Biomedical Engineering Reference
In-Depth Information
through the tests, conversation, and medical observations shows no large deficits in upper
cognitive functions. In any case, the patient was enlisted in cognitive therapy to improve
and generalize his own communicative strategies.
9.3.1.3 Communication Strategy
At the moment the patient uses, with the help of his brother, a codified gestural alphabet
that is very difficult to understand by other people. Through an alphabetic paper chart, he
can compose words by pointing at the letters, but in an extremely slow and difficult way
because of his serious dysmetria.
9.3.1.4 Evaluation of Visual, Perceptive, and Motor Functions
The patient can evaluate after having bandaged his right eye (RE) to counterbalance
diplopia and without wearing the glasses prescribed for a slight myopia and astigmatism.
There is a vertical nystagmus movement more evident in the RE at the beginning of the
evaluation that successively also appeared in the left eye (LE). The patient can only follow
horizontal movements by completely moving his head, but he can more easily follow
vertical movements without needing to move the head too much. A least eye movement
can be observed in the direction of the nasal region. There is no great difference between
the RE and LE. The monocular sight evaluation was 1/10 for the RE and 3/10 for the LE both
at a distance and from a proximal point. However, we recommend not using characters
smaller than 5 mm. There is a slow convergence movement. It is not possible to elicit
efficient saccadic movements, although in this case the patient can compensate for them
with his head movements. The patient can correctly scan stimuli adequately segregated in
a target. The peripheral awareness of stimuli is normal.
9.3.1.5 Aids and Assistance
At the moment, Mr. S.A. has neither aids nor assistance to communicate. In the past he was
able to learn how to use a computer and acquired a good knowledge of its main functions.
He still uses the computer to browse on the Internet, although he needs help. He has never
used either a videogame or multimedia instruments (such as an encyclopedia on a CD).
9.3.1.6 Request
Communication assistance and access to a computer (Macintosh) have been requested.
The request concerning the computer is specified as follows: “use of keyboard and mouse
and facility to visualize the contents of a monitor” to allow the patient to read, write, and
manage the Internet and his e-mail.
9.3.2 The ATA Process
The psychotechnologist acts in the following six steps.
9.3.2.1 Multidisciplinary Team Meeting
• User data valuation
• Setting design
