ERCIM News No.28 - January 1997

Provision of a Communication Device for a Homebound Amyotrophic Lateral Sclerosis Client

by Takuro Hatakeyama, Fumiko Osawa and Akira Hakuno

The Yokohama Rehabilitation Center is designated as the core facility in the rehabilitation service system for the physically and mentally handicapped people in Yokohama, which is the second largest city in Japan. The center provides comprehensive rehabilitation services in medical, psychological, social and vocational fields by 28 different types of rehabilitation specialists. One of the current focuses of the rehabilitation engineering department is the development of telecommunication systems and human machine interfaces for people with severe physical disabilities.

The provision of communication devices for clients with Amyotrophic Lateral Sclerosis (ALS) is one of the greatest challenges in the field of Augmentative and Alternative Communication. Since 1991, in our outreach service, we have been working with a 65 year-old former government officer with ALS in an attempt to maximize his communication ability. Due to his high cognitive function and communication needs, a single switch environmental control and communication system was provided.

The system enables him to switch on a light, a TV set and activate a calling device, as well as operate an auto-scanning word processor. He has been actively utilizing this system for the past five years. Over this period, as his physical function declined, it was necessary to develop two more input devices. Using the word processor, he was able to write about his battle with Amyotrophic Lateral Sclerosis.

The key factor in the successful provision of communication devices is the integration of both environmental control and communication means. In this case his ability to manipulate equipment around him through the environmental control system was more meaningful for him than we had previously thought. This direct manipulation not only enabled him to maintain a partially independent life style, but also provided him with a feeling of well being and a sense of freedom which one feels when one is in control. Therefore, in the initiation of an act, both communication and environmental control have equal value.

Moreover, these feelings were the source of motivation to keep him going and assure him of inner peace, emotional and spiritual stability which are the foundations of his life. We believe that this device was a major factor in the maintenance of a high quality of life for the past five years in spite of his very limited physical freedom.

Please contact:
Takuro Hatakeyama ­ Yokohama Rehabilitation Center
Tel: +81 45 473 0666

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