DOCUMENT RESUME ED 037 856 EC 005 247 kUmHOR Sullivan, Richard A.; And Others TImLE Telephone Services for the Handicapped. Rehabilitation Monograph XXXVII. INSTITUTION New York Univ., N.Y. Medical Center. SPONS AGENCY American Telephone and Telegraph, New York, N.Y. PU_,? DATE 68 NOT 152p. FDPS PRICE EDPS Price MP' -$0n 75 HC-$7070 DESCRIPTORS Audio Equipment, Equipment Evaluation, Equipment Utilization, *Exceptional Child Services, *Physically Handicapped, Sensory Aids, *Telephone Communication Systems AESTPACT A study by American Telephone and Telegraph investigated the use of standard Bell equipment in meeting the needs of the disabled for telephone service. Results revealed that all disabled persons who are able to communicate orally can initiate and terminate a call and carry on a conversation when the correct types of equipment are found, especially when push button dials are universally available or when an operator is available. The monograph presents information on the difficulties encountered in using the phone and on equipment found useful. Each phone, headset, or modification is described through words and by photographs; advantages and disadvantages are noted. Several factors influencing the choice of telephone equipment (answering in time, access, and family use) are considered. Evaluation of the patient and the equipment is discussed in regard to the amount of physical function present and the testing and matching of equipment for various disabilities. Choice of telephone, assistive devices, special services for summoning aid, use of the phone for home business, and coin phones for wheelchair users are also mentioned. (RJ) 4 sr-2S OA S. gio I 1 co° 4 ' U I I alb 0 0.4.4. .01* .11.1. V ERRATUM Please insert the following correctionon page 39 Operation. Rotary Dial A 9-type dial, inclined atan angle of 15° from the horizontal, taking 2 to 6oz. to move. Touch-Tone Dial See Touch-Tone dial.Inclination from the hori- zontal, 15°, taking 6 to 10oz. to move. Please insert the followingcaption on p. 31 Lightweight headset. Rightheadset attached to headband.Below rightacoustic coupler. Center topclip-onamplifier. Leftearplugsin different sizes. REHABILITATION MONOGRAPH XXXVII ( Telephone Services for the Handicapped Richard A. Sullivan, M.D. Fred H. Frieden, M.D. Joy Cordery, M.A.O.T., O.T.R. U.S. DEPARTMENT OF HEALTH, EDUCATION & WELFARE OFFICE OF EDUCATION THIS DOCUMENT HAS BEEN REPRODUCED EXACTLY AS RECEIVED FROM THE PERSON OR ORGANIZATION ORIGINATING IT. POINTS OF VIEW OR OPINIONS STATED DO NOT NECESSARILY REPRESENT OFFICIAL OFFICE OF EDUCATION POSITION OR POLICY. This publication is a result of a two-year study sponsored and supported by the American Telephone and Telegraph Company. Institute of Rehabilitation Medicine i, New York University Medical Center 400 East 34th Street New York, New York 10016 1968 Table of Contents h Foreword Loss of joint range of motion 69 by Howard A. Rusk, M.D. 5 Loss of coordination 69 Loss of muscle strength 69 Introduction Weights of handsets 69 The study and its results 6 Analysis 2) Using switches 71 The local Telephone Company 7 Methods of making contact with a switch 71 Establishing telephone evaluations in a Characteristics of switches 74 rehabilitation facility 8 Analysis 3) Dialing 7r- Some definitions of Terms 8 A) Touch-Tone dial 7b Organization of the monograph 9 B) Rotary dial 75 1) The difficulties encountered by the Comparison of Touch-Tone and disabled person in using a telephone 10 rotary dialing 76 Time available for dialing 77 2) Telephone equipment found useful for C) Repertory dialers 77 the physically disabled 13 D) Manual service and "one-number" Telephone sets 15 dialer 77 1 Equipment for conversation 28 5) Evaluation of the patient: Dials and dialing arrangements 38 Telephones for special situations 47 Phase OnePhysical Function 79 Equipment drawings 51 6) Evaluation of the patient: 3) General factors influencing the Phase TwoEquipment Tests 84 choice of telephone equipment 58 The order of testing the equipment 85 Reaching the telephone 58 Testing equipment for conversation and Use of the telephone by the family 59 choosing a telephone set: 85 Arrangement of the work area and sequence Handsets 85 of actions 60 "Hands-free" equipment 85 Use of the telephone at place of work 65 Testing dials: 86 Touch-Tone dial 86 4) Introduction to the evaluation of the Methods of contacting the dial 86 patient: equipment analyses 67 Procedure for testing the Touch-Tone dial 88 Analysis 1) Using the handset 67 Rotary dial 90 Designation of terms for the position 9) Assistive equipment and its significance of hand and dial 90 for use of the telephone 125 Methods of contacting the rotary dial 94 Wheelchairs 125 Procedure for testing the rotary dial 102 Assistive equipment for the upper extremity:127 Procedure for testing the Card Dialer 105 Balanced forearm orthosis 127 Neuromuscular incoordination 105 Overhead suspension sling support 127 Difficulty in recognition of numbers 106 Elbow flexion orthosis 127 Identification of cards 107 Wrist and hand orthoses 127 o! Perceptual deficit 107 Self-help devices: 128 Writing cuff 128 7) Selected diagnoses and disabilities 109 Mouthstick 128 Amputation of the upper extremity 109 Equipment for respiration: 129 Aphasia 111 Rocking bed 129 Blindness 111 Tank respirator 130 Deafness 112 Chest shell 130 Neuromuscular incoordination 112 Positive pressure equipment 130 113 ,.e Muscular dystrophy 10) Special facilities or services for 4 "The One-Handed" 113 summoning assistance 131 Parkinson's disease 115 "The Person without Arm Function" 115 11) The use of the telephone for a business at home The order of testing 115 132 Microswitches 116 12) Coin telephones for the wheelchair user 135 Positions for standard switches and Appendices: microswitches 116 "The patient with slight motion in the A) The diagnostic and disability categories arms or other parts of the body" 118 of the 305 patients evaluated during "The patient with good motion of the study 140 the trunk" 118 B) Functional analysis of using the handset141 "The patient with motion only at C) Functional analysis of using a head and neck" 120 paralyzed hand in rotary dialing 143 Rheumatoid arthritis 123 D) Telephone equipment for patient Spinal cord quadriplegia 124 evaluation 145 E) Rates for standard telephone ir 8) The final choice of telephone 124 equipment. 147 4: , T F. Illustrations .7? of J Figure 1 The assistance that suitable tele- 16Rotating the rotary dial completely phone equipment can provide to the around. 94 severely disable person. 11, 12 17"Ball" dialing tool: Methods of hold- Telephone equipment found suitable ing it in the hand. 95 for the motion handicapped. 13-51 18Use cif a "grooved knob" dialing tool. 96 Equipment drawings. 52-56 19"Bair dialing tool: in a cuff across 2 Mr. and Mrs. V. Use of the telephone the palm and the corresponding posi- by the family. 61 tions of the dial. 97 3Mr. G. H. Arrangement of the work 20Dialing tools in the spring clip ,)f area. 63 ADL long opponens orthosis. 98 4Mr. G. H. Arrangement of the work 21Using the thumb to dial. 98 area. 64 22Using the palm of the hand to dial 99 5Mr. J. S. Use of the telephone at place 23Special method of dialing when the of work. 65 arm has function but the fingers are 6Holding a standard handset. 68 paralyzed. 99 7Using the Wear-it-and-Hold-it set as 24Special method of dialing when the handset. 71 arm has function but the fingers are 8The patient with loss of joint range of paralyzed. 101 motion. 71, 72 25Positioning a dial according to the 9Positioning the modified 6017-type dialer line. 102 key. 73 26Positioning the rotary dial for dis- 10Lines of force in using the rotary dial tance. 104 ( diagrammatic). 76 27Adjustment in rotation of the dial. 105 11 Methods of contacting the Touch- 28The Above-Elbow Amputee. 111 Tone dial. 87 29Blindness. 112 12Height and inclination of the Touch- 30Deafness. 112 Tone dial. 89 31The One-Handed. 114 13Rotation of the Touch-Tone dial. 91 32Parkinson's Disease. 115 14Designation of terms for the position 33Mountings for microswitches. 117 of the arm and dial. 92 34"The patient with slight motion in 15Axes around which a dial is rotated. 93 the arms and other parts of the body." 119 3 35"Thepatientwithgoodtrunk 39Modified 4A key equipment foruse motion." 120 in a tank respirator. 129 36"The patient with motion only at 40Coin Telephones 200 Series and neck and head." 121 1A1. 136 37"The patient with motion only at 41Approaching a wall mounted tele- head and neck." 121 phone. 137 38Rheumatoid Arthritis. 122 42Use of a stick for inserting money. 138 4 " 4 4 1 e, Foreword ad; AI The importance of a telephone to a disabled per- directed to those concerned with the rehabilita- son cannot be overestimated. It can enable him to tion of patients during their association witha work, it can allow the homebound to reach out to treatment facility; the Bell Manual is directed to . friends and the community, it can providea mea- Telephone Company personnel who are concerned sure of safety to those who live alone. with providing telephone service to theircus- This Monograph provides a method of evaluating tomers at home or at work. the functional motions of the disabledperson and The information for the two publications resulted of correlating these abilities with the physicalre- from a two-year cooperative study conducted at quirements for operating the different items of the Institute of Rehabilitation Medicine under telephone equipment. It provides comparisons be- the sponsorship of the American Telephone and tween the operating features of the equipment Telegraph Company. The depth andscope of the and offers guidelines by which one itemmay be study would not have been possible without the judged more appropriate than another.