Working Together: Computers and People with Mobility Impairments

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[Nohemi] I like computers a lot, and I want to learn more about it, because I want to study computer science, so that's my career that I want to have in the future.
[Buddy] The only thing I need help with is turning the computer on and putting the headset on my head. Other than that, I can operate just about anything else by myself.
[Susanna] It's a real accomplishment and you really feel proud of yourself when you're actually able to make progress and do something without having to ask somebody else, you know. It's like you actually did it by yourself, yea!
[Narrator] Besides an interest in technology, what these people have in common is mobility impairment. But each one is different, and so is the way they use their computers.
[Doug] Each person with a mobility impairment has fairly unique needs. There isn't any specific blanket technology that's going to cover everybody. Some people may have limited use of one hand; others may need specific positioning for a chair, they may experience fatigue; so those things need to be taken into consideration as a unique adaptation for each person.
[Narrator] An individual's mobility impairment may or may not be obvious to others, and people with similar medical conditions may need different types of adaptive technology. The important thing is to work closely with the person using the computer to figure out the best fit.
[Andrew] Pay attention to the individual and what he or she needs, both through observation of him or her in the actual environment in which the technology will be, is being used, and also through consultations with the individual.
[Narrator] We'll show you some examples of adaptive technology that have been used effectively by people with mobility impairments. And we'll start with getting to the computer.
[Narrator] You can't use a computer if you can't reach it. You have to be able to get in the building, get through the aisles, and sit comfortably at the work station. Computers at work and at school should be in locations that are accessible to people using wheelchairs.
[Andrew] Physical access to buildings, labs, classrooms, all that is extremely important because this technology, no matter how good it is, is completely unusable to a physically disabled person if they can't get to it.
[Dan] And that means having a ramp, if there are stairs; having an elevator, if there are stairs inside the building; having enough room between aisles, if it's a computer lab; or having enough room in the hallway.
[Narrator] The furniture makes a difference, too. It's important to be flexible in the way you position keyboards, computer screens, and table height. Adjustable tables can be cranked higher or lower, so that the monitor is at the most comfortable height. Keyboard trays can move up and down, or tilt, to make typing easier.
[Narrator] Some people with mobility impairments don't have the flexibility or range of motion to use a standard keyboard. Fortunately, there's a wide range of alternatives available. Some of those are already built into current popular operating systems.
[Dan] The fact that there are some basic features built into operating systems is really important. There are some very simple things that can be done using control panels--accessibility options control panels-- that give access, basic access, to the keyboard and to the operating system.
[Narrator] For example, someone using a single finger or a mouth stick wouldn't be able to type two keys simultaneously, such as "control" and something else. There's a setting that allows those keys to be entered sequentially. Another setting eliminates repeated keystrokes for someone who keeps a key pressed down too long. And features like AutoCorrect, which is part of Microsoft Word, eviate long words or even sentences with a brief letter sequence. Once the abbreviations are set, they can make typing faster and more accurate. There are also physical adaptations to consider. For example, a keyguard.
[Susie] The keyguard's a grid that fits over the keyboard and it has holes for each key and prevents people from typing a key they don't mean to hit if their movements are not controlled.
[Narrator] For people who have limited range of motion, a mini-keyboard may be helpful. There are also left- and right-handed keyboards, which can be used with only one hand. For someone with good range of motion but poor dexterity, there are keyboards with extra-large keys.
[Jeffrey] One thing that I use is an Intellikeys keyboard, where the keys are enlarged and there's more space between buttons, because when I hit keys on the regular keyboard, I get double letters.
[Dan] Go back to your inbox...
[Narrator] For someone who can't activate a keyboard physically, a virtual keyboard may be useful. This appears on the computer screen as a picture of a keyboard. The keys can be activated with a mouse, trackball, or alternative pointing system. Some virtual keyboards may include features such as alternate key layouts or word prediction software.
[Narrator] Word prediction programs help people type correctly and more quickly. The program prompts the user with a list of possible word choices based on words that have already been typed. Some programs collect new words as they're used, and work with a user's common vocabulary in making predictions.
[Buddy] I throw in a letter, like, let's say I throw in a T, and like, five words that start with T will pop up, the most common ones that I use. They'll pop up and I'll click on it and it'll just print it out.
[Dan] Graphical user interfaces are everywhere, and you need to have some sort of a pointing device to access the material on the computer icons; clicking, pointing, all those things. And so you either need to use a mouse or find an alternative to using the mouse.
[Low-voiced conversation]
[Narrator] Although some people can use a standard mouse, there are alternative pointing devices for those who can't.
[Nohemi] I have a special mouse, so you can move more easily than the regular mouse.
[Narrator] Trackballs are a good place to start. The trackball's control surface is easier to manipulate than the mouse. On some trackballs, buttons provide features such as double-clicking, click and hold, and other commands. They can be used on the desk or, for people who use their feet instead of their hands, on the floor. Another choice is a joystick, which many people already use to drive a wheelchair.
[Jeffrey] I can't really do those real fine motor movements, so they've got to have the joystick.
[Narrator] People with good head control, but no use of their limbs, can use a head-controlled pointing system. This system uses infrared detection and a transmitter or reflector worn on the user's head. It translates head movements into pointer movement on the screen. This can be combined with an on-screen keyboard for full computer control.
[Buddy] Well, the HeadMaster that I use, it just controls the mouse, the cursor on the keyboard, and the little thing that I blow into, that's the button click.
[Switch clicks]
[Narrator] Switches work with a box or emulator that sends keyboard or mouse commands to the computer. They come in a wide variety and can be controlled with nearly any body part.
[Doug] Some people would rely on, for example, a device that could actually attach to their skin, and any variation in their muscle tone would activate the switch. Other people might have a light-sensitive switch, that when they blink, there's enough variation in light that it would activate the switch. And then others may use something that just detects a slight variation in their finger moving on a switch.
[Narrator] Scanning and Morse code are two of the input methods that rely on switches. With scanning, the user activates a switch that brings up an options menu on the screen, then continues to activate the switch to make specific choices. Morse code uses a sip-and-puff switch, where dot is a sip and dash is a puff. Special hardware and software translates Morse code into a form that computers understand. Any switch system should be mounted by a knowledgeable professional.
[Doug] Well, it's important to take into consideration all the needs of the user. Someone may think they can just locate a switch somewhere on a wheelchair, but they might be neglecting other needs of that wheelchair user. For example, if the arm needs to come up for them to come in and out of that chair, that switch is going to need to be located in a position that works with those other adaptations.
[Oscar] I am a junior this year.
[Narrator] Speech recognition products allow users to bypass the keyboard completely.
[Oscar] I use a program that helps me type; whatever I say, it types. It's a microphone; I talk into the microphone and it types it out on the computer screen.
[Narrator] Speech recognition software converts spoken words into text on the computer. The person using it speaks into the microphone in a normal manner. This type of system requires that the user train it to recognize their unique voice.
[Susanna] The truth is.
[Narrator] It's also important to correct any recognition errors that the system makes.
[Susanna] Most of us are intimidated by computers.
[Narrator] To use speech recognition technology effectively, it's important to have good voice and breath stamina. Good reading comprehension is also helpful, because there are always corrections to the program's text output.
[Susanna] But it gets easier with practice.
[Computer] This research effort confirms what so many of us believe.
[Narrator] Reading systems, which involve both hardware and software, are helpful for people who find it difficult to hold printed material or turn pages. A scanner converts hard copy into a digital image, which is then converted into a text file that is recognized by the computer. Next, the words come up on the screen at the same time that a speech synthesizer reads them.
[Computer] ...seems a form of magic.
[Narrator] It's always important to consider the simple things. Sometimes, materials around the house or office are all you'll need to make equipment accessible.
[Doug] There are some fairly low budget easy solutions; you can, for example, get a power strip and duct tape it to the edge of a table where a wheelchair user could role up, activate the switch, and turn on a computer system without relying on another user to turn it on for them. Or you may have a piece of PVC plumbing that you could mount to an area near a touch pad, and someone that uses a mouth stick could store their mouth stick in that.
[Narrator] The most important part of selecting adaptive technology is to recognize the needs of the individual using it. The best adaptations are the ones you choose yourself. It's all about personal success.
[Andrew] The technology that's being adapted is now quickly becoming the core of our modern economy and also our social life. Without access to the technology that allows us to access these new means, it makes it nearly impossible for the disabled individual to participate fully in society.