1. Aaron W. Perlman Center Computer Access Matching the needs of children with SMA Beth McCarty OTR/L, ATP Aaron W. Perlman Center Cincinnati Children’s Hospital

2. Aaron W. Perlman Center 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

3. Aaron W. Perlman Center 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

4. Aaron W. Perlman Center 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

5. Aaron W. Perlman Center 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?

6. Aaron W. Perlman Center 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 Kensington Slim blade Logic Tech Marble Mouse Cirque

7. Aaron W. Perlman Center Joysticks TASH

8. Aaron W. Perlman Center 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

9. Aaron W. Perlman Center 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.

10. Aaron W. Perlman Center The Trigger, Cap, Mini Cup, Lever Switch

11. Aaron W. Perlman Center Picture of Dwell Software

12. Aaron W. Perlman Center 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

13. Aaron W. Perlman Center Adaptive Switch Lab - ASL Electronic Switches: Fiber Optic Proximity Sensor

14. Aaron W. Perlman Center 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

15. Aaron W. Perlman Center Small Profile Keyboards Tash Mini Keyboard DataTech Little Fingers

16. Aaron W. Perlman Center 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

17. Aaron W. Perlman Center

18. 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

19. Aaron W. Perlman Center Adding Computer Access to Your Wheelchair Mouse Mover - Power Mobility: Manufacture TASH Adaptive Switch Lab

20. Aaron W. Perlman Center 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

21. Aaron W. Perlman Center Universal Switch Mount Universal Switch Mounting System by AbleNet, Inc. mounts switches quickly and easily. Can be used from a bed or other positioning device

22. Aaron W. Perlman Center Arm Supports CJTArm slings eliminate gravity

23. Aaron W. Perlman Center BookHolder/Auto Page Turner CJT LEVO Abledate Automatic Page Turner

24. Aaron W. Perlman Center Mounting Computer to Wheelchiar Daessy CJT

25. Aaron W. Perlman Center What is the Future? Robotics http://www.exactdynamics.nl/

26. Aaron W. Perlman Center Perlman Power: Licensed to Drive Encouraged To Stand Out PERLMAN POWER