“Get rid of that pain in my neck!” By Gregor Gilmour, Diana

“Get rid of that pain in my
neck!”
By Gregor
Gilmour, Diana
Mountain & Kate
McCallum
Who we are:
• Gregor
3rd year at Beaumont College.
He is a keen DynaVox user and strong
advocate for people who use AAC.
• Kate
Speech and Language Therapy Technician
specialising in AAC.
Qualified as an OT in July 2013.
• Diana
Speech & Language Therapist
Long interest in AAC and person
centred working.
Where are we from?
• Beaumont College was founded in
Lancaster in 1977.
• We offer both residential and day
programmes to Learners.
• For young adults aged between 18
and 25 who have both physical and
learning disabilities.
• Our aim is to empower Learners to
take responsibility for their own lives.
K
The Big Team
SLT
Family
AAC Tech
Keyworker
Wheelchair
Support
staff
Services
Gregor
Teachers
IT Tech
Occupational
Therapy
Physio
G,D
Aim of placement
Person centred plan to support Gregor‟s
plans for the future…
1st year Objectives:
included
• Develop independence (directing, accessing IT)
• decide on the most appropriate access
method, after a trial of eye-gaze.
2nd year Objectives:
included
• continue to play an active role in finding an
appropriate access method for communication,
environmental controls and IT.
D
Connect 2 Control Project
•
•
•
•
Successor to The Wheeltop Project.
3 year research project funded by BT.
Increase independence.
Through mainstream and „age and
disability‟ badged environmental
control systems.
G
1 Voice – communicating
together
•
•
•
•
•
Listen to me
Weekends
Website
Role models
1 Voice – Communicating Together
- really how it helped.
K,G
Gregors AAC History
• AAC strategies since the
age of 2
– first-pointed to a colourcoded A4 book
– hand function was poor
– Book became so large,
that I needed an
alternative.
K,G
Switch Skills
• Learning switching skills
using switch toys.
• First trialled a high-tech
AAC at age 2.5 in 1:1 SLT
sessions.
• Unable to communicate,
frustrated as a small
child.
K,G
Moving to High - Tech
• After using symbols for a short time, I
quickly established literacy skills (aged
6).
• Age of 5 used DynaVox devices, via
two head-switches.
K,G
D
After 12+ years of using switches
• I thought that this was it!
• I have now discovered new
access methods, and now
(sometimes) use a
combination.
• The aim of the session will be
to share all the ways I was
helped to find a new access
method to my
communication aid.
G, D
AAC Starting college.
Low - Tech
- Spelling Board
High – Tech
- DynaVox V Max
- 2 x Head switches (& Eye Max)
- Group Scanning
- Scanning WordPower
G, K
Getting a baseline
• We used a test sentence.
• “I am going to Scotland this weekend.
What are you doing?”
• Original time
Scanning = 1 min, 20 secs
D
What we did
AAC
programs
(page sets)
Options
previously
tried
Gregor‟s
movement
What was
possible
Seating,
positioning
and
mounting
Access
methods
AAC
equipment
available
D
Evidence Gathering.
To share information between people
(Gregor, IT, OT ,SLT, technicians)
„Access Assessment Progress Recording Sheet‟
Date
31.1.12
Body Type of
Activity
Part: Switch/Position /Settings
/ Movement /
Timings
Eyes
DynaVox eye gaze.
Dwell.
Mount 116 cm from
floor to bottom of
horizontal part of
mount
Observations
Who Photo
Gregor was able to navigate
around the letters page and
speak and clear messages. He
became tired quite quickly
today. He was more accurate
than when using head mouse
and much quicker but told me
he preferred the head mouse.
His head position was off
midline (see photos)
SA
D
All the different methods
Need to be considered motivation and fatigue
Need word prediction for speed.
G, K
Language Packs
• 1 Voice Role Models • Minspeak – Speed
– Cognitive load
– Learning
– Access
• Gateway
• Grid
• Word Power D, K
Scanning
Access Option
What do we know
Possible implications
Scanning,
2x head switch, 6 group
row Colom.
Gregor is a whiz.
Fatigue issues and neck pain
He‟s a fast scanner.
Knows his program Change to auto?
inside out.
Faster?
Anticipation issues?
Comments
Findings
This is Gregor preferred
access
method
for
communication and at
this moment he does not
want to change this.
We did not trial different
options.
Gregor choose to go
down other avenues first.
K
Keyboard
Access Option
What do we know
Possible implications
Computer keyboard’s

Standard

Standard with
Keyguard

Compact Computer
keyboard

Compact Computer
keyboard with
keyguard

Big Keys

Big Keys with Keyguard

Intelly keys
Gregor can point to Accuracy, ability to press
words
through
his keys,
trailing
fingers.
Perspex shield on his Speed. Fatigue.
Vmax.
Comments
Will
need
mouse
access
Findings
still No keyguard not an option
- Miss and accidental hits
- Big Keys 3 min.29 sec
- Intellikeys - “This weekend I am going to
Scotland” (3min).
G
Joysticks, mice, etc…
Access Option
What do we know
Roller plus Joystick
Mini Pointit joystick
Gregor drives his chair Grip, control, Accuracy,
Switches can be used as a A Mini point it joystick and a
heads switch for a left click.
with a joystick with a golf Ability to press buttons, left and right click
With internal speed setting
ball knob.
Speed. Fatigue.
set to the slowest possible
Generally he does this
within the windows software.
with
control
and
Control sentence complete
accuracy.
in 2min.50sec
Roller ball
A Mouse
Orbitrack
Possible implications
Manipulation,
control,
Accuracy, ability to press
buttons, Speed. Fatigue.
Grip, control, Accuracy,
ability to press buttons,
Speed. Fatigue.
Manipulation,
control,
Accuracy, ability to press
buttons, Speed. Fatigue.
K
Comments
Findings
Switches can be used as a slow and difficult to control
left and right click
Switches can be used as a
slow and difficult to
left and right click
control
Switches can be used as a
slow and difficult to
left and right click
control
Wheelchairs
All access methods are going to be affected by
Gregor‟s seating and positioning.
G, K
Head Mouse
Access Option
What do we know
Possible implications
Comments
Headmouse

SmartNav 4 AT

Head mouse xtream
Gregor
has
some Positioning
and
Head Seating and head rest
experience of this though control, Accuracy, ability implications. More success
has had limited success. to Dwell/switch to choose in Triton seat.
buttons, Speed. Fatigue.
Findings
Seating issues
Hard to isolate and hold
movements/
Head
position.
Needed large target area
Vocab reduced
D, K
Eye gaze
Access
Option
Eye gaze
• Eye max
• Tobii
What do we
know
Gregor
has
some
experience
of
this though has
had
limited
success.
Possible
implications
Fatigue,
control,
tone
Positioning,
mounting
seating
Comments
Findings
Gregors
position Using Eye Max -Can‟t calibrate on eye max –
most relaxed in triton rep in.
chair
Gregor struggled to calibrate system without
support to hold his head.
Mounting complicated by weight of device
and distance from him and unintentional
movements.
Gregor to sell eye max.
Tobii PC eye go - Good control using – but
tone increasing and fatigue.
GDK
Touch Screen.
Access Option
Touching the screen,

using touch enter

Touch exit

Audio touch

Zoom touch
What do we know
Gregor can point to
words through his Perspex
shield on his Vmax.
Possible implications
Accuracy, ability to press
keys,
trailing
fingers.
Speed. Fatigue.
Language availability due
to number of cells maybe
compromised.
Touching the screen with Gregor can point to Accuracy, ability to press
Keyguard.
words through his Perspex keys,
trailing
fingers.
shield on his Vmax.
Speed.
Fatigue.
Language availability due
to number of cells maybe
compromised.
Comments
Device dependant
Findings
No keyguard not an option
- Miss and accidental hits
- E.g. Control sentence
complete in 5min.28sec
Very few key guards in our Keyguard – PWP 100
stock
Control sentence
Borrow form Dynavox
complete in 58 seconds
(Now 26 seconds)
G
Dual Access
• Touch Screen & Scanning.
• Combined language packs
• Dropped Scanning with a few weeks.
D, K
Lightwriter
Access Option
Light writer with keyguard
What do we know
Gregor can us touch
screen and keyboard
well.
Possible implications
Accuracy, ability to press
keys,
trailing
fingers.
Speed. Fatigue.
Comments
OH s**T Dynavox is broken
and we‟re in the middle of
writing my CM talk.
Findings
Need a keyguard;
Control sentence complete
in 1.23 sec
K
Conclusions
Diana: I‟ve learned to
• make no assumptions!
• retry things
• Importance of sharing decision-making
with the user. (share & enable this)
Conclusions
Kate:
• A holistic view of a person
• Opportunity to actually try out options
(not just theory of what should work)
• Established method doesn‟t always mean
the best method.
(needs regular reviewing)
K
Conclusions
• Gregor: I can now talk 3 x faster and
people are amazed by the difference
and I have got rid of the pain in my
neck caused by switching. Switching
has been brilliant and I am fortunate
that my body has changed so I can
now access my communication aid
faster.
Future Plans….
• Gregor has a 3rd year at college
Still lots more to work on…
• communication skills (spelling,
conversational art, taking responsibility
etc.)
• physical skills
• And a business plan?
• Trial new AAC devices & gain funding
• Fingers crossed attend ISAAC 2014.
D
Thanks
Questions?