Exploration of multimodal alternative access for individuals with severe motor impairments: Proof of concept

Many individuals with complex communication needs and severe motor impairments are unable to control technologies through conventional means and require alternative access techniques to achieve accurate and efficient access. With current alternative access techniques, individuals with severe motor impairments are limited in that they can only use one access technique at a time. The purpose of this project was to test proof of concept of a new multimodal access technique which integrated eye gaze and single switch scanning selection techniques. The aims were to investigate the learning patterns of two adults with severe cerebral palsy when first introduced to the multimodal access technique and then to compare the accuracy and efficiency of multimodal to single-modality access when selecting targets on an AAC visual scene display. The participants learned to use the multimodal access technique; they demonstrated improvements in their accuracy of selection across sessions and attained at least 80% accuracy within 3-15 training sessions. Both participants achieved similar accuracy with multimodal access compared to single-modality, but took longer to select targets with multimodal access compared to single-modality. The potential utility of multimodal access is explored as well as important avenues for future research.