Computers are everywhere in our lives: home, school, work and play. Children with hemiplegia may seem to start at a disadvantage, but learning to use computers effectively can help them keep up more easily with classmates and workmates.
At school, for example, using a keyboard can:
- Help children with poor handwriting skills.
- Help develop the ability to present work effectively.
- Help develop personal organisational skills.
- Reinforce or teach spelling skills.
On this page we look at how using a computer can be made easier for people with hemiplegia, whether children or adults.
Sitting properly at a computer
It is important to sit your child properly at the computer before they get started.
- The desk or table should be at elbow height.
- Eye level should be at the bottom of the toolbars on the screen.
- The chair should have good back support.
- Feet should be flat on the floor, with knees at 90 degrees. If necessary use a stool or an old Yellow Pages (also useful for raising a monitor to the right height).
- Adjust lighting to avoid glare and reflection.
- Allow space on the surface for the affected hand.
- Before starting to use the computer it can be useful to do warm up exercises (gentle stretching, finger wiggling etc.), and repeat these after a typing session.
- Don’t forget to have your child take breaks.
- As children grow, seating should be monitored regularly.
Tweaking and adapting computers
If your child can only use one hand, they will find that there are some key combinations that are difficult to achieve. Try pressing “ctrl+alt+delete” with one hand and you will see the problem.
Thankfully there is a “sticky keys” function that is built into Windows. Sticky keys changes the behaviour of the modifier keys – Shift, Control and Alt – so that they are “held down” until the next key is pressed. This means it is possible to type a capital “P” by pressing and releasing the shift key and then pressing the “p” key. Or you can get % by pressing shift then 5.
The settings for sticky keys can be turned on by visiting the “accessiblity options” in the control panel. (The control panel can be found from the start menu).
If your child creates a document in a word processor, they will generally find that the text on the screen consists of black letters on a white background. The writing in the menus is generally black on grey, and the title bar is blue. If these colours are not the best for their eyes, you can change them and adjust the size of the text in the menus.
To try this out, revisit control panel and select accessibility options and then display (in Windows 2007 ‘pick a task’, and the accessibility wizard will take you through some of the operations below). Choose the appearance tab and look under “scheme” – if you scroll down through this list you will see a number of pre-defined schemes that use different colour combinations – some of which are available in a number of sizes. For example, high contrast schemes are useful for anyone with a visual impairment.
Some fonts are clearer than others. ‘Ariel’ and ‘Courier’ are considered easier to read than traditional fonts such as ‘Times New Roman’, and children may like using a ‘fun’ font such as ‘Comic Sans’.
The mouse pointer can often be difficult to locate on the screen. If so, then you can try making it bigger. If the screen has a white background, try the “windows standard black (large)” – or try a large white pointer if you have a high contrast black scheme. You can select different “mouse schemes” through the “mouse” item in control panel.
Controlling the mouse
The mouse tab also allows you to slow down the mouse speed if it’s too fast for your child. Enabling sound enables a multi-sensory approach to typing – good for some learners but frustrating for others.
While you are in the mouse properties, think about swapping the buttons over if your child is left handed so that they can do all their clicking with their index finger.
Keyboard options for single handed users
There are some specialist keyboards available for users who can only use one hand. However, if your child learns to type on a specialist keyboard they may need to use that keyboard on other computers. Given that they will probably use a computer throughout their life in all sorts of settings (school, work, home etc.), it may be more practical to use a standard QWERTY keyboard from the start.
Many people find compact “laptop sized” keyboards easier to use as they can be operated more easily with one hand. Turn the keyboard over – most have two retractable legs. Flip these down so that the keyboard has a gently downhill slope. It makes the letters easier to see and gives some forearm support. Next, offset the keyboard to whichever hand is typing, with the letters G and H in the centre. For a right-hander, the keyboard is angled up to the right, for a left-hander to the left.
There is a useful typing tutor called “Five Finger Typist” www.typeonehand.com that helps a single-handed user to develop a touch-typing style based on the keys “FGHJ” as “home keys”. It is suitable for children. Another programme, www.aboutonehandtyping.com, is available from its website.
Most people with hemiplegia use their affected hand, if at all, only for anchoring the keyboard. Some with left-sided hemiplegia can learn to use the hand to access the keys on the left side of the bottom row e.g. z,x,c,v,b.
If your child has a visual impairment, keyboard stickers can make the letters clearer. Another thing you might want to try is Dasher, a text entry interface that requires no keyboard. It is free to download at www.inference.phy.cam.ac.uk/dasher/
If your child finds writing notes or doing written work in class difficult, and finds typing easier, there are some very good lightweight and portable note-taking devices that can be used as “pen and paper substitutes”, for example the Alphasmart Neo. This is a battery-driven word processor (700 hours of operation on 3 AA alkaline batteries) with the added advantage of an extra large font. Work can then be easily uploaded onto a computer.
The standard mouse is quite a challenging device for many people with reduced dexterity. Sometimes changing to a different shaped or different sized device will help, though if your child is left-handed, beware of anything labelled ‘ergonomic’ as it will be designed for right-handed users. If a mouse does not suit then there are large numbers of alternatives – rollerballs, touchpads, joystick devices and so on.
However, as with a Qwerty keyboard, use of a standard mouse has many benefits. Use of a Tiny mouse can be a useful initial step for young or small children. Check that the mouse or alternative is positioned correctly, on the side of the typing hand. There are many activities that introduce and develop mouse control – important skills to master are:
- Accurate mouse control and movement across the screen.
- Single clicks.
- Double clicks.
- Clicking and holding.
The following free sites available on the internet may be useful for teaching mouse skills:
- Paint programme: www.tuxpaint.org
- Various games and activities: www.helpkidzlearn.com
- Mouse games and more: www.starfall.com
- BBC programme orientated games and activities: www.bbc.co.uk/cbeebies/games/
Magnification and screen reading systems
Magnification software and screen reading programs can be bought to help users with significant visual impairments. Magnification software magnifies the area around the cursor or mouse pointer. Screen reading systems monitor the activity on the screen and speak out the current menu options and the keys pressed, and give the user the ability to interrogate the system.
Voice recognition software
This can be useful for those who have good speaking voices. The systems take time to “train” to recognise the speaker, but are improving and becoming cheaper all the time. The most widely used programme is Dragon Naturally Speaking.
Other useful software
Abilitynet has produced two useful software packages for introducing children to computers. Its website also has an extensive range of downloadable information and skill sheets that may be useful for older children and adults. For example, its ‘Dyslexia and Computing’ sheet alone has suggestions on software for planning work, word prediction, speech to text and autocorrecting.
More information and advice
Abilitynet – www.abilitynet.org.uk – whose motto is ‘Adapting Technology – Changing Lives’, works nationwide. It provides assessments, equipment and training to help children with additional needs get the most out of education. Its site has factsheets, skillsheets and free downloadable software.
ACE Centre North – www.ace-north.org.uk – offers free information and advice on Assistive Technology for people with physical/ communication difficulties. The site also has links to useful freely downloadable and open source software.
Cenmac – www.cenmac.com/index.php – works only in London, providing assessments of children, loans of equipment and training, but its website has lots of information, equipment and software recommendations and links that are useful wherever you live.
IT-Can-Help (ITCH) – www.itcanhelp.org.uk – is a network of volunteers who offer free local computer assistance to disabled people. They can diagnose and fix most computer related problems, install and set up hardware, software, internet, email and accessibility settings.