ALS Communication Technology
Comprehensive guide to eye trackers, head tracking, BCIs, and assistive software. Based on real feedback from PALS and caregivers.
Voice Banking
Create a synthetic voice clone before speech declines. Eligible people with ALS/MND can apply for free access through the ElevenLabs Impact Program.
Apply for Free AccessQuick Recommendations
Eye Tracking Devices
Eye gaze technology for ALS communication when hand/voice function is lost.
Low-Tech Solutions
Simple and reliable
Spatial Alphabet System
No-tech communication using room gaze zones - for bedridden PALS
Room Gaze Zones
Physical Alphabet Board
How It Works
From the PALS' bed, the room is divided into gaze zones. Where the PALS looks indicates which letter group they want to select.
| Top Left Corner | Group 1: A B C D E F |
| Left Wall | Group 2: G H I J |
| Front Wall | Group 3: K L M N O P |
| Top Right Corner | Group 4: Q R S T |
| Right Wall | Group 5: U V W X Y Z |
| Ceiling / Fan | Numbers: 1 2 3 4 5 6 7 8 9 |
Usage Tips
- Word Length First: PALS looks at ceiling/fan → caregiver asks "How many letters?" (1-9) → then start spelling
- Common Words First: Always try common daily words before using spatial alphabet
- Practice: Once adapted, eliminates need for physical alphabet board
simple explanation: "Imagine dividing the room into 6 zones. When PALS looks at top-left corner = letters A-F. Left wall = G-J. Front wall = K-P. Top-right = Q-T. Right wall = U-Z. Looking at ceiling fan = numbers. Before spelling, PALS looks at fan to indicate word length, then we start guessing!"
Head Tracking Devices
For PALS who retain head movement.
Free & Open Source Software
Free and open-source options, with licence and compatibility details for each tool.
Mobile Apps
Smartphone and tablet apps for communication.
Brain-Computer Interfaces (BCIs)
Research access and everyday availability
These communication systems remain investigational. Eligibility and study location determine access. Research hardware sales or clearance of an electrode component do not mean approval of a complete home communication system. There is no confirmed general-release date.
Tobii Eye Tracker 4C Setup Guide
System Requirements
- Windows 10 (64-bit) — Note: Core Software not compatible with Windows 11
- Processor: Intel i3 or higher
- RAM: 8 GB or more
- Stick magnetic strip to bottom center of monitor
- Attach Tobii 4C to the magnetic strip or use double sided tape
- Plug into USB 3.0 port
- Go to: gaming.tobii.com/getstarted
- Select "Tobii Eye Tracker 4C"
- Select "Tobii Eye Tracking Core Software"
- Download Tobii Eye Tracking Core Software v2.16.8
- Run the downloaded installer
- Complete installation
- Open Tobii Eye Tracking from Start Menu or system tray
- Go to Display Setup → align tracker edges on screen
- Run Calibration → follow the dots with your eyes
- Save your profile
- Go to: Settings → Ease of Access → Eye Control
- Toggle "Use eye control" to ON
- Eye Control toolbar will appear on screen
- Check Apps & Features → search "Tobii" → should show v2.16.8
- Press
Win + R, typeservices.msc - Find "Tobii Service" → should show "Running"
Tobii Eye Tracker 5 Setup Guide
Note: Tobii Eye Tracker 5 is designed for gaming. For accessibility use, we recommend Path A (OptiKey). Path B uses a discontinued beta driver.
System Requirements
- Windows 10 or 11 (64-bit, version 1709+)
- Processor: Intel i3 or higher
- RAM: 8 GB or more
✅ Path A: OptiKey Setup (Recommended & Verified Working)
Community Verified: This setup is tested and working for ALS patients. The Tobii Eye Tracker 5 does NOT officially support Windows Eye Control, but works perfectly with OptiKey Pro Classic v3.
⚠️ Critical Compatibility Notes
- OptiKey v4 does NOT support Tobii Eye Tracker 5 — You must use OptiKey Classic (v3)
- Windows Eye Control is NOT compatible with Eye Tracker 5 by design (Tobii official policy)
- For Windows Eye Control, you need Tobii 4C (discontinued) or Tobii Dynavox PCEye (expensive)
- Attach the Flex Mount at bottom center of your monitor
- Connect Eye Tracker 5 to USB 3.0 port (USB-A)
- Purple LEDs should light up when connected
- Position yourself 45-95 cm from the tracker for optimal range
- Keep the device plugged in for all remaining steps
- Go to: gaming.tobii.com/getstarted
- Select "Tobii Eye Tracker 5" from the dropdown
- Click "DOWNLOAD DRIVER" button
- This downloads:
Tobii.EyeTracker5.Offline.Installer_4.183.0.30025 - Run installer as Administrator
- Restart your computer after installation
Select "Tobii Eye Tracker 5" and download the official driver
- The driver installation will prompt you to install Tobii Experience app from Microsoft Store
- Or install directly from: Microsoft Store - Tobii Experience
- Wait 5-10 minutes for the app to fully install
- Current version:
1.69.32600.0(as of Dec 2024)
Tobii Experience app version 1.69.32600.0 for calibration
- Launch Tobii Experience from Start Menu
- Create a user profile for the PALS
- Complete Display Setup — align the tracker position on screen
- Run Calibration — follow the dots with your eyes
- Test tracking: Eye icon should appear when looking at screen
- Enable auto-start: Settings → Startup → Enable "Start with Windows"
Tip: Calibrate in both light and dark room conditions for best results across different times of day.
Check that all required services are running:
- Press
Win + R, typeservices.msc, press Enter - Find these services and ensure all show "Running":
- Tobii Eye Tracker Generic Service
- Tobii Runtime Service
- Tobii Service
Verify installed apps (Settings → Apps & Features → search "Tobii"):
Required: Tobii Experience (app), Tobii Experience Software, and Device Drivers
⚠️ Important: You MUST download OptiKey Classic (v3), NOT OptiKey v4. Version 4 does NOT support Tobii Eye Tracker 5!
- Go to: optikey.org/help/versions
- Scroll to "OptiKey Classic (V3)" section at the bottom
- Click "Download OptiKey Pro Classic (v3.2.5)"
- Or direct download: OptiKeySetup-3.2.5-Pro.exe
- Run installer as Administrator
OptiKey versions page — look for Classic (V3)
Download "OptiKey Pro Classic (v3.2.5)"
- Launch OptiKey Pro from Start Menu
- Click the Menu icon (hamburger menu at top-left)
- Go to Settings
- Navigate to Pointing & Selecting tab
- Set Source to "Tobii EyeX" (this works for Eye Tracker 5)
- Go to Management tab → Click Calibration
- Complete OptiKey's own calibration process
✅ OptiKey Pro Classic v3.2.5 working with Tobii Eye Tracker 5
This is the verified working setup for ALS communication
✅ What You Should Have Installed
Result: Full eye tracking control of keyboard, mouse, and speech output through OptiKey!
Path B: Windows Eye Control (Experimental)
Uses discontinued beta driver (Feb 2024). No official support. May have issues.
- Windows 10 version 1709+ (Fall Creators Update)
- Check:
Win + R→ typewinver - Install all Windows Updates first
- Uninstall from Apps & Features:
- Tobii Experience
- Tobii Experience Software for Windows
- All Tobii Device Drivers
- Use Revo Uninstaller (Advanced scan mode)
- Check Device Manager → Software components (remove any Tobii)
- Restart computer
- Download: Beta Driver (Community link)
- Run installer as Administrator
- Installs "Tobii Core Software" (older version)
- Restart computer
Note: NOT an official Tobii link - use at own risk.
- Apps & Features → "Tobii Eye Tracking Core Software"
- Device Manager → Human Interface Devices:
- Tobii Device
- Tobii Eye Tracker HID (v1.1.532.0+)
- If missing, reinstall beta driver
- Launch Tobii Core Software (NOT Tobii Experience)
- Create user profile
- Complete Display Setup
- Run Calibration
- Test eye tracking works in Tobii Core
- Settings → Ease of Access → Eye Control → ON
- RESTART computer (critical!)
- After restart, Eye Control should recognize tracker
- Launch Eye Control from Settings
- Complete Eye Control calibration (separate from Tobii)
- Test basic functionality
Known Issues: May crash on startup, compatibility issues with newer Windows builds, poor accuracy, gaming features won't work. If problems occur → Use Path A (OptiKey) instead.
Comparison
| Feature | Path A | Path B |
|---|---|---|
| Official Support | Yes | No |
| Stability | Stable | Variable |
| Setup | Easy | Complex |
| Recommendation | Use This | If needed |
Download Links
Path A (Recommended):
Tobii Official Driver (v4.183.0.30025) Tobii Experience App (Microsoft Store) OptiKey All Versions (Choose v3.2.5) OptiKey Pro Classic v3.2.5 (Direct Download)Path B (Experimental - NOT recommended):
Beta Driver v5.0.0.6035 (Community - Use at own risk)