Eye Gaze Technology in AAC—Time for a Trial!

So now you have one of these amazing high-tech eye gaze devices in your hot little hands and 2-4 weeks to see if it’s a good fit for your child…now what?

During the trial, you want to set your student up for success. Remember, this is all brand new to her and eye gaze is very, very fatiguing while the eye and neck muscles build up strength. Your goals here are to see which device she is most successful in accessing, and to determine which language access method she prefers. It's really two separate goals rolled into one during the trial period.

CALIBRATING the device:

The device needs to be appropriately calibrated before you can assess how well your student can access the machine. Calibrating allows the device to recognize the nuances of a person’s eyes and eye movements.

Positioning is critical. Each device has specific preferences for placement, both its distance from the user, the height, and the angle. The User Guide and company representative for each device will lead you through these set-ups, but don’t hesitate to customize if you find positioning that is more successful. If your child tilts her head, be sure to adjust the machine to accommodate this.

For keeping her attention during the calibration exercises, you want something that is going to really catch her eye and her motivation. If she has a favorite cartoon character or singer or her own picture, you can incorporate those to make the trial time fun. Dynavox and Tobii allow you to bring in your own pictures for calibrating so that it becomes a game ("Follow SpongeBob with your eyes" is MUCH more fun than "follow the dot"). I don’t recall if PRC’s ECOPoint permits this or not…anyone?

If you have difficulty getting the machine calibrated to your student’s eyes, you can vary the parameters. Maybe a shorter session with fewer calibration points would hold her attention better. You may be able to step through the calibration manually with a keyboard, concentrating on the time she is focused on a calibration point rather than expecting her to follow the points as they move around the screen.

If all else fails, calibrate the device to someone else’s eyes. I’ve heard recommendations for having a parent or sibling calibrate, since the structure of the eyes is likely to be more similar than that of a non-family member.

TWEAKING for accuracy:

Change dwell time, button highlight, the transparency of the tracking “dot” or timer, and the visibility of cursor. Tracking training activities are very helpful in setting these for increased accuracy.

You can also change button sizes and colors and the page’s background.

Place buttons horizontally for more accurate hits. While it is important to explore the full screen to show you what potential the device has for access, for justification purposes, you might organize her choice buttons in a straight horizontal row rather than a 4-button grid, because horizontal eye movements are easier to master than vertical ones. I extend thanks to Judy LaRiviere at the Oakland Katie’s Clinic for this reminder.

Each device we trialed came loaded with fun activities created to develop eye gaze control, and these are effective for fine-tuning dwell features as well. These vary from one manufacturer to another, but they are all very helpful.

They all have a variation of a target practice activity, where the eyes chase a character around the screen. These can be highly motivating for a few tries (imagine being successful right off the bat when your whole life has been a series of discouraging attempts at things you can't do), and they teach YOU, the adult, a lot about ease or difficulty of accessing specific areas of the screen, as well as the button size that can work for your student. I recommend swapping out the built-in character for one you know to be motivating if that is possible with the software on the device.

PRACTICE activities:

Before you expect accurate responses from a child, he will need time to explore the device. I cannot stress this highly enough. Check out this post on a child’s needs for exploration. He needs to have had time to process the types and locations of choices before you can reasonably expect her to use them functionally.

In addition to undirected exploration, you will want to set up activities that are errorless. These are still learning activities and this is NOT a time for “testing!” Activities where your student directs action are a good thing for this. He might direct a bubble-blowing activity or a game like Simon Says or Red Light, Green Light. He might love books and prefer to comment and direct you to turn the page. He might enjoy exploring a tiny library of music clips. He may enjoy leafing through photographs of family and friends or enjoy activating video clips.

And don’t forget those target-practice activities you used to tweak the dwell features!

Also, most of the devices have a puzzle activity where you click to hide each key, unveiling a photo. If you swap out the original photo with one that has personal meaning to your student, this is a highly motivating game.

When you want him to practice indicating choices in a more directed activity, pull in those pictures of characters that he enjoys. "Where is Lightning McQueen?" is much more motivating than "Where is the fork?" Or try photos of family and friends.

Try to involve as many senses and motivational angles as you can. If music is motivating, set each key to play favorite music clip activated. He may enjoy sound clips of favorite people talking or of goofy sound effects. Maybe he would be highly motivated by video clips…your imagination is the limit.

Creating choice screens also gives you a feel for programming each device. Obviously, your ease of programming shouldn't impact the decision, but you will learn a LOT about how the machines function. You might start with just two choices per screen, then 4...simple is key for this.

Whatever activities you design, make them simple so you can duplicate them on each device. Unfortunately (or fortunately, since it teaches you the machines best), you can't transfer files between machines but must make the activities from scratch for each. That's why I recommend simple activities. What this does is let you see how each device handles the same expectations.

 OBSERVE LANGUAGE PREFERENCES:

I can't stress enough the importance of letting kids explore without pressure. This is especially true when it comes to navigating around the communication software to access language. Kids learn so much just by "playing around” without us talking or asking questions of them. As standby observers, we learn incredible amounts about their learning style and can probably determine just by watching them explore which of the language access methods is apt to fit each girl best.

Try to provide as much time during the trial for exploration of the device as possible. The quality of this extended time exploring the language access software is critical—the trial period is NOT the time to impose "interpretation" on those explorations. This gives a neutral environment--non-judgmental, not resulting in an outcome--for developing both motor skills and discovery of the meaning (especially since so many symbol keys are labeled with a single word yet will type/speak a phrase). We can learn so much from those explorations just from quiet observation (as opposed to interaction), noting which symbols get chosen repeatedly, what areas of the screen the child prefers, whether she explored alternate routes to the same content of a message (i.e.: the verb "drink," adjective "thirsty," and noun "juice" are all different ways to express desire for some juice to drink but, depending on the symbol set, may take VERY different routes to get to the message), how she figures out navigation strategies, etc. I don't want to call those "prerequisites" to communication, since communication has none, but they absolutely contribute the accuracy of an intended message.

For the purpose of funding justification, it is absolutely fine (perhaps best) to design a simple page that allows for a successful structured conversation, rather than relying on the built-in language access system.

However, you still need to observe how your student does during extended periods of exploring with the various language access software programs. There may be one she is far more highly motivated to "play with" than others, that holds her attention much longer. There may be one that inspires her to compose meaningful telegraphic statements with during her exploration (remember, we still aren't inserting ourselves yet!). Or she may gravitate to the full phrases or the keyboard…

Later, after the device has been purchased, the child will still require extended time to explore language access software. As the child begins to demonstrate the ability to activate keys with greater intention, there also comes a shift when we move from quietly observing in the background to engaging in conversation. At this point, key activations are credited as deliberate attempts at communication. This is when we move from fun, errorless exploration and activities to place where language takes on the power to make things happen.

So to summarize, the trial period is a time to find out which device the child demonstrates best access and for you to observe which language access system is a good fit. One may leap out as being a “best fit.” There may be another she doesn't even like--her body language and lack of attention will tell you. 

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Other posts that might be useful:

Eye Gaze Technology for AAC:  Looking at the hardware

Eye Gaze Technology for AAC:  Language access software