In 1999, UNUM Provident produced a very useful guide to help organisations to find a solution to a problem caused by a physical impairment. The article describes the stages of decision making as:

1. Define the problem. It is important to emphasise that the problem is not the impairment. The problem is the disability the conflict between what the historical way of doing the work requires and what the impairment limits.
2. Can the work be modified - assistive technology is not the first resort.
3. Can the work environment be modified.
4. Is there some piece of hardware, software, or equipment that is currently being used in the organisation that could be applied to this situation.
5. Is something commercially available which will solve the problem.
6. If nothing is available commercially, can something be created in-house.

To help with the decision making process, UNUM produced a very useful 'decision tree', which provides a guide to possible solutions based on the impairment(s) involved:


The original article and 'decision tree' can be downloaded from Microsoft.


BECTA (formerly known as British Educational Communications and Technology Agency) has also produced a useful guide for teachers trying to support a child with a disability or impairment:

Becta.org.uk

Problem	Possible solutions
The screen font is too difficult for the pupil to see comfortably.	Change the font size. Change the font style to one that the pupil finds easier to read. Set a better contrast between the text and the background by changing their colours or selecting the computer’s High Contrast settings. Use a word processor with a text-to-speech facility so that the pupil can get auditory support.
The cursor or screen pointer is too difficult for the pupil to locate.	Change to a larger pointer. Add a trail to the screen pointer. Turn on the pointer locator in accessibility options. Locate by pressing the ctrl key.
The glare on the screen from reflected light is uncomfortable.	Re-position the monitor or the pupil. Alter the lighting conditions. Consider an anti-glare overlay filter.
The pupil complains of fatigue when working at the computer.	Check the heights of the chair, table, monitor, keyboard and mouse to make sure they are appropriate for the size of the student, re-arranging or re-positioning if necessary. Tilt the monitor to a better angle if it is adjustable. Place a wrist support in front of the keyboard.
The pointer moves too quickly across the screen.	Change the mouse speed (the rate at which the pointer moves in relation to the mouse movement).
There isn’t enough time to double-click the mouse button.	Increase the setting for the time allowed. Use a programmable mouse or roller ball to transfer the double-click action to a single click.
It is difficult for the pupil to hold down the mouse button and move it at the same time.	Turn on the click-lock access facility. Use a mouse or tracker ball that has a locking facility.
Moving the mouse around the table to navigate is causing difficulty.	Use a tracker ball rather than a mouse. Use a different mouse mat to slow down or speed up mouse movement.
The keyboard is too complicated, with lots of keys that the pupil doesn’t need.	Put a mask over the keyboard so that only the required letters are visible. Use a simplified keyboard or an overlay keyboard with a simple ‘qwerty’ keyboard overlay on it.
The keyboard has keys written in upper case and the pupil has difficulty recognising them.	Stick lowercase letters over the letter keys to make them stand out. Use an overlay keyboard and make a lowercase ‘qwerty’ keyboard overlay for it.
Strings of unwanted characters appear because the pupil can’t get their fingers off the keys fast enough.	Switch off or slow down the keyboard’s auto-repeat setting. Do this with 'filter keys' in the accessibility options.
Typing every letter is slow and laborious for the pupil.	Teach keyboard awareness with a typing tutor program. Provide ready-made word banks of the key vocabulary the pupil will need for an activity, either on screen or on an overlay keyboard. Use a word predictor that runs alongside the word processor. Use paired writing with an adult or peer to share the task of scribing.
The pupil uses text-to-speech software but it distracts others.	Use headphones.
A pupil can see the font on screen but has difficulty reading the printout.	Change to a larger font before printing out. Use an enlarging photocopier.

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