Background History

Sue is a 72 year old lady, who had suffered 2 strokes following spinal surgery. She lives with her husband in a 2 bedroomed apartment in a small town. Her son lives in the south of the UK and her daughter lives with her husband and their 3 children in Australia.

Sue had always been an avid and confident computer user before her illness, using it mainly for storing photos, making diary journals for her grand children, skypeing her family in Australia and making movie clips.

Assessment and functioning

Sue was experiencing a number of difficulties as a result of her stroke, affecting her vision, cognitive functioning and executive functioning. She struggled with organisation, planning, memory, sustained attention and acceptance of her disability. Sue also had visual field loss of the upper quadrant.

When I spoke to Sue, she reported she was unable to find the pictures she wanted and struggled to see and find things on her desktop. She was also unable to create the documents she wanted to send to her family.

chaotic organisation of iconsWhat was evident when assessing the desktop screen was the chaotic organisation of icons along with a busy screen background affecting visual discrimination. The size of the icons and text was small making it extremely difficult to see and read. Documents were also randomly stored on the desktop.




changed the background picture to a solid colourI changed the background picture to a solid colour to reduce the visual confusion Sue was experiencing. I also increased both the folder icon and font size. I then moved these into the lower 2/3rds of the screen to make them more easily accessible for Sue to locate in her remaining visual field.




developed a naming systemWorking with Sue, I developed a naming system that helped her organise photos and other important files. By this, I mean we created appropriate folders with names she could recognise and remember enabling her to retrieve the information she needed at the right time.

I spent time teaching Sue to move, copy, cut and paste files into the folders we had created. This work was done repeatedly using a graded approach of support and guidance. It was evident with practice Sue was growing in skill and confidence to complete the task independently. This approach also helped her to memorise the process enabling her to repeat it over time.


With this intervention Sue also developed an ability to create folders, copy and move groups of pictures into folders. She was also able to locate all folders created and named. Furthermore Sue was able to create and name her own folders.

To facilitate carry over in her work with the occupational therapist and occupational technical instructor we created help documents covering the processes we had completed for Sue to refer to for guidance if needed.

Sue is reporting to be feeling happier, she is able to organise and find her folders and photos. She states she is now using her computer more confidently.

Since my visit she has created invitation cards and stationary for her forthcoming wedding anniversary using many of the folders and pictures we had created.

If you would like help to get the best from your IT Equipment or learn more about the Information /Assistive Technologies provided by Independent Rehabilitation Services, please do not hesitate to contact us.

Declan McNichol

Bill Young

Angela Gordon

Birgit Rathje-Vale