Tan of TTSH observed that patients have become more open to using assistive technology in recent years. She and her colleagues at the hospital have received more enquiries on Tobii eye trackers. Isabelle Lim, 26, and Ooi Lin Kah, 62, are among a growing group of people with disabilities who have gone digital in a bid to lead more independent and less isolated lives.
Despite having hearing loss due to a rare genetic disorder called Nager syndrome, Lim can tell when the doorbell rings and knows when it is raining even when not looking out of the window.
Nager syndrome is characterised by facial and limb deformities. Many affected individuals also have hearing loss caused by defects in the internal structures of the ear.
Lim, a full-time photographer specialising in family portraits, wedding and event photography, is involved in a pilot trial of the Smart Home Guide. It is an initiative by SG Enable, an agency dedicated to enabling persons with disabilities, in partnership with Google that guides people with disabilities to set up a smart home ecosystem.
Among the devices that Lim uses is a smart doorbell and lighting system, which is paired with a mobile application. To keep a lookout for people at the door, she programmed the light to flicker whenever the doorbell rings.
“This is especially useful when a deliveryman comes by with my online purchases and food, or when family and guests come over. Before using the smart doorbell, my mother would have to send me a text by phone whenever she is nearing home,” she said.
Isabelle Lim using a smart home product by Google that is linked to a lighting system to help her know she has visitors at the door.
For Ooi, he uses an eye-gaze-enabled technology called the Tobii eye tracker.
The former engineer was diagnosed with amyotrophic lateral sclerosis (ALS), a degenerative motor neuron disease that has robbed him of voluntary movements from the neck down.
With the eye-tracker, he can log on to the internet, use social media and type out long essays — all without having to rely on his caregivers.
Senior speech therapist Tan Xuet Ying from Tan Tock Seng Hospital (TTSH), who introduced the eye-gaze device to Ooi and taught him how to use it, said that the device allows users to click and type on the computer.
It can also be installed on motorised wheelchairs and even act as a remote control, for instance, to adjust bed functions.
When hooked up to a communicator software, Ooi can communicate his thoughts by “typing” with his eyes, and having the computer read aloud the text — an added benefit given that his breathing difficulties have made talking more challenging.
The eye-tracker technology works by creating a pattern of near-infrared light on Ooi’s eyes. The reflected images and pattern are picked up by the eye-tracker’s cameras, and the device is able to determine the position where the person is looking.
In an email interview with TODAY, Ooi said that this digital aid helped to lift him out of the doldrums as his illness progressed.
Under Tan’s guidance, he took around 30 minutes to learn to use the device. He was pleasantly surprised when he could type a 200-word writeup in an hour on his first attempt.
The device has been particularly critical to Ooi’s mental well-being during the Covid-19 pandemic, when he had to stay at home and not receive guests due to his increased vulnerability as an ALS patient.
“Through this technology, I am now in close communication with my family and friends via social media. I can read books and even write essays, no different from normal people except that some patience is needed.
“I am particularly happy because I can share information, ideas, experiences, exchange greetings and encourage other ALS patients and caregivers,” he said.
Under the TTSH’s Help Me Speak programme, patients can borrow the these devices if they are deemed suitable by their speech therapists.
“In the past, we probably had fewer than five patients each year who were aware of the devices and enquired about them. Since starting the (Help Me Speak) service in 2017, more than 20 patients have tried the device each year,” Tan said, adding that some patients have also gone on to buy the gadget.
A full package of the eye-tracking device cost around S$8,000 (RM24,442), Tan said.
Patients who are means-tested and eligible for the Assistive Technology Fund can receive up to 90 per cent subsidy, with a lifetime cap of S$40,000.
The fund provides subsidies for persons with disabilities to buy assistive technology devices and enable independent living.
Tan said that TTSH is now the only hospital in Singapore that can assess patients’ suitability for the Tobii eye-gaze tool and offers a loan programme for the device.
At TTSH, its multidisciplinary rehabilitation team may also propose other suitable assistive devices to patients and their family members.
This is done after conducting a thorough assessment and review of the patient’s cognition, language ability, physical impairments as well as needs and wants, Tan said.
While the majority of patients benefit significantly from the use of the eye-tracking devices, Tan said that patients who do not have the same experience may have medical conditions that have deteriorated to the point where they are no longer able to use eye gazing or are too drowsy, for example. They may also be illiterate or do not use a smartphone.
Over at Tech Able at the Enabling Village — an integrated assistive technology resource centre managed by SG Enable and SPD, a charity that supports people with disabilities — users may check out a range of assistive technology devices to see which ones meet their needs.
They may also borrow the devices at a fee to test them in a home, office or school environment. There are also assistive technology specialists to help users select suitable devices and use them safely.
Alvin Tan, head of the technology catalyst at SG Enable, said that since Tech Able opened in October 2015, it has supported more than 1,300 people with their assistive technology needs.
Examples of smart technology available at Tech Able include the Quha Gyroscopic Mouse, an adaptive mouse that can be attached to the head, wrist, foot or other parts of the body.
Using gyroscopes and tracking, it is responsive to even small movements and makes it easier for people with disabilities to access a computer.
SG Enable also connects tech companies with users to encourage innovation and the development of customised solutions.
An example of this form of ground-up collaborative effort is the see-through mask prototype facilitated by SG Enable in May this year, in view of the government’s call to wear masks as a safety measure for Covid-19, Alvin Tan said.
“During regular engagements with the deaf community, SG Enable learnt of communication challenges that deaf students would face in class with everyone being required to wear face masks.
“As such, SG Enable volunteers and a sewing studio developed prototypes of see-through masks for teachers and allied educators in special needs schools. With see-through masks, deaf students were able to read lips and facial cues of their teachers, and communicate more effectively with them,” he said.
Not all assistive technologies are niche products.
Alvin Tan said that increasingly, mainstream technology providers have been making their products accessible to people with disabilities.
“For example, text-to-speech applications and voice recognition technology are now seen as common accessibility features that are built into mainstream consumer products like smartphones.” Smart home devices, such as the ones that Lim the photographer are using, are another example of how persons with disabilities may tap mainstream technology to live with greater independence.
There was some trial and error when Lim began using the various smart devices, but the time and effort spent was worth it.
“Getting started may be difficult but once you get the hang of it, you will enjoy them immensely. It is like having your personal assistant.”
For instance, she discovered that the Google Home app makes switching on and off the fan “a breeze”. Before that, she would have to bend down to operate the fan because her arms are fused and cannot be straightened.
Lim also uses Chromecast, a streaming device that allows her to cast content from online video streaming platforms such as Netflix directly to the television through her mobile devices.
“Content casted using Chromecast has larger subtitles with better contrast on a black background, so I can read the subtitles better and enjoy movies and Korean dramas more than before, without having to strain my eyes,” she said.
There is no one-size-fits-all solution for every person with disability, but Alvin Tan of said that every individual will benefit from assistive technologies, whether for work, learning or daily living.
“With companies putting in place work-from-home arrangements due to the Covid-19 pandemic, the same assistive technologies used in the office — screen readers for persons with visual impairment and anti-tremor mouse adapters for those who exhibit shaky hand movements, for example — would similarly be helpful when working from home.”
Tan of TTSH said: “Many patient have given feedback that with the eye-gaze devices, they can stay connected with family and friends, express their thoughts about issues and not just ask for basic help like getting a diaper change.
“Some patients have gone further to write articles in international newsletters, do e-commerce work and decide on what they want for home renovation. The ability and opportunity to participate in various activities brings a lot of hope and joy in their lives.”
Originally published by MalayMail