Brief report
Youth With Cerebral Palsy With Differing Upper Limb Abilities: How Do They Access Computers?

https://doi.org/10.1016/j.apmr.2010.08.013Get rights and content

Abstract

Davies TC, Chau T, Fehlings DL, Ameratunga S, Stott NS. Youth with cerebral palsy with differing upper limb abilities: how do they access computers?

Objective

To identify the current level of awareness of different computer access technologies and the choices made regarding mode of access by youth with cerebral palsy (CP) and their families.

Design

Survey.

Setting

Two tertiary-level rehabilitation centers in New Zealand and Canada.

Participants

Youth (N=60) with CP, Manual Ability Classification Scale (MACS) levels I to V, age 13 to 25 years.

Interventions

Not applicable.

Main Outcome Measure

Questionnaire.

Results

Fifty (83%) of the 60 youth were aware of at least 1 available assistive technology (AT), such as touch screens and joysticks. However, only 34 youth (57%) were familiar with the accessibility options currently available in the most common operating systems. Thirty-three (94%) of 35 youth who were MACS I and II used a standard mouse and keyboard, while few chose to use assistive technology or accessibility options. In contrast, 10 (40%) of 25 youth who were MACS III to V used a variety of assistive technologies such as touch screens, joysticks, trackballs, and scanning technologies. This group also had the highest use of accessibility options, although only 15 (60%) of the 25 were aware of them.

Conclusion

Most youth with CP were aware of, and used, assistive technologies to enhance their computer access but were less knowledgeable about accessibility options. Accessibility options allow users to modify their own computer interface and can thus enhance computer access for youth with CP. Clinicians should be knowledgeable enough to give informed advice in this area of computer access, thus ensuring that all youth with CP can benefit from both AT and accessibility options, as required.

Section snippets

Participants

The data analyzed in this report were collected as part of a larger study of motor control and computer use in 60 youth with CP and their families. This study had been approved by the Northern X Regional Ethics Committee in Auckland, New Zealand, and the Bloorview Research Ethics Board in Toronto, ON, Canada. The inclusion criteria were that participants had to be age between 13 to 25 years with a diagnosis of CP. Potential participants were recruited from tertiary level orthopedic and

Results

Sixty youth with CP, Gross Motor Function Classification System levels I to V (mean age ± SD, 16.3±3.9y; range, 13–25y; 29 male and 31 female subjects) were recruited (table 1). All 60 participants used a computer, 54 (90%) both at school and at home. Twenty-six participants (43%) had accessed computers at the library and 22 (37%) at a friend's home. Only 7 participants (12%) had used an internet cafe. Of the 58 (97%) students who attended school, 12 (20%) used laptops and desktops, 27 (45%)

Discussion

The advantages of computer use in childhood and adolescence are well recognized and include enhanced educational attainment, improved social networks, and promotion of fine motor, visual, and perceptual skills.13 For youth with CP, internet and e-mail use has particular salience, providing an opportunity to play and work within a virtual environment, enhancing societal participation. Given the benefits of computer use for youth with CP, it is surprising that they appear to have important gaps

Conclusions

These findings provide some insight into the knowledge and practical choices made by youth with CP with different abilities regarding computer access technologies. Deficits in knowledge of computer access technologies appear common, particularly around the use of accessibility options, despite these being freely available to all who use a standard computer. Both youth with CP and the clinicians who advise them need to be aware of the accessibility options within computer operating systems to

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