ASSISTIVE COMPUTER TECHNOLOGY
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Objectives:
1. Discuss the important components of evaluation needed to select
appropriate technology.
2. Identify the advantages and shortcomings of various technologies.
3. Provide an overview of the AT Kits at One-Stops around the
Commonwealth.
4. Gain insight through hands-on experience.
Presenters: Pat Sitter, OTR/L
Senior Occupational Therapist
Department of Rehabilitation Services
Jeff Graves, OTR/L
Occupational Therapist
Woodrow Wilson Rehabilitation Center
Tim Bobsin
Computer Systems Engineer
Woodrow Wilson Rehabilitation Center
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Assistive Computer Technology
PURPOSE
The purpose of the computer assistive technology program is to assist individuals
with a disability to access computers for educational and vocational pursuits and
to ultimately become successfully employed.
ASSISTVE COMPUTER TECHNOLOGY ASSESSMENT
GUIDELINES
Seating, Positioning, and Mobility Considerations:
Seating is a primary consideration. If an individual is not seated properly, poor
positioning will interfere with the functional activities the individual is attempting to
perform. Seating is a fundamental component of all assistive technology
assessments.
 Sitting tolerance in an office chair, manual wheelchair or power wheelchair
 Types of postural supports (head, armrests, foot)
 Workstation Considerations (work surface, monitor heights, desk
alternatives)
 Mobility within the work environment
Functional Communication Skills:
 Write
 Take notes in class
 Read
 Use the telephone
 Use a tape/digital recorder
 Operate a personal computer
Respiratory Components:
A consistent voice quality is necessary to use speech recognition software
successfully. If a student pronounces words differently, if his/her voice pattern
changes notably during the day or day to day, or if they loose breath support at
the end of phrases or words, the student will most likely have difficulty using
voice input software.
Motor Functioning:
 How is the individual currently accessing the computer?
 What part of his/her body does he/she use to achieve the finest area of
control?
 How much controlled head, arm, and leg movement does the individual
have?
 Does the individual have sensation in his/her fingers to perform touchtyping or does he/she have to look at his/her hands and the keyboard to
type?
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 Within what range is the individual able to reach and manipulate objects?
 How fast can he/she type? Does the current speed meet class/job
requirements?
 What is his/her accuracy when typing?
 How long can he/she type before becoming fatigued or experiencing
pain/discomfort?
Cognition:
 Does the individual understand cause and effect relationships?
 Is the individual able to follow written and verbal instructions?
 Do instructions have to be repeated frequently or occasionally?
 How long is the individual able to attend or concentrate on a task?
 Is the individual able to sequence or organize a task?
 Does the individual have sufficient short and long-term memory to perform
the assigned task?
 Is daily re-instruction on previously learned material required?
Vision:
 Does the individual have sufficient visual acuity to read text on the monitor
screen, read supporting documents, etc.?
 Does the individual frequently loose his/her place when reading or copying
material?
 Is the individual able to quickly locate a specific name or item in a
database? (Scanning)
 Is the individual able to see everything on the monitor screen or just a
particular location such as the very center of the screen? (Field cut)
 Does the individual frequently close one eye when performing
classroom/job tasks or complain of seeing double? (Double vision)
 Does the individual frequently complain of eye fatigue or headaches, rub
his/her eyes, and frequently look away from the computer screen or tasks
requiring near point vision?
Activities of Daily Living:
 Does the individual need an electronic aid for daily living to turn on and off
the computer, printer, monitor, lights, use the telephone, or need an
electric door opener to get in and out of the building or office?
 Is the individual able to lock and unlock his/her office door?
 Is the individual able to use the fax, copier, stapler, three-hold punch, and
scissors? What types of adaptations are needed to perform these
activities?
 Does the individual have reliable attendant care services that will allow
him/her to get to work on time?
 Can the individual perform his/her job from home?
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 Does the individual need assistance with lunchtime activities, transferring
on and off the commode, emptying a leg bag, etc? If so, who will assist
with these activities?
 Does the individual need a note taker in school?
 Does the individual have reliable transportation to and from work?
LOW TECH DEVICES
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Typing Aids
Copy Holders
Tape/Digital Recorders
Note Takers
Thumb Driver
Automatic Staplers
Power Stations
KEYBOARD ACCESS
Keyboards - There are many forms of keyboards with the standard QWERTY
layout with varying sizes, built-in wrist rests, adjustability, etc.
 Small Space Saver
 Ergonomic design
 Expanded
 Cordless
 Keyguards
 Membrane
 Alternative Layouts
o Alphabetical
o Dvorak—adapted to English language; most typing takes place on
the “home row.” Dvorak and Dealy used previous research and
their own to develop the Dvorak layouts based on letter frequency
and letter grouping in the English language. They found fingers
need only travel 1 mile to do a typical day’s typing using the Dvorak
layout and the fingers travel 16 to 20 miles to do the same work
using the QWERTY layout.
o QWERTY—standard keyboard layout
o Left Handed QWERTY—numeric pad and function keys are placed
on the left side of alphabetic layout
o Programmable
On-Screen Keyboards - On-screen keyboards accessed with mouse emulation,
used effectively, will allow the individual to “type” between 12-15 gross words per
minute.
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ACCESSIBILITY FEATURES (WINDOWS XP AND MACS)
Keyboard
Stickey Keys: Enables the individual to press CTRL, ALT, and SHIFT keys and
have them remain active until the next time you press a key other than CTRL,
ALT, or SHIFT. This is useful for individuals who have difficulty pressing two
keys simultaneously; such as is required for capital letters and upper case
symbols. Great for single finger typists, one hand typists or mouthstick users.
Filter Keys: Modifies keyboard function by “instructing” it to ignore accidental or
repeated keystrokes. You can also adjust the keyboard repeat rate, which is the
rate the key repeats when held down. This feature is helpful for individuals with
poor coordination or spastic movements.
Mouse
Mouse Keys: Enables the user to use the numeric keypad to move the mouse
pointer and to click, double-click and drag. Advantage: close to keyboard,
cursor allowed to move in a straight line only regardless of tremors and incoordination, adjustable speed and acceleration settings. This feature is used
frequently with individuals with poor coordination and spastic movements.
Display
High Contrast: Instructs programs to change the color scheme to the one
specified in the Settings box instead of using program-specific colors, and to
increase legibility whenever possible.
VOICE INPUT
Advancements in the voice/speech recognition research, coupled with the
progress in microchip technology, have resulted in speech recognition software
that allows a person’s voice to be the primary interface with computers. The
currently available speech recognition programs allow direct dictation into most
popular applications. All facets of word processing such as editing and
formatting may be completed by voice commands. The newer versions of these
programs also allow for navigation of the desktop by voice and the Web. A
recorder (sold separately) allows the user to dictate outside the office
environment and download the recorded speech to your computer.
MOUSE ALTERNATIVES (LOW COST)
Standard Mouse: There are an amazing number of styles and sizes of “mice”
that are variations on the original mouse. They may have 2-4 buttons, be
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programmable, for the right or left handed user, joystick-like in design etc. Many
mice are now “ergonomically” designed with their own wrist rests in response to
occupations that are now more “mouse-driven” than keyboard. These may be
seen at most local computer retail stores as well.
Trackball Mouse: Unlike the standard mouse with a small ball imbedded in the
bottom that controls cursor movement, a trackball’s ball is easily seen on the top
or side of the mouse. The user’s fingers direct the cursor movement by rolling
the ball; thus requiring only finger movement versus whole-hand movement
required for the standard mouse design. Trackball mice have also gained a lot of
attention and are now available in many forms. Experimentation is usually a
good idea to determine the one most comfortable and suitable to the user’s
needs. Advantages include that they can be controlled with many typing cuffs or
mouth sticks and that the movements and clicks are executed independently so
the user does not need as much stability or coordination.
Touch/Heat Sensitive Pad: The movement of a finger on the pad directs the
movement of the cursor. Mouse button clicks are executed either through taps
on the pad or by clicking the actual buttons. Many laptops and specialty
keyboards such as the Wave 2 from Cirque, include touch pads with the
keyboard. Placement of the pad often impacts the number of “errors” created by
accidentally touching the pad with the hand while doing other things.
MOUSE ALTERNATIVES (HIGH COST)
Trackball with guard and switch activation: The buttons support click, double
click, drag, horizontal/vertical movement and speed adjustment. Five speed
settings are available by just touching the speed button. A red light indicates the
drag button is active. Also included is a removable fingerplate that helps users
locate the target buttons. Switches can be easily connected to the Trackball with
the adapter box (sold separately) to emulate all of the trackball’s buttons. No
additional software needs to be installed.
Joystick: The buttons support click, double click, drag, horizontal/vertical
movement and speed adjustment. Five speed settings are available by just
touching the speed button. A red light indicates the drag button is active. Also
included is a removable fingerplate that helps users locate the target buttons.
Switches can be easily connected to the Joystick with the adapter box (sold
separately) to emulate all of the joystick’s buttons. Additionally, you can choose
from two alternative joystick handles for added comfort, T-bar or Soft Sponge. No
additional software needs to be installed.
Headpointing: Some devices require the user to wear a headset with a
pneumatic switch to made selections. Other devices are coupled with a wireless
optical sensor (a small reflective dot) that is placed on your forehead or glasses
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and replaces the standard mouse. The headpointing device translates your head
movements into the same movements of a mouse pointer. This device can be
combined with an on-screen keyboard and completely replace the existing
mouse. The headpointing devices that use a headset are more reliable and
accurate for computer aided drafting. The headpointing devices with a wireless
optical sensor allow an individual in a wheelchair to com and go freely as long as
they are wearing the sensor.
Joystick head operated mouse: This mouse is controlled with your mouth.
Moving the joystick moves the cursor. The farther you move the joystick, the
faster the cursor moves. Mouse button activations can be made with the sip and
puff switch that is built into the joystick. Typing and other keyboard functions can
be achieved through an on-screen keyboard or Morse code.
Speech Recognition: Complete control over cursor movements can also be
achieved through voice commands. This software allows users to move the
cursor anywhere within the desktop as well as perform button clicks with simple,
intuitive commands. Speech recognition software can control mouse clicks,
directional commands, launching programs, switching between applications and
filling out forms.
NOTE TAKERS
Note takers are light weight, portable, and durable word processor with a small
LCD screen and full-size keyboard. It allows the user to enter and edit text, and
then easily transfer it to your computer or printer. Some of the devices allow for
larger size font, spell checker, word prediction and organizational software.
ACCELERATION TECHNIQUES
Word Prediction: The goal of “word prediction” software is to facilitate text
entry. A text “window” appears within a word-processor; as the user enters each
letter of the target word, words that begin with those letters appear in the word
prediction window. Once the desired word appears in the window, the user may
choose it with a keystroke or a mouse click. If the target word does not appear in
the word prediction window, the user may complete typing the desired word, at
which point it is usually automatically added to the prediction list. In some
software, the more frequently a given word is used, the sooner it appears as a
possible choice in the prediction window. This feature is especially helpful for
long words, since it saves many keystrokes. It is more demanding in terms of
visual attention.
Abbreviation Expansion: Long words and phrases can be saved under the
“abbreviation expansion” feature, whereby a user programs an abbreviation to
represent a string of words that is used often in their daily activities. When typed
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in, the abbreviation is automatically expanded into a proper string. Some
programs come with speech output, to aid persons with reading disabilities.
Some programs automatically learn phrases used repeatedly without the user
having to program them in. A side benefit of word prediction software is
assistance with spelling and word recognition skills.
Macro: A Macro is a sequence of commands that execute through a single
keystroke, a sequence of strokes, or a mouse click. A macro is a shortcut that
you can create to decrease the overall time a number of keystrokes it normally
takes to achieve the desired outcome. It is similar to abbreviated expansion
described above.
VISUAL ACCOMMODATIONS
Display Types: A simple but more expensive option for screen magnifications is
to increase the physical size of the hardware-viewing device. The use of a 17,
21, 27, and 32-inch monitors could be a feasible solution. Also, NTSC video
output devices are available for PCS that allow you to output the video signal to
any size television.
Magnification Software: This software allows the user to magnify text on the
screen. The program is highly customizable and has several powerful features.
The software has a scrolling “screen review” feature that moves the zoom
window methodically over the screen. The speed of the scrolling zoom window
can be adjusted with the mouse. Also, there is a very useful text-tracking feature
that allows the zoom window to follow a text entry cursor (perfect for filling out
forms/e-mail composition) or follow the appearance of highlighted text (i.e. menu
selections)
JAWS: This program reads information from a computer display and speaks it
back through a speech synthesizer. JAWS is a powerful software program
designed to work with a voice synthesizer to improve the productivity level of
visually impaired employees and the ability of individuals who are blind.
Zoom Function in Microsoft Applications: This feature allows the user to
“zoom in” to get a close-up view of the document or to “zoom out” to see more of
the page at a reduced size. “Zooming in” help an individual with a visual
impairment see text on the screen easier. It does not affect the printed font size.
Text Readers for the Learning Disabled and Visually Impaired: This
software will highlight a word, phrase, or sentence as a computer generated
voice reads aloud the text on the screen. Students can request their textbooks
on CD and the software will read aloud the information to the student. The
student can also scan in text. The software will work in reading material on the
Internet as well. This software also comes with study helps for the student. Text
can be highlighted; text notes and voice notes can be inserted.
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Cognitive Aids (includes aids for individuals with learning disabilities):
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Watch Minders
PDA’s (Personal Digital Assistants)
Portable Speaking Dictionaries and spelling aids
Digital Recorders
RESOURCES
For an appointment at WWRC: 540.332.7498 or 540.332.7017
For an appointment at the Richmond Satellite: 804.367.9882
WEB RESOURCES
WWRC, AT Services www.wwrc.net/ATServices/athome.html
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