solutions which were successfully applied by
Foundation staff, often in collaboration with other agencies. The California Department of
Rehabilitation, and the Rehabilitation Engineering Center of the Smith-Kettlewell Institute of
Visual Sciences in San Francisco directed by Lawrence Scadden, are two primary examples of
collaborators.
Dr. Samuel Genensky, Director of the Center for the Partially Sighted at the Santa Monica
Hospital Medical Center, provided additional problem/solution statements relating to sensory
aids useful in work, training, or other aspects of the person's life. The Center offers both direct
services to individuals and conducts an extensive research program.
Dr. O.B. Billings of The Institute for Rehabilitation and Research at the Texas Medical Center
in Houston, provided a large volume of problem/solution statements from their files. All aspects
of life performance, from the most basic activities of daily living to very specialized work related
demands are well represented in the materials from TIRR.
Mickey Christiason, Recreation Therapist at Rancho Los Amigos Hospital in Downey,
California, contributed many items on recreation related devices. Most of these are
commercially available but not well known.
The Rehabilitation Engineering Program at Northwestern University contributed a number of
items, and Margaret Pfrommer of their staff was particularly helpful in providing follow-up
information.
Anthony Staros, Director of the Veterans Administration Prosthetics Center, arranged for the
contribution of several richly detailed descriptions of extensive technological intervention on
behalf of very severely disabled individuals. Many of these solutions reflect the innovative work
of Saleem Sheredos, an engineer who works closely with the VAPC Clinical Engineering Center.
The Rehabilitation Engineering Department of the Woodrow Wilson Rehabilitation Center in
Fishersville, Virginia, contributed items reflecting the innovative work taking place in that
program. Reuven Kruger, of the Research Utilization Laboratory made the materials available.
Florian Caligiuri, Executive Director of the California Association of the Deaf provided
materials for the development of items illustrating problems and technological solutions for
people who are deaf.
Ray Disinger, Director of the Special Assistance to the Handicapped Office of Pacific
Telephone in Los Angeles contributed a number of items based on the efforts of that office.
Finally, James Reswick, Director of the Rancho Los Amigos Rehabilitation Engineering
Center, not only arranged for the contribution of case examples illustrating the work of their
Project Threshold, but also provided general consultation and guidance for the development of
this document.
ii
TABLE OF CONTENTS
Preface
i
Table of Contents
iii
List of Illustrations
iii
Abbreviations and Acronyms
iv
I.
Introduction
I-1
II.
Guidelines for Formulating Problem Statements
II-1
III.
Case Examples: Problems and Solutions
III-1
Activities of Daily Living
III-3
Communication
III-11
Homemaking
III-17
Mobility
III-19
Recreation
III-21
Training
III-27
Transportation
III-33
Work
III-37
IV.
Resources for Further Information and Solutions
For Further Information (FFI) Entries
IV-1
Exhibits and Expositions
IV-5
Publications
IV-6
Rehabilitation Engineering Centers
IV7
Indexes
Problem Index
Solution Index
LIST OF ILLUSTRATIONS
SCANNING BLACKBOARD
111-29
TYPEWRITER MOUNT
III-31
CYLINDRICAL PARTS SELECTOR FEEDER
III-38
HOLDING TRAY
III-39
MODIFIED TUBE BEADING MACHINE
111-40
SPINDLE DRILLING FIXTURE
III-46
PNEUMATICALLY-POWERED WIREBENDER
III-49
SPECIAL TYPEWRITER TABLE
III-55
THREE AXIS CRIMPER
III-56
iii
ABBREVIATIONS AND ACRONYMS
ADL
Activities of Daily Living
ALS
Amyotrophic Lateral Sclerosis
BP
Blood Pressure
CCTV
Closed Circuit Television
E&J
Everest and Jennings
HITE
Houston Independence Through Engineering
L.E.
Lower Extremity(ies)
MD
Muscular Dystrophy
REC
Rehabilitation Engineering Center
SCI
Spinal Cord Injury(ed)
TDD
Telecommunications Device for the Deaf
TTY
Teletypewriter
U.E.
Upper Extremity(ies)
VAPC
Veterans Administration Prosthetic Center
VR
Vocational Rehabilitation
iv
INTRODUCTION
Scope of Document
The document is designed to serve as a sourcebook, or reference work, for day-to-day use by
rehabilitation practitioners whose clients find themselves barred from certain activities by
functional limitations resulting from disablement. Here, the user may learn whether a similar
problem has elsewhere been found to have a technological solution. It is a practical aid which
chronicles actual rehabilitation problems which have been successfully resolved through the use
of technology, especially applications issuing from the field of rehabilitation engineering.
Specifically excluded are discussions of historical, theoretical, and programmatic matters (which
are covered in considerable detail in other current reports and articles) on the role of
rehabilitation engineering in serving people with physical and sensory disabilites.
It is not meant to be a comprehensive or exhaustive sourcebook. It is, rather, a sharing of
information which has been recorded in various projects throughout the country on efforts to
solve client problems, through means of rehabilitation engineering, which have worked - at least
once. The selection of cases presented here reflects the response to efforts to encourage projects
and individuals to share information on their successes. It is not intended to reflect the
proportionate efforts being directed into the various problem areas nationwide. Also, there has
been no intention to generate new information in the course of preparing this document. It is
simply a means for disseminating existing information with great utilization potential which has
been heretofore available to only a few.
The looseleaf format was selected in response to high priority recommendations given by
participants in a study conducted by SRI International, funded jointly by NASA and the California
Department of Rehabilitation, aimed at designing a model rehabilitation engineering information
exchange system. Following those recommendations, the materials presented here are con-
strued as a "starter set" to which the user may add as further resource information of a similar
sort becomes available.
The following section, titled "Guidelines for Formulating Problem Statements" summarizes
the most effective ways for either disabled individuals or rehabilitation practitioners to "place
their orders". That is, it describes how to ask concisely and unambiguously for exactly what is
needed - in functional terms - so the respondent can search effectively and efficiently for
exactly what is needed - in technological terms - to devise a solution.
Section Three, titled "Case Examples: Problems and Solutions" comprises the main body of
the text. These are brief summaries of actual problems experienced in the life performance areas
of: Activities of Daily Living, Communication, Homemaking, Mobility, Recreation, Training,
Transportation, and Work, paired with solutions which were successfully used by or known to the
contributors. It is hoped that this material will serve as a consciousness-raising function, with
respect to the remarkable technological potential existent today, as well as its more specific
informational function relating to the cases cited. The fact is, there are now technologically
feasible solutions to a heretofore undreamed of range of problems stemming from physical and
sensory disabilities. Now that this potential is being recognized with increasing funding from a
variety of sources, progress is being made at a quickening pace. Today, there is often good
reason to hope for a device or a system that will make it possible for a blind, deaf or paralyzed
person to do with relative ease what was unequivocally impossible less than a decade ago. The
materials in the third section will demonstrate this, and will also give the reader an overview of
types of work being pursued by each of the contributing projects.
Section Four presents an annotated listing of the contributing rehabilitation engineering
centers and projects. The annotations briefly describe areas of specialization and/or other
pertinent information about the resource cited. The citations in this section are also given as
sources of further information relating to specific case examples in Section Three. They are
repeated in Section Four simply as a convenience to the reader.
Intended Audience
Because the focus of this document is on the types of problems encountered by disabled
people after they have reached the vocational stage of their rehabilitation, it is oriented toward a
primary audience of rehabilitation counselors and work supervisors. Whether a rehabilitation
counselor is employed by a state vocational rehabilitation agency, a local government, a private
agency or facility, or is working in private practice, the problem/solution case materials presented
here should have relevance to problems encountered in the caseloads. Just as no two human
*Christy, et al, "Suggested Approach for Establishing a Rehabilitation Engineering Information Service for the State of
California," Stanford Research Institute International, 1978.
I-1
beings are alike, no two problems and their solutions will be identical; but similar problems
which have been successfully resolved should provide direction to the counselor in seeking a
workable variant that will solve the problem at hand. The same holds true for work supervisors,
whether they are employed by "sheltered" workshop facilities or are working in mainstream in-
dustry.
It is expected that other rehabilitation practitioners will also find the document useful. Re-
habilitation staff in hospitals may find that the kinds of rehabilitation planning they do at the
early stages of rehabilitative treatment are influenced by their knowledge of the increased
potential of their patients for future life and work activities. Thus, occupational, physical, and re-
creational therapists, nurses, physicians, and other allied health professionals may make use of
this sourcebook. It may also contribute to meeting the needs of rehabilitation engineers - as
suggested in the SRI International report cited earlier - for "information on past attempts to
design equipment for particular needs."
Usage of Document
This sourcebook can be used in several different ways. One reader may wish to simply read
through it to gain an overview of the kinds of technological solutions which have been devised to
meet problems which rehabilitation counselors, work supervisors, and others confront in their
work with individuals who have disabilities barring. them from certain activities. Such a reader
would be making use of the consciousness-raising function of the document, becoming familiar
with the general range of problems which can be solved through the application of technology.
Another reader may already be aware of the general range of solutions being made possible
by the field of rehabilitation engineering, and want to use the sourcebook strictly as a reference
manual, to look up specific solutions which have been devised to meet a particular type of client
problem. This reader might use the index tabs to locate the life performance area in which a
client is experiencing difficulty, or the "problem index" listings at the end of the document to
locate a specific problem, or type of problem, which parallels that being confronted.
Still other readers may have heard of devices, or seen them, but be unsure of their
applications. They could use the "solution index" listings at the end to locate the device in
question in order to learn how that device has been used for practical problem solving.
Every effort has been made to provide ample descriptors in the indexes to help readers who
may have only fragmented information about devices, or who may view the problem in terms of
global disability categories as opposed to specific functional limitations. Descriptors relating to
job or other life performance area demands are also included, providing an additional way to key
into the materials presented.
When the solution consists of a commercially available device, the name and address of at
least one vendor is mentioned, and telephone number, contact name, and approximate cost range
are given if available. When applicable, additional sources of further information are also given.
When an innovative solution is described, the name of the innovator (usually by organiza-
tion rather than an individual) is provided along with the appropriate address to which to write for
further information. Many of the simpler innovative solutions could potentially be replicated, or
serve as a starting point for innovative variation, using only the information presented here -
particularly when illustrations have been provided.
Some of the more complex innovative solutions cannot be described in adequate detail to
permit replication in a sourcebook such as this. The contributors to this sourcebook will
welcome inquiries from users who wish to make use of solutions they have devised, and the
needed information for such follow-up is given with each case example.
The format of the sourcebook allows the user to enter notes when further information is ob-
tained relative to specific problem/solution pairs and to include additional problem/solution pairs
which may become available from a variety of sources, including personal experience.
Future Development of the Sourcebook
As indicated earlier, the present document is construed as a starter set to which users may
add new materials of a similar sort as they become available. Should it be warranted by the
response to this initial attempt to organize scattered pockets of information into a useful
overview of rehabilitation engineering accomplishments, the Institute for Information Studies
may continue to produce supplementary materials for inclusion in Sections Three (case examples)
and Four (annotated listing of resources). Hopefully, other organizations will be encouraged to
do so as well. For this reason, the Institute will appreciate feedback as to the utility of this
document and suggestions for how future efforts along similar lines might be improved. The
form included with this package of materials is an evaluation form, and it is hoped that you will
complete and return it for this purpose.
I-2
GUIDELINES FOR FORMULATING
PROBLEM STATEMENTS
"The quality of the answer depends on the quality
of the question."
In order to make the most effective use of consultants, specialists, and other experts, there is
a fine art which must be developed - the art of asking the question. Conversely, one of the
greatest deterrents to getting an answer that will help is failing to phrase the question in a precise,
unambiguous manner.
This is a familiar issue to rehabilitation counselors who work in state vocational rehabilita-
tion agencies and contract for work evaluation/adjustment services from workshops and other re-
habilitation facilities. If they don't spell out exactly what they want to know about a client's
work capabilities and limitations, they may receive an interesting report which, nonetheless,
offers little helpful guidance for rehabilitation planning. The facility staff are acutely aware of
the problem, too. They express frustration over having to "second guess" what the referring party
wants to know when the request is a global plea for help rather than an explicit, itemized
requisition for discrete items of information.
This is a very old problem within the public-private rehabilitation partnership, and the
lessons are being learned continuously by newcomers to the field. The same kind of problem is
now arising in the new interdisciplinary partnership between rehabilitation practitioners of
various sorts and rehabilitation engineers. For example, many of the questions and problems
posed to Project IMPART of the Texas Rehabilitation Commission and the California Department
of Rehabilitation's Rehabilitation Engineering Section are questions that might more properly be
addressed to another kind of consultant, or they provide insufficient background information to
allow the technological specialist to comprehend the actual and specific need.
Now that referring parties are beginning to learn how to "place their orders" correctly with
work evaluation/adjustment facilities, they must learn to place a different kind of order with tech-
nological specialists. It is even more crucial to do so for this reason: referring parties ordinarily
use work evaluation/adjustment facilities in their own local areas. Thus, any needed follow-up to
clarify an unclear request - though time consuming - is fairly easy to accomplish logistically.
This is not so with many of the rehabilitation engineering resources. Project IMPART, for
example, is a public service available to anyone in Texas and neighboring states who has a work-
related rehabilitation problem. Frequent long distance calls to Austin, Texas may be frowned
upon. And well they might, when the need could be circumvented by learning how to phrase the
request precisely and unambiguously in the first place.
Many readers of this document will have clients on their caseloads or disabled workers under
their supervision who might be helped to function more independently or efficiently through the
application of technology. The reader, therefore, may wish to submit a problem to one of the
resources learned about here - or perhaps some other - in hopes of finding a feasible, afford-
able, technological solution to a rehabilitation problem. The following guidelines are offered to
help in formulating the statement of the problem in a way that will facilitate an on-target
response with minimal delay.
First, it is important to adopt an analytic mode of thinking, a mental set of breaking down the
global, problem-fraught situation into its component problem parts. The technological con-
sultant needs to know what, specifically, the person needs or wants to do that she/he cannot
because of what specific functional limitation(s).
The problem statement should describe the specific activity the person needs/wants to per-
form in what may seem to be microscopic detail. To say that the person wants to work as a
secretary is not explicit enough. What particular aspects of secretarial work are impeded by the
person's functional limitations? Is it reaching top filing drawers from a wheelchair? Is it typing at
a competitive rate due to shoulder weakness? Each specific aspect of impeded performance
must be spelled out.
It is important in this respect to remember that the rehabilitation engineer or other techno-
logical consultant is an expert in technology, but not necessarily in jobs, homemaking, recreation,
or whatever the life performance area in question may be.
As implied above, the specific nature of the functional limitation(s) must also be spelled out
in detail. Diagnostic categories such as spinal cord injury, poliomyelitis, arthritis, and the like do
II-1
not tell enough. Even as explicit a descriptor as "quadriplegic" does not convey suffient informa-
tion because the term is applied to a considerable variety of functional patterns. The specific
activities which are impeded must be spelled out; such as manipulating tape recorder controls,
lifting a telephone receiver, or reaching materials.
One of the most basic rules of good report writing also applies to the formulation of problem
statements in a request for rehabilitation engineering consultation. That is, "Avoid abstractions
and write in terms of directly observable behavior." In report writing, this rule avoids the
miscommunications that can arise when the writer and a reader interpret abstract conceptions
such as "the client tends to be 'dependent' or 'well motivated' in different ways. However, if
writers describe the behavior which leads them to conclude that a client is 'dependent' or 'well
motivated', then readers can draw their own conclusions from the behavioral data and misunder-
standings are less likely to occur.
In consultation requests, the rule provides the same sort of protection against
ambiguity. For example, to say "The client can type only fifteen words per minute due to upper
extremity weakness" does not convey the picture one would observe if one had the opportunity
to watch the client type. On the other hand, to say "The client has good use of her hands but only
fair biceps and extremely weak shoulders; thus, she has the dexterity to type but cannot hold her
arms in position for more than half a minute without resting for an equal time" gives the consul-
tant an immediate picture of the type of solution needed. All that is left is to determine how to
implement it.
In summary, the essential information needed is a description of the client in terms of the
particular functional limitations which are interfering with his or her efforts to perform a
specified activity or set of activities. In addition, it is generally helpful to provide the person's
disability diagnosis and any background information which might clarify the problem statement.
An important example would be previous efforts to achieve a technological solution which were
less than satisfactory.
In formulating the statement of the problem, it may help to ask yourself if you have dealt
adequately with each of the following questions:
1. What does the individual want or need to do that s/he cannot do:
a. At all
b. Efficiently/effectively?
2. What is the general nature of the desired/needed activity in terms of basic life perform-
ance areas? (E.g., training, work, homemaking, recreation, ADL, communication,
mobility, transportation, two or more of these designations, other.)
3. What specific activity (or activities) does the individual wish/need to engage in?
(E.g., secretarial work, college coursework, cooking, bowling, grooming, speaking, stair
climbing, driving, other.)
4. What specific aspects or components of this activity are impeded?
(E.g., reaching, lifting, manipulating small objects, reading, telephoning.)
5. What is the general nature of the functionally limiting condition that interferes with per-
forming the activity (or activities)?
(E.g., Post-SCI quadriplegia, post-polio weakness, arthritic joint inflammation, visual
impairment, hearing impairment.)
6. What is (are) the specific functional limitation(s) associated with the conditions that pre-
clude or impede performance?
(E.g., lack of finger function, unable to do independent wheelchair transfer, unable to
grasp objects, 20/400 vision in better eye, total deafness.)
7. How do the specific performance demands of the activity interact with the individual's
specific functional limitations to create the performance problem?
(E.g., unable to dial telephone, unable to transfer to toilet during work hours, unable to
squeeze stapler, unable to read small typeface on insurance documents, unable to hear
warning signals.)
8. What kind of help is wanted/expected from the technological consultant queried?
(E.g., evaluation only, referral to existing/local resources, device development, other.)
As can be seen, this is a funneling technique in which the questions evolve from the general
to the progressively more specific in terms of both the performance demands of the activity in
question and the functional limitations that interfere with its execution. By answering these
questions, you can better ensure that your problem statement will communicate the needed data
precisely and unambiguously to the technological consultant whose help you are seeking.
II-2
CASE EXAMPLES: PROBLEMS AND SOLUTIONS
This section is comprised of case examples in the form of problem/solution pairs. It has been
divided into eight subsections each of which contains problem/solution pairs applicable to a
particular life performance activity. The eight subsections include Activities of Daily Living,
Communications, Homemaking, Mobility, Recreation, Training, Transportation, and Work.
The format of problem/solution pairs has been standardized to facilitate easy reading and
quick-look referral. Problem/solution pairs contain the following components:
Case Number
Problem Description: (title)
Impairment Etiology(ies)
Functional Limitation(s)
Performance Activity
Device Name
Solution Description: (title)
Each component of the problem/solution format is described below.
Case Number
Each case number uniquely identifies a particular problem/solution pair. The case number
consists of an alphabetic designator followed by a dash and a unique, two-digit number which
is assigned sequentially. There are eight alphabetic designators; they represent the life perfor-
mance activities into which problem/solution pairs may be categorized. The eight designators
include:
A - Activities of Daily Living
C - Communications
H - Homemaking
M - Mobility
R - Recreation
T - Training
P - Transportation
W - Work
Thus the first two problem/solution pairs under the category Activities of Daily Living are
assigned case numbers A-01 and A-02; the first two entries under the category Communications
are C-01 and C-02, and so on.
Impairment Etiology
This element provides information about the disabling condition(s) which may result in func-
tional limitation(s) that interfere with the performance of a particular activity. Examples of
entries under this component include Spinal Cord Injury (SCI), Cerebral Palsy, and Stroke. Some
solutions have been found applicable to specific functional limitations regardless of impairment
etiology; the designation "any etiology" has been used to indicate this situation.
Functional Limitation(s)
Functional limitation(s) describes the particular physical or sensory deficit(s) associated with
the impairment etiology which precludes or impedes performance of some activity. Examples of
specific functional limitations include respiratory paralysis, limited grasp, or upper extremity
weakness.
Performance Activity
The performance limitation is described in terms of the specific activity to be performed as
opposed to the more general categories such as homemaking or work. Specific performance
activities include breathing while sitting, stair climbing, reading, or wheelchair propulsion.
Device Name
The term shown indicates the general type of device utilized to solve a particular perfor-
mance problem. Types of devices may include dexterity aids, mobility aids, remote controls or
muscle stimulators.
III-1