Friday, June 13, 2014

Using No(se)-Tech to Access Technology

I was introduced to Larry when I started my new position as the assistive technology occupational therapist for the school district. Larry has arthrogryposis, a congenital disorder that affects joints, limiting not only range of motion but also strength. When I met Larry, he already had several devices in place, but the team was concerned with how he was accessing his technology, specifically his iPad. Why? Because he uses his nose.

When I first saw Larry using his nose, I was blown away! Here is this student who has found a way to use his iPad, including swiping from screen to screen, entering a password, and even drawing on the whiteboard app without the use of his hands. He had already tried the traditional hands-free options — a mouth stick and a stylus mounted onto a ball cap — with little to no success. He was fast and accurate using his nose, and didn’t want to access his iPad any other way.

In knowing his success, why was the team so concerned? They thought it was socially inappropriate for a middle schooler to use his nose to access technology, and they were concerned about the hygienic issues that would arise if he had a cold. I hesitantly agreed with the appropriateness of using his nose, but figured since the device was his, he wouldn’t be spreading germs, even with a runny nose. After much research and observation, I realized that with Larry’s shoulder movement, he would be able to use a switch to access his iPad. 

Larry learned how to use the Ablenet Blue2 blue tooth switch with his iPad relatively quickly. With some trial and error, we realized he was more accurate using it as a single switch, as opposed to the double switch option that is offered. He learned to click twice to return to the home screen and to wait for the cursor to reach the row he wanted before clicking. He has done relatively well with the switch and now has a more socially acceptable way of accessing his iPad.

The major difficulty we face now is speed. Larry knows how fast he can navigate through his iPad with his nose and there is a major difference between using his nose and using the switch. Luckily the cursor speed can be adjusted, but with Larry’s difficulties moving, it needs to be at a pace to accommodate this difficulty. Plus, when he’s really excited, he will accidentally click the button, and have to wait for it to scroll through all the options again before being able to actually choose the right option.

Larry continues to practice using the switch during our sessions, but prefers his nose. Sometimes high-tech doesn’t mean the right-tech, and sometimes no(se)-tech is the way to go.



Shelly is sad she enjoyed the snow days so much, now that school is in session until the end of June!

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