Communication Support for People with ALS

Eye-Tracking Devices

• What affects how well eye-tracking works for someone?

  ✓Supports this

  “Eye-tracking is often the least fatiguing way of reaching a communication device, and the eye muscles it uses do not fatigue easily.”

  Says eye gaze is natural and that eye muscles generally do not fatigue with use, and that people with ALS often name eye-tracking as the least tiring way of reaching a device when compared with alternatives such as switch scanning.

  First, eye-tracking is often the least fatiguing movement for AAC access.

  6. AAC Use

• What affects how well eye-tracking works for someone?

  ✓Supports this

  “Dry eyes, eyelid problems and glasses can all affect eye-gaze tracking. Glare on glasses is usually workable, but untreated dry eye that damages the cornea can end someone's ability to use an eye-gaze device.”

  In the group it reports on, the one person who could not get eye-tracking working at all had difficulty with eyelid control, which the review names as a known issue in ALS. Glasses were a different story: glare on the lenses was routinely worked around by adjusting the camera angle.

• What affects how well eye-tracking works for someone?

  ✓Supports this

  “Bright light and sunlight can stop an eye-gaze device tracking reliably, and changing the lighting is part of getting it working.”

  Reports that getting eye-tracking systems working for people with ALS often needed changes to the room, and gives dimming lights and closing shades as examples of what that meant in practice.

  Others required environmental lighting changes (e.g., changing incandescent bulbs to fluorescent lighting, dimming lights, and closing shades).

  8. AAC Training and Support

• What is eye-gaze (eye-tracking) technology, and how does it work?

  ✓Supports this

  “Eye-gaze can keep communication going for people who have lost both speech and hand function.”

  A review of communication support in ALS reporting on a group of people who used eye-tracking as their main communication method. Almost all of them got it working, and for around half it was chosen because eye movement was the only access they had left.

  Ninety-three percent of the participants reported successful implementation of the technology.

  6. AAC Use

• Who might eye-tracking help, and when?

  ✓Supports this

  “Because eye-gaze needs only eye movement, it can still work when almost no other movement is left.”

  Reports on people with ALS using eye-tracking to reach a communication device. For about half of them it was chosen because eye movement was the only access route they still had.

  For 53% of the participants, eye-tracking technology was selected because eye movement was the only viable access option available.

  6. AAC Use

• Who might eye-tracking help, and when?

  ✓Supports this

  “It is worth exploring eye-gaze before you actually need it.”

  Gives the clinical reason for not waiting: once speech starts to become hard to understand it can decline fast, leaving very little time to get a communication device in place.

  Unfortunately, once intelligibility begins to decrease, speech performance often deteriorates so rapidly that there is little time to implement an appropriate AAC intervention.

  4. Timely Referral for Communication Support