In just a few years, electronic technology has virtually revolutionized the workplace for everyone from cleanup crew to stockholder. No one has been more dramatically affected by the use of computers and related technology on the job than people with disabilities.

Technology has eradicated many of the physical obstacles to gainful employment that have faced people disabled by neuromuscular diseases. Computers allow people with disabilities to work more independently; they've opened up dozens of new career fields; and they've put job seekers with disabilities on a more equal footing with other applicants.

Thomas H. Bush, associate director of program services for the Muscular Dystrophy Association, noted that computer literacy is "not an option any longer. It's a critical skill like reading and writing."

That computers are used everywhere schools, homes, jobs, recreation is good news for people with disabilities. David Householder, a rehabilitation specialist with the Pennsylvania Office of Vocational Rehabilitation, said, "The ADA says if somebody can do the job you have to give them a chance. The accommodations to a person's physical limitations through electronics are often a way to get that accomplished."

THE MIND'S THE LIMIT

Scott Millhisler devised his own computer input system, using a chin-operated switch to make Morse code signals, which the computer converts to programming instructions.

People with neuromuscular diseases usually look for careers that call on their mental capacities and make minimal physical demands. But before computers, those who lacked Stephen Hawking's scientific genius, or the right temperament to be an attorney, counselor, teacher or writer, had few other realistic choices.

Fifteen years ago, Scott Luber's college professors encouraged him to earn a graduate degree so he could teach in a university. The only problem was, Luber didn't want to. As he tells in this issue's "From Where I Sit", even his chosen field of accounting was considered too physically demanding for someone with a neuromuscular disease until computers came along.

Joey Acosta had planned a career in law until he was required to take a computer course in high school.

"That one semester changed my whole outlook," Acosta said. "It was a course in basic computer programming and I learned that you can control it, create anything you ever wanted to create."

Acosta, 27, now owns and operates Renaissance Computer Organizational Service in El Paso, Texas, selling computer systems and contracting to do computer repair, diagnostics and desktop publishing.

Not only do computers give people with disabilities more ways to use their intellect; technology has also increased job choices by changing the way jobs are done.

Luber, 35, gave up his hopes for an architecture career because drafting was too physically difficult for him. Greg Fleming, 21, of Mulvane, Kan., never faced that obstacle.

Fleming took drafting in high school, then earned a certificate in computer drafting from a vocational-technical school. He's now the Mulvane Utilities Department's only computer draftsman.

Fleming does his job with the same type of computer-aided design (CAD) program, operated by a regular keyboard and a mouse, that all draftsmen use today.

"There's not much demand for table drafting; computer drafting is so much more accurate," he said. "I don't have any special equipment [to operate the computer], but I couldn't do anything by hand."

CHOICES AND MORE CHOICES

As client services coordinator for the Illinois Occupational Information Coordinating Committee, Lola Lucas trains teachers, guidance counselors and job placement personnel to help young people choose careers. Information software has changed the career planning process, especially for those with disabilities.

Less than 10 years ago, Lucas said, advisers generally pointed people with disabilities toward jobs that fit their disabilities, rather than their interests. A change in consciousness and a host of technological adaptations now allow teachers and counselors to show students a much greater range of options.

In new methods of career counseling, "physical ability is approached in a logical way." Applicants rate themselves on lifting ability, desired level of physical activity, eye-hand coordination, finger dexterity and other such measures, Lucas said. With all of the job-seeker's interests and preferences in mind, the adviser can then investigate technology that might enable the person to do particular jobs.

The Massachusetts Rehabilitation Commission helped Mark Geisler find suitable work after a respiratory crisis in 1984 required a tracheotomy and full-time ventilator. The Brewster resident established a part-time, home-based word processing and desktop publishing business, producing letters, newsletters, greeting cards, business cards, fliers, invitations and other printed products. Selecting commands and letters on an on-screen keyboard with a joystick switch, Geisler, 40, can type, edit, design, alter and add graphic elements to his projects.

Even in the least physically demanding types of work, computers and the adaptive tools that enable people with disabilities to use them offer new levels of independence and privacy. For example, rather than dictating every draft, lawyers and writers can input and edit their own written material. Professionals can also research virtually any topic in the many databases available through online services.

Growing weakness in her arms led scientist Louise D. Principe to discontinue her hands-on laboratory research in 1987. She transferred to the New York State Department of Health's Bureau of Toxic Substance Assessment, researching the scientific literature via computer.

For Principe, 52, handling stacks of journals and handwriting notes would have been impossible because of the muscle fatigue caused by her metabolic myopathy. The explosion of databases containing scientific journals enabled her to continue working.

"If computer research had not been available, I probably would not have been able to find a job using my level of education," said Principe, who has a Ph.D. in pharmacology. "Because of the computer, I was still able to write scientific papers and use my education. I had to be able to make the same technical judgments, interpret the same data and read the same scientific papers. I was just doing them in a different way."

LESS WEAR AND TEAR

In administrative and office jobs, computers require much less physical stamina than handwriting, using a conventional typewriter or handling paper files. This aspect of technology has enabled many people with neuromuscular diseases to work longer hours with less fatigue, and to maintain or advance in their careers.

Carol Schaufel-Romero's responsibilities as a senior rehabilitation counselor for the Wisconsin Department of Vocational Rehabilitation in Kenosha are heavy on paperwork. During the 15 years she's worked for the state, her progressive neuromuscular disease has gradually limited her abilities to type and handle paperwork; during the same time frame, electronic technology has introduced new solutions.

Carol Schaufel-Romero is one of many people with disabilities who've found voice input essential to doing their jobs. She bypasses the keyboard by speaking into a microphone on her desk. Headset microphones are also available.

"Until about four years ago, I could move my files myself. Then my doctor told me not to move them any more because I was getting too exhausted," Schaufel-Romero, 48, said.

She did her work by using volunteer assistants and trading tasks with other counselors. Then in 1993, her office was equipped with computers and counselors were required to do most of their own typing and file maintenance. Schaufel-Romero now fills out forms and maintains files on 100 to 125 clients, without anyone's assistance.

She uses the Dragon Dictate voice recognition system, allowing her to bypass the keyboard and speak directly into the computer's word processing system. She moves the cursor with a trackball mouse that can be operated with one finger.

Oscar R. Cardenas of McAllen, Texas, owns a data-processing firm specializing in insurance premium financing, and a computerized bilingual bill-collection firm. Besides being crucial in business today, computers enable Cardenas, 35, to meet the demands of running two companies with more than 50 employees and participate in many community activities by minimizing the physical stress of the job.

"Had it not been for computers, I'd get weak quicker. The computer allows me to put in a full day's work," he said.

THERE'S A TOOL FOR THAT

The same inventiveness that fueled the computer revolution is turning out a host of assistive devices that make technology accessible to people with a variety of disabilities. The major difficulty people with disabilities imposed by neuromuscular diseases face in operating computers is using the keyboard to put data into the system.

Hundreds of hardware and software applications to assist with input ranging from keyguards to on-screen keyboards operated by blinking the eyes are on the market. (See "Living With ALS" and "Becoming Computer Savvy," below, for more details.)

Scott J. Millhisler of Perry, Mich., taught himself to use a home computer a few years ago. Today, he operates a full-time programming and consulting business with two employees. His services include installing and maintaining computer networks for companies and managing an equipment lease-tracking program at Michigan State University in nearby East Lansing. He also used his programming expertise to create his own input system.

"I have no use of my arms or legs, and my neck is in a fixed position. Any movement has to be from the eyes, lips or jaw," Millhisler, who has spinal muscular atrophy, explained.

Because he can't move his neck, a mouthstick, headstick or an adapted or programmable keyboard are of no help. Gaze-operated and voice-recognition systems are too costly and too slow for his needs. And dictation isn't efficient for programming, which requires inputting codes, not words.

Millhisler, 29, devised a Morse code input device operated by a four-position joystick switch pressed against his chin. A conversion device translates his signals, made by moving his facial muscles, into keyboard input that appears on the screen.

"I've got very quick reflexes, and I can tap on the switch for the Morse code quite quickly," said Millhisler, who can use the system while sitting or lying down.

For eight years, Tom Mecke of San Antonio has worked as a process specialist in the Department of Mid-range Computer Operations for Southwestern Bell, managing computers used by engineers. For about half that time, he has used a Magic Wand miniature keyboard, which lets him type with a pointer or mouthstick.

"It requires no force," Mecke, 35, said. "I might not be able to do my job without this system."

THE WORLD ON A SCREEN

Besides being a versatile tool for accomplishing many job- related tasks, the computer has literally opened whole new worlds of employment, entertainment, communication and information gathering. Electronic technology is now so much a part of everyday life that, Lucas said, some schools offer a bachelor's degree in computer game design.

Many people with neuromuscular diseases now have jobs that didn't exist before computers. Technology created places for Luber and Mecke in the job market. For Millhisler, Acosta and others, computers are the substance as well as the means of self-employment.

Millhisler prefers taking jobs on a contract basis rather than working full-time for one employer. Among advantages of working from home, "It's less restrictive. I don't have to worry about transfers or someone getting upset if it takes me more time."

The list of businesses someone can run with a home computer is endless. Internet marketing, multimedia production, information brokerage, market research, investments, security monitoring, reminder services, referral services, and consulting in virtually any area are just a few of the categories Lucas listed. Most involve using online services and the computer's communication capabilities to gather and disseminate information.

Telecommuting working for a company at home and communicating with the office electronically is another growing area.

THE PRICE TAG

New software and hardware tools making computers accessible to people with disabilities appear constantly, offered by scores of companies ranging from giants IBM and Apple to new startup firms. As the market for noncustomized products grows, prices are plummeting.

For example, less than 10 years ago, the Dragon Dictate voice- recognition system cost about $10,000. Today it can be purchased for as little as one-tenth that amount.

According to the Alliance for Technology Access' Computer Resources for People with Disabilities, on-screen keyboards are available for $350-$800, electronic wands at about $1,000, joysticks under $100 and a trackball mouse for $75 to $130. An entire home business setup including computer, modem, printer, voice recognition system, software and accessories can be obtained for well under $10,000. Not an unreasonable investment for something that enables a person to make a living and will require only minor upgrades for several years.

Computer training programs are available through high schools, colleges and companies. The Alliance for Technology Access (ATA) is a network of more than 40 resource centers across the country that matches people with disabilities with technology to help them work, learn and communicate.

The West Tennessee Special Technology Access Resource Center (STAR Center) in Jackson is the largest in the ATA network. Under contract with the state's vocational rehabilitation office, it trains people of all ages to work in their fields of interest, using the latest in electronic technology.

Michael Hays, STAR Center's placement specialist, said that in its first year, the center placed 24 people in jobs, and the "computer relates in all but a few." ATA centers also educate employers, persuading them to give applicants with disabilities a chance and advising worker and employer on technology and other adaptations that will make the placement a success.

Many state vocational rehabilitation departments pay for computers and adaptive devices for clients to use in training and on jobs. Some employers gladly purchase assistive software, particularly after an employee has established a track record.

Job hunters with disabilities can inform prospective employers about adaptive equipment and their training in using it. Tom Bush of MDA suggested that applicants might offer to provide their own specialized equipment, split costs with the employer or negotiate who will pay for repairs and upgrades.

WHAT'S NEXT?

Even computers have their limits, and there's still room for improvement.

Some users of voice-input systems report chronic sore throats and hoarseness. Throat fatigue can limit their usefulness for people with neuromuscular diseases.

Luber would like to see hardware and software manufacturers design adaptations directly into their standard products, making it unnecessary to buy assistive devices. For example, users who type with one finger can get special programs that allow them to hold down two or three keys by pressing only one key. But such an option could easily be the norm in all hardware, Luber said.

Even as the computer industry opens employment doors for people with disabilities, it can't address other workplace obstacles.

Bush said, "The money is there; the technology, the jobs, the information, the motivation to put people with disabilities to work are all there." But he and Luber list other problems that require nontechnological solutions: transportation, health insurance, red tape and restrictions in obtaining state benefits, personal assistance services, a need for flexible work hours, the additional costs that come with being disabled, workplace accommodations, blatant discrimination and, most of all, attitudes of both employers and employees.

People with neuromuscular diseases who use computers at work recognize that technology has multiplied opportunities. Most also agree with Principe that there's something more important:

"You have to believe in yourself. You're the same person with the same intellect, with or without a disability. If you want a career, you can have one."

BECOMING COMPUTER SAVVY

Books

Adaptive Technologies for Learning and Work Environments, by Joseph J. Lazzaro, 250 pages. $35. American Library Association, 50 E. Huron St., Chicago, IL 60611, (800) 545-2433. Describes adaptive computer devices, online services, CD-ROM reference systems and more.

Computer Resources for People with Disabilities, by the Alliance for Technology Access, with foreword by Stephen Hawking, 1995. 290 pages. Paperback $14.95, spiral-bound $19.95, hardcover $24.95. Hunter House, P.O. Box 2914, Alameda, CA 94501-0914, (800) 266-5592. A comprehensive guide that helps readers with any disability choose the best computer technology for their purposes. Includes tips on determining what equipment you need, and full descriptions of hardware and software costs and uses. Its lengthy resource section lists state tech act programs, organizations, conferences, publications, online services, databases and vendors.

The 1995 Earning Power in the Home Guide, by Patricia Galbreaith, 1995, $8; Yes, You Can!, P.O. Box 368, Weatherford, TX 76806, (817) 594-4415. Geared to people with disabilities, this book explores topics such as attitude, training, goals, business plans and networking.

Organizations

Start with your state Vocational Rehabilitation Office to find out about training programs, computer-access evaluations and job referrals. The Technology-Related Assistance for Individuals with Disabilities Act provides funds to each state that may be used to purchase equipment for yourself or your employer. The following agencies offer more specific information on computers and adaptive devices.

ABLEDATA
8455 Colesville Road, Suite 935
Silver Spring, MD 20910-3319
(301) 588-9284; (800) 346-2742
Database of assistive devices, manufacturers, suppliers and costs. Services are free or inexpensive.

Alliance for Technology Access
2173 East Francisco Blvd., Suite L
San Rafael, CA 94901
(415) 455-4575
Network of regional centers offers information and job-oriented computer training. Call to find the nearest center.

American Association for the Advancement of Science
Science, Technology and Disability Project
1333 H. St. N.W.
Washington, DC 20005
(202) 326-6630
Project provides information and support for people with disabilities seeking careers in science, engineering and mathematics; directory of professionals with disabilities who are available for career consultation; publications, videos and programs.

Closing the Gap
P.O. Box 68
Henderson, MN 56044
(612) 248-3294
Organization has a bimonthly news letter, database and annual conference on use of computer technology by and for people with disabilities.

Job Accommodation Network
918 Chestnut Ridge Road, Suite 1
P.O. Box 6080
Morgantown, WV 26506-6080
(800) 232-9675; (800) 526-7234
Part of the President's Committee on Employment of People with Disabilities, this consulting service for employees and employers helps with specific accommodation needs.

RESNA
1700 N. Moore St., Suite 1540
Arlington, VA 22209-1903
(703) 524-6686
Association concerned with advancement of rehabilitation and assistive technology. A good resource on federal funding of state assistance programs.

Trace Research and Development Center
S-151 Waisman Center
1500 Highland Ave.
Madison, WI 52705
(608) 262-6966
This University of Wisconsin center develops hardware and software solutions to improve accessibility of computers and information systems for people with disabilities. A leading center in its field, Trace offers a catalog of publications, CD- ROMs and devices.

Vendors

These are only a few of the hundreds of companies that manufacture and distribute assistive technology.