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Top Ten Rehab Technologies

Denis Anson

September 5, 2007

"Not in any particular order, but I'd say that among the watershed technologies in Assistive Technology are:"

1. The Adaptive Firmware Card

Photo of Adaptive Firmware Card
Developed by Paul Schweda in the late 1970s, this card allowed people with severe disabilities to access "mainstream" computer programs on the Apple II. The card included virtually all modern access technologies (expanded keyboard support, Morse, single switch) except for voice input, and worked in a computer that didn't have a real operating system, to allow keyboard replacement in virtually any program. It promoted the idea that people with disabilities should be able to use the same programs as anyone else, not just the programs produced by hobbyist therapists.

2. Quickie UltraLight Wheelchairs

Photo of Quickie wheelchair
Back in the day when standard wheelchairs were big, heavy, flexible, and inefficient, Quickie showed up with rigid chairs that were light weight and adjustable. Originally designed for wheelchair athletes, we found they were actually most useful for folks with very limited endurance, who lacked the energy to propel themselves in conventional wheelchairs.

3. High-precision Bearings in Wheelchairs

Photo of bearing
Those old wheelchairs, and even the early ultra-lights used standard wheel bearings, which meant that you could push them and they'd quickly roll to a stop. Then we started getting high-precision bearings, and the silly things started rolling, on their own, to the low points in the therapy area floor if you forgot to set the wheel locks. Suddenly, the effort required to propel all chairs, and especially ultra-lights, decreased markedly!

4. Portable Augmentative Communication Systems

Photo of original Unicorn membrane keyboard
When the Adaptive Firmware Card came out, it included a demo program that allowed messages to be stored behind keys of the Unicorn Keyboard. When you pressed a key, the attached Echo synthesizer spoke the message. Therapists went wild! It's a communication system! It's lets non-vocal folks talk! And here is where you plug it in! Of course, it wasn't a communication system, it was a quick and dirty demo program in AppleSoft BASIC. But later, Zygo, among others, developed systems that did the same thing, and that had enough batteries to operate in the real world. Those big, clunky, and *SLOW* systems started it all.
Photo courtesy of Alan Cantor

5. Dragon Dicatate

Photo of Dragon Dictate product
It cost $6000! It required the most powerful PC money could buy, and it required that you stop after each word to let it decide what word you had spoken, but it was a large vocabulary, general purpose speech to text system that allowed people who couldn't use the keyboard to generate written text.

6. IBM ViaVoice

Photo of ViaVoice product
Introduced at $149, it forced the price of speech recognition down to a level that mere mortals could afford. In the process, it also moved speech recognition into the mainstream, and away from disability, so the customer support changed to a much lower level of involvement.

7. LC Technologies Eye Gaze Computer

Photo of Eye Gaze setup
I first saw this at a RESNA conference exhibit hall, and was blown away. I could sit at the computer, and just by looking at letters on the screen, type. I could look away and look back, and go right on typing. It was cool! While I was gazing, a person came in to the booth behind me, and, after a moment, asked what it cost. I don't recall exactly what the price was, but I think it was on the order of $60,000. The person squawked, "Why would I spend $60,000 on this, when right over there, I can buy a HeadMaster for $1000?" The booth person said, "If you could use a HeadMaster, you'd be out of your mind to buy one of these. This is for people who can't use anything else." In 1994, they had sold 50, but they allowed 50 people to talk and to work who would not have been able to do anything else.

8. Morse Code Input

Photo of DARCI Morse Code product
Al Ross, at University of Washington, was a ham radio operator as well as a communications specialist. In the course of his work, he started to wonder if people with profound disabilities might be able to use Morse Code to communicate. He wrote a grant, and did some research with Kathy Yorkston, a speech pathologist, and some others, and found that, indeed, Morse could be used by people with significant cognitive disorders to allow communication at much faster rates than single switch scanning. As part of the project, they built some communication systems to be used for the 6 months of the study (1980). In the late 1990s, some of these communicators were still in daily use.

9. Dynamic Display AAC Systems

Photo of Dynavox Series 4
Early communication systems were limited by the number of keys that could be used, and the amount of information that could be displayed at once. You could swap overlays to get more versatility, but that meant that someone else had to assist (in most cases). If you put lots of icons on the screen, the clutter make it difficult to interpret for many. If you ask the user to remember what the generic symbols mean, you put a lot of load on them. But with dynamic displays, you only have to show the current meaning of a key, not all of them, and the user doesn't have to remember as much.

10. Graphical Computer Displays

Screenshot of a DOS text screen
A watershed event, but not one for the better. Text screens are easy. You need to be able to emulate a keyboard, and generate 128 unique characters. Piece of cake. Then we got the Mac, and Windows. Now, you need to be able to move to any spot on the screen, you need to be able to capture text off the screen without knowing where it is (it's not just the 40th character in the 12th row, it can be anywhere!). The difficulty in providing access to a graphical computer, as compared with a text based one is immense. It was a great leap backwards for disability access, and one that we are still recovering from. (How's your access to Vista?)
Photo courtesy of Denis Anson

Denis Anson, MS, OTR
Director of Research and Development
Assistive Technology Research Institute
College Misericordia
570/674-8054 fax