Being able to use a computer has been such a positive aspect of my life with ALS that I want to
share the tricks and tools I use to keep computing.
Step One: The Right Computer Desk
The first thought in computer access for the disabled is usually about finding hardware and software,
but accessibility has to begin with even more basic problem solving; finding a desk that will allow you to
use your computer!
Over the years I have been through any number of rigged up computer setups as I fought to keep ahead of my ever-increasing weakness. Every setup turned out to be temporary -- and looked it! I finally had enough of
crappy looking desks and set out to find a workable, adaptable, computer work center that looked like
furniture. The desk I came up with is made from Sauder furniture, and is the one I should have started out
with because it is adaptable through many stages of disability. I was already in a power wheel chair when I
came up with the idea for the desk so it was built to wheelchair height, but could be made at standard desk
height and elevated later using leftover, matching wood to maintain its good looks.
The first requirement of a desk is support for weak arms. It amazes me that very, very few computer
desks for wheelchair users have this feature! My arm support is cheap, easy to make, uncomplicated, and
roomy. I use a piece of plywood with a deep cutout so that it wraps around my waist and extends far enough
back to support my elbows. This tray slides out from under the desktop and rests on my wheelchair arm
rests, providing support at just the right height for shoulder comfort. At the time I designed this desk, I
was still able to reach the tray and pull it out, as well as use the keyboard. I can't do either of those
things now, but the pull out tray is easy for my caregivers. (I have to rotate the joystick for my
wheelchair a bit to fit under the tray.)
I also have a portable tray made exactly like my desk tray. It is held onto my chair with two short
bungee cords (the blue straps) that hook through two small holes drilled into the back edge of the tray and
then down to hook on the wheelchair frame. It is a really inexpensive, quick to set up, roomy solution for
computing anywhere I go, but requires assistance to set up even if you have arm strength.
Arm supports recommended by Occupational Therapists are from medical/rehabilitation suppliers and are
very expensive and industrial looking. They attach to the wheelchair which can be a real nuisance for
transfers. The one advantage of this type is that they are available with springs or large rubber bands to
help you raise your arms to feed yourself. This feature isn't needed for computer access
Commercial arm support devices available with the most affordable types found on web sites selling
ergonomic devices for computer users. Besides being inexpensive, they are generally made to clamp onto the
desk and have a finished look. Some combine the arm support with an attached mouse pad support. Perhaps the
most affordable desk to use with arm supports is an adjustable height drafting table. These can be found
for as low as $110. In addition to being inexpensive, they are small enough for cramped quarters, require
minimal assembly, and adapt to any wheelchair height. The downside is that they have no space for a printer
and other peripherals.
Before making the switch from mouse to some type of eye gaze cursor controller, there are some things
that can be done to prolong your mousing ability:
Reduce the need to click the mouse. Point-N-Click can be set to automatically left click whenever you
place your cursor over a clickable item. That alone saves a gazillion clicks, but isn't the only
option. You can quickly (and without clicking) switch back and forth to right click, double click,
click and drag, select multiple items from a list, and more. It doesn't clutter your view of
whatever is up on your monitor. It hides off to the side of the screen and the control buttons are
made visible by putting the cursor on the little edge that remains on the screen. I use this
Change your mouse pad.
I use an oversized pad so that I don't can't push the mouse over the edge and have to struggle to
get it back on the pad. XTracPads Ripper XL™
v2 is fantastic! It is 14 x 17 3/4 wide and has a friction free smooth cloth surface that
maximizes the strength I have left.
Free up your elbows.
quite a while I used a Moving Men pad to allow smoother elbow turning, pushing, and pulling the
mouse. More recently I came up with an elbow roller that works even better. Get 4 small rolling
casters from Banana
Robotics. Cut about a 4X6 piece of thin wood or non-flexing plastic. (It could be smaller but I
found that the small size cut off circulation and made my arm go to sleep.) Attach the rollers with
small screws or glue. Add a pad of cushioning foam and your mouse will skate easily!
Dress appropriately for your office.
Avoid bulky clothing and rough fabrics that limit arm movement.
Get the right mouse and stick to it.
I use a simple optical mouse and prefer one without a scroll button which just gets in the way, but
they are hard to find. A wireless mouse is just too heavy to push around. I have had to switch to my
left hand, and need help to lift my fingers up onto the mouse. When the humidity is low or my hands are
cold and stiff, a piece of tape helps hold my fingers on the mouse. Velcro tabs on the right and left
buttons keep my fingers in place.
Nail that tail.
I have found that the mouse cord hanging down will quickly pull the mouse sideways so the cord is
tucked under the keyboard or taped to the desktop to hold it in place.
And now the Critical Step!
My arm weakness is so severe that even with all those tricks, I don't have the strength to move the
mouse enough to get the cursor to the sides and corners of the screen where all the buttons are! Big
screen monitors offer big views but increase the distance you need to move the mouse to get across the
screen. A simple solution is to reduce the resolution of your monitor display. How you do this depends
on your computer. It will take a few tries to find a size that is small enough to get your cursor
across the screen without being too tight a view.
Additional distance can be achieved an incredible, inexpensive, ergonomic software program called
It cuts the distance you have to move the mouse in order to move the cursor in half! Without it, I need
to move the mouse about 3 inches to cross the screen with the cursor. With Intellipointer, I can
do it with 1 1/2 inches. This is not the same as adjusting your mouse speed. It adjusts
something called "mouse throw". Intellipointer seemed to have disappeared from the Internet a few years ago. Although a search
would give you a link to download it, the links would all come up as “file not found”.
Recently however, it has reappeared. You can download a time limited trial version and purchase it for
$29. I can't recommend it highly enough. It is the primary accessibility tool that has delayed my need
for an expensive head mouse or eye gaze system! The weaker your arms, the more valuable
Intellipointer is. When you first turn it on, it may seem to make little difference if your arm
weakness is only moderate. Use it for a half hour, turn it off, and you will be able to tell the
***A newer alternative to Intellipointer is to try a gamers' mouse. These have settings to reduce the
mouse throw. The correct terminology is to reduce the CPI (count per inch) that controls how far the
cursor moves in response to mouse movement. Intellipointer worked so well for me, but recently it became
just too hard to push the cursor to the corners and sides of the monitor. I bought a moderately
priced SteelSeries Rival 300 gaming mouse. It solved the reaching problem entirely, but has made it a little
more difficult to hit a specific spot on the screen on the first try. That is well worth the small aiming
adjustments in exchange for the struggle to move the cursor long distances. ***
Step Three: Ditch the Keyboard
You don't need to be able to use a keyboard to use your computer, and you don't need to buy any
software! The software programs you need are free. Before you assume that purchased programs would
be better, consider the fact that this website is done using these freebies. I also do photo editing and
have a website for that, Free Photo Fix Magic
So what are these great programs?
The first program I rely on is a free onscreen keyboard called Click-N-Type. It puts a keyboard on the screen and as you move
the cursor over the keys, it types for you -- or lets you control your computer with any keyboard
command (Control/Shift, F4, etc.). You never need to struggle with your keyboard again!
Several great features make this freebie indispensable:
You don't have to click the mouse for each letter. Just set it on auto click and it will
click as you pause the cursor over a key.
You can set it with Macros that type frequently used words, phrases, or sentences with just
It offers a standard Qwerty layout as well as an alphabetical one, and even allows you to
design your own. I have created custom layouts to speed up typing, code html, or use just the
number keys. The one shown here groups the alphabet in the center rather than in two long
lines, making it faster to find the desired letter. The most often used letters are centered,
making it even faster. Having a couple of the blank spaces lets you pause in your typing
without leaving the program.
It has Word Prediction to speed up typing.
The only drawback to using Click-N-Type is that is hard to type with any real speed as it is
essentially hunt and peck. When I want to compose an email or a bit of literary genius, I Use
Dasher, another freeware program.
Dasher is like playing a race car game -- you just drive the cursor, pointing it down the road
to the next letter you want to type. With just a little practice you can move at speeds nearing that of
ordinary typing. The speed allows you to work at composing, not just plunking out letters! I find that
setting the View/Orientation at Bottom to Top works best.
Step Four: Move the Monitor
the slightest amount of neck weakness can make using the computer an effort. Neck muscles tire quickly if
not supported, but leaning back to use a head rest changes the angle of view, causing eye strain. I thought
I needed new glasses when I couldn't read anything but the largest type. Then I discovered that all I need
was a booster seat for the monitor! By raising my desktop monitor up about 5 inches, I can rest my head and
still see the screen at the right angle. I expect that at some point I will have to find a way to
compensate for a more reclined position by both raising the monitor and tilting it forward. But for now, my
monitor is setting on a study plastic tool case awaiting the day when someone gets around to building a
nice shelf for it. My laptop required a much higher boost to bring it up to a comfortable eye level and a
collapsible, completely adjustable for both height and angle monitor stand has
been terrific. Easy to adjust, more and taller heights possible, stable without clamps or bolts, and the
laptop doesn't need to be attached to it. Several brands are available. Here is a link to one online
seller. monitor stand
The End Result...
Me, happily at my computer, surrounded by my adaptive equipment!