Environmental control

Also called ECS, Environmental control system, EADL, Electronic assistive technology, Smart home control

Using the same switch, gaze or voice that runs your communication aid to work the lights, the telly, the door and the bed.

What it is

Environmental control lets a person operate things in their home through their access method: lights, television, curtains, the front door, an intercom, a profiling bed, a phone, a fan. The commands live on pages in the communication aid or on a separate controller, and go out as infrared (like a remote control), radio, or over Wi-Fi to smart plugs and hubs.

The point is independence. A person who can say "I'm cold" but cannot turn the heating up is still waiting for someone; environmental control removes the waiting.

Who it can help

People with significant physical disability who already have a reliable access method: switch, eye gaze, head tracking or voice. Adults with motor neurone disease, multiple sclerosis, spinal injury, cerebral palsy and muscular dystrophy; children and young people too, at home and in residential school.

It is not a substitute for care, and a system nobody maintains becomes a room full of things that used to work. Off-the-shelf smart speakers cover some of it for people who can use speech recognition, but they need a clear voice and an internet connection, which excludes many of the people who need control most.

How it works

Modern communication aids from Smartbox and Tobii Dynavox have an infrared transmitter built in or as an add-on, plus pages of remote-control buttons; the person selects "TV on" the same way they select a word. Anything with a remote can be learnt. Radio and Wi-Fi modules reach door openers, plug sockets and hubs.

In England, complex environmental control is a specialised NHS service, assessed and provided for people who meet the criteria, and it covers the assessment, the equipment, the fitting of door openers and the maintenance. Simpler control, a smart plug and a page on the device, can be set up by the AAC service or a family with patience.

Getting started

Start with one thing the person wants to control most, usually the television or a light, and a smart plug or the device's infrared learner. Put a two-cell page on the aid: on, off. When that works for a week, add the next thing.

Ask the occupational therapist about a referral for an NHS environmental control assessment if the person needs door entry, bed control or an intercom; those are not weekend projects. And write down what talks to what, because in a year somebody will replace the television and every button will die.

Where to get help

Ask your occupational therapist or GP for a referral to the NHS environmental control service; the specialised AAC services and the environmental control services commissioned by NHS England often share a building. The ACE Centre and CALL Scotland publish guides, and the MND Association has practical information for people whose needs are changing.