Assistive Technology Your Customers Use: What You Need to Know

Transcript for What You Need to Know

Hello, everyone, and welcome to Assistive Technologies Your Customers Use. What you need to know. I'm Crystal Preston Watson, Senior Digital Accessibility Analyst at Salesforce, if you find yourself with questions about anything I talk about after today, please don't hesitate to reach out to me on Twitter @ScopicEngineer or through LinkedIn.

Let me set the agenda for this talk. First, I will define precisely what assistive technology is, and go over the various categories and types. And then going to take a closer look at some of the devices, software, and hardware used for digital access. And finally, discuss some of the things you need to think about when designing, developing, and testing products when it comes to assistive technology.

We don't have a whole lot of time and there is a lot to cover, so let's get started. Defining assistive technology. So there are some misconceptions about what assistive technology is, and what it does for people with disabilities. Many people think exclusively of computers and other digital devices. But the word technology in assistive technology uses its most straightforward meaning of accomplishing a task using technical processes, methods, or knowledge.

So assistive technology is any device, software, or equipment used to maintain or enhance the functional capabilities of people with disabilities. If you have or do business in the United States, it's also helpful to be aware of the federal definition of assistive technology. That definition was established in the Individuals with Disabilities Act, is called idea and it was done in 1990. As any item, piece of equipment, or product system whether acquired commercially off the shelf, modified, or customized, that is used to increase, maintain, or improve the functional capabilities of a child with disability.

This definition does use the term child, but this is usually amended to individual depending on the area in an environment of the application. Medical devices that are surgically implanted or the replacement of such devices are exceptions to this definition. Assistive technology is divided into three types; Low-Tech Mid-Tech, and High-Tech. When we talk about Low-Tech, sometimes called no tech assistive technology those are devices that do not need electricity or batteries to be operated, are free or low cost to the user, and require little to no training to use. Example of Low-Tech assistive technology are pencil groups like the ones pictured on the slide, post-it notes, walking cadence, and magnifying glasses you might associate with a particular Victorian detectives.

The second type of assistive technology is Mid-Tech. These devices might be electronic or battery operated. They're inexpensive and need very little training. Some Mid-Tech examples are calculators, screen magnifiers that you would physically place over monitor, and single overlay displays, like the one shown on the slide. This is a go talk, and go talks are battery operated augmented, alternative, communication devices. And these are used by people with limited to no speech to communicate. So a person would record a word or phrase that a user might need, and then the image is generated that can be associated with the word or phrase and that is inserted into the device, and then the user can talk by simply pressing an image.

The third and final type of assistive technology is High-Tech. These are devices that are digital or electronic, and may be computerized. They're usually the most expensive form of assistive technology, costing anywhere from a few hundreds to tens of thousands of dollars, in the case of some electric wheelchairs. High-Tech usually requires it usually requires some extensive training to use. Example of High-Tech devices are, refreshed with braille displays, alternative computer keyboards, and an iPad like the one picture on the slide.

Along with low, mid, and high tech types of assistive technology, 10 categories are used to classify the purpose of assistive technology devices. I'm not going to get too deep into each one of these, but you should be aware of them. Also note that, many devices fit into more than one category depending on an individual's needs and how they would use them. So first category is mobility, seating, and positioning. And this our products for people who need mobility assistance.

Hearing, products for people who are deaf or hard of hearing, including AT use for daily living activities, communication, and other needs. Vision, products for people who are blind and visually impaired. And again, used for daily living activities, accessing computers, way finding, and other needs. Speech communication, products for people with speech disabilities who need assistance with speaking, including face to face communication.

Daily living, products for people with disabilities and older adults with functional limitations due to aging. These products increase independence when performing activities of daily living, such as bathing, dressing, personal hygiene, eating, and other basic home life activities including shopping and money management. Six, computers, software and hardware, products that help people with disabilities access and use computers. And just to note we are going to look closer at some of these devices coming up.

Learning cognition and developmental, products for people who need assistance with learning attention, memory, and organization. Recreation and leisure devices, products that help people with disabilities participate in sports, recreation, and leisure activities. Vehicle modifications and transportation, products that promote safe access to transportation and increase independence through vehicle adaptation. And then number 10, finally, environmental adaptations. Products designed to increase access to homes, businesses, and other buildings by people with disabilities, including systems to open lock doors, controlled lighting, temperature, and other environmental needs.

assistive Technology-Digital Accessibility. So now that we have a baseline understanding of assistive technology. Let's look at some assistive tech devices used by disabled people to access digital products and content. Switch Access or switch devices. These are alternative inputs that replace a standard keyboard or mouse. People with motor impairments will use switches to access and control computers, smartphones, home appliances, and various other devices. And a switch can be operated by any part of the body that has voluntary muscle control. One type of switch is called a sip and puff, and that gives the user control by inhaling or sip, and then by exhaling, puff.

On this slide, there's an image of a switch that looks like a large round button. This is the jelly being switched by AbleNet. It's recommended for users that can access a smaller target area. The jelly being like many others, it can't be plugged directly into a computer and it needs to interface to bridge the gap between the switch and the computer. Windows, Mac OS, iOS, and Android, all have settings that integrate with many switches without the need for additional software or applications other than the switch interface. And that interface is a actual physical hardware device and not software.

Alternative Keyboards. These alternatives to the standard keyboard models are designed for two handed operation. Standard keyboards can be difficult for individuals with physical sensory or cognitive impairments to use. Some examples of alternative keyboards are ergonomic keyboards, Braille keyboards, and compact keyboards that can be placed on a wheelchair. On the screen is the myBoard keyboard. It has large, bold, colorful, easy to read, lettering big keys about one inch. And its color coded so the vowels, consonants, numbers, and function keys all have different color coding. And it's also gentle. It can be operated with gentle finger pressure. And this keyboard is geared towards children with vision and motor impairments.

Mouth and Heat Sticks. These are designed for people with limited or no control over hand movements. The mouth and head sticks are some of the most widely used assistive technology devices due to their low costs. And usually, a usual is, it has a rubber tip on the end for better tip interaction. And then on the other end, there's a plastic or rubber feature that can be inserted into the mouth or in the case of a head stick, usually something that will fit on the head that the stick attaches to.

And that will allow the person to control movement. The image in this slide shows a person using a mouse stick with the Maltron head mouse stick keyboard. And that keyboard shape matches natural head movement, and the ergonomic key arrangement minimizes stick activity to reduce fatigue. Eye Tracking Software. This is another assistive technology for individuals with limited or no control over hand movements. It allows them to navigate and control their computer with their eyes. They can move a cursor on the screen to activate an onscreen keyboard or other specialized software.

This slide is an image of a woman the Tobii dynavox eye tracking software to navigate a website. The Tobii software works through the eye tracker sending out near-infrared light that is reflected in the user's eyes, and then the camera picks up that reflection and then filtering and other kind of processing, the tracker will know where the user is looking on the computer screen.

Speech Recognition Software. This is also referred to as speech to text, voice to text, or voice recognition. This assistive technology is for individuals who might struggle with or can't use a mouse or keyboard or those with learning and cognitive disabilities. It allows a person to speak into a microphone or a headset to convert and convert spoken words into digital text on the screen or commands to control the computer. This slide shows a woman in the wheelchair using a headset to interact with a computer. Dragon Naturally Speaking is one of the more popular speech recognition software out on the market, but many computers, smartphones, and devices also come with some built in speech recognition tools and features.

Screen Readers are assistive technology, primarily used by people who are blind or have limited vision. But users with learning and cognitive disabilities also can frequently use them. A screen reader announces what is on the screen and users can customize them to their particular needs, rate of speed verbosity, how much punctuation is announced. Screen readers allow people to navigate through websites and applications and it gives a speech output point, or it can also be give a braille display.

Nearly all popular computers, tablets, and smartphones on the market have a screen reader function built in, and some of the most popular screen reader programs are JAWS and NDVA for Windows computers, voiceover for Mac and iPhone, and talk back on Android devices. On this slide, you can see a screenshot of the MoMA, the Museum of Modern Art website being navigated via voiceover on a MacBook Pro. Voiceover does have a setting that also gives a visual transcript of what or visual caption of what it announces out loud.

Screen Magnifier. Screen magnification software presents in large text images and content on a computer screen. It functions similarly to a magnifying glass moving over a page. And so the software will follow the cursor and then magnifying the surrounding area. Individuals with low vision uses assistive technology, but also individuals with learning and cognitive disabilities as well. Windows and Mac OS, both have built in screen magnification tools and software in that come with their operating systems. And this slide shows the UI for one of the more popular and a pretty popular screen magnifying software, and it's called ZoomText. This is this is the UI for ZoomText 11. But there is a newer version called ZoomText fusion that integrates with JAWS magnification plus screen reader support.

Captions, Transcripts and Audio Descriptions. Captions display the text version of speech on to video during playback. They are essential for those who are deaf or hard of hearing. And transcripts provide the entire video text separately, sometimes underneath the video or near it, and it does not display that text on screen like captions. And another thing, transcripts are usually can be read by screen readers, and translate into braille display. And this can really-- this also can help with cognitive disabilities to better understand content in the videos that they watch. Audio descriptions are for visuals who are blind or low vision, the description explain all the actions, gestures, and physical descriptions of what is happening on the screen. This slide shows a screenshot from a video from the YouTube channel Kurzgesagt. And the screenshot shows a few lines of the video captions displayed over the video see.

Things to consider. Designing and building digital products that are fully navigated by keyboard and keyboard accessible is essential. Many assistive technologies with keyboard or many assistive technologies use keyboard or emulate keyboard inputs. If you block or require only one type of input that isn't keyboard input and control, you block many assistive technology users from using your products. When it comes to testing your products with assistive technology, while the best test are going to be with the actual existing assistive technology, it's primarily unrealistic due to testing cost and also testers knowledge of these devices.

But as I mentioned, many of these assistive tech devices use and emulate keyboard input. So while not a one to one, your key way and testers can test for many, and honestly some of the most significant and grievous blockers that would face assistive tech users by using a standard keyboard. And this is by no means a replacement for hiring disabled testers and having paid usability testing with assistive technology users.

Finally, I've gone on over some of the more widely used and known assistive technology used by disabled people. But please understand, this is by no means an exhaustive list. Even when dealing with computers, some assistive technology devices they could be low or mid tech, but vital to an individual gaining digital access. Another critical point is that many individuals have simultaneous disabilities, require more than one assistive tech solution. And also as I noted earlier, many assistive technologies fit into multiple categories of purpose depending on individual's needs and views.

That brings us to the end of this presentation. I would like to thank you all for your time and attention today. And again, if you find yourself with questions about anything I talked about after today, again, don't hesitate to reach out to me on Twitter or through LinkedIn. Thank you very much.

Transcript for Live Q&A

(Kevin McDaniel) Can you hear me, Crystal?

(Crystal Preston-Watson) Yes, I can.

(Kevin) Wow. Thank you so much for that was an incredible presentation. I. I'm such a fan of assisted technology and folks who work with assistive technology because it really is one of those things where, you know, if you're not testing with assistive technology, if you're not working directly with people with disabilities who use assistive technology, there's so much you could miss, you know? (Crystal) Yeah. (Kevin) And that was such a comprehensive overview. And even as you mentioned, we didn't even get to everything, but there's still so much that folks don't know.

They think, you know, Hey, I'm going to test with the screen reader, but there's so many different ways. Right? Crystal) Yeah, (Kevin) you know, so. Go ahead, please. (Crystal) Oh, no, no. And it's it's one of those things screenreaders are so ubiquitous that you know when because they come for the most part, you know, already installed in, you know, in

(Crystal) desktop and on on most smartphones. So it's the one assistive technology that you know, many people, like a lot of people are familiar with. And so and it's easy to kind of be like, well, it's everywhere and it's already here.

So this is, you know, obviously this is the only one that matters. [laughs]

(Kevin) Yeah. And you know, it's funny that you say that because I remember ten years ago it was like no one knew what a screen reader was.

Now people think if I hit the screen reader, I take it off my checklist. I've done my job. You know, that's not the case at all, actually.

(Crystal) Exactly.

(Kevin) So you had a lot of very direct questions. If you have and I really appreciate you joining us for the Q&A and, you know, working with assistive technology every day.

This is there was one question here. They talked about what, what role, and I know that we kind of talked about and you've already you addressed at the end of the presentation. But I like to say expand them a little bit, if you can.

What role do you think assistive technology plays in assessing for accessibility that we're in a from a priority standpoint?

(Crystal) I mean, it's definitely acute because for many people, if they cannot, you know, use the assistive technology device that they can't access your, you know, your your product, you know, the website or whatever.

So it's it's a pretty big priority. It and it doesn't seem like it because right now, when it comes to kind of product accessibility and digital accessibility, it's, you know, it's almost like it's the after sort of afterthought, you know, accessibility, you know, sad to say it's still kind of seen as an afterthought.

And when it comes to assistive technology and really making sure that you're really, you know, taking that, you know, you're testing for that, you're making sure that you know your that your products are accessible not just for screen readers, but you know the many types of devices out there.

Sometimes, you know, you don't really get that to think about that and then gets into more of like. And that's where you start to get into more about with broadband and different issues with that, especially with like, you know, not everyone has, you know, fast broadband.

And that can make a huge difference for someone using, depending on what assistive technology device they're using. And so it is a huge priority, but it doesn't get, you know, right now, only you're starting to get people and more companies that think about that when it comes to developing and making sure that their products are accessible.

(Kevin) And incorporating it into the process in the first place. And it's so funny that we talked about, we talk about how it's it's not baked into the process yet. Yet even as you know, in our last session of Jason Taylor, as mentioned before and a lot of our calls that, you know, accessibility is really a subset of usability.

So it's really kind of surprising with all this focus on the user experience, that accessibility is still so low on the prioritization of implementation. Going to assistive technology testing with assistive technology, I think, is in the same vein as, you know, testing with different types of technologies, browsers, different operating systems.

One of the questions we had was, you know, with the proliferation of the PC and mobile, what's not talked about very often is testing with with Apple products and Macs. (Crystal) Yeah. (Kevin) What kind of functionality? What are the user use cases that you see with?

Macs and what what role they play in testing for accessibility?

(Crystal) I don't see it when it comes to Macs. I think, you know, for the most part, you know, the same, you're going to do the exact same test on a Mac as you would on a Windows machine.

Where it starts to kind of deviate is. Well, you know, when it comes to screens like going screen readers now, for the most part, you're only you only have voiceover to work with. And so voiceover comes that that that is the default screen reader, and they're not a lot of, you know, third party screen readers that will work with Apple. And that's very different from from Windows machines. You have Jaws, you have NVDA, there's tons, you know, others there are some in browser screen readers that you know, that happen. But but for the most part with Mac, you do kind of that.

So you you do get into that proprietary issue where there are there, there are assistive technology that is kind of for, you know, it's geared towards Windows and it's easy to develop for Windows machines, but it's not so true with with with Mac.

And that also a thing that comes up is that when it comes to testing with, say, the latest and greatest of actual physical machines so MacBook Pros, I want to say, iMac, I use a MacBook. I do not, but I have not really.

I don't know the desktop because I've never had a desktop for for Mac. But, but, you know, it usually does. Something I usually ran up against is that I, you know, you have a lot of people who want to test with the latest Mac and iOS devices.

And for a lot of people, especially people who are disabled, people who are, you know, who are a lot of times are on very tight budgets, they don't have the latest and greatest, especially when it comes to a Mac, because a new just even like kind of base like, you know, you know, based offering for a

Mac is a couple thousand. And you know, you new even if it's like last year's model, you're still paying, you know, probably around the thousand dollar mark, which is vastly different from, you know, Windows Machine. You can, you know, pick up a pretty, you know, pretty good Windows machine for a few hundred dollars, depending on what you want to do. And so you don't see people, you know, actually testing for older Macs. I, you know, there are a lot of people who are still using Macs that were from 2014. That is their main line they've been using there.

And if you're not testing accessibility on older devices, older, you know, Mac OS versions, it becomes a big issue. You see that a lot for Windows. You know what, because it's a little bit easier to get access to those.

And also, you know, spinning up a VM and things like that. So that's kind of the issue I see with with kind of testing for, you know, Apple products versus Windows. And we didn't even get into Linux because that's a whole different issue altogether.

(Kevin) Yeah. I think then, you know, to your point about that, the different offerings. So that's been my biggest ax to grind. You talked about the cost. And my biggest ax to grind in this in this work we do is the cost, you know, I mean, I remember ten years ago to to get to log on to a computer to access an accessible site or interface as an employee or as a user. There were products you had to buy, you know? And you know, there's really great people in the space doing some really great things. I mean, you mentioned NV Access is actually going to be Michael's going to be on a panel of ours. I'm a big fan, you know, but aside from screen readers, what are some of that in, you know, in your work with assistive technology? And I had so much respect for what you do. I actually know of the director out of fast in Florida, and the things you guys do are really incredible.

What are some of the things that that that you miss if you only test with assistive technology? You know, I can think of some things, you know, like the user experience, you know, being able to locate things, the readability.

What if you're just testing for a screen reader? What are some of the things that you may miss if you don't incorporate other types of assistive technology into your process?

(Crystal) Yeah. So and and what I explain is that when you're just testing a Screen reader or you're just, you know, it's like I in my presentation, I say, you know, if you don't have access to, you know, assistive technology devices, you know, testing keyboard testing is a really good way to, you know, do kind of some, you know, testing that would affect, you know, other assistive technology devices.

But it's not a one to one. There are, you know, you know, if you're a there are going to be things that you miss if you're, you know, say, just using a screen reader versus, you know, testing using a switch.

And I actually have a switch that I this is I have a jelly bean and I've been using I've been trying to kind of train myself to use this because there's, you know, I'm a screener, I don't use the screen reader at all time, but I use a screen reader

A good portion of the time when I because I have visual impairments that call for it and the I, there's just things that that, you know, try to you like one, I don't have, you know, a motor skills impairments.

So, you know, it's it's one of those things of, you know, one, you get used to a particular assistive technology device and you kind of keep thinking about, well, this is how, you know, I'm only looking for this particular types of issues.

And as I have been using, as I've been trying to use this jelly bean, I realize, especially if someone has, you know, a physical impairment, physical disability, that it's not so much about what is being announced and more of where is it particularly, you know, focusing on making sure there's even more kind of accuracy in, you know how the, you know, the switch interprets the the the key, the keyboard inputs and or simulates those inputs. So there are a lot of things like assistive technology devices, even if they use keyboard inputs, are not a one to one.

So you can't say if I tested it with a screen reader, it's going to work the exact same way as if I was using a switch the exact same way, if I was using eye tracking software, the exact same way, if I was using voice recognition.

There are really, yeah, there's just vastly different things. They're going to be some things that overlap, but they're going to be a lot of things because they're, you know, they're solving, you know, different issues for different impairments and disabilities that so you can't just say, if I don't, if I do one, I've done them all because that's just not true.

(Kevin) Well, Crystal, I really appreciate it. And I have, as you were speaking in Alycia's popping back up, and I know we have, we have we have to. But I had four or five more questions pop up as you were talking.

And so I'm going to if it's OK, I'm going to shoot you an email with these questions and I'll I'll follow up and. And how can folks reach out to you if they have questions that we don't get to just very quickly?

(Crystal) Oh, I am. I am probably too online on Twitter. So Twitter is a great way to reach out to me. I. My username is @ScopicEngineer and also LinkedIn, and my username is just Crystal Preston-Watson all altogether.

So those are two really good ways to reach out to me. And yeah,

(Kevin) Thank you so much Crystal.

(Alycia Anderson - MC) Yeah, we're going to be BFFs now. I can already tell.

(Kevin) All right. Thank you. Thanks, Crystal.

(Crystal) Thank you.

(Alycia) This was an amazing session, Crystal.

You're so awesome. I'm so happy that our paths have crossed personally. Thank you for all of your insight.