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Communication Devices for Stroke Victims?
chowbok asks: "My grandmother recently had a stroke, which left her with the inability to speak or move the right half of her body. It also seriously impaired her motor skills on the half she can move, so she can't write. She does understand what is said to her, but she has no way to communicate. I'd like to set something up for her so that she can write notes. What I have in mind is a keyboard with rather large keys (perhaps 2" square) and a screen or monitor of some sort. I'm sure they make such stuff specifically for stroke victims, but anything labeled 'medical' will undoubtedly be astronomically expensive, even if it is a rather simple device like what I have in mind. I thought it would be easier to build one or find something similar (perhaps a toy or some such). I thought Slashdot readers might have some good suggestions along these lines. I'm not totally against doing it with a computer with a modified keyboard, but that seems like overkill when all I want is really a 'video typewriter'. Has anyone seen anything that might work for my purposes, or might serve as a good starting point?"
I found it by searching google for "really really big keyboard" ... no joke.
A man talking sense to himself is no madder than a man talking nonsense not to himself.
I'm not totally against doing it with a computer with a modified keyboard, but that seems like overkill when all I want is really a 'video typewriter'.
...
No, you want a computer.
Why, you ask? So that you can get some sort of predictive typing interface. You'll probably also want something that allows easy one or two key selection of common words and phrases.
That way your grandmother won't have to type as much, or feel self-conscious as
P E O P L E
W A I T
F O R
H E R
to laboriously type out sentences which they've probably already guessed.
Suggestion: predictive typing based on words already typed, with a completion list mapped to a meta key and some other key, and a special meta key that pops up a list of words and phrases, each mapped to a single key:
A - "Hello"
B - "Goodbye"
C - "Visiting hours are over, you annoying cretin"
Ok, maybe not that last one.
If she's especially immoble, you might even use a two button mouse, and some Huffman encoded alphabet that includes stock words and phrases. While learning the Huffman encoding might be laborious, this could be made considerablly easier with large on screen prompts:
> Press mouse button one to select any of "A E I O U", press mouse button two for any other letter or word.
> You pressed mouse button one. Now press mouse button one again for the letters "E" or "A". Press mouse button two for "I O U" or to start over."
> You pressed mouse button two. Press mouse key one for "I". Press mouse button two for "O" or "U" or to start over.
Opinions on the Twiddler2 hand-held keyboard?
Couple of ideas here.
You don't want to make it painstakingly slow for her to type out a sentence. That makes it really hard for even an oversized keyboard to work.
A keyboard with 2" keys will be over 28" wide. Moving from key to key will be even more difficult when her arm gets tired. Keyboards are optimized for two-hand use; it's tiring enough using even a regular keyboard with one hand. (Stop it! This is serious!)
A version of T9 input gets around the size limitation; she could operate a 6"x8" pad easily without moving too far. If there was a custom app that let her tree down through word lists, that would be ideal. Say she wants to say "granddaughter." She hits the 4-G-H-I key once and a pointer scrolls to the G's. Then she hits the 7-P-Q-R-S key three times to get to the gr's (a list of perhaps half a dozen words). She could hit the 2-A-B-C key once to narrow it down further, or use a scroller wheel to select the right word. If a word does not exist in the database, she can enter a non-matching mode to tap in the word so she can use it later.
Another method, if she has even less dexterity, is a joystick or wheel that can scroll through letters and words, perhaps in a directory-like fashion as above. Only requires two basic movements and a button press, and hardware is easily custom-built. Common phrases can be added, or even custom mad-libs type templates for common conversation topics, requests, etc.
Hope this helps in some way!
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There was an interesting presentation at last year's OSCON by someone who developed something like what you describe in Perl/Tk for a quadriplegic friend.
83chrise.nuf
if you're willing to do something in the interim, my wife's grandmother had a plastic coated sheet of paper she used when she was in the hospital and couldn't talk. It was divided into grids and had pics and words for common phrases such as "i'm tired", "i'm hungry", "it hurts.. (then a drawing of the human body for her to point to)", "i'm thirsty", lots of others. they actually had it at the hospital, but it would be easy to make one up. maybe several with different sets of phrases even..
Free Webmail
They also sell a programmable foot switch with a keyboard interface for $120.
-- ;-)
Kuro5hin.org: where the good times never end.
I do not know how serious "seriously impaired" is. But even a large keyboard may require too much mobility/flexibility to operate efficiently. While it does not seem from your post that her condition is as bad as Hawking's (ALS a.k.a. Lou Gherig's Disease (sp.?)), she may benefit from an interface similar to his.
According to this old write-up on Hawking's website, he uses a simple DOS interface. A cursor moves across the screen (through the letters?), and he stops it on the desired letter with a click of a button. Now, this could be improved upon easily if your grandmother has slightly more mobility, though it requires some reaction time. Add word-guessing software (and sentence guessing) that learns her most common words to help speed up text entry, as per the suggestions above. I envision a two button device... a hacked mouse for example... where the left button selects the letters from a scrolling cursor, and the right button selects the words that pop up as suggestions simultaneously.
A cursor scrolling through the letters, stopped on "G"... "A" was entered first:
A B C D E F G etc...
She enters: A G
Suggestions List: (pops up under the scrolling cursor, so she can continue to enter letters if she likes, as the suggestions narrow)
AGE
AGO
AGORAPHOBIA
- - - - - - - -
AGE COMES BEFORE BEAUTY.
AGED BEEF TASTES BETTER.
etc.
As she becomes accustomed to the software, you can gradually increase the scroll time through the letters; and, as she enters more and more text, the system will get better at guessing what she will say and rank the probable selections higher in the list. Also, depending on how many buttons she can use (2 is quite enough), you can add certain functions to combinations of clicks. For example, Hawking lacks an "undo" button. Here, you could make it 'right click - left click - right click' in relatively quick succession. Or, to switch to numbers and punctuation, you could program it so that she pressess both buttons simultaneously, or set it to another combo, etc.
Finally, a quick google shows a project working on open source (albeit VB) software to improve upon Hawking's interface while keeping in mind the poor mobility of ALS victims.
shameless plug: Prentke Romich makes dedicated speech output devices. Pre-stored words and messages can be stored and retrieved efficiently. Call the 800 number and they will put you in contact with a local speech-language pathologist (also a company rep) who can help you choose the correct technology and device. /shameless plug
Your sentiment in trying to find your grandmother a keyboard to communicate with is admirable but I think that perhaps you might do better to speak to the speech pathologists at the institution where she has been hospitalized and is receiving rehabilitation. The problem is that a left middle cerebral artery territory stroke (of which you are describing a partial territory stroke given preservation of comprehension) is that it isn't just the motor functions with the right hand that are destroyed, but the actual LANGUAGE areas as well... meaning that not only can she not move her mouth, but the part of her brain that used to deal with finding the right words to express a concept are also gone. The result is that in many cases such patients not only are unable to speak, but also are unable to write (and presumably also unable to type). Your speech pathologists may be able to help provide you with alternate forms of communication with pictureboards etc which will likely be cheaper and more workable than oversized keyboards which she may be able to use anyway regardless of motor limitations if her expressive language areas have been destroyed by the stroke.