Using a Handheld to Help People with Neuro-Muscular Disorders Brad A. Myers, Sunny Yang, Brian Yeung, Jeffrey Nichols, and Robert Miller Human Computer Interaction Institute School of Computer Science Carnegie Mellon University Pittsburgh, PA 15213 bam@cs.cmu.edu http://www.cs.cmu.edu/~pebbles/ ABSTRACT People with Muscular Dystrophy and certain other muscular and nervous system disorders lose their gross motor control while retaining fine motor control. The result is that they often lose the ability to move their wrists and arms and so their ability to operate a mouse and keyboard deteriorates over time. However, they can often still use their fingers to control a pencil or stylus, and thus can use a handheld com- puter such as a Palm. We have developed software that allows the handheld to substitute for the mouse and key- board of a PC, and tested it with four people (ages 10, 12, 27 and 53) with Muscular Dystrophy. The 12-year old had lost the ability to use a mouse and keyboard, but with our software was able to use the Palm to access email, the web and computer games. The 27-year-old found the Palm so much better that he is now using it full-time instead of using a keyboard or mouse. The other two subjects reported that our software was much less tiring than using the conven- tional input devices, and enabled them to use computers for longer periods. We report the results of these studies, and the adaptations made to our software for people with dis- abilities. Keywords: Assistive Technologies, Personal Digital Assis- tants (PDAs), Handicapped, Disabilities, Hand-held computers, Palm pilot, Muscular Dystrophy, Pebbles pro- ject. INTRODUCTION About 250,000 people in the United States have Muscular Dystrophy (MD), which is the name given to a group of noncontagious genetic disorders where the voluntary mus- cles that control movement progressively degenerate. One form, called Duchenne Muscular Dystrophy (DMD), affects about one in every 4,000 newborn boys [4]. With Duchenne, boys start to be affected between the ages of 2 and 6, and all voluntary muscles are eventually affected [12]. First affected are the muscles close to the trunk, and nearly all children with DMD lose the ability to walk some- time between ages 7 and 12. In the teen years, activities involving the arms, legs or trunk require assistance. Becker Muscular Dystrophy is a much milder version of MD, and the onset can be in late adulthood. A related disorder is Spinal Muscular Atrophy, which is an inherited neuromuscular disease that causes weakness in the body, arms, and legs. It affects both boys and girls starting at 6 months to 3 years, and progresses rapidly [12]. Many other disorders also affect people’s ability to control their muscles and use their hands, including Amyotrophic Lateral Sclerosis (ALS, also known as Lou Gehrig’s Dis- ease, which affects approximately 30,000 in the US [5]), Cerebral Palsy (which affects about 500,000 people in the US [17]) and Arthritis (affecting nearly 43 million Ameri- cans). Increasingly, people with these disorders, like the rest of the population, are experienced with using computers. Unfortu- Submitted for Publication Figure 1. 12-year old Kevin has Duchenne Muscular Dys- trophy. He is operating his PC by using two hands to control the stylus on the Palm running RemoteCommander.