The primary vocational goal for any individual with a disability is maximum independence. This includes independence in the areas of mobility, self-care, and communication. For persons who are quadriplegic such independence necessitates access to assistive technological equipment. Quadriplegia is paralysis or a lack of an ability to use all four limbs (arms and legs), also known as tetraplegia.
Assistive Technology Device
The Individuals with Disabilities Education Act (IDEA) defines an assistive technology device as "any item, piece of equipment, or product system, whether acquired commercially off the shelf, modified, or customised, that is used to increase, maintain, or improve the functional capabilities of a child with a disability." Adults with disabilities require similar equipment to meet daily needs to maintain independence and quality of life. These assistive technology devices may include high-, low-, or no-tech devices. Low- and no-tech devices are usually inexpensive and require no electronic equipment. These may be normal items slightly modified for the individual's needs. High-tech devices are those that are generally more expensive and may require high-maintenance electronic equipment.
Switches are probably the most common assistive technology device for persons with disabilities. These devices usually resemble a large button, which an individual can activate with a low-tech head wand or mouth stick. These can be attached to devices such as electronic toys for younger children so that they can activate the toy independently. Switches can be programmed to act as an on/off switch for almost any electronic device, including lamps, computers, and televisions.
Aids for Daily Living
A person who is quadriplegic may require many devices to assist with normal daily tasks. Some of these include: bath lifts, shower chairs, special feeding equipment or utensils, adapted toothbrushes with suction cups, and adapted toilets. Private health insurance may pay for some of these devices, depending on the age and needs of the individual.
Individuals with quadriplegia often have difficulty communicating their needs because of weak or paralysed vocal chords. Alternative and augmentative communication devices are among the most useful devices in this area. These are generally devices that allow individuals to communicate their wants and needs into audible speech via a communication board or other device. Some of the most common adaptations for individuals with quadriplegia are eye-gaze devices, which allow people to make choices by focusing their eyes on a specific choice. Head wands, devices attached to the head, allow individuals to use their heads to activate switches or communication devices. These head wands can include low-tech wands to physically touch objects or optical pointers mounted on the head to access other electronic equipment. Mouth sticks are similar in use to head wands, but rely on an individual's use of the mouth rather than the entire head.
Computers and software can be adapted for individuals with quadriplegia. Text-to-voice/voice-to-text software can be very helpful. For individuals who can speak, the software can turn their spoken words into text. Those who cannot speak can use augmented devices, such as optical head wands, to convert their choices into speech. Mouth sticks can be used to press keys on a keyboard. Basic switches can be added to computers to make it easier for an individual to turn them on. Touch screens with on-screen keyboards can be helpful when paired with a head wand or mouth stick as well.
Most of the devices listed so far are helpful for children and adults in an educational environment; however, some devices are specific to an education or work setting. Adapted desks to accommodate wheelchairs and electronic equipment may be helpful. A recording device with an appropriate switch can be useful for note-taking. Individuals may need special calculators with large keys for use with a head pointer or mouth stick. Software to convert worksheets or other materials to computer-friendly text are also widely used.
Transportation and Mobility
Wheelchairs are very important assistive technology devices for individuals with quadriplegia. Mobility is essential for them to access education and other community services. Wheelchairs may be manual or powered. A variety of high- and low-tech exercise equipment is also available to assist with relaxation and keep muscles as strong as possible. In addition, there are many devices to assist with transporting individuals with quadriplegia. Wheelchair lifts, adapted motor vehicles, and wheelchair restraint systems are among the most common devices used.