Technology for People with Vision Impairments

Canadian Interdisciplinary Vision Rehabilitation Conference – Seminar 3

Julia Foster and Mark Nicol

IntroductionsMark Nicol, Adaptive Technology Specialist, CNIB (mark.nicol@cnib.ca; 250-519-1110)◦ CNIB, Vancouver Island District

◦ Low Vision Specialist in training

◦ Has had low vision since birth - Congenital Stationary Night Blindness

Julia Foster, Occupational Therapist, Inclusive Design Research Centre, OCAD University (jfoster@ocadu.ca; 416-977-6000 x3967) ◦ Vision Technology Service (ADP High Tech)

◦ Employment Accommodations Service

◦ SNOW Resource

◦ Co-Chair, Canadian Association of Occupational Therapists (CAOT) Occupational Therapy and Low Vision Rehabilitation Network (OTLVRN)

Objectives ◦ Identify technologies available for individuals with low vision

by applying to client cases (e.g. built-in, third-party, and stand alone devices)

◦ Discuss ineffective and effective strategies

◦ Hands-on option: try out examples of built-in accessibility settings

◦ Q&A: Discuss questions from the audience

Find a phone!Feel free to follow along with the demonstrations by doing the same on your own devices

◦ Android users – see if you can find similar features in your phone (likely under Settings > Accessibility)

BUT for the speech portions, please either just watch / listen OR use an earbud

Human Activity Assistive Technology ModelStart with the PERSON doing an ACTIVITY in a CONTEXT, then figure out the best TECHNOLOGY

◦ I.e. fit the tech to the person, not the person to the tech

Goal: enabling participation ◦ I.e. more than targeting a simple activity (e.g.

reading)

◦ (i.e. how does that activity fit into the day to day life; e.g. tech to support managing a calendar might help a person manage their healthcare appointments or a student manage their assignment due dates)

(recreated from Cook & Miller Polgar, 2008)

Case 1: Margaret Jenkins◦78 Year old widow

◦Has ARMD, reads 6M print comfortably without magnifier

◦Son is very supportive but has limited time to devote

Case 1: Margaret Jenkins –Technology and Goals

Issues/goals

◦ Continue using email, use social media, video chat

◦ Read any necessary hard copy print - mail, magazines, etc.

◦ Find cooking ingredients

Technology

◦ Has older Windows PC that is not working for her visually◦ Discussed pros/cons re: iPad and

desktop – client chose iPad

◦ Has relied on her son to address issues in the home, has cut back on use of technology because of vision loss

Tablet accessibility features for Margaret◦ Example: iPad Pro 12.9” Recommended

◦ Pinch zoom where available

◦ Use iOS Zoom for global, variable strength magnification

◦ Turn on bold font, increase contrast, darker colours

◦ Declutter home screen

◦ Plain black home screen

◦ Siri for easy tasks such as timers and alarms

◦ Dictation in place of typing for longer passages

◦ Safari Reader to simplify compatible web pages

◦ VoiceOver Screen Reader to listen to long articles instead of reading visually

CCTVs with OCR for Margaret◦ Example: Optelec Clearview C with Speech (OCR)

◦ Can be used to magnify print, images, 3 dimensional objects such as pill containers.

◦ Provides high contrast settings to increase contrast where it is poor, i.e., news print

◦ Has a full page OCR mode for listening to text

Labeling devices for Margaret ◦ Example: PenFriend Audio Labeller

◦ Comes with stickers that can be stuck to magnets, bag clips

◦ Magnets can be attached to cans, bag clips to dry goods

◦ Stickers correspond to audio labels stored in PenFriend

◦ When PenFriend is pointed at the sticker on the magnet attached to a tomatoes, PenFriend will announce “Diced tomatoes”

◦ Food directions can be dictated on to labels “Cook for 40 minutes in oven at 350 degrees celsius”

Other potential devices◦Bank Note Reader

◦Hand magnifier

◦Hand held video magnifier

◦Any others?

Case 2: Layla Kouri – Overview◦ 36 year old lawyer

◦ Supportive manager but competitive workplace

◦ Moderate technology skills

◦ Health history: retinitis pigmentosa with central vision loss; attention deficit hyperactivity disorder (ADHD)

Case 2: Layla Kouri – Technology & Goals

Technology

Work Technology◦ Windows laptop

◦ Magnification software

◦ Scanning & reading software

◦ Blackberry

Home Technology◦ Mac computer and an iPhone

Issues/goals

◦ Read documents when not at her desk (e.g. handouts in meetings, etc.)

◦ Decrease fatigue and increased efficiency when reading

◦ Delay disclosure of her vision loss

Smartphone accessibility features for Layla◦ Read(er) mode – simple article view

◦ VoiceOver – with and without speech

◦ With speech (for vision)

◦ Without speech (for focus)

◦ Headset – for speech

◦ Visual enhancements (minimize changes because not wanting to disclose)

◦ Zoom

◦ Magnifier (like camera but with contrast and colours, Y/B)

◦ Text replacement and word prediction

◦ Siri potentially with scripts to learn commands

◦ Organizational apps

OCR Apps for Layla◦ Low vision specific (i.e. with speech) versus basic OCR

◦ OCR = optical character recognition converts images of typed text into electronic text

◦ Various costs

◦ Some integrated with other products (e.g. Office Lens)

◦ Some integrated with file sharing platforms (e.g. Google Drive, Dropbox)

Software features for LaylaGeneral and built-in◦ Keyboard shortcuts!

Organization and simplification (e.g. read mode)◦ Efficiency strategies (e.g. abbreviation expansion a.k.a. auto-correct)

◦ Built-in accessibility for Windows / Microsoft Office (e.g. strategy for Outlook)

Magnification software / apps ◦ Focus enhancement + keyboard shortcuts

◦ Visual enhancements

Speech◦ Build in speech step by step – know how to quickly turn on and off

◦ Headset

Additional devices/strategies◦ OCR software + scanner

◦ Electronic documentation

◦ Others?

Roadblocks to using technology

◦ General web accessibility

◦ Stigma/workplace

◦ New learning to use visual environments non-visually

◦ Case management/enterprise software

◦ Cost of adaptations

◦ Lack of support in learning process

◦ Degenerative conditions require re-adaptation

◦ Breaking old habits (e.g. mouse use)

◦ Switching learning modes (e.g. visual versus auditory learners)

◦ General discomfort/fear of troubleshooting / making changes to technology (“don’t want to break anything”)

Client strategies we’ve seen◦ Use of hand magnifiers on computer, tablet or smartphone screens

◦ Pushing of computer screen resolution and DPI settings to increase font sizes

◦ Memorization of location and labels of icons, buttons and other controls in apps, programs and operating systems

◦ Hunt and peck typing

◦ Poor posture to get close to desktop or laptop screens

◦ Move pointer into a corner of the screen / shake pointer to find it

◦ Avoiding technology - adopting non-technical means of accomplishing tasks or sometimes just going without

Client strategies we’ve seenPushing of computer screen resolution and DPI settings to increase font sizes

Memorization of location and labels of icons, buttons and other controls in apps, programs and operating systems

Client strategies we’ve seenUse of hand magnifiers on computer, tablet or smartphone screens

Move pointer into a corner of the screen / shake pointer to find it

Client strategies we’ve seen – Leaning In

Client strategies we’ve seen – no tech!

Common Recommendations◦ Touch typing

◦ Dictation (note: potential for voice strain if pre-existing vocal cord issues/overuse)

◦ Learning keyboard shortcuts regardless of level of vision loss

◦ Exploring built-in features independently

◦ Teaching problem solving

◦ Control lighting to reduce glare on screens

◦ Use text-to-speech for long reading

tasks to reduce eye fatigue

◦ Build skills slowly (e.g. a little bit of

speech at a time) to get buy in

◦ Focus on client-chosen goals

◦ Monitor arm

◦ Ergonomics/posture

◦ Break down tasks to identify

strategies

◦ Others?

Thank you!Any questions?

References◦ Cook, A. M., & Hussey, S. (1995). Assistive technologies: Principles and

practice. St. Louis, MO: Mosby.

Open Source Images

◦ Cortarypegar. (2003). Español: Paola Aboitz en el año 2003. Retrieved from https://en.wikipedia.org/wiki/File:ABOITZ.jpg

◦ Chatham House. (2015). Dina Habib Powell, Head, Impact Investing Business, Goldman Sachs; President, Goldman Sachs Foundation. Retrieved from https://www.flickr.com/photos/43398414@N04/19459892442