Aaron W. Perlman Center

Computer Access Matching the needs of children

with SMA

Beth McCarty OTR/L, ATPAaron W. Perlman Center

Cincinnati Children’s Hospital

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Provide Early Access To Computer Technology

• Exploration– Provides opportunity to explore– Assist with development

• Play– Independent play – Interactive play– Decrease learned dependency

• Learning– Early access – Software to assist with learning

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Identify Equipment Needs• Laptops:

– Portable– Mounted to a wheelchair– Placed on a bedside table

• Mouse• Right and Left Clicks• On Screen Keyboards/Low Profile

Keyboards• Software

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Environments

Whether the child is in school, active in the community or at home, multiple considerations for accessing a computer are important

• From a wheelchair• Bed• Alternative positioning devices

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• Seating and Positioning must be established

• Locate the strongest, most reliable access site or multiple sites

• Keep in mind the access must be used in all environments or allow for alternative access for bed/alternative seating

Locate an Access Site

How is the child going to access and use a computer when they have limited movement?

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Mouse Function

• Trackball– Require a small excursion for

travel– Hand placement remains the

same– Speed of cursor can be

controlled– Switch ports for L/R clicks

• Trackpad– Can use one finger– Hot buttons can be added– Switch ports for L/R clicks

KensingtonSlim blade

Logic Tech Marble Mouse

Cirque

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Joysticks

TASH

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Right and Left Clicks

• Established through the use of switches– Mechanical Switches require force– Proximity Switches: no force but require a

power source

• Dwell software– Ability to place cursor on a target and

automatically click: time determined

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Switches

• Sensitive switches: Little movements require switches with a light touch

– Micro Light - Activated by pressing down on the top surface with a feather light touch!

– Leaf- Activated by pressing lightly against the leaf in one direction.

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The Trigger, Cap, Mini Cup, Lever Switch

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Picture of Dwell Software

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Proximity Switches

– For lengthy tasks or frequency of use an electronic switch is less fatiguing

– Electronic switches require a power source• WC battery• Power adapter for manual chairs

– More expensive– Require no force/ pressure– Becomes transparent to the user– No auditory feedback

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Adaptive Switch Lab - ASL

• Electronic Switches:

• Fiber Optic

• Proximity Sensor

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Cruise• Cruise requires no hand or wrist movement, and unlike a

touchpad, the cursor does not have to be “guided” around the screen by constant finger movement.

• Control the speed and direction of the cursor with a single, soft touch of its control ring.

• Cruise can store personal settings for automatic retrieval each time the computer is powered up.

• Limitation: Size and placement

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Small Profile Keyboards

Tash Mini Keyboard

DataTech Little Fingers

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On Screen Keyboards• Use with mouse• Change size/color of keyboards• Word Prediction

• Soft Type• Reach• WiVIk• On screen keyboard embedded in

most computer systems• Free on line onscreen keyboards

– Click N Type

Click N Type

Soft Type

WiVIk

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Aaron W. Perlman Center

Integration of Systems

• Controlling the computer through the power wheelchair control

• Require custom electronics

• Connect wirelessly• New systems allow for

Environmental Controls/IR

TV/MP3/Phone

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Adding Computer Access to Your Wheelchair

• Mouse Mover -

• Power Mobility: Manufacture

TASHAdaptive Switch Lab

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Software• Toddler: Skill building software can include

standard off the shelf products – Reader Rabbit

• Doesn’t require a click• Excellent for exploration using new equipment

• School: Read Write Gold/ Kurzweil– Text to Speech -- Human Sounding Voices Word Prediction – Phonetic Spell Checker– Voice Recognition– Scan In and Listen to any Printed Material Audible

Dictionary

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Universal Switch Mount

Universal Switch Mounting System by AbleNet, Inc. mounts switches quickly and easily.

Can be used from a bed or otherpositioning device

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Arm Supports

• CJT • Arm slings eliminate gravity

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BookHolder/Auto Page Turner

CJT

LEVO

AbledateAutomaticPage Turner

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Mounting Computer to Wheelchiar

Daessy

CJT

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What is the Future?

• Robotics

http://www.exactdynamics.nl/

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Perlman Power: Licensed to Drive

Encouraged To Stand Out

PERLMAN POWER