Since this course is self-directed, it is up to learners to decide what areas of the course they would like to pursue in depth. The course will introduce participants to a wide variety of adaptive technologies, though none will be covered in great detail. This is up to you. The course project will allow you to focus on a particular type of technology, and investigate it deeper.

We suggest the following goals:

• familiarize yourself with the full range of adaptive technologies available,

• create a resource that will assist you in using and assembling technologies for a particular situation (eg. a particular client, student, or group of students; see case studies for examples; see project information page),

• become an expert in at least one area of adaptive technology.

Many of you have been designated the "tech person" at your school or organization. These people may want to create a more general resource and become experts in a number of different areas.

We will have a moderator available to help you achieve your goal as either a generalist or a specialist. The resources and technology summaries contained in the course modules should be used as guides rather than comprehensive coverage of their topics. Participants should view the course content and resources and ask themselves:

• When and for whom would these technologies be appropriate?

• What are the advantages and disadvantages of one technology over another (eg. cost, functionality, availability).

• How could I combine this technology with others to create a technology package?

• What information can I not find that I should ask for help with in the course forums?

• How would I find more information on the topic by searching the Internet?

• Who else in the course has interests similar to mine? How could we collaborate to assist each other's learning?

 

1.1 Project Information [top]

Project Due Date T.B.A.

If you are taking the course for a certificate you are required to develop a small web site which will house your project. A basic understanding of HTML is helpful but not necessary. You may choose to work in groups of two or three, in which you can delegate duties among group members. If one of the members is a proficient user of HTML, that person can take on the duty of setting up the group's site. Of course that means balancing the amount of effort each member puts into the content of their group web site. Or, you may choose to work on your own and learn some HTML through the Tech Forum. Knowledge of HTML is an invaluable asset for those intending to use the Internet as a teaching tool. I would suggest you take the time now to develop this skill.

Exceptional sites will be given space on the SNOW server where they will be linked to the SNOW site and where they may be developed further after the course has ended. Others may download their sites and move them onto another server if they choose. On your home page, be sure to include your names and email addresses, who is responsible for creating what, and a link to the SNOW site.

Project suggestions:

The suggested projects below are only guidelines. With the diversity of participants the project topics will be left open. If you choose a topic other than one listed below, send me a brief proposal for your site by email, so that I can offer suggestions. Or, you might want to put your proposal before the other participants in the forums, and solicit ideas, or perhaps collaborators.

1. Choose one of the topics covered in the course (eg. Alternative Input Devices, or Augmentative Communication, or Voice Recognition) and develop a small web site expanding on the content presented in the course. You should:

   1. Divide your topic into three to five major subtopics.(eg. for Voice Recognition--software, hardware, continuous and discrete speech, keyboard commands)

   2. Create a homepage from which any other pages you create can be linked. Think of it as a title page and table of contents. You should include a short description of your site there as well.

   3. Collect the URLs (web addresses/bookmarks) of a number of related web sites and create a web resources page (or two or three). You can use the web resource pages of the course as models but try to find sites they don't already contain. If there are particularly relevant sites, do use them. Usually though, you should go to sites listed in the course resources and find links to other sites, or use the search engines for broader web searches.

   4. Create a series of short subpages to link from your home page. They can be pages like: Purpose, Web Resources, Summary of Technologies, Papers,... or what ever. Any of these pages can have subpages linked from them. Keep pages non-commercial, though you may link to commercial sites through a resource page.

2. Create a hypothetical child who requires assistive devices and assemble a adaptive system for her/him. You should:

   1. Create a homepage from which any other pages you create can be linked. Think of it as a title page and table of contents. You should include a short description of your site there as well.

   2. Collect the URLs (web addresses/bookmarks) of a number of related web sites and create a web resources page (or two or three). You can use the web resource pages of the course as models but try to find sites they don't already contain. If there are particularly relevant sites, do use them. Usually though, you should go to sites listed in the course resources and find links to other sites, or use the search engines for broader web searches.

   3. Create a series of short subpages to link from your home page. They can be pages like: The Child, Assessment, Interventions, Technologies, Web Resources, ... or what ever. Any of these pages can have subpages linked from them. Bring together different areas of the course to assemble a system for the child. Keep pages non-commercial, though you may link to commercial sites through a resource page.

3. Assess your need for assistive devices and create a resource that will help you in adapting and utilizing your abilities. You should:

   1. Create a homepage from which any other pages you create can be linked. Think of it as a title page and table of contents. You should include a short description of your site there as well.

   2. Collect the URLs (web addresses/bookmarks) of a number of web sites related to your area of interest and create a web resources page (or two or three). You can use the web resource pages of the course as models but try to find sites they don't already contain. If there are particularly relevant sites, do use them. Usually though, you should go to sites listed in the course resources and find links to other sites, or use the search engines for broader web searches.

   3. Create a series of short subpages to link from your home page. They can be pages like: My Needs, Adaptive Technologies, Useful Keyboard Commands, Web Resources, ... or what ever. Any of these pages can have subpages linked from them. Bring together different areas of the course and develop a set of resources which compliment your abilities. Keep pages non-commercial, though you may link to commercial sites through a resource page.

Posting Your Presentations

During week 1 you are invited to explore the follow topics and sections: 

1. About Adaptive Technologies

2. Alternative Input Devices

3. Adjustable Tables

4. Software or Freeware

5. Mouse Alternatives

6. Miniature and Expanded Keyboards

7. Switch Input

8. Web Resources

9. Augmentative Communications 

 

This workshop will introduce you to computer based adaptive technologies and alternative access systems for computers. For someone with a disability, computers can perform several functions.

• Computer access is needed to do everything everyone else is doing with computers (e.g., word processing, e-mail, computer games, etc.).

• Computers may also provide alternative methods of doing things which are difficult to do the standard way (e.g., banking by computer for someone with limited mobility or speech).

• Computer systems can augment or act as substitutes for impaired sensory, motor or cognitive abilities (e.g., reading machines, electric wheelchairs, cochlear implants, augmentative communication devices, wayfinding systems).

To benefit from any of the above the individual must be able to reliably control and interact with a computer. For this reason we will discuss alternative computer access methods in some detail.

One term that will be referred to throughout this workshop is the term Curbcut Advantage. This is derived from the cuts made to sidewalk curbs which were originally created for people with wheelchairs but which benefit almost everyone including people with baby carriages, rollerblades or shopping carts to name a few. This phenomenon is prevalent in this field: captions made for people who are deaf are used in noisy bars or by archivists to perform text searches on videotapes, voice recognition benefits the busy executive who can't type, etc.

Alternative Access to the Computer

In order to control a computer you must be able to achieve the equivalent of controlling a mouse, typing on a keyboard, reading a display and listening to auditory system cues. The user must also be able to interpret and determine the appropriate response to the computer user interface. Thus, access to the computer makes demands on visual, auditory, perceptual, motor and cognitive skills.

People who can benefit from alternative computer access systems include those who:

• have difficulty or cannot control a keyboard,

• find it difficult to control a mouse,

• have repetitive strain injuries,

• have difficulty or are unable to see the display,

• are unable to hear auditory cues,

• have a learning disability which makes it difficult to write or read text,

• require simplified interfaces due to cognitive impairments.

High Tech options for computer access

High tech options vary from utilizing built in or shareware/freeware software modifications, to adding sophisticated hardware and/or software packages that translate the user input or the computer output, and modify desktop management and system control. The options grouped below are usually available for either Apple or IBM compatible systems and are in order of increasing complexity.

Enhancements to the Visual Display

A number of adjustments can be made to the visual display using built-in system controls or free software. These adjustments provide higher contrast and can enlarge icons, display fonts and mouse cursors.

A number of screen magnification programs are available. These vary largely in the operating system they are compatible with. Features to consider are:

• the quality and degree of font smoothing at higher magnifications,

• the types of viewing windows available for viewing magnified text (full, overlay, lens, etc.),

• options for scrolling or moving to desired areas of the screen,

• options for tracking the cursor, the insertion point, alert boxes, focus, etc.,

• choices of text and background color,

• integration with screen reading,

• quality of image magnification,

• complexity of keyboard or mouse commands required to control the magnifier.

For clients who have difficulty reading or writing (due to a learning disability or emerging literacy) talking word processors and add-ons are available which highlight words or phrases as they are being read and allow reading in various chunks (e.g., by word, by sentence, by syllable). These programs also support writing by echoing what is being typed.

Alternative Displays

Alternatives to the visual display include screen readers which speak the text displayed on the screen and refreshable Braille displays which translate the text to Braille.

There are a number of screen readers to choose from. Screen readers which are compatible with Windows or the MacOS take various approaches to dealing with the graphical user interface. Some require that the user visualize the desktop and use the desktop layout as a reference for navigating, others reorganize the desktop in a two dimensional hierarchy. The approach best suited to the user depends upon their previous experiences and skills in grasping inherently spatial models. In setting up a screen reading access system, control of the interface without use of a mouse must also be considered. Many actions can be performed with keyboard equivalents, but the user must learn these. Input alternatives must be found for actions which have no keyboard equivalents (i.e., macros).

Considerations in choosing a screen reader include:

• the completeness, and cohesiveness of the display model presented,

• methods available to navigate to desired sections of the display or interface,

• differentiation of insertion point and exploration cursor (so that the user can look around without losing their place),

• supports to assist in orienting to status and location, (where am I, what is happening),

• options available for echoing what is typed (e.g., letter, word, phoneme),

• options available for reading text (present, next, previous word, line, sentence etc. ),

• pronunciation dictionaries, and speech options (e.g., rate, pitch, volume, prosody, modulation, voice, voice change tied to different functions),

• strategies available for getting information about non-text items, (e.g., reading tool tips),

• strategies for controlling interface controls which do not have a keyboard equivalent,

• compatibility with software applications the client wishes to use.

Braille displays vary in the number of cells that are displayed, (usually either 40 or 80), the method of navigating around on the display, the status information that can be displayed and the available quick reference keys or short cut keys available. Some Braille displays are designed to be compatible with screen readers.

Enhancements and alternatives to the auditory display

For individuals who cannot hear or fail to attend to auditory system cues, such as alert sounds, system software (ShowBeeps) can be used to provide visual cues in place of auditory cues. Captioning is only beginning to be explored for audio streams or audio tracks of videos. CD manufacturers, in response to ADA legislation and educational buyers, are beginning to provide text transcripts or captioning for audio. World Wide Web authors are becoming aware of the need for captioning, and file formats which accommodate a captioning track are being developed. Caption authoring packages are available to add multimedia and overlay captioning to computer based video.

Rate enhancement or literacy supports

Major word processors have a variety of features that may enhance the user's input. Abbreviation-expansion, spelling and grammar aids are a standard feature. Macros and templates are available which allow the automation of tasks and keystroke input. Word prediction, word-completion prediction and abbreviation-expansion software, with or without auditory feedback, aids users with slow keyboard input or those with difficulties spelling.

Mouse Alternatives and Replacements

Trackballs, joysticks and various forms of tablets are frequently easier to control than a mouse. The mouse pointer can also be controlled using head movement which is tracked using infrared or ultrasound technology. Buttons on many alternative pointing devices can be programmed to perform a double click or to lock down the mouse button for a drag. Mouse buttons can be replaced with switches (e.g., puff-sip switches, foot pedal switches, etc.) or with software that performs the mouse click, double click, and drag by dwelling on a target for a predetermined time and then moving the mouse cursor in one of 4 directions.

The mouse pointer can be controlled using keys on the numeric keypad, or keys on an on-screen keyboard. Mouse emulators exist for single switch users and users of voice recognition systems; these employ vector scanning strategies or grid systems to quickly zero in on the target.

Keyboard Modifications and Alternatives

Free software or operating system modifications allow changes to be made to keyboard response by: slowing response time; eliminating or slowing key repeat rate; and holding keys used in multiple key depressions when selected sequentially. Standard keyboards are also available with on-board memory for text or command macros. Mainstream keyboard alternatives include keyboards which are smaller, are more ergonomically shaped, provide more efficient keyboard layouts (e.g., DVORAK vs. QWERTY) and have built in Trackballs or other mouse alternatives.

Specialized keyboards have been developed to accommodate a variety of individual needs. Miniaturized keyboards accommodate those with limited range of movement or strength. These may have mouse emulation as a built in feature. Enlarged keyboards are more suited to those with poor motor control, but with adequate range of movement. Programmable keyboards allow for customization of the keyboard layout (key content, key size) with individualized overlays depicting the key contents for the user. Keys may also be programmed with mouse emulation functions.

Numerous on-screen keyboard software programs allow the user to select keystrokes, (letters, words, commands, phrases) using a mouse or mouse emulation.

Switch Input

Switch input is also used to emulate keyboard and mouse functions. Single, dual or three switch input of Morse code can be translated by a hardware and/or software interface into keyboard and mouse input to the computer. On-screen keyboards support a number of scanning strategies including:

• stop and continuous automatic scanning,

• inverse scanning (hold switch down to move cursor, release when target is reached, hit second switch or wait to select), step scanning, and

• directed scanning (direct cursor movement by holding one of four directional switches).

Considerations when choosing a scanning on-screen keyboard include the presence of:

• strategies for controlling the desktop and manipulating windows,

• methods of emulating the mouse,

• user definable keyboard layouts,

• integration of acceleration strategies such as abbreviation-expansion or word completion prediction,

• context sensitive keyboard layouts, and

• adequate control of scan speed, initial delay, debounce time and switch configurations.

Voice Recognition

Voice recognition of commands or text input is available with some operating systems. Voice recognition software that provides text input, mouse control and software application control, including optional levels of vocabulary and macros for various professions or specialty groups, is also available.

Current dictation systems do not allow the ideal, continuous speech, speaker independent, unlimited vocabulary dictation which most people expect. Although voice models in the system allow the recognition of words without explicit training, each user has their own voice model file which must be carefully trained to allow optimal recognition. Proper maintenance of the voice model requires vigilance to errors made by the user and the system and proper correction of the errors. Most voice dictation systems have very large dictionaries, but proper names and specialized vocabulary must be added by the user. Several dictation systems rely on mouse control to control the desktop and dictation functions.

Adaptive Technologies which Augment or Substitute Impaired Functions

One of the primary properties which allows computers to act as powerful tools for people with disabilities is the ability to translate. Computers can be used to translate auditory signals to visual signals or vice versa, small print to large print high contrast, Morse code to standard typing or an eye blink to words and phrases, to list only a few examples. Another property is the ability to efficiently perform repetitive, predictable tasks, thereby saving limited energy and time. A third property is the facility to store, process and allow the retrieval of large amounts of information.

However, presently computers are limited in mimicking human functions in that they:

• do not consistently learn from their mistakes

• do not repair themselves

• do not grow with the person

• do not react well to the unpredictable or surprising

• are terrible communicators both receptively and expressively.

The range of adaptive technologies and issues and considerations in choosing these will be explored further in various sections of this course.

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Introduction

Module by Linda Petty

What are alternative input devices? They are non-standard products and methods for inputting text and mouse commands needed to operate software, manage files and navigate a desktop in a graphical user interface. The standard input devices are the keyboard and two button mouse; for many people with physical disabilities these are awkward, slow or impossible to use. When considering other alternatives, a thorough assessment of the user's physical skills and computer needs is required. This is generally done by an occupational therapist who specializes in assistive technology, to ensure that the physical, cognitive, visual and ergonomic needs and factors are considered. Each of these technologies can meet a range of needs and each individual has unique needs and strengths. In this module, input devices will be suggested for specific disabilities or needs, however, a successful user/alternative input device match only can be made based on an individualized assessment. As we look at the variety of alternative input devices available, I would caution participants against picking devices from the information presented for specific users without a local assessment. Providing an assessment with appropriate range of equipment trials also prevents the frustration of the "try this, try that" approach, where less than optimal solutions are purchased to be later abandoned.

This section of the course will cover a broad range of commercial tools and technologies available to input text and mouse commands into a computer system. We will begin with simpler solutions and progress to the more complex and expensive. In each area I will give you illustrations of potential users of the input device as well as web resources for companies selling or developing the technology.

Selecting a computer access system for a client may entail choosing the assistive technology as well as the computer and all its components, or simply choosing the assistive technology which is compatible with the client's existing system.

Clients who can benefit from alternative computer access systems include those who:

• have difficulty or cannot control a keyboard

• find it difficult to control a mouse

• have repetitive strain injuries

These difficulties may be:

• Congenital, meaning from birth, such as Cerebral Palsy (as in Case Study #1 ) 

• Acquired through an accident which results in an injury, such as quadriplegia (as in Case Study #2) or a disease process, such as Multiple Sclerosis 

The computer input modifications required may be:

• Static, as the client's physical strengths and needs are stable or 

• Flexible, as on-going modifications will be needed to meet the needs of a changing condition, as in Amyotrophic Lateral Sclerosis (as in Case Study #3) or improving literacy or educational skills. 

Regardless of the client's input needs, remember that computer technology is changing rapidly and most computer systems will need to be replaced approximately every 5 years. Sometimes an older system still meets the client's needs, however, changes in operating systems and software compatibility often force upgrades to continue to exchange information with vocational or educational settings.

Think of the individuals you know using alternative input devices: how often have there been changes to their computer systems? What has been the need behind those changes?

 

Here are some of the lower tech methods/strategies for inputting to standard computer systems.

Sometimes a modification to the physical layout of the computer can enable a user to effectively access the standard keyboard, especially if keyboard modifications like Sticky keys or a slowed response rate are used to compensate for coordination difficulties. Positioning the keyboard on an angled, height-adjustable keyboard table, providing support through armrests or a wrist rest can all help stabilize the limbs to maximize accuracy. Positioning the keyboard at foot level is more functional for some users with better control of their lower extremities than the upper

Some users with poor motor control of the arms can use a stick held in the mouth or attached to headgear to depress the keys of a keyboard, with Sticky keys to help with depressing multiple keys sequentially. Keyguards are metal or plastic grids over the keyboard that allow a user to slide across them and then push a digit or stick down the holes to depress a key, preventing inadvertent hits. They can obscure the view of the keyboard and also are increasingly hard to purchase, due to the plethora of keyboards available.

Other users who benefit from wrist rests, adjustable keyboard heights and ergonomic positioning are those with Repetitive Strain Injury(RSI). RSI is an occupational hazard of our times, forcing some people to change types of work or limit keyboarding time. Although some can modify their work station and work styles to continue, others use Voice Recognition for keyboard and mouse input. For some information on this disability and equipment to compensate, see the Typing Injury Faq at http://www.tifaq.com

To look at equipment sources for this section, see Adjustable tables, wrist rests, mouth and chin sticks and keyguards in the Resource page.

 

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Operating System Modifications

There are some fairly easy modifications which can now be made via software to enable someone with poor motor control to use a standard keyboard or a mouse from the keyboard. Initially Apple and now Microsoft have incorporated these features in their operating systems. Look in the Control Panel of the computer you are using. If it is a Macintosh, these features are called Easy Access. If it is a PC running Windows 95, the features are called Accessibility Options. Windows 3.1, NT and DOS systems have to have these features added with a free utility available from the Trace Center or Microsoft, called Access Pack for Windows [ http://www.utoronto.ca/atrc/reference/tech/altkey.html ]or AccessDos [ http://www.utoronto.ca/atrc/reference/tech/altkey.html ]The modifications available are described as follows, although the names may differ between operating systems: 

Sticky Keys

Many software programs require users to press two or three keys at one time. For people who type with a single finger or a mouthstick, that just isn't possible. Sticky Keys allows users to press the keys of a key combination one at a time and instructs Windows to respond as if the keys had been pressed simultaneously. When Sticky Keys is turned on, pressing any modifier key--that is, ctrl, alt, or shift--latches that key down until either the mouse button or a non-modifier key is released. Pressing a modifier key twice in a row locks it down until it is pressed a third time. In Windows 95, to adjust StickyKeys go to Control Panel, Keyboard, or it can be turned on or off using a hotkey: pressing the shift key five consecutive times.

SlowKeys (In Windows 95 found under FilterKeys)

The sensitivity of the keyboard can be a major problem for some people, especially if they often press keys accidentally. SlowKeys instructs Windows to disregard keystrokes that are not held down for a minimum period of time, allowing users to brush against keys without any ill effect. When users put a finger on the correct key, they can hold the key down until the character appears on the screen; an optional sound effect also indicates when a keystroke has been accepted. To activate and adjust SlowKeys go to Control Panel, Accessibility Options, Keyboard, click on the FilterKeys checkbox, then the Settings button, and choose Ignore quick keystrokes and slow down the repeat rate. It can be turned on or off using a hotkey: holding down the Right shift key for 16 seconds. Users hear a warning after four seconds, an up-siren after eight seconds, a double-tone after 12 seconds, and a triple-tone after 16 seconds. Releasing the shift key after the triple-tone activates BounceKeys at the most conservative settings. (This hotkey also turns on RepeatKeys.)

RepeatKeys (In Windows 95 found under FilterKeys)

Most keyboards allow users to repeat a key just by holding it down. This feature is convenient for some but can be a major annoyance for people who can't lift their fingers off the keyboard quickly. RepeatKeys lets users adjust the repeat rate or disable it altogether. The functionality of RepeatKeys is adjusted through the Control Panel, or it can be turned on or off using a hotkey: holding down the Right shift key for eight or more seconds. (This hotkey can also turn on SlowKeys or BounceKeys, depending on how long the shift key is help down.)

BounceKeys (In Windows 95 found under FilterKeys)

For users who "bounce" keys and produce double strokes of the same key or similar errors, BounceKeys instructs Windows to ignore unintended keystrokes. The functionality of BounceKeys is adjusted using the Control Panel, Accessibility Options, Keyboard, FilterKeys, Settings, Ignore repeated keystrokes. It can be turned on or off using a hotkey: holding down the Right shift key for 12 seconds. Users hear a warning after four seconds, an up-siren after eight seconds, and another double-tone after 12 seconds. Releasing the shift key after the double-tone activates BounceKeys at the most conservative settings.

MouseKeys

The MouseKeys feature lets people control the mouse pointer using the keyboard. Users don't need to have a mouse to use this feature. Windows 95 is designed to allow users to perform all actions without needing a mouse. However, some applications may require one, and a mouse can be more convenient for some tasks. MouseKeys is also useful for graphic artists and others who need to position the pointer with great accuracy. When MouseKeys is turned on, the following keys navigate the pointer on the screen:

• Press any number key except 5 on the numeric keypad--these keys are also called the direction keys--to move the pointer in the directions indicated below.

• Press the 5 key for a single mouse-button click, and press the + key for a double-click.

• To drag an object, point to the object, press ins to begin dragging, move the object to its new location, and press del to release it.

• Select the left or right mouse button or both mouse buttons for clicking by pressing the /, -, or * key, respectively.

• Hold down the Ctrl key while using the direction keys to "jump" the pointer in large increments across the screen.

• Hold down the Shift key while using the direction keys to move the mouse a single pixel at a time for greater accuracy.

In Windows 95, the functionality of MouseKeys can be adjusted using the Control Panel. Go to Accessibility Options, Mouse, click on the MouseKeys checkbox and click the Settings button to customize the feature. Or it can be turned on or off using a hotkey: pressing the Left alt, Left shift, and num lock keys simultaneously.

ToggleKeys

ToggleKeys provide audio cues--high and low beeps--to tell users whether a toggle key is active or inactive. It applies to the caps lock, num lock, and scroll lock keys. The functionality of ToggleKeys can be adjusted through Control Panel, Keyboard,or it can be turned on or off using a hotkey, by holding down the num lock key for five seconds.

Adjustable Tables, Wrist Rests, Mouth and Chin Sticks, Keyguards

Software and Freeware modifications

There are a variety of other "helps" that can be added using software, such as word prediction, for slow typists or poor spellers, text-to-speech programs for those who benefit from auditory feedback, and more. Look at the programs available for the Mac and PC at these locations at the following sites:

• The Trace Center 

  http://trace.wisc.edu/

• Apple Computer's site 

  http://www.apple.com/disability/

• Virtual Assistive Technology Center 

  http://www.at-center.com/

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There are switch controllable mice, such as the Cross scanner and Mouse mover listed in our As you can imagine, control of the mouse is a must in this graphical user interface world is a must. This can be difficult for users with coordination problems or limited strength or range of movement. As we have already discussed, the keyboard keypad can function as a mouse using Mousekeys; this method of mousing around can be slow, but is effective. Many of the alternative keyboards have Mousekeys built in, so the keys on the keyboard can toggle between text input or mouse input.

Trackballs are upside down mice, with the ball on top and several buttons. Look for those which offer the left and right mouse buttons plus one or two more which can be programmed to be a double click or drag lock. Many local computer vendors stock trackballs- the programmable ones are also available from assistive technology vendors. technical glossary. These allow the user to use one to 5 switches to control the mouse- the more switches the user can control, the faster the mousing around.

Mouse input can also be given by high tech pointing devices, which transmit the location of a transmitter or reflective dot on the user's head to the computer system. Separate switches or just dwelling on a location are used for mouse clicks and drags. These are frequently used with on-screen keyboards for text input by people with limited movement due to quadriplegia or muscular dystrophy.

These keyboards emulate regular keyboards, offering all the keys needed for the Apple or PC.

Some miniature keyboards have these keys layered, so you first select the Function key, then press a number to get the equivalent of F2, for example. This takes more time, but minimizes the space needed, which is particulary important for users with minimal strength and range of movement. The most effective layout for such users is a center weighted layout, so the E, I, O, U, T, and Space are grouped in the middle and the other characters further away according to their usage patterns. This can take a while for someone to learn who has always used a QWERTY layout, so these keyboards are also frequently available in the standard QWERTY layout as well.

Enlarged keyboards suit someone with large range of movement with a foot or arm, and less than optimal accuracy for a regular keyboard. A young man I worked with who had ataxic movement due to Cerebral Palsy used his so much and so well that the letter names would bet worn off the keys. He is now doing well in a university business program....

For links to these products, see the Resource page for this module.

A programmable keyboard offers the flexibility of mapping the keyboard to suit the application or the user's input needs for content or access. A popular example is the "Intellikeys" which comes with overlays for Apple and IBM keyboards with mouse keys built in and adjustable response and repeat rates. This keyboard can be programmed with a software package to input strings of text or commands to the computer, and even read out text associated with the key as desired. This allows a teacher to create a customized overlay for a student to write a letter or journal, with common sentences or words under a paper overly which depict them in words or pictures. This type of early literacy activity frequently utilizes a talking word processor, so the text can be read back to the student. A student with poor targeting skills or playing a simple computer game can have only one or two items programmed and shown on the overlay. Overlays are quick to program and print off; a number of ready made overlays come with the products as well.

These keyboards can be equally useful in operating applications, such as web browsers. They can have functions like moving between links or to favorite sites and can call up text-to-speech software to read information out to students with literacy needs.

As the name suggests, this input mechanism is to make selections from a keyboard which is displayed on the screen, by a software package. Selections are made by mouse clicks from trackballs, mice or pointing devices or by dwelling on the keyboard location for a pre-established period of time. The disadvantage is the screen real estate lost to the keyboard- a large monitor is helpful. The advantage is the lack of movement required- the individual does not need to take their eyes off the screen to look at a keyboard. On-screen keyboards generally operate transparently with applications.

On-screen keyboards usually include sticky key features and some colour coding. Some incorporate word prediction or voice output for face-to-face communication. Some of the augmentative communication softwares offer programmable on-screen keyboards for those with literacy needs. Some keyboards have versions which can be operated by single or dual switches, becoming, in essence, scanning keyboards- more on scanning later. Keyboards vary significantly in price, with additional features like voice output, word prediction or scanning at marketed at higher prices.

Less direct methods of inputting keystrokes and mouse clicks are slower and less effective than direct methods of pointing or keyboard input. Individuals who have very poor accuracy in targeting or very minimal movement use switches to input data into applications. There are two main methods of inputting data using a switch:

• Scanning: 

  Using this approach, a line of letters, mouse input and possibly even computer commands are displayed on screen. A coloured marker moves across the array of choices in linear or in a row/column pattern. The individual hits the switch when the marker is at the selection they want to input. Again, due to the slow rate of input, other strategies such as word prediction, are frequently used with this input method.

• Morse Code: 

  Although rarely used among the general public, inputting the Dits and Dahs or long and short signals of Morse Code continues to be a fairly efficient means of computer input for switch users. I have known Morse Code users with disabilities such as quadriplegia or muscular dystrophy who achieved input rates of 20 to 25 words per minute. If the user has good voice control, voice recognition can be a faster alternative, but for those without, or with limited funds, Morse code can give full text and mouse input for Macintosh and Windows or DOS operating systems. Morse can also be augmented with speech or word prediction.

Switches themselves can be purchased from a variety of sources. The interface which produces the scanning array or Morse Code translation to the system is usually a combination of software and hardware.

See the Resource page for this module for switches and interfaces for scanning and Morse Code.

General Resources

For resources on mobility impairments, please see the:

• Adaptive Technology Resource Centre site.
  http://atrc.utoronto.ca

For equipment, please see a searchable database called:

• Abledata.
  http://www.abledata.com/

Alternative Input Device Sources

Adjustable tables, wrist rests, mouth and chin sticks

Adjustable furniture and ergonomic supports are available from your local office supply store or catalogue. Photos with item numbers are availible at:

• Typing Injury FAQ
  www.tifaq.com/

• Assistive Technology Inc
  www.assis-tech.com/

Mouse Input

For Mice and Trackballs please see:

• Technical Glossary
  www.utoronto.ca/atrc/reference/tech/altmouse.html

• Typing Injury Faq
  www.tifaq.com/mice/mice.html

Alternative electronic pointing devices are listed under:

• "Other Devices" at the Typing Injury Faq.
  www.tifaq.com/mice/other-devices.html

Expanded and Miniature Keyboards

For expanded and miniature keyboards see:

• TASH
  www.tashinc.com/catalog/ca_index.html

• In Touch Systems
  www.magicwandkeyboard.com/

Programmable Keyboards

For programmable keyboards see:

• Intellikeys
  www.intellitools.com/products/IntelliKeys/home.htm

• Key Largo from Don Johnson, Inc.
  www.donjohnston.com/catalog/catalog.htm

On-Screen Keyboards

For on-screen keyboards, see our list in the:

• Technical Glossary.
  http://www.utoronto.ca/atrc/reference/tech/altkey.html

Switch Input

Switches are availabe from:

• TASH
  http://www.tashinc.com/catalog/

• Don Johnston, Inc.
  http://www.donjohnston.com/catalog/catalog.htm

• Ablenet
  http://www.ablenetinc.com/

Scanning interfaces are available at:

• Don Johnston On-screen keyboards & Ke:nx (For students who need a switch to write) 
  http://www.donjohnston.com/catalog/catalog.htm

• Words+ products. 
  http://www.words-plus.com/

Morse code interfaces are listed in the:

• Technical Glossary on the ATRC website
  http://www.utoronto.ca/atrc/reference/tech/techgloss.html

---

Excerpted from "The Clinician's Guide to Assistive Technology" Computer Access Chapter by Jutta Treviranus and Linda Petty. Mosby Publishing, Inc. In publication

Application/Goal

The problem addressed by this application was to provide flexible computer access and equipment to meet the changing physical development and educational/ literacy/communication needs of a very young child with a congenital condition, Cerebral Palsy.

Function/Ability

Christopher was initially assessed for technology access in Dec. 1993, at the age of 4. Computer access recommendations were given to his community team for single switch programs to develop motor control and letter recognition. Further assessment and equipment trials in April 1994 resulted in the lease of a Macintosh LC II computer system with Ke:nx, several single switches and an expanded Unicorn keyboard and keyguard, Apple 11e emulator card and disk drive. Software included a Macintosh talking word processor, Intellitalk, Apple 11e early learning software such as Charlie Brown's ABCs, First Letter Fun, etc. Christopher's family and support workers were trained in running the system and programming overlays when the system was put in place in early June. The computer access was flexible, promoting concrete, direct upper extremity targeting for some software with limited targets and training scanning skills with hand targeting of single switches for other software packages. Christopher's motor control was affected by fluctuating muscle tone and reflexes; the flexible access promoted development of motor control while operating fun, age appropriate and educational software programs.

Other technology recommendations at that time were:

• improved seating and a power wheelchair training program for the following summer, using a DU-it Armslot switch for power chair access with limited upper extremity control, which resulted in a power chair and seating prescription in the fall

• communication book with a variety of large targets, spaced out for clarity of indicating choices

• a low tech switch operated signalling aid for telling jokes, passing on news from nursery school, greetings, etc.

• use of a similar Macintosh system for Grade 1 in Sept. 1994, with a CD ROM.

Re-assessment of physical access in April 1995 indicated increased muscle tone following a growth spurt, increased prominence of an Asymmetrical Tonic Neck reflex and increased athetosis affecting active movement patterns. Quantified computer access trials demonstrated to Christopher's parents and the support team the greater effectiveness of using a switch accessed with head rotation for critically timed access needs, such as scanning for face to face communication and letter input to the computer system. A Zygo lever switch and mount was added to his computer access set up and his computer was upgraded to a Macintosh Performa 580CD to give adequate RAM and CD ROM access for educational and reading programs. ClickIt software was added to the use of Ke:nx for single switch access to CD Roms, using programmable "hot spots".

Other technology recommendations included the use of a portable Apple Powerbook system with Speaking Dynamically, Boardmaker, ClickIt, Ke:nx and a talking word processor, Intellitalk, for use at school for face to face and written communication. This system was accessed with the lever switch to obtain the best possible speed and accuracy needed for scanning. As Christopher used the larger Armslot switch on his tray for driving, the Powerbook system was secured in it's place on his tray for in-class or in-home sessions only, rather than being available at all times. Christopher continued to use his communication book, eye gaze, etc. for immediate communication needs.

By the winter/spring of 1996, Christopher was demonstrating improved physical control, particularly of his right upper extremity. This was attributed to extensive driving practice with the arm-slot switch, maturation, excellent seating and therapy. A gated, center mounted joystick was introduced for driving, and after a training period, substituted for the Armslot switch. The new power chair access allowed for flexibility in mounting the portable computer system and new options for computer access using the joystick. Trials were next carried out with Direct Point computer access technology, where an interface allows the user to "drive" the computer cursor with the wheelchair control with a remote selection switch in summer 1996. This was successful, offering faster, more immediate access to face to face communication displays and an on-screen keyboard for computer access. The head switch was still used for selecting targets once the mouse pointer dwells over them, as this offered faster and more accurate than selecting with a timed dwell setting. As the Armslot switch was no longer positioned on the wheelchair tray, Christopher's portable computer system could be mounted with a modular bar and bracket to give him multiple work surfaces and more ready access to his portable system. The Direct Point is used to access both his stationary system for dedicated writing, literacy activities and the portable system for face to face communication and portable writing needs.

Considerations/Options

Technology is available to support even very young children with multiple disabilities, however, the funding and support systems need to be flexible to allow regular re-assessments and changes of equipment to suit changes in physical status and educational/communication needs. Integration, compatibility and overlap of training with systems used for communication and education need to be considered and promoted in choosing equipment.

Outcome/Social Validation

The computer access equipment described supported Christopher through very crucial formative years of development from ages 4 to 8, and from nursery school to Grade 2 in educational and communication content. The cost of the original computer system and access technology was approximately $3,000.00 USD, however, as Christopher had rapidly changing needs he was able to use a Province of Ontario leasing program. This provided flexibility and recycling of equipment as Christopher's needs for physical access and educational/communication material changed. As technology was also changing throughout this time, it supported the transition between the early use of Apple 11e software to Macintosh educational CD ROMs 2 years later. Costs of his later system of the DirectPoint, Performa 5800, etc. was approximately $3500.00 USD, with the access hardware being shared between the stationary and portable system. The changes in hardware, software and access methods were made following assessments or re-assessments which clearly demonstrated the gains in speed, accuracy and computer input and the compatibility needs of the school environment, which made the requests acceptable to the funding/leasing agency. The changes were done with thorough discussion and consultation with the family, school staff and support team, with documented rationale, resulting in full support by all concerned. The changes were also introduced sequentially, to prevent overwhelming the client and support system with new technology for computer, mobility and communication all at once. Christopher was able to access technology for age and grade appropriate written and face-to-face communication with a minimum of frustration due to his physical limitations. The uncounted costs of not providing this progressive access technology and support would have been behavioural problems due to frustration, limited literacy and communication skills and increasing dependence for any educational programming. In contrast, the client now can attend a regular school independently with some teaching assistance support for his equipment and full opportunities to participate in classroom and home learning opportunities.

Technology Resources

Macintosh computers: Apple Computers, Inc.

Ke:nx, single switches - alternative access interface for the Macintosh from Don Johnson, Inc.

1000 N Rand Rd, Bldg 115
PO Box 639 
Wauconda IL USA 60084-0639 
Phone:800-999-4660 USA & CANADA 
847-526-2682 USA & GLOBAL 
E-mail: djde@mcs.net
URL:http://www.donjohnston.com

intellitools

Unicorn keyboard, Intellitalk, ClickIt software: expanded keyboard and software from Intellitools Inc.

55 Leveroni Ct., Suite 9 
Novato, CA 94949 USA 
Phone: (415) 382-5959 
Email :intellitoo@aol.com
URL: http://www.intellitools.com

Armslot Switch Controller:

DU-it control Systems Group Inc.

8765 Twp. Rd. 513, 
Shreve Ohio 44676-9421 USA 
(216) 567-2906 

Speaking Dynamically, Boardmaker

Mayer-Johnson Co. 
P.O.Box 1579 
Solana Beach, CA 92075-1579 
Tel: 619-550-0084 Fax: 619-550-0449 
E-mail: MayerJ@aol.com
URL: http://www.mayerjohnson.com

Zygo Lever Switch:

Zygo Industries, Inc. 
P.O. Box 1008 
Portland OR 97207-1008 
Tel: 800-234-6006 or 503-684-6006 Fax: 503-684-6011 

Zygo Switch mounting:

David Cooper, Sunnyhill Health Centre for Children

3644 Slocan St.,
Vancouver, BC, V5M 3E8, CANADA 
(604) 436-6527

Direct Point:

Jerzy Antczak, Bloorview MacMillan Centre

350 Rumsey Rd., Toronto, ON M4G 1R8, CANADA 
(416) 425-6220 
E-mail: ortcja@oise.utoronto.ca

Excerpted from "The Clinician's Guide to Assistive Technology" Computer Access Chapter by Jutta Treviranus and Linda Petty. Mosby Publishing, Inc. In publication.

Application/Goal

Computer access technology for a high school student with an acquired long term disability of C4 quadriplegia that would be suitable for high school and post secondary educational settings as well as writing in the home environment. The client, Derren, used Peach Tree controls for power mobility and supportive seating. Macintosh computers were available in the high school resource room and drafting classes, however, the client and his family were very technically adept in use and support of IBM compatible systems.

Function/Ability

Initial assessment in Jan. 1990 was requested for access to a 386 IBM compatible system running WordPerfect 5.1 for home use. The client, Derren, had good control of head and neck movement and speech. As voice recognition was financially unfeasible and limited in performance, a miniature keyboard with built in Sticky Keys, the Bloorview Mini Keyboard, was prescribed for use with a mouth stick. This keyboard was a modified Sharp 360 pocket calculator and plugged into the keyboard port of the 386. It provided mouse emulation or could be used in conjunction with a trackball.

In 1991, the client had returned to a full high school program and found a voice activated tape recorder ineffective for note taking. Re-assessment indicated that a "notebook" computer, a new technology at the time, would have a small enough keyboard as to be effective for note taking and in-class work with a mouth stick, or could be paired with the use of a Bloorview Mini keyboard. A Sharp PC 6641(40 MB hard drive, 4 MB RAM) was prescribed with a custom mount and wheelchair battery adapter. The notebook system lasted approximately 5 years before the system became irreparable and unable to support compatible software needed for access and course work. Recommendations were given to the high school which provided a Bloorview Mini and trackball for use with the Macintosh systems for drafting and other graphics needs.

Derren enrolled in the University of Toronto following high school and was able to obtain Vocational Rehabilitation Services financial support for computer equipment at home to support his studies. At the onset of the migration from DOS to Microsoft Windows, Derren was able to upgrade his home system to Microsoft Windows version 3.1, accessed with the Bloorview Mini and a trackball. When the Bloorview Mini was no longer available, a SpaceSaver keyboard was found as a replacement. By 1996, Derren was able to upgrade his home computer system to a Pentium running Windows '95 and accessed using Dragon Dictate voice recognition, which had decreased significantly in cost and improved significantly in performance, and/or the SpaceSaver keyboard and trackball. Use of voice recognition will improve Derren's speed of text input for writing and ease the demand on neck musculature which is heavily used for driving as well as mouth stick access. A 21" monitor also decreases the need for accessing scroll bars and provides additional screen space for running multiple applications. At the University, a Pentium system was made available with Dragon Dictate for exam writing and on-site writing needs. The library was also modified to improve wheelchair access to the computer systems and offer sticky keys and mouse control via the system keyboards.

Considerations/Options

Commercial and access technologies are changing with increasing rapidity. It is important to address immediate needs with existing, but state of the art, technology, while recognizing that it will not be a permanent solution. Coordination with educational facilities and other areas of the client's environment is crucial to maximize the person's function across environments and prevent the unrealistic expectation that one piece of technology will meet all needs in all settings. Technical access solutions in the late '80's, early '90's often required custom fabrication of equipment like mounting devices, battery adapters, or modification of commercially available products, such as gave rise to the Bloorview Mini. Current access technology can frequently be found in mainstream product lines or companies which produce a commercial product that is marketed both to the mainstream and rehabilitation or disability markets, such as Dragon Dictate.

Technology Resources

SpaceSaver Keyboard - Datalux Corporation

155 Aviation Drive 
Winchester, VA 22602 USA 
Toll Free: 1-800-DATALUX 
Phone: 540-662-1500 
Fax: 540-662-1682 

Dragon Dictate, Classic Edition - Dragon Systems, Inc.

320 Nevada Street 
Newton, MA 02160 USA 
Phone: 1-800-TALK TYPE or +1-617-965-5200 
FAX: +1-617-527-0372 
E-mail: info@dragonsys.com
URL: http://www.dragonsys.com

Outcome/Social Validation

Each technical solution met the existing needs, however, each eventually became inadequate as newer technology offered greater speed of access or compatibility with current software needed for educational programs. The costs of the original Mini keyboard was $250.00 USD, the notebook system was $3,000.00 USD, with the custom mounting and power supply totalling $800 USD. The client's current system is a very powerful, state of the art, Pentium with a large monitor and 32 MB of RAM, retailing at approximately $3500 USD. Dragon Dictate, the Classic Edition, was obtained for $500.00 USD and the Space Saver keyboard for $125.00 USD. The client was able to receive funding through provincial Ministry of Health equipment programs and Vocational Rehabilitation Services to support the equipment purchases over time. Improvements in performance with each system were simple to document, as each system offered improved speed of text input and system control over the previous, or enabled the client to fulfill the normal scholastic demands which had previously been unmet.

The client is very satisfied with the speed and functionality of his current system, however, will want it to keep pace with the latest releases of commercial software and so will probably continue to upgrade the voice recognition access as new versions are released. The current solution offers the preventative measure of minimizing repetitive use of the client's neck musculature and virtually eliminates access barriers to commercial software used by future potential employers. Outcomes can also be verified by surveying the educational facilities as to the client's ability to meet institutional standards for workloads, exam writing time, etc.

Excerpted from The Clinician's Guide to Assistive Technology, Mosby, Inc. In Press. Computer Access Chapter, by J. Treviranus and L. Petty

Application/Goal

Dr. S. was a humanities professor at a large urban university. At the age of 48 he was diagnosed with Amyotrophic Lateral Sclerosis, a degenerative neurological condition. Dr. S.'s goals for computer access were to allow him to continue to teach, mark assignments, council students, exchange information with fellow academics and his department, prepare and modify his lectures and conduct research as long as possible. The goals for the computer access system were that it would adapt to his changing condition, and that it would not have a substantial initial learning curve.

Functions, Abilities, Considerations and Options

In response to his changing skills and goals, the computer access system went through a number of phases over a two and a half year period. Throughout the process, access system components were chosen which would require skills which could be transferred to access systems used at later stages

When initially assessed Prof. S. identified his major problems as: difficulty controlling a mouse, poor control of a pen, difficulty handling books and papers and fatigue when working at the computer for an extended period. Finger and wrist movement was well controlled while larger arm movements were more difficult. Holding or gripping objects caused fatigue. A trackball which required primarily finger and wrist movement was used to replace the mouse. Dr. S. was taught keyboard shortcuts for a number of mouse actions. He was also tutored in more efficient control of both the desktop and the most frequently used computer applications. A macro, abbreviation-expansion package was prescribed. His mailer was upgraded to a more efficient mailer which performed a number of the tasks automatically. He was also provided with a wrist rest , document holder and book holder. In anticipation of challenges in the future, a number of changes were made to his job tasks. Books or papers on the computer do not need to be handled, can be easily searched, can be read by a voice synthesizer and can be annotated. Professor S. was made aware of sources of electronic reference and research materials and electronic catalog tools. He was also referred to an electronic-text transcription service. When surveyed it was found that the majority of his students had computers or access to computers, many also had access to e-mail. Instructions were prepared for submitting papers and assignments on disk or over e-mail, and students were encouraged to do so. With assistance from academic computing staff and network staff at the University, a listserve was set up for exchange of information between Prof. S. and his students and between the students themselves. This was later used to conduct tutorials

Six months later his endurance and accuracy when using the standard keyboard had greatly deteriorated. He was loaned a miniature keyboard which required a reduced range of movement, reduced the pressure required to activate the keys and optimized the keyboard layout to decrease the movement required between keys. The volume of his voice had declined making it hard to deliver lectures. His lecture hall was modified to include a microphone and a computer projection panel. He was taught to prepare overheads and slides using an application called Power Point. This served to clarify his verbal lecture.

During the next phase the range of movement of his wrist was further reduced as was his finger control. He was able to control an analog miniature joystick accurately with his index finger when modified with a thimble like top. However, he was unable to keep the cursor over a target and activate a swi

Therefore, targets were selected using a method called dwell select: holding the cursor over the intended target until a time threshold was reached. He was prescribed an on-screen keyboard with a keyboard layout which matched the miniature keyboard. He also purchased a portable computer with a voice synthesizer and voice utility: to clarify his speech and converse with strangers

During the next academic year he had reduced his job tasks to one graduate course which did not require lectures, supervision of thesis students, and completion of a book and two articles. He now had difficulty in targeting keys with the analog joystick. However, he was able to control the four directions of a miniature gated joystick with a similar thimble top. The selection method used with the on-screen keyboard was therefore changed to a quartering technique, whereby the keyboard was divided into four quarters, each of the quarters into four quarters and each of these quarters into four quarters. Dr. S. would choose a key by choosing the overall quarter, then the sub-quarter and then the sub-sub-quarter using the four positions of the joystick. Word completion prediction was also added to the on-screen keyboard.

During the last four months before his death Dr. S. could no longer control his index finger. A remaining voluntary movement was jaw opening and closure. He used automatic single switch scanning (and the same on-screen keyboard) to finish his writing, communicate through e-mail and converse face-to-face with unfamiliar listeners.

Outcome/Social Validation

As much as possible, new skills were introduced early on, when energy was least compromised. Tools which required skills which could not be transferred to the next phase were avoided. Professor S. mastered each of the access systems introduced within a single teaching session, making steady gains in speed and accuracy until his physical condition deteriorated. With the introduction of each new access modification his endurance and productivity improved in the short term.

Equipment which was required for a shorter period of time was loaned (i.e., the miniature keyboard, the wrist rest, the track ball). Despite his rapidly changing skills and needs, additions to Dr. S.'s computer were limited to: the on-screen keyboard, two joysticks, one chin switch and the mounting system. The most costly item was the portable computer with voice synthesizer.

With the assistance of alternative computer access, computer mediated instruction and computer based text, Dr. S. was able to continue teaching until shortly before his death. Dr. S. found that he conversed with more of his students using e-mail and the listserve than he had previously face-to-face. He also felt that discussions were more lively, involving a greater proportion of the class. He found conversing with the voice synthesizer very frustrating. He was not able to interject or claim his turn in academic debates. Conversing over e-mail or the listserve removed the time constraints of face-to-face communication, thereby allowing him to converse on a level playing field.

Literacy Support Technology: Introduction

This section of the course will provide participants with a general introduction to the field of Augmentative and Alternative Communication (AAC). AAC technology continues to expand and develop, and there are many references on the internet. But, not all AAC technology is "high tech". "Low tech" strategies are also frequently used to assist individuals in clarifying messages.

There will be five sections to this module:

1. What is AAC?

2. How to Determine which Strategy to Use? 

   • Strategies used in AAC - "Low tech"

   • "High tech "

3. Case studies/Examples - Work in Progress

4. AAC Links and Resources

Voice Recognition: Introduction

This section of the Adaptive Technology Course will describe voice access to computers with the goal of accommodating a learning disability or physical impairment.

Here are the five sections of this module:

1. What is voice recognition

2. Why voice recognition works and creating user files

3. Voice recognition products

4. Working with continuous speech

5. Creating macros in Dragon Dictate

A note on format:

After a days discussion of an aspect of voice recognition technology there will be some thoughts on how the aspect is relevant to a user with a disability.

What is Communication?

Communication is the process of sending and receiving messages. Both parts of the process are essential, and breakdowns in communication can occur at any point in the process.

Communication of a message can be accomplished in many ways, not just by using ones verbal skills. Eyes repeatedly glancing towards the clock as 5pm looms, shrugging ones shoulders and waving good-bye are alternative ways of conveying messages that we use everyday. Indeed, facial expression, gestures, signing, and eye gaze are simple strategies that very young children use to communicate their basic needs prior to the development of recognizable speech patterns.

What is Augmentative and Alternative Communication?

Augmentative and Alternative Communication (AAC) refers to a number of strategies that aid individuals who are unable to achieve full participation in society as a result of breakdowns that occur in their communication. AAC as a collective term refers to methods that support (augment) or as an alternative to their speech or written communication. As previous discussions have dealt with issues related to strategies to augment written communication, this section will focus on spoken communication. This can include eye pointing, facial expression, gesture, signing, symbol or word boards, or a speech output device. Although we all use these methods from time to time, an AAC user depends on a variety of these strategies all of the time.

Who is a Candidate for AAC?

As stated previously, everyone uses basic strategies on a daily basis to clarify messages that they communicate. i.e. pointing and as you say "I want the big red ball over there". An individual who has difficulty communicating may clearly point in a general direction to indicate a basic need, or to the object which they would like to speak about. But when it comes to more complex communications, this previous strategy quickly breaks down with the message being misunderstood, the individual becoming increasingly frustrated, and/or their basic needs not being met.

AAC strategies may be use to clarify or communicate message. Communication may occur in verbally or in print. Thus, anyone who is unable to use natural speech to meet all of their communication needs is a candidate for AAC.

Follow this link to view an SLP's explanation of who is a candidate for AAC [ www.remc11.k12.mi.us/lcisd/augment.htm ] (Don't forget!!! Hit the "Back" key on your navigation bar to return to the course)

Benefits of Augmentative and Alternative Communication

Use of AAC enables individuals to express needs and wants, to share their feelings, thoughts and who they are - in effect, to fully participate in society.

Where is AAC Used?

AAC strategies can be used in any environment, but, individuals may find that different strategies are required in different environments or social situations. At home, the need may be for clarification of a message that was partially understood. In the community, all verbalizations may be misunderstood, therefore the individual may need to express a more detailed message. Thus, AAC strategies may be utilized in any environment in which an individual has need to express or clarify a message.

There are many strategies used in Augmentative and Alternative Communication. From a picture board to a specialized software program, the strategies chosen must successfully integrate into the individuals lifestyle. It is a challenge to determine which strategies will work optimal. The decision made regarding the best method of AAC for an individual is best achieved with additional input from the team of family members and professionals involved with the individual user - with the potential AAC user remaining the key team member. Other team members would include a Speech Language Pathologist and caregivers and somewhat less frequently Occupational Therapists, educators, physiotherapists, and other service providers as deemed appropriate.

Typical Roles of various team members:

• Individual/potential AAC User: Identify needs for communication in everyday situations, prioritize all intervention goals, ultimate decision maker 

• Caregivers: Assist in identifying situations in which communication breaks down in home and community environments, assist in obtaining information regarding physical and social environments, assist with funding issues. Caregivers role may vary depending on clients level of independence. 

• Speech-Language Pathologist: Consultation regarding language development; able to assist individuals in determining most appropriate symbolic/language system; assistance in lexical organization of symbols; education regarding AAC devices. 

• Occupational Therapist: Consultation regarding physical access and/or alternative access to systems; may consult regarding equipment and positioning needs to maximize physical control for accessing systems; identification of barriers to communication in physical, social and or emotional environments. 

• Educators (if applicable): Identifying individual's needs within educational setting. Encouraging development of expressive communication in classroom environment, implement programming to encourage use of AAC strategies as decided upon. 

• Physiotherapist (if applicable): Consultation regarding gross motor skills, equipment and positioning issues. 

• Computer Programmers and Technologists: May be involved in customization issues involved with alternative access issues. 

• Social Workers: Support to family, identification of global family issues and goals, assist with funding issues. 

The Assessment Process:

An assessment of the individuals need for a communication aid requires that many areas be addressed. The messages required to be conveyed; the type of communication system; the method of access; and the physical and social environments in which the device is to be used must all be considered.

The message requiring communication must be identified. Is it a complex series of tasks or a yes/no response? Does the communicator use a symbol system to communicate, or are they able to spell their messages? How many messages are to be available to be communicated? Does the display of messages need to change during conversation or would messages related to one theme suffice? Is the individual an experienced communicator or is this their first experience using AAC? All these questions have an impact on the final decision made. 

The type of communication system chosen is affected by many factors. The cognitive complexity of the device, the intelligibility of the voice, the overall weight of the system, size of keys and force required for activation, language structure, alternative access options, sensitivity, vocabulary and ability to change displays/screens/messages are a few of the differences between devices. The portability of the system must also be considered. Can a mobile 4 year old safely carry a 4 pound device? 

Physical skills must also be considered. The ability to reach accurately, point independently, exert force to activate a switch, as well as the other skills areas that have been discussed in the previously, must also be assessed. The individuals vision and hearing may also affect the decision made regarding the type of feedback required from the device. 

Suggested Reading

Cerebral palsy and visual impairment: An access challenge [ www.closingthegap.com/cgi-bin/lib/libDsply.pl?a=1013&b=8 ]

Environment

The physical and social environments that the individual lives, works, and socializes in must be considered. Is the individual or those who care for him/her accepting of, and are they able to adequately maintain the system? Are those who the individual wants to communicate with accepting of and are they able to understand the system? If the individual is frequently changing positions, portability and positioning of the device must be considered.

The strategies used in Augmentative and Alternative Communication are classified in varying ways. Frequently communication systems are referred to High and Low "Tech" - generally referring to the level of technology being used. Both High Tech and Low Tech strategies require a significant investment of time for the in-depth assessment and training process. When considering AAC for children, developmental milestones must always be considered. Children require regular reassessments and changes of equipment to suit changes in their physical status, educational and communication needs. This can add a significant stress when considering funding issues for families.

One more formalized questionnaire that has been developed to provide professionals involved in the prescription of such devices background information required is the "Matching Person and Technology" [ members.aol.com/IMPT97/MPT.html ] . A tool that is used by Canadian Occupational Therapists is the Canadian Occupational Performance Measure (COPM) [ www.caot.ca/copm/ ]. This encourages client centered care with the client (or appropriate caregivers) being requested to identify the primary concerns/needs. The COPM has been used in a modified manner by Occupational Therapists involved in the field of Assistive Technology. 

There are many ways to augment a message that one is trying to communicate. A few we have mentioned before, such as gesturing and signing. These can be very successful, as in the use of American Sign Language. But, if ones' motor skills are limited, or if the person receiving the message does not understand it, the communication is unsuccessful and this may not be the most viable option. Pointing to objects is successful if the object desired by the individual is in the immediate vicinity. Gestures are understood by some, but not necessarily by all, and they may only express a limited "vocabulary". Gestures and signing systems have been referred to as "Unaided systems" of Augmentative communication due to their lack of dependence on external objects. "Aided" systems of Augmentative Communication that may be considered "low tech" would include communication boards and simple electronic communication aids.

A communication board may be a set of symbols (Bliss, Picture Communication Symbols, or another similar system) or letters, words, or phrases. The greatest advantage of such systems is their portability, their greatest limitation, the limited number of messages that can be stored on any such device. Modifications are fairly simple, but considerations must be made as to symbol size, lexical organization, symbol set used, number of messages available based on the size of the board

A simple electronic aid could be the use of a Big Mack [ www.utoronto.ca/atrc/reference/tech/switch.html ]switch, a looped tape, or a series of switches connected to generate a limited number but varied messages. These simple electronic devices are able to generate only a limited number ofmessages. A few have alternative access features such as multiple switches and/or scanning. Generally messages on these devices can be changed quite easily. 

Suggested Readings:

Creating communication boards and displays 
[ www.closingthegap.com/cgi-bin/lib/libDsply.pl?a=1009&b=4 ]

Simplified Technology for Children with Disabilities:Assistive Technology and Augmentative Communication
[ www.lburkhart.com/main.htm ]

If facilitators to the individual are unfamiliar with the AAC method chosen, the lack of education must be the first barrier to be overcome. Group learning experiences offer much more than knowledge about the device, but group sharing can provide additional strategies on teaching the use of the device and its' vocabulary.

For references written by and/or for educators who work with students, please note the links referred to at the end of this section.

Hi-Tech aids are electronic devices that are able to generate printed and/or spoken text. There are many different products available. Some products are dedicated for communication purposes only while others are software programs in lap-top computer systems. Some have additional features built in such as appointment schedules and reminders, simple environmental control units, alternative access methods, dual displays, and abbreviation expansion programs. As opposed to simpler low tech electronic communication aids, high tech aids provide a greater number of messages and/or the ability to generate completely novel messages.

As products are constantly changing, it is not possible to review them each individually. For product specific information contact the Communication Aid Manufacturers Association (CAMA) at: 1-800-441-CAMA . They will provide equipment catalogs for the current product lines.

After the individuals skills have been fully assessed, the decision as to which "high-tech" aid may best assist an individual may be based on some of the following features that vary from device to device:

• Literacy Level and Device Display: 

  If the individual is literate, a traditional qwerty or alphabetical display could suffice. If the individual is preliterate, there are various symbol based communication systems. Depending on the complexity of the symbols based language system, a message may require one or more keystrokes to be communicated. The ability to fully customize the overlays is not possible with some symbol based language systems. Devices using symbol based communication vary in the symbol based language system used.

  The number of messages and a symbols based communication system chosen may influence the style of display. If a great number of messages are required, a dynamic display or multiple overlays may be required.

• Output Required of Device: 

  Possible output for devices includes text and voice. Text may appear on a printed tape (helpful if wanting to refer back to a previous statement), or on a changing LCD display. Voice output may be digitized or synthesized speech. Digitized speech is a recorded human voice. The length of total storage of digitized messages varies from device to device. Synthesized speech is pre-stored in the device. With synthesized speech there generally is some choice between the 'voices' available. Environmental requirements may require a voice output system if those the individual interacts with are preliterate.

• Memory: 

  The amount of memory for digitized speech, and message storage and retrieval varies from device to device. The ability to pre-program various phrases is available on some devices. This may increase the individuals speed of communication and ability to be an active participant in on-going conversations.

• Operating Time: 

  The length of battery life varies. A low battery warning is common. Some devices will lose digitized messages when shut off. Typically dedicated communication devices have a greater operating time than devices integrated with laptop computer systems.

• Interfaces: 

  Interfaces for integration as a computer input device are available on some devices. A growing trend is for Infra Red communication to the computer to minimize the need for the user to connect cables.

• Alternative Access Options: 

  The ability to activate the device using various alternative methods including switches, light pointers and visual and auditory scanning vary from device to device. Most have key guards as an option to minimize accidental activations. For individuals who are able to directly access the device, the 'keys' that are activated may or may not provide auditory feedback (i.e. a "click"). Auditory feedback provides additional cues to the individual that the key has been successfully activated. The keys may also be able to vary in size. Some keys that are adjustable in size have "dead" spaces where the key will not be activated.

• Portability: 

  The weight of the device, the ability to mount and carry the device may affect the availability of the device for individuals' communication

Augmentative Communication Solutions: Fitting Technology to the Task - a simple case study of an eighth grade student and his choice for a communication aid, as well as some of the issues that surrounded his decision for this communication aid at this point in his life

The Case study of JT - a 22 year old male who suffered a severe brain injury 2 years preivously as a result of a motor vehicle accident.

AAC Resources

Continuing Education re: AAC

• Barkley Augmentative and Alternative Communication [ aac.unl.edu/ ]

• Barkley Augmentative and Alternative Communication- AAC Assessment Materials and Intervention Reports is a great start [ aac.unl.edu/intervention.html ]

• Simplified Technology for Children with Disabilities:Assistive Technology and Augmentative Communication [ www.lburkhart.com/main.htm ]

• Archives of ACOLUG@LISTSERV.TEMPLE.EDU created to exchange ideas, information and experiences on augmentative communication by people from all over the world. By using e-mail, people who use augmentative communication and their friends and families discuss issues related to augmentative communication, such as equipment, funding, learning techniques and supports. [ listserv.temple.edu/archives/acolug.html ]

• International Society for Augmentative and Alternative Communication [ www.isaac-online.org/ ]

AAC in the Classroom - Teaching Strategies

• Creating Visual Environments [ atto.buffalo.edu/registered/ATBasics/Populations/aac/schedules.php ]

• IMPACT: Implementing Augmentative Communication Training [ www.liberator.co.uk/liberator-pre/docs/impact%20training.htm ]

• Strategies to Motivate Students to Use a Communication System [ www.aea10.k12.ia.us/assist/strtomov.html ]

Glossary

• AAC Vocabulary Terminology [ aac.unl.edu/academic/AACGBM1.html ]

 

2.12.4 Links to vendors of AAC devices, additional resources on the Internet [top]

• Contact Communication Aid Manufacturer Association (CAMA) for a complete package of information on the leading AAC manufacturers products. [ www.aacproducts.org/ ]

• Prentke Romich Company - development and manufacture of augmentative communication devices, computer access products, and other assistive technology for people with severe disabilities. Products include Liberator II, DeltaTalker, AlphaTalker II, WalkerTalker and the Unity [ www.prentrom.com/ ]

• Zygo Industries - high-tech, yet easy to use augmentative communication systems for profoundly physically disabled individuals since 1974. We manufacture and distribute augmentative communication systems, computer access and other assistive technologies. Products include ZYGO®, MACAW, PARAKEET, PARROT and SWITCHBOARD, GEWA (page-turner) and the LightWRITER. [ www.zygo-usa.com/ ]

• Words +, Inc. - manufactures electronic devices and computer software that let people communicate, access computers, control their environment, and more. Products include E Z Keys & Talking Screen for Windows, Pegasus LITE, Message Mates, and the Radar Mouse. [ www.words-plus.com/ ]

• Intellitools - The mission of IntelliTools is to provide high-quality adaptive computer products that are affordable and innovative. We provide these products in order to help people to learn, communicate, and live to their fullest potential. We support our products with respectful service and effective training. [ www.intellitools.com/ ]

• Mayer-Johnson Company - The Mayer-Johnson Company is the originator of the Picture Communication Symbols (PCS). The PCS is a set of 3200 picture symbols used for communication by nonverbal individuals. Our catalog features educational materials, books, and software that use the PCS to help you meet your augmentative communication needs. [ www.mayer-johnson.com/ ]

• Assistive Technology Inc. - is dedicated to providing assistive technology and product solutions to individuals who experience learning, communication (conversational and written), and access difficulties. Products include LINK, MultiPhone, MultiVoice, WriteAway [ www.assistivetech.com/ ]

• Crestwood Company - Crestwood Company of Milwaukee, Wisconsin, presents its 1997-98 catalog, called “Communication Aids for Children and Adults," which has world-wide circulation. It has 275 helpful light-tech products.[ www.communicationaids.com/ ]

• Gus Communications Inc. - makers of the Gus! Multimedia Speech System.A software program that converts any Windows compatible computer into a dynamic display communication system. The user selects the symbol(s) that represent the word (or phrase) that is to be spoken. [ www.gusinc.com/ ]

• Adaptivation - products include Taction Pads, the Voice Pal Plus [ adaptivation.com/ ]

• Able Net, Inc. - products include the BIGmack and SpeakEasy. Our innovative, simple-to-use products minimize individual differences and help people with severe/profound disabilities build meaningful relationships with peers, family members, coworkers and others in their communities through shared experiences that are accessible and enjoyable for all.[ www.ablenetinc.com/ ]

• Sentient Systems Technology, Inc. - provides of multi-platform, integrated augmentative communication solutions. Products include the DynaMyte, DynaVox and DynaSyms. [
  www.sentient-sys.com/ ]

• Lab Resources - 1997 Catalog - a reference for a variety of high tech and low tech aids with brief summaries of the products they carry [ my.execpc.com/~labres/ ]

• Delaware Assistive Technology Initiative - DATI focuses on improving public awareness, public access to information, funding for assistive technology devices and services, training and technical assistance, and coordination of statewide activities.[ www.asel.udel.edu/dati/ ]

Organizations Related to AAC

• ISAAC - International Society for Augmentative and Alternative Communication [ www.isaac-online.org/ ]

• RESNA - Rehabilitative Engineering and Assistive Technology Society of North America [ www.resna.org/ ]

• ASHA - American Speak-Language-Hearing Association [ www.asha.org/ ]

There are seven sections to this week's module:

1. Word Prediction

2. Text-to-Speech

3. OCR

4. A Case Study

5. Tips for Getting the Most Out of Literacy Support Technology

6. Technologies for Remediation and Compensation of Learning Disabilities Technologies for Remediation and Compensation of Learning Disabilities

7. Web Resources

Module by Greg Gay

Literacy support is abundant on the Internet. This support includes a wide variety of information on the development of literacy, reading disability, learning a second language, and the technologies available. There are also commercial, shareware, and freeware programs available for download, which can easily be used to develop systems to assist a persons with literacy impairments.

Technologies such as voice recognition, abbreviation expansion, and reading machines could be included in this section, but they are being covered in some detail in other sections of the course.

Word prediction software can be termed "smart" technology; it learns and becomes more efficient the more it is used. It predicts, based on what a user has entered (either letters or words), what will follow. For example, after typing in the letter "t", the software will display the 10 most likely to be used words beginning with "t". Suppose you were looking for the word "their". The first time a "t" is entered, "their" may not appear in the list of predicted words. (see figure 1). Entering the next letter in the sequence, "h", brings up another list of predicted "to be used words" based on the first two letters of the word. This time "their" is more likely to appear given the odds based on two letters instead of one. Word prediction is more complex the just odds however. It learns. Suppose the word "their" did appear in the prediction list after entering the first two letters. The user could then press or click on the number associated with the word on the prediction list, and the computer would fill in the rest of the word, adding the letters "eir" and a space. The software would note that the word "their" had been used, so next time the word "their" would inch closer to the top of the prediction list. If the word appears very regularly in a users writing it will eventually appear at, or near, the top of the list.

A second type of word prediction, rather than predicting which letters will follow, predicts which words will follow; after completing the word "their" and adding a space, the prediction list will change and present the user with a list of words that could follow it. Similarly, the program will learn which words are most likely to follow another based on a user's writing habits.

Word prediction programs are often part of a larger literacy support package, and are included in augmentative communication packages such as Ez-Keys, or Wivik (see Augmentative Communication section). These allow users with limited mobility to type as few keystrokes as possible.

For those having trouble spelling, word prediction allows them to bypass their weakness and focus more on the creative aspects of writing. Likewise, those who have difficulty assembling gramatically correct sentences have a tool to help them overcome this difficulty.

Last Modified: Wednesday Jul 30, 2003 - 09:35. Revision: 1. Release Date: Tuesday Jul 29, 2003 - 14:00.

 

3.1.2 Text-to-Speech [top]

Text-to-Speech (TTS) software converts text on a computer screen into spoken words. Like word prediction software, TTS software can learn and become more efficient with repeated use. TTS software comes with a dictionary of words and phonemes, thus avoiding the need for a speech synthesizer. It will recognize a word that it has never seen before and speak it with a compilation of phonemes from its phoneme dictionary. In English, pronunciation based on regular letter to sound correspondence is not always a good strategy however, so new words which contain irregular letter/sound correspondence are often mispronounced. When such occurs, it is usually necessary to correct the error in pronunciation through a diction subprogram included with the software, typing in the word and its correct phonetic equivalent. If corrections are not made, the program will assume that the mispronounced version is correct and use it on subsequently encountering that word. In some instances where a word can be pronounced in a number of ways (eg, read: I have read or I will read.), TTS programs tend to stick to the most common pronunciation unless it is changed in the diction subprogram. Few TTS programs have advanced to the point where they can base pronunciation on the context in which a word appears.

A few mispronounced words does not usually hinder comprehension however; users tend to build context as they listen and make the correction in ongoing self-speech. In the beginning, a user's attention may be swayed by mispronunciations, though this problem will disappear with repeated use. Many mispronounced words can be very distracting however, and comprehension can be hampered. Thus it is important to correct mispronunciations when they are first recognized.

A word that is recognized and processed as phonemes, will be added to the word dictionary and recognized as a whole word after repeated use; the time needed to access and pronounce the word decreases.

Many TTS programs will highlight text being spoken, most often by word or by sentence. This is analogous to following the bouncing dot, often seen in television commercials. This acts to focus the viewers' eyes on the words being spoken or read.

TTS programs can be used for both reading and writing. For reading, a user will usually highlight a chunk of text (eg. a paragraph, a page, or a few pages), click on "read", and the computer will start reading the selected text. The reader can either read along or just listen. For those having phonemic processing difficulties (the most common among reading disabilities), TTS programs can help them overcome their shortcoming by supplementing self-speech and filling in the blanks where letter to sound correspondence fails, or is delayed In many cases the amount of processing space required to decode letters and convert them into sounds leaves little for the comprehension process. TTS programs can reduced strain on working memory, helping free up processing space for comprehension.

TTS programs can be used as writing tools as well. A user can type and simultaneously listen to the words they are typing. Though this can be distracting in the beginning, with repeated use the distraction become less intrusive. Words mistyped or misspelled are immediately recognized and can be corrected (a spell checker should be used along with TTS). TTS and word prediction programs are often combined to aid in writing.

Similarly, a user can combine TTS and word prediction with a common word processor such as Wordperfect or MS Word, which feature spelling and grammar checkers. Documents can be written, spell checked, then read aloud. Errors are easily recognizable when they are heard.

TSS programs can be helpful for anyone who writes. They are invaluable as a proof reading tool and can greatly assist in note taking (see the tips section of this module)

Optical Character Recognition (OCR) software is used to convert printed text (ie. text on paper) into electronic form. Most OCR packages are compatible with the major word processors and will convert scanned documents into a format which can be opened in them. Documents can also be coverted in rich or plain text formats. These documents can then be opened in the appropriate word processor and read with a Text-to-Speech program. Though it may seem time consuming to scan in and convert a whole book chapter or journal article for example, the increase in speed of reading (though still slower than the average reader), and increased comprehension as a result of reduced processing load, greatly reduces the effort needed to read for someone with a reading disability.

OCR programs are usually standard with the purchase of a scanner (though usually a limited edition). An OCR program will take a scanned image of a page and compare the lines and squiggles with a set it has in memory, and where it finds a match, will write a letter in a sparate document. After the OCR process you end up with picture of the page you scanned and another document containing the recognized characters.

There are many settings that can be adjusted in an OCR program which will influence how well a scanned, then OCRed, document turns out. With incorrect settings, an OCRed document can end up being a jumble of letters and other symbols. Similarly, if the text being scanned is degraded, for example coming from an old, yellowed, journal article, there are likely to be many errors in the OCRed text. Small text is also more difficult to recognize; scanning a reduced photocopy of an article or book chapter will also result in many errors. Opening the document in a word processor and running the spell checker will correct many mistakes, but it is much more time efficient to get the scanner setting right. It is helpful to be careful when photocopying documents for scanning by adjusting the brigthness setting of the photocopier so that there is no background toner is left within the text. Books that have been marked up by previous readers also provide a problem. Most OCR programs are confused by markings in amoungst text and will not recognize it.

Depending on the individual, a few errors in the OCRed document may not pose a problem, as they can usually correct errors while they listen based on the context in which words appear.

For most scanners, the optimal resolution setting is between 200 and 300 dpi; any lower letters become to degraded, and any higher the scanner begins to pick up imperfections in the paper, adding noise in amongst the letters to be OCRed, thus reducing the quality of the final OCRed document. Depending on the OCR program you choose to use, you may also be able to compensate for degraded text in an original document by adjusting the brightness and contrast of the scan.

In the final year of his undergraduate degree Jeremy was referred for a psychological assessment after one of his professors noticed that it took him an exceedingly long time to read passages assigned in class. The intake interview revealed that Jeremy was an exceptionally bright student, though he was only performing at about average. His notes were well organized and extensive and contained many mnemonic devices to aid learning. They also revealed an excess of spelling errors. He performed at a level commensurate to his abilities on written assignments however,as he had mastered the use of a word processor which allowed him to bypass his spelling difficulties. He performed poorly on tests however, particularly those that required a fair amount of reading. On many occasions Jeremy failed to complete tests in the time alloted, though the portion he did complete was at or above average performance. Jeremy was aware that he was above average intellectually, and found it very frustrating that he performed so poorly on tests, and that it took him so long to complete reading and written assignments.

His disability was an annoyance to him rather than an impediment. Though he realized for quite sometime that he was a below average reader, it had never occured to him that he had a disability, and it had gone unrecognized through his grade school years because he had adapted himself so well. Frustration had lead Jeremy to drop out of highschool at grade eleven. After several years in the work force he returned to college and received his highschool diploma then went onto university.

In the results of the assessment, Jeremy performed at the 91 percentile on the performance scale, and the 88 percentile on the verbal scale, of the WAIS-R. On the Nelson-Denny he performed at the 7 percentile for reading speed but at the 78 percentile for comprehension, given time beyond the 20 minute completion criteria for the test. It was also found that he had a deficit in working memory capacity as revealed on the digit span task. On the list learning and paired associate tasks he performed at near perfect however. He attributted this to a strategy he applied to visually associate list items. Elaboration strategies had helped him bypass his deficit in working memory capacity

It was clear that Jeremy had adapted to accomodate his disability, but he needed accomodation from his school in the form of more time on tests. It was recommended that Jeremy receive extra time to write tests, and be accomodated with a computer system that would reduce the time he spent reading for course assignments.

Jeremy was given time and a half to write tests, and was supplied with a Pentium 120 MHZ computer, a Microtek flatbed scanner, WordScan (an OCR program),and textHelp, a literacy support package developed by Lorien systems. Jeremy easily learned to use the software and equipment with a minimum of instruction.

By providing Jeremy with extra time on tests, within a semester his GPA rose a full grade point, bringing him from a mid B average to a mid A average. He also indicated that he had more time on his hands as a result of having to spend less time reading for course assignments, and was leading a more active social life.

In this case, as is often the case, a person of above average intelligence is held back by a specific deficit in reading. Since it was clear that Jeremy was a motivated learner, having developed many strategies to compensate for his weaknesses, it was decided that rather than a remedial approach, a compensatory approach would be used. This approach proved successful as Jeremy went on to complete his undergraduate degree with distinction, and then went onto complete a Master's degree with high distinction, and is currently working on his Doctorate. For a young man who had barely got by in high school, and had eventually dropped out, this was quite an accomplishment. He attributes his success to the renewed pleasure he gets out of reading, a task that was exceedingly stressful prior to his learning of the technologies that could reduce the effort.

 

3.1.5 Tips for Getting the Most Out of Literacy Support Technology [top]

 

3.1.6 Technologies for Remediation and Compensation of Learning Disabilities [top]

Greg Gay
Ontario Institute for Studies in Education
University of Toronto
1996

1. Abstract

2. Introduction

3. Technologies in Remediation and Instruction

4. Technology as a compensatory tool for persons with learning disabilities

5. What is quality in the use of technology for children with LD?

6. Conclusion

7. References

Abstract

A relatively new area of research has emerged in the 1990s which focuses on the use of technologies for the remediation and compensation of learning disabilities. The international symposium on "Technology for Persons with Learning Disabilities", held in July of 1993, resulted in a collection of papers which address the uses of these technologies. They are reviewed here. Remediation has been the primary use of these new technologies but they have also been used as tools for persons with learning disabilities to circumvent their deficits, thus improving the quality of their lives. The discussion focuses on the efficacy of computer assisted instruction and the use of text-to-speech technologies, and the research conducted over the past decade, and briefly talks of the criteria for development of quality technologies. The advances of technologies since the symposium are also discussed, and direction is offered for future research on their effectiveness as tools for remediation and compensation of learning disabilities.

Word Prediction

• Use it regularly when composing documents and the words you use will move increasingly closer to the top of the prediction list.

• If you do not have difficulty creating coherent sentences, you should probably not use word prediction. Spell checking a document after it is complete is usually more efficient than using word prediction to correct as you go along.

Text-to-Speech

• Use it regularly when composing and reading documents and it will become increasingly faster and more accurate.

• Correct pronunciation errors the first time they are detected, they will become increasingly more difficult to correct the more often the program speaks the incorrect pronunciation.

• Try a variety of TTS programs and stick with one you like. Part of being an efficient listener of computer generated voice, is getting used to its imperfections. Though the technology is about to pass this stage, for the meantime, computer voices take a little getting used to. Macintosh machines do a much better job with computer generated voices than PCs.

• Use TTS to read any electronic document, whether you have a disability or not. Most people agree that reading from a computer screen is more difficult than reading from paper. TTS can make reading from a computer screen easier than reading from a page.

Scanning and OCR

• Spend some time learning how to manipulate the scanner settings and find the optimal setting for scanning text. This will greatly reduce the time spent correcting errors in poorly scan pages.

• Save your settings (most scanning software allows this) so that if they change for some reason (eg. you decide to scan graphics) you won't have to go through the setup process again.

• Save templates for pages that have the same layout. Instead of locating the text you are adding to a recognized document templates will locate it with the click of a button.

• Be aware of effects photocopiers can have on copied documents and subsequent OCR, and be aware of the effects of degraded text. It is often possible to adjust scanner settings to compensate for degraded documents.

  Technologies for Remediation and Compensation of Learning Disabilities

  ---

  Technologies for Remediation and Compensation of Learning Disabilities

  Greg Gay
  Ontario Institute for Studies in Education
  University of Toronto
  1996

  1. Abstract

  2. Introduction

  3. Technologies in Remediation and Instruction

  4. Technology as a compensatory tool for persons with learning disabilities

  5. What is quality in the use of technology for children with LD?

  6. Conclusion

  7. References

  Abstract

  A relatively new area of research has emerged in the 1990s which focuses on the use of technologies for the remediation and compensation of learning disabilities. The international symposium on "Technology for Persons with Learning Disabilities", held in July of 1993, resulted in a collection of papers which address the uses of these technologies. They are reviewed here. Remediation has been the primary use of these new technologies but they have also been used as tools for persons with learning disabilities to circumvent their deficits, thus improving the quality of their lives. The discussion focuses on the efficacy of computer assisted instruction and the use of text-to-speech technologies, and the research conducted over the past decade, and briefly talks of the criteria for development of quality technologies. The advances of technologies since the symposium are also discussed, and direction is offered for future research on their effectiveness as tools for remediation and compensation of learning disabilities.

Word Processing and Reading

• Set up your word processor so that your OCR and TTS programs can be run directly from its button bar. This will save time hopping back and forth between programs. Some OCR programs require that you associate it with a word processor. This will allow you to aquire an image and OCR it directly from a menu listing (usually placed in the "file" menu when you associate the two programs)

• Work with two word processors, or two documents within the same word processor, and a TTS program simultaneously. This allows you to listen to one document, and take notes in another. You can type into the second word processor as you listen, or you can cut and paste important statements from one document into the other, pause reading if taking notes or pasting text detracks your comprehension. With practice, it is possible to carry out multiple activities while listening.

• Use a TTS program to proof read what you write. This can benefit disabled and non- disabled readers alike.

• Develop a routine for the whole process from scanning, to OCR, to correction of errors in the scanned document, to reading and taking notes, then to using those notes to write new documents. This will be a highly personalized set of strategies which develop over time (a couple months with regular use), but by being aware of the procedures while you learn them and keeping your goal in mind, one can master the process in a relatively short period of time.

• Choose between having your written documents read to you while you write them, or after they are partially completed. If the TTS is distracting while you write, turn it off and use it only to read back chunks of text.

• Consider a continuous speech voice recognition program for dictating new documents (eg. Naturally Speaking)

It was not until the early part of this decade that serious attention was paid to developing technology for persons with learning disabilities (LD). In July of 1993 an international symposium was held to address the subject, bringing together researchers from six countries around the world to share advances that had been made developing hardware and software that could be used to improve the lives of those with LD. The purpose of the symposium was to open international dialogue regarding implications of technology for persons with LD, to promote international cooperation, identify current technologies, and to establish research priorities for investigating the efficacy of technology for enhancing the lives of these people.

Raskind, Herman, & Torgesen (1995) described several major themes that emerged including: general models and paradigms, purpose/intent, social/psychological implications, contextual consideration, ethics, and cross-cultural considerations. Two general paradigms emerged. The first was a traditional scientific/empirical world view which emphasized the use of technology for remediating academic and cognitive deficits of individuals with LD. Technology could be used to present large amounts of highly focused, carefully sequenced, and effectively monitored instruction and practice on a variety of academic skills, cognitive skills, or content areas.

The second paradigm that emerged was a holistic/constructivist perspective which emphasized the use of technology to help persons with LD accentuate strengths, while circumventing areas of deficits. Further, technology has the potential to allow persons with LD to recognize special talents that may otherwise go unnoticed, and allow them a certain sense of empowerment, letting them pursue life goals rather than academic achievement.

The purpose/intent for utilizing technology with persons having LD fell into six categories: (a) remediation, (b) instruction, ( c) compensation, (d) assessment, (e) information access, and (f) fostering special talents. Remediation and instruction were classified in two different categories to reflect instruction in skills development and instruction in content areas. Compensation focused on providing persons with LD an avenue for independence, or a way to bypass areas of deficit. With regard to assessment, technologies offer a precise, objective, and flexible tool for assessing cognitive abilities and deficits, providing a cost-effective means of conducting widespread screening and early detection of LD. Next, information access is particularly relevant with today's growing flow of information available from online databases, electronic bulletin boards, and CD reference systems, and provides persons with LD access through the use of speech technologies, still graphics, and interactive video. Finally, it was seen that computer technologies could be used to foster special talents of persons with LD in areas of visual arts, music, and divergent thinking, capitalizing on strengths often found in persons with LD that are not fostered in our educational system.

The social/psychological implications of computer technologies can be either positive or negative depending on the particular person, task, technology, and context. On the positive side, technologies offer persons with LD a common interest from which peer relationships can be developed, while on the negative side technologies may serve to enhance isolation if used as a substitute for interpersonal relationships.

Contextual considerations need to include the implications of technologies in environments such as work, social, and familial contexts. It was agreed that technologies may not be appropriate in all contexts. Considerable attention was given to a "lifespan perspective" for technology utilization. Particular situations, goals, desires, challenges, interests, and tasks must be considered within a developmental framework spanning from childhood through to old age. While technologies may be appropriate for providing remediation at a particular point in life, at other times remediation may be detrimental to a person's development. Likewise, the role of cultural context must be considered, with the effects of language, religion, social structure, customs, and economics playing an important role in how technologies are utilized. This area received considerable attention at the symposium and was discussed separately from contextual considerations.

Cross-cultural concerns include the definition of LD across varying societies. Definitions are not universally recognized or accepted. These divergent definitions are likely to affect how technologies are used. We must be cautious not to impose a "single world view" that may inhibit specific cultural norms, values, or practices. Since it is the Anglo-American developers which dominate the software industry, there is a need to explore ways in which technologies can be used to enhance or preserve specific cultures. Regarding language, software appropriate for instruction of the phonological aspects of language in cultures which use an alphabetic orthography, is not appropriate for cultures whose language is ideographical, such as Chinese, for example. Economically there is the potential of increasing the gap in cultural development; inaccessibility of technologies to those in third world countries runs the risk of setting them even further behind those of the first world. It was also noted that technology creates it's own culture, or "hyper-culture", with its own language, norms, and values. This acts to bring persons of different ability together with professionals in the area of LD from different cultures.

Ethical issues focused on the overriding concern of the dangers of rushing into using technologies without fully understanding their complexity and potential effects. We need to remind ourselves that use of technologies for persons with LD needs to be based on solid theoretical constructs and upon valid research indicating the efficacy of specific technologies and technological approaches.

The primary focus of this paper will be on technologies as remedial and compensatory tools, focusing on computer assisted instruction (CAI), and text to speech (TTS) technologies as a means of bypassing reading deficits. Quality of CAI will also be discussed.

 

3.1.6.2 Technologies in Remediation and Instruction [top]

A central issue of the symposium was on remedial and instructional uses of technologies. The primary focus was on the use of TTS technologies. Several researchers offered their understanding of its uses, and summarized research that focuses on the efficacy of using particular technologies for remediation and instruction.

Torgesen and Barker (1995) offer suggestions on how different CAI programs can help children with LD learn to read more effectively. The purpose of their research was to illustrate how computers have the potential to provide substantial help in both preventing the emergence of serious reading problems in young children and providing remedial help to children demonstrating difficulties in reading. They based their efforts on research indicating that reading disabilities result from a specific deficit in the phonological domain, and the resultant difficulties children have acquiring accurate and fluent word identification skills. These children experience special difficulty in academic programs that do not provide explicit instruction in phonological decoding; they cannot reason the underlying alphabetic relationships that are essential to generalized word reading skills. The consequence is children receive less practice in reading, read fewer words, and read less outside of school than children who learn to read normally. These children also find themselves reading material that is too difficult for them which results in poor comprehension and a displeasurable experience. The focus of instruction for these children is on correction of word reading problems, at the expense of instruction in comprehension and thinking skills which become the centre of instruction for normal readers.

Torgesen and Barker (1995) go on to discuss the use of computers for prevention and remediation of reading disabilities. It has been argued that the use of computers in special education has focused on providing drill and practice exercises while the use of computers in other educational settings has tended to expose children to a wider variety of software. Similarly, children with sensory disabilities use technology to compensate for their deficits, while children with LD use technology to remediate their disability (Poplin, 1991).The most common use of computers in special education has been to supplement teacher instruction by providing practice to increase fluency of skills that are originally taught elsewhere. This has been criticized as "simple-minded", or "dull and uninteresting", and as such underutilizes a computer's capability to provide interesting, novel instruction that may enhance more complex thinking and problem solving in young children. Torgesen and Barker (1995) argue that this attitude may be a mistake and suggest that children with reading disabilities require more drill and practice than their normal reading peers. They contend that LD children need to be exposed to the variety that their normal reading peers are exposed to, and that drill type programs need to be made more appealing.

Torgesen and Barker (1995) go on to discuss the research that has been done with several computer applications that focus on teaching children reading and pre-reading skills, centering on programs designed to improve skills for identifying words from print. They discuss their own research with DaisyQuest and Daisy's Dilemma, two programs designed to teach 4-7 year old children phonological awareness, training analysis and synthesis (segmenting and blending) of text to speech. They note however that the current technology in speech recognition (SR) was not sufficiently developed. Since it is much easier to provide computer instruction in phoneme identification than it is to provide instruction in segmentation skills, which requires SR, the programs provide most of their instruction in phoneme identification, which utilizes TTS technologies that are sufficiently developed.

Children receive instruction and practice with seven different phonological awareness tasks through a graphic rich environment which can be controlled exclusively by mouse. An instructional component is also a part of these programs so the focus is not strictly on drill and practice. Even the youngest children can operate the programs without the supervision of a teacher. Fifty-four children between 76 and 102 months of age were selected for the study of these programs based on their low scores on the WRMT-R word analysis subtest. These children were randomly assigned to three groups: 1) those receiving approximately eight hours training on DaisyQuest and Castle Quest (DQ), 2) those receiving equivalent training with Hint and Hunt (HH), a program which provides practice learning to decode medial vowel sounds in short words, and 3) a math control ( C) group who spent an equivalent amount of time using math programs on the computer. On four measures of phonological awareness adapted from "An Evaluation of Computer-Assisted Instruction in Phonological Awareness with Below Average Readers" at posttest, the DQ children significantly out performed both the HH and C groups on three of the four subtests, and outperformed both groups considerably on measures of word identification and word analysis adapted from the same test. It should be noted here however that the tests used here require both validation and replication studies to confirm their validity as a measure of reading skill. It should also be noted that generally, children who are selected for the treatment group are those judged to be most in need of specialized instruction. There is always the possibility that these children scored uncharacteristically low and regression toward the mean may have occurred (also see Lundgren, 1995).

Torgesen and Barker (1995) went on to investigate programs which focus on improving children's ability to use subword units (letters and letter groups) for identifying words. Hint and Hunt was developed to increase children's ability to fluently decode medial vowels and vowel combinations, skills often difficult for children with reading disabilities. Results from other research indicate that these children do acquire generalized decoding skill with vowels as a result of exposure to this program (Roth & Beck, 1987, cf. Torgesen & Barker, 1995). A second program, Construct a Word, helps children learn to recognize common word endings, or multi-letter units as an aid for decoding words, providing practice in matching beginning consonants and consonant blends with appropriate word endings. Following approximately 20 hours of training using this program children improved from a 1.7 to a 3.0 grade level of reading based on scores from the California Achievement Test (CAT), while a control group only improved from a 1.6 to a 2.0 grade level of reading. At the same time the treatment group increased from 2.6 to a 4.5 grade level on the vocabulary subtest of the CAT while the control group increased from 2.6 to 3.5 grade level (Roth & Beck, 1987, cf. Torgesen & Barker, 1995). Results found by Torgesen and Barker (1995) are less impressive, and for the most part insignificant, though they indicate that the control group in their study was receiving intense instruction in reading skills, suggesting that teacher intervention is as effective as computer intervention.

A third class of programs were studied by Torgesen and Barker (1995) which focus on recognizing individual words as wholes, designed to increase the sight vocabulary of children with LD. Though no results are offered it is suggested that these types of programs include methods for monitoring progress and include practice on words that are particularly difficult for children with LD.

Lundberg (1995) studied the effectiveness of "talking computers" in special education. He notes that non-automatic, slow, effortful, and dysfluent word decoding, or word recognition, results in a major obstacle for successful reading comprehension. And, as past research indicates, these core symptoms lead to retarded growth of vocabulary, verbal intelligence, and the general ability to comprehend, a so called Matthew effect (Stanovich, 1986, cf. Lundgren, 1995). The challenge is to provide children with reading disabilities the opportunity to acquire these higher order skills despite poor phonological skills. One method of doing this is with inbuilt speech support for computers in which children can highlight difficult words for the computer to speak back to them. This reduces the decoding demand placed on short term memory, and provides immediate corrective feedback. Reading disabled children are thus able to read material that is above their decoding ability, and the primary focus shifts from decoding to processing meaning. It is noted however that the reader must know when help is needed in order to utilize this technology. A methodological factor that hinders interpretations of results from studies of the effectiveness of CAI is also discussed; since the tendency is to offer this instruction to those most in need, the control group is more likely to have higher pretest scores and the treatment group is likely to show larger gains thus resulting in regression and an interaction which is difficult to analyze statistically. Likewise, studies of this kind have been restricted to relatively small samples thus the statistical power of analyses are relatively low. It is suggested that more qualitative data be collected, such as teacher reports and case studies, in order to better understand the effects of technology on instructing children with LD.

Lundberg (1995) describes the findings of a series of studies conducted by one of his graduate students. Two drill-centered programs are discussed. The Read-Write program presents briefly on a computer screen either whole words, or segmented parts of words, which the subject must subsequently type and try to spell correctly. A game element is added in which more points are offered for briefer exposures and fewer repetitions of the exposed word, each controllable by the reader. Attempted spellings, use of repetition, and use of speech feedback are recorded in the computer for teacher lead discussion afterwards. The purpose of the program is to encourage the discovery of segmental structures, the architecture of words, root morphemes, inflections, derivations, syllables, spelling patterns, relationships to other words, and so on. The Word-Matching program presents a target word briefly in the center of the screen followed by the presentation of four words at the corners of the screen, one of which is the same as the target word. The student must identify which word appeared in the center. The purpose of the program is to boost automaticity of word recognition. Both decision times and accuracy are recorded so error responses can be analyzed to provide diagnostic direction for further remedial teaching.

A total of 83 poor readers in grades 2-8 worked regularly with the programs two or three times per week over the course of a school year for a total of about 30 hours. The level of difficulty was automatically adjusted for each reader. A group of 59 control subjects, also diagnosed as poor readers, received traditional special education instruction without computer instruction. Comparison of pre and post test for each group were made. Again, one limitation of this study was that the children more in need of remedial instruction received the computer assistance. Results indicate that there was no effect of computer training at the younger ages but a clear positive effect emerged at the grades 7 and 8 level, which was interpreted as indicating that a certain amount of metacognitive ability is required to benefit from such CAI. The author does not expand on this point. It is also pointed out that the older children are more likely to be skilled typists, another factor which affects the outcome of such programs. Comparing the results from the older children in the treatment and control groups indicate that those receiving computer instruction made more significant increases in their word reading and spelling scores. A subsequent study with a small group of grade 7 reading disabled students used results of a reading comprehension test as the criteria for success of computer programs over special education instruction. A crossover interaction found also suggests that the CAI provided better comprehension instruction, favouring post test scores for the treatment group over the control group. A regression effect cannot be ruled out here however, since the control group's scores at pretest were significantly higher than those of the treatment group. A parallel case study of two students over the course of three years had one student receive special education instruction and the other receive special education and CAI. A series of six cloze-tests were administered to both subjects over the course of the three year study and showed clear advantage for the student who had received both special education and CAI. Though this series of studies is limited by the small sample sizes and the possibility of regression effects, their convergence points to the effectiveness of CAI for improving the reading skills of children with reading disabilities, and they stimulate interest in the area of computer adapted instruction.

Leong (1995) also conducted research on TTS computer systems used to improve comprehension in reading disabled children. Results from previous studies investigating the effectiveness of TTS for improving comprehension have been mixed. As Lundberg (1995) has mentioned, factors such as metacognitive activities, and perhaps more so, working memory capacity, determine how effective computer mediated reading is for disabled readers. (Swanson & Trehan, 1993, cf. Leong,1995). Leong's study was thus design to include these factors in conditions each using TTS. It was hypothesized that children of older grades and of superior reading ability would comprehend better than younger and/or less skilled readers, and that providing simplified passages or explanations of difficult words would improve comprehension. Scores were based on answers to inferencing questions and ratings of verbal summaries of passages read. One hundred and ninety two students from grades 4, 5, and 6, were divided into above-average (AA) and below-average (BA) readers and assigned to four groups based on vocabulary (CTBS), general ability (BAS), word reading (WRAT-R), metacognition (IRA), and working memory (WKM). These groups were: 1) on-line reading and DECtalk auding (reading along with synthesized speech), 2) DECtalk with the addition of explanations of difficult words (presented both in text and synthesized speech), 3) DECtalk with the addition of explanations and metacognitive activities (i.e. reading awareness), and 4) DECtalk with simplified passages (low frequency words replaced by high frequency words). Results indicate differences across grade levels on measures of metacognition, general ability, and working memory, but not on vocabulary or word knowledge. Results of an ANCOVA using three initial tests (BAS, IRA, WKM) as covariates showed significant effects of grade ( 4, 5, 6), reading level (AA, BA), and response mode (questions or summaries) in favour of inferencing questions, but no significant differences were found between the experimental conditions.

In a second study using the same methodology as the one just mentioned, Leong (1995) compared "garden variety" (GV) poor readers, referred by teacher nomination, with reading level (RL) and chronological age (CA) matched control groups. Results indicate significant differences between group and response type, but not experimental condition. Results were comparable to those in the first experiment. The results of both experiments considered together indicate that a change occurs in the way children read between grades 4 and 5, suggested by differences that were found between the grade 4 group and the other two groups but not between the grade 5 and 6 groups. It was suggested that children switch from a "knowledge telling" to a "knowledge transformation" strategy at about age 10 (Bereiter & Scardamalia, 1987, cf. Leong, 1995), so it was advised that more research be devoted to identifying this change and the effects this has on the effectiveness of CAI. It was also suggested that computer-mediated reading with or without DECtalk, may not be superior to off-line reading at least for prose or language comprehension. Likewise, no beneficial effects of metacognitive-like activities were found though it is not clear why this was the case. This research contradicts other's findings that reading disabled children benefit from on-line reading with TTS auding (no reference provided by the author other than mention of work by Wise & Olson, Barron, and others). In conclusion the author suggests that the negative results point to the complexity of computer-mediated comprehension training, and that the pros and cons of computer-mediated reading need to be seriously evaluated.

 

3.1.6.3 Technology as a compensatory tool for persons with learning disabilities [top]

Another primary focus of the symposium was on liberating persons with LD by way of technology that could be used to circumvent their disabilities. The use of technologies for persons with LD can be observed from two philosophical stances (Poplin, 1995). First, reductionism holds that world knowledge can be broken down into parts, and these parts can be added together to explain a whole phenomenon or meaning. This is parallel to the traditional approach discussed earlier. Holism, on the other hand, holds that world knowledge cannot be broken down into parts and that acquiring knowledge is an exponential process in which phenomena and meaning are more than the sum of their parts. This is parallel to the constructivist approach discussed earlier. With regard to the use of technologies for improving the lives of persons with LD, a reductionist may say that remediation of the part that is deficient is how technology should be used. A Holist on the other hand may say that compensation for the part that is deficient is how technology should be used. Both of these perspectives need to be considered in special education. In the case of LD, component skills in reading for example, need to be explicitly taught with a focus on remediating the deficient subskills. On the other hand, LD is life long and can be debilitating if allowed to hinder learning in areas other than the specific deficit. Thus remediation and compensation are important features of technology that can assist persons with LD to improve the quality of their lives.

Additionally, Poplin (1995) goes on to discuss the use of technologies for helping persons with LD recognize special aptitudes. Poplin includes a quote from Ward (1991, cf. Poplin, 1995) that is particularly relevant to the topic of aptitudes and LD:

Very long ago, hunting was all-important and reading (in whatever form) was a pursuit of marginal value. In the modern era, reading is all-important and hunting is a pursuit of marginal value. We might imagine, however, the beginning of another era, a third phase of development--a post literate society where the most highly valued combination of traits is reversed once again...(p. 84)

...[aptitudes as marketable skills] may gradually begin to reward, instead, the creative, visual-thinking dyslexics and others like them who have had such a difficult time in literate society for so long....(p. 89)

With the advancements in technology, these "visual-thinking dyslexics" may become an important part of the development of the technological era.

Poplin (1995) points out that special education for those with sensory disabilities do not focus on remediation as does special education for LD. A number of technologies are available which can be used as compensatory rather than remedial tools such as: word processing, spell checking, proofreading programs, speech recognition, speech synthesis, optical character recognition, talking calculators, and several more. It has been argued by some that such use of technology can create dependency. This cannot be ruled out, however as adults, we come to understand our limitations and try not to use compensatory tools when it is not necessary. For children however the focus is not on preparation for life but rather on particular processes that require remediation. Using a word processor and speech synthesis for example, a child can learn to write despite problems reading and spelling, and can be quite successful. Trying to remediate the deficit is often a laborious task, and one that takes away from the more important task of being able to read or write. West (1991,cf. Poplin, 1995) has noted, based on Gardener's theory of multiple intelligences, persons with LD, while having a deficit in one area also tend to be exceptional in other areas of intelligence, and particularly with technologies. Using the Computer Aptitude, Literacy, and Interest Profile, Poplin found that LD students show the same high level of computer aptitude as normal functioning peers. Similar results were found for music, visual arts, and divergent thinking. Together this evidence suggests that instruction should be geared toward developing strengths, so as to develop them in preparation for life.

Several studies are discussed by Poplin (1995) which note characteristics of successful adults with LD. Some of these characteristics include an understanding of the disability one has, perseverance and coping strategies, a drive to be in control of one's own life, using technologies as assistive devices, and as a tool for increasing creativity. These characteristics are those that should be fostered in our schools but are not. It was also noted that the adults in these studies almost uniformly agreed that school had nothing to do with their success, and criticize those who insist that reading and spelling are critical for success. Technology easily circumvents deficits in these areas.

Raskind and Higgins (1995) investigated the effects of speech synthesis on the proof reading efficiency of post secondary students with LD. This was an attempt to research an area that has been relatively untouched. Students with LD were assigned to three groups: 1) those using speech synthesis that highlighted and spoke words on a computer monitor, 2) those having text read aloud to them by another person, and 3) those receiving no assistance. Those in the speech synthesis group were able to recognize more errors in their writing than those in the other two groups. The difference between the speech synthesis and LD groups was not significant except for error detection; the LD group performed best. Both groups performed significantly better than those receiving no assistance. This supports past research that indicates that hearing text helps persons with LD identify more errors in their work than when they are left to their own, and increase the quality of their writing (eg. Brown, 1987; Lees, 1985, cf. Raskind & Higgins, 1995). The success of the speech synthesis group was attributed to the lack of need to attend to decoding thus freeing up working memory to concentrate on proofreading. It is also possible that receiving input in two modes (i.e. seeing and hearing) may have also resulted in superior performance for those reading and listening. It is not clear however, why the speech synthesis group outperformed the read too group given that other factors such as prosody and body language of the readers should also give clues to potential mistakes. It could be that the speech synthesis group was exposed to a more compelling mode of compensation. Long term studies need to be conducted which investigate the motivational effects of technologies and the resultant effects once the novelty wears off.

It should be noted however that performance was still low with only about 35% of errors detected by the speech synthesis group, and their superior performance was limited to identifying capitalization, spelling, and typographical errors, while those who were read too performed better than the speech synthesis group identifying grammatical errors. Interestingly, speech synthesis does not allow one to identify capitalization mistakes. Why this occurred is not clear. Raskind and Higgins (1995) note that at the postsecondary level, the focus of disability support services is on compensating for a weakness, while in K-12 special education the focus is on remediation. It is also pointed out that with the shortage of persons available to read too those with LD, the cost of hiring such people, and the increasing numbers of persons with LD entering postsecondary education, compensatory strategies utilizing computer technology is both economical and more efficient than traditional compensation. Though the results of this study are limited given the small size and homogeneity of the sample, it does suggest areas for future research and it does suggest that speech synthesis is a viable means of helping persons with LD obtain independence.

Larsen (1995) discusses the factors which determine quality CAI. Three considerations must be made when developing CAI: 1) a general pedagogical theory, 2) considerations related to the specific impact of the computer on the learning process, and 3) identification of the specific nature of the child's LD and the implications for choice and development of computer assisted programs. A general theory of learning must include the notion that learners are the most significant factor in their ability to learn, with the teacher playing only the role of an "enzyme", or something that facilitates, enhances, and accelerates the inner processes of the learner. This "enzymatic theory of education" requires a teacher to know the factors which enhance learning when using and designing CAI, such as: the degree of learner control, motivational factors, feedback types, use of graphics, and screen design. Gay (1986, cf. Larsen, 1995) notes that the effect of learner control is moderated by the prior knowledge of the learner; those with prior knowledge of a subject are likely to benefit from learner-controlled instruction while those with little or no prior knowledge of a subject are not. Thus, when designing CAI, it is critical to know the experience the learner has with a subject when giving them learner controlled assignments. Learner control consists of a dynamic and a directive factor, dynamic being the initiative a learner possesses, and directive being the guidance from others. Dynamically, CAI leaves a learner in control. Instruction presented in a computer program should come in short bursts, with the learner controlling the path travelled through the material. Long chains of events should not occur. Each click of the mouse or strike of the keyboard should elicit as few events as possible. For this to be successful the learner's background knowledge comes into play, having to know where to go next. Children with LD tend not to activate prior knowledge spontaneously, thus CAI must include a certain amount of direction from a teacher or the program itself. When designing software there must be a balance between dynamic and directive factors. This can be accomplished with self-monitoring programs which automatically adjust to the learner's level of ability, analyzing a student's activity pattern and balancing dynamic and directive factors.

Motivational factors fall into two categories: extrinsic and intrinsic. Extrinsic rewards are those that are not inherent to the instruction being presented. They might include a happy face appearing, or verbal praise, when a question is answered correctly. No instructional cues are present. However, many students are not motivated by such rewards, and some may be turned off by them. Children with LD are particularly resistant to extrinsic motivators (Neuman, 1991, cf. Larsen, 1995). For them a game like scenario may be more appropriate, where "winning" may be exceptionally motivating for them; within a context where losing or failure is the norm, the novelty of winning is very inspiring. Intrinsic rewards are those arising out of a particular interest in a content area, including challenge, curiosity, and fantasy. When material is of great interest to the learner no extrinsic rewards are necessary; the material motivates the learner. In this situation, extrinsic rewards may be damaging, undermining the intrinsic interest of the task (Lepper, 1985, cf. Larsen, 1995). Extrinsic rewards act to change the characteristics of the learner, from a focus of pursuing knowledge to a focus of pursuing rewards; when rewards are removed, the initial intrinsic motivation is lost (Deci, 1971, cf. Larsen, 1995). Thus, three motivational factors must be considered when implementing educational software: 1) extrinsic rewards used for drill type programs, 2) extrinsic rewards present in game type programs, and 3) intrinsic motivators of material inherently interesting to the learner.

Feedback types must include a directional element which explains why a learner's action was wrong and how it can be changed into a function that leads to the perceived learning goal. CAI is particularly good at providing such feedback, more so than traditional learning settings. Graphics as feedback has gone relatively uninvestigated, though those who have studied its effects indicate that its effectiveness is based on three factors: 1) task requirements, 2) subject matter content, and 3) learner characteristics (Moore & Newrocki, 1978, cf. Larsen, 1995). Developmental factors also come into play, with younger learners relying more on graphical representations for learning than older learners (Otto, 1962, cf. Larsen, 1995). Older learners may become distracted by graphical presentation, reducing the quality of their learning (Elkind, Medvene, and Hockway, 1971, cf. Larsen, 1995). It has also been shown that graphics have a tendency to produce functional fixedness (Dunker, 1935, cf. Larsen,1995). For example, students who knew how to figure out the perimeter of a square were unable to when the problem was presented in graphical form on a computer screen (Cofman, 1985, cf. Larsen, 1995).

Screen designs include both graphical and/or textual screen elements which are linked in the form of "sequential pipelines". It is critical that these pipelines be consistent throughout the pages of the program so that as little effort as possible is required for program administration; buttons, links, graphics, and their location on the screen etc., must be consistent so learning focuses on the content rather than how to manipulate the program. Content should appear at the center of the screen and function keys/buttons etc., should appear around the periphery. Research indicates that learners often miss material presented around the periphery of a screen, particularly when animation or other graphics appeared in the center (Neuman, 1991, cf. Larsen, 1995).

Since the symposium in 1993, technologies have advanced considerably. Speech recognition technology, which received relatively little attention because of its infancy of development at the time, has now developed to the point where it can be used with relative ease in the remediation and compensation of LD. It is sufficiently developed to the point where programs can be navigated through by speaking to a computer, and text can be constructed without ever having to touch a keyboard.

One area of technology that was not touched on at the symposium is word prediction. Though it is a new technology that has emerged since the symposium, it is now sufficiently developed to be a useful tool for persons with LD. Text can be written by clicking on words that appear in a text prediction window. As each word is entered, individual lists of possible words that may follow are presented on the screen. When one of the words is clicked on, it is added to the text and a new list of predicted words appear. These are "smart programs" which learn the users vocabulary the more they are used, so that with repeated use they become more efficient at predicting possible words that may appear next. TTS and speech recognition programs have also adopted this "smart" technology so with repeated use they also become more efficient. These technologies are also useful for persons with other disabilities such as mobility problems or sensory deficits. Some are even being adopted by business for tasks such as transcribing documents or adapting settings to accommodate persons with disabilities of all sorts. 

Another recent development in technologies which was only briefly discussed is that of communal learning environments. Projects such as CSILE (Computer-Supported Intentional Learning Environment) have the potential to connect children around the world into a communal classroom (Scardamalia, Bereiter, Brett, Burtis, Calhoun, & Smith Lea, 1992). Children submit their work to a network connecting schools worldwide, comment on each other's work, and contribute to each other's learning. The network acts as an intelligent tutoring system, maximizing active learning from individuals as well as utilizing the expertise of teachers. It provides the capability to present knowledge in many different forms, forms which reflect the strengths commonly found in children with LD. Systems like these show great potential for the future of education and the integration of children with LD.

Our knowledge of technologies for improving the quality of life for those with LD is still in its infancy, and suggestions for their uses lacks sufficient empirical investigation to justify making educated recommendations. Caution must be taken when utilizing technologies for remediation and compensation of LD, though this is not to say they should be avoided until sound research validates them, anecdotal evidence for their efficacy is abundant. We are entering an era in which LD is going to loose its label as a deficit in learning to be replaced by one of a difference in learning, and as a result research and development of adaptive technologies is becoming a very rewarding field of endeavour.

Larsen, S.(1995). What is "quality" in the use of technology for children with learning disabilities? Learning Disability Quarterly, 18, 118-130. 

Leong, C. K. (1995). Effects of on-line reading and simultaneous DECtalk auding in helping below-average and poor readers comprehend and summarize text. Learning Disability Quarterly, 18, 101-116. 

Lundberg, I. (1995). The computer as a tool of remediation in the education of students with reading disabilities--A theory-based approach. Learning Disability Quarterly, 18, 89-99. 

Poplin, M. S. (1995). The dialectic nature of technology and Holism: Use of technology to liberate individuals with learning disabilities. Learning Disability Quarterly, 18, 131- 140. 

Raskind, M. H., Herman, K. L., & Torgesen, J. K. (1995). Technology for persons with learning disabilities: Report on an international symposium. Learning Disability Quarterly, 18, 175-184. 

Raskind, M. H. & Higgins, E. (1995). Effects of speech synthesis on the proofreading efficiency of postsecondary students with learning disabilities. Learning Disability Quarterly, 18, 141-158. 

Scardamalia, M., Bereiter, C., Brett, C., Burtis, P. J., Calhoun, C., and Smith Lea, N. (1992). Educational applications of a networked communal database. Interactive Learning Environments, 2 (1), 45-71. 

Torgesen, J. K. & Barker, T. A. (1995). Computers as aids in the prevention and remediation of reading disabilities. Learning Disability Quarterly, 18, 76-87

Learning Disability

• SNOW Learning Disability Resources [ snow.utoronto.ca/resources/disability/disdisspec.html#learn ]

• SNOW Adaptive Technologies for Learning Disability [ snow.utoronto.ca/resources/technology/techadap.html#learn ]

• SNOW Reading Disability Resources [ snow.utoronto.ca/Learn2/resources.html ]

• SNOW E-Text Resources [ snow.utoronto.ca/Learn2/resources/etext.html ]

Word Prediction

• Adaptive Technology Resource Centre's word prediction page [ www.utoronto.ca/atrc/reference/tech/wordpred.html ]

Text to Speech

• HELPRead [ helpread.net/ ]

  Free text-to-speech software from the Hawaii Literacy Project.

• Telesensory: Blindness Products [ www.telesensory.com/ ]

  This site contains a number products, and includes a text-to-Speech program for download (Screen Power Speech)

• Adaptive Technology Resource Centre's Text-to-Speech page [ www.utoronto.ca/atrc/reference/tech/textspeech.html ]

  This page contains links to a number Text-to-Speech products.

• textHelp Systems Inc. [ www.texthelp.com/ ]

  This site contain information about the different technologies available for those with print disabilities. "Read and Write" is a software package including: wordprediction, on the fly spell-checking, screen magnification, abbreviation expansion, and more.

• Don Johnson's Co. Writer --Write:Outloud--Simon Sounds it Out [ www.donjohnston.com/catalog/cow4000dfrm.htm ] and [ www.donjohnston.com/catalog/simonsio.htm ]

  Co:Writer is an intelligent word prediction program that works with any word processor to reduce keystrokes necessary to complete an intended word. This productivity tool can help make writing easier for writers of all ages. Type in a letter and Co:Writer suggests logical word choices that fit your sentences.

Optical Character Recognition: OCR

• Ceare Products - 

  • OmniPage Pro 12 Office [ www.scansoft.com/omnipage/ ]

  • PaperPort Deluxe 9 [ www.scansoft.com/paperport/ ]

  • OmniForm 5 [ www.scansoft.com/omniform/ ]

• TypeReader [ www.indiana.edu/~letrs/help-services/QuickGuides/TypeReader/about-TypeReader.html ]

  An explanation of an OCR program.

Scanners

• Scanner vendors [ www.scanhelp.com/index.html ]

There are the five sections of this module:

1. What is voice recognition

2. Why voice recognition works and creating user files

3. Working with continuous speech

4. Creating macros in Dragon Dictate

A note on format:

After a days discussion of an aspect of voice recognition technology there will be some thoughts on how the aspect is relevant to a user with a disability.

This is intended to be an introduction to Vision Technology. It is important to always keep in mind that knowing the medical side of a visual disability is not necessarily the largest part of a visual disability. Each person who has Diabetic Retinopathy, Retinitis Pigmentosa, Macular Degeneration or any other eye disease will give you a slightly different "way of seeing things."Often vision is dependent on the weather, bright or cloudy, high or low pressure; the person's mood and emotions, the way the light is bouncing off of surroundings and any other number of things. Our vision is quite subjective and although we can measure it to some degree, it is not an absolute science.

My vision begins an eye test at 20/200 and fifteen minutes later, when my eyes grow tired of the test, they measure 20/800. The verdict then is that I cannot see anything other than light images which is not true.

Each person's experiences with their vision are different and need to be respected. Some of us have had to fight for every inch of educational ground covered, others have not. some of us adjusted quickly to our disability, others did not. These experiences affect the way we see the world around us and invariably "our vision." These issues have to be kept in mind when trying to accommodate in the classroom, home or workplace. The best thing to do is to try and ask as many questions as you need to in order to understand the needs of your student, relative or client.

 

3.2.2 What is Voice Recognition? [top]

Voice recognition is a technology which allows computer users to input text and commands into a computer using their voice instead of the traditional keyboard and mouse.

Voice Recognition products generally fall into three categories:

1. Voice recognition products that come with operating systems only allow the user to give commands to the operating system. For instance starting an application, finding a file, or pulling up the start menu are all things this type of application could accomplish. These products are typically user independent, free, and will not allow the user to dictate text.

2. Desktop voice recognition products, designed for use by desktop computer users, are capable of recognizing the commands and text of a trained user. Newer voice recognition are quite different from their predecessors. 

   • Current desktop voice recognition applications allow a user to dictate text into a dictation window or third party application, and control the computer system. For text dictation the user may speak in fluent sentences and paragraphs. This type of dictation is called continuous speech.

   • Older Voice Recognition Products use a discreet speech method of dictation. When using discreet speech the user must leave a space between each word, so the computer can tell where one word stops and the next begins. Older Voice Recognition applications such as Dragon Dictate allowed a user to dictate text and control their computer system.

3. Industry level voice recognition products are those which are used for automated telecommunications systems or voice activated electronic kiosks. These systems are user independent, designed to recognized a defined number of commands, very powerful, and very expensive.

There are several reasons why voice recognition is a desirable method of input.

• The most natural way for a human to communicate is through the voice (although speaking to another person is quite different than dictating to a computer).

• Using a pen, keyboard or mouse will cause injury with prolonged use. The voice can be used over extended periods of time with no adverse affects (provided the voice is being used properly).

• The voice recognition system will not use incorrect spelling.

• The voice recognition system will default to the grammatically correct form of a word based on the context of the sentence.

Most of the disadvantages to using a voice recognition system stem from limitations in technology.

• A voice recognition system will occasionally make a recognition error which the user must correct.

• Old style voice recognition systems require a user to leave a space between each word while dictating text. Many users find this to break their flow of thought. (New recognition applications support continuous speech - meaning the user can speak naturally)

Voice Recognition Applications to Physical Disabilities

In cases where users are lacking either gross or fine motor control voice recognition can provide hands free access to a computer.

Depending on the degree of impairment a user may decide to use keyboard and mouse commands to supplement voice recognition.

A user whose physical disability prevents them from speaking consistently may have trouble using a voice recognition system. If the user's speech is only altered by their physical impairment (but they can consistently produce sounds), a voice recognition may be able to adapt.

Voice Recognition Applications to Learning Disabilities

Users who have a writing impairment connected with a learning disability can compose written material orally. The voice recognition system will always use correct spellings and the correct grammatical form of a word.

Some difficulties such a user may have with this technology are the reading of the initial training and correcting misrecognized words.

Often voice recognition users with learning disabilities have difficulty with continuous speech, as they must dictate entire sentences instead of working word by word. Other users with LD may find that discreet speech interrupts their train of thought and prefer continuous speech method.

 

3.2.3 Why Voice Recognition Works and Creating User Files [top]

Surprisingly, recognizing human speech is very difficult for a computer. This is because no two humans speak in exactly the same way, while computers are absolutely consistent in everything they do. To complicate matters no one human will never say a word exactly the same twice.

Keyboard and mouse input are methods which produce consistent results. Computer systems can easily interpret this type of input. The algorithms native to a computer system are not equipped to handle input which is inconsistent (such as the human voice).

The voice recognition system accomplishes this by using a technology called neural networking. This allows the computer to imitate the human ability to learn.

Creating voice files:

In continuous speech applications such as "Naturally Speaking" and "ViaVoice" a user is required to read the text of a story for about 45 minutes. This allows the recognition system to analyze the speech cadence of the user, and the way the user pronounces phonetics.

Older voice recognition systems such as "Dragon Dictate" require the user to read lists of words into the computer. The system is then able to memorize how the user pronounces the words and also analyze the phonetic patterns of a user for words which are trained specifically. New versions of system wide voice rec. applications only require a user to read the word once (up to three times if the system is having difficulty placing the phonetics). For older systems (Dragon 2.5 and older) it is recommended that a user train each word three times.

These initial training sessions are essential. As noted previously the voice recognition constantly analyses how the user is speaking, and alters its recognition accordingly. In the absence of an initial training session the voice recognition system is prone to making so many errors that the user does not correct properly, exacerbating the problem.

Maintaining Voice files:

The method a computer uses to recognize a word or phrase is basically that of the educated guess. This educated guess is based on a model of the users voice created in the initial training session and is adjusted every time the user corrects a word or does additional training.

Every time a word is corrected the model for that word, and the phonetics contained in the word are reinforced or modified.

To properly correct a word the user must select the miss-recognized word and tell the voice recognition system what word to replace it with. Simply selecting the word and typing in the correction will not correct the recognition of the word

Applications to Users with Learning Impairments:

The creation of a voice file requires the user to read text on the screen. This could pose a barrier for a user with a learning impairment.

One solution may be to use text to speech to read the text (via an earphone) which the user can then repeat. Another possibility would be to have an assistant quietly read the text for the user to repeat.

Correcting a miss-recognition requires the user of a voice recognition system to be able to recognize the written version of the word they have spoken. This could present a problem to a user who has a leaning impairment.

Continuous speech allows the user of a voice recognition system to dictate text in a fluent, natural manner. Even though the user can dictate text fluently, it is important to remember that dictating text to a computer is quite different from speaking to another person.

Points to remember when using continuous speech:

• The voice recognition will benefit if complete sentences are spoken as a group (as opposed to one word at a time)

• Flavoring words, such as 'like' and 'um' , that we use to fill space or add emphasis while speaking to another person need to be eliminated when dictating text or commands.

• One should speak in an even toned voice. Unlike a person the computer will not respond to a raised voice versus a calm voice. A significant change in the tone of your voice will degrade recognition.

These applications (such as IBM's "ViaVoice" and Dragon's "Naturally Speaking") present a very high recognition rate (over 95% after initial training).

In addition to allowing a user to dictate fluent text the user is able select text be saying "select" and the text to be selected, and format their document with commands such as "set size 16" or "bold that" (in the case of "Naturally Speaking").

Applications to users with learning disabilities:

People with learning disabilities have very different opinions on how helpful or hindering continuous recognition is.

Many find the ability to fluently transcribe their thoughts into text very helpful, bypassing the difficulty of transcribing thought to paper and the challenge of spelling words correctly.

On the other hand many people with learning disabilities find the pressure of speaking well-formed sentences and paragraphs without the use of flavouring words a hindrance.

Providing the voice recognition user has an extremely high rate accuracy fewer corrections need to be made due to miss-recognition. This is an advantage to users with learning impairments as correcting miss-recognitions may provide a barrier for them.

Applications to users with physical impairments:

Because continuous speech is not totally hands free these applications may not solve all access issues faced by users with physical impairments. It may be necessary to use this software in conjunction with a system wide voice rec. system.

System wide voice recognition (Dragon Dictate) allows a user to completely control his or her computer with speech. This includes opening and closing applications and files, changing operating settings, manipulating objects with the mouse, and controlling applications.

To increase efficiency of work, and facilitate the dynamic (changing) electronic workspace Dragon Dictate allows the user to create macros. This feature allows the user to create customized commands which can perform a series of tasks with a single command. The user also controls when these commands are available.

The creation of a new command is done in the "New Word" dialog box. Here are the steps a user will go through in the creation of such a command.

1. Type the name of the command enclosed in square brackets ([]). The square brackets tell the system that this is a command and not a word. The system will alert the user if the name is already taken.

2. The user must then decide which vocabulary group the command should reside in. A vocabulary group divides all the commands in words in the applications repertoire into context relevant sections. For instance commands contained in the Word Perfect vocabulary group are only available when the user is in Word Perfect. The Netscape Navigator command "Open Location" would not be available when Word Perfect was active.

3. Next the user must decide which keyboard commands should be initiated when the command is given, and capture these commands as allowed by Dragon.

4. Finally the user must train the voice rec. system what to listen for in order to initiate the command. This sound need not represent the text contained in the square brackets, however it is most intuitive if this is the case.

Applications to users with learning impairments

Users with learning impairments may find it helpful to be able to achieve a set of tasks with a single voice command.

Applications to users with physical impairments

This feature of system wide voice recognition allows a user to control the computer with a totally hands free method.

A user is also able to maximize efficiency of their system by creating macros, preventing fatigue.

In this week you are encouraged to explore

• The medical condition that affect the eye

• The access technology that is available both high and low tech

• Get to know some of the people with visual disabilities from case studies and Internet profiles

• Begin thinking of ways to integrate high and low tech devices into the classroom activities for your students who are blind or visually disabled

 

4.1 introduction [top]

This is intended to be an introduction to Vision Technology. It is important to always keep in mind that knowing the medical side of a visual disability is not necessarily the largest part of a visual disability. Each person who has Diabetic Retinopathy, Retinitis Pigmentosa, Macular Degeneration or any other eye disease will give you a slightly different "way of seeing things."Often vision is dependent on the weather, bright or cloudy, high or low pressure; the person's mood and emotions, the way the light is bouncing off of surroundings and any other number of things. Our vision is quite subjective and although we can measure it to some degree, it is not an absolute science.

My vision begins an eye test at 20/200 and fifteen minutes later, when my eyes grow tired of the test, they measure 20/800. The verdict then is that I cannot see anything other than light images which is not true.

Each person's experiences with their vision are different and need to be respected. Some of us have had to fight for every inch of educational ground covered, others have not. some of us adjusted quickly to our disability, others did not. These experiences affect the way we see the world around us and invariably "our vision." These issues have to be kept in mind when trying to accommodate in the classroom, home or workplace. The best thing to do is to try and ask as many questions as you need to in order to understand the needs of your student, relative or client.

Screen reading or voice output technology, has two main components: software and hardware. The hardware component is an external voice synthesizer, which is equipped with a volume knob and an on/off switch. This device is connected to one of the computer's communication ports via serial cable. The hardware can also be internal, and can appear in the form of a card(E.G. a Sound Blaster with the Text Assist option). This card is placed in one of the computer's seven slots.

The software component is installed on the user's hard drive. This program provides the hardware with instructions about things such as: how quickly to speak, how to pronounce words, abbreviation, and numbers, and which portion of the screen to read aloud. Adjustments in verbosity, pitch, and cursor voices can also be made. The software package also determines which operating environment the speech output system is suited for(E.G. Windows 3.1, Windows 95, Unix, or DOS).

Screen reading programs are applications that run in conjunction with mainstream programs(E.G. word processors, spreadsheet programs, web browsers, HTML authoring tools...). Each software package has its own unique set of features. However, screen readers have some primary responsibilities in common.

• They present the information on the screen in a linear format

• They let the user know which item, icon, or block of text is currently in focus.

• They provide the user with feedback about what is being entered into the computer via its keyboard.

• They identify the computer's responses to the data and commands that are being inputted.

• Text to speech technology can also work with screen magnifiers as well as refreshable Braille displays.

Screen Readers

• JAWS for Windows - Henter-Joyce [ www.hj.com/fs_downloads/jaws.asp ]

• WinVision 97 for Artic Technologies [ www.artictech.com/wvis.htm ]

• Screen Readers from the ATRC web pages, includes examples of screen readers and the external/internal synthesizers used with them [ www.utoronto.ca/atrc/reference/tech/scread.html ]

• An Introduction to Screen Access Realities (article) [ leb.net/blinux/blynx/sarsi.html ]

• outSPOKEN for Windows [ www.aagi.com/catalogue/ProductVersion.asp?SerieOSW ]

 

4.3 Screen Magnification [top]

 

4.4 Scanners and Optical Character Recognition (OCR) Software [top]

 

4.5 Braille Displays, Notetakers, Printers and Translation Software [top]

Macular Degeneration

Deaf-Blind

Retinitis Pigmentosa

Glaucoma

Diabetic Retinopathy

 

4.7 Case Study and Low Tech Solutions [top]

Case Study and Low Tech Solutions