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Development of software for multi-handicapped individuals.

Focus: School Years

Topic: MDVI

Thomas Ragnarsson

Low Vision Instructor and Computer Pedagogue

SPRIDA Communication Centre

Örebro County Council


SE 701 15


+4619602 42 42


I work at a centre for Augmentative and Alternative Communication (AAC) attached to the County Council of Örebro, Sweden, called SPRIDA. I will tell you about my 12 years of experience from tailor-made software.

In the spring of 1991, SPRIDA got a request from a low vision clinic, about trying out a communication aid. This visual aid was meant for a boy suffering from a degenerative disease, called Batten disease. The disease causes serious communication disorders.

Together with the people around this boy we had a few meetings to shed light on the future needs. Those meetings ended in a list of criteria, of which most are still valid. The list of criteria was like this:


·       The software had to be very easy to use, still flexible enough to make it possible to introduce the method of switch control at an early stage, without boring the pupil.

·       The software had to be possible to control with only one switch, if necessary.

·       The software had to be designed with a structure of main and subtitles where complementary information could be entered.

·       The feedback would be synthetic speech and digital sound.


Our visual aid analysis showed that there was no appropriate aid available, due to the specified needs in this case. We decided to try to develop flexible PC software. We wanted to be able to use the software in school from the beginning, using a desktop computer, along with suitable add-on equipment. The software should have such a simple command structure that it also would work as a communication aid in the final stage of the disease.

Work in this matter required much more of SPRIDA resources than evaluations and try-outs normally did. Therefore, we applied for funds from the Swedish Handicap Institute to be able to complete our intentions and our work with the boy. We obtained funds, and from February 1992 and on, we worked on this as a 3-year project.

The project lasted for three years and was concluded by the writing of a report. The project made it possible, in a way unique to us, to document our work. We developed simple communication software from the view of fundamental demands and weighing in our collected experiences. It also opened up the opportunity for a continuing follow-up of three boys suffering from Batten disease, and to share their experiences from having used the software.

We learnt a lot from our experiences. The most important thing was that we could see what great use and great joy everyone had from using their computers. We could also note that, so far nothing had been suggested to prove that our chosen path was wrong and would not work for communication. However, we discovered one weakness. Our resources to train and support the local user were not satisfactory. This meant that, in the future, society would have to give subsidies in this aspect too, to make it possible to give effective support and training in something as complex as a communication aid. We also discovered, that if we were too focused on communication during the training sessions, it simply blocked people from using the computer for that purpose. Showing how to use the equipment in the ordinary work in school broadened the use and the communication in the classroom. This fact also opened our eyes to see the possibility to use this software for other groups of disabled people.

Over the years Struktur has been developed in co-operation with Ekeskolan, Örebro, Sweden, with Tambartun Kompetansesenter, Trondheim, Norway, with Tikoteekki, Helsinki, Finland and with Refsnæsskolen, Kalundborg Denmark. The software has been translated into the respective languages. Each centre has taken the responsibility for distribution and education in their country. Every second year we have a Nordic conference dealing with Batten disease. During this conference experiences concerning Struktur is discussed. Next conference will be held in Norway 2004.

Furthermore, in each Nordic country there are network sessions two times a year when teachers and assistants exchange experiences. These sessions are of great importance for the use and development of Struktur.

The software.

In Struktur you can do a lot. First of all it is a text processor supported by a text-to-speech converter. The text may also be coloured by recorded sounds. The software is controlled via five switches and you can use the switches, for example, to open and read a text. From the “message bar” the pupil has to select what to do. What can be done is custom made for every individual, so the content of Struktur differs from user to user.


            Text window

            Message bar

            Five switches

All modules in Struktur are developed from the user’s needs, as a starting point. The modules are all navigated by the switches and supported by the text-to-speech converter. Depending on the needs and the ability of the user you can choose between the following modules in Struktur:



Play CD

Play MP3

Play Memory

Make telephone calls

Read in a Picture Book

Send and receive e-mail

For parents, teachers, etc. there are modules to create files appropriate to the user.

All such modules are reached from Settings in Struktur.

Case studies.

Frida is 12 years old and suffering from CVI. She is in a school for handicapped children. On “good days” Frida can tell much of what she sees and works with. Other days Frida is not in the mood to do so at all. She can not read or write. In Struktur she reads texts, made by the teacher, via the text-to-speech converter. The texts are tales, about schoolwork and excursions they do. They often use the Picture Book to document their work. As the text-to-speech converter tells Frida what’s in a picture, Frida is not forced to interpret the picture, and then she often becomes more interested in finding details. Printouts and texts on floppy discs are used as messages to and from Frida’s parents.

Marcus is 32 years old. He suffers from a brain injury after an extensive bleeding in his brain 4 years ago. He is blind, mentally retarded, suffers from a perception of touch inability and has difficulties using his right hand and foot. He can not read or write. In fact he can hardly do anything by himself. When we met him and his parents we talked about what he was interested in. Reading books, making phone calls to friends and listening to music were two subjects that we noticed. After a few days of planning we saw him at our centre and showed how he possibly could use a custom built computer with the software Struktur to read and listen to the music he wanted. Now he uses a computer together with the software Struktur, a barcode reader, a text-to-speech converter, 3 switches and a scanner with OCR program. That helps him to choose between 10 music-CD’s so that he can play his favourite tunes whenever he wants to. He can also read texts scanned into the computer and make telephone calls to 8 close relatives and friends.

Charlie is 18 years old and suffering from CVI. He has three personal assistants and he has a job in a coffee bar 4 hours a day. Charlie is fond of travelling, swimming and singing. Charlie does not interpret shapes, but can identify different colours. He also uses colours as numbers. When we met Charlie the first time he knew about 6 characters in Braille. Unfortunately Charlie’s perception of touch was bad so it was difficult for him to read Braille. When Charlie works in Struktur he uses a coloured keyboard, the keys (F,D,S,J,K,L,A,Ö on a Swedish keyboard) numbered as in Braille from 1 to 8. When typing Braille, each letter is spoken via the text-to-speech converter. Except for reading and writing Charlie uses Struktur to make telephone calls and his assistants make him Picture Books from his travels.

Tina is a blind girl who is autistic and goes in a class for handicapped children in a regular comprehensive school. She is 12 years old and can not read or write. She often gets afraid when she tries to do new things. The teachers and parents want to try to use a computer to motivate her to practise a little on writing and reading. They also hope to start a positive progress.

Tina gets a computer with the software Struktur and a Concept keyboard. The teacher starts to write social tales about difficult situations in her daily life. After a few weeks they can notice that she is calmer in those situations and that she does not have to ask so many worried questions before doing those things.

After several months of using this equipment she is keener on learning new things and calmer in situations that worried her a lot earlier.

So far she has not started to read or write Braille. But she uses the Concept keyboard for practising every week.


Struktur has developed and become an important tool in teaching multi-disabled persons. We believe it depends on the fact that we sell the program including education on how to use it and we do try to create networks of users in regions. In network sessions teachers and assistants exchange experiences and support each other. When we attend during these sessions we get a unique possibility to take part of the pupils´ and the teachers´ ways of using the software. During these sessions suggestions about new functions and program modules often turn up. And we think that this is a splendid way to develop a pedagogical tool. But as we all know a tool is just a tool. To make it work and to customise it for each individual there has to be a well educated, committed teacher. No more nor less than that.

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