ALANNA RAFFEL: Welcome, and thank you all for-- I'm recording, right? OK. Oh, hang on, let me let some people in. OK, great. OK, now I'm really ready. 

Thank you all for joining us today for our December Tech Accelerator webinar. Our presentation topic this month is Assistive Technology for Recreation. This session is being recorded, and the video will include picture-in-picture ASL interpretation as well as a full transcript. You'll be able to access that video on our website, which I will put a link to in the chat. 

This series is part of the Tech Accelerator project. This is an initiative funded by the Office of Developmental Programs and the Office of Long Term Living, here in the Commonwealth of Pennsylvania. It's made possible through funding from the American Rescue Plan Act. 

The Pennsylvania Tech Accelerator project includes five major focus areas: training and resources to build capacity for stakeholders, readiness evaluations to develop tools for successful adoption of remote supports and assistive tech, statewide assessment to plan and benchmark a technology for systems change, a provider survey to assess technology awareness and resources among providers, and finally, two technology summits, which were live events hosted in Philadelphia and Pittsburgh this past spring. You can learn more about this fantastic project on our website at disabilities.temple.edu. And that link will also be in the chat. 

So I'm going to pass it over to our special guest for today, and we'll get started. 

KATIE GRIFFITHS: Hi, everyone. [LAUGHS] We're just going to start sharing our screen. Give us one second. Hopefully no technical difficulties because we are a little bit of tech experts. 

[LAUGHTER] 

But thank you for joining us today. We are live from our Inglis Innovation Center, which is located off of Belmont Avenue, Conshohocken area-- Conshohocken, Belmont, Kenwood, if you're familiar with Inglis. It is a nursing home skilled facility that has focused on clients with physical disabilities for over 100 years. 

We are very unique because the Inglis House only-- our residents all have to have a disability that has a mobility impairment. So it's considered a wheelchair community. But we get to do so much more than just providing mobility. We do a lot of assistive technology. We have PT, OT, speech. We have a gym. We do a lot of community integration. And on top of just our housing, we do a lot of community-facing programs. 

Move to the next slide. But before we get into that, we're going to just introduce ourselves. I'm Katie Griffiths. I'm our ATP. CTRS is my background. I went to Temple and specialize in recreational therapy. Started out in rec therapy, found out about assistive technology at Inglis, and applied for a job. And I've been here almost 14 years. Started out in the House. And when we say House, that's really where we all started-- Inglis House. 

And basically helped run a computer lab that was built for 30-plus residents to sit at any workstation and receive an assistive technology evaluation, which included all different types of inputs-- keyboards, mouse, some really high-tech items that we'll talk about today, or as simple as just making an adjustment to provide a prop under a wrist to use a trackball. 

And a lot of it is just heavy on education. One of our things is just providing the support. Janet also started out in Inglis House. 

JANET SHOEMAKER: Hi, everybody. I'm Janet Shoemaker. I'm also ATP and CTRS. Started out in rec therapy, graduated, came straight into this AT program at Inglis. I am one of the AT educators out in Philadelphia. As Katie was saying, we start in the House. Or at least, I've started in the House and then made my way out to the community. And we'll continue to talk about all those services in this presentation. 

CHRISTINA RENNIE: And I am Christina, also ATP and CTRS, also went to Temple. I'm the only one that didn't start in the House. I was in rehab and long term care. But I've always been connected to here. I had my senior internship here with Nancy, who's going to join us this afternoon. So I'll introduce Nancy. 

[LAUGHTER] 

All right. Let me go to our next slide. 

KATIE GRIFFITHS: But yeah, getting back to history of Inglis. 

JANET SHOEMAKER: Yeah, so just to give us a little bit of history of who Inglis is-- I know Katie just touched on it. But Inglis has been around for more than 150 years now. We were really committed to helping individuals with a physical disability, as well as their caretakers. 

Inglis, like it says on the slide, serves people living independently in the community as well as those in the residential nursing facility-- again, Inglis House. Yeah, we really like to enable individuals to live their fullest life, to achieve the goals, and find ways to make those barriers disappear. 

KATIE GRIFFITHS: A lot of our residents and folks in the community are folks that might have cerebral palsy. So we'll see folks that graduated from a program and moved to Inglis to get continued support, folks that have multiple sclerosis, traumatic brain injury, spinal cord injury, and other neuromuscular diseases. 

JANET SHOEMAKER: To further break out our entire company-- so there's really three major entities to Inglis. And it's Inglis House, Inglis Housing Corporation, and then Inglis Community Services. So Inglis House, when we talk about it again, it's that skilled nursing, long term care facility that's here in Philadelphia. Then we have our housing corporation, which is the largest private provider of affordable, accessible housing in the greater Philadelphia region, with more than 400 affordable units and nearly half fully accessible for people with disabilities, which is really great. 

And then the entity that we really sit under is the community services. So we offer a variety of programs and resources, which includes us, assistive technology, employment services, home modifications, and housing opportunities. 

So again, our mission for ICS, which, again, is Inglis Community Services, is we champion independence through innovation, life-enhancing services, and communities. And what's really awesome is we opened up this center in Philadelphia right at the end of 2019. We had a little hiatus because we had our friend COVID. And then we launched our Innovation Center in Pittsburgh-- last year? 

KATIE GRIFFITHS: Two years. 

JANET SHOEMAKER: Two years ago. So that's a little bit more recent. So we are now able to proudly say that we are statewide services. So really diving into, again, ICS-- so the different services that we have here. It's, again, as we said, it offers comprehensive programs that support physical, emotional, and spiritual well-being of individuals with disabilities living independently in the community. So that includes not only our housing services and individuals who live there, but really all over Philadelphia County, as well as the five surrounding counties around Philadelphia. So we have a pretty far reach. 

It's not only individuals with disabilities now. We've actually really tapped into our senior, who are trying to live in age, in place, living in their own homes and learning what is available for them, which is really awesome. 

So really talking about our programs, assistive tech solutions-- so IATS is Inglis Assistive Tech Solutions, is our program. We provide individualized goals-based AT services for people with disabilities and older adults who are seeking to increase their independence, social engagement, or life management through technology. 

And this can be everything and anything that you think of. It could be the basics to a cell phone, a tablet, a computer, to, hey, I really want to do smart home and integrate everything, as well as, hey, I want to learn about what social media is and connect with individuals that way. How can I be safe on the internet? I want to do online shopping, online banking. We really hit a lot of things, I want to say, a really huge range. 

But our services are always provided by a team of certified assistive technology professionals. So all of us have the ATP credential, and we're always ready to adapt environments and provide really creative solutions that overcome barriers of independent living. So just to show you about the pictures that we have at the bottom, the very far left is one of our housing sites. 

We just opened a computer lab thanks to funding with PA Health and Wellness. So we have not only accessible computer stations that we are also providing education with, but as well as a gaming station for individuals who are interested in that and want to learn about how they can continue gaming as well. 

The middle picture is a class that we held with Philadelphia Senior Center. In that time, we really took on, probably, a class of 10 to 12 individuals weekly to talk about their cell phones, really understanding the basics of just navigating it, all the way to how to play with your settings, how to find certain things, how to-- I think we also hit email on that, I want to say. We had a huge range with that. And then, Katie, you want to talk about that picture to the right? 

KATIE GRIFFITHS: You touch on that. That same grant helped provide services down at McGee on the waterfront. So we did a lot of education with the phone and really just unlocking technology to do a lot of different leisure, recreational activities, as well as just access and education. Basically, in this picture down on the right, I'm with a group home project. And I was just doing a lot of, not only smart home stuff-- like, have you guys heard of Ring doorbells to enhance safety, and things like that. 

But as I was like working with those folks and assessing more, there was like-- we really just had to dive into how to use your device, or how to use your device to do things that 20-year-olds are doing, like Instagram and Snapchat and social media, but then diving into-- oh, we have to evaluate the safety hazards with these devices. And what does it mean to get a chat? You got invited to be a friend of somebody. And what does a friend mean? 

And really just diving into all of those little pieces that allow folks to engage in technology for leisure components, but also how to do it safely. And that goes back to a lot of what we do with the education. 

JANET SHOEMAKER: So continuing on. 

CHRISTINA RENNIE: Oh, I'm so sorry. 

JANET SHOEMAKER: We're good. I'm going to go back. So just our approach to all the services that we provide. Like we said, we provide individualized assessment, ongoing support, and education and training. So our first step with assessment, we're really learning and understanding the abilities and challenges of a service participant. 

And that could be, again, just like, hey, I want to learn something, to, I want to do adaptive gaming, I want to do leisure, online shopping, all of that fun stuff. It's really, what are you wanting to do, what services? And what challenges are you seeing? And then from there, we really build out a quite extensive list of recommendations, which, again, often get funded by insurance. Or if we have grants, we will purchase all of those for them. 

We bring all the equipment and install them, support it, set it up, and then provide very personalized training sessions that are skill based, and a lot of hands-on support. We're seeing that a lot of individuals love what they do. They love that they can really accomplish their goals and build a lot of confidence in knowing, hey, I can do this. But in order to get them to that confidence, it's a lot of hand-holding in the beginning, understanding that education has to be very personalized to the individual. So we really like to tailor it depending on the individual that we are working with. 

And then once we feel like the education is complete-- "complete." You can always learn. But, complete-- we like to provide ongoing support. So this is assistance through troubleshooting. Maybe it's further education on a topic we didn't hit because now they're learning. Hey, I'm having trouble with this. What else can I be doing? To just ensure that it's sustainable, it's effective, that we're not just going to hand something off to an individual and say, hey, good luck. 

We really want to avoid device abandonment, skills abandonment. We really want it to be ongoing and self-sustainable. 

KATIE GRIFFITHS: And really unlocking just the potential, any technology. We always try to say, your phone can do so much. And the iOS updates are really empowering. Sometimes we'll do an assessment with somebody, and they've been using their phone the whole session. And then at the last 10 minutes, they're like, you know what? This phone is kind of old. And we're like, oh, let's update a phone just to unlock the potential of the accessibility options. 

Other things are what we learned in the House. And one of the luxuries of the House is we have an assistive technology program that started in there and is continuing. And one of the things we did really good with that program and that helped support all the other programs and the programs in the House as far as rec therapy goes, or working with an OT for access to things, is we've always funded an in-room support position. 

That looks huge now, because years ago when it was created, it was just to support a few folks that were able to obtain a device. And mostly, folks were coming up to the computer lab to access technology, or we were going in a room with a therapist or assisting with a program to make some modifications. 

But now that in-room support position, as well as opportunities in gaming and just the explosion of what assistive technology and 3D printing can do-- that position has been maintained for 14 years, as long as I've been here, to support folks in their individual technology. Because I think every resident has some level of technology in their room. And it could just be as simple as an adaptive call bell or something like that. 

JANET SHOEMAKER: And just again, to give you another overview of our services in our program, we really like to focus on digital literacy-- so really understanding and using computers, your devices, smart home, your tablets, all of it-- and software programming, understanding how to navigate it, to be confident in it, just learning to troubleshoot yourself as well. Then we like to do skills development is huge, acquiring the skills needed for successful and fulfilling independent living. 

We also touched on web browsing-- so again, the online shopping, social media, telehealth, understanding that being online, being connected through the web, is extremely important as things are becoming more streamlined. So learning those skills are there. And then, like we said, troubleshooting, learning to identify and fix those common issues-- at least the basic troubleshooting. We want people to feel confident in doing that themselves. And of course, if they have trouble with that, they can always reach out to us. 

As well as equipment setup-- so this is including our smart home devices, like our Alexa, your smart lights, your Ring doorbells, all of those fun stuff. So we do that, as well as a big one is our email and account management-- so understanding how to reset passwords, how to recover devices, how to recover accounts, making sure that everything's up to date and connected. 

So we have folks that forget their own password, reset them. Then they don't connect something. Then it's like, hey, I cannot use this. So we like to really also educate folks on saying, hey, it's really important to keep your account password, your info, in a secure location that you can access. 

KATIE GRIFFITHS: Sometimes our evaluations, or even day one of implementation, is a huge discovery phase of-- just yesterday, we were setting up a Ring, and they had two, three different emails. And we were like, OK, but which one's linked to Amazon. And just having that thinking ahead of writing it all down-- we call them our cheat sheets. Really just supporting longevity of using the technology, and training the support staff. Making sure others know how to support. 

CHRISTINA RENNIE: So I feel like that-- it's a long background to understand where we're coming from in this field. But the purposes of this presentation, we're going to focus on more the integration of all these different technologies into recreation and leisure. So we'll identify some of the categories. We'll talk about the role of recreational therapy. We're going to look at some different applications and modalities used. And then we'll talk about the different opportunities. 

So just important things to talk about. What is assistive technology? We really jumped in without even saying anything about it. So it's any device or software or equipment that helps individuals perform a task that they otherwise couldn't. So that's really overarching for a lot of things. And what is recreational therapy, if you don't know? It uses recreation and leisure as treatment to improve health, well-being, and function in multiple domains of health. 

So just an overview of the options of assistive technology. It can cover different categories. They cover mobility, communication, sensory needs, cognitive supports, and environmental controls. And we'll talk about how all of these things intertwine with recreation and leisure as well. The photos are just some examples of them. We were frequently talking about-- an Amazon Alexa. It can be your power mobility device, your AAC device. My new favorite thing is the Meta glasses. So I'll let you-- but yeah. 

So I like to break it down into three different things because I feel like it's a lot easier to understand. So we have low tech, mid tech, and high tech, which-- I don't know who's in this group. So I'm sure we all have heard these things before. 

But my famous low tech example is something like a card holder. It's pretty easy to find off the shelf. And you can utilize it. That photo's from Amazon. They're pretty readily available. But then your mid tech, I always say, it's one step up, that it needs a little bit more. So we have our switch-activated toys, which I'm sure you guys have all seen through TechOwl throughout the years. But it could be as high tech as our adaptive gaming setup. So that's an adaptive Xbox there with all the switch access as well. We'll go through all of these. This is just an overarching understanding. 

KATIE GRIFFITHS: I do have to point out back in the day, and I'm talking 15, 16 years ago-- when phone books were still available, that was our original card holder. So we would wrap one in duct tape and then slice it in four quadrants. And that would be the card holder for our big poker nights. 

CHRISTINA RENNIE: Yeah, but you got to use what works. I've used a hairbrush. I've used a pool noodle. Amazon is next day, but if you need it right then, you got to make it work. 

KATIE GRIFFITHS: And these things are sometimes free. 

CHRISTINA RENNIE: Yeah, exactly. So just also a review of what recreational therapy is. So their role is to use recreation to improve our physical functioning, emotional-cognitive skills. We're also talking overall quality of life, which we talk about all the time. It's very important to all aspects of health, and also with that, community inclusion. So having the ability to adapt games and activities and any other recreational activity will just include people into whatever their peers are doing. 

So yeah, both recreational therapy and assistive technology aim to remove barriers and promote independence for the individual. It expands participation in sports, arts, games, leisure. It enables inclusive recreation. And it supports goal setting and skill development, which is what we all do. 

So these are just some examples. We're going to break down through the modalities that we have used in Inglis House, but just an overarching, some ideas to get you thinking is-- so, when I think of what assistive technology could be used in your physical well-being, some things that pop, usually, to people's heads first is your adaptive sports equipments, like an adaptive bike, but also your prosthetic device. So I always think of-- I mean, the Paralympics is coming up, the Winter Paralympics. So you have all the devices that go with that, too. 

The cognitive health-- you're adding adaptive puzzles, memory games. You can have different games with voice commands and all of-- there's so many things you could do. 

[LAUGHTER] 

With your creative leisure, you could do a switch-adapted music instrument, which we'll talk about, but you can also use eye tracking to do an art project as well. Our outdoor recreation-- there are all-terrain wheelchairs, or if you've been down to the Jersey shore, they have accessible beach wheelchairs. 

KATIE GRIFFITHS: We do an annual trip. 

CHRISTINA RENNIE: Yeah, so that's always something that I feel like people have seen, so they're more familiar with it. And I always talk about adaptive kayaking gear. I don't know why. I always found it interesting. So I bring it up all the time. 

KATIE GRIFFITHS: It's funny, too. You said what we learned as rec therapists still bleeds and is really a big part of our intake for assistive technology evaluations. Just the other day, Christina and I, the family-- we were like, all right, this referral is for these needs-based assessment. And family's like, yes, but can you wrap in education on the iPad to do some novel tasks and some matching and things like that? 

And we can really make a case for that because there's the need there. And then we can see-- here's an extra 10 minutes of just sharing our expertise or what we're passionate about that will, in our minds, improve overall quality of life through the device. 

CHRISTINA RENNIE: Yeah, do you want to talk about music? 

KATIE GRIFFITHS: I can. I can. So at Inglis, we are just really lucky to have music therapists. So we use that as a modality, as a contracted therapist as well as an on-staff therapist. And it used to be a lot. I remember my first days of rec therapy. We used to get a harpist come in, and I just thought that was so wonderful. And I was on a different unit. It was a lot of traumatic brain injuries. So just pairing those two can be really relaxing. 

And now that technology-- music therapists aren't just using the instruments and their passion or ability to help with pain relief through relaxation and music and things like that. They can really leverage technology to really engage clients. You think of Guitar Hero as a gaming thing that we did in college and goofing off. That can really allow somebody that can't strum a guitar anymore to engage in playing music. 

And we did a really cool thing with switches. We did a switch ensemble and really allowed folks to engage by pressing a switch to play a certain note. Or you even think of just bells, like you're gripping. Maybe you can add a weight to that. And now you're having somebody play. Everybody is given a bell to play a song. 

And just working together with speech and the PT and OT team to find different avenues for that. It could be on your AAC device, and you're pressing a piano key to play that part. Maybe they can't reach out for a switch, but we can adapt through recording a sound on an iPad with just a quick gesture button, like leveraging an AAC button. 

Also, we've done a lot of adapted piano and drumming, doing the digital drums that can get really close up to somebody. You don't have fear of damaging anything. They're truly made for folks to actively engage. 

And then just using the team for mounting. Mounting, I think, is so important. So we do a lot of modular housing or mounts to mount switches or devices near somebody where they can touch it. Even thinking of a proximal switch-- as long as you can make this movement or gesture, it's going to activate a sounds or a piece of technology. 

So I think we do a really good job. And it's really neat because these were all just the what ifs. Like, what if I could do a drum again? What if I could play piano again? And now we have a group of guys that get together, and they actually are performing at our Music Fest every year and recording. And it gives them a different skill set and just something to be proud of, like being part of a band, living out some dreams, right. 

I can talk about art as well, because I've been here for a long time. And Inglis has always done this wonderful job at bringing art to folks that might have a severe physical impairment. And back in the day, we're talking a cap with taping a paintbrush to and allowing somebody to actively engage in painting. We've done it with cuffs. We've done it with mouth sticks, building up paint brushes, using overbed tables to really bring the painting and mounting it perfect way. 

We have folks that paint independently in their room. And it's been care planned to help that person set up the canvas, their brushes and stuff. And there's folks that make a living still painting in their rooms. 

We have folks that make cards. Hallmark cards was huge in the computer lab for the past 15 years, because folks were making cards and personalizing cards for family members, different residents, different staff, their children. And then we'd address them and mail them out. So that was art. It was just so neat to see folks make something from scratch for themselves and using digital platforms to do that. 

We had a lot of folks that had severe impairments, and even an adapted brush or a head stick weren't going to be means of access for them. So they couldn't, maybe, hold a paintbrush, but maybe they could move a mouse, a trackball. Maybe they could click a switch and move their mouse and unclick the switch to make it stop and have had a drag for a paintbrush. 

We incorporated Corel paint program that let them have a variety of different brush styles and change their colors. And really, some of that art was just beautiful. And we've actually paired digital art and traditional art, and we've allowed folks to get it mounted and printed out. And we've assisted them in getting them framed and helped them submit to different art exhibits. 

So we [INAUDIBLE] art abilities and really let folks try and sell their art and be at an event and just show off their work. And just thinking of all the ways to do it. I'm trying to think. We even bring in art specialists that talk about different artists. And then they will focus on that modality for the month and learn about different techniques and take a stab at it. 

So it's just a really neat thing to watch, and just how assistive technology-- we've done adaptive cuffs through 3D printing or mouth sticks and head sticks and just trying different angles and things that worked for folks. 

You can do reading because you have that one client that you'd like to do it. 

JANET SHOEMAKER: Reading is another big modality within the House. We don't have it on here, but we do have a library in-house, which not only has books and movies, but also large printed books, which has been really popular. But for individuals who can't physically hold a book, turn it themselves to-- maybe, even, I'm having trouble even seeing the large print. We really found different ways to still provide that same access in their own space, in their own rooms. So that's kind of where a lot of our e-readers come from. 

So thankfully, your local libraries also have this service where there are audio tapes for a lot of these books, as well. So I know some individuals love having that tape in hand that they can play themselves because they like to be there old school, which is great. And they get assisted with returning and borrowing out new ebooks. 

But another way that we found that's been a little bit more accessible and giving a little bit more independence back to the individual is our ebooks. And I'm sure we're familiar with Audible and those other services that are out there. But the big one that we love to promote is Libby. 

So Libby is a free app as well as a free service. It is connected with your local library. And you can just sign up right on there. You can get a library card for free, and same concept of going to a library to borrow or return books and ebooks-- or ebooks and audiobooks. Sorry-- is all on that one platform. And they can choose whether they want to flip through it themselves. And that could be through switch access, voice activation. Now with some of our newer iOS, it's eye gaze is also on there that you can do all in one device, which is amazing-- as well as audiobooks. 

So I had a client back in the day that I love, love, love because I started this whole project with her. She would always be in her room. She was independent, loved to read. She loved reading and hearing about the royal family in Britain, which is amazing. 

And she'd be like, what biographies can I read? What autobiographies? What stories? What fiction, non-fiction, everything about them? And I was able to be like, hey, did you know you can get a free library in the palm of your own hand, in your own bedroom. And she instantly lit up. 

Once she was comfortable going through it herself, we checked out, I want to say, maybe seven books every two weeks. This lady was nonstop on it, and I absolutely love it. And she still uses it to this day. She's able to do it independently. She uses voice activation when she gets tired instead of just physically touching the iPad, as well as her caregivers also know how to set it up for her and make sure that she's able to navigate it when she is having those bad days that she needs a little bit of extra help. 

So this is also a great feature that we've been also recommending out in the community, which is awesome. Yeah, because who doesn't love ebooks? It gets [INAUDIBLE] 

KATIE GRIFFITHS: And like Janet said, we have folks that want to just actually follow along with reading and downloading a book. So we even had somebody donate three touch screen computers. And that was really neat for folks, because they're reading. They're picking something. They're tapping the screen to change. 

And then we had a gentleman that couldn't do that. So then we created a right and left click switch. So we mounted a right switch and a left switch, so he could either go back a page or forward a page. But it gave him independence. We would just set him up with his switches, pick his book. And this man read so many books. 

We had a card donated specifically for buying books. And he was the one pushing it every week. I'm like, OK, another best seller, right. Because back in the day, I mean, you had to lug around a big magnifier, or we had a big device that would mechanically catch the page and turn it over. And I mean, there are folks that still use ancient equipment to access because they like what they like, but it's really neat to just see how all the technologies are helpful and useful to all sorts of needs. 

We had a recreational therapist who recently retired, Jay Lee, who was here for-- 

JANET SHOEMAKER: 38 years. 

KATIE GRIFFITHS: --38 years, yeah, a lifetime. And she loved horticulture and did a really good job at bringing in all different modalities to horticulture. Simple as planting seeds, and then transferring that to a pot, and then transferring it to a larger pot, and coming in and watering it, and maybe working with PT or OT to add a weight to the wrist to then add to watering, or adapting different watering cans so that somebody could still engage in watering. 

And then it's really neat. We have a whole wall of lamps for different gardening and different vegetables and different herbs and all the different things. And now, Inglis just has plants of years and years, and propagating. Even practicing cutting with scissors to propagate something and cut off and then put it in water and water that and then replant that. 

And then as it gets warmer out, the group then transitions outside. And we have adapted beds outside. And now they're digging. So they might have an adapted shovel or an adapted utensil for digging. And then they're transferring their little babies and watching that grow. 

And the best part of that is, OK, now we have herbs and tomatoes and peppers. So then she transitions that into a cooking class. So now our residents are using herbs and different fruits or vegetables to be placed in a recipe. And now they're cooking for their group from the seeds they raised into the recipe. 

It's just a really cool full circle program. And it touches on even nurturing or just something that-- oh, I have to check on my plant. I have to water my plant, all that. That goes into caring for your plant and then assisting in being able to still garden from your wheelchair with these raised beds that we had built. 

So it's endless. There's actually a rec therapy-- horticulture therapy program. McGee does it really well as well. And just all the natural benefits from horticulture and just making that accessible to our Inglis House residents, as well as just seeing their plants throughout the entire landscape of our quad area and residence rooms and all the shared spaces. 

JANET SHOEMAKER: Absolutely. 

CHRISTINA RENNIE: This is my bread and butter. I love tabletop games. [LAUGHS] So there's a lot of things you can do with tabletop games. I don't even know where to start with tabletop games. 

I feel like card holders are always used. We see them all the time. I showed you a picture of them. But you can also change different graph styles on the game pieces itself. On the bottom right, you can see it adapted a game of checkers in order to pick it up. 

You can also mount the game differently. So the Scrabble board in the middle picture is on an easel. You can do tactile pieces. Katie has sequins in her hands now, and that's what I was using to make tactile game pieces. 

So I try to make tabletop games a little bit more low tech, because it makes it a little bit easier for that client to be able to take it either home or with their loved ones, and modify it as well. I feel like my favorite case to talk about is I was able to program somebody's AAC to play Crazy Eights and Uno with their family on FaceTime. So they were able to select-- if they had a wild card, they would tell you what color it was. They liked Uno. 

KATIE GRIFFITHS: Who doesn't? 

CHRISTINA RENNIE: Who doesn't like Uno. But he was younger, so he liked to be sassy. So if he hit you with a draw four, he had, sorry, not sorry, programmed on there. So that's one of my-- we really integrated everything. So it's not just-- it gave him the opportunity to play with his family again, but it also gave him a new skill. Yeah, I could talk about-- that could be its own hour thing of just tabletop games. So I can't keep going. 

KATIE GRIFFITHS: Jan and I just did an evaluation for somebody that was just really limited and just feeling stuck. And then we decided, all right, well, we're just going to mirror your iPad. And we were like, and do Wordle. 

So it was so neat because we got to-- he had no idea about Wordle. And he wanted to do something that he could engage with his family. So they can help a little bit. There's some memory impairments, or just needing some cueing. So it was something that he could engage with the family. I think the sister really wanted to play a game with him, and not just Mario Kart. 

We were starting to really tap into the needs, like starting to recall and problem solve. So we mirrored Wordle on his screen, and he just thought that game was awesome. And it's a novel task. He's learning something different, using different strategies to solve the problem. And also, he was doing it on the iPad and leaning down. 

And we were able to mirror it on a big screen, which really invited a group effort in engaging in the game. So just finding all different opportunities. This is also yours. 

CHRISTINA RENNIE: I know, yeah. 

[LAUGHTER] 

Adapted sports, I feel like, is what everyone thinks about when they think of including assistive technology and recreation. A lot of people are familiar with the sports chairs, like ones used for wheelchair basketball. There's wheelchair tennis, there's racing. Those are the ones I feel like-- like how I was saying, you see on the Paralympics and everything. 

But there are other opportunities as well. This photo shows you a modification of a fishing pole. I modified a pool stick. I don't know pool. I shouldn't speak about pool like that. But I would modify a pool stick that would use one hand, and it had a little stand that came with it. And it was this person's personal-- 

KATIE GRIFFITHS: I think we 3D printed those-- 

CHRISTINA RENNIE: Yeah, so I feel, really, anything in adapted sports, I feel like, tends to be, honestly, a little bit easier to adapt because it's bigger equipment. So it's easier to add a universal cuff to it so you can use it one-handed, things like that. 

You can also modify the rules of the game and things like that to make it a little bit more user friendly. Again, adapted sports could be its own entire thing. 

KATIE GRIFFITHS: And we'll get into it, but we do a lot of adapted gaming, sporting, at Inglis. 

CHRISTINA RENNIE: I'm moving it around. 

KATIE GRIFFITHS: We even do competitions in digital gaming. 

CHRISTINA RENNIE: Adapted video games, I feel like is-- I know Tech Accelerator had its own highlight on them, so we'll gloss over it real quick. But the computer lab at Inglis does have a lot of people interested and continually enjoy the adaptive gaming. We have the adaptive Xbox, the PlayStation, and a Nintendo Switch. 

And there's frequently groups that they do adaptive gaming with peers, but they also get to learn from each other the different controls. Yeah, if you guys want to say anything else about adaptive gaming, I feel like-- 

KATIE GRIFFITHS: It's just such an-- it's just so popular and such a need. Even we'll see it when we're doing evaluations from an insurance waiver. It's like, oh, there's a gaming need. 

[LAUGHTER] 

We can't get gaming through your insurance, but we can refer you to our programs and leverage that. We touched a lot on computer access. The reason I think we all got into it is that computer access is the vehicle to recreation and leisure when there are huge barriers, or just a way to encourage folks to try different things. 

Hey, a lot of our assessments at Inglis House are just, what do you want to do? Like Janet was touching on, what's the goal? What would you like to do? What did you do? What would you want to do if you had the vehicle to do it? 

A lot of folks wanted to go back to school and wanted to just practice going to school, like the screen readers, just being able to read, using a Google Chrome extension just to be able to screen read your homework, because it's too difficult to maybe have a textbook anymore, things like that, touching on the digital art. 

And a lot of it is just social connectedness. I mean, what a huge modality, especially during COVID. We were able to use technology for folks that have never touched the computer lab, never had any desire to even own a cell phone. I mean, during COVID, we were able to, I think, just explore and explore folks that didn't have any desire for technology. I mean, families were getting iPads and Amazon Alexas and just FaceTiming. 

And the lack of social connectedness allowed us to explore technology. And then we were able to then-- OK, now that you got this iPad and you did FaceTime, what else would you like to do? So as tough a time that was, it was really neat to see how access really helped those barriers, especially in social connection, and just expanding all leisure opportunities. 

And then really doing what we do best is-- all right, you have a desire for access. What else do we need in order to get you on a computer? Adapting mice, keyboards, working with SLPs and OTs and PTs. We've done a lot of just using AACs for TV access and things like that. 

And we did touch on Inglis Keen Games. That's one that's something close to Janet's heart, so I'll let her talk about it. 

JANET SHOEMAKER: Very, very close. So for those of you who don't know what Keen Games is, it's essentially our own Olympics for the residents at Inglis House. It has a bunch of different games and activities that individuals can sign up and compete for. And it's a whole couple of days in September, which is always awesome. And it's every year. 

In the pictures alone are just some of the events that we have-- there we go-- that we have helped adapt. So as you see in the first video-- I know it was really short-- but essentially, what we used is a leaf blower and a inflatable soccer ball. And we created, basically, a shootout, which is what we call it, allowing our individuals to play soccer, which is really great. And we have a little goalie that does go back and forth and tries to block it. It was a huge hit, finding different ways to adapt the games that some of these individuals thought they would never be able to participate in. 

The middle video, if you see, is also switch activated. Sorry, the leaf blower was also switch activated, and we connected all of that. 

But the middle one, it was off the idea of archery, trying to do something a little bit different. Some folks can't hold a bow and arrow. So we were like, hey, how about a Nerf gun? Let's adapt it, slap it on a switch, and mount it so that it's just sitting on a table. 

The individual can ask the staff member to move it around for them, to move the table around for them. The switch can be brought closer to the individual if their reach is not as far. What's also really cool about that Nerf gun is the individual who wants to grab it themselves and pull that trigger, it's all up to them. So it really gives us a range of what it allows the participant to do. 

And then the very last one that we have on there is we did make a skeeball table, essentially, which is what this is. So instead of the individual having to throw it and roll it themselves, they're able to push it down a ramp, which will then launch it into one of the buckets. 

In the past, we've had a very similar concept, but instead of this, it was a bouncy ball. So you would drop it on the ground and have it bounce into one of the holes, which I believe a school of students had created for Inglis back in the day. But that was a little bit harder to bring individuals up to it so that they can push it themselves. 

Another couple of examples that we have. 

KATIE GRIFFITHS: Eight minutes. I know there was some stuff in the chat, so we'll-- 

JANET SHOEMAKER: Yeah, we'll keep it going. I'll move faster. So the far left is golf. As you can see, all we did for this individual is put a little bit of a platform. He wanted to use a golf club himself. But if you look all the way to the right, we have another adaptation to it. So an individual who cannot hold and swing it themselves, we created another ramp that they can drop in or, with assistance, have it pushed down. 

We found that if we move that ramp away from the target, it allows it to bounce off the floor, which allows for a little bit more of a probability, instead of it just dropping into a spot, which individuals are really open and excited for. 

The middle top is ax throwing. So instead of a normal ax, obviously, we're using suction cups onto a whiteboard, which was a lot of fun for individuals to do themselves. And then our picture in the middle on the bottom is our computer lab being involved in Keen Games as well. So allowing individuals to play Bejeweled on any kind of setup, anywhere from eye gaze to your own AAC device to standard mouses, adaptive mouses, all the shebang. It's really allowing everybody to participate, which was really important to us. 

CHRISTINA RENNIE: Do we want to-- OK, I'll go really fast. So like we were saying in the beginning, similarly to how we deal with that in the community, we're going to assess and implement their recreational needs as well. And again, all of the above, the benefits from including assistive technology into recreation are listed here. But I think, overall, as we keep saying, it just overall includes their better quality of life and their ability to connect with others. 

Some of the barriers that we have frequently run into is mostly costs and funding, along with their training and their support needs. Not everyone has a place like Inglis house that's able to have these things and want to try different opportunities with people. And just using the accessibility and the compatibility of, also, the software devices as well. 

Some future things that I always tend to look forward to is the importance of AI and virtual reality into all of leisure, but also the development of inclusive recreational spaces to allow people to go to any space and feel welcomed and have things available for them. But also just an emphasis on training, not only for providers, but caregivers and everyone that is interested. 

So some of our big resources, I typically point people towards utilizing the recreational tab on TechOwl to borrow different equipment and try things. The PA Center for Adapted Sports is a great opportunity as well. They help provide different equipment, but they can also advise and teach you. And you're also surrounded by other people with disabilities too, which becomes more of a social thing. 

And GamingReadapted is our trusted resource for anything with adaptive gaming. 

KATIE GRIFFITHS: And what we're seeing out in the community, as well, and in the House, is just the evaluations. What we do for the IATS program is really just-- even if we get a referral, we work really hard to try and find funding. 

We just had somebody in here yesterday. And it was just something very simple. Like, well, what do you want to do? What does it look like at home, and things like that. And she was like, well, I can't vacuum anymore. 

And just thinking outside the box. Like, well, a Roomba is AT. And then I'm like, well, that's kind of a home mod need. And then maybe there's a grant for a home mod need that might tie into some other assistive technology, because I probably need you to have a smart device to run that. 

So really just trying to use all our expertise and assess a person for the full quality of life needs, and always tying in that rec therapy background to really just make sure that we're being appropriate and ethical with what we're recommending, but also something that will be helpful and overall something that they won't abandon and want to use, and use for all types of things. 

So that's everything. [LAUGHS] And more. 

[INTERPOSING VOICES] 

ALANNA RAFFEL: Hi. Yeah, well, partially. That was fantastic. Thank you guys so much for sharing all of this wonderful information. I always learn something when I hear from you and talk to you guys. 

Lori wants to know if it's OK for us to share out this slide deck after. So if that is OK with you guys, you'll send it to me, and I can share it out with all the registrants. And otherwise, I don't think we got any other questions in the chat. So I'll open it up to the audience in our last minute or two here, if anyone wants to pop on and share a question in the chat, or they can ask a question. 

I also put a feedback survey link in the chat. And I'll also reshare the links for past recordings of our monthly webinars, as well as a link to find your state Assistive Technology Act program, in case some participants here don't live or work in Pennsylvania. You can find your Assistive Technology Act program through that link. 

We're also doing this again at 4 o'clock today. So if you know someone that might be interested in hearing this presentation and learning about this topic, you can share the registration link with them. I'll put that in the chat again. 

And otherwise, I'll give it a moment to see if anyone has any questions. 

JANET SHOEMAKER: And even if you don't have a question now and you think of something later, feel free to reach out to us by that email that's on the screen. I may or may not be covered based on our chat. But yeah, you can feel free to just email us. Or if you just want to speak to us about-- maybe you have a client or a case study that you're working on and you're struggling for. We're here, so please reach out. 

KATIE GRIFFITHS: Yeah, I've done a lot of consults just through friends and helping out and sharing resources. 

ALANNA RAFFEL: Thank you guys. Thank you to our interpreters. And we'll see you again at 4 o'clock. Bye, everyone. 

KATIE GRIFFITHS: Thanks, Alanna.