1. Level of Spinal Cord Injury

2. What movements are available to the client?

3. Possible access points on client (head, chin, cheek, hands, elbow, knees, feet)

4. Clients familiarity with technology or openness for technology

5. Client goals

6. Clients psychosocial status

1. Mental state
2. Emotional state
   1. Suicidal ideation
3. Social health
4. Spiritual health

7. Environmental concerns

1. Where will equipment be used? (home, work, outdoors, play or school, rural vs city)
2. Identified environmental (physical) and social barriers

8. Mounting: where will AT be mounted?

1.  Avoid mounting to movable components
2.  Mount above the tilt, if a tilt is present
3.  Consider a locking frame clamp if tilt is present

*MOST IMPORTANTLY, DON’T FEEL OVERWHELMED.

IF YOU CAN THINK OF AN AT SYSTEM, IT CAN BE CREATED*

1. Alternative input devices allow individuals to control their computers through means other than a standard keyboard or pointing device. Examples include:
   1. Alternative keyboards—featuring larger- or smaller-than-standard keys or keyboards, alternative key configurations, and keyboards for use with one hand.
   2. Electronic pointing devices—used to control the cursor on the screen without use of hands. Devices used include ultrasound, infrared beams, eye movements, nerve signals, or brain waves.
   3. Sip-and-puff systems—activated by inhaling or exhaling.
   4. Wands and sticks—worn on the head, held in the mouth or strapped to the chin and used to press keys on the keyboard
   5. Joysticks—manipulated by hand, feet, chin, etc. and used to control the cursor on screen.
   6. Touch screens—allow direct selection or activation of the computer by touching the screen, making it easier to select an option directly rather than through a mouse movement or keyboard. Touch screens are either built into the computer monitor or can be added onto a computer monitor.
2. Accessibility software: software designed to help individuals with physical limitations
3. Communication aides: electronic and non-electronic devices and software solutions that provide a means for expressive and receptive communication
4. Computer access: input and output devices, alternative access aids, modified or alternative keyboards, switches, special software, and other devices and software solutions
5. Electronic aids to daily living (EADLs): Any electronic technology used for the specific purpose of providing independent operation of any electrical equipment. EADLs can be adapted for control by any individual, as long as that person can perform a consistent voluntary action.
6. Mobility: electronic and non-electronic aids such as wheelchairs (manual and electronic), walkers, scooters that are used to increase personal mobility
7. On-screen keyboards provide an image of a standard or modified keyboard on the computer screen that allows the user to select keys with a mouse, touch screen, trackball, joystick, switch, or electronic pointing device. On-screen keyboards often have a scanning option that highlights individual keys that can be selected by the user. On-screen keyboards are helpful for individuals who are not able to use a standard keyboard due to dexterity or mobility difficulties.
8. Switches and Switch Software: Switches offer an alternative method to provide input into a computer when it is not possible to use a more direct access method. Switches come in various sizes, shapes, colors, methods of activation, and placement options. An interface device and software program are usually required to connect the switch to the computer and interpret the operation of the switch.
9. TTY: Text Telephone
10. Visual Aids: electronic and non-electronic aids such as magnifiers, talking calculators, Braille writers, adapted tape players, screen reading software applications for the computer, and Braille note-taking devices.