AdaptABLE World

Low Tech vs. High Tech

2012-09-29T09:28:00.002-07:00

What is the difference between low tech and high tech in regards to Assistive Technology?

First, it is important to understand what is assistive technology to begin with. To paraphrase many definitions that are available, assistive technology is the use of a device to assist with improving the function of the user. For example, a pair of glasses can be considered assistive technology as they assist with vision. A walker can be considered assistive technology as it helps with walking or ambulation. There are also different levels of assistive technology, and this can be broken down into low and high tech devices.

Low technology does not require a power source. Sometimes this can be the easiest and most practical of solutions in assistive technology. Low tech devices are items that facilitate independence in an area as does high tech devices. Examples of low tech are a cane for assistance with walking, a pencil grip for children with grasp issues, or even glasses to assist an individual with seeing their environment.

Even if an individual can benefit from high tech assistive technology, it is always important that they have a low tech "backup". Technology can fail, batteries die, and emergencies can happen. In these cases, an individual will continue to meet their needs using their low tech device. Also, low tech devices might be all a user needs. High tech is not indicated for everyone.

Before we discuss high tech devices, there is another classification that many individuals use, mid tech. The difference between mid tech and low or high tech is that mid tech has a battery source. Typically, they have limited capability but do have a power source. This can include communication devices that can be pre-programmed with single pre-saved phrases or simple remotes that can control an individual's lights.

Again, mid tech can also be an appropriate option for individuals. They are simple devices that can facilitate independence for the user.

High Technology:

Users of high technology are typically individuals with significant functional impairments. This can includes folks with spinal cord injuries, Lou Gehrig's disease, or muscular dystrophy. Examples of high tech devices are:

Communication devices with alternative access methods such as eye gaze
Stand alone environmental control units, with alternative access, that can control multiple devices in the user's environment
Computer workstations with alternative software and hardware for access, such as a head mouse or dwell click software

These devices can assist a person with the most minimal of movement to independently communicate or control their computer.

Funding can be a challenge for these devices and they can be quite costly. Communication devices (or AAC devices) can often be partially covered by insurance companies. A qualified professional can assist with the selecting the appropriate device for the user's needs and goals, as well as obtaining funding for best device choice.

What have your experiences with these forms of assistive technology?

What is Word Prediction?

2012-08-17T08:48:00.003-07:00

What is Word Prediction Software?

Word prediction software attempts to assist the user by "predicting" words as they type. The words predicted can very depending on the program and the settings for the user. This can range from the first letter typed, the previous words in the sentence, and frequent use.

With some text to speech programs, the users can make a choice by either hitting the number (or with some programs key combinations) and have it inserted into their sentence. Choices can also be made using a mouse. Words can be programmed into the program's dictionary that are not initially there, such as the user's name. There are many other options that can be changed with this type of software, such as:

Font size of the words in the predicted list
Spacing added after words chosen off the list
Two spaces added after a period
Text to speech features for words chosen. This can also include reading the entire sentence when punctuation is added if set up for this feature.

What about phrase prediction?Phrase prediction predicts phrases. For example, if a user types the word "go" in addition to words that begin with go phrases such as "good morning" will also be predicted.

Where could someone use word prediction?

Word prediction can be used with any program that a person would normally add text. This would include email, social networking sites, documents, even instant messaging.

Who would benefit from word prediction software?

Word prediction software can benefit adults and children with various issues. This can include individuals with learning disabilities such as dyslexia or other issues with spelling.

Adults that would benefit:

Typists slower than 15 WPM
Individuals that have pain with extended typing. Word prediction software will decrease the amount of keys that need to be pressed.
Word finding difficulty
Individuals that user alternative access for typing such as a head mouse or eye gaze

Word prediction can be an important tool for users with varying impairments. Through evaluation and trial of various hardware and software can increase an individual's independence.

Talk About Adaptable!

2012-08-02T18:27:00.002-07:00

This is an amazing video that highlights the goal of having an adaptABLEworld! It highlights the importance of thinking outside of the box to address the needs of individuals with disabilities. Through the use of a 3-D printer, this child has gained a level of independence she might not have known otherwise.

http://www.youtube.com/watch?v=WoZ2BgPVtA0&feature=youtu.be

Just another example of ways to adapt or use technology for individuals with disabilities!

Mouse Keys

2012-07-21T19:16:00.001-07:00

What Are Mouse Keys?

Mouse keys are an alternative way to perform mouse skills for individuals that have physical impairments that would limit their ability to utilize a conventional mouse. Mouse keys allow the numeric keyboard to emulate mouse functions. For example, when the user presses the number 8, the pointer will move up. Pressing the number 6 moves the pointer to the right. When using mouse keys, the conventional mouse is not required. The image below helps illustrate these buttons and their correlating movements.

This feature is available with both the Windows and Macintosh operating systems. Below are screen shots of where to access this feature in both operating systems.

Macintosh:

Windows:

The rate of speed of the mouse point can be modified in the settings to accommodate for the users needs. Access of the numeric keyboard can be achieved through direct selection of the an individuals hands on the keyboard, a mouth stick or pointing device on the physical keyboard, or use of the on screen keyboard. In addition, if is easier for the individual, the mouse pointer can be made bigger for increased independence in the mouse settings (please see an earlier post).

Mouse keys is another example of how simple modifications can facilitate independence for an individual with a disability.

Alternative Mouse Control

2012-06-26T18:17:00.001-07:00

There are many ways that an individual with disabilities can control their computer. If the individual can control their mouse, they can typically control their entire computer. This can be achieved through alternative access methods such as head, eye, or mouth control.

Using a Quad Mouse:

An example of an alternative mouse is a Quad Mouse or a mouse that the user can control with their mouth.

A Quad Mouse is a joystick that plugs into a computer that enables an individual with significant physical impairments control their computer. The user moves the joystick with the mouse to move the mouse pointer. For example, if the individual moves the mouse up with their mouse, the pointer on the screen moves up.

How does the user click with this mouse?

The user can click one of several ways. The first way is to use dwell click software, see previous blog post describing this:

http://adaptableworld.blogspot.com/2012/03/what-is-dwell-click-software.html

The second way to click is through sip and puff clicking. Through sipping and puffing, the user can emulate all mouse functions. This includes left and right click, double click, and lock and drag.

An additional way that the user can click is through an ability switch that is mounted at a site of accurate movement. This can be through a very small movement, such as a toe or finger, or a gross movement, such as a knee or elbow. When accessing a switch access site, it is very important to choose an area that does not fatigue.

How does a user type?

The user types using an on screen keyboard. This can be the keyboard that comes within the accessibility options of the computer. Additional on screen keyboards can be installed that have features to increase efficiency with typing such as word prediction.

It is always important to remember to trial various types of hardware and software before making the final decision on the most appropriate equipment. After a fully evaluation, assisting with setup and training is just as important to facilitate independence for the user.

Voice Recognition Software

2012-06-04T18:39:00.002-07:00

Voice Recognition Software or speech recognition software translates spoken words into text in regards to computer access or typing on a computer. It is software that has been around for many years. It can benefit a large population of individuals; ranging from people suffering with repetitive strain injuries to spinal cord injured individuals.

Many voice recognition programs require the user to participate in a "training" task. With this task, the user reads a passage so that the software can "learn" that person's speech patterns and pronunciations of words. The program might also "read" text that is already saved on the user's computer to see how that individual writes grammatically.

What are some of the benefits of voice recognition software?

Voice Recognition Software can enable an individual with limited or no upper extremity movement to access their computer independently. It can be a quick way to get a lot of words on the page possibly decreasing fatigue and pain for certain individuals. Since we speak faster than we type, once independent in the use, the user could "type" quickly, increasing efficiency and productivity in a work related environment as well as if used for leisure tasks.

What are some of the challenges of voice recognition software?

It can never be 100% accurate. We have to remember that this is a computer and not a person. If we say the wrong word, the wrong word will be typed; it cannot infer what was meant.

Speaking to type is a completely different way of typing and can take some getting used to for an individual that is used to access their computer with their hands. There can be a higher cognitive load to prepare what you want to say versus just figuring it out as you type. Extended talking can be very fatiguing. Often, this type of software would not be best for individuals that fatigue easily or energy conservation is important for their function.

Background noise can affect the accuracy as can if the user has a cold and does not sound like their usual self. It is best to use this software in a quiet environment.

It requires quite a bit of memory and processing speed. If you are thinking of investing in this type of software, be sure to check the specifications required to run this software effectively.

Finally, there are a large amount of commands that this software requires in order for the user to be completely hands-free. For an individual with a spinal cord injury, they would need to learn the commands for independence with use. If the user can access the keyboard, sometimes they choose to use the software to get the words on the page but use the keyboard and the mouse to fix any errors. The individual has to see what works best for them.

Overall, the use of voice recognition software can be beneficial for the appropriate individual. As with any assistive technology, there are pros and cons to its use. It is important to remember that there are many software options available to facilitate independence in an individual. If voice recognition software is not an appropriate option, there are many other items on the market to try.

Large Button Keyboards

2012-05-20T16:51:00.003-07:00

Earlier, a blog post was done on mini keyboards. It is also important to know about large button keyboards.

Typically, mini keyboards are indicated for one handed users or individuals that good fine motor control but impaired gross motor control. Conversely, large button keyboards are indicated for individuals with impaired fine motor, poor gross motor skills. Users with poor fine motor require larger buttons since they need larger targets for increased accuracy.

With both mini keyboards and large button keyboards alternative layouts can be obtained; either the standard QWERTY layout that is most commonly used or an ABC layout. Depending on the keyboard, additional features can be obtained such as alternative colors or number of keys.

Something as simple as changing the size of the keyboard can facilitate independence for an person with impairments. Individuals that would benefit from this type of change can vary but are not limited to individuals with Parkinson's disease, stroke survivors, Multiple Sclerosis, or Cerebral Palsy. It is important to always evaluate all forms of technology, including various large button keyboards to make sure to find the best fit for the user for an adaptABLE world.

Direct vs. Indirection Selection?

2012-05-13T19:28:00.004-07:00

Selection Options for Device Use:

When evaluating an assistive technology device, the selection method is one of the most important aspects of the evaluation. The if the appropriate type of selection method is not being utilized then the user cannot be as efficient and might become frustrated with the device use. These selection methods can be used with computer access, communication devices (AAC or SGD), and environmental control units.

Direct Selection: Direct selection simply is just what it sounds like; you press a switch and your "selection" is made. An everyday example of direct selection is a light switch; you "flip" the switch and the light turns on or off. Other examples of direct selection is the left or right buttons on the mouse, dwell click software, or touch screen use/access for computer skills. Direct selection can be a very quick form of access for the appropriate individual. If it is not appropriate, then the individual might spend an extended amount of time to fix errors or be unable to effectively access the device at all. Direct Selection does not need to be performed with a hand but any body part or technical device in order to make a selection.

Indirect Selection or Scanning: Indirect selection is also known as scanning which is an indirect way of accessing a device.

The user will access a switch which will begin intermdiate steps or scanning in order to make a choice. There are several different types of scanning. Either one or two switches can be used with scanning; these switches are mounted or positioned at the body part with the best strength or that will not create fatigue with use over time.

The most common form of scanning or indirect selection is linear scanning. With linear scanning, the user accesses their switch which begins the scan. This scanning moves row by row. When the scan gets to the line with the letter or choice that the user wants, they access the switch again; this begins a column scan. Once the scan gets to the desired choice, the user accesses their switch again and the desired action happens. This could be a pre-saved phrase for communication or a letter for typing with an on screen keyboard.

Inverse Scanning is performed with the user holds their switch down to being the scan. The user holds their switch down until the desired choice is highlighted and lets go to have their choice made.

Group Scanning: With group scanning, the user accesses their switch and groups are highlighted. As the group with the desired choice is highlighted, the user accesses their switch. It then will narrow the choices with a linear scan.

Item by Item Scanning: The user accesses their switch to move the highlight or cursor in order to make a choice. This method requires multiple switch access "hits" in order to get to the desired choice.

Other, individuals are concerned that scanning is slower than direct selection. Points to consider are if the individual is unable to perform direct selection without making a considerable amount of mistakes, indirect selection will be more efficient and less fatiguing.

Indirect selection is appropriate for an individual with limited movement. For example, if the user has only one area of movement such as one finger, scanning would be an appropriate access method for access of the computer or a communication device.

Positioning is very important for scanning use. The switch must be mounted to the area with the best strength so that the user will not become fatigued over time. Switches can be mounted to any surface such as a wheelchair, tabletop, or bedrail.

Considerations with scanning is that it requires a higher cognitive load. The user must be able to anticipate the scan and understand the cause and effect of indirect selection.

There are many features that can be modified with scanning. These include:

The rate of the speed of the scan
The type of scan
The type of feedback

Audio

Click sounds
Reading the scan choices out loud

Visual

Highlight color
Magnification of the scan

One or two switches

When evaluating an assistive technology device, the type of selection is one of the most important parts of the evaluation and consideration of particular devices. It is important to remember that the most appropriate access method might not be established within the first session; it can take time to figure out the best method as well as the modifications required to make this method the most appropriate.

Switch Use

2012-05-05T06:24:00.000-07:00

What is a switch?

Switches are used with all forms of assistive technology. The easiest way to think about a switch is a device that can start or stop a device. The most common type of switch is activate with some kind of touch, creating the contact of two surfaces or switches to work with an assistive technology device.

What kind of switches are there?

There are literally hundreds (if not thousands) of switches available for assistive technology access. Switches are meant to be accessed by the available body part or motion that is strongest for the user. This area of access needs to be consistent and not create fatigue with extended use. The area of access can also vary dependent on the position of the individual. For example, a person might use their finger for switch access when in their wheelchair and a sip and puff switch for when they are in their bed.

When evaluating what is the best switch site, it is recommended to evaluate distal to proximal. This means, start with the hands or fingers. If this is not an appropriate site, what can be done as we move up? Are gross movements easier than fine movements? If the individual cannot use their arms, what other areas are appropriate?

Addition considerations for switch use is the amount of force required to press the switch (if it is a tactile switch). When looking at the "specs" of the switch, you can find the amount of force in ounces or pounds for access. This is very important for an individual with limited movement or a harder switch user that needs a more durable switch.

How can a switch be mounted for access?

There are many ways that a switch can be mounted. Switches can be mounted to a wheelchair, tabletop, or any other surface for best access. If appropriate, Velcro can be instrumental in attaching a switch for access.

If additional mounting options are required, a simple tabletop mount might be appropriate.

Removable mounts can be used that would attach the switch to a wheelchair, tabletop, or any other surface. These mounts can be purchased with varying arm lengths and plate sizes.

More permanent mounting can be done in wheelchair components such as in the headrest. Conductive fabric and clothing can be used to create novel switches, making it a part of clothing.

What if the user cannot "hit" a switch?

There are switch options for an individual with limited or lack of movement that would be required in order to touch a switch.

Sip and puff: A sip and puff switch is a great option for users with limited movement or issues with significant fatigue when attempting to touch a switch. Through the actions of sipping and puffing, the user can control their assistive
technology device.

Proximity: A proximity switch is activated when the user gets closer to the switch. Dependent on the switch chosen, the range of how close the individual the user has to get to the switch to activate it can vary. This switch can be mounted pointing at any area for the user.

EMG switch: An EMG switch is also known as a muscle twitch switch. A muscle twitch sensor is placed on a muscle that can be used consistently without pain or fatigue. When the user contracts the muscle, it activates the assistive technology service.

Sound switch: This is a switch option that has been around for sometime. The Clapper is an example of a sound switch. When the individual makes a sound, it activates the device such as a communication device. There are very sensitive sounds switches available allowing for changes in the sensitivity, how loud or soft the sounds needs for access.

To conclude, the importance of switches and their positioning is very important. If the individual is not setup with the best switch for the strongest access site the user will not be efficient or conserve their energy. Through a full evaluation, an appropriate recommendation can be made not only for the device but for the appropriate access method.

Using a Joystick as the Mouse

2012-04-22T16:53:00.001-07:00

There are many options for alternative mouse hardware. In earlier posts both a head mouse and a trackball mouse have been explored. What about a joystick mouse?

Traditionally, a joystick has been associated with gaming devices. In addition to gaming, a there are joystick mice available that can be very helpful for individuals with both physical and cognitive disabilities.

The standard mouse that comes with a desktop computer can be very challenging for people with various impairments. The movements required for effective mouse use can be very difficult. How many times have you had to lift up the mouse and place it back down to get your pointer back on the screen where you can see it? What if the user has upper extremity weakness from a stroke or tremors from Parkinson's? How do you think this would affect their mouse function?

It can also be difficult for individuals to understand the cause and effect of the types of movements required to move the mouse that translate to the movements of the pointer on the screen. This can make the mouse extremely difficult for the user with cognitive impairments.

The use of a joystick mouse can eliminate these problems. With a joystick mouse the movements seem more intuitive than with a standard mouse. For example, if press the joystick up, the pointer moves up. Many hardware options can include alternative methods for clicking as well as the shape and size of the joystick itself. This can assist people with grasp issues by having the flexibility to change the joystick top.

The joystick mouse pictured above comes with interchangeable joystick top options as well as buttons for double click, single click, right click, lock, and speed changes. The accessibility of the buttons can create increased ease of use.

In addition, if access of any joystick buttons are a challenge, any ability switch can be used for click features. This can be plugged directly into the joystick mouse, dependent on the model, or with the "swifty" USB adapter for ability switches. Dwell click software (discussed in an earlier post) can also be used for click needs.

There are joystick mice that are not only geared towards individuals with disabilities but people that require a more ergonomic computer workstation setup.

The mouse pictured above will hold the users hand in an ergonomic position in an attempt to decrease or eliminate repetitive strain injuries. The right and left click is performed by the thumb positioned at the top of the joystick. Again, if clicking is an issue, ability switches or dwell click software can be used.

Additionally, software can be used to "turn" any USB joystick into a mouse. The software acts as a driver, interpreting joystick movements into mouse movements to move the pointer.

Always remember that changes in the control panel might still be required to facilitate independence with any adaptive mouse hardware or software. With the appropriate adaptations, the mouse does not have to be a challenge for a wide range of individuals, helping to create an adaptABLE world!

Word Prediction Software

2012-04-15T11:09:00.000-07:00

What is word prediction?

Word prediction software is a very important tool in regards to typing and communication. It is seen with both computer access assistive technology as well as with communication devices.

It is a software that predicts the words as the user is typing. The goal is to decrease the amount of keystrokes of the user. Depending on the user, this can can have a variety of benefits including increasing the typing speed of the user or decreasing spelling errors.

When using word prediction software, a word list is displayed on the screen. The user will press the corresponding button in order to choose the appropriate word. In some programs, the correct word can be chosen with the mouse as well. This can be used with email, text based documents, social networking, or any program where text is inputted.

How is this different from word completion software?

Word completion software works in the same way as prediction but it makes predicts the word as you type it. When the user sees the word they are intending to type, they press the corresponding button.

With both word prediction or word completion software, there are varying modifiable features that different programs have. This can include but are not limited to:

Method of prediction

Frequency of use
Alphabetically

Number of words on the list

This can slow the user down as they will require extra time to scan the list

Words can be programmed or added to the program dictionary

Such as the user name
Some programs will "learn" new words automatically

Font size of the words on the list
Spaces to be added after choosing the word off the list or at the end of a sentence
Text to speech options

If this is an option, the words will be spoken as they are chosen off the list
This can also include text speech of letter by letter or at the end of the sentence
The voice (male or female)
Rate of speed of the speech

Phrase prediction

Some programs will not only predict words but phrases as well. For example, if the user types the word "how", "how are you" can be part of the prediction as well as single words.

Why is word prediction or word completion software beneficial?

There tends to be differing thoughts as to if word prediction or word completion software really increases rate of speed with typing. In of the some literature, it is explained that word prediction software will only increase rate of speed if the user types less than 15 words per minute. Although this is a good standard to keep in the back of your mind when trying this software, there are many other benefits to its use, outside of possible increase in speed.

Outside of rate of speed, this type of software can assist many types of individuals.

Fatigue

Individuals that fatigue quickly with typing can decrease the amount of keystrokes required for typing skills. This can facilitate energy conservation and increase the amount of time tolerated for typing.

Pain

If the user experiences pain with extended typing, this software would decrease the amount of "button pressing" required.

Impaired spelling

Words predicted would be spelled correctly, decreasing errors and time spent correcting errors.

Word finding issues

If the user has difficulty with word finding or even mild aphasia, if they can type the first letter with word completion and prediction, the desired word would be on the list. This could be difficult if the word is not initially prediction, requiring the user to type additional letters. This would work best couple with text to speech features.

Can also assist folks with learning disabilities, adult and children

OnScreen Keyboard users:

Increases the efficiency of OnScreen Keyboard (OSK) users, especially for individuals using alternative access such as a head mouse. The use of this software would increase efficiency and rate of speech when typing. Many OSKs come with word prediction and completion software. This includes the standard OSK in the accessibility options in Windows 7.

Word prediction or word completion software is a very important tool for individuals with disabilities or difficulty with access. If you think that this software would be helpful for yourself or someone you know, remember that it is very important to trial different programs to see which features are right for you.

What is an On-Screen Keyboard?

2012-04-08T19:20:00.002-07:00

Many individuals do not know what an on-screen keyboard is (or that it is already on their computer).

An on-screen keyboard is exactly what is sounds like, a keyboard that is on the screen or monitor of your computer. It is another way to type or access your computer. It can replace the keyboard hardware that came or is part of your current system. An on-screen keyboard can be used with any program that requires text. This includes the internet, TextEdit, Microsoft Word, Excel, etc.

If the individual cannot use the standard computer (the hardware) due to physical limitations, an on screen keyboard can eliminate this issue. For example, if the user is using a head mouse for alternative mouse skills, the on screen keyboard would allow that individual to type. If the individual is able to effectively use any mouse (mouth mover, trackball, joystick for example) but has significant issues with keyboard use, the on screen keyboard would be very important. Individuals that would benefit from on-screen keyboard use can vary from Parkinson's to people with a spinal cord injury.

In order to "press your button" or click on the desired letter, dwell click software or an ability switch can be used. Dependent on the keyboard that works best for the user there are various ways that the keyboard could be modified. This could include the color, size of the font, ability to dwell and the features associated with that.

Other options can include word prediction (to be featured in the next blog post), phrase prediction, or even favorite websites for increased internet access.

How can you get an on-screen keyboard?

The most economical option would be to access the on-screen keyboard located on your computer. Both the Windows operating systems and Macintosh have on screen keyboards as part of their accessibility options. The amount of modifications available in these keyboards might be different or not as vast as keyboards for purchase. An easy way to find the on-screen keyboard in your computer just type it in the search window.

To purchase an on-screen keyboard many of the companies will allow anywhere from a 14 day to 30 day free download. An Assistive Technology Practitioner can also be helpful in educating the individual on companies, features, and possibly perform an evaluation to assess the appropriate keyboard. Keep in mind that what works for one person might not necessarily work for the you so that trialing various options are very important.

Mouse Hardware, the Trackball

2012-04-01T08:52:00.000-07:00

There are many options for mouse use other than the conventional mouse that come with computers. The standard mouse that comes standard is very difficult for many individuals to use. It is not very intuitive. It is oddly shaped, doesn't always do what you want (ever have to lift it and move it?). It also requires good coordination throughout the entire arm. If there is any weakness, incoordination, or spasticity, it can be had to control and use correctly.

As in a previous post, if the individual is overshooting or undershooting with the mouse pointer, there are changes that can be made in the control panel. Additional changes can be made with the double click, size of the mouse pointer, ways to find the mouse pointer, as well as many more. During the trial of alternative options, looking at different mice for the hand could be appropriate. If the user does not have hand use, there are additional options as well (look at previous post for a head mouse as an options, although not limited to that only choice).

Trackball Mouse:

A trackball mouse is different from a convention mouse is that the user moves the ball with his thumbs and fingers; arm movement is not required.

The size of the ball and buttons vary between brand of trackball. Some trackball mice have buttons that can be programmed for other features such as drag lock.

This mouse can be very successful for individuals with work related pain such as carpal tunnel or someone that has weakness in the shoulder from a stroke or other injury. It can be positioned or mounted to utilize the best strength of the user's arm.

It is though a small change such as using a trackball vs. a conventional mouse that can enable independence for a computer user.

Feel free to leave comments on your experiences with alternative mice.

Do you dwell...click that is?

2012-03-28T19:28:00.001-07:00

What is dwell click software?

Dwell click software is a way to click the mouse without having to physically press the button or "clicker" on the actual hardware. This is very important for individuals with a variety of physical impairments. For example, if the user has a spinal cord injury and is accessing their computer through a head mouse, they would require this software to perform all click features. Without it, they would only be able to move the mouse pointer but not be able to click. This software enables the user to open items on the desktop, links, or just to click anything that a conventional mouse user would access by a button press.

This software not only can assist individuals with a lack of mobility but also those with coordination issues or pain. If the user has pain in their finger when accessing the buttons on the mouse, the use of dwell click software would eliminate this pain.

How does the software work?

When using this software, a toolbar is visible on the screen. This toolbar provides all mouse click functions.

Dependent on the program, the size of the toolbar can be modified. Other modifications include the amount of time that the user has to "dwell" or "hover" over the item that they want to click on. This can usually vary from .25 seconds to several seconds. The dwell timing is very important; if the time is too short the user will perform unintended clicks. If the dwell time is set too long, the user might have a hard time holding the pointer over the link or icon.

When trialing this software, it is important to trial more than one version in addition to seeing can be modified in that particular program to meet the users needs.

The use of this software can increase the level of independence of the individual for their computer access skills. Its another way to create an adaptABLE world!

Mouse...head mouse that is...

2012-03-19T19:25:00.000-07:00

The computer mouse is a very interesting device that was designed for accessing a computer. A simple definition of the mouse can be found on wikipedia:

A mouse is a pointing device that functions by detecting two-dimensional motion relative to its supporting surface. Physically, a mouse consists of an object held under one of the user's hands, with one or more buttons. It sometimes features other elements, such as "wheels", which allow the user to perform various system-dependent operations, or extra buttons or features that can add more control or dimensional input. The mouse's motion typically translates into the motion of a pointer on a display, which allows for fine control of a graphical user interface.

A mouse comes standard with a desktop computer; laptops have the trackpad. In working with individuals with varying disabilities, the mouse one of the biggest issues to independent computer use. In the earlier posts, there is information on how control panel changes can assist with mouse use. In addition that that, alternative hardware and software can be utilized for mouse skills as well.

If the user is experiencing poor gross or fine motor skills in either arm or lack of movement, they can still use a mouse. One product that can be used if the person has no arm movement (as with a person with a spinal cord injury) is a head mouse.

The head mouse:

The head mouse is an input device that can be used by an individual with little or no arm movement. The camera sits on top of your computer and follows a small shiny sticker that is placed on the forehead or a baseball cap of the user, moving the pointer.

Essentially, the user moves his head, the pointer follows.

How does the person click?

There two most common ways for clicking is either by switch use or dwell click software. Many of the head mice on the market have ports for a switch to be plugged in. The switch can be positioned or mounted to the area that is strongest. This could be a finger, foot, elbow, etc. The switches vary in size and amount of pressure that is required.

Another way to click is through dwell click software. Dwell click software eliminated the need for a physical click. This would be important for an individual that is unable to press the button due to pain, arthritis, stroke, spinal cord injury, just to name a few.

The user would move the pointer over the area they want clicked. A pre-set time (which can be adjusted for the person) will be established, which can vary from .25 seconds to longer. After the pointer is held there for the established time, the software will click for the user. Many features can be adjusted with such software. This can include the sensitivity or feedback for the dwell feature. Not only can this software be used with a head mouse for clicking but with a conventional mouse if the user can move it but is unable to perform clicking.

Always keep in mind, there is never one way to use a mouse or access a computer. The most important thing is to trial as many options as possible to see what is the best person for the user.

Cell Phone Adaptability

2012-03-10T11:14:00.000-08:00

Often, when people think about cell phone accessibility, they think that if the phone has voice activation or recognition features, then its accessible. Unfortunately, often a small button is required to initiate these voice features. What is the user to do if they cannot access this button?

Switch Accessibility:

Through various hardware options, a switch can be added to a bluetooth for access.

The picture above shows an example of a switch adapted bluetooth. Any ability switch can be plugged into the switch port. The user would then access the switch (with the strongest area of their body) to answer a call, hang up a call, or dial (using the voice commands). This eliminates the need to hit the small bluetooth button for voice command use. It can also work fairly well with the Siri features of the iPhone 4S, for writing text messages and emails.

Voice Activation:

There are options with hardware that will enable full voice activation, without the requirement of pressing buttons.

Through the use of voice commands, the user can dial and answer calls. This device is a speakerphone which would limit the privacy for the user but still can enable independence. The original intent for this device was for hands free calling when in a car but it can be adaptable for many individuals.

The thing to remember about all voice activated devices that they can never be 100% accurate. These are devices, not people. They cannot interpret what the user means if they say the wrong word or name. Furthermore, if there is background noise it can affect the accuracy of the device.

These devices can be very important to facilitate independence for individuals with varying disabilities.

Telephones telephones telephones

2012-02-27T14:07:00.002-08:00

Telephones are a necessity to our daily life but a piece of technology that is not accessible for all users. Not only is the telephone a requirement for for keeping in touch with friends and family but it is important for home safety. If you cannot access your telephone, how can you call for help. Here are some of the options, although there are more available on the market dependent on your needs.

Call your telephone company. The company that is providing your service might have options for phones without any or a limited additional cost. These services might include accessibility for the death or hard of hearing population, or for individuals with minimal physical impairments.

Scanning Telephone: The use of a phone that has a scanning feature can be very beneficial for a user with limited mobility. The telephone featured below has a remote control that allows for any ability switch to be plugged into it. There are 20 preset numbers that can be pre-programming. When the user presses the switch, the scanning through the 20 preset numbers begin. The speed of the scan can be adjusted for the user. Once the scan gets to the desired number, the user presses the switch again and it dials out. To answer or hang up, the user only needs to hit the switch. Not only can this be accessed by a physical switch but by an air switch as well. If the user cannot use their hands, the physical switch can be mounted by their head or the air switch might be appropriate.

Voice Amplification: If an individual has issues with the volume of their voice, using a telephone can be very challenging. The people that they are speaking with might be unable to hear or understand them, asking them to constantly repeating themselves, requiring more energy for telephone use. A nice solution might be using a telephone that amplifies the speaker. There are many options that amplify the incoming person for a hand of hearing individual but limited for amplifying the outgoing for low volume. There are some "inline" amplification options that connect between the phone and the wall. There are also telephones that amplify through the handset, pictured below.

Computer Based: A computer could be used for telephone needs. There are certain websites that can be accessed for free that connect to an operator. You enter the number to dial, the operator dials it, and then speaks for you. The user would type what they want said, the operator speaks it and then types back the response. This is great for someone who is deaf or hard of hearing, or for an individual with limited or no upper extremity use that is accessing their computer through adapted means.

Picture Based Dialing: For individuals with cognitive issues or have issues with remembering or recognizing numbers, picture based dialing can be helpful. These types of phones allow the user to program preset numbers with the pictures of who they are dialing onto. The individual only has to press the picture to dial the desired individual. The amplification phone above has this feature has does many other phones.

Keep in mind that these telephones are options but not the only options for making telephone calls. Cell phone adaptations are to be addressed in an upcoming blog post.

Light Controls

2012-02-18T11:54:00.000-08:00

There are everyday tasks that we all perform without thinking about it that is very difficult for many individuals. An example would be turning a lamp on and off.

The fine motor skill needed to turn the switch could be severely impaired for an individual with Parkinson's disease or severe arthritis. There a many reasons why it could be unsafe for an individual to attempt to get up and walk across the room just to turn a light on and off. Getting up to turn on or off a light is not exercise but a necessity; if balance is an issue, it should not be attempted. Think about the person that needs to use the bathroom in the middle of the night but cannot access their lamp. This individual might decide to walk to the bathroom in the dark, putting themselves in an unsafe situation, possibly falling and creating a debilitating injury. Also imagine the individual that sits in the dark because there is no one available to turn their light on for them. There can be many simple solutions for this problem.

Touch Lamps:

Purchasing a touch lamp can be a great solution for those individuals that can walk to their lamps. For the person that does not want to change out their lamps, touch lamp modules can be purchased at a fairly low cost. These modules would eliminate the need to turn the switch inside the lamp. The user would have to touch any metal part of the lamp to turn it on and off.

X10 devices:

X10 devices have been around since the 1970's and enable the user to turn any device on and off through a simple remote. This is performed through a radio frequency transceiver and appropriate module boxes.

The lamps (or other basic on off devices) are plugged into a module box. A transceiver is plugged into a different outlet in the same room. The remote, module box, and transceiver are all placed on the same radio frequency code; each lamp or device has their own number for the remote use. When the individual presses the corresponding number on the remote, it will turn the lamp (or fan, alarm, etc) on or off. This allows the user to turn on their lights without having to get up. This can enable independence for a wheelchair user or for an individual with balance problems that could not safely walk to the lamp. There are many options for remotes, some controlling one device, others controlling up to 16. For individuals with more significant disabilities, many power wheelchairs or environmental control units have X10 capability.

The Clapper:

I couldn't talk about light controls without talking about the Clapper. Often, when I discuss light controls with individuals they reference the clapper (thanks to all the ads in the 1980's). The Clapper is a sound switch that controls lamps. When the user creates the clapping sound, it turns the light on or off. This is another perfect example of an adaptABLE world. Yes, these are still for sale, I found them easily on the internet.

Just When You Thought There Wasn't Much More to Talk About For Mouse Properties

2012-02-13T18:29:00.000-08:00

Who knew there could be so many available changes in the control panel for the mouse pointer and properties. The picture below shows another option for changing mouse pointer features once in the control panel under "mouse properties".

Honestly, there are really only two features that I use often here but it is important to highlight all of them.

Motion:

In my opinion, one of the most important is the "motion", the ability to select the pointer speed. If the speed of the pointer is not appropriate for the user it can greatly affect their accuracy with "hitting" icons on the desk or internet links. If it is too slow, the user will have to perform multiple swipes or movements of the mouse to get the pointer over there. If it is too fast, they will over shoot their targets, almost "flying" all over the screen, resulting in frustration and decreased efficiency with use.

Also, keep in mind, if you change the mouse hardware, you might need to change the mouse speed. This would not only include changing mice types for the hand but is especially important if you are working with a head mouse.

Snap To:

If you turn on the snap to feature the pointer will automatically "snap" to the default button such as "apply" or "ok" when you open a dialog box.

Visibility:

Display pointer trails creates a trail of pointers as the mouse moves. I have not found this to be helpful with the clients I have worked with in the past but I am sure that there are individuals that would find this useful for their needs.

Hide the pointer when typing does exactly what it says, hides the pointer when typing. This can be useful if the individual could become distracted by the pointer.

Show location of the pointer when I hit the CTRL key I have found very helpful. It is very easy to "loose" the mouse pointer. Instead of having to move your mouse until the pointer comes out of hiding hit the CTRL key. This creates almost a "radar" circle around the pointer, making it easier to find the pointer, hopefully decreasing any related frustration.

Remember that a combination of multiple control panel changes (with possible hardware changes) could make computer access easier for all individuals, creating an adaptABLE world!

Mini Keyboards

2012-02-11T10:47:00.000-08:00

I often get asked about mini keyboards and one handed keyboards. These keyboards are helpful for one handed users or individuals with good fine motor but impaired gross motor skills.

Often, I do not recommend one handed keyboards. Although there are many options for one handed keyboards, I have yet to meet an individual that is very successful with this kind of keyboard. The reason I find them difficult for training and use is that for an individual that was a typist prior to their injury or disability this is a new way to learn to type. This is a "chording" form of typing, holding down multiple keys to get the letters that would have been on the other half of a conventional keyboard.

As for mini keyboards,they can be very helpful for your one handed user. They have the standard QWERTY layout but since the keyboard is mini is decreases the amount of "travel" that the user requires for typing. There are many types of mini keyboards. Some are marketed to the disabled community, others are just "mini" keyboards, marketed to a more mainstream population. It is important to trial various types and sizes to find the perfect fit.

Typically, if a keyboard is for a disabled individual, it will be more costly. The keyboard below is $585.00, marketed towards individuals with disabilities.

There are also keyboards that are mini but marketed towards gamers. This keyboard below I love because it can be used with thumbs only (similar to a blackberry keyboard) and has a mouse mover as well. I have used this keyboard with individuals with varying disabilities. It has facilitated independence in all of the appropriate folks I have worked with. Since this is not for disabled individuals, it can be found online for $119.00

Even "childsize" keyboards can work as a mini keyboard. This one below can be found for $62.00 plus shipping online.

It is always important to remember that not all keyboards fit everyone. Whenever evaluating keyboards for an adaptABLE world, all options must be tried for success.

What Can You Change About Your Mouse Pointer?

2012-02-07T20:09:00.000-08:00

Continuing the discussion on the mouse, there are many options that can be changed with the pointer itself. I find the pointer in its standard settings small, white, and difficult to find at times. This can easily be changed in both the Macintosh and Windows operating systems.

On the Mac, by going into the Universal Access in the System Preferences, click on mouse, there is a slider that you can move to make the pointer much larger.

With Windows, go into the control panel then choose mouse. It is here that you
can make the pointer larger, change the color, or even the shape of the pointer. If you look through the drop down menu in the "scheme" for pointers, there are many options in regards to these changes.

Changing small features with the mouse pointer, it can make it easier for the user to find and use. This could increase the level of independence of the user, decrease frustration, and increase efficiency.

Mouse Function 2.0

2012-02-02T18:51:00.000-08:00

Buttons:

Thinking about mouse use in Windows, there are many options that can be modified for increased function. Although there are changes that can be made in Macintosh as well, due to the fact that the mouse design is different, there are not as many modifications (or need for modifications).

The mouse properties can be access in the control panel. The three areas that are to be discussed can usually be difficult for individuals primarily with fine motor coordination issues.

Button Configuration:

When this is checked off, the primary and secondary buttons have "swapped". This means that the left click now acts as the right click and vice versa. This can be very helpful for individuals with fine motor coordination, maybe there is a deformity in their fingers that create issues with access. This simple "swap" can affect an individuals level of independence with mouse skills.

Double Click Speed:

Changing the double click speed can be very helpful. If an individual has issues with coordinating the double click, slowing it down can make a huge difference. Often, with folks that cannot perform double click adequately, they use their right click to bring up the menu, then click open. By slowing down the double click speed, it eliminates the need for these multiple steps.

ClickLock:

This feature is rarely used yet can really be very beneficial. Often, individuals with fine motor coordination issues demonstrate difficulty with holding down the left click and moving the mouse at the same time for highlight, copy, cut, etc. If the ClickLock is turned on, the user just has to briefly hold down the mouse button (left click), then it "locks". The user then only has to move the mouse to highlight. To "unlock" it, the user hits left click again. The amount of time that the left click has to be held down to lock it can also be modified for the individual. This feature is also enabled for Macintosh.

The next blog post will include mouse pointer size and speed.

Mouse Functions

2012-01-31T19:26:00.000-08:00

Mouse Functions:
Double Click changed to Single Click.

There are many changes that can be made to mouse functions in the control panel. One area that can be very difficult is the need to "double click" to open an icon (left click) on the desktop or links on the internet. This is typically only a problem for Windows operating systems as Macintosh does not require double click (for the most part anyway).

Any Windows operating system can be made for "single click" only. This can be done under "folder options".

You can choose single click to open. When this is chosen, the user no longer has to double click. Also, the pointer turns into a "pointed finger" when it is in a "clickable zone" for the icon. This provides a visual cues for the individual that it is "ok to click now".

2012-01-29T10:29:00.000-08:00

Computer Accessibility:

The computer is the one of the only pieces of technology that is mass marketed that comes with accessibility options. The accessibility options are geared towards individuals with physical or sensory impairments. These options are to change keyboard or mouse access, as well as the screen appearance and add features for individuals that are hard of hearing. Both Windows and Macintosh operating systems have these features built in, and both operating systems have similar features.

The ease of access center in Windows allows you to adjust these settings to the users needs. In the Macintosh operating system is it Universal Access:

The Keyboard Features:

Sticky Keys: You can turn on sticky keys by either going through the control panel on both systems or by pressing the Shift Key five times. This allows the users to create two keyed characters without having to press both keys down at the same time. For example, the user would press shift then the key that they want capitalized. This is very helpful for individuals that are one handed users. This can work for symbols and CTRL-ALT-DELETE as well.

Filter Keys: This feature "filters" out repeated keystrokes. This can be modified, changing the amount of time that the system waits before it filters or allows the key to accessed. This can be very important for individuals with tremors that cause multiple keystrokes.

Toggle Keys: This feature creates a tone when either CTRL, ALT, or CAPS LOCK is pressed. This is very important for individuals that might accidentally hit CAPS LOCK without knowing. Often, many individuals are "hunt and peck" typists, not looking up at the screen until they are done typing. If they kit CAPS LOCK without knowing it then their whole document is in all caps and they would have to delete and start over. This feature is very helpful in cueing the user to prevent this issue, increasing their efficiency and decreasing their frustration with typing skills.

For the next few blog posts I am going to continue to explore how adaptations can be made to the operating system of a computer, both within the accessibility features and in other ways to increase the performance of the user.