Expectations Around Eyegaze Lynne Allsopp Occupational Therapist Access

Nigel • 41 year old IT worker with basilar artery CVA with cerebello-pontine infarct

Referral to ACT • Originally referred when in acute care • Referral rejected –

Rehab Goals • Transfer with hoist with 2 • Sit in tilt in space

Initial ACTappointment • Goals – to develop head switching skills through EC • To

Communication • ‘On admission he could only communicate yes and no via vertical eye

Eye Movement • Initially vertical • On discharge, some movement to the right noted

Eye Gaze Trial • Initially when in Acute setting: • Able to calibrate but

2 nd Review Apppointment • • October 2017 At home since July Excellent use

Emego • Emego uses electromyography (EMG) to let the user control applications via a

Brain Fingers Use minuscule muscle movements or the brain’s electrical signals to control a

ACTion Switch • EMG switch • Can be fined tuned

3 rd Review Appointment • Nigel’s goal is to access his music on his

Key Learning points • • Use of language in reports The importance of visual

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Expectations Around Eyegaze Lynne Allsopp Occupational Therapist Access To Communication and Technology

Nigel • 41 year old IT worker with basilar artery CVA with cerebello-pontine infarct 4/06/2016 on holiday • Presented in hospital with reduced GCS and found to have DKA • Tracheostomy • PEG • Catheter (from March 2017)

Referral to ACT • Originally referred when in acute care • Referral rejected – team advised to develop low tech – 20 questions, PAS, eye pointing • Re-referrred once in an in patient rehabilitation unit

Rehab Goals • Transfer with hoist with 2 • Sit in tilt in space chair for up to 3 hours • Explore ability to use head control to allow use of a communication aid • Maintain joint ROM • Explore low and high tech communication aids • To explore swallow assessment

Initial ACTappointment • Goals – to develop head switching skills through EC • To develop low tech strategies • Team still convinced that eye gaze will offer a solution

Communication • ‘On admission he could only communicate yes and no via vertical eye movements’ • Low tech options tried – visual communication symbol and written charts, auditory scan of alphabet • Categorised communication chart

Eye Movement • Initially vertical • On discharge, some movement to the right noted – ‘associated with Nystagmus and diplopia on the midgaze’ • ‘Nigel has been assessed by the local ACT service to look at eye gaze, to which he is keen to continue to aim for as a future goal’

Eye Gaze Trial • Initially when in Acute setting: • Able to calibrate but only cope with 6 options on screen • 2 nd trial with different company – cause and effect • 3 rd trial in rehab – December 2016 with 1 st company

HAAT Model

2 nd Review Apppointment • • October 2017 At home since July Excellent use of low tech Joint Appointment with physio – full assessment of movement • Eye/eyebrow movement is the only option

Emego • Emego uses electromyography (EMG) to let the user control applications via a wireless switch sensor. Created for those with severe disabilities to retain independence.

Brain Fingers Use minuscule muscle movements or the brain’s electrical signals to control a PC. The headband software can be completely adjusted and customised to specific individual needs with a wealth of options. From switch-like integration to mouse control,

Scatir

ACTion Switch • EMG switch • Can be fined tuned

3 rd Review Appointment • Nigel’s goal is to access his music on his computer • Plan – Use Grid 3 on Nigel’s desk top PC with simple Grid set and Scatir or ACTion switch

Key Learning points • • Use of language in reports The importance of visual assessment Whose goals Low tech AAC is a personal issue Importance of support and environment Timing of introduction of eye gaze How do we prove its not a financial decision