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Word Becomes Action: Assistive Tech and Control Regained


“Alexa, play Pandora. George Thorogood,” Jeff Wirth says

Three of the QLI staff members in Jeff’s on-campus rehabilitation apartment give out a low chuckle at the command. Jeff, a high-level spinal cord injury survivor whose life has been reframed within the confines of a powered wheelchair, is demonstrating a potentially transformative piece of technology.

A beat passes and the room is quiet.

Then, a trotting blues guitar riff and Thorogood’s signature warm, rough-edged cover of Hank Williams’ “Move It On Over” fills the apartment. As the song kicks and rocks to life, Jeff gives out a second and third command—one to adjust the speaker volume and another to control the window blinds. After a moment the music becomes a touch quieter, and automatic roller shades mounted to the apartment’s windows begin to drop closed.

Jeff is a quadriplegic. Without the use of his hands or feet, he operates his wheelchair with a sip-and-puff system, a series of tubes and sensors that converts air pressure into input commands. But within this room, Jeff has complete authority. His word becomes action.

Across the room on Jeff’s microwave rests a small disc, jet black and only slightly larger than a can of shoe polish.

This is the Amazon Echo Dot, a proprietary hands-free device for smart home control. QLI’s clinical team has installed the device in Jeff’s simulation apartment, hoping to trial its effectiveness in helping Jeff complete everyday tasks. In demonstrating it before a group of his QLI therapists and team members, Jeff shows that the Echo Dot is more than an exciting toy or simply one of the holiday’s most popular fads. Instead, it may very well be the tool that paves the way for Jeff’s independence.

“The Echo Dot pairs with the home automation technology we previously had installed in QLI’s simulation apartments,” says Erin McNamara, QLI’s assistive technology specialist and the clinician who proposed Jeff should give the device a practical test. In her role she incorporates an arsenal of assistive devices into Jeff’s rehabilitation program, leveraging both cutting-edge innovations and widely-accessible technology to maximize his quality of life.

Erin gestures toward a sheet of paper taped to the apartment’s closet door. On it, a list of custom commands to manipulate the room’s lighting, activate specific television channel and volume presets, and choose various internet radio options.

The Amazon Echo Dot’s reach stretches far beyond luxury applications, however. With simple voice commands, the room’s heating and air conditioning levels can be adjusted in real-time, an immense benefit for Jeff—who, after his spinal cord injury, experiences difficulty and discomfort when regulating his body temperature.

This degree of environmental management is possible thanks in part to Control4, a pre-existing home automation system wired throughout the apartment, which even provides users nuanced control over home accessibility and home security options. Pairing the Amazon Echo Dot to such a robust system means Jeff can open and close automated doors, as well as remotely monitor home surveillance cameras and activate door locks from within the safety of his living space.

“Essentially, we’ve used the Echo Dot to ease the burden of care on Jeff. That burden might otherwise restrict someone with an equivalent high-level injury to a recommendation of 24-hour assisted care,” Erin adds. “If simple, accessible technology can promote his independent activity, then it can support his independent living.”

The George Thorogood song ends with a definitive drum hit and muted guitar strum, and Jeff asks the Echo Dot to stop playing the music. He speaks again to the motionless black disc, dimming the lights to a soft glow and turning his television set to ESPN, where highlights of a recent college football game roll with quiet commentary. After his rehabilitation at QLI concludes, Jeff plans to return home to his vocation as an attorney in central Nebraska. QLI’s therapists, including Erin, have recommended he install a home automation system alongside Amazon’s home control technology. It’s a recommendation he agrees with and can’t help but reflect on.

“This is all overwhelming,” Jeff says. “The hardest thing after an injury like this is going from independence to not being able to do anything at all for yourself. Losing control.”

He pauses for a thought, then he smiles.

“It’s nice to have that control again.”

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