What criteria is necessary to create an ideal placement for a switch site?
An ideal switch site is going to use as small a movement as possible. That movement should be isolated and volitional with controlled switch activation. They may need to use sustained pressure if that is required for a power wheelchair, as well as a controlled release. The six features that create an ideal switch site are as follows:
- small movement
- isolated movement
- volitional movement
- controlled activation
- sustained pressure
- controlled release
There is a hierarchy of potential switch sites:
- Lower Extremities
- Upper Extremities
The hands are the most common placement for many of our clients.
Another question I often hear when talking about switch access is that sometimes the client is able to access switches in several areas. As you are looking at potential switch sites, you might think there are a couple different places this client can activate a switch. How do I choose which one is best? Again, go back to our switch assessment and look at those features of an ideal switch site. We want a movement that is small, accurate, has good speed, with sustained pressure if required for power mobility, consistent, and has a timed release (for safety). As you look at these potential switch sites, make sure that you are choosing the one that has those features to the most extent. That will be your optimal switch site.
If a client is scanning on a communication device, some clients use two switches for scanning. If that is the case, you are going to choose the two most efficient switch sites for the client. If the client is using several switches for power mobility, such as one switch for forward, one switch for left, one switch for right, you are going to choose the strongest site for forward because that is the switch the client is going to use most frequently.