CSD 823X S10
Reports on Our Visit to Lee Abramson

Name
Comments
Nicholas Hugh Craft
Allison Ann Dery Name of Observer: Allison Dery

Name of Client:  Lee Abramson

Date of Birth:
                        (September 13, 1970)

Age on Observation Date:
                                           39; 5

Diagnosis and Etiology:

Amyotrophic Lateral Sclerosis-Limb onset


Date(s) and time(s) of Observation:

1. Describe Lee's abilities and challenges.

Mr. Abramson's is a pleasant 39 year old male who was diagnosed with Amyotrophic lateral sclerosis 5 years ago. Mr. Abramson currently uses an electric wheelchair for mobility and is able to adjust his chair's position through moving a joystick with his right hand. Mr. Abramson has limited mobility and strength of his fingers and hands but is able to manipulate touch--screen software and click buttons that require light pressure to depress. Additionally, Mr. Abramson's present ability level includes: Within normal limits (WNL) expressive verbal abilities; WNL receptive language abilities; and WNL cognitive skills. Mr. Abramson over exaggerates speech articulators to slow his rate of speech for increased intelligibility. When fatigued, Mr. Abramson independently uses a voice output software system to communicate. It was particularly noted the Mr. Abramson has decreased respiratory support but is receiving external treatment for this issue. Mr. Abramson appears to be currently consuming a regular diet and thin liquids with family assistance for setup. Through online modes of communication such as Facebook, Twitter, and Instant messenger, Mr. Abramson maintains social contact with friends and family. Adaptive software is utilized with these websites to expedite written messages. Mr. Abramson enjoys creating music with a particular interest in 13 century Rumi poetry to inspire lyrics.  


2.What technology does Lee use?
As indicated above, Mr. Abramson currently utilizes an electric wheelchair with a joystick for mobility. A Mac computer with adaptive software such as word generating programs and voice output systems have been installed and are independently used by the client. The voice output system can be modified to express a variety of moods such as angry and happy. Music creation and collaboration software has been installed. In particular, Sibelius (music composition software) and Logipro (music mixing software) have been installed. Mr. Abramson also uses an adaptive key coding software for use with Logipro. This key coding software was recently created by a friend of Mr. Abramson and therefore, Mr. Abramson is continuing to learn the icons and their usages.


3. Additional comments:

Mr. Abramson appears to be using technology independently. It should be noted that Mr. Abramson requested assistance with installing a larger monitor for use with his Mac computer. Dr. Eulenberg acknowledged the request and is attempting to provide the services for Mr. Abramson.

Overall, the visit has provided this clinician with a sense that technology with Mac computers is highly sophisticated and requires much time and effort to learn to use. However, adaptive technology can be used in coordination with software on Mac computers for maximum usage by clients. Mr. Abramson has demonstrated this point by effectively creating and mixing his own music with the aide of adaptive software as well as by independently expressing voice through a Mac software program.

Mary Margaret Gebbia-Portice Michigan State University
Department of Communicative Sciences and Disorders
CSD 823X
Artificial Language Laboratory Visit Report Form


Name of Observer:  Mary Gebbia-Portice

Name of Client:  Lee Abramson

Date of Birth:  September 13, 1970

Age on Observation Date:   39; 5

Diagnosis and Etiology: ALS (Amyotrophic lateral sclerosis); limb onset; diagnosed approximately 2005 via EMG secondary to torticollis follow up; previous cervical surgery 6 months prior to torticollis onset

Date(s) and time(s) of Observation: video recorded on Wednesday, March 3, 2010 at Lee Abramson's home; viewed video on April 5, 2010
1. Describe Lee's abilities and challenges.
Daily functioning: Lee is not able to walk or use arms fully. Can use his hands, but has little or no fine motor control and limited strength. Lee has difficulty breathing, and says this is the biggest difficulty he has from the ALS. The breathing difficulty affects his speech, but he feels "extraordinarily fortunate" that his condition is not as bad as it could be. Lee's mental capacities are completely in tact and he is able to communicate fully. Speech is slowed, but intelligible.
 
2.What technology does Lee use?
The program Lee uses the most is called "KeyStrokes" and is an on-screen keyboard. By using the on-screen keyboard, Lee can use a touchpad, or even a joystick, to type rather than having to type each letter on a traditional keyboard. Traditional typing requires much hand dexterity and Lee just does not have that capability anymore. KeyStrokes also has "word prediction" which greatly speeds up communication.
"KeyStrokes" is made by AssistiveWare (www.assistiveware.com). Lee says that this software has been a major advance in his quality of life.
Additional software used is ModelTalker speech synthesis software. www.modeltalker.com
ModelTalker creates an artificial voice based on pre-recordings of the individual's own voice, and currently includes four choices of mood (cheer, gloom, contradiction, and angry).
Sibelius and LogicPro are software programs that Lee uses regularly to produce digital music based on the poetry of 13th century Sufi poet and philosopher Jallaludin Rumi. Rumi music has provided an excellent outlet and hobby for Lee, which keeps him active and engaged in life.
Social networking software and sites such as Facebook also allow Lee to connect with friends and family, providing a critical support network.
 
3. Additional comments:
Lee is a very intelligent and talented individual with a positive attitude and strong self-motivation despite his current condition and limitations. His positive attitude has been instrumental in helping him to remain active and engaged in life. Lee seeks out connections and activities.
A good example of his self-motivation is his accomplishment of teaching himself how compose and produce music. Lee had only a music theory text book and a friend to help him accomplish this task. Now, he produces creative and original music with the software available to him. He also has two or three musician friends who come to his home to accompany the Rumi music while Lee records and composes additional tracks.
Lee originally turned to music shortly after his diagnosis and what he describes as feeling "despondent". Music became a therapy for him, and essentially, Lee became his own music therapist.
 
Comparing visits:
One major difference between Lee's challenges and those of the other individuals we have visited is the level of communication ability. Because Lee is currently more capable of verbal communication than individuals with severe cerebral palsy, he is capable of communicating more quickly and easily with the people around him. This allows him to more easily express his intelligence and stay better connected to a support network.
 

Leathia Hodge

Jessica Marie Kaman
Andrea Marie Kujawa Name of Observer: Andrea Kujawa

Name of Client:  Lee Abramson

Date of Birth:
                        (September 13, 1970)

Age on Observation Date:
                                           39; 5

Diagnosis and Etiology:  ALS

Date(s) and time(s) of Observation:  3/3/10

1. Describe Lee's abilities and challenges. 
Lee has had ALS for several years and is still able to speak very well.  He has limited motor abilities, and is in a wheel chair.  One of his greatest difficulties from ALS results in his respiratory troubles.  He is very friendly, creative and intelligent.  He creates music through his special computer program, composing songs inspired by lyrics from  poets (such as Rumi) in a beatiful fashion.
 

2.What technology does Lee use?
Lee has two augmentative communciation software programs.  Lee has one computer device (Key Stroke) that has several different variations of his personal "voice", depending on the mood he chooses.  The system has the technology to take the first few letters, and acts as a predictor to create the rest of the words for Lee to choose from among, which speeds along the process of his ability to type a message.  He also has his music software program, in which he has created beautiful musical pieces by synchronizing several elements of voice and computer synthesized instruments.  Lee has demonstrated extreme artistic abilities while creating these compositions.  He is very talented.

3. Additional comments: 
It was a pleasure meeting with Lee and learning about his communication devices as well as his ability to create amazing musical masterpieces.  He is very talented and he has really used the time that he has to develop a really special talent.

Chelsea Rebecca Adler Marks

Name of Observer: Chelsea Marks

Name of Client:  Lee Abramson

Date of Birth:
  (September 13, 1970)

Age on Observation Date:
  39; 5

Diagnosis and Etiology:
 Amyotrophic Lateral Sclerosis

Date(s) and time(s) of Observation: 3/3/10; 7:00pm

1. Describe Lee's abilities and challenges.

Lee has had Amyotrophic lateral sclerosis for about five years now and even though his breathing has become difficult, his speech still remains intact. Lee also has limited motor ability, which has caused him to need a wheel chair. He is a very creative individual who uses one finger to create his music. Lee is in a daily battle with himself and continues to fight hard which in turn has inspired a lot his music. He has special software installed on his computer for which he can create his music. His music has been inspired by lyrics from 13th century poet, Rumi.

2.What technology does Lee use?



Lee uses two augmentative communication software programs, one being a synthetic voice on backup incase his condition leaves him voiceless. First, he had a music software program that allows Lee to program individual synthesized instruments as well as add the voice of his lovely singer; His singer also happens to be his masseuse. Secondly, Lee has another program that has personalized variations of his own voice so that he can “talk” in the mood that he is feeling. This device will come in handy if Lee ever loses his voice caused by ALS.


3. Additional comments:

Lee is a very talented adult that continues to fight through everyday. He is an inspiration to many and continues to convey his talents through his music.

Amanda Marie Vanhuysse Name of Observer: Amanda VanHuysse

Name of Client:  Lee Abramson

Date of Birth:
(September 13, 1970)

Age on Observation Date:
39; 5

Diagnosis and Etiology: Dysarthria, secondary to ALS

Date(s) and time(s) of Observation: 3/3/10

1.      Describe Lee's abilities and challenges.

Lee is an intelligent man and a very talented musician who uses his computer and help from friends to compose music. He was diagnosed with ALS about 5 years ago and uses a wheel chair due to limited mobility. He is able to operate his computer with his fingers and his voice is still intact. Lee has respiratory problems due his ALS

2.      What technology does Lee use?

As mentioned above, Lee is still able to use his voice, although there is noted weakness, decreased volume and increased breathiness/hoarseness. He currently has a computer program with his own voice recorded should his voice fail in the future. He can type in sentences for it to speak in a variety of different ?moods.? Lee also has a computer program for writing and composing music.

3.      Additional comments:

It was very interesting to see Lee and his ability to compose music. He has a tremendous talent for writing music and it was great to see how he puts it together. Programs like the one Lee uses are great for people with limited mobility who still want to express themselves artistically.