Ann Rehabil Med.  2012 Apr;36(2):268-272. 10.5535/arm.2012.36.2.268.

Augmentative and Alternative Communication Training Using Eye Blink Switch for Locked-in Syndrome Patient

Affiliations
  • 1Department of Rehabilitation Medicine, National Rehabilitation Center, Seoul 142-884, Korea. drwgy@naver.com
  • 2National Rehabilitation Center Research Institute, Seoul 142-884, Korea.

Abstract

Locked-in Syndrome is a severe pontine stroke causing quadriplegia, lower cranial nerve paralysis, and mutism with preservation of only vertical gaze and upper eyelid movement in a conscious patient. We present a case of a Locked-in Syndrome patient who received communication training with augmentative and alternative communication equipment by using eye blinks. After 3 weeks of training, the patient was able to make an attempt to interact with other people, and associate a new word by Korean alphabet selection. Augmentative and alternative communication equipment which uses eye blinks might be considered to be beneficial in improving the communication skills of locked-in syndrome patients.

Keyword

Augmentative and alternative communications systems; Communication aids for handicapped; Locked-in syndrom

MeSH Terms

Communication Aids for Disabled
Cranial Nerves
Eye
Eyelids
Humans
Mutism
Paralysis
Quadriplegia
Stroke

Figure

  • Fig. 1 Self-Calibrating Auditory Tone Infrared switch.

  • Fig. 2 Raw signals from the sensor were amplified and transferred to the control sensor box. Then, the controller sent information to the personal computer by using a phototransistor that converted optical signals into electrical signals. A light emitting diode and a beep sound would occur with one blink (click) of the sensor by the patient. At the same time, electrical signals were output by voice through the Switch Interface.

  • Fig. 3 Scanning training program for motor skills, response time and accuracy; (A) when patient clicks, the arrow moves to the target; (B) when patient clicks, bubble grows; (C) when entering into the squared circle, patients are required to click and; (D) when insects enter the circle, patients are required to click.

  • Fig. 4 The patient practicing training program using eye blink.

  • Fig. 5 The Clicky2.0 automatically scans each item (alphabets, commonly used words and sentences) according to the order and time interval previously set up. When a patient blinks his eye at the intended moment, a Self-Calibrating Auditory Tone Infrared switch is activated.


Reference

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