Minimizing the Digital Divide for Individuals with MS – Part 1

The Importance of Assistive Technology

By Carrie Bruce, MA, CCC-SLP, ATP
Computers are frequently used for various tasks at work, in the home, at school, and in other community settings. For individuals with a chronic illness or disability, computers can be a bridge to independence and an outlet for expression. Based on data from 1998, however, individuals without a disability were almost twice as likely to have a computer at home, and nearly four times as likely to access the internet, as compared to those with a disability (Kaye, 2000).

The disproportionate number of computer users who have disabilities may be due to a variety of factors, including physical access to the equipment. Standard or off-the-shelf computer systems are frequently not accessible to individuals with disabilities without some type of accommodation. Alternative access for a computer may involve assistive technology (AT), strategies, or modifications to tasks.

The term “AT” refers to any product that is used to increase, maintain, or improve the functional capabilities of an individual (adapted from PL 100-407, the Technology-Related Assistance for Individuals with Disabilities Act). Assistive technology products exist for mouse access, typing, viewing information, reading, and a host of other activities on the computer. These products can be divided into hardware and software options, and represent technology that may be specialized, devices that are fabricated, or items that are available in many office stores.

Individuals with MS can benefit from the full range of AT options available for the computer. When working on the computer, individuals with MS may experience typing difficulties, problems seeing the information on the monitor, trouble using the mouse, and/or cognitive issues that make operating the computer a negative or challenging event. These concerns can impede access to peer support groups, medical information, contact with family and friends, shopping, and recreational resources, which are vital aspects of daily living for many individuals.

Seating, Tables, and Workstations

Physical access to the computer starts with comfortable and supportive seating, as well as proximity to hardware. Seating is an essential component for accessing any environment and should be addressed as the centerpiece of computer access. Improper seating can affect muscle strength as well as endurance, and can lead to additional health and function issues if not dealt with properly.

If an individual uses an office chair, many options are available for adjustable seating. Basic adjustable seating can be found at office supply stores and will certainly be less costly than more flexible systems offered by seating specialists. Seating specialists or ergonomic seating distributors offer chairs with more features that can accommodate a wider range of needs, including those which fall outside the typical seating spectrum. Examples of such needs include contractures, circulation problems, pressure relief, and other position-related issues.

Some of the features to look for in computer access seating are:

• Comfortable seat cushion
• Height-adjustable seat
• Adjustable armrests
• Pelvic tilt
• Adjustable backrest
• Easy-to-use knobs and levers

Individuals who use scooters, manual wheelchairs, or power wheelchairs may have difficulty transferring to another seat, or they may prefer not to switch to other seating for computer access. In either case, seating is less of an issue since the scooter or wheelchair should already be properly fitted, but proximity is still important.

Height adjustable tables or table risers (blocks or extensions that are placed under existing table legs) can provide room for the wheelchair or scooter to be positioned comfortably under the table. If the individual does not need to be close to the table because he or she uses a laptray or doesn’t use a standard keyboard or mouse, the monitor can be placed within viewing range or mounted on a moveable platform.

Other options are available for individuals who feel more comfortable in positions other than the typical upright position. (Brand names of specific products are given after each listing.)

• A self-contained workstation and chair with headrest, attached as one unit that moves simultaneously to a semi-reclining position of 20 degrees or forward tilt of 10 degrees. (Aptus®, NetSurfer®)
• A mobile, tilting, computer support frame that straddles the user’s own bed or recliner. (ErgoPod®)
• A portable work surface that resembles a tilted TV tray that is designed to hold a book or laptop computer while the user is reclining on a couch or bed. (Laptop Laidback®, KayJae®)
• A hospital over-the-bed table with a tilting feature to allow a laptop computer user to work from a somewhat reclined position. Some models may not have a “lip” along the edge to hold the laptop in place while tilted, in which case the bottom may be secured with Velcro. (Rolling Ergo Desk Mate®)
• A steel frame, which supports an adjustable monitor, arm, and attached pull-out keyboard tray, that is positioned over the users recliner or easy chair. (EasyChair Workstation®)

Computer users with MS can experience numbness, pain, tingling, and circulation issues. Seating should be investigated to make sure it isn’t making things worse. Simply by adjusting the seat, changing the seat cushion, or repositioning one’s body may help. Ideally, if an individual has specific seating needs or will be spending a great deal of time on the computer, he or she should receive an ergonomic seating assessment by a professional. Some professionals who may provide ergonomic seating evaluations include occupational therapists, assistive technology specialists or practitioners, physical therapists, ergonomists, seating specialists, or rehabilitation engineers who may provide ergonomic seating evaluations include occupational therapists, assistive technology specialists or practitioners, physical therapists, ergonomists, seating specialists, or rehabilitation engineers.

For More Information

The next two issues of The Motivator will feature parts two and three of this series on “Minimizing the Digital Divide for Individuals with MS.” Part two will include information about computer hardware, primarily the monitor, mouse or cursor control, and keyboard. Part three will discuss AT software programs and other ways to use the computer to enhance quality of life.

For additional information on assistive technology or computer access, please contact the Center for Assistive Technology and Environmental Access (CATEA) at Georgia Tech by calling (800) 726-9119. Many of these products can also be found online at http://www.assistivetech.net.

Reference

Kaye, H. S. (2000). Disability and the Digital Divide. (Disability Statistics Abstract Rep. No. 22). Washington, DC: U.S. Department of Education, National Institute on Disability and Rehabilitation Research. Retrieved May 19, 2004, from http://dsc.ucsf.edu/view_pdf.php?pdf_id=20