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ATU524 – Adaptive Switch Laboratories Inc. with Lisa Rotelli

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Your weekly dose of information that keeps you up to date on the latest developments in the field of technology designed to assist people with disabilities and special needs.

Special Guest:
Lisa Rotelli – Director of Adaptive Switch Laboratories Inc.
ASD Diagnosis Device Story: https://bit.ly/3x6PdrP
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———— Transcript Starts Here ———–
Lisa Rotelli:
Hi, this is Lisa Rotelli and I am the Director of Adaptive Switch Laboratories. And this is your Assistive Technology UpdateJosh Anderson:
Hello, and welcome to your Assistive Technology Update, a weekly dose of information that keeps you up to date on the latest developments in the field of technology, designed to assist individuals with disabilities and special needs. I’m your host, Josh Anderson, with the INDATA Project at Easterseals Crossroads in beautiful Indianapolis, Indiana. Welcome to episode 524 of Assistive Technology Update, it’s scheduled to be released on June 11th, 2021.

Josh Anderson:
On today’s show, we’re super excited to have Lisa Rotelli on to tell us all about Adaptive Switch Laboratories and everything that they have to offer. We also have a quick story about a new device said to be able to diagnose autism that was just approved by the FDA. Now, let’s go ahead and get on with the show.

Josh Anderson:
So, I started off the day with a story that I found over at disabilityscoop.com. It’s written by Michelle Diament and it’s titled FDA Approves Device to Help Detect Autism. So, anyone who maybe has a family member or has ever had any experience with anyone with autism knows that sometimes getting that diagnosis can be one of the hardest parts. There’s not a whole lot of specialists who can actually diagnose autism and not only that, because of the way funding is and everything else, sometimes you might wait, well, even up to a year or longer for an appointment.

Josh Anderson:
So, this story is about a first of its kind device that’s there to help primary care doctors determine whether or not a child has autism. So, if you really think, this could allow kids to be diagnosed a whole lot sooner and avoid some of those lengthy waits to see specialists. It says here in the story that the Food and Drug Administration gave the green light to market the Cognoa ASD Diagnosis Aid, which will be branded Canvas Dx. This device uses machine learning-based software and an algorithm to analyze data submitted by the parents and healthcare providers and return either a positive for ASD or negative for ASD response for a child.

Josh Anderson:
It says in order to use the device, parents and caregivers answer questions about behavior, submit videos of the child through a mobile app and the healthcare provider can also answer questions through a special portal that they have access to. All these videos are reviewed by a certified specialist, and then the algorithm makes a determination just as long as there’s sufficient information provided.

Josh Anderson:
This is the first device authorized by the FDA to help primary care physicians diagnose autism. I can see this going a lot of different ways. The first way, and of course, what this story is mostly about is just cutting down on that wait time to get that diagnosis could be great. You could already have behavior therapy, some other therapies to really helping individual with autism spectrum disorder cut down on the delays and physical cognitive and social development.

Josh Anderson:
They could get services such as OT, PT, speech, all these other services as they’re younger and as we learn a little bit better, as we all know, kids are like sponges with or without autism spectrum disorder. So, really, the earlier you can get those interventions in there, probably the better they’re going to take. My only concern would be, I don’t know, it’s how much are these clinicians and specialists actually looking at these videos? How much are they just relying on the software to kind of do it?

Josh Anderson:
I’ve known some folks who don’t want to take their kids for a diagnosis, because they know once that diagnosis is there, it doesn’t go away. So, they’re a little bit worried that maybe their child may have that diagnosis, but it’d be mild, but get treated a little bit differently because of that. So, I guess I would worry about the software or the algorithm, perhaps, maybe diagnosing autism when it’s not there or not finding it when it is.

Josh Anderson:
I guess I’m still just a little bit old school. And even though this is a technology show and I use it all the time and really use it to help folks, I’m still one of those people that really just believes there’s not much that can really beat human beings when it comes to some of these different kinds of things.

Josh Anderson:
It does say here that the diagnosis aid did have a study that involved 425 children from ages of 18 months to five years. The device was able to return a result for about a third of those kids. So, apparently it does need quite a bit of information and doesn’t always get that. Of those who were found positive for autism spectrum disorder, a panel of clinical experts found that 81% were actually on the spectrum. They also agreed with the aid’s finding in 98% of the children who got a negative for autism spectrum disorder.

Josh Anderson:
So 81%, I guess, isn’t bad of the third that it could actually diagnose. I mean, that’s better than guessing and perhaps better than a primary care physician could do. I’m not real sure, but I would have to guess that the actual specialist would be able to do a whole lot better.

Josh Anderson:
Where I could really see this being useful is to perhaps get a diagnosis while you’re waiting on that meeting with a specialist, while you’re waiting for that actual diagnosis to come through so that maybe some services can go ahead and be rendered and the individual can be involved in some different programs to help with the different behaviors or different services that they might need.

Josh Anderson:
So, I’ll put a link to this over in the show notes, you can go check it out for yourself, but pretty wild, pretty wild that this machine, this device is actually able to take data, put it all together and perhaps come back with a diagnosis of autism spectrum disorder.

Josh Anderson:
If your really boil this show down to what it’s all about, the word access would come to mind. How can we make things more accessible to all? What’s needed to allow individuals of all abilities to access the world around them? And what do you do when the standard access methods just don’t suffice? Well, our guest today is Lisa Rotelli, Director of Adaptive Switch Laboratories, Inc. And she’s here to tell us about some of the amazing solutions that they’ve created and implemented to increase access for individuals. Lisa, welcome to the show.

Lisa Rotelli:
Thank you for having me. I’m excited to be here.

Josh Anderson:
And I am really excited to talk all about Adaptive Switch Laboratories. But before we do that, could you tell our listeners a little bit about yourself?

Lisa Rotelli:
Absolutely. I’ve been working with assistive technology basically my whole life. I feel like I want to tell people I started when I was 10, but actually I started right out of high school. When I was going to college, I was working at a rehab hospital, an acute care rehab hospital. So, I’ve been really trying to help find solutions, I feel like, for my whole life, for people with compromised mobility and compromised assistive technology needs.

Lisa Rotelli:
So, again, I started in California and I’ve worked in 1995 and I actually got ahold of the person that started Adaptive Switch Labs. And it was life-changing, I do want to say, as far as the technology that he had to help the people and patients that I was working with. So that kind of became my life’s goal. And I went to work for a Adaptive Switch Labs in 1996, moved to Texas, and I’ve been here ever since.

Josh Anderson:
That’s awesome. It’s awesome when you can find a place like that, that you really respect and then can actually get on there. I must admit that I didn’t know what I wanted to be when I grew up until I found assistive technology. Now I can’t imagine doing anything else either. So I completely understand. So, getting into that, tell us about Adaptive Switch Laboratories.

Lisa Rotelli:
Well, Adaptive Switch Laboratories started as a company in 1990, but before that, the inventor and owner of Adaptive Switch Laboratories, Rucker Ashmore, had a son with a disability, an acquired disability, he had a spinal cord injury. And as any family thrown into the assistive technology world, there’s a lot to learn and a lot to try to understand. When you try to find answers, there’s not too many places to go get them.

Lisa Rotelli:
So, he started working with powered mobility and found that he was having a hard time finding solutions. So, he decided to make his own. And with that, when he was trying to make adaptations for his son’s chair and do repairs, he found out that there’s a lot of other families that were running into the same issues. So, he started a business, Adaptive Switch Laboratories, and his focus and goal was customer service and solution finding for people. So, it was all found around finding solutions to try to help families be able to help their children and help people with disabilities have access to the world.

Josh Anderson:
That’s excellent. I really want to talk about some of these solutions and I figured we should probably start with the ASL 110 FUSION. Just because, and I know people have a hard time bragging on themselves, but I know this was the winner of the 2020 Mobility Management Product Awards. So, can we start by talking about that?

Lisa Rotelli:
Absolutely. That is one of our newest controls that we have. At Adaptive Switch Labs, one of the things that we pride ourself in is, number one, not just thinking about one thing, not just thinking about mobility, which is critically important to people, but we want to think about, number one, who are the patients and customers that are using our products and what are their needs. So, not just within a one hour evaluation of, “Oh, you can do this.” But what does your 24 hour life look like? What do you need access to throughout the day, besides just mobility?

Lisa Rotelli:
On our newest product, the 110 FUSION that we designed and came out with, I think it meets a lot of those needs and really is one of the closest things to our overall mission that we’ve ever come up with, and that is access. So, the FUSION is proportional and digital drive control that you can use with your head and/or it’s proportional or digital, which means I can make it very simple, I get near something, a switch and it makes it move for somebody that’s just brand new to mobility, brand new to movement for the first time in their life. Then, I can actually grow by programming the system itself into a fully proportional drive control. So somebody that has had some experience, and can control pressures and I can adjust that to meet their needs.

Lisa Rotelli:
So, this is the most programmable system that we have ever had. I think it has really changed a lot of things in our world, as far as how we access powered mobility. It also allows me to connect to Bluetooth. So, just right through the drive control itself, and I know a lot of chairs have Bluetooth in them, but a lot of times that Bluetooth isn’t the type of Bluetooth signal we need to make something happen. So, all of ASL drive controls that we’ve come out with for the last almost 10 years now, which is hard to say, has Bluetooth in it, because we want to really help a patient be able to access possibly Xbox adaptive controller, if they have lights or things in their home, we want them to be able to answer the phone when it’s ringing, and we get a lot of those types of questions from people, from patients.

Lisa Rotelli:
If they have their phone paired to their chair, sometimes they have to call someone back every time, because they can’t get to it in time. And that’s something that we are trying to solve a lot of those problems for patients, so they can have quick access to talking, quick access to phones, any of those types of things besides just driving. So, we’re trying to look at a bigger picture there.

Josh Anderson:
Very nice. And I know that you have a lot of different kinds of driver controls, but then you also have a lot of other kinds of solutions. What are some of them? I know we could talk about this all day, but what are some of the other solutions that you guys do have available?

Lisa Rotelli:
So, we do a lot of access to communication devices, dedicated to communication devices and/or iPads and tablets, if somebody is using that for communication. We have a whole line of products… Everybody thinks of a switch is just a switch access to technology, but it goes way beyond that. There are a lot of people that can’t manage activating a switch quickly or activating a switch or pushing on something, because their ability is weakness. So, they can’t do things either quickly or they can’t have very much pressure at all. So, we make a lot of systems for a wide range of a person’s abilities.

Lisa Rotelli:
So, if somebody wants to access a communication device, we can make a fiber optic switch that we can plug into a communication device that you just get near the switch and it activates. You can also drive a chair that way. But we try to take a look at someone’s abilities and what might change throughout their time that we can actually make products that change with them. It may be that when I’m laying down in bed, I have one movement, and when I’m up in my chair, I have another. So, we really do try to look at the whole picture of somebody, where they are in the situation they’re in and how we can access their devices the fastest and most accurate.

Josh Anderson:
You brought up a great thing there, I love that you think about the life cycle of what are they able to do now? What are they going to be able to do later? What are they going to want to do? And really looking at that on, finding that solution, so it’s not something that has to be redone all the time.

Lisa Rotelli:
Correct. Yeah. Because it’s so critically important. We get upset if our Bluetooth comes unpaired from our car, but if it happens to one of our patients or our customers and they can’t re-pair it. So, it means that they have lost access. And I think that that’s something that we always try to… These things need to always work. They need to work like they’re expected and they’re supposed to for a patient, because it means a lot more if something happens with their system than it does with us.

Josh Anderson:
Oh definitely. And if you’re looking for access and independence, if I have to rely on someone else to sit there and pair my devices all the time, then really that’s no kind of independence.

Lisa Rotelli:
Correct. Yeah.

Josh Anderson:
Now, you also offer, in just looking at everything, some kind of special technical support. Can you tell me about your technical support?

Lisa Rotelli:
Yeah. That’s something that I’m particularly proud of at Adaptive Switch Labs, that we pride ourself in making sure that we have the best understanding and knowledge of power wheelchairs or wheelchair electronics devices and how they work and how they function. ASL’s employees are amazing. Again, they really dig in to understand things that wheelchairs are capable of, like what can happen with them? So, we can be a resource for somebody when they call us with a question and say, “Hey, I have a patient, they have this power chair when they have this drive control. I want them to be able to do this also.” So, we try to be a resource as much as humanly possible so they can find the best solution to get a patient to be able to do what they want.

Lisa Rotelli:
That level of independence is where we all need to be. So, we do a lot of training and education. Again, not just on Adaptive Switch Labs products, we really dig into wheelchair electronics, how things pair with them? What are they capable of? How does the navigation sequences happen with them? So, if a patient has limited movement, how can they go from driving to using their seat functions? How can they go from driving to talking with their drive control? So, we love it when people call us with questions and we really try to be a resource as much as humanly possible to help them out.

Josh Anderson:
Yeah. And just because, I was just looking through the website, I found so many great things and you’ve kind of mentioned it there, but if I’m not even the user, if I’m another provider and I kind of have questions, I can find a lot of stuff just on the website. I mean, from videos, programming drawings, all kinds of stuff. And that’s great that you thought to be a resource to everyone, not just the folks that you serve, but the folks who serve others too, that’s very important.

Lisa Rotelli:
That’s correct. We feel that knowledge should be shared, because the person at the other end of all of this thinks that we making the technology is the one that we need to all support. So, that’s our motto and that’s what we try to live by here.

Josh Anderson:
That’s excellent. And you mentioned just a little bit about education, but you guys actually do workshops, is that correct?

Lisa Rotelli:
We do. And it’s been a little bit of a hiccup, obviously, because of COVID, because we do hands-on training, but it’s something else that I think that we are proud of at ASL is our courses that we teach. So, we do a CE courses, so continuing education courses, and they’re two day classes, and typically they’re full of clinicians, therapists and ATPs, and they come, the first day is lecture. So, we talk about different power wheelchairs and the things that are available on the market today and different drive controls for different diagnoses.

Lisa Rotelli:
So, if somebody has weakness, if somebody has cerebral palsy, what are some of the things that you need to consider when you’re prescribing equipment for them? Because this is a prescription. So, there’s a lot of things you need to think about. But the other thing we talk about is how you can maximize the ability of that chair and of the drive control to do other things.

Lisa Rotelli:
So, again, first day, we go through patient scenarios and see patients learning and doing things from people that have never driven before or ever moved before up to someone that has had mobility and lost it, and the things that they may, from day one, need. So, everybody grows and changes. So, we try to talk about that a lot.

Lisa Rotelli:
But on day two, it’s all hands-on. So, we have a lot of power wheelchairs here. We break up into groups and people are driving chairs with alternative drive controls. They’re using the seat functions, because it’s critically important for someone to be able to change their position. So, to know how the wheelchair electronics let me go from driving to moving my seat.

Lisa Rotelli:
Then, the next thing they have to do is access communication devices through their drive controls, iPads, TVs. We do some games, so we have an Xbox adapted controller. So, people realize the parts they will need and the questions they need to ask when they’re doing an evaluation with someone. And hopefully the realization that almost anything can be done, we just need to dig into the right questions with the persons we’re working with to find out what’s important to them. Then, we can go on the problem solving scenarios to make it work.

Josh Anderson:
That’s excellent. That’s great training, especially for folks who maybe have been in the field for a while even, those are great things to remind them of, of just you might be the expert on some of the equipment, on some of that stuff, but the person that you’re serving is the expert on what they actually want to do and what their abilities are.

Lisa Rotelli:
Exactly. And there’s a lot of people that don’t really know, because this is all either new to them, because of a new injury, or they just don’t know what’s available. Our job I feel like is to make informed consumers. So our job is to be the educator to them to make choices. So, show them what’s available and then we can figure out how to get them there.

Josh Anderson:
And that’s always the hardest thing. I’ve worked with so many folks that have an acquired disability of some kind, and it’s always, “I’m not going to be able to do the things I used to.” And it’s like, “Well, you might, just there’s going to be a different way of doing it.”

Lisa Rotelli:
That’s correct.

Josh Anderson:
And like you said, it’s so hard to find that information and I always feel so bad. But I guess, in our field, it’s great when you get to show them and they have that kind of aha moment of, “Oh, wow. I can do this again.”

Lisa Rotelli:
Yes. And it may just be, like you said, absolutely, it just may be in a different way, but there is a way.

Josh Anderson:
Exactly. Well, speaking of that, Lisa, can you tell me a story about someone that’s been helped by ASL?

Lisa Rotelli:
I definitely can. I was having a hard time figuring out which story to share with you, because I can’t tell you how fortunate I feel that I get to do the jobs that I do every day, to be able to help someone gain access to something in some level of independence, which is different for every single person. But one young man in particular with a FUSION Head Array, there was a young man with arthrogryposis as a diagnosis, and he’d been driving with the chin control. So, he had independent mobility, but there were so many other things he was completely dependent upon.

Lisa Rotelli:
One of the main things that was a problem for him is the fact that someone had to feed him and he’s in middle school and going into high school, that meant he always had to have an attendant or an aid with him to get his food, to get him up to the… He could drive up to the table, but then take his… Drove with the chin control, take his chin control off and get him situated and sit there and feed him with all his friends around, which really decreases interactions for somebody of his age, especially.

Lisa Rotelli:
So, first of all, feeding is so personal. And second of all, having an adult around all the time really, it makes kids not comfortable. So, one of the things that we have done and his therapist is amazing, she introduced him to the FUSION Proportional Drive Control, because he wanted to be proportional as he should be. She helped him attain an Obi Feeder.

Lisa Rotelli:
So, we have, because of the Bluetooth system that we have in our ASL products, we call it ATOM technology, we have a Bluetooth switch interface, that plugged into the Obi Feeder and it was sitting on a table, it can sit at the table, he can drive up to the Obi Feeder, someone just has to put the food in and then they can take off, he can change into his Bluetooth mode and actually use Obi Feeder to feed himself.

Lisa Rotelli:
It may not seem like a giant, I don’t want to say win, but it just is so important, it’s such an important thing to be able to interact with his peers without an adult around in the same thing with all the other children and saying all the things that they’re either appropriately or inappropriately saying at the table, to not have someone around.

Lisa Rotelli:
His mom wrote a beautiful letter, said that, “My son can walk through the lunch line with everyone else. It has increased his friend group exponentially just for the fact that people come up now and say hi and stuff that they would never have done without an adult around. And for him, it’s so important for him, because he could pick what he wants to eat. And he said, ‘I can now skip my vegetables, even if they put them in the bowl, because I don’t want to eat them.’ But he can pick the order of the food he eats it in. But that couldn’t have been done without that wireless connection for him to be able to drive up to not have someone else connect him and him being tied to the table. Now he can actually turn around and leave when he wants to, if the food’s not great, or if he wants to run with somebody else, he can go.”

Lisa Rotelli:
So, that’s been a giant win and we have a nice video of him doing just that as an example on our website. And one of the other newest parts of our website that I’m most proud of is we have an ambassador’s program. The ambassador’s program really is, it’s not necessarily about ASL, but it’s about patients and the things that they’ve come up with to help their lives, help make things better for them. I want them to be able to be shared.

Lisa Rotelli:
So, on our website, if you go onto clients and then it goes ambassadors, I think we have five or six now, I want to fill up the page. So, if anybody is considering that, please consider being an ambassador for us, but showing us some of the things that you have figured out that have helped your life, because probably they will help someone else’s. So, Addison’s videos on there and I’m okay to use his name, because they gave me permission. So, he is one of them, one of the ambassadors on that page.

Josh Anderson:
And you brought up so many good points there. And I think it seems like eating is something that so many of us take for granted and don’t really think about, but as someone who has a 12-year-old at home that has heard him talking to his friends when they don’t know adult is around is compared to when adult is around, that is a huge thing. That is a huge thing. And a huge just bunch of independence that you can get, like you said, he’s actually got more friends and more people, I’m sure, willing to sit with him than having to sit by the adult and tone down that teenage, I don’t know, angst or whatever the heck they call it these days.

Lisa Rotelli:
Rhetoric. [crosstalk 00:23:56].

Josh Anderson:
That is awesome. Well, Lisa, what is on the horizon? Where is ASL going in the future? You guys working on anything new or is there anything you’re allowed to tell me?

Lisa Rotelli:
We are working on some amazing things, actually. I think in the last five years, we’ve really caught our stride a little bit. It’s always kind of an ebb and flow with products, and they never come out as fast as we want them to. But we sit down and before we design a product, we really think of a need first in a patient population. What are some of the needs that are not being met right now? And how could we make things better even if we make something, how could it be better for somebody?

Lisa Rotelli:
We’re coming up with some controls that we’re putting in for a patent for. So, I can’t say too much about it right now, but it’s going to be an amazing product for ASL. I think we are really trying to think of, like I said earlier, someone’s 24-hour life, what really do are the things that they need to be able to control in their life? And it’s everything we do. So, we really are trying to think of, if I have limited motion or too much movement, how can I still control all of these things? And I think this product will be a big step in that direction.

Josh Anderson:
We will look forward to learning about that in the future. Well, Lisa, if our listeners want to find out more about Adaptive Switch Laboratories or you, or anything that you all offer, what’s the best way for them to do that?

Lisa Rotelli:
You’re welcome to please go on our website and browse and look, and we have a section there, if you want to type us questions, we will get back to you is www.asl-inc.com. I always say, we want you to use the whole keyboard, so sorry about the dash on there, but you’re welcome to call us at any time. All of our information is on there, reach out. If you have questions, we try to have answers. And if we don’t, we will for sure tell you or try to get them for you. So technology has advanced a lot, but it seems to me we still have the same access issues. So, that’s something that ASL is trying to tackle.

Josh Anderson:
Excellent. We will put that down in the show notes. Lisa Rotelli, thank you so much for coming on today, telling us all about Adaptive Switch Laboratories and the amazing things that you folks do for individuals with different abilities.

Lisa Rotelli:
Thank you so much for having me. It’s been an honor and a pleasure to be here.

Josh Anderson:
Do you have a question about assistive technology? Do you have a suggestion for someone we should interview on Assistive Technology Update? If you do, call our listener line at 317-721-7124. Shoot us a note on Twitter @INDATAproject, or check us out on Facebook. Are you looking for a transcript or show notes? Head on over to our website at www.eastersealstech.com.

Josh Anderson:
Assistive Technology Update is a proud member of the Accessibility Channel. For more shows like this, plus so much more, head over to accessibilitychannel.com. The views expressed by our guests are not necessarily that of this host or the INDATA Project. This has been your Assistive Technology Update. I’m Josh Anderson with the INDATA Project at Easterseals Crossroads in Indianapolis, Indiana. Thank you so much for listening and we’ll see you next time.

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