David Dikter, CEO ATIA

 

This past month I had the chance to present at some pretty cool events. In DC I participated in the second M-Enabling Summit, a global event focused on accessibility and mobile technology. Scheduled in tandem was also a policy briefing at the US Senate. There I served on a panel to discuss the impact of the Convention on the Rights of Persons with Disabilities (CRPD) on global commerce and the international accessibility eco-system. Both left strong impressions that I think are worth sharing as we consider this month's newsletter theme--"Going Mobile."

There's little doubt that assistive technology (AT) is going mobile; after all, this is now the direction of the digital world in general. In the developing world, people are more likely to have smart phones and tablets than desktop or laptop computers. This means, increasingly, mobile tech is how people around the globe are accessing the Internet and all its content. And in the US and elsewhere we continue to see AT developed for mobile platforms, from apps to AT that's built-in.

The M-Enabling Summit, hosted by the G3ict (the UN's Global Initiative for Inclusive Information and Communication Technologies), addresses an essential need. In the US, the 21st Century Communications and Video Accessibility Act is bringing urgency and focus to the need for mobile technologies that work for everyone. M-Enabling provides a venue to hear from telecommunications providers about the commitment they are making to accessibility and it provides a rare opportunity for learning and sharing between the mobile tech sector, government, and the AT and broader disability advocacy communities. Indeed, at the Summit I was struck by how few opportunities really exist for multi-national technology companies to tap the knowledge our AT community daily lives and breathes.

In connection with the Summit, at the US Senate, over 300 people turned out for the policy briefing on the Disability Treaty (which is how the CRPD is now known). The US has yet to ratify the Treaty, and the good news from that event is a sense of a growing awareness that this must happen. After all, the Disability Treaty is modeled on our ADA. And while we have much left to do in this country to achieve our goals, there is a growing understanding that we need to be at the table of ratifying nations; they are looking to learn from our decades of experience creating access to education, transportation, employment, and other arenas. It's also in our economic interest. Around the world the Treaty is, in effect, putting into place AT and accessible information technology (IT) programs to support citizens with disabilities. It's creating markets and we have a leadership role to play. As longtime disability/accessibility advocate John Kemp remarked at the opening of the Summit, "Business isn't waiting around for Congress to ratify. It sees opportunities, needs, and consumers."

What we know well, however, from our decades of AT experience, is that building assistive and accessible technology alone has little impact on potential users. There must also be awareness of what is possible, an understanding that your neighbor who is blind, for example, can also access the newspaper, can learn and work and participate, that technology can make a powerful difference. AT, also, goes nowhere without training, support, and education. People need to know it exists and how to use it. Indeed, not long ago I observed a woman straining to read her mobile phone--in this case an iPhone--with a magnifying glass. 

At ATIA we know something about how challenging this is--both building accessible mobile technology and educating people to use it. For our conference this year we developed our first app and mobile web platform for all our conference planning materials. Doing so revealed layers of challenges--particularly as developing mobile technology is outside of our organization's "core competencies." ATIA's strengths are with providing access to training and professional development and knowledge about AT. And yet here, too, we learned the challenges with moving even our AT community to adopt the new accessible mobile format. So educating the much broader world of developers and users about accessibility can seem daunting indeed. This is why I am grateful for the opportunity to take part in the M-Enabling Summit and Disability Treaty policy briefing. ATIA is committed to making connections, collaborating, and building community. We understand that sharing our knowledge and learning from one another will be essential if we are to help mobile technologies move forward in a direction that is satisfying for all users. 

 

--David Dikter, CEO ATIA 

Accessibility Drives Innovation!

AAC and the Tablet Revolution 

by Angela Standridge, M.A., CCC-SLP, ATP

Angela Standridge

A scenario:  a 6-year-old boy who is non verbal uses a tablet computer in the classroom. He arrives at school and checks his virtual visual schedule on a "story app" bookshelf. The bookshelf orders the day's activities and displays them as clickable "stories" created with photos, videos, audio, and text. Next he goes to circle time where an app with a grid of activity specific vocabulary is used. He exits out of the grid to use his core vocabulary AAC program to tell his friend he saw his Granny over the weekend. He has math next. He sets the virtual timer and plays an addition game. Next is reading where he plays a phonics game and then listens to a story with text-to-speech. He uses his core vocabulary AAC program to tell his teacher he didn't like the way the story ended because it was sad. Later that day his class uses a video conferencing app to watch a zoo keeper talk about new baby chimpanzees at the zoo. He draws a picture of the babies in a paint app and posts it to the class science wiki and emails it to his mom. And so his day continues, with the tablet integrated into all aspects of learning and communicating.
 
Every few years a new AAC gadget will come along and grab the spotlight as "the thing that will fix everything." The latest gadget is the tablet. Tablets will likely not "fix everything," but as the scenario above demonstrates, they can be a powerful tool for communicating and more. Tablets are inexpensive, accepted in the mainstream, very portable, and when used with the appropriate AAC app, can be a viable communication option for potential AAC users. Tablets can also be used for participation, engagement, education, vocation, productivity, entertainment and social media.

Tablets and apps--how to choose?

There are many tablets and apps to choose from and it can be overwhelming. AAC communicators, professionals and families need to establish what they want from a device, conduct an AAC evaluation, trial a tool, and utilize established AAC best practices for intervention.
 
The good news is that processes for AAC assessment and intervention are firmly established in the profession and do not change with the tool. In general, AAC evaluations are used to establish cognitive functioning and expressive and receptive language levels. Literacy skills are also identified. If the communicator has physical limitations that make using the device difficult, alternative access options are explored.

Next, the features needed in the tablet and app are determined (i.e. tablet platform, education needs, productivity needs, language[s], access, spelling/word prediction, etc.) Typically apps that support core vocabulary are most effective. Core vocabulary consists of 300-500 of the most commonly spoken/written words (personal and content specific vocabulary will have to be added, but the bulk of the needed words will already be available). Two great resources to review AAC apps are this Spectronics Web page, and Bridgingapps.org.

Staff, family, and caregivers are then trained to support the tool and to be effective communication partners. A tool trial is conducted. If the tool is a good fit, communication skills are then taught in naturalistic settings with abundant opportunity for practice and engagement.

Apps beyond AAC

In addition to AAC, other apps may be beneficial to the communicator. Apps that promote participation and engagement can be useful. They might allow users to choose preferred items or activities, use video to model activities and expected behaviors, track rewards and consequences, or serve as a virtual schedule board. There are thousands of academic education apps ranging from useless to amazing. In general these apps provide drill and practice (often as games), writing, creating (with a variety of media), and collaborating. Productivity apps can assist a communicator with managing their time and obligations, completing assignments or engaging in vocational activities.

Tablets are also a socially-acceptable and portable way to stay entertained (i.e. games, reading, internet, music) and electronically connected to others via social media. For many individuals who do use speech, these activities were previously not accessible. To keep up with so many apps, it is helpful to follow a general app review blog or website such as APPitic.com or IEAR.org.

Hardware and funding challenges

In addition to so many choices, two more challenges exist for persons with disabilities who use tablets. First, the hardware is one of the biggest barriers for potential AAC users. They are fragile devices, the speakers are not particularly loud, the batteries may not hold up to rigorous use, and there are very limited alternative access options available. Also tablets are marketed as disposable technology to be replaced every 2-3 years, so keeping hardware and system software updated can be difficult and costly.
 
Second, funding is limited. In most states tablets are not considered durable medical equipment (DME), so insurance and Medicaid may not be willing to provide funding. Some good resources to know about include your state's AT Act program and AACFundingHelp.com (created by the Assistive Technology Law Center at Duke University.) Additionally, tablet manufacturers have not established effective mechanisms for schools or other large institutions to easily buy and purchase tablets and apps. To successfully deploy tablet technology, organizations need to research each platform's options for enterprise and/or education hardware and app purchasing. They should clearly establish their organizational goals and objectives for tablet use and develop operating guidelines and procedures for initial and continued support.

Tablets, however, are here to stay and are changing the way we do so many things. For many individuals with disabilities, they provide access to the world in ways never imagined. What will they look like in 5 years, 10 years? The possibilities seem limitless.
 
Angela Standridge, M.A, CCC-SLP, has worked in AT and AAC for over 25 years. She is currently employed at Region 4 Education Service Center and provides training and technical assistance in AT for public school personnel in Houston, TX.

Jonathan O'Dell

by Jonathan O'Dell

Before mobile devices and associated mobile information streams came along, there was the telephone. And while the telephone, especially the cellular telephone, certainly proved to be a boon to hearing people, it presented deaf people with insurmountable barriers. Even people who are severely deaf can usually lipread some of what another person is saying; with the telephone, lipreading becomes impossible. While technology was developed that allowed deaf people to type text at first over land line telephones and then cellular phones, they were either bulky, expensive or unreliable.

Mobile devices, as we know them today, however, have proven to be as much a boon for people who are deaf or hard of hearing as they are for anyone else. Through them we receive messages, texts, emails, Tweets, and Facebook status updates like any hearing individual; the barrier that used to exist in terms of access to what we call "incidental information" (information that may be overheard and of interest, but not specifically directed to someone) is starting to fall away simply due to the sheer ubiquity of mobile computing and communicating devices, and the flood of information that is received on them.

Generally speaking, "mobile devices," here, references smart phones and tablets. These come in a bewildering array of sizes, features, capabilities and operating systems (OS). The operating systems with the most features available today are iOS (Apple) and Android (Google).  Windows Mobile and BlackBerry are also on the market, but as yet they do not provide access to Video Relay Service applications (VRS) which allow deaf mobile device users to call hearing users--an essential service.

Video relay and point-to-point video calling

Through VRS mobile applications, deaf persons may sign a conversation to an operator (also known as a "communication assistant") using the device's camera. The operator then voices it for the hearing caller and signs back the voiced response. In addition to Video Relay Service apps, are Video Phone apps (and apps that provide access to both). Video Phone apps allow deaf persons to communicate directly in sign language without an intervening operator.

Direct, point-to-point video communications are also accessible through Voice Over Internet Protocol (VoIP) video providers like  Skype and Oovoo and through apps like Facetime (native to iOS) and Google Talk (Android). Such point-to-point video services can also boost speech comprehension for some hard-of-hearing individuals due to the added assistance of the visual component. Both VRS and point-to-point video calls are possible with iOS and Android--on tablets as well as smart phones--so long as the mobile device has a front-facing camera, and a fast enough Internet connection (inadequate bandwidth will render video choppy, pixilated, and essentially useless). Users may also need a specific version of their device's operating system since manufacturers continually update their OS, and an OS that is generations behind will usually not be compatible with the newest versions of any Video Phone or VRS software.

Apps for texting, captioning, and more...

Text and email applications are invaluable for many people who cannot hear or speak; while those who can speak but not hear often use captioned telephone applications. Captioning services, such as Hamilton Captel, allow a caller to use speech and then read the text of the other person's spoken reply as relayed through an operator. Operators hear the other person's voice and repeat their words into speech recognition software. The software sends the text to the deaf or hard-of-hearing caller's phone.

Also useful for some individuals who are hard of hearing are sound amplifier apps. Apps like SoundAMP boost sound for greater clarity. For individuals who are completely deaf, decibel measuring apps can alert them to the presence of loud sounds in their environment. These display when the decibel level of background noise has suddenly peaked against the previous "baseline normal" sound level.

Other applications, such as GPS, while not specifically designed for deaf or hard of hearing people, can free a person from having to ask for directions from someone who may not understand them or whom they may not understand. Also useful are applications for travel, online ordering, and the like which make it possible to conduct business without having to talk to someone else--a boon for people who don't find that easy to do.
In summary, mobile devices and applications are powerful tools for individuals who are deaf or hard of hearing, individuals who will usually choose devices and services based on accessibility features. Such considerations include the availability of closed captions and subtitles (such as provided by Netflix), the adequacy of  volume controls, accessory headphone jacks, and more. However, also important are battery life, screen size, weight, portability, the network coverage, and service plan. For example it's important to know who may offer a discounted rate for deaf users who will not use voice plans and instead opt for unlimited text and larger data buckets as part of a text access plan.

Indeed, devices, apps, operating systems, and service plans change and/or multiply constantly. The single best tool to make your experience successful is knowledge, and there is much information online about mobile devices, apps, and plans. As the expression goes, the best consumer is an educated consumer; and it cannot be forgotten that each and every one of us has certain communication preferences and auditory differences that make the search for the "single best device/software/application" as elusive as the hunt for the fabled unicorn.

Compare mobile devices for features of potential interest to deaf/hard of hearing users at this FCC Accessibility Clearing House Web page. Learn more about specific apps of interest to deaf/hh mobile tech users from this annotated list of Android and iOS apps compiled by the Minnesota Dept. of Health (PDF).

Jonathan O'Dell is the assistive technology manager and training specialist at the Massachusetts Commission for the Deaf and Hard of Hearing

Use Your Mobile Device Hands Free!

Therese Willkomm

by Therese Willkomm, PhD, ATP

Many individuals with or without a disability can benefit from hands-free solutions for using a tablet or mobile phone. Simply holding a device can be challenging for someone who has the use of just one arm or who experiences a grasping impairment due to arthritis or neuromuscular impairments. In addition, individuals who experience blindness or low vision may need hands-free solutions to scan and read documents using optical character recognition (OCR) apps that require their device be held very still.

Below are two quick and simple low-tech solutions I have created to support individuals with different hands-free or one-handed needs.

1. Portable Scan and Read Station

The Scan and Read Station is for use with a smart phone to capture and read text off 8.5 x 11" paper. It helps stabilize an iPhone, for example, for use with an OCR app such as TextGrabber. TextGrabber takes a photo of text and uses OCR technology with the iPhone's VoiceOver feature to read it aloud. This is useful for many individuals who experience a print disability. However, it requires the camera to be held very still and at an appropriate distance from the text.

My solution is made using corrugated plastic that is scored and folded, acrylic sheeting (for the top), and clear tape (VHB) for fastening components.

These create a trifold box that supports the iPhone above the text, docked in the correct location so that when the camera on the phone is turned on, the text's image lines up perfectly within the screen for scanning. Any document that is the size of 8.5" x 11" can be quickly slid into place, and the acrylic does not interfere with the clarity of the camera using the app. View a PDF of complete step-by-step instructions for the Portable Scan and Read Station.

2. One-Handed Shoulder-Mounted Solution for Using Tablets on the Fly
 
This is used by individuals who only have the use of one hand and need to quickly access their tablet. It is also a great solution for individuals who experience communication impairments and want to communicate on the fly. The shoulder-mounted strap allows the device to be quickly slid into place and then rest on a shelf attached to a belt or the waistband of a pair of pants. It supports the tablet in front of the user's body and enables typing with one hand.

The solution uses two Velcro Rapid Strap kits (2" and 1" widths), a tablet case with a rotating handle, and a clip-on shelf made from corrugated plastic. The Rapid Strap kits require no sewing. The strap material is cut to size to create a neck strap and waist belt. To support the bottom of the tablet, a clip-on spring-loaded shelf made from corrugated plastic slides over the belt (or a waist band). When the person is done typing or using the iPad, they can simply lift up on the iPad with one hand and swing it over their shoulder.

Therese Willkomm, PhD, ATP, is the director of New Hampshire's State Assistive Technology Program with the Institute on Disability at the University of New Hampshire (UNH) and is an assistant professor in the Department of Occupational Therapy. Willkomm is a popular presenter on low-tech AT solutions as well as apps and iPads at ATIA Orlando.

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