Evaluating accessibility in the world around you: Assessment tools and

approaches for public spaces, home residences, products, information,

and educational materialsRochelle Mendoca, PhD, OTR/L

Roger Smith, PhD, OT, FAOTA, RESNA FellowNoralyn Pickens, OT, PhD

Denis Anson, MS, OTR, RESNA FellowJaclyn Schwartz, MSOT, OTR

Linda Struckmeyer, MA, OTR/L, ATP

Agenda

• Introduction• Overview of accessibility and universal design• Residential spaces• Public spaces• Information accessibility• Learning and education accessibility• Product accessibility• Wrap-up

Residential Assessments

Approach

• Context of evaluation provision• Degree of client – centeredness• Degree of PEO• Skills of therapist/evaluator• Range of tools– Availability

Acute Care Rehabilitation Home Health Care Home Mod Specialist

WESTMEADE

AARP

HEAP

SAFER-HOME

COUGAR

CASPAR

I-HOPE

AARP Home Safety ChecklistPurpose: Assess safety and comfort of home for well elderly with minor impairmentsContext for assessment: Acute, Rehab, HHPEO: Occupation orientationDeveloped: Updated 2011, caregiver checklist 2007Description: Client assesses accessibility and safety of home by answering questions such as “Are cabinets and cupboards easy to open?”; if the answer is “no”, suggestions for improvements or modifications are made.AARP. http://www.aarp.org/home-garden/livable-communities/info-07-2011/make-your-home-a-safe-home.html

SAFER-HOME v3Purpose: Assesses client’s ability to safely carry out functional activities in the home and evaluates effectiveness of modifications as an outcome measureContext for assessment: Rehab, HHPEO: Occupation orientationDeveloped: 2006 (v3)Description: Using interview and observation of client participating in activity, assesses 75 items around the home; level of safety risk is scored on a 4-point (0-3) scale

Chiu, T., & Oliver, R. (2006). Factor analysis and construct validity of the SAFER-HOME. OTJR: Occupation, Participation & Health, 26(4), 132-142.

Home Environment Assessment Protocol (HEAP)

Purpose: Assesses home environment of people who have dementia for safety hazards and provides recommendations for home modificationContext for assessment: Rehab, HHPEO: Person centeredness revolves around caregiver, Occupation centered , environment is considered a treatment modalityDeveloped: 2002Description: Information on 192 items in eight areas of the house are rated through caregiver interview, direct observation with caregiver clarification, and direct observation ; presence or absence of safety hazards, adaptations, visual cues, and comfort are scored as present or notGitlin, L ., & Corcoran, M. (2005) . Home Environment Assessment Protocol (HEAP) Assessment in Occupational Therapy in Dementia Care. Bethesda, MD: AOTA

In-Home Occupational Performance Evaluation (I-HOPE)

Purpose: measure in-home activity performance and change in fit of P-E before and after home modification interventionsContext for assessment: Rehab, HH, Home mod specialistPEO: client-centered/occupation orientationDeveloped: ©2011Description: card sort followed by prioritizing, identifying level of satisfaction and observation of activities, identifying barriers to participation

Stark, S. L., Somerville, E. K., & Morris, J. C. (2010). In-home occupational performance evaluation (I-HOPE). American Journal of Occupational Therapy, 64, 580-589. doi: 10.5014/ajot.2010.08065

I - HOPE

Westmead Home Safety Assessment (WeHSA)

Purpose: Systematically identify fall hazards in a client’s home for any client at risk for fallsContext for Assessment: HH, Home mod specialistPEO: client-centered/ environment orientationDeveloped: 1997Description: 72-item inventory/checklist that identifies relevance of item to client and rates as a hazard (with type of hazard listed) or not a hazardClemson, L., Fitzgerald, M., & Heard, R. (1999). Content validity of an assessment tool to identify home fall hazards: the Westmead Home Safety Assessment. British Journal of Occupational Therapy, 62(4), 171-179.

COUGARPurpose: Occupational therapy assessment of safety in the home for a variety of clients (Fisher, et al, 2007)Context for assessment: Acute, Rehab, HHPEO: Occupation orientationWhen developed: 2007 (v2.0)Description: Assessment of 52 items through observation, testing and questioning resident in the categories of fire and carbon monoxide hazards, emergency/medical, electrical/water temperature, flooring/hallways, kitchen, bathroom, closets/storage, parking areas, and entrances; marked as safe or unsafe with comments

Fisher, G., Baker, A., Koval, D., Lishok, C., & Maisto, E. (2007). A field test of the Cougar Home Safety Assessment (version 2.0) in the homes of older persons living alone. Australian Occupational Therapy Journal, 54(2), 124-130.

Purpose: Assesses tasks done by resident in the home for problems/difficulties; appropriate for clients with a variety of impairmentsContext for assessment: Home mod specialistPEO: Occupation orientationWhen developed: 2001Description: Identifies each task as a problem to do independently, if someone helps the client complete the task, and if a device is used; problem areas are ranked according to urgency of need for change; client offers ideas for change in problem areas; therapist takes photos and measurements of problem areas for construction specifications (Sanford, et al, 2002)

Sanford, J.A., Pynoos, J., Tejral, A., & Browne, A. (2002). Development of a comprehensive assessment for delivery of home modifications. Physical and Occupational Therapy in Geriatrics, 20(2), 43-55.

References for residential tools• AARP.

http://www.aarp.org/home-garden/livable-communities/info-07-2011/make-your-home-a-safe-home.html

• Chiu, T., & Oliver, R. (2006). Factor analysis and construct validity of the SAFER-HOME. OTJR: Occupation, Participation & Health, 26(4), 132-142.

• Clemson, L., Fitzgerald, M., & Heard, R. (1999). Content validity of an assessment tool to identify home fall hazards: the Westmead Home Safety Assessment. British Journal of Occupational Therapy, 62(4), 171-179.

• Fisher, G., Baker, A., Koval, D., Lishok, C., & Maisto, E. (2007). A field test of the Cougar Home Safety Assessment (version 2.0) in the homes of older persons living alone. Australian Occupational Therapy Journal, 54(2), 124-130.

• Gitlin, L ., & Corcoran, M. (2005) . Home Environment Assessment Protocol (HEAP) Assessment in Occupational Therapy in Dementia Care. Bethesda, MD: AOTA

• Gitlin, L.N. (2002). Evaluating home environments of persons with dementia: Interrater reliability and validity of the Home Environmental Assessment Protocol (HEAP). Disability and Rehabilitation, 24, 59-71

• Sanford, J.A., Pynoos, J., Tejral, A., & Browne, A. (2002). Development of a comprehensive assessment for delivery of home modifications. Physical and Occupational Therapy in Geriatrics, 20(2), 43-55.

• Stark, S. L., Somerville, E. K., & Morris, J. C. (2010). In-home occupational performance evaluation (I-HOPE). American Journal of Occupational Therapy, 64, 580-589. doi: 10.5014/ajot.2010.08065