How to do a remote assistive technology assessment

Because of Covid-19, there’s a greater need for assistive technology practitioners to conduct remote assessments. This post presents a method used by occupational therapist Charlie Danger to assess for eyegaze access remotely.

How to do remote assistive technology assessments. Photo of Charlie Danger in front of two computer monitors: one showing a client's face and one showing the client's on-screen keyboard.

How to do remote assistive technology assessments. Photo of Charlie Danger in front of two computer monitors: one showing a client's face and one showing the client's on-screen keyboard.

Overview

Charlie Danger (@DangerOT) is an occupational therapist who is part of the Barnsley AT Team in the UK. A big part of his work is helping people improve their physical access to AAC and computing devices. He created a short video to show how he conducts an assessment for eyegaze access entirely remotely. This video shows a specific setup, but the concepts could also be adapted for other types of remote assistive technology assessment.

Let’s first look at the video and then describe some of the details of this approach.

Basic setup

The client in the video uses an IrisBond eyegaze camera on a GridPad 12 running Grid 3 (all available from Smartbox). Charlie shipped this device to the client for trial, after first having a remote session discussing the client’s goals and needs. The setup uses TeamViewer to provide video-conferencing and to connect Charlie’s computer and the client’s GridPad. Two computer monitors give Charlie a clear view of the client’s shared screen, as well as the client’s face. The client sees their Grid3 AAC software, running on the GridPad computer, and they can also see Charlie’s face in the TeamViewer window.

Basic procedure

Here’s the basic procedure that Charlie follows in the video, once he and the client are connected via TeamViewer. By the end of these steps, he’s got a good idea of whether the eyegaze setup is working well for the client. He may also have insights into what might be done to improve the performance.

  1. Remote control. Charlie requests control of the client’s computer, so that he can run the client’s Grid3 software remotely.
  2. Start with Grid3 in Rest Mode, so that the client’s eye movements won’t be selecting any Grid3 cells (for now).
  3. Check the eyegaze video. Charlie opens the Eyegaze Settings window within Grid3 and displays the Eyegaze Monitor. This provides close-up video of the client’s eyes — basically the same view that the eyegaze camera is seeing. Charlie uses the Eyegaze Monitor to carefully observe whether the setup and the client’s eye movements look suitable. There are lots of good details about how he does this in 1:20 – 4:18 of the video.
  4. Calibrate. Charlie starts the Calibration within the Eyegaze Settings, observes the client during the calibration task, and gets the calibration scores from Grid3. See 4:20 – 5:03 in the video.
  5. Low-stakes trial. Charlie turns on the small dot option in the Highlighting eyegaze setting. This allows him to get a sense of how well the client can gaze in different cells, before asking her to do any actual typing. The client tries to move the small dot to various cells in the Grid3 keyboard. See 5:20 – 7:00 in the video.
  6. Actual typing. Now that everything looks like it is setup for success, Charlie asks the client to dwell on the Rest button (the red box with ZZZ in it) to activate real selections. She then types a short message. See 7:00 – 8:00 in the video.

Step 3 is a key step as it provides Charlie with a close-up video of the client’s eyes as the eyegaze camera “sees” them. This allows direct observation of the client’s eye movements and other issues like glare that can affect eyegaze success.

Why TeamViewer?

Charlie uses TeamViewer because it meets National Health Service criteria and has been approved for the Barnsley team to use. Other virtual platforms like Zoom might also provide the same features and meet the standards in your own setting. But this of course depends on your particular setting. The main features you need are video conferencing and remote control for the client’s computer.

Other issues in a remote assessment

Charlie notes that the video represents only part of a full assessment. For example, in a real appointment he would also connect to a smartphone camera in the client’s home, so a caregiver in the home could use the camera to show Charlie things that aren’t visible from the client’s webcam. This allows Charlie to have a look around the environment, check their seating and positioning, and check the position of the eyegaze device, all remotely.

And the video is a simulated assessment, so it doesn’t show challenges like interruptions in the background or problems that may be difficult to address remotely, like poor positioning. It’s difficult to cover all scenarios with remote assessment. Still, for some individuals and some contexts, the procedure does allow for effective remote assessment.

What about other eyegaze systems?

This approach involves a GridPad 12, running Grid 3 software and an IrisBond eyegaze system. Charlie reports that you could also use this approach with the Eyegaze Edge and Alea cameras. However, not all eyegaze systems provide the video view of the client’s eyes. According to Charlie, you can’t follow these exact steps with Communicator 5 because the Tobii camera doesn’t allow access to the video feed. In that case, you would have to skip Step 3 in the procedure above, so you’d have to rely on less direct information.

What about other types of access technology?

You could also adapt this remote approach to doing assessment with other types of assistive technology, such as hands-free mice, switches, or alternative keyboards. One big challenge, of course, is identifying a good set of candidate devices to ship to the client, based on their specific needs. If it’s a client you’ve already met and worked with in-person, this might not be so difficult. But it presents some definite challenges if you need to do it entirely remotely.

With non-eyegaze AT, you won’t have a built-in tool like the Eyegaze Monitor to watch the client’s movements while using their AT. So you may need to rely more heavily on the connection to the smartphone camera in the client’s environment. Someone in the client’s home may be able to position the smartphone to give a clear view of the client’s interaction with their access AT.

Final thoughts

If you want to take performance data while your client performs tasks using their AT, you can use KPR’s Compass software. See our blog post on using Compass remotely for details. And of course, you can always contact me at hhk@kpronline.com with any questions.

Charlie plans to create additional videos showing other aspects of remote assessment, so you may want to subscribe to the Barnsley YouTube channel.

How are you doing remote assessments? Please share your thoughts and questions below!

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