1.1  DETERMINE BEST PHYSICAL SWITCH SETUP FOR INDEPENDENT CONTROL

The initial basic step in switch access is to determine the best switch system.  The components of the switch system are:

1.   Movement
a.  joint movement – which joints are involved and what movements occur at each joint
b.  range of motion required at each joint
c.  type of movement required – sustained hold, quick movement, soft touch or strong / hard movement

2.   Control site – physical site on the body at which switch is placed or the part of the body activating the switch
(examples – switch may be placed at side of head (control site) and movement is at neck, switch site could be the mouth for a sip and puff switch.)

3.   Switch type
this can be any one of many different types of switches – mechanical such as push button or string, infrared, touch, proximity switches or even the newer camera switches. 
See list of switch types.

The most important outcome of this phase is the establishment of a switch setup that has good potential to be an ‘independent’ use switch system.  This specifically refers to the ‘independent physical activation and control’ of the switch without requiring any physical hands-on assistance,  or stabilization once the switch has been set up and put in place for a work session.  Physical cueing that might be necessary during the training phase may be needed for these purposes.  

However, the goal is to determine the most effective switch system for INDEPENDENT PHYSICAL ACTIVATION.  The need for verbal cueing, limited physical cueing, training, ongoing teaching and learning in terms of switch access at appropriate times for a variety of academic, learning and communication activities is obvious.  However, these aspects should be clearly delimited from the physical aspects of switch control.  Regardless of the severity of the physical activity, it is almost certain that physically disabled individuals, given the best physical switch system (setup, control site, movement, type of switch), will be able to independently, physically activate the switch. 

The best switch setups for most individuals includes switches which are activated with small, low force and low effort movements or actions.  Remember that not all switches are push button.  Some can involve just a small breath, or a tiny muscle movement or tongue movement.  Finding the optimal switch and the idea switch site can be a time consuming and challenging process.  Lateral and 'creative' thinking will go a long way in helping find the best system.  The type of switch used can be one of the myriad of commercially available switches, or a custom fabricated switch which could be extremely simple or more complex depending on the individual's needs and goals.

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