Richard Dodds on Technology
Produced in 1990 (Run time 27:58)
Richard Dodds: Hello. I'm Richard Dodds, and I will be talking to you today about all the stuff on this table. I actually will be talking about rehabilitation technology, basically, the application of technology in a very general sense to people with disabilities.
Let's start off with some of the most simple concepts, the idea of cause and effect in very early types of environmental control. When we talk about that, I always like to bring up my favorite device here, a very simple toy. By the addition of a small jack on the back here, this toy, which was typically turned on from the bottom here and it was turned on and let run until it ran out of batteries, can now be turned on and off using a large switch like this.
By pressing on the switch, I can activate the toy. This is called a momentary contact switch, meaning the moment I make contact, it goes on; the moment I release contact, it goes off. Very much like a doorbell in your house. You wouldn't want a doorbell in your house that you pushed and stayed on and then you let go and it still was on. You want something you hold and it's on and then you release, and it stops.
For children, this is a very early type of environmental control, but it gives them an idea that they can, first of all, react with things in their environment that they can control things in their environment, rather than having all these things just plopped in their laps and done for them. It's also, obviously, a great way to play. I can spend hours watching this guy's tail go.
There's other types of toys. This one, obviously, there's a connection between the toy and the switch. Here's a toy, and I am going to activate it with a different type of switch. All the switches have different names. This one's called a plate switch. Somebody has a great time thinking these names up. This is called a wobble switch because it wobbles back and forth. And by plugging it into this remote control for this toy here, and this is another toy from just a regular toy store, I can turn this switch and off the toy goes.
Now for some individuals, the activation of a switch like this can be done with a head movement or it can be done with a leg movement or a knee movement or other types of movement of the body. But for other people, they don't... they have good movement of maybe the wrist but their arms are going all over the place, so we can take this same switch and we can just strap it right onto your wrist here, and now I can move my arm freely and still activate the toy. I can be moving my arm all over the place and still turn a toy on and off. That's kind of nice.
As we move on from sophistication of toys, now these are just toys that do one particular thing. Here's a toy, and you've probably all seen regular music boxes, when you press the… This particular one is designed so when you wind it up, it's starts to play and you see Sesame Street characters go back and forth. By adding this switch – and this is called a wafer switch, very flat – when I hit the switch, the toy begins to operate. And what happens here is that we have a linear scan.
Basically, this roll goes around and around, and some very bright speech therapist said, "You know, if you can cut a hole in the back of this, I can paste on pictures of Mom and Dad and shapes of apples and oranges and squares and all those types of things, and we can put a big arrow down here." And imagine my thumb is the arrow.
When I go around, if I, for example, say, stop the device when Big Bird appears, and it could be a ball or whatever, now we have what is called a linear scan or linear tracking and now we can signify that we may want a ball or talk to Mom or Dad or want to look at the picture of Big Bird. So we can do all that using a very inexpensive device.
Now all the switches that we have been talking about can be plugged into different toys, and they're all standardized so I can plug this one in and activate this toy also.
What's nice about this is now we're learning environmental control, being able to control things in our environment. We move on from that. We look and look at being able to control probably larger items in our environment. We look at being able to control lights and radios and televisions, but we can't do that using these toys and switches. We have to go on to something a little bit more sophisticated.
Now these are commercially available in a lot of different forms. Here's one from Radio Shack called a Sonic switch. And you can plug it into your outlet and plug your lamp into it. And by activating this device here, make the sonic noise, I can turn the light on and off. I can also activate it by just rattling some keys in front of it. Now this has some advantages and disadvantages.
The advantage is that if you cannot activate a device like this, it needs good hand grasp, you can look at something like a set of keys dangling near the area that you could just hit with your leg or arm, and it would turn the light on and off. The disadvantage is that obviously outside sounds can turn on this light. You wouldn't want to plug in life-threatening devices to an environmental control like this. For example, if you have an iron, you wouldn't want to plug the iron in and leave it down or a coffee pot machine that would be left on. So we like to remind people not to do that with environmental controls.
Another type of environmental control, for example, would be like this. This is a… This brown piece here is a module that you can buy at almost any hardware store and it usually goes under the heading "Your touch is the switch." And what it allows is for this lamp, which is a regular lamp that I've taken the light bulb and screwed it into this unit, it allows this lamp to become a touch-base lamp. Now these lamps are sold commercially at stores like Sears and some of the large chains of department stores.
However, if you already have the lamp and you want to modify it yourself, for about $15 you can add this piece. And now with my first touch, I get a low beam; my second touch; I get a mid beam; and the third touch I get a high beam; and, of course, the fourth one turns it off. And this is a regular one-way light bulb that's turned into a three-way light bulb using this very inexpensive module and allows someone who can't turn the small knobs here to be able to activate this light just by touching the base.
What I'd like to talk about now is a different type of environmental control, a device that allows you to control where you are in your environment. And that's typically done for people who are unable to functionally ambulate themselves or functionally walk around themselves, and that's the use of a wheelchair. Let's look at manual wheelchairs first.
Now the difference in the typical manual wheelchair of many years and in this particular manual wheelchair, our initial one we look at is the color. This is black. In fact, they come in almost any color you can imagine, and there's a reason for that. Wheelchairs tended to be stainless steel because the manufacturer of wheelchairs happened to have a large business in chrome plating and that seemed to be the color that looked most hygienic in most institutions.
But now people wanted to be able to choose the color the wheelchairs. Most of us choose the color of the clothes we wear. We choose colors that match us, that we like to wear, that look good on us. We don't wear stainless steel pants and stainless steel colored shirts. We look at clothes that really make us feel good about ourselves.
Well, individuals who are going to be spending their entire day in a wheelchair want to have a wheelchair that makes them feel good about themselves. I've found children who have a choice in the color of the wheelchairs they are going to be sitting in start to enjoy the wheelchair a lot more. I worked with a girl not too long ago who chose hot pink as her choice of wheelchairs.
Now this one is a black wheelchair. It's called an ultra light wheelchair because it does one thing that's very nice, it's very lightweight and easy to pick up. It's a big change from the wheelchairs that typically weighed 60 to 70 pounds. This one weighs about 30 pounds and is easily transported into and out of a car if you're using one hand to get in and out with. And the other thing is, it's a lot easier to push a 30-pound wheelchair rather than a 60-pound wheelchair. There's 30 pounds difference in the two.
Now for individuals who use manual wheelchairs, we look at a term called functional independent mobility. And that's the idea that a person in a wheelchair can move as fast as the average person walks. When we look at functional independent mobility, we look at someone who can cross a room in the same time it would take anybody else who's walking across that room to cross it. That comes into play very clearly when you are going shopping.
And, for example, if you're at the grocery store and you're at the beginning of the aisle and you're selecting foods and the person who's pushing your cart is down the end of the aisle and you're still wheeling as hard as you can to get to the end of the aisle to join them. You can't make good selections if they're way up ahead of you. So we look at manual wheelchairs in a functional sense. If someone isn't able to get around in that wheelchair as, again, as fast as the average person walks, it isn't a functional situation.
So I'm going to look at power wheelchairs. Let me just slide this one over here. This particular power wheelchair has a seating system called a ROHO cushion, and it gives an air flotation above the particular seat and gives a very smooth seat to sit on. This particular wheelchair is driven using what's called a proportional joystick. And a proportional joystick is designed so the farther I move the joystick, the faster the chair goes. If I push this just a little bit, the chair moves very slowly.
And if I pull it back a little bit, it moves very slowly in reverse. Now if I push it all the way forward, it moves quite a bit faster. And if I pull it all the way in reverse, it moves quite a bit faster in reverse. So with a proportional joystick, I have control over where the chair is and how fast it's getting there with one particular device here called the joystick, and it moves in all the different directions.
Now some of the other attributes of this particular chair is that when it moves, it's very quiet. More and more power wheelchairs are using the quiet mode of operation rather than the older type that you could hear coming from blocks away. Most of us when we walk into a room don't make very much noise. When we enter a room when we're late for a particular session of one kind of another, we don't want everybody turning to look at us and making a big thing about the fact that we're late. We want to be able to easily enter the room without anybody knowing.
Now for some individuals, a joystick like this would be very difficult to operate because it uses fine motor control. Basically, being able to push this forward and back, you can control where you are and the speed at which you're going; it takes a certain amount of hand control. Those individuals would have a little bit of... Those individuals who have athetoid or spastic movements, meaning very rapid movements from side to side, would have a tough time operating this. They would grab hold of it, push it all the way forward and then head off to the wall or damage something in front of them. So we look at a different type of control for them, a control that's called a micro switch control.
So what we're going to do right now is change this chair around to operate with a micro switch control. Now this particular chair is very easy to do that with. By simply removing this joystick we have in here now… I'm going to set that over here, and I'm going to place a lapboard on here that'll give me an opportunity to put some other things on here. And here's a box that will allow me to plug a number of different types of joysticks into this chair.
Okay. I can change this power wheelchair to operate not only with that proportional joystick but with a number of others. Now here's a joystick, and you're probably very familiar with this one. Here's another joystick, and here's a joystick. All three of these do the exact same thing. They can be plugged into any Atari or a Commodore computer, and they all work off the same premise, that they have four directions and a select or fire button.
In this one, when you want to go forward, you push the forward arrow. The harder you push won't make any difference in the speed you go; you will just continue forward at one speed in a forward direction. And there's one for each other direction and one for reverse. On this joystick, the little orange mark here designates the forward position, the center is the fire position or the select position, and then we have other different directions to go in.
To give you an idea, these are specialized joysticks designed for people to utilize both computers and power wheelchairs and they run between a hundred and two hundred dollars. Now this one I got from a specialty company called ToysЯUs, and it runs for about nine dollars. It can be plugged into this or any Atari computer or Commodore computer and allows me to operate this power wheelchair. Once I've turned it on, I hit the fire button and I scan into the slow position, and now I can drive this chair. And as far as I push that joystick, I won't go any faster in any of those different positions.
What's nice about this, it's also virtually indestructible for kids, but if they do destroy it, you pay nine dollars to have it replaced and you don't even look at fixing it, as opposed to the others which run a couple hundred dollars each. Now this one if I grab hold of it and floor it, I only go forward at one speed.
Now, we're going to get back to the power wheelchairs in a minute, but let's go and talk about environmental controls and environmental control systems.
Okay, now that we've looked at environmental control of very large areas and moving around our environment, let's talk about environmental control in a very localized way. We talk about activities of daily living aids, devices that allow us to pick things off the floor or turn knobs and makes life a little easier for us.
An example of that is a device called a reacher. And a reacher is designed to allow someone to either pick something off a very high spot or something off a very low spot. For example, if you drop something out of your wheelchair and you can't reach down and pick it up, it's nice to have a reacher like this, and just grab hold of it and bring it up to you.
Now most reachers, and they come in a lot of different shapes and sizes, collapse so they can be very compact and put in the back of your wheelchair, and they come in a lot of shapes. This one here is particularly good in an office environment.
In fact, we've been using these a lot to adapt job sites because on the very tip it has a magnet, so if you drop a paper clip on the ground, you can even pick a paper clip off the ground. It also grabs very well onto pencils and other things that are typically used in an office environment.
Now those two both work in an up-and down-motion. This one here opens up and it works in a side-to-side motion. It also gives you a lot of support in your wrist here, so if you can't operate it as easily, you have something you can support it with, and now I can pick up something and put it down and do quite a bit of work that way.
Moving on from reachers, we look at things like knob turners. A knob tuner is a great device. If you have washing machines, dishwashers, kitchen stoves – all those things that you operate that have knobs – for some people that's very tough to operate. And we want to be able to do is build up those handles, allow those handles to be a little bit longer and easier to operate.
This device is designed to just push against that knob and allow it to be twisted, and it gives you a nice handle to work with. Very inexpensive; all these items go for under 20 dollars. This is around a five dollar item. Here's one, a great novelty item. It actually has a lot of great uses for people who are disabled and people who are non-disabled. This is designed to go on a half gallon milk carton or an orange juice carton or any kind of box carton that you would pour liquids from and acts as a handle. It gives you a nice way to grab onto that carton and pour out your milk there.
Finally, another device that's particularly good on job sites and also at home. People ask me a lot, "What kind of telephone should I buy? Should I buy one with big buttons? I have a small button telephone right now, but it's tough to operate those buttons." Devices such as this allow you to… It Velcros right onto your existing telephone and allows you to hit all those same numbers, and they sell for less than five dollars. It's a great device.
Moving on from that, we look at devices that can be used in the home and also at a worksite. Let's talk about job site accommodation for a minute. If I move some of these things to the side, I was recently working with somebody who was looking at a job at a retail store. In the backs of many retail stores, people hang clothes, day in and day out. The clothes don't just suddenly appear on the rack, all on hangers. Somebody puts them on the hangers.
Typically, the clothes get to the store in a large box and they're all stuffed in a box, and somebody hangs them. Or, in fact, several people hang them all day long and put them out on the racks so when you see them, you can select them and try them on. Now you're all probably very familiar with hangers that look just like this. The idea is you have clips and you hang pants on this or skirts or shirts or whatever, and these are clipped to clothes.
Now the gentleman who was going to work at this job site had very good use of one hand. He utilized a manual wheelchair for mobility, and this is a job site he was hopefully going to get. It paid very well. And the difficulty he had there, as you can imagine, is if you have a shirt and you're trying to grip this on with one hand, you may get it like this, but it's not going to work too well and it may just slip off like that. So what we want to be able to do is with one hand be able to open these clips and put this shirt on very easily.
So we went down and we fabricated a device on the site that was designed to allow hangers to be dropped in. And this hanger can drop into this particular jig, and now, when I close this bar, I open up the clips on the hanger. And now, when this is sitting upright like this, I can take my shirt and lay it out right and slide it underneath these particular clips. And when it looks good to me sitting like they are, I just flip this back and I've hung the shirt up, just like that. And I can hang quite a few shirts up very quickly doing that.
In fact, a lot of those job site accommodations we've done, people who were non-disabled see people working with these jigs and say, "Can I get one of them? Because they work very well for that person, and they could even increase my rate of production."
So job site accommodations using all this material here is commercially available. It's not particularly specialized, it's just hard plastic. And using a combination of that with commercially available hangers, we have a very simple job site accommodation.
Now on the job site and at home, one of the most important things we do is communicate. Now on a job site, it's hard to work day in and day out without communicating with people. It's hard to grow up without ever communicating with people in one way or another. For many of the people we work with, communication is a difficult task. They may be verbally impaired for one reason or another, and that back and forth communication that many of us take for granted may be a very difficult thing to do.
Typically, you've seen people with language boards, and they can point to words and phrases and communicate in a very slow method but communicate needs and feelings by using this board. Unfortunately, that system requires somebody be there who can actually read the board or understand the pictures. It's tough to talk to a sibling who may be two or three years old if they can't read the board as the individual points to the pictures. But they can understand speech, and more and more communication aids based on computers have looked at speech output.
Now I have two different ones here. And I'll bring them in and I'll sort of shove this off to the side.
Both of these devices are computer based and allow me to communicate. Both have different types of voices. This particular one has a female voice, and they're both synthesized [Hello] speech. Sorry. Let me have that say hello again. I can type in the word hello. H-E-L-L-O, return. [Hello]. And I can have it say the word hello. I can actually print out the word hello. But imagine if I gave my whole talk today using this device and typing each word. You saw how long it took me to type the word hello. If I was to, say, type the sentence, "May I have a drink of water with ice, please?", most of the television sets would be off by now.
So we'll look at being able to take that phrase and compacted somehow so the rate of output is greater. This particular system uses logical letter coding, meaning that I can take two letters to logically put out a whole sentence. For example, again, drink of water with ice, please. May I have a drink of water with ice, please, is DW, the two letters DW. And by hitting the letters D and W and actually I programmed this in beforehand, I can hit return.
Computer Voice: May I have a drink of water with ice, please?
Richard Dodds: And if you weren't able to understand that, I can also print out the entire phrase.
Now it's nice to have the spoken output. It's also desirable to have the male and female output. Now this device uses a slightly different voice, and I can operate this particular one 25 different ways. I have it set up right now to operate with a joystick. By plugging this joystick in, I can turn it on. Let me move this one over to the side.
And this uses a symbol sequencing technique called Minspeak. And Minspeak allows me to remember phrases in a little bit different way. It allows me to associate pictures with a phrase. And for some individuals that's quite a bit easier than trying to remember letters to remind me of a whole phrase.
You can imagine that DR might be something very different, and you can't remember what DR is, then what's DW? This, you have a picture that reminds you of the whole phrase. For example, if I'd like to tell you my name, I can start off. And if you look right here in the middle, there's a light next to the man or number 6, and I think of the man as myself, and by selecting the man, and then coming on down and selecting the autograph.
Computer Voice: My name is Richard Dodds.
Richard Dodds: I can tell you my name. And this is using a male synthesized voice. This particular one is called Smooth Talker. All of them have interesting different names. I could also tell you, for example, where I live. I could do the picture of the man again, and then maybe the picture of the house, reminding me of the house where I live.
Computer Voice: I live in Phillipsburg, New Jersey.
Richard Dodds: Phillipsburg, New Jersey. For those of you who aren't familiar, it's just sort of off the west coast of New Jersey.
Now if we look at this type of communication aid and we go back. Now I'm operating this one with a joystick again. And we get into the same problem we had with environmental controls. If I'm operating my power wheelchair with a joystick, do I then have to switch to operate my communication aid with a joystick? Or my environmental control with a joystick? Well, again, going back to that wheelchair system, there's ways around it. So let's take a look at that for a moment.
We have a power wheelchair that we're spending a lot of our day in, in fact, about 14 hours. It allows us to get around our environment. What we want to be able to do is be able to turn on and off things in our environment. For at home, we want to be able to turn on and off the lights. If we're at a worksite, we want to be able to turn on and off maybe a computer that we're working with. We want to be able to do that from our power wheelchair.
So this power wheelchair is designed with an environmental control system built into it. I can scan by holding the fire button down to the center section here, which has a letter for each direction of the joystick, B, R, G and Y. B is in the forward position, and, if I push the joystick forward, I can turn on the light. And if I push it forward again, I can turn off the light.
The same thing with our small handheld joystick. If I push it in the left position, I can turn on the cassette tape and turn the light on and turn the two off. So now our power wheelchair is not only getting us around our environment, but allows me to turn things on and off in my environment.
We run into the problem of using this same joystick when we operate our communication aid, as we've just demonstrated. And here's our communication aid set up to operate with a joystick. And now we look at a way of interfacing the two.
There's a very inexpensive item that can be plugged into both our power wheelchair and into our communication aid. I'll plug it into the power wheelchair first, and then we'll plug the other end into our communication aid. And this allows us to communicate and also use our power wheelchair with the same joystick. Let me demonstrate that.
First we can now scan into the speed mode and actually come in and drive into our room. We can scan into the environmental control mode and maybe turn on a little music. And then, finally, we can scan over to our communication aid mode, and I can communicate.
Computer Voice: Good morning.
Richard Dodds: Now for some individuals, the total package may be the way to go. For other individuals, maybe just the communication aid, or maybe just the power wheelchair is all they need. When we look at technology, we look at bringing all these things together as parts or as a whole to provide services to people with disabilities. Thank you.
Rehabilitation technology seeks to use commercially available devices to solve a lot of those problems that people have with disabilities in getting around in everyday life.