On Mice and Handicapped Children

Ivailo Ivanov, Temenujka Zafirova, Nina Jordanova Department of Information technologies, Sofia University,

Special hospital for residential treatment of prolonged therapy and rehabilitation of children with cerebral palsy “Saint Sofia”

iivanov@fmi.uni-sofia.bg, tzafirova@fmi.uni-sofia.bg, ninajordanova@yahoo.com

AbstractWhen beginning to work with a computer everyone starts by learning how to operate the mouse. For normal children this period is quite easy and takes very little time. However, for children with motor difficulties a programme of step-by-step practical exercises is required in order to learn the manual skills required. That process takes quite a long time and does not always produce a successful outcome. The paper describes certain problems related to teaching children with cerebral palsy how to control a mouse. A systematic program based on specially developed Logo software products that aim to teach the children the basic mouse activities was devised. The results, realized at the Center for Treatment and Rehabilitation of Cerebral Palsied Children (Sofia, Bulgaria), will be presented.

Keywords: Handicap, children, mouse control, Comenius Logo, cerebral palsy

1. Introduction

Because of its ability to combine text, sound, graphics and animation, the computer has become a wonderfully attractive instrument for today’s children. A child could spend hours and hours taking in what is happening on the screen. In order to take part in such activities and not just observe them, a child requires the necessary skills for navigating the computer system.

The graphic user interface, initiated by Apple, has become standard in computer systems since the arrival of Windows95 as an operating system for IBM compatible computers (PCs). The main device used to navigate software is a graphic pointer (usually looking like an arrow) displayed on the screen. This is the reason why it so important to improve skills in navigating the pointer as a first step in computer education. This process of pointer navigation depends on three factors: individual skills of the child; what peripherals are used for navigating; what software has been selected for learning.

2. Individuals

When we consider the individual characteristics of the children, we should pay attention to the fact that physically healthy children have mostly psychological difficulties when meeting something new, not known and challenging /learning to navigate the mouse pointer/. In the case of handicapped children the major problems are caused by difficulties that mainly reside in specifically physical processes, caused by their illness and physical disability. These characteristics of the handicapped children lead to a need for the provision of specialized education in separate periods, including learning separate sub-activities of working with the mouse. When providing these periods, we should consider the following points:

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1. The way gross motor functions are affected by the illness.2. The way more general physical functions are affected by the illness.3. The way fine motor functions are affected by the illness.4. The impossibility of concurrent learning of two activities, caused by the relative deficits in gross and fine

motor control. 5. The long time period necessary for mastering every separate movement of the mouse to the point when it is

mechanically automatic, releasing the child to think about the problem to be solved, and not about the actions entailed.

3. The Peripherals

There are two possible approaches to the problem: using a standard two-buttoned mouse; using some alternative.By alternative we mean working with a joystick, trackball, a touch-screen and their variations, or specially developed instruments similar to a normal mouse. A different position of the elbow, wrist and hand is used for working with these devices. It is claimed that they make some of the operations in navigating the mouse pointer on the screen easier.

In our two years of working with children with cerebral palsy and other neurological illnesses in the Special hospital for residential treatment of prolonged therapy and rehabilitation of children with cerebral palsy “Saint Sofia”, we came to the conclusion that in 70% of the cases the use of standard peripherals is better, for the following reasons: Handicapped children are enabled to work with the same equipment as the healthy children and thus they

don’t feel different. The standard two-button mouse allows for software adjustment, such as combining the active button and the

preferred for work right hand. In the cases when the right hand is not available at all, the child could work with a mouse with the right button active, instead of the left one. The same possibility is available in the cases of spastic palsy, because of the impossibility of a child to position their right hand, caused by the spoiled fine motor control of the child. Adjusting the buttons is easy and standard in the operating system.

The standard two-buttoned mouse was preferred to the track-ball, because the handicapped children can use the surface on which the mouse moves as a support whilst moving it with their hand to control the different activities. The positioning of the hand relative to the table is very important, particularly the wrist relative to the elbow. A standard posture is essential, maintaining an angle of 90degrees relative to the body in line with the leg bone, and a 45degree angle relative to the body and the shoulder bone.

The standard two-button mouse was also preferred to the Joystick, because the latter causes difficulties in spatial orientation. In most of the cases the handicapped children have poor body scheme and are not able to adjust their thinking to a three-dimensional situation. The Joystick therefore causes difficulties in the coordination of the position of the hand relative to the position of the mouse pointer.

Because of the fine and gross motor deficit of the handicapped children, they cannot take the right position of the body and the hand when working with a mouse, which makes it necessary for the hand to be straight from the wrist to the shoulder. Nevertheless, the decision to use the standard mouse provides the most flexible solution, allowing the child to work in spite of the difficulties.

Given the current economic conditions in the country, we considered it unreasonable to use in the process of education peripherals that could be expensive for the families. This could also lead to a necessity for teaching the child to use a new hand position and actions in order to work with those peripherals.

In the process of teaching a number of problems have arisen, concerning the children’s learning of the operations required for a two-buttoned mouse:

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Figure 1: Input screen

1. Most of the children can’t distance themselves from the work with the mouse on the desk. In some of cases, the child thinks that the mousepad defines the limits of its movements and pays attention to this and not on the action, hence position, on the screen.

2. Because this group of handicapped children has a visual thinking deficit, most of them cannot connect the mouse as a peripheral to the pointer on the screen. This leads to difficulties when synchronizing mouse movement with that of the pointer on the screen.

3. Because of their condition, cerebral palsy, and its effects upon fine and gross motor control, the children have difficulties in keeping the mouse pointer in a constant position.

4. The biggest and most frequent difficulties are those in the coordination of combinations of operations: button pressing, holding down the button and dragging with the mouse.

4. Software solution

We have developed a group of games (in Comenius Logo), allowing a systematic approach to the main mouse operations: free movement with the mouse upon the desk base and positioning of the pointer on an object on the screen; one click with the left or right button; dragging with the button pressed.

The main purpose is for the child to feel in a game situation, which involves mouse activity. Game problem solving motivates the children to be precise in their movements. At the same time the games have educational content, which takes into account the specifics of these children (1).

The learning of the main movements with the mouse is integrated into the structure of the separate games, at different levels. Thus, for example, in one of the first games Silhouettes, the child manipulates the shadow of an object, which is to be placed over the silhouette of the same object. Here we use a large graphic object as a pointer on a contrasting gray background as it is easy for the child to follow. On every turn of the game the pointer takes on the form of a different familiar object, which helps motivate long periods of work. This leads to a better mastering of the movement, on which the game is based. In the final level the child meets the standard form of the mouse pointer for the first time, except that it is bigger in size but it may be regulated to reach the original size.

Taking into account the problems of working with the mouse mentioned above, we created the following software solutions for dealing with the main movements (3).

SILHOUETTES

In this game the pointer takes the form of an object, which is to be placed over another. Free movement of the mouse on the desk base can be used to do this. This game is introductory and it plays a great role especially for children who have not previously worked with computers.

Able children will have few difficulties mastering the required movement. Within 2 or 3 days they will be able to move the mouse to any part of the screen without problems. The situation is very different for children with cerebral palsy. There are particular problems with two forms of cerebral palsy. The athetoid form, some 20-30% of the cases, results in very poorly coordinated random and chaotic hand movement. Children with the ataxic form have difficulty stopping a movement and hence overshoot (2). This makes it very difficult for them to hold the mouse pointer still on the screen and move it smoothly to another point. The problem with the spastic form of cerebral palsy is different. The muscular spasm in the hands of these children, leaving the fingers bent and the wrist

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Figure 3: Title screen

twisted, results in incorrect holding of the mouse, which cannot be corrected. They usually use the right button.

Figure 2: Screen dumps from Level 1and 3 of the game

For these reasons, each of these groups of children follows a specific training programme for mouse holding and control. In this way children become surer in their movements, the holding of the mouse becomes more stable and this leads to easier learning of the mouse movements.

SHADOWS

In this game the accent is upon acquiring two important movements with the mouse – clicking with the left button and dragging an object with the left button pressed.

Several educational problems are found here. This game helps the development of abstract thinking in the children, their curiosity and ability to analyze, synthesize and compae. In this case this is accomplished by the comparison of two collections of objects – colorful pictures and shadows. The first collection contains rich detailed objects, colors and forms, whilst the second contains matched simple shaded images, which retain only the outline form of the objects.

Figure 4: Screen dumps from Level 1 Figure 5: Screen dumps from Level 2

It is no coincidence that the picture is composed of objects highly familiar to children, i.e. we work in the so-called ‘Area of Actual Cultivation’ of the children, and we suppose that they need no help with the actual problem posed. That is, we do not aim to teach them new objects but to help them acquire and improve the new skills. This is made possible by using a base of childhood objects with which the children have an immediate familiarity.

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Figure 6: Input screen

Figure 8: Input screen

SOUNDS

In this game the movements, as above, single click of the left-button and dragging on the screen with the left button pressed, are acquired and improved.

In addition to these manipulative skills, the game is important for children with cerebral palsy, who also have language and speech problems and problems with phonemic analysis. This often leads to communication difficulty and misunderstandings. The game has two main resource banks - of pictures and of the sounds that are pictures' names. Thus the child could hear the right pronunciation of the word and connect it with the right image – a familiar exercise for children. The game develops in children the ability to differentiate sounds that have been heard. Given that mechanical memory is stronger in most of these children, the game assists the correct perception of an adequate number of words, each connected with an image the children could directly relate to.

Figure 7: Screen dumps from the Levels

WORDS

The game helps the process of acquiring and training of the movements single click of the left-button and dragging an object on the screen with the left button pressed. Two resource collections are employed - one of the colorful images and another of associated words, so this game is for children who can already read and write. In addition to the manual skills for working with the mouse acquired in the game, the intellectual development of children is also promoted. The connection of word-to-picture helps develop their logic. With the Shadows and Sounds games the images common to all the games and the names of those images have already been introduced, and the visual and hearing skills of the child have been exercised. Here the names of those objects are displayed in written form and hence the child needs to be able to recognize the letters, to read and write. Literacy is a prerequisite for the problems at this game level.

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Figure 9: Screen dumps from the Levels

All programs are created in such a way that they can be easily modified by the user. The following adjustments are possible:

changing the number of pictures appearing simultaneously on one and the same screen, which allows the definition of different levels of complexity;

changing the size of the pictures by entering a number, which allows children with visual problems to see the details more clearly;

changing the list of pictures and the corresponding words. This makes possible the easy adaptation of the programs for another language.

5. Educational program

An educational program was developed for all the above software solutions, including continuity in the use of each separate problem, psychological and educational aspects of using the program.

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Table 1: Program for trainingGame Name Age Group Period of Education Educational Aspect Psychological Aspect

Silhouettes 4 years old Until a free movement with the mouse is acquired, but not more than 3 months

Free movement with the mouse, recognition of picture images

Comparing an object to a shadow, developing the attention line in each aspect

Shadows 4 years old 1. Until the single click of a button is acquired

2. Until dragging with a button pressed is acquired, but not more than 6 months

Ability to do a simple logical operation

Developing abstract logical thinking, analysis and synthesis

Sounds 4,5 years 1. Until the single click of a button is acquired

2. Until dragging with a button pressed is acquired, but not more than 6 months

Ability to do a simple logical operation

Developing abstract logical thinking, analysis and synthesis, development of phonemic analysis

Words Over 5 years 1. Until the single click of a button is acquired

2. Until dragging with a button pressed is acquired, but not more than 6 months

Ability to do a logical operation

Developing abstract logical thinking, analysis and synthesis, development of phonemic analysis, learning the graphic image of the word

6. Results

The educational program for acquiring the main mouse movements was applied over a one-year period and its use produced significant psychological and educational effects. The following results were observed: In acquiring mouse control, the skill level reached depends on the individual characteristics of the children. Spatial orientation was improved for the children with cerebral palsy. Improving in coordination, spatial and constructive praxis with children with dis-praxis. Improving in all the indices in the psychological profile of every separate child, due to the educational effect

of the program.

The software solutions for the acquisition of the main mouse movements, which have been presented, and the results achieved using them prove the usefulness of the program. The results suggest that application to other groups of children with disabilities, with problems similar to these in the computer education, would be valuable. (Коментар: Смисълът на предишното изречение е неясен.) The educational program for working with the mouse is suitable for children with normal physical ability as well as for children with cerebral palsy, MBD, epilepsy, praxis disabilities, and combined disabilities connected to cerebral functions.

7. References

1. Ilieva V., Ivanov I. (1999) Graphics – series of books “The Computer in Primary School”, Regalia 6, Sofia.2. Valente, J. A. (1983) Creating a computer-based learning environment for physically handicapped children, USA

3. Ivanov I., Zafirova T., Jordanova N. (2001) Special games for handicap children to get control on the mouse, EUROLOGO2001, Linz

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