1. Safe Operation of Equipment in Agricultural Settings AgrAbility NTW 2014 John Hancock, KY AgrAbility Carol Weber, ATP, KY OVR Maryfrances Gross, CDRS

2. Session Goal Examine the need for an effective evaluation tool/protocol for determining adaptive equipment necessary to allow an individual with a disability to operate equipment on the farm safely and effectively. Group discussion about the current best practices and who should be involved on the team making the determination of equipment to be used. Kentucky AgrAbility

3. Session learning objectives Identify the need for the development of standards and protocols for determining when a farmer is able to independently and safely operate farm equipment. Identify the special considerations for operating farm equipment vs. operating a motor vehicle on the road and the need for additional evaluation. Discuss methods that have been used to determine a farmer’s ability to safely operate equipment. Kentucky AgrAbility

4. Biggest Barrier: Getting on or off the Equipment (creates a natural barrier to operation) As technology to modify agricultural equipment becomes more available, farmers with disabilities are gaining access to farm equipment that has been inaccessible to date.

5. Internet Available Resources Kentucky AgrAbility

6. Question: How do we know farmers with disabilities are safe when operating equipment (of many types)?

7. –OK with driver evaluation for personal vehicle –Do not allow individuals with head injuries to operate equipment Current “Standard” Practice:

8. Problems with this Approach: Undiagnosed Head Injury Driver’s Evaluation revealed no issues

9. Problems with this Approach: Rand: Head Injury – no driver adaptations needed

10. Problems with this Approach: Jimmy: CP – not going to drive on the road –Going to farm (no matter what)

11. Problems with this Approach Kentucky AgrAbility

12. Farm vs. Road: Terrain FarmRoad Open, may be gravel or dirt roads Marked Lanes Fewer “obstacles”High number of other vehicles, pedestrians, visual stimuli, traffic signs, etc. FamiliarMay be unfamiliar Wide variety – hilly, steep, flat, sinkholes Smooth terrain, gradual turns Best practices, suggestions, the way I have always done it Rules of the road - expectations Kentucky AgrAbility

13. Farm vs. Road: Vehicle FarmRoad More wheels, more horsepower, more weight. Typical passenger vehicle Varied types of controls: skid steer, rear steer combine, etc. Steering wheel, gas and brake pedals Generally SLOWEven slower speeds tend to be faster than farm speeds Also operate another piece of equipment or perform an additional task One task: drive from one place to another Operating in conjunction with another operator Typically a solo task Several pieces of equipmentOwn one car Possible exposure to heat/cold/dust Typically climate controlled Kentucky AgrAbility

14. Farm vs. Road Use many different vehicles on a farm

15. Another Consideration Seating and Positioning –Number of hours spent on a tractor per day vs. in a car per day –Positioning on the tractor or other equipment is as important as wheelchair positioning or vehicle seating

16. Another Consideration Seating and Positioning –While air ride seats may help with the jolts of running across a field, they may not have good pressure relief. –It’s not all about the cushion (2x4)

17. How do we address these issues? AgrAbility: expertise in farm equipment modifications CDRS/OT: expertise in adaptive equipment operation & analysis of driving tasks Vocational Rehabilitation: funding, assistive technology expertise Kentucky AgrAbility Vehicle Modification Specialist: expert in providing custom adaptations for driving

18. Driver’s Evaluation Initial Screening: –Medical Clearance Medications Seizures/Blackouts Physician clearance for driving –Driver license status Expiration Restrictions Driving history Suspensions/revocations Kentucky AgrAbility

19. Driver’s Evaluation Clinical Evaluation: –Physical Function – Range of motion, strength, coordination, endurance and sensation. –Vision – Visual acuity, depth perception, contrast sensitivity, peripheral and color recognition. –Cognition – Attention, judgment, memory, spatial, perception, problem solving. –Reaction Time – Ability to respond timely and accurately with regards to driving tasks. –Self Control – Ability to modulate oneself in response to demands in the environment. Are the same skills needed for farm equipment operation? Kentucky AgrAbility

20. Driver’s Evaluation Clinical Driver Assessments –Vision Useful field of vision Kentucky AgrAbility

21. Driver’s Evaluation Clinical Driver Assessments –Cognitive Trail Making Test Kentucky AgrAbility

22. Driver’s Evaluation Clinical Driver Assessments –Cognitive Kentucky AgrAbility

23. Driver’s Evaluation Clinical Driver Assessments –Cognitive Kentucky AgrAbility

24. Driver’s Evaluation Clinical Driver Assessments –Cognitive (not standardized) Kentucky AgrAbility 1 3 2 4 5 6 13 8 9 10 11 12 14 7

25. Driver’s Evaluation Behind the Wheel Assessments –Performance categories Observation Communication Speed adjustment Vehicle positioning Time and space judgment Vehicle response Kentucky AgrAbility

26. Causes of Accidents Causes of car accidents: –Environmental factors include slick roadways, reduced visibility due to fog or darkness, obstructions to a driver's view, and roadway design problems. –Vehicular factors include vehicle malfunctions such as brake failure, inadequate tire tread or tire underinflation, and inoperable lights and signals. –Driver Factors: Recognition errors were probable causes in 56% of the crashes, decision errors in 52% of the crashes, and performance errors in 11% of the crashes. Are these accident causes similar on a farm? Kentucky AgrAbility

27. Other factors Kentucky AgrAbility

28. KY AgrAbility Ride ‘n Drive –Addresses ability to operate the equipment on a course : similar to driving in a parking lot.

29. KY AgrAbility When a driver’s evaluation is done, a CDRS uses an adapted vehicle set up specifically for the consumer. KY AgrAbility –Adapted UTV –Adapted Tractor – seated and standing lift available, with hand controls Kentucky AgrAbility

30. KY AgrAbility Ride ‘n Drive

31. KY AgrAbility Ride ‘n Drive

32. KY AgrAbility Ride ‘n Drive: Tractor setup –Onboard video “Go Pro” better observation – no “buddy” seat On the Farm Evaluation –Can’t get enough information on a closed course –Evaluate consumer in the environment –Evaluate consumer performing tasks Other shortfalls: –Can’t get consumer operating his own tractor

33. Who should be involved in making a decision about safe operation? Farm Specialist (AgrAbility) –Understands operation of equipment – how it is used, considerations –Farming adapations Farm Safety Specialist Rehab Techs Vocational Rehabilitation CDRS –Understands safe driving task –Cognitive aspects of driving –Driving adaptations OT/PT: Positioning Consumer/Family

34. Suggestions? Next steps to develop guidelines