Intended for healthcare professionals

Clinical Review

Fortnightly review: Environmental control systems for people with a disability: an update

BMJ 1997; 315 doi: (Published 16 August 1997) Cite this as: BMJ 1997;315:409
  1. D J Wellings, consultant in rehabilitationa,
  2. J Unsworth, directora
  1. a Regional Rehabilitation Centre, Birmingham B29 6JA
  1. Correspondence to: Dr Wellings
  • Accepted 14 March 1997


It is of great importance that disabled people should have sufficient help to achieve their potential. There are many ways of reducing handicap. Aids for mobility and communication are well known, but the use of “environmental control systems” is less well described.1 The collaboration of technologists, engineers, therapists, and medical staff has led to the development of systems that enable people with a wide range of impairments to control their home environment and offer some choice to the individual (R S F Schilling, unpublished).


This review is based on a literature search in late 1995 and was financed by the NHS research and development programme for people with physical and complex disabilities. In view of the paucity of publications on the subject, we used a wide range of sources. We searched the following on-line and CD ROM databases: Medline, CINAHL, PsychLIT, BIDS, ASSIA PLUS, ERIC. We included early work on environmental control systems and case reports to give a historical perspective. We have highlighted the technological aspects of equipment design by including papers on microelectronics and robotics. We also included several official publications to provide an insight into the organisational aspects of provision of environmental control systems. Finally, much valuable information came from personal contact with colleagues interested in environmental control systems, disability organisations, and manufacturers.

Summary points

Environmental control systems, using sophisticated electronics, enable people with severe physical impairment to use a wide range of electrical devices

Small, unobtrusive control units (resembling remote controls units for television) may have up to 500 functions; switching can be individually designed for users with complex motor problems

Environmental control systems are commonly used for home security (including door intercoms, door release, and alarms), adapted telephones, television, lights, and internal intercoms

Referral for provision of a system is made by doctors or therapists to …

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