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Expectations Around Eyegaze

This article explores the use of eyegaze technology as a communication aid for a 41-year-old IT worker with severe disabilities. It discusses the initial rejection of a referral to an Access to Communication and Technology (ACT) service, the trial of low-tech communication aids, and the eventual introduction of eyegaze technology. Key learning points include the importance of visual assessment, personal preferences in AAC, and the timing of introducing eyegaze technology.

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Expectations Around Eyegaze

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  1. Expectations Around Eyegaze Lynne Allsopp Occupational Therapist Access To Communication and Technology

  2. Nigel • 41 year old IT worker with basilar artery CVA with cerebello-pontine infarct 4/06/2016 on holiday • Presented in hospital with reduced GCS and found to have DKA • Tracheostomy • PEG • Catheter (from March 2017)

  3. Referral to ACT • Originally referred when in acute care • Referral rejected – team advised to develop low tech – 20 questions, PAS, eye pointing • Re-referrred once in an in patient rehabilitation unit

  4. Rehab Goals •  Transfer with hoist with 2 • Sit in tilt in space chair for up to 3 hours • Explore ability to use head control to allow use of a communication aid • Maintain joint ROM • Explore low and high tech communication aids • To explore swallow assessment

  5. Initial ACTappointment • Goals – to develop head switching skills through EC • To develop low tech strategies • Team still convinced that eye gaze will offer a solution

  6. Communication • ‘On admission he could only communicate yes and no via vertical eye movements’ • Low tech options tried – visual communication symbol and written charts, auditory scan of alphabet • Categorised communication chart

  7. Eye Movement • Initially vertical • On discharge, some movement to the right noted – ‘associated with Nystagmus and diplopia on the midgaze’ • ‘Nigel has been assessed by the local ACT service to look at eye gaze, to which he is keen to continue to aim for as a future goal’

  8. Eye Gaze Trial • Initially when in Acute setting: • Able to calibrate but only cope with 6 options on screen • 2nd trial with different company – cause and effect • 3rd trial in rehab – December 2016 with 1st company

  9. HAAT Model

  10. 2nd Review Apppointment • October 2017 • At home since July • Excellent use of low tech • Joint Appointment with physio – full assessment of movement • Eye/eyebrow movement is the only option

  11. Emego • Emego uses electromyography (EMG) to let the user control applications via a wireless switch sensor. Created for those with severe disabilities to retain independence.

  12. Brain Fingers Use minuscule muscle movements or the brain’s electrical signals to control a PC. The headband and software can be completely adjusted and customised to specific individual needs with a wealth of options. From switch-like integration to mouse control,

  13. Scatir

  14. ACTion Switch • EMG switch • Can be fined tuned

  15. 3rd Review Appointment • Nigel’s goal is to access his music on his computer • Plan – Use Grid 3 on Nigel’s desk top PC with simple Grid set and Scatir or ACTion switch

  16. Key Learning points • Use of language in reports • The importance of visual assessment • Whose goals • Low tech AAC is a personal issue • Importance of support and environment • Timing of introduction of eye gaze • How do we prove its not a financial decision

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