Especially if her hands are getting weaker, she may wish to start to think about a transition to eyegaze. As Margaret points out, larger words with increased space in between but some low tech comm. boards based on categories of needs might be helpful for basic needs.

For spelling, how about a large font ETRAN board? (Picking the color, then picking the letter idea?) http://www.cogain.org/wiki/File:Esa_interacting.jpg . She would need to look at the group of letters that her desired letter is in, and then at the corresponding color. While this is traditionally used for eye gaze and perhaps she needs to use it that way; it occurs to me that she could potentially use her hands the same way.

While it also sounds like it would be premature to use partner assisted scanning, I would mention that as an option in the event that her motor function deteriorates further and I gaze does not work.

Ed Hitchcock OT/L

Technology Center

Rehabilitation Institute of Chicago

From: xxxxxx@xxxxxxxxxxxxxxxxxxxx [mailto:xxxxxx@xxxxxxxxxxxxxxxxxxxx] On Behalf Of Margaret Cotts
Sent: Friday, January 06, 2012 4:14 PM
To: xxxxxx@xxxxxxxxxxxxxxxxxxxx
Subject: RE: info request

Hi Alisa-

1. What about using a low tech keyguard? A keyguard might her stabilize her hand.

Buddy Speak has a pre-made one, but the space for the letters might not be large enough…

http://www.buddyspeak.com/xcart/customer/home.php?cat=248

He could also probably get a larger keyguard cut by a plastic store, if it seems like it would be helpful. He could probably even make a mock up out of stiff thick cardboard, just to try it out.

2. I appreciate that they can’t afford anything expensive, but if a keyguard is useful to her, it might allow her to use something like a iPad. (There is a company which makes them specifically for the iPad)>

3. Another high tech option would be to use a true 9-pin joystick (not a mouse emulator). This means she could only travel on an X/Y axis.

In terms of the diplopia- it might be useful to have a fair amount of space in between each letter. Also, to experiment with contrast (i.e. white letters on a black background).

Hope this helps.

--
Margaret Cotts
Low Tech Solutions
phone: (510) 681-3639 | email: xxxxxx@xxxxxxxxxxxxxxxxxxxx
lowtechsolutions.org | store.lowtechsolutions.org

From: xxxxxx@xxxxxxxxxxxxxxxxxxxx [mailto:xxxxxx@xxxxxxxxxxxxxxxxxxxx] On Behalf Of Alisa Brownlee
Sent: Friday, January 06, 2012 1:35 PM
To: National ALS Association AT Listserv
Subject: FW: info request
Importance: High

Hello fellow AT professionals,

Below is an email I received this afternoon. Anyone have any out of the box ideas for this family?

Thanks,

Alisa

Alisa Brownlee, ATP
Clinical Manager, Assistive Technology Services

Follow me on Twitter @alsassistivetec
or visit my blog on assistive technology for people with ALS: http://alsassistivetechnology.blogspot.com

Direct phone number 215-631-1877

From: Vlahos Ioannis [mailto:xxxxxx@xxxxxxxxxxxxxxxxx]
Sent: Fri 1/6/2012 4:23 PM
To: Alisa Brownlee
Subject: info request

Dear Ms Brownlee,

I have found your e mail while searching for information about augmentative communication and I am addressing you ,hoping to get some advice and information.

We live in Greece, island of Crete, my wife 58 yrs old., was diagnosed 5 years ago with ALS (bulblar form). Two years ago she underwent tracheostomy, and she cannot speak since then. For more than a year She was able to write on a board as her hands were not affected. However , In the past 8 months her condition worsened and she cannot write anymore-or she does , but we cannot read her writing.

I have made for her a large board with printed capital letters of the alphabet , so that by pointing at the letters we can know what she wants to say.

Unfortunately her vision is not so good (diplopia) so when she points to a letter her hand keeps shaking and she ends up pointing to a different (neighbohring ) letter than the one she intends to show.

This makes communication very difficult and requires a lot of time and patience and most of the times we cannot make up what she wants to tell us.

Would you have something to suggest and advice us for helping and making communication possible?

I know there are computers . but she cannot use one , because of the eye and the hand problem.

Whatever the apparatus proposed, it has to have large letters (not a regular keyboard) and be easy to look at or touch.

I would appreciate any information you can give us.

we could not afford a very expensive apparatus, so a rahter simple solution would be the most advicable.

Thanking you in advance

sincerely,

Yannis Vlahos

Eva's husband and caregiver.