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| Job Accommodations One of my most commonly-requested services is job accommodations. These referrals include learning about a person's abilities and difficulties, analyzing the job tasks, and designing accommodations that can adapt the work situation to match the strengths of the employee. I have provided job accommodation services to individuals with ergonomic concerns, low-energy illnesses, mobility restrictions of all types, sensory difficulties, and unusual positioning requirements. I provide job accommodation services wherever people work:  at home  in an office  or in industry I usually install the accommodations I recommend and provide on-site training as well.
 This person, who had chronic back and hip pain due to an injury and subsequent surgeries, used a hard, straight-backed, non-adjustable chair at work. She was so uncomfortable that she could not tolerate working full-time, even though she had added layers of padding to the seat.  I recommended an ergonomic chair with adjustable height, seat angle, back angle, and back height. It also rotates easily and includes an adjustable lumbar support. This chair also includes a "spinal cord channel" in the back cushion to reduce pressure on this person's surgery site and a "spine pocket" that reduces vertical pressure on the tailbone and entire spine. After I adjusted the chair for her, she reported much less back pain and has been able to work full-time. One client who is blind had to pass a certification exam; however, the training materials were 700 pages of articles, tables, charts, legal documents, graphs, and lectures by various authors. As he did not read Braille, an assistant and I read this material out loud, including describing the graphics, and recorded it on 11 microcassette tapes. I also marked each tape with a system of notches (arrows) so that he could uniquely identify each one by feel. He passed the exam!  This typical office is not wheelchair-accessible and is essentially impossible for someone with reduced hand function to use. The paper records in file folders are extremely difficult to handle. I redesigned the office so that the employee's worksurface is wheelchair accessible, adapted the computer so that he can use it easily, added a wireless telephone headset to improve phone access, and designed a custom file holder (on the back wall) so that he can independently retrieve large folders of records. I also installed a program that improved the employee's productivity on the computer by automating routine tasks, such as entering the employer's name and address on forms.  I adapted this elementary school teacher's desk for a person with a spinal cord injury; she types on a small keyboard (A) with her mouthstick (B), which is supported at a comfortable height by an adjustable mounting arm (C). I also replaced the computer mouse with a trackball (D), which is much easier for her to use with a mouthstick. (The existing keyboard was left in place for the school's technical support staff to use if necessary; I set up both keyboards to work simultaneously.)  This person required additional support for her left arm and shoulder, which she had injured in the past. I removed her chair's left armrest and installed a "floating" arm support, which is height-adjustable and moves with her arm for maximum support. This assistance significantly reduced her upper body fatigue and discomfort. This person had difficulty typing on standard keyboards due to repetitive strain injuries; I recommended this "split" adjustable keyboard, which can tilt upwards for increased comfort. I also had to design a locking box to keep others from disturbing the keyboard while she was away from her desk. An adjustable height worksurface and an ergonomic chair completed the accommodations. I designed this wheelchair camera mounting system for a professional filmmaker; he can now operate his video camera independently for the first time. The camera can pan, tilt, and rotate completely around so that he can reach the buttons and controls on both sides of the camera. He can also use this mounting system on his other wheelchair. The mechanical arm is very adjustable and easily removable.  This person, who has a spinal cord injury, does not have enough control of her fingers to handle papers. I proposed using an inexpensive hand aid, which holds a pencil with a special non-slip tip. This device allows her to move individual papers and turn pages in books. Here's another wheelchair-accessible workstation I designed for a new employee at a local company; I also matched the style and appearance of the other workstations and included a check-writing surface (top right) as well. In addition, I recommended a trackball to replace the keyboard's tiny touchpad. Finally, the worksurface height is adjustable for comfortable positioning.  Some job accommodations are very quick and easy; I inserted rubber doorstops under the keyboard to create a negative-tilt arrangement for a person with carpal tunnel syndrome. This simple fix reduced the user's wrist angle so much that he can type comfortably for long periods of time. I also recommended a trackball pointing device and tilted it up to match the keyboard position. Finally, I provided an extra-tall wrist rest for additional support. This obstacle seemed very difficult at first; a person who is blind was to be in charge of updating a monthly calendar at an assisted-living facility. Obviously, it was not practical for him to write on this whiteboard by hand. However, I recommended changing the whiteboard to a corkboard. The client simply created weekly sections of the calendar on his VoiceNote speech-enabled computer. Then he printed out one week per page and posted them for the rest of the employees to see. (I selected a corkboard that was 4 pages wide to make this task easier to do by touch alone.) Here's another job accommodation; a person with severe arthritis had great difficulty writing for any length of time. Holding a hard pen with her fingertips was very uncomfortable. I added this soft foam cushion to the pens and she can write much, much longer with minimal fatigue. Her fingertips now have a yielding, flexible surface to hold. Some jobs may need one single accommodation; this person only required a screen-magnification program on his computer. Then he was able to read the screen clearly and perform his job duties easily. As he had the keyboard memorized well, he did not even need large-print keyboard labels. I designed this unusual workstation for someone with chronic upper body pain due to multiple neck and back injuries. Her positioning is very critical to her comfort and she is only relatively comfortable when her neck, back, and arms are supported properly. A standard desk and chair is simply intolerable for her to use. This workstation allows her to elevate her feet, partially recline, and move the entire workstation and adjustable-height and adjustable-angle keyboard shelf close to her. The monitor is positioned so that she can see it clearly; she is very farsighted. As a result of this equipment, she can work comfortably for long periods of time. She is attending an online training class in this picture; she plans to work at home in the future. | |
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