Amyotrophic lateral sclerosis (ALS), often referred to as “Lou Gehrig’s disease,” is a progressive neurodegenerative disease that attacks nerve cells in the brain and the spinal cord. Motor neurons reach from the brain to the spinal cord and from the spinal cord to the muscles throughout the body. When the motor neurons die, the ability of the brain to initiate and control muscle movement is lost. With all voluntary muscle action affected, patients in the later stages of the disease become totally paralyzed. In most cases, ALS patients do not experience impaired intellectual reasoning, vision or hearing. Eye muscles are not normally affected. (Sources: ALS Therapy Development Foundation; ALS Association)
Steve Nichols is a self-employed software engineer who has had ALS for nearly 10 years. As the disease progressed, he sought technology that would enable him to continue using the computer for both personal and professional reasons.
“I needed to maintain a computer system where I could continue developing software and satisfy all of my communication functions lost to ALS,” said Nichols.
As he began to lose mobility and could no longer type or click the mouse, Nichols used a variety of technologies for text input and speech output. He first employed an on-screen keyboard with a dwell cursor mouse, which tracks mouse movements and clicks when the user pauses. He operated the mouse with his shoulder.
When his shoulder would no longer support moving the mouse properly, he went to a single switch scanning system. The system works by sequentially scanning items on the computer screen. Once the correct item is highlighted, the user selects the item by pressing a switch. Nichols powered the switch using his legs.
“While this system is very versatile it is slower than having the ability to directly select the item you want to click onto, so I turned to eye tracking systems,” Nichols explained.
Because eye muscles are usually unaffected by ALS, eye tracking systems can be extremely useful and sometimes the only option for operating a computer. However, the eye tracking system Nichols first selected, while functional, did not meet all his needs: “It’s bulky, needs a separate monitor and computer, needs a second PC to provide Internet access and access to Windows and applications, and its cost is enormous comparatively. I wanted a system that was truly portable, provided access to the Windows environment for Internet access and applications, provided a wireless capability for true mobility when traveling, was easy to use, and was a fair price.”
Originally developed at the University of Virginia, the ERICA system has evolved over 20 years and now allows eye-driven control over all Windows software. This enables users to speak, write e-mail, surf the Internet, create documents or play games solely through eye movement. No keyboard or mouse is needed.
The ERICA system works by determining where its user is looking on a computer display. The system uses a camera and infrared light to create effects off the user’s eye. These effects are used to compute where someone is looking. The mouse cursor goes directly to wherever the user looks on the screen, and clicks wherever the user dwells.
The camera and light source are compact units that can be used with any Windows-based desktop, notebook or tablet PC system. No separate computer is needed. These devices can also be mounted on a wheelchair. The system is noninvasive, requiring no attachments to be worn by the user.
ERICA works with any Windows-based Augmentative Access and Communication (AAC) software designed for persons with communication impairments. The system has its own onscreen keyboard with voice output. ERICA can also be used for environmental controls, such as turning lights on and off. These controls work via a USB port and infrared remote control to access devices around a home or office.
ERICA’s imaging system is fully integrated into the Windows 95, 98, ME, NT, 2000, or XP platforms.
Nichols first demoed the ERICA system on a notebook PC, but then discovered that Eye Response was offering the system on the Motion Computing tablet PC.
“It wasn’t until the Motion tablet version became available that I was intrigued/impressed enough to procure one,” said Nichols.
According to Chris Lankford, Eye Response’s chief technology officer, users like the portability of the Motion tablet with its integrated wireless capabilities, clipboard-sized shape and bright 12.1-inch screen. The slate-style tablet was designed without an integrated keyboard, so it weighs only about three pounds and has no hinges or clasps to manipulate. The tablet also has a full-fledged operating system, Windows XP Tablet PC Edition.
“It’s a fully contained portable system,” said Lankford.
Nichols began using the ERICA system on the Motion tablet in August 2003. The system is mounted on his wheelchair, where he uses it exclusively without the need for a separate monitor or computer. He has an adapter for powering the system from the powerchair battery. In his three-story home, he has access to two floors and can use the system wherever he goes in the house. With an 802.11b wireless network, he can also connect online wherever he roams in the house. The tablet’s integrated wireless capabilities are also useful for traveling.
As Nichols says, “This system allows me to not only use it in different rooms, but different floors as well. It has also proved its utility for traveling. The week after I received it, I took it on a five-week cruise to Russia. It provided communication and Internet access via the 802.11b. Likewise at the inns we have visited. We are frequent travelers.”
Nichols said he also selected ERICA on the Motion tablet PC because of its affordable price.
In addition to using the onscreen keyboard and speech engine for daily communication, including e-mail and instant messenger, Nichols uses ERICA for software development, TV and DVD/VCR control, environmental controls (lights and appliances), online bill paying, managing finances, bookkeeping (via Quicken) and games.
Since releasing it in August 2003, Eye Response reports that it has sold the ERICA system on the Motion tablet to about 50 users. Most are ALS patients, with a few assisted technology centers using the system to show what is available to people with disabilities.
For more information on Eye Response, visit www.eyeresponse.com.