Irwin Mitchell - Design for life

Throughout history, countless inventors, scientists and thinkers have looked for ways to improve the lives of others by using technology. From the simple prosthetics of the Middle Ages to the advanced electronic systems of today, each invention has one purpose: to ensure everyone has the right to the best quality of life possible.

Here, Irwin Mitchell takes a look at the evolution of these assistive technologies, from the Renaissance period to the present day, where even more exciting and incredible supportive technologies are being developed.

1620 (then mid-18th century)

Sign language

The earliest use of sign language as an "official" means of communication is fiercely debated; Native American and Ottoman communities were understood to have used from the 15th century, whether deaf or not.

In 1620 Spanish priest Juan Pablo Bonet published the first official text on sign language, entitled "Reduction of the Letters of the Alphabet and Method of Teaching Deaf-Mutes to Speak"¹. Bonet explained the phonetic values of letters, as well as the positioning of the lips and tongue when articulating them. This was accompanied by manual signs and a finger alphabet, which forms the basis for all modern signing.

Now, many of the world's sign languages have been legally recognised, though others are not acknowledged and are frequently misunderstood. Over 130 official sign languages were documented globally in 2013, including British Sign Language (BSL), which traces its beginnings back to 1760, when Scottish teacher Thomas Braidwood founded his Academy for the Deaf and Dumb².

It is estimated that 50,000 to 70,000 people in the UK now use BSL as their preferred language³. Much like the English language, BSL evolves quickly – perhaps quicker than the spoken word – as it is wholly defined by the actions and often-personal developments of this small community⁴.

17th Century

Ear trumpet

The ear trumpet can be traced to ancient times, though these devices found their real footing – and initial acceptance – in the 17th century, around the same time they were first described in writing by Jean Leurechon in 1624's "Recreations Mathématiques"⁵.

They were produced in a range of shapes and sizes, mimicking anything from smoking pipes to musical instruments. The ear trumpet had many famous adopters throughout the 1700s and 1800s, including Ludwig van Beethoven and John VI, King of Portugal, though its popularity would later wane.

It would not be until the 20th century that the hearing aid would go about changing the way people were able to cope with hearing problems, while also slowly tackling the discrimination that many showed towards people who relied on the ear trumpet.

1824

Braille

Louis Braille invented his world-famous binary writing system when he was just 15. Having lost his sight in a childhood accident at just three years old, Braille went on to master his disability in a matter of years, notably with the support of parents who raised him in the same manner as any other boy. This led him to become confident in his abilities, and his creativity and passion for learning won him a place in the French education system.

By the age of 15, under a scholarship at the National Institute for Blind Youth in Paris, Braille – desperate to read more books – experimented with the alphabet to make it easily read with the fingertips⁶. He took the lead from Charles Barbier's "Ecriture Nocturne" ("night writing"), which was developed for, but rejected by, Napoleon's army chiefs who wanted a means of sending military messages that could be read at night on the field of battle⁷. After several revisions, Braille's final language was published in 1837.

Despite resistance, Braille was instrumental in the creation of the Royal National Institute of Blind People (RNIB) in the UK. Thomas Rhodes Armitage, a physician with sight problems, brought together a number of blind people to create the British and Foreign Society for Improving the Embossed Literature for the Blind.

1898

Hearing aid

The hearing aid as we know it today was only developed after its two parent technologies – the microphone and telephone – were invented in the latter half of the 19th century. It is widely believed that the first true hearing aid to embrace these two creations was created in 1898 by Miller Reese Hutchison in the form of the "Akoulallion"⁸, developed by his company Akouphone. This table-top model was a commercial flop, and the organisation fell into receivership three years later.

The hearing aid was only developed after its two parent technologies – the microphone and telephone – were invented in the latter half of the 19th century. It is widely believed that the first true hearing aid to embrace these two creations was created in 1898 by Miller Reese Hutchison in the form of the "Akoulallion", developed by his company Akouphone. This table-top model was a commercial flop, and the organisation fell into receivership three years later.

From the 1910s onwards, technology advanced rapidly, and wearable devices were produced by Siemens, Marconi and Western Electric. Notably, Utah-born physicist Harvey Fletcher – the "father of stereophonic sound"⁹ – and his company Bell Laboratories would produce the first hearing aid that utilised the moulding process to fit the device to the user's ear.

This process shaped the future of the device, which got smaller as the Second World War streamlined the miniaturisation of technology and improved further with the creation of the microprocessor.

Now, the once-traditional behind-the-ear (BTE) hearing aids are being gradually replaced by on-the-ear (OTE) aids, as well as even more discreet in-the-ear (ITE), in-the-canal (ITC) and completely-in-canal (CIC) aids – though these are yet to be provided as standard by the NHS¹⁰.

1920s

Stair lift

While it bore no real resemblance to the stair lifts of today, it's believed that Henry VIII brought about the invention of the first means of transporting someone up and down stairs when they were incapable of doing so¹¹. Research led by historian David Starkey found that a "chair throne" was developed to go up and down 20 feet of steps at Whitehall Palace to carry the king, who weighed over 30 stone at the time.

Despite its foundations in 16th century Britain, the first modern stair lift was invented by CC Crispen, a Pennsylvanian entrepreneur, in 1923¹². The self-taught engineer created it to help a friend who was disabled due to polio; the basic chair sat on a rail and ran on small wheels, moved by a chain. Dubbed the "Inclin-ator", it drew the investment of the Philadelphia Electric Company.

Now known as Inclinator Company of America, the organisation still produces stair lifts, alongside countless international corporations who continue to refine this simple, yet effective, design.

1933

Wheelchair

While the wheelchair has been commonly used for centuries, the first lightweight, collapsible wheelchair – one that would act as the blueprint for those still produced today, utilising an X-joint to allow it to be flattened – was invented in 1933¹³.

It was developed for Herbert Everest, a man who broke his back in a mining accident, by his friend Harry Jennings. It did, however, lack larger wheels for self-operation; later versions reintroduced this feature, which had been common in fixed wheelchairs prior to this collapsible model's creation.

The motorised wheelchair was invented shortly after the Second World War by George Klein, an engineer who was also responsible for the creation of the microsurgical staple gun and an early nuclear reactor¹⁴. His idea was developed for veterans of the conflict, though would become one of the most important technological developments not only for those with mobility problems, but also those with cardiovascular and pain-based impairments.

1949

Zimmer frame

Commonly referred to as a Zimmer frame due to the genericised use of the company name most famous for producing them, walking aids were first developed by William Cribbes Robb of Stretford, England, who submitted a patent in 1949¹⁵ for his means of assisting someone with walking or balance difficulties.

Primarily designed as "both simple and convenient in use and of light and inexpensive construction", Robb's original creation did not have wheels; these were factored into patents granted in 1957¹⁶.

Now, those needing help of this kind have a range of options open to them, including canes that double as Zimmer frames, as well as the popular Rollator, a frame which also offers a seat for resting, brakes for safety, and adjustable handlebars depending on the height of the user.

1961

SIP-AND-PUFF

The sip-and-puff system allows individuals who do not have the use of their limbs to operate electrical devices by converting the act of breathing into an electrical signal - inhaling being the 'sip' and exhaling the 'puff'.

The technology dates back to 1961, when engineer Reginald Maling, volunteering at the National Spinal Injuries Centre at Stoke Mandeville Hospital, encountered a man who had been paralysed from the neck down and could only signal to nurses by blowing on a whistle suspended near mouth. Maling then designed a sip-and-puff device that activated micro-switches, allowing the patient to turn his bedroom lights and television on and off by sucking or blowing through a mouthpiece¹⁷.

Maling's assistive technology was acclaimed across the world¹⁸, and his company Possum, along with others, helped to develop this technology further to assist quadriplegics and those suffering from debilitating muscular and neurological diseases, such as motor neurone disease.

Modern sip-and-puff systems have been developed to measure the amount of pneumatic pressure being applied to the system, enabling individuals to control the movement of motorised wheelchairs – including forwards and backwards motion as well as steering – using different exhalation/inhalation lengths and pressures.

1970s

Speech-generating devices

Speech-generating devices, or SGDs, were first made commercially available in the 1970s. The first company in the UK to provide them was Toby Churchill Ltd¹⁹; the man himself was diagnosed with locked-in syndrome in 1969 after swimming in a polluted lake, and only later regained the use of his arm and legs.

The engineer’s Lightwriter was simple; the user typed a message on the keyboard, which was displayed on an outfacing display. The speech synthesiser was soon added while advancements in technology meant basic sentence structures could be easily or automatically put together.

Professor Stephen Hawking's use of an SGD brought the technology to the public’s attention in the 1980s. His battle with amyotrophic lateral sclerosis, combined with a life-saving tracheotomy in 1985, meant his British accent was replaced with an American synthesiser²⁰.

However, this style of computerised speech is rarely, if ever, offered to those in a similar situation today. As technology developed in the 1990s, programs became able to synthesise the voices of those who had their own voices recorded at an earlier date, such as renowned film critic Roger Ebert, who started using SGDs shortly after cancer treatment. This innovation was provided by Scottish firm CereProc²¹, which built on its pre-existing platform that already mimicked regional accents.

Illustration of a speech generating device

1980s

Prostheticlimb

Prosthetic limbs have been around in some format for as long as people have needed them, though most lacked the technology to act as a hygienic, visually-convincing or comfortable replacement for a partial arm or leg. Major breakthroughs were made in the 1980s, as developments in design and materials vastly improved the connection between the stump and socket²².

Newer systems developed over 30 years ago prioritised the distribution of weight, the comfort of bone and the containment of muscular tissue. In 1990, British firm Blatchford started to develop the first commercially-available microprocessor-controlled prosthetic knee in the world, which was programmable to individual users to ensure the smoothest energy-saving gait pattern possible²³.

This was soon followed up with hybrid pneumatic and hydraulic microprocessors that could detect ramps, stairs and speed, responding to these environments. Over the last few years, systems have become even more bespoke, created especially for each individual user, with lower costs than ever before and computer-aided design ensuring nobody gets an off-the-shelf replacement.

1990s

Accessibility software

The development of accessibility software for users with one or many disabilities was given a significant boost by Microsoft. The company sought to take the lead of several small independent companies during the Windows 95 era to patch its flagship operating system ahead of a full, standard release with Windows 98²⁴, introducing Magnifier and the Accessibility Wizard.

Many organisations recognised that they must consider the needs of those with disabilities – particularly as the world becomes more reliant on computers²⁵.

This has led to the development of numerous other improvements as part of operating systems, both on computer and mobile platforms, including: alternate input devices and voice recognition software, which allow people to use keyboard and mouse alternatives; comprehension tools, meaning dyslexic people or those with learning difficulties can understand and hear text; ease of access changes, which standardise methods of interacting, documenting and saving with program suites (e.g. Microsoft Office); and touchscreen technology.

Ongoing

Prehensilerobotics

Modern prosthetic limbs have come a long way, providing amputees with prehensile (grasping) functions. However, each innovation has been within the framework of mechanically-operated limbs; the individual must use muscle movement to stimulate the limb into performing the desired function. The next step is the creation of technology that performs prehensile functions using only signals from the brain.

In February 2014 experts at Cornell University and Harvard Medical School published important research that shows positive results in the development of the brain machine interface²⁷.

The technology works by targeting parts of the brain that send the message to the muscles when a movement is thought of, and they still activate even when the neurological link system between the brain and the muscles is broken. Sensors placed in these areas record the neurological signal, and using algorithms decode it and transmit an appropriate action to the prosthetic limb.

Further development in this field does not just restrict itself to prosthetic limbs, however. It is hoped that once this brain-machine interface has been developed to allow prosthetic limbs to perform complex tasks using thought, it could be evolved to restore function to natural, paralysed limbs, bypassing the broken neurological pathways that have caused the paralysis.

Illustration of brain-computer interface

2020

Autonomous cars

Satellite-navigation systems using GPS began to appear in the 1980s, using digitised maps on cassettes. The development of the internet has given us instant access to detailed digital maps from across the world, and in the early 21st century a host of the world's leading car manufacturers - General Motors, BMW, Mercedes-Benz and Toyota, to name a few²⁸ - and top tech companies such as Google and Apple are engaged in the battle to be the first to produce a commercially viable autonomous vehicle.

Passenger-carrying driverless cars have already been tested on roads in certain US states, with the UK set to legalise them as of January 2015.

The highest-profile autonomous car project is that run by Google. It uses a 64-beam laser system to generate a constantly evolving 3D map of its immediate environment, combining this with Google Maps to navigate its way from A to B and react to the motions and hazards from other road users. To date, Google's vehicle has logged over 700,000 miles with only two accidents - one a rear-end collision caused by another road user, and one a crash when the vehicle was being manually operated.

The technology is still developing, but it is thought that autonomous cars will be a feature of our roads by 2020²⁹.

These are just some of the assistive technologies that have shaped - and continue to shape - the lives of those living with physical impairments. But innovation breeds innovation, so why stop here?

Entries are now closed for Design for Life, our competition with Disability Rights UK, supported by NESTA. We’ll announce the winner of the £10,000 of funding on Thursday 22nd January 2015.

Sources

¹ "Juan Pablo Bonet", Encyclopaedia Britannica (http://www.britannica.com/EBchecked/topic/72993/Juan-Pablo-Bonet#ref265152)

² "Thomas Braidwood, the Braidwood School", University College London (http://www.ucl.ac.uk/dcal/bslhistory/early-deaf-education/thomas-braidwood)

³ "The Beginnings (of British Sign Language)", University College London (http://www.ucl.ac.uk/dcal/bslhistory/beginnings)

⁴ "BDA – About BSL", British Deaf Association (http://www.bda.org.uk/British_Sign_Language_%28BSL%29/About_BSL)

⁵ Multiple sources; the common consensus is 1624, while the BBC says 1642, though this is likely a typographical error (examples: http://www.daviddarling.info/encyclopedia/L/Leurechon.html; http://www.healthscreenuk.co.uk/blog/ear-trumpets-the-original-hearing-aid/; http://news.bbc.co.uk/1/hi/scotland/3083330.stm)

⁶ "What is Braille?", American Foundation for the Blind (http://www.afb.org/info/living-with-vision-loss/braille/what-is-braille/123)

⁷ "Invention of braille", RNIB (http://www.rnib.org.uk/braille-and-other-tactile-codes-portal-braille-past-present-and-future/invention-braille)

⁸ "Hearing device timeline", Washington University School of Medicine (http://beckerexhibits.wustl.edu/did/timeline/)

⁹ "In Memory of Harvey Fletcher", Brigham Young University (http://www.et.byu.edu/~tom/family/Harvey_Fletcher/harvey_fletcher.html)

¹⁰ "Hearing aids – Live Well", NHS Choices (http://www.nhs.uk/Livewell/hearing-problems/Pages/hearing-aids.aspx)

¹¹ "Henry VIII used his very own 'stairthrone' when the steps became too much, says Starkey", Daily Mail (http://www.dailymail.co.uk/news/article-1138522/Henry-VIII-used-stairthrone-steps-says-Starkey.html)

¹² "About Inclinator", Inclinator Company of America (http://www.inclinator.com/about-inclinator/)

¹³ "Folding wheel chair", Google patent index (http://www.google.com/patents/US2095411)

¹⁴ "George J Klein – Hall of Fame", Canada Science and Technology Museum (http://www.sciencetech.technomuses.ca/english/about/hallfame/u_i19_e.cfm)

¹⁵ "Walking aid", Google patent index (http://www.google.com/patents/US2656874)

¹⁶ "Invalid walker and transfer device", Google patent index (www.google.com/patents/US2792052)

¹⁷ "The Beginning", Possum (http://www.possum.co.uk/values/)

¹⁸ "Obituary: Reginald George Maling (1 December 1927–3 January 2007)", Nature (http://www.nature.com/sc/journal/v45/n7/full/3102050a.html)

¹⁹ "About", Toby Churchill Ltd (http://www.toby-churchill.com/about/)

²⁰ Interview with Stephen Hawking, USA Today (http://usatoday30.usatoday.com/life/people/2006-06-15-hawking_x.htm)

²¹ CereProc (https://www.cereproc.com/)

²² "Artificial limbs", US National Library of Medicine/National Institutes of Health (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1121287/)

²³ "Company History", Blatchford Clinical Services (http://www.blatchford.co.uk/about/company-history/)

²⁴ "History of Microsoft Commitment to Accessibility", Microsoft (http://www.microsoft.com/enable/microsoft/history.aspx)

²⁵ "History of Software Accessibility", Mozilla (http://www-archive.mozilla.org/access/today)

²⁶ "Man's high-tech paradise lost", The Whig (http://www.thewhig.com/2012/11/28/mans-high-tech-paradise-lost)

²⁷ "Rain signals move paralyzed limbs in new experiment" Science Daily (http://www.sciencedaily.com/releases/2014/02/140219143229.htm)

²⁸ MIT Technology Review (http://www.technologyreview.com/featuredstory/520431/driverless-cars-are-further-away-than-you-think/)

²⁹ "Here's What It's Like to Go for a Ride in Google's Robot Car", Recode.net (http://recode.net/2014/05/13/googles-self-driving-car-a-smooth-test-ride-but-a-long-road-ahead/)