Assistive Technology for People with Limited or No Use of Their Hands

Optimizing Hand Use

Many people, even those with severe difficulty using their hands, prefer to maximize their manual capabilities rather than use alternative strategies. Fortunately, there is a wide range of assistive technologies Products or systems used by people with disabilities in order to perform functions that might otherwise be difficult or impossible; examples include specialized keyboards, screen magnifiers, and captioning. that can help with this:

• For people who have difficulty with grasping, ring pens such as the RinG may help with writing. These slip over a finger and also require less arm movement than regular pens or pencils.
• Some people prefer to type by holding a pencil or similar type of stick in one or both hands. If necessary, devices such as the Handi-Writer can be used to help steady the stick.
• Grips can be added to pencils, eating utensils, crochet hooks, etc. to make them easier to grasp. These can be made inexpensively by wrapping a small piece of foam around the object and anchoring it with duct tape, or by using the foam insert from a hair curler. Commercially available grips range from small pencil grips to larger, round grips such as the Arthwriter.
• The Virtually Indestructible Keyboard requires less pressure than most standard keyboards, and may be easier to activate for people who find pressing keys difficult or painful.
• Windows and Macintosh computers have a variety of utilities already built in that help users who have difficulty with unwanted repeated keys, pressing multiple keys, etc.
• Touchscreen devices often require simultaneous use of more than one digit, e.g. the “pinching” motion of the thumb and index finger used to zoom in or out on the screen. However, some devices such as the iPhone permit flexibility in which digits are used, which benefits people who have one or more missing or non-functional digits.

Mouthstick

Some people use a mouthstick, which is held in place by biting; some models permit the mouthpiece to be shaped to the individual user’s dentition. Simple sticks allow keyboard keys to be pressed, others have rubber or suction cup tips for tasks such as page turning.

Plain mouthsticks will not work with many touch screens that operate by sensing heat from a finger. However, there are several websites that provide information about easy and cheap ways to make styli work with these screens, including this one from MAKE Magazine, and this will work for mouthsticks as well.

Mouse Alternatives

Use of standard mice requires grasping, arm movement, and clicking, any or all of which may be difficult for individuals with physical disabilities. For people who have no use of their hands, infrared and eyegaze systems provide a hands-free option. The ATC article on Alternative Mice lists a range of solutions, some of which facilitate use of the standard mouse and some of which use the keyboard or alternative mice. 

Keyboard Alternatives

Substitutes for the standard keyboard include a wide variety of creative hardware designs, as well as on-screen keyboards that can be activated using a mouse or the infrared/eyegaze solutions discussed below. The ATC article on Keyboards for Users with Dexterity Impairments provides an overview of these strategies.

Speech Recognition Any technology that converts spoken words into text or commands.

Speech recognition can be used as an alternative to keyboard use, mouse use, or both. The technology has improved significantly in recent years; however, it still does not meet the needs of all users, including those who have speech impairments or who use computers in noisy environments. The ATC article on Speech Recognition Software provides information on the basics of its use, as well as on its pros and cons for various user groups. 

Brain-Computer Interface

An emerging input technology that has promise for people with severe disabilities are brain-computer interfaces such as the Intendix. These track brain waves in reaction to on-screen stimuli such as a highlighted letter on a virtual keyboard, and translate them into computer input.