Electronic aids for daily living

Abstract

OVERVIEW Electronic aids for daily living (EADLs) are devices used to help people access, operate, and control electrical appliances in the home, school, or workplace. The primary purpose of an EADL is consistent performance of necessary daily tasks. These devices also maximize functional ability and independence. Other names for EADLs are environmental control systems and environmental control units. Persons who use and benefit most from these devices are those with severe physical limitations that affect their mobility and upper limbs. Common diagnoses are tetraplegia, muscular atrophy, muscular dystrophy, cerebral palsy, multiple sclerosis, and amyotrophic lateral sclerosis. EADLs are controlled either by an ability switch, touch screen, voice recognition, or integrated with other controls; controls can be integrated with computer access, wheelchair controls, or augmentative communication devices. For persons who use a switch to operate an EADL, a dual switch offers more control by allowing them to scan and select at their own speed and ability. Single-switch operation requires the user to activate the device by scanning through a list of choices, which limits the speed of operation to the scanning speed programmed into the unit. Integrated controls that operate an EADL are helpful and often necessary when a person has a limited number of switch-control sites available. For example, by integrating controls, a person can operate an environmental control system through the same controls (sip'n'puff switch, joystick, head array, etc.) used to operate a wheelchair. CATEGORIES Two broad categories of EADLs exist: computer-based and stand-alone. A computer-based EADL is a combination of hardware and software that is added to a computer system and allows control of the environment. A standalone EADL does not rely on a computer for its function. In general, a computer-based voice-activated EADL can offer superior voice recognition, vast amounts of visual and auditory feedback and prompting, and superior programmability. Although a computer-based system can be used for other functions in addition to control of the environment, the system becomes more vulnerable to viruses, glitches, and crashes. Stand-alone EADLs are not subject to the general vulnerabilities that can plague a computer system that is used for multiple applications. Stand-alone systems usually offer fewer options in terms of feedback, prompting, and programmability. Stand-alone systems are often more easily transported. Additional EADL resources can be found in the Appendix (available online only at http://www.rehab.research.va.gov). EADL feedback to the user may be visual or auditory. Visual feedback can be either static or dynamic. Static visual feedback could include a fixed label on each option. Dynamic visual feedback allows the options to change in accordance with the user input or option being presented. Auditory feedback could be in the form of a beep or a given word or phrase. Depending on the EADL, a combination of visual and auditory feedback is possible. DEVICES TO CONTROL Common types of electrical appliances controlled by EADLs are telephones, lights, door openers, door locks, fans, drapes, blinds, beds, audiovisual equipment, home climate controls, call systems, and security cameras. These appliances are usually controlled by one of the following methods: (1) infrared (IR), (2) X-10, and (3) direct connection. IR controls many different appliances in the same way a television remote control. IR transmission requires line of sight. As a result, the controlling signal cannot operate a device located in another room or even in the same room if the two devices cannot see one another with a ray of light. If a device requires IR control, an IR extension cable or distribution box can be used to extend the signal to the remote area. Alternatively, IR can be transformed into a radio frequency (RF) signal, which will allow more pervasive transmission of the signal. …