A-Tech Review

AT Help for Dementia

Laurie Blanchard has been helping compile some great resources at her Long Term Care blog.

Today she offers help on one of the least-noticed areas in assistive technology, dementia.

We are accustomed to looking at assistive technologies helping the blind, the deaf, even the paralyzed. Those with mental problems, we think, not so much.

But that's not true. There are products that can help these people, too. The site's product listings are divided into groups:

• prompts and reminders.
• communication
• leisure
• communication

More Than Words Are Needed

Following its Florida conference last week, the Assistive Technology industry Association hosted a full-day of gab in Orlando, where corporate executives tried to talk things up.

IBM was the main driver of the program, and the result was a business case with numbers like these:

• 155 million people in the U.S. need accessibility technologies of some type.
• Disabled Americans represent $175 billion in discretionary income.

Big numbers. But if the opportunity is so enormous, why are so few corporations pursuing it?

The reason is that this market, by its nature, does not speak for itself. Most of those who speak for the disabled are advocates, who speak from a non-profit or government viewpoint. They mainly see this area as a cost, not as an opportunity.

When your body is locked in a nursing home, or you are locked in your own home by blindness or paralysis, it's very hard to turn that buying power into a market force which must be respected.

Until the people within this market gain more control of their money, and demand entry to the mainstream, this won't change.

So I have the most optimism here regarding the aging of America, especially the baby boomers (of which I am one). We are accustomed to whining, to demanding action and holding out vast sums of money to those who meet our needs.

One Giant Step For Open Source

There is a new name on our blogroll today, Chris Hofstadter's Blind Confidential.

Let me tell you why.

Chris, who worked on the development of the JAWS screen reader at Freedom Scientific, is the first major assistive technology developer to represent the power of open source. He is also the first to understand the need for those in the industry to get closer to Universities, and the research work they are doing.

Open source can help in that effort as well. There is a growing struggle in the University community between those who see the purpose of research as aiding mankind and those who see it as aiding the University. Those who practice the former want more openness in every way, and this includes support for open source.

What Microsoft Has Done Right

Regular readers here know I have a tendency to bash Microsoft.

But there's something they're doing right, something very important.

They are bringing out all their accessibility features with Windows Vista and Office 2007 alongside the launch of the software.

This is especially important with regards the operating system. Microsoft has been working for three years on this release and hundreds of application programs will come out alongside it. These programs, too, can be expected to have accessibility features implemented.

Web 2.0 For All

One continuing frustration is the lag between technical improvements and their adaptation for disabled users. (Image from AndyBudd.)

The Apple iPhone, for instance, does not meet the requirements of Section 255 in the Federal Communications Act. That means your needs haven't been considered, and you really shouldn't be considering it.

As Chairman Mal (the newest addition to our blogroll) notes,

I’m still waiting for access to I Tunes and those nifty little I Pods.  During the ice storm last week, I thought there might be a chance this could happen, but hell froze over with no word from Apple!

The same problem exists with the improvements known as Web 2.0.

Is the iPhone Really a Step Forward?

The Apple iPhone is considered a giant step forward in user interface design.

But is that true for everyone?

Just like current phones, the iPhone features tiny icons. While it can be programmed for voice commands, that programming requires good vision -- it can't be done by voice alone.

The sad fact is that the cellular revolution has happened with almost no input, and no attention paid, to those with disabilities. It's a welter of proprietary designs and interfaces. When you change phones you lose everything you put into the old one.

And from here the iPhone doesn't really look different.

The IBM-Microsoft Battle

A recent Associated Press feature on assistive technology for the Web makes casual note of the continuing IBM-Microsoft rivalry in this area, without giving it the emphasis it deserves.

Many Web 2.0 features can be very difficult for blind users. What are you supposed to do about text that appears only when your mouse scrolls over it, or the welter of keywords, each a different size (depending on how common it is) you find on many sites today?

The story goes into detail about how IBM's iAccessible2 is, through programs like Firefox, making such content accessible. But only near the end does it even mention the real problem:

For now, programmers and assistive technology vendors still have to figure out how to incorporate [Microsoft] User Interface Automation with other technologies, including iAccessible2.

This at least is the heart of the problem.

The Twin Purposes of Assistive Technology

There are two main purposes to assistive technology, although they both come down to one word:

Productivity.

On the one hand, assistive technologies make more people productive. Can't see the keyboard? Can't hear the prompts? Can't move anything but your eyes? We can make you productive. Or we can help you learn, which in turn will lead to a marketable skill.

The second purpose of productive technology is to make caregivers productive. Give more people the same level of care, or allow it to all be done at home longer, and both sides in the relationship benefit. The patient gets better, more compassionate care, while the caregiver's productivity gains could lead to a higher salary (especially if the technology takes skill to manage).

Both these goals come with a deadline, of course.

Buy This Book?

Do you face disease? Disability? Troubles for which there seems no solution?

Is that's what's troubling you, Bucky?

I have the solution. It's called Zen for Tough Guys, the new book by this blog's co-author, Martin K. Bayne.

Zen for Tough Guys is a short story collection, but not just any collection. These are very short stories, the kind that can fit on a greeting card (that's an idea), the kind visitors can read during the briefest hospital visit.

These are also stories that stay with you. Like O. Henry, who wrote many of his stories for newspapers a century ago, Bayne has the ability to pack a lot of emotional wallop into a very little space.

Threat of the Gadget Decade

This is the gadget decade.

Technology progress today is defined by client devices, gadgets like the iPod, the cellphone and the like.

This is good for Apple Computer Inc. (now Apple Inc.) but it can be very bad for the assistive technology community.

Take the new Able Planet Able Talker for example. Please.

On the surface, this is a very good thing indeed. It's a noise-filtering microphone that can link to a headphone and deliver clear sounds from up to 35 feet away.

It's also hopelessly proprietary.

Everything about it is proprietary. The way it works is proprietary. The way it transmits data is proprietary.

That means, when it becomes obsolete, you're stuck. More important, it means you can't really connect this device to anything else. You can't improve it. You can't access its innards, and neither can anyone else.

The Thin Edge of the Wedge

Assistive and adaptive technology are not a unitary market.

They are a collection of mini-markets, with products offering a wide variety of help from minor to major, across a wide field of disabilities.

Today I want to briefly discuss one of the mildest such disabilities, the thin edge of the wedge if you will.  Specifically, dyslexia.

I have a child with dyslexia. We used a variety of computer software tools to try and help her. But it was eventually something beyond tech, the skills of a trained teacher, that changed her life. We learned that there are a variety of ways to learn -- by seeing, by hearing, by doing -- and that our daughter was a highly tactile learner. She had to get her hands on the letters and their relationship to one another. One of our most effective techniques was to spread shaving cream on our glass dining table and have her spell words into it.

A Promising Acquisition

One good way to boost assistive technology is to have technologies from other parts of the market acquired by folks who can bring them to the assistive market.

That seems to be the case with this week's deal by Nuance Communications of Burlington Mass. to acquire MobileVoiceControl, based in Mason, Ohio.

MobileVoiceControl makes a system that lets Blackberry users access features of their units without typing on its quirky keyboard. Nuance launched its Nuance Mobile Platform last month, aiming to do the same thing with a wide variety of mobile devices. The hope is the smaller company's system can be deployed generally.

In making its announcement Nuance noted most phones' data interfaces are kludgy. Users have to go through many menus to do even simple things, since the phones only have 12 keys (plus some function keys).

But there is more to it than that.Nuance also owns Dictaphone and Dragon, the leading general voice technology outfits. Nuance is involved heavily in the health market, through Dictaphone. And every blind user is facing the equivalent of a 12-key keypad when they try to access the Web.

There is enormous hope in this deal, if Nuance takes full advantage of it.

The Words Drop and Bucket Come to Mind

The University of Delaware is trumpeting a $600,000 grant for three years of disability computing assistance.

Delaware is a relatively small state, but the words drop and bucket still come to mind.

The director of DATI, the Delaware Assistive Technology Initiative, which includes 19 state agencies, called the grant "fiscally and environmentally responsible." What she means by that is a lot of the money will go to re-use existing assistive technology equipment.

Nothing wrong with that, but it doesn't really provide anything new to anyone. And you get photo ops with people claiming the problem is solved. When it's not.

Cheap and Open

In order for assistive, adaptive and accessibility technology to be effective in meeting the needs of all those who need it, it needs to be inexpensive and, more important, open.

I'm not talking here about open source. I'm talking about open protocols, which allow all applications to take advantage of hardware and software remediation.

This is a new idea. I think it is embodied in the Microsoft UI Automation system we discussed yesterday (although you always have to note the fine print). But low-priced, even free tools are also important here, and you won't find a better directory to them than at Paul Hami's site on Edublogs, which I have just added to the blogroll here.

Hero or Villain?

I am trying to decide today whether Rob Sinclair is a hero or a villain to the assistive technology community. (Picture from IEEE Spectrum, which credits Houghton Mifflin.)

I am inclined toward the former view, but hear the other side before deciding.

IEEE Spectrum has a profile of Sinclair the hero this month. He is the head of the accessible technology group at Microsoft. In that job he has added many good things to Microsoft Vista, the new version of Windows introduced late last year. These include "enhanced                 screen magnification, voice control, and dictation, plus                 improved compatibility with third-party assistive                 technology products."

All good things.

Perhaps the most important contribution Sinclair has made is the Microsoft User Interface Automation model. The idea is to let any application talk to any assistive technology through a set of APIs, or Application Programming Interfaces. Best of all, Sinclair wants to expand the use of MUIA, making an industry standard so it can be used with Macs and Linux systems.

So what's the problem?

What is Assistive Technology?

I'm defining things as broadly as possible.

The fact is there are many types of disabilities. There are movement disabilities, sensory disabilities, even simple learning disabilities.

These run the gamut, from quadriplegia to carpal tunnel syndrome on the movement side, from total to color blindness in the sensory area, and from autism to simple ADHD dyslexia in the learning area.

The amount of remediation you need, and the type of remediation you need, in order to happen will vary.

That's reflected here. My co-author, Martin Bayne, is nearly paralyzed by Parkinsonism. He is required to live in a nursing home, although he's just in his 50s, as I am. He requires enormous amounts of technology just to stay alive. I, on the other hand, require very little, although one of my children is dyslexic, and my wife complains of both arthritic pain and carpal tunnel.

Assistive technology, then, is in the eye of the beholder. Where you stand depends on where you sit. And thus defining it is simple. It's whatever you need in order to be productive.

Always-On Is Here

I have long advocated what I call "The World of Always On."

The idea is to use a WiFi network as a technology platform, connecting sensors with analysis via the Internet so that we have better control over our homes, our possessions, and our independent lives.

This last niche, medical monitoring, is finally coming to market through two companies (so far), Quiet Care and Lusora.

Both are similar platforms. Wireless sensors (fairly large in the case of QuietCare) are placed near doors, and next to such things as refrigerators and medicine cabinets. These detect the patient's motions through the house during the day, and send results to a PC in the home. That PC, in turn, then reports to a central server over the Internet.

The sensors keep their clocks going and quickly learn about the patient's habits -- when they wake up, how they move about. This database is then matched against current actions, and if there's a discrepancy a quick phone call may take care of things. Or a visit from a care-giver may be required. Or the ambulance. Lusora adds a "panic button," usually a necklace, which patients can use themselves to call for help at any time.

This is literally a 'killer app' in that it can save your life of the life of someone close to you. And it's much less expensive than hiring a full time home care worker.