Carolina Computer Access Center

Q: What would you like to see Technology help you do that you cannot do now?

9:30  Petesie C

Goal:  My goal is to have Petesie talk with the button on the computer

Initial Observation: Rhett system, stims with hands especially girls, has full head control.

Software/Hardware:  mini-arm with switch (easy to use with minimal nobs), Compac switch by RJ used but could use spec switch,  using the computer with the flat screen with LCD screen  arm (can be purchased at Best Buy for $100), use Point to Picture

Access Method: Head access seems to be the best.

Session:

1..Using waker shaker with button switch. Now appearing to like it.-causing stress or interest. Using the button to make things happen. RJ had to help her hit the button gently.

2. RJ recorded Petesie’s voice using Facemaker in  Children’s Switch Progression. If your Happy and You Know It.  RJ assists in using head with switch. No doubt that head access is good. But for some reason, cognitively or behaviorally doesn’t want to access. Petesie is interested and happy about trying it. RJ assisted very gently. (Using the switch is at a 1 to 2 year cognitively and cursor control is about 5 to 6 years)

3.  Take some pictures of mom and had her sing for reward when Petesie choose her mother and used a Fashion magazine as motivators for Petesie (using Point to Picture)(Full screen scan every 6 seconds, auditory scan) Petesie making choices. Choose mom instead of Vogue magazine and back rub.  Second time choose Mom again got voice or back rub. Push button for more-she did that.  She choose Vogue catalogue. “Let’s look at” better than “Here is this thing.”  Invites participation and helps her hold the catalogue. Petesie chooses the catalogue again and looks at pages.  Petesie worked at this for 30 minutes.

Summary: Petesie did not hit the switch independently but shows good potential.

10:00  Catherine D.

Goal:  Catherine wants to teach young children to read

Initial Observation: Catherine has cerebral palsy; her left hand works well.  Catherine is verbal. She tells RJ. she lives in a group home. Catherine does contract work in a sheltered workshop all day and does not like it.  Catherine tells RJ that she wants to “work with handicapped children and help them read.”

Software/Hardware: Spell-A-Word, Big Keys with key guard and device adaptor to mount BigKeys

Access method: Left hand

Session:

1. How would she teach children to read?  RJ shows her the word CAT in Spell-A-Word. Catherine would tell the children the letters in the word.   Then maybe help them with the sounds of each letter.  RJ asks how she writes and Catherine tries with pencil and paper. Curtis, her counselor, said she could start by volunteering at Circle School She will need to learn to teach the core of 100 words, Judy Be Jones book. Catherine will need to learn a technique with definite steps and practice to perfection. It was suggested that she could volunteer in an after school program to teach reading to kindergarteners and first graders.. Using an arm to mount the Big Keys keyboard with a key guard. RJ has Catherine look at the red row and work on three words in Spell A Word, dog, mom, and ?.   RJ role-played with Catherine being the teacher.

Summary:  RJ feels that Catherine could teach reading to young children. .  RJ says she will need a very structured environment to volunteer to teach.  Catherine will need to be extremely targeted and goal oriented.

11:30 Jasper H.

Goal: To hit the switch to make meaningful choices

Initial Observation:  Mother says he is operating at 2 or 3 years and 6 sporadically.  Clicks for yes consistently. Pushes the switch.  Switch placement vs motivation. Motivated but not in school things. Arms and legs quiet. Rotates head at will. Jasper has used cheek switch but not successful, because he will just land on the switch and appear to hit it randomly.
Software/Hardware: Point to Pictures, Using mini arm with switch, Flopper Stopper

Access Method: head control

Session

Needs a switch with tactile and auditory feedback.  Likes switch on cheek. Wants to filter out what is on purpose. Using Point to Pictures so we can know what Jasper really wants.  (Get an inexpensive digital camera so that real and meaningful objects/concepts can be featured) Uses letters of things that are meaningful to him D for dad. Uses real life digital pictures and voices.  Label sounds and consequence sound.  Mommy’s coming up to give you a kiss and then kiss Ma switch interface with extension cable.

Summary:  Use Flopper Stopper to keep Jasper from resting on switch and have him activate the switch with his chin.  RJ helped Jasper make a choice of mom and got positive feedback using the button-touch his cheek.  RJ helped him choose backrub go 20 to 60 seconds to make it real.  “Thank you for choosing. You choose the button.  Now use the button to choose some more.”  RJ trying to facilitate- Jasper seems to be sleeping.  Constantly moving the button position. Need to do this quickly. Changing backrub to music.( Illustrated chair dancing-keeping hands under not interfering with switch). RJ changed order of choices. If the tissue choice is not strong enough use lemon juice on a cotton swab, so he avoids that choice.  Hitting the switch is to make a choice so don’t let the switch be accessible when you are not doing button choosing. Jasper seems to be a head turner and gets locked on a side. Using a flopper stopper will help his head return to neutral.  RJ is going to try up and  down head  control rather than back and forth.  Using a vibrator-buzzing toy below his chin, Jasper turned the toy on and had help turning it off. RJ might like this chin access (up and down) a little better.  Scan time to 5. Move button to one of the side panels is possibly an option.  Use ready set go -to let the student know you are ready to start.

1:15 Andrea R.

Goal: To write for her job using the IntelliKeys keyboard with a Magic arm that doesn’t break. Andrea is so strong that she often knocks the keyboard off the arm. Wants to communicate more easily, efficiently.

Initial Observation: Andrea is a very social woman with a strong desire to communicate

Access method: both hands

Software/Hardware: RJ suggest the device adaptor that connects to the back of the IntelliKeys keyboard to secure the keyboard to the Magic Arm. Suggest the use of the BigKeys because of size of the board being smaller. Possible use of the “I Can E-mail” and joystick to mouse program

Session:

1. When typing, Andrea says she switches hands. RJ requests she spells her name any way she wants to use her hands.  Suggestion to Andrea to count to 3 between keyboarding  letters.  Next, he asks her to breathe between each letter, slow down, breathe. The result is much better control on the keyboard.  RJ says computers should be enjoyable, slow everything down and “chill”.  Try this for about 2 weeks—may slow down your productivity at first.

Another thing, there is a distinct advantage in using  BigKeys instead of IntelliKeys.  Difference in keyboard sizes is small.  Key guard maybe good on the BigKeys for Andrea.  Never mind trying to go fast, just relax and enjoy it!  (Mounted the Magic Arm upside down to experiment with Andrea’s range of motion) 

2. Tried “I Can E-mail” program RJ wrote for simpler access.    Joystick to mouse program was demonstrated with “I Can E-mail” letting Andrea use the joystick as a mouse. Andrea liked the voice and text being read to her to help her stay on track, keep herself from being distracted.  Andrea recorded a message on  e-mail.    Demo of time saving using voice vs. typing the same message. 

Summary: Suggested Andrea use a  device adaptor for her IntelliKeys keyboard, possible use of BigKeys, use of the “I Can E-mail program and to slow down when she keyboards is very important.  Suggestion from the audience for a program to be developed to do journals and notes for job purposes that could be read into and then replayed.  RJ will work on this! Andrea seemed very satisfied with the experience and appreciative!

1:45 Joey W.

Goal: To find technology that can help Joey at school attend to task and  structure  his day at school. Functionality

Initial Observation: Autistic like behaviors, uses picture  symbols, Realistic pictures have been tried.

Access Method: uses hands

Software/Hardware: Mini Augie, Spell A Word

Session:

RJ showed Mini Augie, augmentative communication  device that is very portable, durable,  and you can carry easily with Mayer Johnston picture symbols include. Explored the feelings icons on the device-touched happy. Remind Me is a software option with Mini Augie.  The device can help put structure in the day,  used the example about going to the library. In looking at literacy, RJ tried Spell a Word.  First given an example to copy and then ask to spell on his own. Spelled ball and also played with a ball. Did bubbles too. Joey was asked to say ball and bubbles after typing.  Sometimes students need pay offs. But you can put all digital pictures and create your words into the Mini Augie.

Summary: Joey needs an augmentative communication device so “he could target conversation and help with structure”.

22:30 Jaynie, W.

Goal:

Jaynie says she wants to have people understand her better. Ms. S, Jaynie’s speech therapist, would like Jaynie to use a device for communication. Jaynie is resisting the speech output device (a DynaMite) currently available to her; and Ms. S. wondered if a more advanced device that offered a wider variety of options, such as the DynaVox, would be more suitable (and acceptable to Jaynie.)

Initial Observation:

An attractive, personable sixteen-year-old student in a wheelchair with limited speech.

Access Method:

Can use a mouse, but does have some trouble with keyboarding due to reported visual tracking inconsistencies.

Software/Hardware:

Mini Auggie (small communication device), BigKeys keyboard, Magic Arm (mounting system), Question and Answers (software program)

Communication:

Jaynie’s best friend who can understand all she says and has known Jaynie for seven years, states that “people don’t understand her all the time especially when they are out at the mall.” She said Jaynie finds it frustrating. RJ sympathized and gave the example of how one feels about a bad phone cell signal.   Voice recognition is not a reliable option now. RJ suggested encouraging Jaynie to interact with friends and creating environments in which Jaynie can flourish, e.g. like church youth groups. Those types of settings will give her more confidence and successes.  She needs to feel she has something she can do.  Technology is not going to work with her all the time. RJ had her use the Mini Augie, a PDA-type device to help with functionality but not her conversational ability.

Academics:

Tried Big Keys keyboard mounted on a Magic Arm with the Questions and Answers software  program, which is for early readers and non-readers.  Information area read by using the up arrow and down arrow. Speech sometimes not so great in this program.  Had Jaynie “read” each word. She was able to answer the question by looking at the information box and copy. After awhile the user can answer the question with a complete sentence. Jaynie probably needs help scaffolding from information to questions.  This program helps with decoding.

Summary: Create environments where Jaynie can communicate, use a combination of a device and voice, possible use of BigKeys and Question and Answer software.  (Question and Answer is still in development.  RJ Cooper is looking for people to volunteer to test it and provide constructive suggestions.)

3:00 Zach M.

Goal: Would like to see Zach be able to type faster, more efficiently for his schoolwork

Initial Observation: Spinal cord injury resulting in  left hand better than right but fatigues easily

Access Method: left hand

Software/Hardware: AlphaSmart, CoWriter Applet, Magic Arm, Device Adaptor

Session: Zach has used AlphaSmart successfully in school. . RJ suggest the Co:Writer applet, which would reduce the amount of keystrokes because of word prediction and abbreviation expansion. CCAC staff demonstrated Co:Writer. (CoWriter price $199).  The user can add own dictionaries or other dictionaries. Next, explored positioning of the AlphaSmart.

Summary:, Magic Arm and the Device Adapter and CoWriter were suggested additions to help Zachbe more efficient in doing his school work and save energy.

Will L.

Goal: Parents would like to see Will focus on activities in school so he can learn.

Initial Observation: Very active, wanders, distractible

Access Method: hands

Software/Hardware: Spell  A Word, Big Keys

Session:

Will sat down with RJ to use the program , Spell a Word. Used a Big Keys to spell out Bubbles. Will self corrected.. It was difficult for Will to be focused. It is necessary to choose things that Will has an interest in. RJ used bubbles to engage Will.  He can copy letters but needs to scaffold between copying and then trying to write himself. Will wandered off, but came back eventually for more.  Suggested a digital camera (around $100),  to use real pictures, real words, and real examples, with Spell a Word. This program should work for 3 to 4 years.

Summary: Working backwards will be important so think of where you want him to be at 20 and what skills he will need to get there.  Need to fix the world to accommodate him, group home may be a future solution.

Notes compiled by Jamie Evans and Lynn Koch.