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Using Eye Gaze to

Communicate

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Pennsylvania Training and Technical Assistance Network (PaTTAN) Pennsylvania Department of Education

Commonwealth of Pennsylvania Mark Schweiker, Governor

Department of Education Charles B. Zogby, J.D., Secretary

Office of Elementary and Secondary Education Thomas P. Carey, Ed.D., Deputy Secretary

Bureau of Special Education Fran Warkomski, Ed.D., Director John J. Tommasini, Assistant Director The Pennsylvania Department of Education (PDE) does not discriminate in its educational programs, activities, or employment practices, based on race, color, national origin, sex, sexual orientation, disability, age, religion, ancestry, union membership, or any other legally protected category. Announcement of this policy is in accordance with State law including the Pennsylvania Human Relations Act and with Federal law, including Title VI of the Civil Rights Act of 1964, Title IX of the Education Amendments of 1972, Section 504 of the Rehabilitation Act of 1973, the Age Discrimination in Employment Act of 1967, and the Americans with Disabilities Act of 1990.

The following persons have been designated to handle inquiries regarding the non-discrimination policies:

Complaints regarding discrimination in schools: Human Relations Representative, Intake Division, Pennsylvania Human Relations Commission, Harrisburg Regional Office (717) 787-9784; Pittsburgh Regional Office (412) 565-5395; Philadelphia Regional Office (215) 560-2496

Complaints against a Pennsylvania Department of Education employee: Pennsylvania Department of Education, Equal Employment Opportunity Representative, Bureau of Personnel, 11th Floor, 333 Market Street, Harrisburg, PA 17126-0333; Voice Telephone: (717) 787-4417; Fax: (717) 783-9348; Text Telephone TTY: (717) 783-8445

Information on accommodations within the Department of Education for persons with disabilities: Pennsylvania Department of Education, Americans with Disabilities Act Coordinator, Bureau of Management Services, 15th Floor, 333 Market Street, Harrisburg, PA 17126-0333; Voice Telephone: (717) 783-9791; Fax: (717) 772-2317; Text Telephone TTY: (717) 783-8445

General questions regarding educational law or issues: Pennsylvania Department of Education, School Services Unit, Director, 5th Floor, 333 Market Street, Harrisburg PA 17126-0333; Voice Telephone: (717) 783-3750; Fax: (717) 783-6802; Text Telephone TTY: (717) 783-8445

PaTTAN – Harrisburg Office: 6340 Flank Drive, Suite 600, Harrisburg, PA 17112-2764; (800) 360-7282 (PA only), (717) 541-4960; Fax: (717) 541-4968

PaTTAN – King of Prussia Office: 200 Anderson Road, King of Prussia, PA 19406; (800) 441-3215 (PA only), (610) 265-7321; Fax: (610) 265-5737

PaTTAN – Pittsburgh Office: 5347 William Flynn Highway, Gibsonia, PA 15044; (800) 446-5607 (PA only), (724) 443-7821; Fax: (724) 443-1310

Website: www.pattan.k12.pa.us

A special thanks to Linda Brown, Central Intermediate Unit 10 and Karen Narvol and Wilma Soliday, Capital Area Intermediate Unit 15.

Table of Contents

Section I. A. What is Eye Gaze? .................................................................................. 2 B. Why Consider Eye Gaze? ....................................................................... 2 Section II. A. What Do Eye Gaze Systems Look Like??? ............................................ 3 B. Direct Selection: Objects/Symbols....................................................... 4 C. Direct Selection: Lapboard................................................................... 5 D. Direct Selection: Eye Gaze Frame/Display.......................................... 6 E. Direct Selection: Mirror ....................................................................... 7 F. Direct Selection: Eye Gaze Vest .......................................................... 8 G. Direct Selection: Multiple Display Eye Gaze Vest.............................. 9 H. Direct Selection: Half Tran System ................................................... 10 I. Encoded: Color Coded Eye Gaze System.............................. 11 J. Encoded: Alphabetic Eye Gaze System................................. 12 K. Encoded: Numeric Coded Eye Gaze System ......................... 13 L. Computerized Eye Gaze Systems ......................................................... 14 Section III. A. Eye Gaze Into Action: The Team Process ........................................... 15 B. Eye Gaze Into Action: Suggestions.................................................16-17 C. Glossary................................................................................................. 18 D. Resources for Eye Gaze ...................................................................19-20 E. Eye Gaze Product Providers.................................................................. 21

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Section I.

A. What is Eye Gaze?

A method by which the user directs his or her eyes toward a symbol or object to indicate choice. (Glennen & DeCoste, 1997)

B. Why Consider Eye Gaze? _ Eye gaze evolves early as a means for communication. _ Eye gaze can serve as a primary mode of communication for some individuals. _ Eye gaze can serve to supplement other communication methods. _ Eye gaze is effective across many environments. _ Eye gaze is often "available" as a backup option when other systems breakdown. _ Eye gaze can serve as a foundation of skills to apply to the future use of technology.

"In an age in which we continue to be impressed with the marvelsof technology; it is easy for the professional to underestimate the potential benefits of eye gaze techniques." (Goosens & Crain, 1987)

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Section II.

A.What Do Eye Gaze Systems Look Like??

Let's Look at Some Examples of Eye Gaze Systems: • Direct Selection: Objects/Symbols • Direct Selection: Lapboard • Direct Selection: Eye Gaze Frame/Display • Direct Selection: Mirror • Direct Selection: Eye Gaze Vest • Direct Selection: Multiple Display Eye Gaze Vest • Direct Selection: Half Tran System • Encoded: Color Coded Eye Gaze System • Encoded: Alphabetic Eye Gaze System • Encoded: Numeric Coded Eye Gaze System • Computerized Eye Gaze Systems

Each example includes information about the role of the speaker and the role of the listener. The speaker is defined as the individual sending/communicating the message. The listener is defined as the individual receiving the message. Considerations for use and implementation are provided for each example.

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B. Direct Selection: Objects/Symbols p

Speaker's Role: Look at the desired target. Listener's Role: Position oneself facing the speaker and "receive" speaker's eye gaze as communication message "said". Considerations:

• A strategy most people use without recognizing it as an early eye gaze method of choice making.

• Can be done anywhere, no batteries required. • Targets can be held by listener; the speaker can gaze at targets in

his/her environment. • Speaker can confirm message by looking back at listener after looking at target; this can indicate end of message. • Easily used for selections of people, friends to be with, locations in room, etc. • Descriptive feedback should include a repeat of the perceived message from speaker.

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C. Direct Selection: Lapboard

Speaker's Role: Look down at desired target on lapboard. Listener's Role: Position self in front of speaker. Respond to communication message "said" by speaker, using their eyes. Considerations:

• Communication targets can be easily changed and customized to the activity.

• The person is looking down to communicate, so it can be difficult to know at which target the speaker is looking. • Can be tried with individuals who already use a lapboard. • Can be done anywhere. (No batteries required!) • Speaker can look back at listener after looking at target; this confirms communication/end of the message. • Descriptive feedback should include a repeat of the perceived message from the speaker.

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D. Direct Selection: Eye Gaze Frame/Display

Vertical Frame

Opening

Opening

Horizontal Frame

Plexiglass

Symbols Speaker's Role: Look at desired target on eye gaze frame/display then look back to listener. Listener's Role: Position self facing speaker and "read" speaker's eye gaze at target on eye gaze frame. Respond to communication message "said" by speaker. Considerations:

• Messages should be placed on both sides of frame so both the speaker and listener can see the same thing. • Frames can be either transparent or opaque; consider visual distractions in the background. • Communication targets can be represented by objects, photographs, line drawings or symbols. • The frame can be held or attached to table, tray or on a stand. • Make sure that space between pictures is significant enough for listener to discriminate speaker's message. • Descriptive feedback should include a repeat of the perceived message from the speaker.

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E. Direct Selection: Mirror

Mirror

Symbols

Speaker's Role: Look at desired target on mirror then look to listener's reflection. Listener's Role: Position self behind speaker and "read" speaker's eye gaze at desired target, which is reflected in the mirror. Respond to communication message "said" by speaker. Considerations:

• Objects, pictures, line drawings or symbols are displayed around the mirror. Requires mirror. • Position mirror at speaker's eye level whether seated in chair,

being held by listener, or standing. • If mirror is metal, object magnets can be used, or pictures/symbols can be placed in magnetic photo holders. • Descriptive feedback should include a repeat of the perceived message from the speaker.

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F. Direction Selection: Eye Gaze Vest

Speaker's Role: Look at desired target on eye gaze vest, then look at listener. Listener's Role: Wear vest and "read" the speaker's eye gaze selection on the eye gaze vest. Respond to communication message "said" by speaker. Considerations:

• Because the individual is looking at your body to communicate, it can be difficult to know at which target the individual is looking. • Frees listener's hands for interaction. • Messages can be represented by objects, pictures, symbols or line

drawings. • Messages can be easily changed and customized for activities. • Usable in an activity with more than one individual (one environment). • Pockets on vest can be used for picture storage. • Descriptive feedback should include a repeat of the perceived message

from the speaker. p

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G. Direct Selection: Multiple Display Eye Gaze Vest

Speaker's Role: Look at desired target on multiple display eye gaze vest. Return eye gaze to listener to confirm completion of message. Listener's Role: "Read" speaker's eye gaze at target. Change display as requested by speaker or in response to inquiry by listener. Respond to communication message "said" by speaker. Considerations:

• Develop a "message" for the speaker to indicate that "message" is complete. • If there are "messages" that are repeated on several displays, keep that

message in a consistent location. • Provide a "message" on each display to indicate a desire by the speaker to change to another display. • Descriptive feedback should include a repeat of the perceived message

from the speaker.

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H. Direct Selection: Half Tran System Removable

Plexiglass Open

Speaker's Role: Look at desired target on half tran system, then look at listener.

Listener's Role: Position oneself facing the speaker and "receive" speaker's eye gaze as communication message. Respond to message "said" by speaker. Considerations:

• The half tran is open at the bottom, so the listener can "reach through" and provide any needed support to the student. • Consider speaker's view of activity and visual blockage from half tran. • Descriptive feedback should include a repeat of the perceived message

from the speaker. * Special Note: This system was designed by Jim Yocum, Assistive Technology Consultant with Lincoln Intermediate Unit #12, New Oxford, PA.

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I. Encoded: Color Coded Eye Gaze System

Block Targets Color Corner

lexiglass

pening

How To: Blocks of targets are placed around the frame. A block contains 4 to 9 items. Each target in the block has a symbol with a different color background. These back-

O

grounds remain consistent for each block. The color of each background is represented in the corner of the Etran (eye transfer) system. P Speaker's Role: Communicate desired target through two steps. 1. Look at Block where item is located, then look back to listener. 2. Look at the corner with the background color of the target, then look back to listener. Listener's Role: Position self facing speaker and "read" individual's eye gaze first to the block then to the targets color. Respond to communication message "said" by speaker coding. Considerations:

• Use color backgrounds that contrast with communication targets. • Use as many blocks as user can discriminate with eye gaze. • Communication targets can be represented by objects, photographs, line

drawings, symbols, or words. • Frames can be either transparent or opaque. • Place messages on both sides of frame. • Can be held or attached to table tray or on a stand. • Can be used in testing, as a full communication board, or

back up strategy. • Descriptive feedback that tells the listener exactly what the speaker is receiving is important.

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J. Encoded: Alphabetic Eye Gaze System

Opening

A 0 B

C 1 D

E 2 F

G 3 H

I 4 J

K 5 L

M 6 N

O 7 P

Q 8 R

S 9 T

U V W

X Y Z

Space Delete

Speaker's Role: Communicate by spelling. Indicate letters/numbers through three steps. 1. Look at block where letter/numeral is located then look back to listener. 2. Imagine that the chosen block expands across the entire frame.

I 4 J

K 5 L

3. Look to location of letter/numeral within the indicated block. Continue until word or message is spelled. Return eye gaze to listener to indicate end of choice. Listener's Role: Position self facing speaker and "read" individual's e{ye gaze first to the block, then to the letter/numeral location within the block. Repeat until word is spelled and speaker indicates end of message. Respond to communication message "said" by speaker. Considerations:

• May also be used with symbols, line drawings, pictures, or words. • May be used as a back-up system to hi-tech device. • May be used as a test-taking adaptation. • May want to say each letter out loud as chosen. • Use "space" between words on a continuous message. • Use "delete" when speaker misreads.

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K. Encoded: Numeric Coded Eye Gaze System How to: Place numbers around laptray. Develop vocabulary targets and arrange on communication board. Code each target with a number (start with two digits). Place a listener display with codes and targets either on a wall or hang from front of display. C Tar

Cod

Laptray

ommunication Target

Number for code

gete

Speaker's Role: Communicate desired target through two steps. 1. Look at first number of target code then look back to listener. 2. Look at second number of target code. Listener's Role: Position self in front of speaker and "read" individual's eye gaze to first number then second number. Match number code to communication target and respond to communication message "said". Considerations:

• Communication targets can be represented by sentences, photographs, line drawings, symbols, or words. • Numbers can also be placed at distinct points in a room or play/work

area. • • More numbers can be added if speaker is able to eye gaze to distinct locations. • Three digit codes can be added as speaker progresses. • May be used as a back up system to a hi-tech device.

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L. Computerized Eye Gaze Systems

How to: There are only a few eye gaze input systems commercially available. These systems include a computer monitor (sometimes two monitors), a camera, and eye-tracking software. Software is also needed for word processing, speech output, text reading and/or game playing. Speaker's Role: Eye gaze to control keys which are displayed on computer monitor. Build messages through spelling or combining words. Activate speech output button to talk. Listener's Role: Respond to communication message "said" by speaker. Considerations:

• Training, support time, and costs. • Strain on speaker's eyes and concentration. • Reading and spelling abilities of speaker and listener. • Not an entry level method for access for a child. • Speaker must have limited motion of their head.

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Section III.

A. Eye Gaze Into Action: The Team Process

T T

arget the activity

Choose Type of Eye Gaze System and Symbols

Position the System

rain the Speaker Communication Partner(s)/Listener within the activity

Choose Symbols toRepresent Messages

Target Communication Message Needs for Activity

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B. Eye Gaze Into Action: Suggestions This only works when done by a team (e.g., Educators, Family members, Speech-Language Pathologists, Vision Consultants, Occupational Therapists, Physical Therapists, Paraprofessionals, Students, etc.). Remember to utilize your vision consultants, occupational therapists and physical therapists for information on visual considerations and seating and positioning issues for the individual, as well as the eye gaze system. Target the Activity:

• Choose meaningful and motivating activities. • Speaker needs to develop familiarity. • Provide opportunities for natural communication. • Activities should occur three-five times a week.

Choose the Type of Eye Gaze System and Symbols:

• See options in Section II for types of eye gaze systems. • Symbol options may include objects, photographs, line drawings, colored drawings. • Gather input on student's visual skills. • Gather input on optimal seating/positioning.

Position the System:

• Some systems can be held by the listener. • Consider permanently/temporarily attaching the display so the speaker

has a consistent and predictable location for use. • Request support from OT/PT in determining system position. • Put system at speaker's eye level. • Assistive Technology or camera mounting systems can be used for placement and attachment to allow speaker and listener to have hands free.

Target Communication Message Needs:

• Break down activities into tasks. • Identify natural opportunities for communication within the tasks. • Identify messages that provide opportunities for the speaker to initiate,

maintain and terminate an interaction. • Target messages that support the range of communication messages.

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Select Symbols for Messages:

• Select symbols that best represent each communication message. • Include the speaker in symbol selection. • Utilize a message gloss (written words/message) on the symbol, so listener

knows the intent of the symbol; this encourages literacy. • Use input from vision consultant.

Train Communication Partner:

• Focus attention on the speaker. • Communicate/validate eye gaze as an accepted means of communication using

words such as: tell, ask, answer, say, and describe. • Feedback to individual should provide description such as "you told me with

your eyes that....." • Position oneself as close to eye level of speaker as possible. • Accept initial gaze. • Do not over-confirm choice, meaning, when a student communicates, accept the message; do not ask the student if that is what they really wanted to say, this may result in the child changing their message and being perceived as an inconsistent communicator. • Respond to communication and allow speaker to change request if you have

interpreted them incorrectly. Train Speaker:

• Within the activity, not separately. • To gaze at target and then return gaze to listener. • Teach speaker to first look at listener, then look to target, then look back at

listener to complete communication sequence. • For some way to indicate that the listener has received the message incorrectly.

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C. Glossary Direct Selection: The process in which the speaker chooses a communication message through indication of one item. Encoded: The process in which the speaker chooses a communication message through making a series of item selections.

E-tran: This is a term used for an eye-transfer system, which is a system for communication. This type of communication occurs when an individual uses their eyes to "look" at what they are "telling" someone. Frame: The physical support on which symbols are placed. It can be held by listener, speaker, or mounted to a table, chair, or floor. Listener: The individual(s) who is/are receiving the message. This could be a student or an adult. Speaker: The individual who is communicating the message. In this resource, this refers to the person who is using the eye-gaze system. Target: This refers to the visual representation of the communication messages. Symbols can include objects, line drawings, photos, color pictures, words, letters, etc. Some individuals will have a combination of the above based on their communication needs and skills. Also referred to as item, message, or symbol. Vest: An item worn by the listener onto which symbols are placed. Can be purchased or homemade using fabric which is velcro sensitive, or made with clear pockets.

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D. Resources for Eye Gaze

Beukelman, D., Yorkston, K., & Dowden, P. (1985). Communication Augmentation: A Casebook of Clinical Management. San Diego, CA: College-Hill Press. Beukelman, D. & Mirenda, P. (1982). Augmentative and Alternative Communication: Management of Severe Communication Disorders in Children and Adults. Baltimore, MD: Paul H. Brookes Publishing Company. Blackstone, S. (1992). Communication Module-Technology in the Classroom: Applications and Strategies for the Education of Children with Severe Disabilities. Rockville, MD: American Speech-Language-Hearing Association. Blackstone, S. & Bruskin, D. (Eds.) (1986) Augmentative Communication: An Introduction. Rockville, MD: American Speech-Language-Hearing Association. Blackstone, S., Cassatt-James, E., & Briskin, D. (Eds.) (1988). Augmentative Communication: Implementation Strategies. Rockville, MD: American Speech-Language-Hearing Association. Carlson, F. (1981). Alternate Methods of Communication: A Handbook for Students and Clinicians. Danville, IL: The Interstate Printers and Publishers. Carlson, F. (1982). Prattle and Play: Equipment Recipes for Nonspeech Communication. Omaha, NB: University of Nebraska Medical Center. Charlebois-Mariois, C. (1985). Everybody's Technology: A Sharing of Ideas in Augmentative Communication. Montreal, Quebec, Canada: Charlecoms. Faux, C. (1989) Developing Effective Communication for the Physically Handicapped Child. Tuscon, AZ: Therapy Skill Builders. Fishman, I. (1987). Electronic Communication Aids: Selection and Use. Boston, MA: College-Hill Press. Glennen, S.L., & DeCoste, D.C. (1997) Handbook of Augmentative and Alternative Communication. San Diego, CA: Singular Publishing Group, Inc. Goossens', C., & Crain, S. (1986). Augmentative Communication Assessment Resource. Birmingham, AL: Sparks Center for Developmental and Learning Disorders, University of Alabama at Birmingham. Goossens', C., & Crain, S. (1987). Overview of Nonelectronic Eye-Gaze Communication Techniques. AAC Augmentative and Alternative Communication. Volume 3, No. 2, pages 77-89. Goossens', C., & Crain, S. (1988). Suggestions for Developing Peer-to-Peer Communication Through the Use of a Shared Eye Gaze Frame. Assistive Device News, Volume V, No. 1, pages 3-4.

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Goossens', C., & Crain, S. (1988) Augmentative Communication Intervention Resource. Birmingham, AL: Sparks Center for Developmental and Learning Disorders, University of Alabama at Birmingham. Goossens', C., Crain, S., & Elder, P. (1992). Engineering the Preschool Environment for Interactive Symbolic Communication. Southeast Augmentative Communication Conference. Birmingham, AL. Holton, R. (1990). Eye Gaze Communication Systems: Unlocking "Locked-In Syndrome." 1990 ASHA Convention, Seattle, WA. Kangas, K., & Lloyd, L. (1988). Early Cognitive Skills As Prerequisites to Augmentative and Alternative Communication Use: What Are We Waiting For? AAC Augmentative and Alternative Communication, pages 211-221. Musselwhite, K., & St. Louis, K. (1988). Communication Programming for Persons with Severe Handicaps: Vocal and Augmentative Strategies. Austin, TX: Pro-Ed. Owens, R. (1982). Program for the Acquisition of Language with the Severely Impaired: Training Level Activities Guide. Columbus, OH: Charles E. Merrill Publishing Company. Reichle, J., York, J., & Sigafoos, J. (1991). Implementing Augmentative and Alternative Communication: Strategies for Learners with Severe Disabilities. Baltimore, MD: Paul H. Brookes Publishing Company. Silverman, F. (1989). Communication for the Speechless. Englewood Cliffs, NJ: Prentice-Hall. Tatenhove, G. (1986). Development of a Location, Color-Coded ETRAN. Orlando, FL: Communication Systems Evaluation Center. Vanderheiden, G., & Grilley, K. (Eds.) (1977). Non-vocal Communication Techniques and Aids for the Severely Physically Handicapped. Baltimore, MD: University Park Press. Williams, G. (Ed.) (1988). The North Carolina Augmentative Communication Association Activity Book. North Carolina Augmentative Communication Association. Yorkston, K. (Ed.) (1992). Augmentative Communication in the Medical Setting. Tuscon, AZ: Communication Skill Builders.

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For additional resources and support with eye gaze systems and their implementation, contact the local assistive technology consultant at your intermediate unit.

E. Eye Gaze Product Providers Eye-Com Board Transparent Vinyl Overlays Transparent Pocket Overlays Innocomp Suite 302, 26210 Emery Road Warrensville Heights, OH 44128 800-382-8622 FAX: 216-464-3638 E-mail: Innocomp@aol.com Web site: http://www.sayitall.com Eye Transfer Communication System Table, Floor and Clamp Mounts Zygo Industries, Inc. 16260 SW Upper Boones Ferry Road Box 1008 Portland, OR 97207-1008 800-234-6006 FAX: 503-684-6011 Web site: http://www.zygo-usa.com Eye Gaze Communication Systems LC Technologies/Eyegaze Systems 9455 Silver King Ct. Fairfax, VA 22031 800-393-4293 FAX: 703-385-7137 E-mail: info@eyegaze.com Web site: http://www.eyegaze.com Opticommunicator Acrylic Board Object Communicator Acrylic Board and Shelf Crestwood Company 6625 N. Sidney Place Milwaukee, WI 53209-3259 414-352-5678 FAX: 414-352-5679 E-mail: crestcomm@aol.com Web site: http://www.communicationaids.com

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