Life on Wheels (101 page)

Word-prediction software puts up a numbered list of words on the screen as soon as a letter is pressed, suggesting what the program “thinks” the desired word might be. You select a word by typing its number. If the word you want has not appeared, you type more letters until it does appear. The software learns by remembering the words that you use the most, making them more likely to appear sooner on the list. With experience, you will usually only need to type a few characters per word.

Macro software lets you define keystrokes (usually in combination with the Control, Alt, or Option modifier keys) to enter blocks of standard text—for example, the closing for a letter. Many programs also allow you to automate command functions and sequences. You might enter a single keystroke to open your email program, tell it to check for mail, and enter a password. Macro software has been available for some time and is incorporated into the Microsoft Windows operating system. The Macintosh operating system also includes many powerful shortcut tools.

Some users are unable to hold down two keys simultaneously. Functions that use the Control key, for instance, become inaccessible. “Sticky Keys” allows you to press one key then the other, and the computer will react to them as if they had been pressed together. This is another standard feature of both Windows and Macintosh system software.

The standard computer keyboard is a set of small keys that you press with your fingertips. The standard keyboard requires dexterity and accuracy beyond the capacity of many people, whether paralyzed by injury or stroke, restricted by arthritis, missing fingers or limbs, and so on. There are keyboards available with large pads sensitive to touch; it is not necessary to press down on a key. Another design allows you to rest your hands directly on the keyboard and apply a slight additional pressure to select a key. There are also keyboards designed for one-handed use.

Most adaptive keyboards work in combination with abbreviation or word-prediction software or allow you to use macros to define keystroke shortcuts. Designers try to make use of all available features to ease the physical demands of computing.

Once it is possible to position a pointer on the screen and initiate a “click” that transfers your intent to the machine, you can do quite a lot. An onscreen keyboard allows you to click on letters and commands by simply allowing the cursor to rest on a button for a user-determined pause. A physical keyboard is no longer necessary.

The cursor can be manipulated using a standard mouse, trackball, or pen and pad. For those with no hand use, a “head cursor” can be used, of which there are two types. One senses an object, such as a small, sticky dot placed on your forehead or eyeglasses. Another calibrates to your pupil, whereby you move the cursor with your eyeball, rather than the movement of your head.

People whose speech is impaired now have access to augmentative communication devices that function as the person’s voice. These increasingly powerful and portable devices allow the user to piece together sentences with a variety of buttons on the fly or to preprogram sentences or whole speeches. Many people have great difficulty speaking but have enough dexterity with their hands to operate the device. People can have conversations or make public presentations using this technology. Originally the size of a small desktop computer, augmentative speech products now come in sizes as small as your hand.

The Trace Center at the University of Wisconsin at Madison was established in 1971 to address communication needs of people who cannot speak. In the early 1980s, they began to receive funds from the federal government for research in adaptive technology. The Trace Center has worked with computer companies to promote and integrate disability access features. They coordinate conferences and provide publications, such as a 900-page resource book. They continue to pursue research on a variety of computer platforms, including Macintosh and UNIX. Many staff members have advanced science and engineering degrees and play a significant role in the development and promotion of adaptive technology.

People with quadriplegia lose a substantial degree of independence and, naturally, want to regain as much independence as possible. They necessarily employ personal assistance for dressing and other personal matters, but they also need help operating a light switch, opening a door, answering the telephone, or turning the television on or off.

Computers to the rescue. Systems are available that allow almost complete control of the electrical systems in your house, even for people with no use of their arms. Such systems can be controlled by puff-and-sip control, voice command, or switches—of which there are many types that require minimal dexterity and accuracy.

An example of how such systems work is that a menu, shown on a small display, shows programmed options, such as telephone, lights, bed, and television. You rotate through the choices and choose one, for example, lights. Another set of choices appears, for example, main bedroom fixture, bedside lamp, and hallway light. Once again you scroll through the choices and choose. For a telephone, commonly called numbers can be programmed into a speaker phone that requires no hand use. The menu will also include the operator. Some local phone systems provide special services to disabled customers, such as free operator assistance to dial numbers. Chapter 7, Home Access, further discusses environmental control systems.

People can get hurt using computers. Injuries are typically referred to as cumulative trauma or repetitive strain injuries. Computer users with disabilities need to pay special heed, since the primary locations of computerrelated injuries are in the upper extremities—hands, wrists, elbows, and shoulders. For people with a disability, the additional impairments of injured arms or hands are the last thing that they need.

Although having computer skills and using them in the workplace improves your ability to work full time and earn the same pay as nondisabled workers, be vigilant about protecting yourself from overusing your arms, wrists, hands, or shoulders. Learn something about ergonomics—the science of how to relate your body to your work—and develop a work style that does not exceed your body’s ability to remain healthy:

There is much available information about ergonomics now—in books, on the Internet, from consultants, and from people assigned to the job in larger companies. There is no reason for someone today to develop the chronic pain that has already struck many thousands of computer users and has forced some to give up or change careers.

Ergonomics means being comfortable and using the body efficiently. Ergonomic skills at the computer or workplace are similar to the ergonomic skills you learn for using a wheelchair—conserve energy, move smoothly, and take care not to overexert and overstrain your tissues. Be aware of what you feel, and don’t accept discomfort. Fatigue and discomfort are messages from your body telling you to slow down or make a change in how you use your body. When you are in pain, there is always a cause. Ergonomics as a discipline is about identifying that cause and making changes to the physical setting or work habits to prevent pain.

Muscles—even small ones—are not made to be held in continuous contraction. The flow of blood is substantially reduced when a muscle is in a fixed, “static” exertion—even at a low degree of effort. Particularly for people with limited muscle capacity, being able to make the most of what you have is an even higher priority. When you lean in toward a computer screen, work with arms extended to reach a mouse or keyboard, continuously hold a mouse button, or keep your head in a fixed position for a long period of time, you are making those muscles contract without rest. A computer screen that is too high or low will make your neck and shoulder muscles work constantly. Low-level, continuously held exertions eventually become a source of pain as you exceed the limits of muscle tissues and they begin to send out messages to cease and desist!

Sit as upright as possible without effort, letting your skeleton carry you so your muscles don’t have to. Good posture becomes more complicated when fewer muscles are working in your body or if you have a spinal curvature or other asymmetry of the body. The higher a spinal cord injury (SCI), for instance, the less of the trunk muscles are working and the greater the tendency to have to sit in rounded postures for stability. A person with such an injury using a computer needs to take care not to encourage increasingly rounded postures.

Wheelchair users sitting at desks have extra challenges. Ablebodied workers sit in chairs that rotate on a stem, so that they can turn to other areas of the desk or workstation without twisting their bodies. Wheelchairs don’t rotate sideways, so you must twist your body to reach to the side. To compensate, keep objects you use most—keyboard, mouse, telephone, paperwork, stapler, and so on—close to you, within easy reach, and more in front of you than to the side. If you turn from the computer to work on some papers or make a phone call, first take the time to turn your wheelchair so that you can still sit straight.

Take advantage of shortcuts and efficiency tools built into your system and applications to help address the problem of cumulative trauma injuries. Why press any more keys or click any more buttons than you have to? Make an art of finding how few clicks it takes to do your work. You will be protecting yourself in the process.

Ergonomics is really about common sense: listening to your body and taking care of yourself. If you eat a balanced diet and drink less coffee and more water, you will lower your risk of injury. If you make a point to breathe, relax, and let go of muscle tension, you lower your risk of developing a repetitive strain injury. If you mix tasks and take regular, small breaks from computing, using your body in a variety of ways throughout the day, you further lower your risk. If you make comfort a high priority, you can safely take advantage of the power and creativity possible through computing.

Any school in the US that receives federal funding falls under provisions of the Rehabilitation Act of 1973 and, therefore, has been required for some time to make facilities accessible. In 1975, the Individuals with Disabilities Education Act was passed, which helps ensure that children with disabilities get access to public education according to their abilities. These children have historically been placed in “special ed” and fallen far short of their intellectual abilities—and so have been denied the chance to aspire to higher achievements. With more children moving through public schools, more students with disabilities are arriving on college campuses, where this growing demand has helped foster the availability of services for students with disabilities.

Education is a definite advantage when it comes to employment. A study by economists Douglas Kruse from Rutgers University—a wheelchair user with spinal cord injury—and Alan Krueger at Princeton University found that more than half of college graduates with SCIs were employed in the study sample of nearly 6,000 persons; only one-sixth of high school graduates were employed. Those with a college education earned 60% to 75% more than those with a high school diploma.
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Your first priority is getting an education at the school you prefer, rather than choosing the most accessible school. Identify what you want and then see what it will take to make it work. Contact the school you are considering and ask for the disabled students’ services office. They will have staff available to help you with a variety of needs, from housing to financing and transportation to personal assistance services, or ensuring that appropriate furniture is in the classroom.

Some older campuses are a little harder to get around. Older buildings are not so easy to adapt. In some cases, access to a course might necessitate its relocation to another classroom. If you are a manual-chair user on a hilly campus, you might consider using a power chair to get around.

Sheldon Ginns was a staff architect at the University of Michigan in Ann Arbor. In the early 1970s, he was the first to investigate what it would take to provide access on the campus. At the time, there were very few wheelchair riders. He found: