TASK FOR COMPLETION #2

Case Study 2 

Ian 

Ian is an 8 year 1 month old male diagnosed with spastic quadriplegia cerebral palsy.  He is fully included in a general education 2^nd grade classroom.  He attended a special education preschool, but has been fully included in general education since then.  He is nonambulatory and independently drives a power wheelchair using a joystick with his right hand.  Ian receives physical therapy three times per week for 30 minutes per session and occupational therapy two times per week for 40 minutes per session.  Ian uses speech to meet his daily communication needs.  His speech is generally intelligible to most communication partners unless he is tired or sick or otherwise has inadequate breath support.  He lives at home with both parents and a younger brother where English is the only language spoken.  Ian participates in boy scouts and therapeutic horseback riding once each per week. 

Ian demonstrates age-appropriate or higher receptive and expressive language skills.  He fully and independently participates in all academic activities in his classroom.  His teacher has no concerns about his cognitive abilities. 

Ian’s parents have recently expressed concern that Ian is unable to write independently and as the writing demands of school are increasing, he is becoming more dependent on others to write while he dictates.  They would like Ian to have the opportunity to independently engage in writing activities.  You are part of the transdisciplinary team that has been formed to determine the most appropriate assistive technology supports to provide Ian with independent computer access for writing.  Following are the results of assessments that have been completed by the team: 

Ian is unable to use a standard keyboard due his inability to isolate his fingers and his jerky arm movements when attempting to activate a small target.  When presented with an expanded keyboard, he experienced limited success in accurately selecting letters using the knuckle of his thumb.  But he also experienced numerous miss-hits due to his hand dragging across the surface of the keyboard.  When a keyguard was attached to the expanded keyboard, Ian’s accuracy increased and he was able to accurately type three words per minute.  The keyboard used a standard QWERTY layout and Ian expressed frustration in trying to find the letters that he wanted.

 

Next, the team tried the use of a head controlled system whereby a reflective dot was placed on Ian’s forehead and a camera mounted on the top of the computer monitor “read” Ian’s head movements to control the pointer.  An on-screen keyboard was used for text entry.  This system was tried with practice sessions one time per day for three weeks.  Each practice session lasted approximately 30 minutes.  After three weeks, Ian was able to accurately control his head sufficiently to type approximately two words per minute, but he had extreme difficulty dwelling on individual keys long enough to activate the key.  When the dwell time was reduced, Ian experienced multiple inadvertent activations.  Ian expressed extreme frustration in using the head controlled system and refused to try any more after three weeks. 

The team then introduced Ian to the concept of scanning using an on-screen keyboard.  He was able to activate a single switch with his right hand, but he was more accurate at releasing the switch than in activating the switch.  Ian easily grasped the concept of scanning, but it proved to be a slow process.  At the end of two weeks, he had achieved only 2.5 words per minute. 

The team then inadvertently discovered that Ian has a PlayStation at home.  With minimal assistance from his parents with set up, he is able to independently play some games.

Use the Feature List as a reference to complete the Feature Match Guide for AT for Ian.  The Guide has been started for you.  Identify potential hardware and/or software that best meets Ian’s needs.  Write a brief summary of the system you would recommend for a trial period.