Control Bionics Neuro Switch

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Nuts

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My husband spent an hour with Hannibal Rock Bray of Control Bionics last week, and he was very impressed with the neuro switch. He's tried the Tobi Eye Gaze a couple of times, and he was much more impressed with the Neuro Switch. Small electrodes are attached to the skin and they sense electrical activity (muscles don't actually have to work). It can be put anywhere on the body. The cost is $17,500 with 24/7 support and they can make adjustments over the internet. Can anyone tell me how this price compares to the Tobi 15?
 
Possibly the more important question would be: does insurance/Medicare cover it?
 
That's a great question, Greg. I'm betting price difference will play into the answer.
 
On the Web site, it mentions classification by Medicare as an SGD but as you know, until/unless the Gleason act passes the House, SGDs are capped rentals now and the laptop and interfaces probably are not covered, only the software. If you go for it, I would ask for itemization so you can buy an Air on your own if theirs is marked up, though then they would probably jack up the install (sorry for cynicism).

If I am reading correctly, the VA covers the entire package, though. Also, as a general reminder, get any DME you need before enrolling in hospice, lest you have to go in and out as we saw on Augustmoon's thread. Maybe someone more legislatively adept can estimate if/when the House might pass the Act.

Following my mantra about trying cheap things first, I would d/l the AssistiveWare software demos for your existing laptop and try to borrow a less glitzy switch from your state's ATP program or a patient or loaner closet and see what he can do w/ that first. Using a virtual keyboard or speech panels, if he has not, is an art in itself, either way and he can see how it would be. Also, if he has head movement, he can use that w/ the iPad without any additional software. I'm sure the switch is great, but Hannibal's title is Director of Sales for a reason. On the other hand, you may have VA coverage, so I'll stop here.
 
Laurie, hubby has tried out the Tobi twice and is aware of what it will take to step through menus with each. We seem to be far away from needing any speech generating devices, but he's gotten good about researching in advance so that we know what direction he'll want to go when the time comes. The encouraging thing about the neuro switch is that is can control much more than just a speech generating device. Eventually, it will be able control PWCs, TVs, etc. There will be no need to recalibrate as with the eye gaze, and it comes with the ability to test positions on the body to insure that a signal is present (so the user/caretaker can move the pads around as needed).

I'm in agreement about simple fixes, but am very excited about the potential for this device. If it is all that it appears to be, it could provide much more than just speech to PALS using something as subtle as a forehead twitch.
 
As I understand it, it will be bluetooth enabled and able to control anything that is bluetooth. I imagine that one would need to be able to see the computer screen to select between devices to control, but conceivably this will allow one to switch between such things as phones, computers, TVs, DVRs, etc.
 
Yup, there are several Bluetooth switch interfaces now (four are capsuled here). These, of course, require/allow the user to add the switch that works best, and there are other switches that attach w/ pads, are movable, etc. There are also USB interfaces. With the EMG switch, you need move less voluntarily, because you are leveraging nerve impulses rather than movement per se. So it really is a separate category from eye gaze and other switch use. For any interface, if you are interested in controlling other devices, it is worth discussing compatibility (current and future) with the mfr of the device(s) in question.

As I've said before, too many people are rushed into eye gaze when they could be using switches or alternative mice. This is like the Lexus of switches.

So I hope you don't mind if I make the point that a switch interface + switch is far less than the package you're evaluating, even omitting the laptop. It's about finding what you need at a price you can afford. I'm sure it's a great option to consider for those who can fund it.
 
I both agree and disagree Laurie. The thing is if you are to end up with eyegaze getting it early so you can practice will make using it easier when the time comes. This obviously presupposes one will have the discipline to practice while other easier methods can still work and that you survive to the point where eyegaze is the only option ( or neuroswitch I guess). My sister is eyegaze dependent. I don't know if neuroswitch would work or not. But leaving learning eyegaze until nothing else worked made it very hard She tires so easily and it was hard and frustrating for a long time. It is better now finally. But if your progression is different it might be unnecessary. One of my aunts retained enough hand movement until the end
 
I would agree that if it looks like the PALS may be in the group that needs eye gaze, best to start early. From what I have seen/heard/read, that group is smaller than SLPs, OTs and the popular press believe.

But the same logic could apply to twitch switches and alternative mice as well, even the SmartNav, that some people wait too long to try and it's too hard. And, as you point out, eye gaze is hard to master. So they might end up with nothing.

So could we agree on ... shop around early, do demos, and if you see something that looks like it could work for you, which if not in the heat of the moment, people have reasonably good predictive abilities about, and perhaps can get an SLP/OT to weigh in, jump on it. Don't wait. Make mastering it your top priority while you have more energy and ability. Even as you progress, if you are good at something, it's easier to make it keep working for longer.

If it stops working for you, sell it to another PALS, MS or SCI pt, or donate it to your ALSA or MDA chapter, your clinic, or ALS Guardian Angels.

How's that?
 
Laurie, thanks for the links to the other switches. I've forwarded it to hubby for comparison. I respect your position on simple and inexpensive; I'm just impressed with the longer term capabililty of the neuroswitch (I've read enough posts from CALS who say their PAL can no longer activate the switches), and hope to see the technology grow and price decrease in the future. As for passing equipment along--that's already in the plans. We see it as a way of sharing the bounty with which we've been blessed. Thank you also for your continuing sage advice. Your wealth of knowledge is one of our great treasures here.
 
Certainly agree Laurie. Prediction may be harder for some than others of course. And getting equipment back into the chain is vital. In my family we have equipment on the third user a different kind of hand- me-down!
 
Oh, I know everyone here would put things back into circulation, though, Nikki, I wish you did not have a hand-down chain! Just a note for newbies.
 
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