u/Top_Distribution_189

Thank you for such a thoughtful and detailed response! I really appreciate hearing from someone who has experience with that many different assistive technology solutions.

To answer your question about the external webcam, there are actually several reasons I chose that setup.

First, I'm using an M4 Mac mini, which doesn't have a built-in camera. My current webcam is a Logitech C922e, and I've been experimenting with different camera settings and software to get the best possible experience.

However, even if my Mac had a built-in camera, I would probably still prefer an external webcam because of the flexibility it offers in terms of positioning, viewing angles, lighting adjustments, and accessibility.

I have spastic quadriplegic cerebral palsy, and I'm a full-time power wheelchair user. Because of my physical limitations, positioning is incredibly important when it comes to using technology independently.

Something as simple as adjusting the camera angle can make a significant difference in how effectively head tracking or facial-expression controls recognize my movements.

For example, depending on my seating position, headrest, and how my wheelchair is positioned relative to my computer, my head may not always be perfectly centered in front of a monitor. An independently adjustable camera allows me to compensate for those variables without having to change my seating position just to accommodate the software.

I'm also very interested in the software side of accessibility.

I've been experimenting with applications such as OBS Studio, webcam adjustment utilities, and Apple's native accessibility features. I like having control over camera positioning, exposure, brightness, and other variables because those details can influence the overall experience.

One of my biggest interests is how mainstream consumer technology can reduce the need for expensive, dedicated assistive technology hardware.

I've been using power wheelchairs for many years, and my current primary wheelchair is an Amylior Alltrack R3 Hybrid, equipped with R-Net electronics and multiple programmable seating and control functions.

I've also had experience with other power wheelchair platforms, including the Quickie Q700M and Permobil F5 VS.

My current wheelchair has Bluetooth mouse functionality through its control system, which allows me to interact with computers through my wheelchair controls. I'm particularly interested in comparing those established access methods with newer options such as Apple's Head Tracking, facial gestures, eye tracking, and other hands-free technologies.

For someone with limited upper-extremity function, the ability to switch between different input methods can be extremely valuable. What works well when I'm comfortable and properly positioned may not be ideal when I'm fatigued, experiencing increased muscle tone, or sitting in a different position.

That's why I believe accessibility should be about providing multiple reliable options rather than expecting every individual to use the same solution.

I also agree with your observations regarding Apple's accessibility technology.

I recently spent time experimenting with the facial-expression controls on my iPhone 17 Pro Max, including setting up gestures, testing the camera calibration, and exploring how facial movements could be used to control the device.

I was particularly interested in the ability to use expressions such as opening my mouth to trigger actions.

What impressed me was that these capabilities are already built into devices that many people own. You don't necessarily need to purchase an expensive additional piece of hardware just to begin experimenting with alternative access methods.

That said, I believe there's still an important distinction between accessibility features that are good enough for occasional use and assistive technology that someone depends on for continuous, reliable access throughout the day.

Reliability, calibration, fatigue, positioning, and the ability to recover from tracking errors are just as important as whether the technology technically works.

Your experience with the Quha Zono systems, GlassOuse, and other dedicated head-tracking solutions is particularly interesting to me. I would love to have the opportunity to evaluate some of those systems firsthand and compare them with Apple's built-in solutions.

The eye-tracking AAC application you mentioned is also fascinating.

Being able to make selections on a 7 × 12 grid using a consumer iOS device is a significant achievement, especially considering the limitations of camera-based tracking and the precision required to make reliable selections.

I would be very interested in learning more about that application, particularly how it handles calibration drift, accidental selections, dwell timing, and changes in head positioning.

I also think the distinction you made between consumer-based eye tracking and dedicated devices such as the Irisbond Hiru and TD Pilot is important.

In my opinion, mainstream accessibility technologies have tremendous potential, especially for people who may not qualify for funding or cannot afford specialized hardware. However, dedicated assistive technology still has an important place, particularly when an individual's communication or independence depends on consistent, highly accurate performance.

Beyond my personal experience, I also work independently in disability advocacy, accessibility consulting, and assistive technology evaluation.

I'm involved in wheelchair product development and advisory activities, and I've participated in testing accessibility-related equipment, including a rearview camera and proximity-awareness system designed for power wheelchairs.

I also work with 3D printing and have been exploring ways to create functional adaptations for wheelchair components and controls.

My long-term goal is to help bridge the gap between manufacturers, developers, and the people who actually depend on these technologies every day.

I believe one of the biggest opportunities in assistive technology development is getting people with significant physical disabilities involved much earlier in the design and testing process.

A feature can look fantastic in a demonstration, but using it independently for several hours every day is an entirely different experience.

That's where real-world feedback becomes invaluable.

I'd genuinely enjoy continuing this conversation. You clearly have considerable experience with alternative access technologies, and I would be particularly interested in hearing more about the AAC application you discovered.

Do you happen to remember the name of the Chinese-developed AAC application? I'd love to investigate it further and potentially evaluate its accessibility features.

I'm also curious whether you've found any particular head-tracking system that offers the best balance of accuracy, comfort, and independence for people with severe upper-extremity limitations.

Thanks again for sharing your knowledge. Conversations like this are exactly why I enjoy being involved in the accessibility and assistive technology community.

Thank you for the support, my friend

Yes, I can use voice control, but the problem with that is I have a lot of people around me all the time. I want to make a video so I can show you guys, but I don't know if I actually will.

You are 100% fine. Thank you for the help. I appreciate the help.

Generally speaking,, no, it does not hurt.

## My Cerebral Palsy Specialist in Buffalo, New York

For anyone looking for a doctor who understands cerebral palsy, rehabilitation, pain management, and assistive technology, I wanted to share some information about the doctor I've been seeing for approximately 10 years.

**Dr. Amrit P. Singh, MD**

- **Hospital:** Erie County Medical Center (ECMC)

- **Department:** Physical Medicine and Rehabilitation

- **Address:** 462 Grider Street, Buffalo, NY 14215

- **Physician's Office:** (716) 898-5498

- **Hospital Main Number:** (716) 898-3000

- **Outpatient Rehabilitation:** (716) 898-3225

- **Medical Specialty:** Physical Medicine and Rehabilitation (PM&R), also known as physiatry

- **Board Certification:** American Board of Physical Medicine and Rehabilitation

- **Areas of Care:** Rehabilitation, neurological and musculoskeletal conditions, chronic pain, mobility limitations, and cerebral palsy

- **Official Physician Profile:** https://www.ecmc.edu/team/amrit-p-singh/

### My Personal Experience

I'm 33 years old and have spastic quadriplegic cerebral palsy. I've been seeing Dr. Singh for approximately 10 years, and I cannot say enough good things about him.

Before specializing in rehabilitation medicine, he also worked in primary care.

**He was the first and only doctor who ever helped me get a standing wheelchair.** He also gave me the opportunity to try out a robotic arm, which was an incredible experience.

What makes Dr. Singh different is that he doesn't just focus on my medical condition. He looks at my independence, mobility, quality of life, and what technology might help me accomplish things that otherwise would be difficult or impossible.

He consistently goes above and beyond to make sure I have access to the care, equipment, and opportunities I need.

After nearly a decade of working with him, I have tremendous respect for his dedication to people with disabilities.

If you're in Western New York or willing to travel to Buffalo and are looking for a physical medicine and rehabilitation specialist, he's someone I highly recommend considering.

**Having a doctor who believes in your independence and is willing to explore what's possible can make a tremendous difference.**

Hello my friend, how are you?

My cerebral palsy specialist is a doctor who specializes in physical medicine and rehabilitation, with a focus on pain management and cerebral palsy. Before going into this specialty, he actually worked as a primary care physician.

I've been seeing him for about 10 years now, so he knows my medical history extremely well and has seen how my condition and needs have changed over the years.

I feel fortunate to have a doctor who understands the complexities of living with spastic quadriplegic cerebral palsy and has been involved in my care for so long.

I was on a ferry and yes, I hit a small a small wave

yes

https://buildmywheelchair.com/permobil-aware-a5-rnet-powered-rear-view-camera-with-permobil-rail-track-mount/ 489

no

The only thing I used was a background replacement, no actual AI was used. Thank you for your input though. for your reference. I used remove.bg

no, that doesn't matter to me. What matters to me is people's advice.

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yes

Thank you for clarifying

If you've actually been banned from NSM, I would think they would stop working on your order altogether. If that's the case, the first thing I'd do is contact your insurance company and ask which wheelchair dealers are in-network and can work with your policy. Personally, I'd recommend Numotion if they're covered.

If Numotion does accept your insurance, there's a sales director named **Evan** who travels throughout Maine. If you send me a DM, I'd be happy to give you his contact information. Once you've confirmed that Numotion works with your insurance, Evan can either help you directly or connect you with the right local representative.

Just like someone else mentioned, be prepared for the possibility that you'll have to start the process over. That could mean another seating evaluation, pressure mapping or a skin clinic appointment if required, along with updated **ATP** recommendations, depending on your insurance requirements.

In the meantime, if your current chair isn't usable, you may also want to consider finding a good used wheelchair to get by until everything is sorted out.

On my end, I've had excellent experiences with my **ATP** at Numotion, a great manufacturer sales representative, and the Numotion sales director who oversees my region. Having the right people involved can make a huge difference.

If you want to talk through your situation or need Evan's contact information, feel free to send me a message. I'm happy to help however I can.

There are a couple of options you could consider.

First, you can switch to a different wheelchair dealer altogether. **Numotion** is often a good alternative, depending on your area.

Another option is to contact the manufacturer of the wheelchair you want and ask to speak with the sales representative for your region. They can usually recommend another authorized dealer if your current provider isn't meeting your needs. They often know which dealers have the best reputation for service and can point you in the right direction.

If neither of those works, I'd seriously consider changing dealer networks. Personally, I've had a very good experience with **Numotion**. After switching from NSM, they've done exactly what I asked, communicated well, and I haven't had any issues since making the change.

If you'd like, feel free to send me a message anytime and we can talk more about it. I'm not a certified wheelchair technician or ATP, but I've been around power wheelchairs for many years and I'm happy to share what I've learned if it helps.

I also hope you'll post an update once everything gets resolved. I'd love to see your new wheelchair when you finally get it. Wishing you the very best, and I hope everything starts moving in the right direction soon!

It's usually pretty plug-and-play, but it does depend on the make and model of your wheelchair.

If you ever need help, feel free to send me a message, and I'll do my best to point you in the right direction. Just keep in mind that I'm not a certified wheelchair technician, nor do I claim to be one. I'm simply a fellow wheelchair user with nearly 30 years of experience modifying, repairing, and upgrading my own equipment.

I've spent a lot of time figuring things out, sourcing parts, and navigating the technical side of wheelchair equipment. If I know the answer, I'm happy to help. If I don't, I'll do my best to help you find it.

Thank you for this support, my friend. I really appreciate it.

Make sure you follow me to find out when I actually post pictures so yes, I will post picture when I do it. Also, probably I will probably be putting it out underneath the armrest somehow I haven't figured out yet. Still working on a cupholder for it I also want to add voice control if I can

I will try to get a better picture when my help comes back in the morning. I'm sorry Im suck your pain in the ass like I said I've never had this problem before so it's new territory for me. I appreciate everything you have done so far

Is that what you think is right? I'm just trying to figure this out I never had this issue before