How was school today ? is a project from the University of Aberdeen aimed at giving kids with severe mobility and communication problems a voice. I found the reference to it on Dorkbot, and between Googling and calling around I found more.
The main thrust of the project is to use sensors to record the subject's position (GPS), position of dumb objects (RFID), and something ( definitely toss the barcode idea ) for people's position. Software and speech synthesis then help the child construct a narrative of the day. The goal is building the child's communication resources.
I can't address the interface problems. There are so many kinds of gestural limitations that each unit might have to be programmed to order and reprogramed as things developed. Publishing a high level computer language designed for a medical tech to use might speed this aspect up. Perhaps the folks in robotics have something on their shelves that could be adapted. As for the natural language aspect, yikes. The PhDs are going to need one of those proverbial fourteen year olds.
Hardware looks to be off the shelf. RFIDs are coming down in price, much to privacy advocates' dismay. GPS, speech cards, wi-fi, and IR or sonic position sensors, are all on sale at your local computer megamart. Kid-proofing the electronics to medical standards might take some work, but heck, if they can adult-proof it......
What I'd like to focus on is the interaction between kids. A child who has difficulty making herself understood, especially at playtime, might be afforded some relief using block visuals. The program could catalog what's in the vicinity using RFIDs, and pop a picture on the screen. An icon set of the most-used requests and a simple way to generate new requests could behave like a toolbar. Gestural manipulation of the picture's position would convey intent. A communication card, complementing the speech card, could transmit the desktop and sound to any machine set to receive it. MIT's Media Lab might have something ready to go on that point.
One last idea. The narrative self is necessary, but a kid needs a private self too. I think being physically limited and thoroughly dependent would only increase this need. Perhaps an icon of a treasure chest on the screen, a place to tuck parts of the story that want to be saved, but aren't quite ready to be shared just yet.
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