PhysicalTherapy.com Phone: 866-782-6258


A New Era: From EADLs to Alexa!

A New Era: From EADLs to Alexa!
Michelle Lange, OTR, ABDA, ATP/SMS
May 4, 2021

To earn CEUs for this article, become a member.

unlimited ceu access $99/year

Join Now
Share:

Learning Outcomes

  • After this course, participants will be able to describe the challenges of the use of consumer technologies for home control faced by people with disabilities.
  • After this course, participants will be able to list several consumer products that can be used to control devices in the home environment.
  • After this course, participants will be able to describe limitations to consumer technologies and instances where disability-specific solutions are appropriate.

What We Will Be Covering

Electronic Aids to Daily Living (EADLs) provide an alternative means of controlling devices, primarily within the home environment, including audiovisual equipment, lighting, and thermostats.
Advances in consumer home automation technologies have opened new control opportunities for people with disabilities.

This is an area that I have been teaching about my entire career. This came on my radar in my first year as an occupational therapist, but at that time, the technology that was available to us was very primitive. We have come such a long way since then. There is tremendous crossover now between this area of technology and consumer electronics, and that is what we are going to cover today. Please keep in mind this is rapidly changing, and a lot of the onus is still on us to make sure we are aware of the most available options.

What are EADLs? This is an area of assistive technology known as Electronic Aids to Daily Living and has been known by other names as well such as environmental control units. These provide an alternative means of controlling devices, usually at home like audiovisual equipment, the TV, cable box, music, lighting, thermostats, et cetera. Advances in consumer home automation have opened up control not only for the general population where we are controlling devices in a much different way, but it is also creating many opportunities for those with disabilities.

Different Technologies/Same Goals

Many people with disabilities have difficulty controlling devices in the environment due to physical, visual, and/or cognitive limitations
This control is important for independence, safety, and overall quality of life
Early ECU systems became available in the 1980s
The name later became EADLs
This area of assistive technology was chronically underfunded and behind the level of consumer technology advancement

People who have disabilities have difficulty controlling things in the environment due to physical, visual, and cognitive limitations. For example, it might be difficult for someone to turn on their television and switch channels. They may not have the motor ability to reach out, grab the remote, and push a button. Or, they may not be able to see what is on the remote. They may not be able to remember a specific sequence of commands. For people with disabilities, this control becomes very important and it is not simply a convenience. Being able to control the environment increases a person's independence, safety, and overall quality of life.

Environmental Control Units  (ECU) became available in about the 1980s. Consumer technologies were not very advanced during this time. In fact, this is when VCRs and CDs were just coming out. The name later changed to Electronic Aids to Daily Living (EADSs) to better define this area of technology and to improve funding. The challenge was, regardless of the name, that this area was chronically underfunded and constantly behind consumer technology advancement. It was also often overpriced.

  • This technology fell into two main categories
    • Basic EADLs
      • Simple switch control of battery-operated and electrical devices
      • SLATs, PowerLink
    • Multi-Function EADLs
      • Full control of a variety of devices and functions in the home
      • Multiple access methods – direct, switch, voice
    • Overlap with Home Automation and even Robotics over the years
    • Now being replaced by Consumer Technologies, such as Alexa

This area of assistive technology tends to fall into two main categories: Basic EADLs and multi Function EADLs. Basic EADLs are not used as much as they used to be due to advances in technology, but they still have a place for the clients we work with, particularly with children and with adults who have significant cognitive limitations. Basic EADLs provide simple switch control of battery-operated devices or simple electrical devices. For example, a stuffed cow that we see here in Figure 1 can be set up with a switch for a child to operate.

Switch operated toy

Figure 1. Switch operated toy.

Other examples are single on/off appliances like a light or a fan. This area of technology includes devices such as Switch Latch and Timers (SLAT--shown with the cow toy). This is made from AbleNet that allows switch control of a simple electrical device.

Then, we have multi-function EADLs and these provide full control of a variety of devices and functions within the home (Figure 2).

Multi-function EADL by Tash

Figure 2. Multi-function EADL by Tash.

Instead of just operating one item, we now have control of an audiovisual system as an example. These devices allow you to not only turn the power on and off, but it also allows the changing of channels, the operation of the DVD player, and so on. 

While there are still some of these devices out there, many are overpriced and often there is no funding. There are times when these are appropriate and we will review them. The other difference between multi-function EADLs versus our basic EADLs is that these devices can be accessed directly by pushing a button (if the client has the ability), by a switch, or by voice.

There has been an increasing overlap over the years between home automation devices and even robotics in the EADL realm and much of this technology is now being replaced by consumer technologies such as Alexa as seen in Figure 3. 

Alexa

Figure 3. Alexa.

Electronic Aids to Daily Living

  • EADLs provide alternative control of devices in the environment:
    • Audiovisual equipment
    • Electric hospital bed
    • Nurse call
    • Door openers
    • Telephone
    • Lights
    • Appliances: fan
    • Heating and air conditioning

Electronic aids to daily living provide alternative control devices in the environment. This can include an electric hospital bed, nurse call, door openers, telephones, lights, very simple appliances like a fan, and heating and air-conditioning systems. We now have the ability to control a more significant number of devices as well as functions for each of those devices. These systems typically use infrared. Infrared is what a typical television remote uses to send signals.

Multi-Function EADLS

  • Provide control of a variety of devices and functions
  • Typically use infrared and Insteon technologies
  • Access:
    • direct, switch or voice
  • Usually too complex for young children or persons with cognitive impairments

A technology called Insteon can be used to control things that plug into the wall by using the wiring within your house. Insteon Technologies has, for the most part, replaced technology called X10. Some of these systems use other wired transmission options as well. One example is the PocketMate by SAJE Technology in Figure 4.

PocketMate by SAJE Technology

Figure 4. PocketMate by SAJE Technology. 

Access, again, is by direct contact, switch, or by voice, and these systems are usually too complex for young children or people who have cognitive disabilities. Additionally, these systems often require good vision and good literacy which can be a limitation for some of our clients.

To earn CEUs for this article, become a member.

unlimited ceu access $99/year

Join Now

michelle lange

Michelle Lange, OTR, ABDA, ATP/SMS

Michelle is an occupational therapist with over 30 years of experience and has been in private practice, Access to Independence, for over 15 years. She is a well-respected lecturer, both nationally and internationally and has authored numerous texts, chapters, and articles. She is the co-editor of Seating and Wheeled Mobility: a clinical resource guide, editor of Fundamentals in Assistive Technology, 4th ed., NRRTS Continuing Education Curriculum Coordinator and Clinical Editor of NRRTS Directions magazine. Michelle is a RESNA Fellow and member of the Clinician Task Force. Michelle is a certified ATP, certified SMS, and is a Senior Disability Analyst of the ABDA.

 



Related Courses

Matching Products to Seating Needs
Presented by Michelle Lange, OTR, ABDA, ATP/SMS
Recorded Webinar
Course: #4099Level: Introductory1 Hour
Once the wheelchair seating assessment has been completed and seating interventions considered, it is time to match specific client needs to product interventions. This course presents various categories of seating systems. Seating systems, whether linear, contoured, or molded, are comprised of primary support surfaces, secondary support components, and materials. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT/PTA.

Dependent Mobility Intervention
Presented by Michelle Lange, OTR, ABDA, ATP/SMS
Recorded Webinar
Course: #4102Level: Introductory1 Hour
Dependent mobility devices are not designed for self-propulsion. These include adaptive strollers, transport chairs, tilt-in space manual wheelchairs, reclining manual wheelchairs, and standard manual wheelchairs. For very small children, adaptive strollers are often required to meet positional and dependent mobility needs. Other dependent mobility bases, such as transport chairs and standard wheelchairs, are used for quick trips or for temporary use. Clients may also use a dependent mobility base as a backup to a power wheelchair. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT/PTA.

Computer and Tablet Access
Presented by Michelle Lange, OTR, ABDA, ATP/SMS
Recorded Webinar
Course: #4128Level: Intermediate1 Hour
This course will present a hierarchy of computer and tablet access options for clients unable to use standard access, such as a keyboard, mouse, and touch screen. Access assessment requires analysis of motor skills, vision, cognition, and functional applications. Alternative keyboards and mice will be presented, as well as other alternative access options. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT/PTA.

Manual Wheelchair Mobility: Self-Propulsion
Presented by Michelle Lange, OTR, ABDA, ATP/SMS
Recorded Webinar
Course: #4176Level: Introductory1 Hour
Most manual wheelchairs are designed for self-propulsion and fall into categories. This course systematically explores each category with clinical indicators, as well as optimal frame configuration to increase propulsion efficiency and reduce the risk of repetitive stress injury.

Power Wheelchair Advanced Features
Presented by Michelle Lange, OTR, ABDA, ATP/SMS
Recorded Webinar
Course: #3990Level: Advanced2 Hours
Power wheelchairs do far more than drive – the driving method can be used to navigate and control other features including Reverse, Speeds, Power Seating, or an Interfaced Assistive Technology device (i.e. a communication device). Power Wheelchairs can send Bluetooth signals to control devices such as tablets and smartphones. Finally, new SMART technologies are making power wheelchairs safer and more efficient for everyone. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT/PTA.