Selecting a telephone for a person with a disability

by Elizabeth Steggles
This article and reviews were originally published in the September/October 1999 issue of Occupational Therapy Now magazine published by the Canadian Association of Occupational Therapists

Telephones and modems are examples of telecommunication technology that may extend control over one’s environment. A telephone may enable a person with a disability to call for assistance or emergency help. It may also be used to organize and direct care, do banking and maintain social and work contacts. Through the telephone line, people now have access to e-mail and the Internet to retrieve or exchange information efficiently.

Telephones that may be appropriate for users with disabilities can be divided into three categories as follows:

• Standard telephones which can be found in the local store or local Phone Centre. Some may have features which help people who have accessing difficulties.
• Adapted telephones. These are stand-alone devices which are designed with special access features. It may be possible to integrate them with other technologies. They are more commonly sold by companies who supply equipment for people with disabilities.
• Environmental controls with dedicated telephones. These are part of a comprehensive system which may enable the user to activate appliances such as home entertainment units, lights and electronic beds in addition to the telephone.

When helping a client to select a telephone there are a number of factors to consider:

Access

Can the client see the information on the telephone?
Is hand function adequate to pick up and hold the hand set and can the user activate the number and memory buttons?
Is the user numerate and can he remember numbers?
Can the user get to the phone quickly enough either to answer it or dial out?
Can the user hear and be heard? Are the user and/or telephone positioned appropriately?
Does the telephone need to be integrated with other technologies like as powered wheelchair controls, voice output communication devices or environmental control systems?
What is the telephone's purpose? Does it meet needs adequately?
What are the client's needs and will they change either as he deteriorates or becomes more independent?
If the system is complex, can caregivers provide technical support ? Is there someone with enough knowledge to set up the telephone to meet the user's specific needs?
Is it important for the client to have private conversations? If so, a speakerphone may not be the best solution or the user may need assistance to position a headset.
Is it necessary to use a dialing prefix to reach an outside line? This is often the case in an institution and it may not be possible to program prefixes into the device.
If the user wants to connect to an automated system, can he access the numbers specified?
Is battery back-up required in case of power failure?

Having identified the user’s requirements, it may be possible to find a relatively inexpensive standard telephone. The Ameriphone Photophone P300 (see review below) is reasonably priced and has many features useful to people with a variety of disabilities. The following web sites may also be helpful in your search:

Elizabeth Steggles, OT(C) is an occupational therapist at Independence Technologies, at Chedoke Hospital, Hamilton, Ontario. E-mail: steggles@hhsc.com

Product Review: Ameriphone Photophone P300
Hall Telecommunication
PO Box 1416, Guelph, ON. N1H 6N8
1 (800) 265-2667

A common complaint of long-term care facility residents is that contacting family and friends can be extremely difficult and frustrating. They may not remember area codes and phone numbers or have difficulty accessing their telephone numbers. They also must find an available phone and remember to dial 9 to get an outside line. All this can be daunting for a person who has difficulty remembering, hearing, seeing or pressing small buttons. As a result, ability to contact family and friends is reduced and feelings of isolation may develop. To minimize these fears and help eliminate some of these accessibility problems, maintaining a link to the outside world may be facilitated by selecting an appropriate phone. The Ameriphone Photophone P300 was designed to assist children use the telephone; however, with its many features, this adapted phone can be useful to people of all ages and needs. The following list provides an overview of the Photophone’s special features along with considerations for their use.

Photo-dial memory buttons
There is room for nine small photographs of family and friends to be placed on the phone. Phone numbers may be programmed in and the user need only press the photo of the person they wish to call. This improves access for those who have memory, visual or fine motor difficulties. Emergency numbers can also be programmed to promote home safety.

Amplifier and Automatic Tone Enhancement
This feature amplifies incoming calls up to ten times their standard level. It also provides automatic tone enhancement to clarify hard-to-distinguish words. These are features to consider for users who have difficulty hearing or interpreting what is being said to them. The handset is also compatible with a hearing aid. Last but not least, the volume and ringing tone can be adjusted. This is handy for people who are experiencing hearing difficulties or who may confuse the ring with something else.

High-Contrast Buttons 
Nine extra-large buttons can accommodate visual or fine motor difficulties, and large white numbers are printed on a dark gray buttons to further assist those with visual difficulties. A red light flashes during incoming calls to alert those with hearing problems, while an illuminated emergency button allows those with visual problems or disorientation to access it more easily. It should be noted that the hold, programme, amplify, flash and redial buttons are standard size.

How easy is it to program? The installation simply involves plugging the cable into a phone jack. The instructions for programming in phone numbers are clear and easy to understand so that even a non-technical person like myself was able to put them in with ease!

— Sheila Boatman,OT(C)
    St. Joseph’s Hospital
    Guelph, Ontario