Thursday, March 22, 2007

Process in Further Developing the Handwriting System

Since Heidi works with the target population on improving handwriting, a combination of her expertise, journal articles, and online literature from occuational therapy facilities has been used in developing an understanding of the target population and approaches to improving handwriting.

In practice, this involved sitting and talking, looking at some relevant articles, and eating chinese food.

Now that we have a working idea, we will additionally consult some of Heidi's colleagues for feedback. Next steps include this consultation, acquiring the materials to build a prototype, and beginning the process of obtaining permission from the school and parents to test the system with children once the prototpye is in working order.

More detailed description of users and project

Target Users:
Five- to ten-year-old students with handwriting problems

Primary Goal:
Develop students' awareness of the connection between posture, pressure, and handwriting; and improve student's ability to be aware of and correct his/her body position/posture while writing.

Explanation of Problem:
A major problem in handwriting is excessive grip pressure and excessive downward force on the pen, often in combination with awkward positions of holding the pen. Excessive grip strength is often a compensation for weakness in the trunk, often express in hunching over, which leads to insufficient support for the hand. If there is adequate trunk support, there is better hand support, and pressure/force can be reduced, allowing the student to write more easily.

For optimal trunk support, a student should sit at a 90/90/90 position: the feet should be flat on the floor directly under the knees, with the knees bent at a 90 degree angle. The student should be sitting upright, with the hips at a 90 degree angle and the spine straight. The student may lean forward somewhat, but should bend from the hips rather than curve the spine.

Often the student moving the feet off of the floor or at different angles can lead to shifts in body position, with compensatory changes in posture and a resulting increase in grip pressure and downward force and increased difficulty in handwriting.

Signs of hunching forward are concavity of the chest, shoulders hiked up around the neck, bent neck, head down.

Special Considerations:
Because the target users are children in an educational setting, certain considerations are important:
1. Use of the system will require approval from parents or guardians, so the needs of the parents should be considered
a. there should be materials that explain how everything works and clearly show the whole system
b. for both the children's and parents sake, the system must be noninvasive and not cause discomfort to the student
c. (since the system will include a camera) students' privacy should be considered
2. the students may range from enthusiastic to apathetic, and will probably want to touch and explore everything
a. the system should be designs in such a way that it doesn't look off-putting--either scary or markedly unlike devices that children in the target population might choose to use.
a. items should be sturdy, so that students have the opportunity to explore and play with the system without breaking it
b.similarly, connections, wires, and other fragile elements of the system should be out of the normal reach of the students.

System goals and design:
We will design a system that measures three key components in handwriting difficulties and provides real-time feedback to a student using the system. The system will also record these components over time and will provide appropriate visualizations of that data, so that the student and the OT can review them later.

The three elements that will be measured are:
1. foot placement
2. position of the shoulders relative to the neck as a measure of posture/hunching
3. downward pressure on a surface (measuring grip or force on a pen or pencil is less helpful, because if the weight or shape of the pen is changed, then that will affect the student's handwriting and may not ultimately help the student adapt to writing with standard pencils or pens)

Foot placement will be measured with two simple switches; if the student's feet are in the right position, the switches will be closed.

Position of the shoulders relative to the neck will be measured with a camera looking at the child's back. Three points (one on the shoulder, one on the base of the neck, and one on the spine of the upper back) will be marked with stickers that the camera will be able to track.

Pressure on a surface will be measured using a writing surface designed for the purpose.

The system will give two types of real-time feedback. On the writing surface, three LEDs will light up when a student is in the correct range for the relevant measurement. When the student is in the incorrect range for a given measurement, one of three (pleasant) sounds will indicate that fact. (The sound may be speech rather than an abstract noise.)

The OT will be able to choose how many items to measure and which feedbacks to provide, to allow the student to learn the system and to adjust for different students' sensory learning styles.

User Scenario:

1. At first view, student gets introduced to the system and is asked what they think it is and what it does. The student is informed how the system works, why they are using it, and that it will not hurt them. The teacher will show the student how it works, and will have a diagram of a person using the system and showing how the different elements are used.

2. What does it look like?
*There are footprints, bigger than students feet, connected to wires. At the first use, the child has the opportunity to trace his/her own feet, cut them out, and place them on the larger footprint.
* There's a writing surface, flat, about the same size as a piece of paper. There will be at least one wire attached to it. The wire will be facing away from where the kid is sitting.
* There's a camera mounted somewhere in the room, behind and slightly above the kid's back. (Note: at no time is a permanent image of the student recorded. rather, the position of the stickers are tracked and used to calculate an angle of shoulder to neck, which number is recorded.)
* There are stickers. The child has a choice of a couple colors that are different from the color of the kid's clothing. The stickers will go on the kid's back. ideally, these will be solid color stickers in shapes (like dinosaurs) that the students find appealing, and the student can keep the sticker afterwards.

3. What does the student do?
* Each time, there is an initial calibration, where the student and the OT position the student with optimal posture. They place the footprints under the student's feet, position the writing surface and the paper appropriately, and take a calibration image of the students back (with stickers).
* The student then writes the given assignment. Depending on the feedbacks chosen, the student may hear a sound when he/she moves out of the optimal range of foot placement, posture, or pressure, and/or the student may light up LEDs when he/she is in the optimal range.
* After a previously agreed upon period of time, the student stops writing. He/she then has the option to review a visualization of performance over time, possibly compared with previous uses of the system. (We don't have this fully visualized, but it will consist of some sort of abstract/symbolic display that should make sense to students in the 5-10 age range.) The student may also view visualizations of uses of the system by other student or by the OT, in order to develop a better understanding of the system and/or of the connection between body position and handwriting.

Friday, March 9, 2007

Initial Post

Here are our initial notes for developing a system to measure different elements of position and pressure that contribute to handwriting.

--who
1. elementary school students with handwriting problems (primary
target population)
2. other people who could benefit from the system could include adults
with CVA, traumatic brain injury, other causes of handwriting problems

--what
an integrated system that measures one or more of:
downward pressure on the pen
grip pressure
arm and hand position
leg position and foot position
body position/posture
attention (glances away)
letter formation
pen position

---how we would use it:
* for research and evaluation
1. record video and have it available for review by eye
2. record measurements and process those measurements to develop
baselines, learn how different elements are connected and build from
there

* feedback for kids
1. some sort of game that uses real-time feedback
2. in general, a scaled-down automated system that provides feedback
as a person writes

--where
1. in schools in occupational therapy room
2. in rehab centers
3. in private rehab
4. at home?

--why
1. help children become more successful in school
2. help teach body awareness, proprioception, tactile awareness, etc.,
to children with handwriting problems
3. help adults regain lost abilities and independence

--outside people who we will work with
1. Heidi
2. other OTs or a facility (Rusk institute?) that works with handwriting rehab
3. Heidi's students


******

Equipment:

--some sort of equipment for measuring pressure and letter formation
using a pen and/or a surface (daniel research pen pressure technology,
surface measurement technology)
--a webcam for direct video recording (attention and posture and
letter formation) and tracking arm and hand position and possibly pen
position
--switches or another webcam for leg/foot position
--switches for arm positioning?
--what are good ways to measure posture?