Projector-Illuminated Communication (PIC) Board
J. A. ALLAIRE, B.A., M.A./C.C.C. L. K. VOGTLE, B.S., O.T.R. P. E. ALLAIRE, B.S., M.S., PH.D.
The problem of providing an adequate means of communication for the nonvocal, severely handicapped child is one that has interested the occupational therapist, the biomedical engineer, and the speech pathologist alike. With each discipline contributing its individual expertise, a simple solution may be possible. This solution will help to diminish the frustration experienced by the alert cerebral palsy child whose physical involvement is so severe as to preclude the development of oral speech. Giving this child a means of communication will also facilitate the educational process. Furthermore, a communication board facilitates language development 8 .
Several studies have been undertaken to determine the feasibility of nonoral electronic communication devices 4,5,6,7 . LaVoy 7 designed a device composed of a circular display board and a pointer. A part of the body must pass across a light beam to activate the device. Others 5,9 have developed devices that utilize an electronically actuated printout display, and Feallock 2 suggests the use of printed communication boards. Hagen, et al. 3 , devised a signal device that allowed children to utilize a yes-and-no response. Recently, more sophisticated devices have employed a commercial character generator and a television monitor1. This system allowed the child to communicate by using a headstick to point to various letters.
We have developed a new communication board which uses a rear-projection screen and a standard carousel slide projector. The carousel slide projector offers the advantages of availability, low cost, and large storage capacity for slides of pictures or words. The remote-control slide advance provides the possibility of allowing the child to control the slide-selection process, thus making the child more independent and able to develop skills on his own.
There are two primary ways for individuals to operate the Projector-Illuminated Communication (PIC) Board. Pointing with the hand or finger and a small wooden dowel is one way. Another way is by using a standard headstick and relying on head control to indicate words. The feasibility of each of these ways is determined on an individual basis, depending on the abilities of each individual child.
Prototype PIC Board
A prototype rear-projection board, shown as a schematic diagram in Figure 1 , has been constructed from a 41 cm x 61 cm x 0.6 cm (16 in. x 24 in. x 1/4 in.) sheet of clear Plexiglas. The board is supported in its 61 cm-high vertical position by a simple wooden base which rests on the floor or on a table. Six electrically conductive bands approximately 2.5 cm (1 in.) wide (indicated by slashed areas in Figure 1 ) were painted on the board with silver conductive paint of the type used for printed circuits. Flat blue acrylic artist's paint was used to divide the board into six rectangular panels of size 14cm x 11.5cm (5 and 1/2 in. by 4 and 1/2 in.) with the silvered band located at the bottom of each panel. A thin panel at the top was left for a title. Ordinary masking tape was found suitable for masking both the silver and acrylic paints. The back of each panel was covered with thin typewriter paper to provide a surface suitable for rear projection ( Figure 2 ).
A small six-volt red light (drawn as a small circle in Figure 1 ) was placed in the center of each silvered panel. One lead from each light was connected to the silvered panel with a small bolt, and the other lead was connected to one terminal of a six-volt dry-cell battery. The other terminal of the battery is connected to the child's headstick or pointer with a thin wire, and the tip of the headstick is coated with electrically conductive paint. When the child touches the silvered band with the silvered tip, the red light is activated. The use of a six-volt system makes the PIC Board completely incapable of electrical shock, but capable of long-term operation.
The carousel slide projector is placed behind the board a sufficient distance for the projector to fill the board while in focus, as shown in Figure 3 . A 35-mm camera was used to prepare slides containing various combinations and arrangements of pictures corresponding to the six panels. An appropriate title for each slide was placed at the top. The slide projector was advanced by the speech pathologist as required, using a remote-control button. If the small remote box was held against the board, most of the patients were able to depress the forward and reverse buttons.
The reliability of the individual's response was noted to be influenced by numerous factors. Motor response was found to be the most critical factor in successful use of the PIC Board. Time and care were taken to maximize the individual's motor control by adapting position of the patient and the board.
The speed with which the individual was able to code the messages was a factor that varied with the reliability of the patient's response and the content of the board. For this project we attempted to choose children who demonstrated word or picture recognition skills that were average, or no more than one year below their chronological age, as measured by the Peabody Picture Vocabulary Test. In this way, comprehension skills were controlled. The position of pictures and words on the slides proved to be very important. Using a six-square matrix, it was determined that the majority of children had difficulty in reaching both the uppermost and lowest squares. When headsticks were used, lateralized head movements proved to trigger less total body extension than vertical head movements in most patients. It was felt that a picture grid which used a horizontal configuration would be more successful.
Presently, the slides are reversed in the projector to obtain the proper orientation for rear projection. This leads to a minor distortion because the slide-projector lenses are ground to compensate for the normally expected curvature of the cardboard-mounted slides. Some experiments with commercially available mirrors to reverse the image while keeping the slide in normal position indicated that a portion of the light intensity was lost. Also, small manufacturing errors in the lenses near the edges combined with similar errors (ripples or other slightly nonplanar configurations) in the mirror to give equal or larger distortions. While the decrease in clarity of the picture is observable with either system under close examination, it does not significantly affect the rear-projection technique.
The prototype PIC Board did not prove to be as durable as desired. The Plexiglas proved sturdy. However, day-to-day use caused many loose wires and inoperative lights. Frequent and strenuous use caused the Plexiglas to loosen in its base. The board remained easy to transport, but the six-volt battery lacked compactness with the total unit. The battery frequently slipped from the base.
The materials used in the prototype PIC Board cost between $40.00 and $50.00. The slide projector, carousel, and slides brought the total cost to $300.00. This remained a reasonable amount for families or local charity groups to pay.
As the children learned new words, more slides were produced to accommodate the increment of their vocabulary. The Medical Photography Department was most helpful in their work of producing the numerous slides necessary. Experimentation was carried out with both the number of pictures and combinations of pictures and words. Slides incorporated combinations of random numbers of pictures (up to six) in various positions on the board. At times, depending on the needs of the child, single words were used instead of pictures.
The PLC Board has several advantages. First, the direct selection of words provides for a faster speed of coding. Unlike devices which require pointing to single characters1, the PIC Board allows for quicker communication. It is also faster than devices which employ a scanning selection process 7 and cause the patient to lose time while the cycle completes itself. The PIC Board proved to be feasible in terms of cost. It proved much less expensive than devices employing television monitors or computer terminals for output. Finally, the PIC Board provides a simple way to build vocabulary.
Certainly the PIC Board solves some of the inherent problems of the traditional communication board. Boards usually are constructed from paper or cardboard. The PIC Board provides both durability and easy increment of vocabulary. These goals are not easily achieved with a traditional board constructed from cardboard. In addition, the PLC Board meets the low-cost criteria not met by many electronic devices. Children using the PIC Board found the light system to be fun, while the speech pathologist and the occupational therapist appreciated its reinforcing value. Young, severely involved, cerebral palsy children cannot be placed on a reinforcement program using food as a primary reinforcer because of the feeding problems they usually exhibit.
Use of the present prototype has revealed some disadvantages. For example, it has been determined that the vertical format made it difficult for the child to reach the bottom of the board. It was found that horizontal presentation of material was superior to vertical presentation for reasons previously discussed. Also, the projected images are somewhat difficult to see unless the light in the room is at a fairly low level. The board-projector combination may be picked up and moved to another location, but it still is not fully portable because of its separate component parts. Future boards can be improved by placing the rear-projection board at an angle to the vertical and enclosing the projector in a box to avoid loss of light while enabling the board-projector combination to be carried as one unit.
The success of the patients in changing slides by themselves is highly encouraging. Some difficulty was encountered in pushing the small remote-control buttons with the headstick, but this operation could be improved by modifying the board to include silvered panels for control of the projector. The same six-volt battery-powered circuit could be used to trigger the projector forward or reverse. Thus the PIC Board could be used for self-study by the patient.
The PIC Board does not solve all of the problems that are inherent within the complex problem of nonoral communication. However, it appears to open some avenues of thought that may provide some solutions. Further study may provide more answers to these problems.
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