Joystick access

Also called Joystick control, Joystick mouse, Wheelchair joystick integration, Integrated control

Driving a pointer with a wheelchair-style joystick, sometimes the very joystick that drives the chair. Familiar, robust, and slower than it looks.

What it is

Joystick access moves a pointer around the screen with a stick, and selects with a button on the stick, a separate switch or dwell. It can be a small desktop joystick, a chin- or lip-operated one, or the powered wheelchair's own joystick, switched over to drive the communication aid instead of the wheels.

That last version, integrated control, is the reason this entry exists: a person who already controls a chair with a joystick has years of practice with exactly the movement a pointer needs.

Who it can help

Powered wheelchair users with a reliable joystick movement, from the hand, the chin or the lip: many people with cerebral palsy, muscular dystrophy, spinal muscular atrophy or spinal injury. People with some hand movement but not enough accuracy for touch.

It is not fast for selecting from a grid; the pointer must travel, and a big page set means a lot of travel. A joystick user with good head control may be quicker on head tracking. And integrated control has a safety cost: while the joystick is driving the screen it is not driving the chair, and switching modes must be quick and obvious.

How it works

A desktop or chin joystick plugs in as a mouse; gain and acceleration settings decide how far the pointer moves per deflection. Some run in "switched" mode instead, where each direction of push is a switch and the software scans or steps in that direction, which is more accurate for grids.

Integrated control uses the wheelchair's electronics: a mode switch (often a button or a hold on the joystick) moves the chair controller from drive to a mouse or a switch output, connected to the device by cable or Bluetooth. Set-up is done by the wheelchair service and the AAC service together; it is not something a family can do alone.

Getting started

If the person has a powered chair, ask the wheelchair service whether the controller has a mouse or Bluetooth output; many modern ones do, and the feature may already be there unused. Ask for a joint appointment with the AAC service.

Meanwhile, try a cheap USB joystick on a tablet or laptop, with a big grid and dwell at 1.5 seconds. Switched mode, if available, is worth trying against pointer mode: many people prefer the crisp step of a switch over chasing a pointer.

Where to get help

Integrated control needs the NHS wheelchair service and an AAC service working together; ask for an AAC assessment and mention the chair. The ACE Centre and CALL Scotland publish access guides, and Smartbox and Tobii Dynavox both document wheelchair integration with their devices.