In the corner of Nuffield Orthopaedic Hospital in Oxford, the ACE (Aiding Communication in Education) Centre advisory trust building is a little like Dr Who's TARDIS. It appears small from the outside but huge within, and it is packed with technical gizmos. These may not transport its occupants across time and space, but will definitely provide children with physical and communication difficulties with the time and space to explore materials and facilities they would otherwise not be able to access.
The ACE Centre has an experimental ethic when it comes to technology. Around 60 per cent of the children they work with have cerebral palsy, and no two arrive at the centre with the same needs. For most of these children, using computers is usually not an option - not when controlling a keyboard and mouse is far beyond their abilities. The assistive technologies which ACE develops, though, help to make computer hardware and software simple, intelligent, and accessible enough that they can be operated using switches and presser pads - simple, single-mechanism peripheral devices - or even headpointers and eye motion control mechanisms.
The core user group for ACE are switch users. At the most basic level, switches can be used to control electronic toys and cassette players so that with one click a child can begin to understand cause and effect: if he pushes the switch once the robot dances and its lights flash; if he pushes it again it stops. Likewise, switches can be used with simple communication aids, allowing children to select words, usually represented by easily recognisable symbols, and hear them spoken back to them in a computerised voice. "Drink!" might be the selection. Such switches can be used as the trigger for playing a variety of games, and ACE have games tailored for every ability level and according to every form of learning difficulty.
But what about accessing computers? And, more importantly, what can computers do for these kids? The first step is finding mechanisms by which computers can be controlled. Eye trackers, which reflect low-resolution infra-red light from users' eyes, allow a cursor to be directed purely by eyesight. Similarly, sensors can be attached to a computer that monitor head movement and translate it onto the cursor. Useful tools, no doubt, but for many sufferers of cerebral palsy, motion control of any sort is not easy, and these tools alone will never be sufficient. In the same way, speech input devices and voice recognition software are restrictive rather than enabling for children who find pronunciation and enunciation a day-to-day struggle - whatever their underlying skills may be.
Concept keyboards and IntelliKeys keyboards are some of the most useful hardware products that ACE uses. These are intelligent, programmable keyboards that provide access to the computer for people who have difficulty using a mouse or standard keyboard. The user touches a printed overlay that has been placed over a touch-sensitive panel - on some products, up to A3 size. Areas on the printed overlay correspond to keys on a standard keyboard and to mouse buttons. The benefit here is that your keyboard can have as many or as few functions on it as you wish. At the other end of the scale, ACE uses tiny PDAs in work with children with muscular dystrophy, who find the miniature keyboard easier to use with much less strain on their wrists and arms. Colour screens now also make these much more attractive, usable, and creative tools for children: the sensitive screens even allow you to draw with just your fingertip.
Innovative technology like this is useless unless you have access to decent software though. ACE uses a variety of applications in its support work with children, and part of their operation is to develop software themselves. An important area for research and development has been word prediction applications. Predictors such as Prototype, Prophet or Penfriend sit on top of standard word processing devices and provide support by predicting words based on first letters or by common association. A child using a single switch can effectively begin to type using these items.
WordAid, developed by ACE, incorporates many of the features of a predictor but without moving the position of words in a list according to frequency and recentness of use or by association. It allows the user to decide where a new word should go in a topic list or whether, alternatively, it should go into an alphabetically ordered list where it is easy to find. WordAid reduces unnecessary keystrokes for slow typists or switch users because it directly interacts with the text being typed. WordAid2, now nearing completion, augments text with a layer of audio as well.
Another ACE product, AccessMaths, allows users to explore mathematics through shapes and measurements. Simple enough to be used with just cursor keys or a set of switches, it is also sophisticated enough to allow children to create highly detailed technical drawings. One student at ACE has created images of tractors and jeeps using thousands of tiny shapes - even going so far as to create the reflection of light on windscreens. Each tiny section and the degree of its angles can be measured using the programme. In fact, children can import images and measure these, thus reinforcing their mathematical skills through simple image analysis. The measuring tools can be operated with just a few keys, rather than a whole set of geometry instruments.
Though the term 'augmentative and alternative communications' fits the range of approaches ACE takes, it is primarily reserved for collaborative research they are conducting into electronic communications including websites and e-mail-based technologies. The WWAAC (World-Wide Augmentative and Alternative Communications) project is a pan-European initiative to make web and e-mail-based technology more accessible to people with communication, language and/or cognitive impairment.
Part of the project is dedicated to the development of customised browsers to enhance accessibility. These deliver websites modified so that function icons are bigger, URLs appear in larger font, and so that every user's homepage features their favourites list, each one accompanied by an image from that site. With much content on many sites unnecessary, site summaries may also be provided so that users can select only the sections they wish to see. What is more, browsers are being developed to account for the huge breadth of differently-able children. Planned as a fully automated, real-time process, there is much work to be done on the project and in the area in general.
Finally, SAW freeware, available to download from the ACE Centre website, is software that enables Windows packages to be controlled by one or two switches, a joystick, trackerball or a headpointer. It replaces the mouse and keyboard with a series of on-screen selection sets - arrangements of letters, words, symbols, numbers and shapes that can be automatically or manually scanned, item by item, and selected using switches.
Through a selection of software applications such as this, accessible hardware, and well-considered strategies for teaching, the ACE approach provides children with physical and communication difficulties the opportunities to begin exploring computers. The evidence at the centre is that these children can develop their writing, maths, cognition skills, as well as their creativity - in short, they are beginning to gain access to digital learning facilities that have traditionally been the privilege of fully-able children.
Links:
The ACE Centre - www.ace-centre.org.uk WWAAC - http://80.60.189.118/wwaac/
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