TCAT Holiday Toy Recipient Sign Up

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This is the enrollment form for the 2020 TCAT Adapted Toy Holiday Drive presented by the Taskar Center for Accessible Technology.

WHAT IS THIS? This is a request form for a switch adapted toy, specifically suited for an individual that is unable to access store-bought toys due to the switching mechanism being inaccessible to them. The intended recipient MUST HAVE access to switches that s/he can operate. The toys will not be operable without a switch, and switches are not provided with the toy since different individuals have very different switch requirements.

EQUITY STATEMENT: No person shall be excluded from participation in, be denied the benefits of, be subjected to discrimination nor shown preference in any program or activity available at TCAT's Toy Hack on the basis of race, color, sex, religion, creed, political belief, age, national origin, linguistic and language difference, sexual orientation, socio-economic status, height, weight, marital or familial status, or disability

DISCLAIMER: due to the pandemic, we are unable to run our usual mass toy hack event, so we are going to do our utmost best to satisfy all the toy requests, but sadly cannot make any guarantees this year.

Please answer the following questions to help us better understand how the service can be most beneficial to you and your learner.
If you need assistance or accommodations to complete this survey please contact uwtcat@uw.edu

Name

Email Address *

We call our toy recipients 'learners' because play is an incredibly important part of development. What is the learner's favorite toy? (adapted or non-adapted)

Has the learner (recipient of a toy) used an adapted toy before? *

Yes

If yes, what is their most commonly used adapted toy?

If the learner has used an adapted toy before, what type of adapted switch do they most often use?

What is the biological age of the learner? *

<1 year old

2-4 years old

5-6 years old

7-9 years old

10-12 years old

13-15 years old

16-18 years old

18+ years old

Does the learner act younger than their biological age? *

Yes

Sometimes

Other:

What is the learner's current educational level? *

Preschool

Elementary School

Middle School

High School

Transition Program

College

Work

Other:

Does the learner have trouble letting you know what they want? *

Yes

Sometimes

Other:

Does the learner ignore some sounds? *

Yes

Sometimes

Other:

Does the learner sometimes ignore things or people that are moving? *

Yes

Sometimes

Other:

Does the learner ignore some lights? *

Yes

Sometimes

Other:

Does the learner have trouble hearing? *

Yes

Sometimes

Other:

Does the learner have difficulty concentrating? *

Yes

Sometimes

Other:

Does the learner find it hard to read or write? *

Yes

Sometimes

Other:

Does the learner have trouble moving around a room? *

Yes

Sometimes

Other:

Does the learner have trouble pushing buttons? *

Yes

Sometimes

Other:

Does the learner have trouble operating switches? *

Yes

Sometimes

Other:

Does the learner have trouble using touch to activate a click on a touchscreen? *

Yes

Sometimes

Other:

Is the learner sensitive to flashing lights? *

Yes

Sometimes

Other:

Is the learner sensitive to loud noise? *

Yes

Sometimes

Other:

Is the learner sensitive to touch or certain textures? *

Yes

Sometimes

Other:

Please let us know which features we haven't discussed you LIKE in a toy for this learner?

Please let us know which features a toy should NOT HAVE?

If you are comfortable, please help us better understand the learner by specifying a diagnosis, if any (optional).

How did you find out about the The TCAT Holiday Toy Hack?

Unfortunately, 2020 has brought on unprecedented challenges and we cannot have a large toy adaptation event. We will be teaching toy hackers, via zoom, how to adapt a toy.

Do you have a person who may be interested in adapting the toy for your learner? (it could be you, a family member, or someone in your support community who would be doing the adaptation) Please list their FULL NAME HERE.

Please list their E-MAIL ADDRESS HERE

What city do you live in?

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