Physical and Motor skill impairments in Students

This page talks about:

1. Basic information about Physical and Motor impairments
2. Types of motor disabilities
3. Assistive Technology
4. Reading: technology that students can use
5. Writing: technology that students can use
6. Using hardware in a classroom to make life easier
7. Other information to help
8. Final thought

Basic information about Physical and Motor impairments:

Children with physical disabilities find gross movements difficult and may also have difficulties with finer movements, or a combination of both. Many students with physical disabilities cannot write or type, others can only do so at a slow pace and the end result may still be illegible. To be considered a disability, the problem must cause a person to have motor coordination that is significantly below what would be expected for his or her age, and the problem must interfere with the activities of learning and daily living.

Access to the curriculum can be difficult for children with physical disabilities. Unfortunately, many aspects of the curriculum were inaccessible to these children until the advent of Information and Communication technologies (ICT) in recent years.
Peripheral devices and other ICT equipment can be used to compensate for students' lack of motor control. Innovative educators have begun to recognize the potential of computers to compensate for the loss of normal means of access to educational materials and other resources.

Christopher Reeve was asked in an online, chat-based interview if he saw "this medium of cyberspace as one that's particularly useful for people society labels as 'disabled?'"

Mr. Reeve replied: "Yes. [The Internet is] an essential tool. And, literally, a lifeline for many disabled people. I have Dragon Dictate. And while I was in rehab, I learned to operate it by voice. And I have enjoyed corresponding with friends and strangers with that system. Many disabled people have to spend long hours alone. Voice-activated computers are a means of communication that can prevent a sense of isolation."

Mr. Reeve was fortunate to have a voice that is understandable enough to be processed by voice recognition software. Not everyone with a motor disability can take advantage of this particular technology, but there are many other technologies that can help such people.

Types of Motor and Physical Disabilities

  1. Traumatic Injuries
    1. Spinal cord injury
    2. Loss or damage of limb(s)
  2. Diseases and Congenital Conditions
    1. Cerebral palsy
    2. Muscular dystrophy
    3. Multiple sclerosis
    4. Spina bifida
    5. ALS (Lou Gehrig's Disease)

    6. Arthritis
    7. Parkinson's disease
    8. Essential tremor
  3. Key Concepts

Assistive Technologies

  1. Assistive Technologies
    1. Mouth stick
    2. Head wand
    3. Single-switch access
    4. Sip and puff switch
    5. Oversized trackball mouse
    6. Adaptive keyboard
    7. Eye tracking
    8. Voice recognition software
    9. Other assistive technologies


Reading: technology that students can use

  • Interactive Booksexternal image tbook2.jpg
    Many students with physical disabilities have difficulty with reading. Some children may have visual difficulties and other students may have associated learning difficulties. Interactive books can provide students with physical disabilities access to reading material, which would otherwise be inaccessible to them. These stories are illustrated, animated and have attractive sound effects and animations. The student simply points and clicks to listen to sentences while following the highlighted words on screen, can highlight and listen to words read aloud, and can practice key words in and out of context. Many of these programs have switch access features and ancillary activities. Examples include Oxford Reading Tree, Clicker Talking Books, Living Books, Wellington Square and Start to Finish Books.

  • Scan/Read Software
    When used together, a scanner and a comprehensive screen reading package can make even very slow readers, self sufficient. Almost any printed material can be scanned in and reproduced on the computer screen. Size of print and color can be varied. Words, sentences or whole text can be spoken and the speed of reading varied. The software will also read web pages from the Internet. The student can just listen to the text being read, or read and listen. This software will also speak words and letters as they are typed, allowing the student to correct mistakes as s/he types. It will also give definitions of words. Examples include Kurzweil 3000, WYNN and Texthelp Read and Write Gold.

Writing: technology that students can use

  • Word processors
    Word processors may be the most useful application of ICT for certain students with physical disabilities. These students may be unable to write clearly and legibly. Computers and other word processors can bypass these difficulties and enable these children to put ideas onto paper easily. Some word processors can be mounted on to a wheelchair for ease of use. Many students who have physical disabilities may also have learning difficulties. These may include difficulties with spelling, grammar and punctuation, generating ideas, organizing, editing and revising, reading ability, motivation and interest in writing. Grammar/spell checkers, dictionaries and thesaurus programs assist in the mechanics of writing.

  • Talking Word Processors
    Talking word processors simplify the writing process by reading each word, letter or sentence out loud as the student writes. Consistent auditory feedback reduces the physical effort of writing and lets pupils use a minimum of keystrokes. Talking word processors can provide students whose oral language skills are superior to their written language abilities with an opportunity to hear what they have written and perhaps, identify errors in grammar, spelling and punctuation that might otherwise go undetected. Attractive graphics and sound effects are features of some of these packages, making the writing process a more enjoyable experience. Examples include Write Out Loud and Co Writer, Talking Textease, Inclusive Writer and Clicker 4.

  • Storyboards
In addition to the talking word processors, this technology allows the children to select pictures from the screen in order to form their own
individual thoughts. The use of these storyboard softwares allows those children with developmental disabilities, in addition to their physical
ailments, to communicate their ideas in a meaningful way to others.
    • Something that goes right along with storyboards are augmentative communication devices. It is sometimes overlooked that physical and motor problems can also involved the speech mechanisms. Being a speech pathology major, I am continually reminded of this. Some children are unable to refine the motor movements of their mouth and surrounding areas in order to formulate speech, and augmentative communication devices help them to be able to communicate with others. A few examples of these devices, which i have worked with are Delta Talker, and Walker Talker, but there are tons of different devices that provide the same type of assistance to students. (Ashley Weishahn)
    • Info on Boardmaker: Boardmaker is a computer software program used to make communication boards, picture schedules, instruction sheets and more. It is one of the most commonly used programs in the field of augmentative/alternative communication. Boardmaker contains over 3,000 Picture Communication Symbols in it's picture libraries. These symbols can quickly and easily be pasted onto communication boards for use by children and adults whose speech is not readily understood by others.

  • On Screen Grid Software
    This software has switch access making it a supportive writing and multimedia tool for all abilities. The software comes with ready-made grids, and you can also create your own grids very easily. The grids are scanned at whatever speed and setting you choose, then using a switch the student clicks on the word, picture, sound, or phrase and they are transferred into a talking word processor. The fact that grids can be made to suit any child's ability and any curricular material makes this a very versatile tool for any student with physical disabilities. Examples include Clicker 4 and Quick Fire.
  • Word Prediction Software
    Word Prediction Software can be helpful in reducing the number of keystrokes required to produce a document and for students who have difficulty with word recall or spelling. As soon as you type in the first letter of the word that you want, up come suggestions on the screen for you to choose from. If the word you need appears you select it by clicking on an adjacent number or by clicking the mouse. Alternatively, if the word you require does not appear, then type the next letter for a further list and so on. The more often you use a particular word the higher up on the list it goes, so the software quickly learns vocabulary for any given subject. Examples include Co-Writer, PredictAbility and Penfriend.
  • Voice Recognition Software
    This technology can be useful for people who can speak but do not necessarily have good motor control. It can also assist students with physical disabilities whose oral language exceeds their written language abilities. Using a microphone, the user can dictate written assignments, letters, notes or essays onto a computer, which then converts the oral language to written text. This technology requires clear speech and good proof reading and editing skills. This may take away from the effectiveness of voice recognition software to aid many students with cerebral palsy and other disorders which cause both motor control difficulties and produce a halting speech which is common in many students with neural disabilities. To improve performance rates, it is possible to invest in a microphone volume booster, which links the microphone and the machine and boosts the volume. Voice Recognition software can empower a student who has no hand function or associated reading difficulties and enable them to produce wonderful written work. Examples include Dragon Naturally Speaking and Via Voice.

Using hardware in a classroom can make things easier:

There are a variety of peripheral attachments, which can be of great assistance to students with physical disabilities:

Head Pointer
A student can wear a headset or a reflective dot on their forehead or other part of their body, which is then tracked by a sensor box. As he/she moves his/her head, the pointer responds accordingly, by moving across the screen. A switch could then be used to do the equivalent of a mouse click. With an on screen keyboard, the pupil can make key selections by positioning the mouse pointer over a key for a set period of time. This type of technology is still quite expensive, however, it means that a student with severe physical disabilities could still have access to the curriculum and learning, once they demonstrate the ability to control the movements of any single part of their body.

Joysticks and Rollerballs
Joysticks and rollerballs are an alternative to the conventional mouse. They are designed for those who do not have the hand function necessary to use a mouse or keyboard. Joysticks are familiar devices, found on most electric wheelchairs and on many computer games. As a result, students with limited hand function can find them easier to use.
A Rollerball or trackerball is fundamentally a mouse turned upside down. The device is stationary and the user moves the ball with their fingertips. Many rollerballs have additional features, such as the ability to slow down the movement of the cursor, buttons which cause a right click, left click, double click or combinations of same. Some rollerballs can even have a switch connection, facilitating students who may have difficulty with finer movements.

Keyboards and Keyguards
Standard keyboards can often be unsuitable for children with physical disabilities. There are many alternatives available. Large, robust keyboards with keys that are up to four times the size of standard computer keys can be useful for students with visual difficulties or limited hand function. These are available in multi-color, plain white, ABC or Qwerty format. Some have even speech feedback, permitting students to talk and work at the same time. (Examples include: Discover:board and Big Keys Plus)
Keyguards are rigid plates, which rest on top of the keyboard. They can take the weight of hands and arms and have holes for each key to facilitate accurate depression. Keyguards can be of great assistance to children who have tremors or uncontrolled hand movements. Many keyguards come in clear Perspex, which is easily cleaned and has the additional function of protecting the keyboard, especially for students who find it difficult to control drool.
Overlay keyboards are an ideal way to give physical, visual and cognitive access to people with a wide range of disabilities. Standard overlays have a barcode, or alternative signal, which is immediately identified by the computer. Overlays can be customized to each individual's needs. Some students may have difficulty pressing individual keys and as a result may be limited in the amount that they write. Overlay keyboards can supply words and phrases for easy selection. These keyboards often have additional features, such as keyguards, alternative overlays and switch access. (Examples include: Intellikeys and Discover: board)

Eye Tracking
Eye tracking devices can be a powerful alternative for individuals with no control, or only limited control, over their hand movements. The device follows the movement of the eyes and allows the person to navigate through the web with only eye movements. Special software allows the person to type, and may include word-completion technology to speed up the process. These systems can be expensive, so they are less common than the less sophisticated devices, such as mouth sticks and head wands.

In the past, connecting alternative devices or peripherals to the computer was a problem. It was necessary to switch off the computer, connect up the new device, and then restart the computer again. Now, most new machines have a universal serial bus (USB) port and many devices are USB compatible. What this means, is that the computer instantly recognizes the devices when you plug them in, so that you don't have to restart the computer. Also a USB port can take up to 128 interchangeable devices and the connections are sturdy and not easily damaged.

Other Information to help:

Mathematics: Students with physical disabilities, like other students, can have difficulties in the area of mathematics. There are many maths software packages available that consolidate a wide variety of mathematical topics, from number, patterns and shapes, to time, money, place value and problem solving to name a few. Examples include: Millies Maths House, Numbershark, Maths Made Easy 1-5, Maths Circus, Primary Maths 1 & 2 and Learn more about maths. Other programs focus on problem solving, in the form of an adventure game or basic programming e.g. LOGO or The Crystal Rainforest. Some students with limited hand function may use an on screen calculator for mathematics. The multi-sensory dimension of ICT can be a useful way of consolidating any mathematical topic given the right piece of software.

Switch Accessible Cause and Effect Software
Cause and effect software is aimed at making the student aware of how one action can lead to another. These simple programs also teach students with physical disabilities how to use single and two switch operations. The convenient thing about switches is that they can be activated with any part of the body, most likely the part of the body that they have the best motor control. For example, a face, car, dog or house is built up on the screen gradually, by each click of a switch. Examples include Switch it! Series, Touch Funfair, Smart Alex, Happy Duck, Step by Step and Sensory software.

Multimedia Authoring Packages
Students with physical disabilities can use multimedia authoring packages to create electronic stories or multimedia projects with pictures, sound effects, voice over and text. As it is quite difficult to get software that features characters with physical disabilities, perhaps students could use digital cameras to include pictures of themselves or their friends, thus making the writing experience more real.

Art Packages
Many students with physical disabilities have difficulty manipulating a paintbrush, crayon, pencil, scissors etc. Art packages can enable students with disabilities to experience art in a unique and empowering way. The ability to erase errors, choose from a wide variety of tools and colors, and experience built in sound effects/animations can delight children with physical disabilities.

There are many encyclopedias and reference libraries available on CD-ROM, which can be useful sources of information on a variety of topics. These provide an alternative to visiting the library, which may not always be accessible to students with physical disabilities. Furthermore, the World Wide Web is a huge library of up to date information on any subject.

Some students with physical disabilities can also have visual difficulties. Most word processors have a choice of large fonts in a clear style. You can literally change the size of a word so that it takes up the whole screen, by going up to the font size button on the menu bar in Microsoft Word. Highlight it and enter a new font size (e.g. 150). This can enable a student with visual difficulties to see much clearer. There is also magnification software available, such as Zoomtext and TextHELP, which can assist children with visual limitations.

Final Thought:

Many of us forget that a lot of these students spend time in the hospital. Many surgeries and sicknesses slow their progress and take these students out of their classrooms. There is an example of a student who needs to have their feet surgically repaired because she was born with structurally incorrect feet. These necessary surgeries would cause this student to learn from nothing but books and be held out of the classroom. With the developments in technology the school is able to broadcast the classes over video strait to her computer. This not only helps her with her learning but allows her to take more time off of her feet when necessary and on her feet for rehab. This advance in technology helps these students keep up with their work, while advancing their physical conditions, these gifts are not to be taken lightly and need to be fully utilized.

(page format edited by Heather Winslow 10/16/07)