Motor Neurone Diseases (MND) are a group of progressive neurological disorders:
- amyotrophic lateral sclerosis, also called Lou Grehig’s disease (ALS)
- progressive muscular atrophy (PMA)
- spinal muscular atrophy (SMA)
- progressive or pseudo-bulbar palsy (PBP)
- primary lateral sclerosis (PLS)
MND destroys motor neurone cells, the cells that control voluntary muscle movement. As a result symptoms generally include a gradual weakening of muscles which then effect walking and movement of the hands and eventually speech and swallowing. It also causes spacicity and twitching of the muscles.
Better Living through Technology
There are many environmental barriers to people with the physical difficulties caused by motor neurone disease. Fortunately computers can provide a huge amount of independent access through e-books, online radio and video, email, games, online shopping and more.
The complex and tiring movements required to write by hand can prove to be an obstacle for most people diagnosed with MND. Many clients find a computer keyboard much easier to use. However as the condition progresses many clients start to find the keyboard and mouse increasingly difficult to use due to the accuracy and effort necessary.
They may find that the free accessibility options included with Windows can make the keyboard and mouse more accessible:
- slowing down the mouse makes it more accurate…
- … or speeding up the mouse makes it less tiring to use
- increasing the size of objects on screen to make them easier to focus the mouse on
- decreasing keyboard repeat rate reduces repetition errors
- enabling StickyKeys allows pressing of more than one key concurrently with a single hand (like Ctrl + Alt + Del)
- enabling FilterKeys and SlowKeys reduces errors caused by hitting the wrong key
Specialist Hardware and Software
Some rollerballs such as the BigTrack require far less fine motor control and ability to grip than a mouse. They can be controlled by wrist, foot or any other part of the body the retains decent voluntary control.
A BigKeys or IntelliKeys keyboard both demand less accuracy than a standard keyboard. The Intellikeys needs far less pressure to activate a key and, as with the BigTrack rollerball, the IntelliKeys can even be operated by foot. Alternatively a compact keyboard can be easily positioned in a comfortable position and a keyguard allows the user to rest their hands on the keyboard without typing inadvertently.
Prediction software such as Penfriend or Co-writer can help with the effort required to produce long pieces of text by reducing the total number of keypresses.
Motor Neurone Diseases are usually progressive and consequently even a specialist rollerball and keyboard may become inefficient and uncomfortable to use over time.
Switches allow the harnessing of any part of the body that shows voluntary muscle movement and won’t tire too quickly.
The control of one or two switches (or more in some cases) can then provide access to writing (via an on-screen keyboard), the internet, email and most other tasks performed on a computer. They can also provide access to environmental control and speech through voice output communication aids (VOCAs).
Accessing a computer using switches can be quite a slow and laborious task but software such as The Grid employs innovative scanning methods to make this solution as practical and enjoyable as possible.
Eye Tracking Systems
Eye tracking systems can provide powerful, comfortable and efficient access to the computer using eye movement alone. The movement of the eyes adjusts the position of the mouse cursor on-screen. Mouse clicks are issued through blink recognition, using dwell delay or via a supplementary switch.Typing can be accomplished through an on-screen keyboard such as Dasher.
These are new technologies and many users will find the costs of these system prohibitive. You can find out more from the major manufacturers on their websites:
Access to smartphones and tablets
Apple devices (iPhones and iPads) are primarily controlled through touch. Styluses can be used, sometimes made, to make touch access easier and more efficient. Special head-mounted styluses are also available. Switches can be used to access some apps on the iPad and iPhone, including many inexpensive apps that can be used for alternative and augmentative communication (AAC).
Android devices (Samsung, Lenovo etc.) can be accessed through touch and switches, as above, but will also allow you to connect a bluetooth mouse or wired device using USB-C or an On The Go (OTG) adaptor. This allows powered wheelchair joysticks and other devices to be used to control the tablet or smartphone.