Case 7: Improving Computer Access to Improve Productivity

Background

QQ (name and initials changed for confidentiality) was 41 years old when she was referred for an AT evaluation in September 2007. QQ was diagnosed with MS in 1985. QQ resided at home in a townhouse by herself in an urban area. She previously was employed as a free lance journalist with interests relating to animal and human rights. Effects of MS in Participating in Functional Work Activities At the time of this evaluation, QQ experienced the following limitations:

• Physical: QQ experienced mobility impairments. Although right hand dominant, she had little functional use of her right hand and had decreasing use of her left hand. She was able to complete activities with her left hand pointer finger when the arm was supported. She ambulated in a power wheelchair and had no functional use of her legs.
• Cognitive: No thinking, attention or memory concerns were observed or reported.
• Visual: QQ reported no functional visual difficulties.
• Hearing: No hearing difficulties were reported.
• Communication: QQ reported no speech or communication difficulties.
• Current Access to AT: QQ had been using a power wheelchair for the past 6 years with the joystick located on her left side. She had been a frequent computer user in the past when she was able to use the navigational features (touchpad) on the computer.

Treatment Intervention Goals

QQ would like to improve computer access in order that she might participate in productive computer activities related to writing, web related research, shopping, and banking.

Assistive Technology (AT) Intervention

QQ was evaluated by Curt Johnson, MS, ATP, a Rehabilitation Counselor and Assistive Technology Practitioner in October 2007. The following equipment and adjustments were recommended, based on evaluation and trials with equipment and taking into account QQ’s preferences.

Trackball Mouse: It was recommended that QQ receive the Kensington Expert Mouse Pro trackball to allow her to navigate during computer use.

Mini Switch Click: Due to fine motor deficits, range of motion limitations and weakness, QQ was not able to complete clicking of the mouse. To allow for clicking, a “mini Switch Click” devices was recommended to be positioned on the right side of her head and acted as a left click when it was activated. It has a USB port and plugs into the computer.

On Screen Keyboard: “WiViK3” on screen keyboard was recommended as it has a variety of features to improve productivity and accuracy. It has a number of features including dwell selection or switch-based scanning, word prediction, visual enhancements, text-to-speech and abbreviation expansion. QQ was particularly pleased with the word prediction component and felt that it would increase her typing options.

Outcome

All of the above recommendations were implemented and determined to be successful. QQ was very pleased with her equipment and feels that she is now able to participate in a variety of life activities that were previously available only on a very limited basis, if at all. She had plans to resume contact with prior friends and hoped to return to writing.

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