IDRC - Celebrating 25 Years

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Supports for complying with the Accessibility for Ontarians with Disabilities Act (AODA)

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Linda Petty

This email address is being protected from spambots. You need JavaScript enabled to view it.

http://idrc.ocad.ca

 

 

Table of Contents

Meshing Technology:

Introductions

Vision Technology Service

Funding

Equipment funding

The bleeding edgeÖ

Concurrent Visual and Physical Disabilities

Congenital

PPT Slide

Incidence of Vision Problems: Normal population

Incidence of Vision Problems: Cerebral Palsy

Incidence of Vision Problems: Developmental Delay

Incidence of Vision Problems: Downís Syndrome

Acquired Neurological Impairments

Acquired Neurological Impairments

Demographics of Vision Loss

Demographics of Vision Loss

Third Group- Lightening can strike twice

Difficult to fit population technically

Process to accommodate both areas of need

Quantitative Computer Access Eval

Lower extremity control and range of movement, if reliable and adequate upper extremity or head/voice control have not been found

Equipment Trials

Using Alternative Computer Input with Vision Technology

Keyboard Modifications

Mice and trackballs

Alternative Keyboards

Alternative Keyboards

Big Keys Keyboard

Intellikeys Keyboard

Modifying Overlays

Web Browser Overlay

Intellikeys and Screen Magnification Software

Intellikeys and Jaws for Windows

OCR software

Sources of Overlays

On-Screen Keyboards

Switch Scanning

Customized Scanning Arrays

Switch Access

Morse Code

Hardware Morse Code devices

Voice Recognition

Web Browsers

Support software

Resources

Service Requirements

General recommendations

 

 

Meshing Technology:

    Computer Access for Visual & Physical Disabilities

    Linda Petty, OT

    www.utoronto.ca/atrc This email address is being protected from spambots. You need JavaScript enabled to view it.

Introductions

  • University of Toronto Adaptive Technology Resource Centre and Centre for Academic Technology

  • Research & Development, Education and Services


Vision Technology Service

  • Regional Assessment Centre for provincial Ministry of Health for SE and SS High Tech Vision Aids

  • Employment Accommodation contracts, linked to local hospitals, schools, AT clinics


Funding

  • Province of Ontario funds equipment for schools under Min. of Ed., ìPersonalî equipment under Min. of Health. No funding or legislation mandating employment accommodation.

  • Personal equipment: assessment service funded and 20 hours of training

  • Range of software/hardware eligible


Equipment funding

  • Computer system and screen reading or magnification funded up to $4900

  • Scanner and OCR program OR CCTV funded to 75% or 100%

  • Personal Information Managers funded 75% or less

  • Alternative keyboard access funded through Writing Aids clinics up to 75 or 100%


The bleeding edgeÖ

  • Two very different groups of disabilities

    • Different medical specialities, support systems, special educators
    • Different access technologies from different vendors, developers
    • Little support from a technical/design perspective for products that work together well

Concurrent Visual and Physical Disabilities

    Congenital, Acquired and Dual Disabilities



Congenital

  • 75 - 90% of children with severe impairments have a visual impairment

  • High Risk populations for visual impairment include: Cerebral Palsy, Premature births, Downís Syndrome, Hearing Impaired, Fetal Alcohol Syndrome

    • Beukelman & Mirenda, 1992; Erhardt, 1990; Mirenda & Mathy-Laikko, 1989

PPT Slide

  • Impairments include: visual acuity loss, eye muscle imbalances, visual field deficits, visual perceptual skill delays and processing problems

  • Treatments focused on motor impairments- visual problems are often undiagnosed, not treated or poorly understood, esp. in clients with motor-speech or literacy impairments


Incidence of Vision Problems: Normal population

  • Refractive error :15-30%,

  • Strabismus: 2 - 4%

  • Total: 30-35%

  • Compared to vision problems associated with congenital conditions...


Incidence of Vision Problems: Cerebral Palsy

  • Refractive error : 21-76%,

  • Strabismus: 15 - 60%

  • Other problems: 1 - 25%

  • Total: 50 - 78%


Incidence of Vision Problems: Developmental Delay

  • Refractive error : 52%,

  • Strabismus: 16 - 40%

  • Other problems: 21%

  • Total: 50 - 80%


Incidence of Vision Problems: Downís Syndrome

  • Refractive error : 42-73%,

  • Strabismus: 30 - 57%

  • Other problems: 0%

  • Total: 60 - 85%


Acquired Neurological Impairments

  • High Level Spinal Cord Injury, Acquired and Traumatic Brain Injury, Neuro Muscular Skeletal disabilities, Amyotrophic Lateral Sclerosis, Multiple Sclerosis

  • The physical insult or disease process affects optic nerve pathways, occipital lobe processing or ocular motor control of eyes


Acquired Neurological Impairments

  • For example: Traumatic Brain Injury at the brainstem level

    • in one client results in severe nystagmus, decreasing acuity, unable to read 12 point text on 15î monitor, speech loss, quadriplegia
    • in another client causes inability to open the eyelids, move eyes for tracking, reading effectively, loss of speech, quadriparesis

Demographics of Vision Loss

  • Between 1% and 2% of western populations have conditions resulting in Low Vision- Diabetes Mellitus, Age Related Macular Degeneration, Cataracts, Glaucoma, Retinitis Pigmentosa

  • LV most prevalent among the elderly- 25% of over 65, and the % of elderly in popín ?

  • 0.2% are ìlegallyî blind


Demographics of Vision Loss

  • From 1.7 to 2.8% report visual disabilities in surveys from US, UK and Canada

  • Clients may present as needing high technology equipment but could be corrected with conventional medical or optometric intervention- need sequential assessment: Ophthamological, low tech, then high tech


Third Group- Lightening can strike twice

  • People with existing blindness and low vision conditions can acquire physical disabilities: e.g.

    • blindness from RP: acquires head injury, hemiplegia through water skiing accident
    • glaucoma and arthritis
    • Retinitis Pigmentosa and Multiple Sclerosis
    • Cerebral Palsy and Multiple Sclerosis

Difficult to fit population technically

  • Computer access methods for physical disabilities rely heavily on vision

  • High tech aids for visual disabilities rely on multiple keystrokes from whole keyboard, esp. numeric keypad, and are memory intensive

  • Conflict between timing and representation of alternative input device and vision aid


Process to accommodate both areas of need

  • Thorough identification of needs and problems- physical and visual- in personal, productivity and leisure reading and writing

  • Quantitative computer access evaluation to establish optimal computer access method

  • Application of computer access to control of visual access software, computer system and application software


Quantitative Computer Access Eval

 

  • Seating and positioning and the influencing reflexes, muscle tone and posture
  • Upper extremity range of reach (ROM), target size and accuracy and speed of sequencing, amount of pressure applied, grasp/release skills
  • Head control for active movement, jaw and mouth movement and voice control

Lower extremity control and range of movement, if reliable and adequate upper extremity or head/voice control have not been found

 

  • Lower extremity control and range of movement, if reliable and adequate upper extremity or head/voice control have not been found

  • Visual skills in peripheral vision, tracking, scanning and eye-hand co-ordination

  • Determine the Movements, body sites, interfaces and positions for best access


Equipment Trials

  • Conduct a series of trials with each Movement/site/interface/position, collecting data on accuracy and speed, making modifications to improve performance as needed

  • Finalise on best configuration for the technology use or need

  • Training required on both visual and physical access technology


Using Alternative Computer Input with Vision Technology

    Main target technology of screen enlargement, screen reading and OCR software



Keyboard Modifications

  • Sticky keys, filter keys in Win 95/8 work with screen enlargement software

  • With screen reading have to confer with manufacturer, often use non-keypad layout for laptop system, as Sticky keys will not hold down a numeric keypad Insert

  • Many clients can use filter keys instead of keyguard, which blocks view of keyboard


Mice and trackballs

  • Variety of mouse/trackball devices

  • Look for those with reliable drivers and right mouse button function

  • Match with strength ROM, coordination


Alternative Keyboards

  • Provide full text entry and function keys

  • Incorporate mouse emulation

    • Tash Mini and King
    • Magic Wand
  • Increased visual and cognitive load, keystrokes


Alternative Keyboards

  • Hardware miniature or expanded keyboards work well for text entry, but do not offer extensive control of vision software unless hot keys of vision software are re-configured or in laptop configuration

  • Usually do not have numeric keypad

  • Can be used in conjunction with a mouse to minimise some extra keystrokes


Big Keys Keyboard

  • Available in ABC or QWERTY large target keys, durable

  • Can get large black letters on tan background for adult users

  • www.bigkeys.com


Intellikeys Keyboard

  • Have used Overlay Maker extensively to develop large print overlays with keys to operate functions of screen enlargement/reading/OCR software

  • Overlays are customised

    • for clientís visual requirements for colour, contrast, label size
    • for physical targeting skills and range of motion

Modifying Overlays

  • Can increase contrast of background/ foreground

  • Can use puff paints for tactile feedback, or Braille labels on overlay


Web Browser Overlay

  • For client with needs for large target areas, large font and literacy support


Intellikeys and Screen Magnification Software

  • Can create custom overlays for visual needs and with macros to operate screen enlargement software

  • Re-configure ZoomText Extra Hotkeys and map under 5 overlay keys- Magnify plus and minus, ZT on/off and DocReader On

  • Can also use standard QWERTY or ABC overlay and re-label hot keys for in-frequently used keys


Intellikeys and Jaws for Windows

  • With Jaws for Windows have used Intellikeys with a high contrast overlay and laptop layout.

  • Will leave a ìJî keystroke when using insert key


OCR software

  • Minimise the amount of buttons needed with OCR, etc. by mapping most used keys- New, Open, Scan, Read, etc.

  • Can put reading controls on same overlay as writing control if space is available- other wise create separate reading overlays if support for changing overlays is in place


Sources of Overlays

  • www.Intellitools.com has an Activity Exchange section

  • Can search the database of overlays for those designed for low vision, also for various grade levels and subject areas, Mac or PC


On-Screen Keyboards

  • Compatible with Screen enlargement- need to make sure the focus alternates properly from the keyboard to the document

  • Ensure that the client can visually scan keyboard for selections

  • Usually need 21 inch monitor due to the amount of screen real-estate needed


Switch Scanning

  • Pre-programmed (EZKeys) or customizable (Discover Ke:nx, Discover Switch)

  • Switch access of on-screen keyboard: ie. WiViK

  • Switch access for mouse emulation only from Words+, Gus, Madenta, RJCooper


Customized Scanning Arrays

  • Best option for single switch specific application access

  • Can add text-to-speech support for visual or literacy needs

    • Ke:nx setups included with product
    • Switch Clicker Plus
    • Discover Switch
      • CAT: el.net/CAT/matrix.html

Switch Access

  • At present have not found a program which provides non-letter based scanning arrays for single switch scanning which can communicate with screen reading or enlargement programs.

    • Switch Clicker Plus and Discover Ke:nx will not operate LPWindows and ZoomText Extra; Does not give commands at a level the program could interpret.

Morse Code

  • System of inputting text and commands/mouse movements through 1,2,or 3 switches through hardware switch box with or without software

  • Only alternative computer input method that does not rely on vision- use auditory tones to identify codes, text echoing/ reading programs to review what is written.


Hardware Morse Code devices

 

  • Attaches to keyboard port - MiniMorse or PCMCIA card- Darci

  • Does not offer faceto face communication support, instant phrases, etc.

  • Does not conflict with other software- screen reading/magnification


Voice Recognition

 

  • Continuous speech voice products can run in conjunction with screen enlargement; for speech feedback/ editing of what is written is best to use document reading from the enlargement program

  • Likewise, can run JFW and Naturally Speaking for non-hands free voice in-out

  • Jawbone available for JFW, NS and DD


Web Browsers

 

  • Opera is a ìnimbleî shareware browser with zoom features and complete control from the keyboard

  • Can download in 3 - 5 minutes, carry on a floppy

  • Available at www.opera.nt.nl


Support software

 

  • Help Read program from Hawaii literacy program at www.pixi.com~reader1

  • Shareware/freeware linked to Trace site at http://trace.wisc.edu/world/computer_access/multi/shareware.htm

  • Electronic text - links from SNOW site: http://snow.utoronto.ca


Resources

 

  • Adaptive Technology Resource Centre, Univ. of Toronto

  • Library of Papers with Conference presentations

    • www.utoronto.ca/atrc
  • Barrier Free Education site from Georgia Tech at

    • http://barrier-free.arch.gatech.edu

Service Requirements

 

  • Multidisciplinary team with occupational therapists & technologists experienced in alternative computer access

  • A range of computer access devices and mounting/positioning aids

  • Access to individuals support team for seating adjustments, training support


General recommendations

 

  • Encourage manufacturers/developers to consider each otherís products, develop scripts/set files, etc.

  • Need to test each configuration of alternative access software/hardware with the screen reading/magnification/OCR software to ensure compatibility

  • Document what works and share it!