Regaining independence: environmental control systems and their psychological influence

Spinal cord injured (SCI) people with a cervical lesion (tetraplegia) suffer severe levels of impairment and consequently lose a substantial amount of their independence,and this can be a huge blow to their quality of life (QOL). Their loss of independence involves a wide range of aspects of daily living, however, this chapter will focus on their inability to control devices in their immediate environment (such as the television,computer, telephones, lights, doors, etc.). To help SCI persons regain some independence, research and development has been conducted into assistive technologies designed to provide control over such devices. An environmental control system (ECS) is an example of assistive technology that is designed to provide alternative means of switching and activating devices without the use of hands or fingers. There is an abundance of work conducted on ECS technology, resulting in a number of creative control systems that are designed to be used by the severely disabled. These include switching systems that utilize voice, muscle, brain activity, head motion, eye blink,breath, chin, and so on. Unfortunately, the efficacy of most of these systems has not been scientifically established. This chapter will present a range of ECS technology, and discuss psychological benefits, challenges and future directions of ECS technology for the severely disabled.