SPD’s assistive technology specialist Tan Chuan Hoh shares how with the right types of devices, people diagnosed with severe physical disabilities can also surf the Internet, engage in online games and use the computer.

With no nerves to activate the muscles, they will gradually weaken and become wasted. As a result, those diagnosed with Motor Neuron Disease (MND) are likely to be confined to their beds most of the time, dependent on the ventilator to breathe, experience weakness in all their limbs and suffer from speech impairment. They would usually require moderate to maximum assistance in managing their activities of daily living.

Help with assistive technology
All that said, would anyone still think that it is possible for persons with MND to use the computer? The answer is an absolute YES! With the use of assistive technology (AT), people with MND or other severe physical disabilities can type, surf the Internet, access social media and engage in online computer games as well.

Types of input devices
Input devices such as keyboards, mouse, scanners and webcams, are tools from which the computer receives information. There are several input devices that people with MND can choose from.

If users are unable to use their hands or feet to access the computer, they can consider hands-free devices such as a head mouse to access the computer. An infrared camera is mounted to the top of the desktop or laptop computer and a reflective dot attached to the user’s forehead or spectacles. When the user moves his head, the movement is recognised by the infrared receiver which in turn translates head movements into cursor movements on the computer screen.

To achieve a complete hands-free computer access, the user usually requires two other components – an on-screen keyboard for typing and a dwell-clicking toolbar for making the mouse clicks. The dwell-clicking toolbar has all the capabilities of a mouse which includes allowing the user to drag objects around the screen.

For users who have one reliable movement (ie. finger, elbow, foot etc.), a single-switch scanning computer system may be recommended. The switch prompts the computer software to scan the on-screen keyboard by briefly highlighting the keys. Once a desired key on the keyboard is highlighted, the user again activates the switch to select another key.

It is important to choose the right type of switch as they come in various sizes and shapes and ways of activation such as through exerting pressure, movements (ie. eye blink), and even sip and puff (ie. by sucking and blowing on a tube attached to the switch). Using a word-prediction software along with the scanning software will help increase typing speeds.

British theoretical physicist, cosmologist and author Stephen Hawking uses a single switch activated by the movement of a muscle in his cheek along with some specialised software that presents choices that narrow down to what he wants to say or do.

Users who only have eye movements can consider eye-gaze technology to activate the computer. Eye-gaze technology works by using infrared beams to identify the user’s pupils and a camera to track the movements of the eyes around the computer screen. The user would select the desired letters on the screen by either blinking or dwelling the cursor over the letters.

Some important considerations
Software compatibility – It is important to check the system requirements for the on-screen keyboards and scanning software to ensure that they are compatible with the users’ computer systems. Some of these software work with different versions of the computer’s operating systems (ie. Microsoft Windows, Apple Mac OS).

Cost – Cost can be a prohibitive factor when selecting input devices. Cost aside, it is important that the users consider the long term usage of these input devices based on their needs and lifestyles.

Seating and Positioning – When considering computer access, it is essential that the user is positioned properly in order to utilise full control over the input devices. Persons with MND would probably be spending most of their time lying on the bed as they may not be able to sit upright for more than an hour. There are alternative ways, such as the use of mounting systems, which can hold the computer screen or laptop computer in a position in line with the user’s line of sight in order for the person to be able use the computer whilst lying on the bed.

Consult an AT practitioner for the right fit
There are a range of commercially available input devices that may be suitable for persons with MND. However, it is recommended that the person with MND consult an AT practitioner to assess their needs and lifestyles before purchasing any AT input devices.