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ALS / Lou Gehrig's Disease

Users find the Eyegaze Edge a fast and easy method of computer access, even if they retain verbal and head control to use other methods.


ALS / Lou Gehrig’s Disease

The Eyegaze Edge is a premier communication system that was designed for, and with  feedback from, people with ALS over three decades.  Our engineering excellence and design have resulted in a low-fatigue, high-accuracy medical communication device to meet the needs of people with ALS (PALS). 

PALS have specific communication needs and abilities that change over time. These changes may impact their communication generally in the areas of respiration (breathing), resonance (sound), articulation (clarity), and phonation (voice).

Specific changes may include decreases in the ability to move the oral and laryngeal musculature, sustain phonation with adequate breath support. This may result in slurred speech, reduction in rate and speech intelligibility, and dysarthric speech characteristics such as imprecise consonants, harsh or strained vocal quality, and pitch variation.

For many PALS, these changes lead to aphonia, or complete loss of voice. The use of augmentative and alternative communication (AAC) strategies is a dynamic process that should be implemented early and gradually over the course of the disease.

Eyegaze Edge® Features

Allows Users To Manipulate Computers More Quickly

Speech Generation for Non-Verbal Users

No Dependence on Head Movement

Available as a touch tablet first, then upgrade to eye tracking when needed

Quick access to keyboards, phrases & social media to stay connected by eye movement


ALS and Communiation

When evaluating communication function, a speech-language pathologist may evaluate communication ability along a Speech Staging System For ALS (Yorkston, Beukelman, Strand & Bell,1999).

This system describes speaking ability in the following stages:

    • Stage 1 No detectable speech disorder
    • Stage 2 Noticeable speech disturbance, but still intelligible speech
    • Stage 3 Reduction in speech intelligibility
    • Stage 4 Use of Augmentative and Alternative Communication (AAC)
    • Stage 5 No functional or natural speech

With communication training from a speech-language pathologist and other professionals, PALS and their families can maximize communication function in almost every situation. Training may initially include education to address identified communication needs and what to expect with decreases in verbal communication over time. Communication strategies can be used by the speaker and listener, and range from no-tech to high-tech solutions.


The eyes become a portal for basic communication.
No-tech options include implementing a writing system, using an alphabet letter spelling board, providing written choices for the PALS to select with gestures, or asking yes/no questions with a physiological response (e.g., look up for ‘yes’, down for ‘no’). Depending on speaking ability, the speaker can actively use compensatory speech and conversation repair strategies as well as energy conservation techniques to communicate their most important utterances. In addition, teaching listening strategies to a conversation partner will be equally as important. Some families use a letter or picture icon board with partner-assisted scanning to spell words or ideas, or a static eye gaze board (e.g., e-tran board or a laser pointer board) to spell words and sentences. Some individuals may benefit from mid-tech options such as use of a voice amplifier or palatal lift to increase speech volume and intelligibility. These techniques can provide PALS with many communication options according to their level of ability.

Using an eye gaze speech generating device is a high-tech, robust communication access point that is safe, easy and comfortable to use, and appropriate for long-term use throughout the day and night with minimal effort on the user. The Eyegaze Edge is a robust speech generating device that uses the minimal amount of infrared light needed for gaze point accuracy, and compensates for challenges specific to the ALS community–that of having dry eyes, ptosis of the eyelids and specific positioning needs to facilitate energy conservation.

Using the Eyegaze Edge® with ALS

People with ALS are generally very successful operating the Eyegaze Edge. Consideration must be made for potential eye challenges as a result of the progression of the disease. Users with ALS may in time experience droopy eyelids, dry eyes, or inhibited range of eye movement. Adjustments to both the Eyegaze software and hardware may often accommodate those issues. Droopy Eyelid Compensation in the Eyegaze Edge will automatically accommodate users with ptosis of the eyelids.


Pauline and Reggie are a loving couple taking control of their communication with the Eyegaze Edge®.

Over time, people with ALS may have a decreased blink rate. The eye’s surface (cornea) is normally moistened by tears, which are spread around by blinking. As the blink reflex decreases, the cornea dries out, and does not reflect infrared illumination as well. Eye trackers need to see a corneal reflection in order to function. Using over-the-counter artificial tears eye drops will typically provide adequate moisture. The Eyegaze Edge ECS Settings program includes a diagnostic tool to help determine the presence of dry eyes. The Eyegaze Edge calculates the user’s distance from the screen precisely. When Focus Range Compensation is active and the user has dry eyes, congealed tears on the surface of the cornea will affect the range prediction, causing the eye image to display changes in color to alert the user that his eyes may be dry. The eye image will alternate between red and green as it tries to find the correct range. If turning off the Focus Range Compensation results in a return to normal Eyegaze function it has diagnosed the problem.

Limited eye movement in some people with very advanced ALS makes it difficult or impossible for them to perform the more complex Eyegaze functions, such as typing, on traditional Direct-select Eyegaze keyboards. Two solutions are included in every Eyegaze Edge: a large-key two-stroke keyboard and a scanning keyboard with an eye motion switch. Additionally, the Eyeworld program makes it possible to create custom screens that can accommodate limited eye movement.


What Users Say About Eyegaze

My arms and hands were deteriorating quite rapidly meaning I couldn’t work anymore. The Eyegaze saved my software engineering job. I can control a Mac and do everything with my eye that I used to do with my hands. I can respond to email, I can surf the web, and I can hold conversations…

Software Engineer, MIT

I can read books using Kindle, listen to music, email, surf the web, play games, and more. I am once again my old self. Without it I would be a prisoner in my body, with it I am the same smart guy I used to be, with the exception of being paralyzed.


Thank you and everyone you work with. My son Jack is laying in his hospital bed right now using his Eyegaze to chat with his friends on Facebook, check his email, and he just posted on his web page… the nurses and doctors are amazed watching him do all of this with a breathing tube in his throat and about 20 other assorted lines attached to various parts of his body.


My student does research on the Internet for the library, with the aid of her Eyegaze Communication System, and she loves it.
Mary Whitley

Service Coordinator, TCRC Alph Resource Connections Library

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