Learning to make choices

Chelsey Paradis had never laid her hands on anything like it: a device that taps brainwaves, eye movement and facial muscles to shift a computer cursor.

But the Minnesota State University Moorhead graduate student was more fascinated by the owner of the Brainfingers device – a man her age, with severe cerebral palsy and daunting obstacles to communicating.

In December 2008, The Forum profiled Malachi Larson, 24, and his grandparents, a hard-working Moorhead couple who raised him from birth. With a grant a year earlier, Elaine and Wallace Larson had lined up Brainfingers, one of a new generation of hands-free computer control devices using an electrode-covered headband.

Malachi’s progress in mastering Brainfingers has been slow. But he’s had a productive year: Paradis’ MSUM department has taken him under its wing. Along with Brainfingers, the students are trying some lower-tech tools, from electric switches to old-fashioned camaraderie. Malachi cultivated instant friendships on campus.

“Malachi has so many physical limitations, and yet he is so full of life,” Paradis says. “He’ll have a spot in my heart for the rest of my life.”

A step sideways

Learning to harness subtle facial muscle movement to control a cursor takes practice. It can take a lot of practice for someone like Malachi, who has little control over his body and little history of communicating. His grandparents interpret he is pleased when he smiles abundantly and distressed when he arches in his wheelchair.

Malachi works on getting the hang of the device at Moorhead’s Heartland Industries, a center for adults with disabilities. Last summer, Marilyn Larson, Malachi’s former Moorhead High teacher, approached MSUM about lending a hand.

Kris Vossler, a speech, language and hearing sciences professor, was happy to oblige. Her department works with more than 40 community members with disabilities.

Last semester, Paradis and another student met with Malachi on campus three times a week. Paradis was nervous at first: She had never worked with anyone who had so little experience communicating. But Malachi’s bright disposition set her at ease.

Malachi grew so enamored of his new friend, she had to occasionally hide behind his wheelchair.

“Otherwise, he spent more time watching her than trying to do whatever task they were expecting of him,” says Vossler.

The sessions were good digital fun: With the electrode headband on his forehead, Malachi moved an animated skateboarder on the computer screen and made billiard balls bounce up on cue.

For the first time, Brainfingers had given Malachi a measure of control over his environment. At Heartland, he mostly takes in the action as the other adults chat or do crafts.

“He just observes more than he participates, and I don’t like that,” says Elaine, who cares for Malachi on her own and works at a retirement home.

Malachi was making headway with Brainfingers, but the video-game-like exercises to master the device weren’t yet helping him communicate. Vossler likens them to playing solitaire.

Vossler decided to “take a step sideways.” A new pair of students working with Malachi this semester is trying something new.

Calling the shots

Kayla Leidholm and Jillian Leach are holding a round button to each of Malachi’s cheeks: Blue is for music. Red is for a flashing lights display. He gets to pick by turning his head and pressing his cheek to one of the buttons.

The switches connect to a device that plays prerecorded commands.

“I want more music!” a voice says when Malachi presses against the blue button. A grin spread across his face.

“Of course you do; it’s your favorite,” Leidholm says and plays a snippet of “We Can Work It Out” by the Beatles.

“Now we’re going to be tricky,” Leidholm says. “We’re going to switch sides.”

Malachi’s consistent choice of music, even when the women switch, has reassured the MSUM team he gets the concept of “voicing” a preference – something he has never been able to do.

In high school, Malachi worked on activating switches with his hand, but that was slow going. His arms move almost entirely of their own accord.

But, Vossler and her students noticed, Malachi has more control over his neck.

“He’s really responding to the ability to make some choices in his life, which we all like,” Vossler says.

Eventually, the team hopes to tackle Brainfingers again. Once he has mastered moving the cursor purposefully, Marilyn Larson says, he could select among multiple options on a computer screen or even type up an idea.

“I want to know what’s in his thoughts and what’s in his brain,” Elaine says. “I’m very hopeful it’s going to happen. But you have to keep on it because it’s so new to him.”

“You just never know,” Vossler says. “I’ve learned to never set a limit on my expectations for anyone. With Malachi, there’s a lot of untapped potential.”

Readers can reach Forum reporter Mila Koumpilova at (701) 241-5529

Tags: higher education, malachi larson, news, brainfingers, msum, health, communication