Alternative Mouse Options

The mouse is another important tool for accessing the computer. Much like the keyboard, it too can be difficult for someone with a disability to operate. In order to operate a mouse, one must be able to grasp the fairly small device, move it along a surface in all different directions, target fairly small areas on the screen, and click one of the buttons to select an object. People that possess a disability that has effected their ability to grasp, move their hands and arms, control a device for fine targeting, and use their fingers to press buttons all will have difficulty using a standard mouse. To help all people use the mouse to access a computer, alternative mouse options have been developed that utilize various access points from the hand to the head to the eyes. This section discusses different mouse options for people with various disabilities.

• Ergonomic Mouse - An ergonomic mouse is designed to prevent RSIs. The design makes this device look like a joystick, but it is operated as a standard mouse. The joystick-like handle provides an ideal hand position for preventing RSIs. Since it is used as a standard mouse, this device requires the user to be able to accurately move it in all directions. Thus it is not a good option for someone with a gross motor disability effecting their ability to use a standard mouse.

• Trackball - A trackball is essentially an upside down mouse. This stationary device consists of a ball that one rolls in the desired direction resulting in corresponding mouse movement on the screen. This is ideal for an individual with a disability preventing them from being able to accurately move a mouse due to either limited fine or gross motor control. A trackball's stationary nature removes the need to control the movement of the entire device. The only movement required is the ability to role the ball in the desired direction. This movement can be accomplished with the fine motor movement of the fingers, the gross motor movement of a hand, or with the assistance of a typing aid. The trackball's design is also considered more ergonomically appropriate than a standard mouse, thus it helps prevent RSIs. Because of this, it is used by many able-bodied individuals and is widely available at standard computer stores.

• Joystick - A joystick provides an alternative to a mouse for people lacking fine motor control or the ability to grasp and move a standard mouse. The joystick is a stationary device that requires only movement of the stick to control mouse movement on a computer screen. The size of a joystick makes it easy to move without grasping it, thus making it ideal for someone with limited fine motor control. Numerous adaptation options can also be used to help people lacking fine motor control "grasp" the joystick for better motor control. One such option is a goalpost attachment which attaches to the top of a joystick allowing a user to rest his/her hand on it to control the joystick. Raised sides (like a goalpost) prevent the user's hands from sliding off the side, offering more control. An important note about joysticks is that most standard joysticks are designed for gaming and thus do not provide mouse control. Software can be obtained to convert standard gaming joysticks into mouse joysticks.

• Switch-Controlled Mouse Emulator - This mouse emulator allows a mouse to be controlled through a series of switches. Each switch either moves the mouse in one direction or acts as a clicking option. The user can use any number of switches he/she would like, but the minimum advised number is five providing up, down, left, and right movement with an option for left clicking. A typical user would be someone with a disability severely affecting his/her fine motor control, but having enough gross motor control to accurately target and press a large switch. Even though switch access points can be any movable body part, because of the number of switches necessary for reasonable mouse movement this device is best used if the user can activate switches with his/her hand or fist.

• Mouth-Controlled Mouse - This type of mouse is ideally used by someone completely lacking movement or usable control in his/her hands (typically due to a high level SCI or ALS). Essentially, this type of device is a joystick, where the user bites the "stick" and moves his/her mouth to control the mouse on the screen. To click, the user simply sips or blows on the "stick" which also acts as a sip and puff switch. Of all of the options for a mouse controlled by points above one's neck, because it is a direct mouse control, the mouth-controlled option is often the most accurate and provides the best "fine" control.

• Head-Controlled Mouse - A head-controlled mouse is used by people with the same type of disabilities as those that use the mouth-controlled mouse. These devices consist of a camera that sits on the top of the user's computer. The user then wears a small reflective dot on his/her forehead. The camera emits a infrared light that reflects off of the dot. The camera follows this reflection and translates it into mouse movement on the screen. Long periods of use of this device can lead to sore neck and shoulder muscles, and due to the lack of direct device control, it does not provide as good "fine" control as a mouth-controlled mouse. It is, however, an effective device for the proper populations. To click when using this or the eye-controlled mouse, a user typically uses a switch or dwell clicking.

• Eye-Controlled Mouse - The eye-controlled mouse works similar to a head controlled mouse and is ideal for someone with severe disabilities that limit even the movement of his/her head. An eye-controlled mouse consists of a camera that shoots an infrared beam into the user's eye to create a reflection. The camera then tracks that reflection and the movement is translated into mouse movement on the screen based on where the user looks. The user's head must remain still while using an eye-controlled mouse because if the eye leaves the camera's view, the user will have to recalibrate the device. Another negative aspect is that due to it's sophistication as well as the fact that it must be used with its own dedicated computer system, an eye-controlled mouse is expensive. Primary users of this type of device include people in advanced stages of ALS and people with high spinal cord injuries. 

Clicking Options

No discussion on alternative mouse options is complete without addressing clicking options. If someone cannot grasp or move a standard mouse, chances are they are also unable to press a button on a mouse to provide a click when necessary. Thus, utilizing an alternative mouse is not effective unless there is also a means of clicking. The two primary click options associated with alternative mouse options are switch clicking and dwell clicking.

• Switch Clicking - Two types of switches are typically used for switch clicking, touch switches and sip and puff switches. A touch switch is a stationary device with a large target area that needs to be touched to activate or "click". These switches can be placed near any body part the user can accurately control and can be used in combination with any alternative mouse. Access point options for these switches include hands, knees, head, feet, elbows, etc. The second type of switch is a sip and puff switch. These switches are straws that the user sips on for one type of click (left or right) and puffs on for the other. A typical user is someone such as a quadriplegic, who lacks accurate control of any body part due to a disability. For either of these types of switches to act as a click, they must be used with a switch interface which connects the switch to the computer and allows the switch activation to act as a click.

• Dwell Clicking - This click option works in conjunction with any of the alternative mouse options discussed. It also provides a means for clicking without introducing another device such as a switch. Dwell clicking works by automatically clicking wherever the cursor is located when the user holds the cursor still for a defined period of time. This requires special software and most often is used by people using a head-controlled or eye-controlled mouse because they do not have the ability to access a switch with another part of their body.  The software allows the required time period prior to clicking as well as what is considered "held still" can be customized to fit the user. The downside of this clicking option is that the mouse must be consistently moving to avoid unwanted clicks. For people who cannot operate a manual click, dwell clicking is a good option. 

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Alternative Mouse Option Examples

Clicking Option Examples