Low Tech vs. High Tech

What is the difference between low tech and high tech in regards to Assistive Technology?

First, it is important to understand what is assistive technology to begin with.  To paraphrase many definitions that are available, assistive technology is the use of a device to assist with improving the function of the user.  For example, a pair of glasses can be considered assistive technology as they assist with vision.  A walker can be considered assistive technology as it helps with walking or ambulation.  There are also different levels of assistive technology, and this can be broken down into low and high tech devices.
 

Low technology does not require a power source.  Sometimes this can be the easiest and most practical of solutions in assistive technology.  Low tech devices are items that facilitate independence in an area as does high tech devices.  Examples of low tech are a cane for assistance with walking, a pencil grip for children with grasp issues, or even glasses to assist an individual with seeing their environment.  

Even if an individual can benefit from high tech assistive technology, it is always important that they have a low tech "backup".  Technology can fail, batteries die, and emergencies can happen.  In these cases, an individual will continue to meet their needs using their low tech device.  Also, low tech devices might be all a user needs.  High tech is not indicated for everyone.

Before we discuss high tech devices, there is another classification that many individuals use, mid tech.  The difference between mid tech  and low or high tech  is that mid tech has a battery source.  Typically, they have limited capability but do have a power source.  This can include communication devices that can be pre-programmed with single pre-saved phrases or simple remotes that can control an individual's lights.  

 Again, mid tech can also be an appropriate option for individuals.  They are simple devices that can facilitate independence for the user.

High Technology:

Users of high technology are typically individuals with significant functional impairments.  This can includes folks with spinal cord injuries, Lou Gehrig's disease, or muscular dystrophy.  Examples of high tech devices are:

• Communication devices with alternative access methods such as eye gaze
• Stand alone environmental control units, with alternative access, that can control multiple devices in the user's environment
• Computer workstations with alternative software and hardware for access, such as a head mouse or dwell click software 

These devices can assist a person with the most minimal of movement to independently communicate or control their computer.  

Funding can be a challenge for these devices and they can be quite costly.  Communication devices (or AAC devices) can often be partially covered by insurance companies.  A qualified professional can assist with the selecting the appropriate device for the user's needs and goals, as well as obtaining funding for best device choice.

What have your experiences with these forms of assistive technology?

Switch Use

What is a switch?


Switches are used with all forms of assistive technology.  The easiest way to think about a switch is a device that can start or stop a device.  The most common type of switch is activate with some kind of touch, creating the contact of two surfaces or switches to work with an assistive technology device.

What kind of switches are there?


There are literally hundreds (if not thousands) of switches available for assistive technology access.  Switches are meant to be accessed by the available body part or motion that is strongest for the user.  This area of access needs to be consistent and not create fatigue with extended use.  The area of access can also vary dependent on the position of the individual.  For example, a person might use their finger for switch access when in their wheelchair and a sip and puff switch for when they are in their bed.


When evaluating what is the best switch site, it is recommended to evaluate distal to proximal.  This means, start with the hands or fingers.  If this is not an appropriate site, what can be done as we move up?  Are gross movements easier than fine movements?  If the individual cannot use their arms, what other areas are appropriate?  


Addition considerations for switch use is the amount of force required to press the switch (if it is a tactile switch).  When looking at the "specs" of the switch, you can find the amount of force in ounces or pounds for access.  This is very important for an individual with limited movement or a harder switch user that needs a more durable switch.

How can a switch be mounted for access?


There are many ways that a switch can be mounted.  Switches can be mounted to a wheelchair, tabletop, or any other surface for best access.  If appropriate, Velcro can be instrumental in attaching a switch for access.  


If additional mounting options are required, a simple tabletop mount might be appropriate.

Removable mounts can be used that would attach the switch to a wheelchair, tabletop, or any other surface.  These mounts can be purchased with varying arm lengths and plate sizes.

More permanent mounting can be done in wheelchair components such as in the headrest.  Conductive fabric and clothing can be used to create novel switches, making it a part of clothing.


What if the user cannot "hit" a switch?


There are switch options for an individual with limited or lack of movement that would be required in order to touch a switch.


Sip and puff:  A sip and puff switch is a great option for users with limited movement or issues with significant fatigue when attempting to touch a switch. Through the actions of sipping and puffing, the user can control their assistive 
technology device.

Proximity:  A proximity switch is activated when the user gets closer to the switch.  Dependent on the switch chosen, the range of how close the individual the user has to get to the switch to activate it can vary.  This switch can be mounted pointing at any area for the user.

EMG switch:  An EMG switch is also known as a muscle twitch switch.  A muscle twitch sensor is placed on a muscle that can be used consistently without pain or fatigue.  When the user contracts the muscle, it activates the assistive technology service. 


Sound switch:  This is a switch option that has been around for sometime.  The Clapper is an example of a sound switch.  When the individual makes a sound, it activates the device such as a communication device.  There are very sensitive sounds switches available allowing for changes in the sensitivity, how loud or soft the sounds needs for access.  


To conclude, the importance of switches and their positioning is very important. If the individual is not setup with the best switch for the strongest access site the user will not be efficient or conserve their energy.  Through a full evaluation, an appropriate recommendation can be made not only for the device but for the appropriate access method. 

Light Controls

There are everyday tasks that we all perform without thinking about it that is very difficult for many individuals.  An example would be turning a lamp on and off.  


The fine motor skill needed to turn the switch could be severely impaired for an individual with Parkinson's disease or severe arthritis.  There a many reasons why it could be unsafe for an individual to attempt to get up and walk across the room just to turn a light on and off.  Getting up to turn on or off a light is not exercise but a necessity; if balance is an issue, it should not be attempted.  Think about the person that needs to use the bathroom in the middle of the night but cannot access their lamp.  This individual might decide to walk to the bathroom in the dark, putting themselves in an unsafe situation, possibly falling and creating a debilitating injury.  Also imagine the individual that sits in the dark because there is no one available to turn their light on for them.  There can be many simple solutions for this problem.


Touch Lamps:


Purchasing a touch lamp can be a great solution for those individuals that can walk to their lamps.  For the person that does not want to change out their lamps, touch lamp modules can be purchased at a fairly low cost.  These modules would eliminate the need to turn the switch inside the lamp.  The user would have to touch any metal part of the lamp to turn it on and off.

X10 devices:


X10 devices have been around since the 1970's and enable the user to turn any device on and off through a simple remote.  This is performed through a radio frequency transceiver and appropriate module boxes.  

The lamps (or other basic on off devices) are plugged into a module box.  A transceiver is plugged into a different outlet in the same room.  The remote, module box, and transceiver are all placed on the same radio frequency code; each lamp or device has their own number for the remote use.  When the individual presses the corresponding number on the remote, it will turn the lamp (or fan, alarm, etc) on or off.  This allows the user to turn on their lights without having to get up.  This can enable independence for a wheelchair user or for an individual with balance problems that could not safely walk to the lamp.  There are many options for remotes, some controlling one device, others controlling up to 16.  For individuals with more significant disabilities, many power wheelchairs or environmental control units have X10 capability.


The Clapper:

I couldn't talk about light controls without talking about the Clapper.  Often, when I discuss light controls with individuals they reference the clapper (thanks to all the ads in the 1980's).  The Clapper is a sound switch that controls lamps.  When the user creates the clapping sound, it turns the light on or off.  This is another perfect example of an adaptABLE world.  Yes, these are still for sale, I found them easily on the internet.