The relative concepts of accessibility and accommodation

In Morocco, you were either blind or deaf, but not visually impaired or hard of hearing (except if you’re older and in that case, you either turn up the volume of the TV or radio and have people speak louder). From my experience, there were no in-between categories.

I was fortunate enough to attend an American international school, where the classes were small enough to get individual attention and the teacher’s approach more adaptable to its students needs. If I had gone through the French or Moroccan system, I would have drowned in the myriad of students and been forgotten by unconcerned teachers.

That’s not to say that the public system is void of caring teachers or successful students, but rather that the challenges that students with disabilities face in such impersonal settings make the student’s job more difficult.

I never thought of myself as disabled because I wasn’t raised to think of it that way. The words, “disability”, “accessibility” and “accommodation” didn’t really become a part of my vocabulary until I moved to North America. When I was diagnosed, my father, who was an ophthalmologist, asked one of his French colleagues what to do. The colleague told him to mainstream me. And that’s what they did. I was raised to think of all I could do, not what I couldn’t do.

So when I found out, at 17 that I couldn’t drive, as naive as it may sound, I was devastated. Until then, my visual limitations were my own to work around. This was different. While I probably knew on some level that it would never happen, I’d grown up looking forward to driving. Until that moment, no one had ever had that discussion with me because it wasn’t part of the language.

Accommodation and the stigma that goes with it

After moving to Canada for school, I discovered the wonders of accommodation and the stigma that goes with it. While you may think that accommodations would be a godsend, an opportunity to jump on, it took me a couple of years to feel comfortable asking for what I needed and not thinking, well, I don’t really need this or that, I can manage. Adapting to accommodations isn’t always as straightforward as you would think, especially if you’re not used to them.

My father once told me the story of a mother who came with her child for a consult. When he told her that her child had albinism, the mother became upset and never came back. The mother eventually came to her senses and did what was right for her child’s education, but the point is that cultural aspect of enabling kids and adults with disabilities to learn isn’t just about the physical access, it’s about the culture too.

When most think of disability, they think of it in terms of extremes. To be disabled is to be in a wheelchair or being unable to see light. They don’t think of the spectrum on which your impairment can reside. While the nuances of ability are better delineated in North America, they don’t always seem to be applied in technology.

It’s great to have accessible technology designed for learning, but if the accessibility options aren’t integrated on basic products, than who will use them? Never mind that much of the technology is unaffordable (even in Western terms), the cultural barriers won’t help the implementation. A magnifying glass is one thing, but when you get into electronic technology, I think that they need to have multiple uses. A CCTV can be very helpful, but who has that kind of money and who wants to be seen using one?

Also, there is no excuse for technology not having integrated adaptive features. And adaptive features doesn’t mean Text to Speech. In the U.S. for example only 12 percent of legal blind children use Braille, that’s down from 50 percent in the 1960s, the rest use the vision they have to interact with their world. It’s easy to say, “Well this product already exists, so use it”, but if you’re not an auditory learner, how much does it really help? Why aren’t there more options to change the contrast or font size on a screen?

So here’s a question, is it easier to change culture or change technology?

I’d vote for the technology because a lot of it already exists. Perhaps highly priced and restricted by IP, but changing culture requires bigger strategies that require more expertise than any one ICT4D organization can offer. Cultures differ from region to region and country to country, but the disabilities don’t. Whether you’re albino in Morocco, Canada or India, the challenges you will face will, for the most part be the same.

I’m not sure what research has shown about the varying cultural takes on disability, but I think it’s something that should be looked at.

Lack Of Electricity And Financial Constraints

Technology that relies on access to grid electricity will not serve the poorest 1.5 billion people. Sadly, this barrier isn’t likely to be removed soon – the International Energy Agency predicts 1.3 billion people will remain without electricity for the next 20 years.

Alternative energy options are ideal, but one should proceed with caution, as the practical amortized cost will often exceed what is possible for consumer-sustained revenues or even for government education budgets. When an education ministry has USD 100 a year per student to split between teacher pay, books, furniture, and construction of running water and toilets, little remains for new educational technologies. Program designers need to thoroughly measure and disclose the total cost of ownership of any solution, particularly technology based solutions.

Mobile-based technologies have greatly impacted development; but there are three important costs to consider: 1) the cost of the handset, 2) the cost of network access, and 3) the cost of energy consumption. Smart phones have potential as education devices, but their cost is out of reach of the poorest two billion. Even basic phones may still stretch available financial resources; and if the educational value requires the mobile network, the cost of network time and even the availability of the network may reduce the feasibility. Finally, use of mobile handsets as everyday learning tools requires constant recharging, which adds cost and additional logistics.

Content

No matter how well a technology adapts to resource constraints, it has little use without good content. Good content includes a “killer app” that supports a school system’s goals (including their existing curriculum, exam requirements, and methods of teaching); but content can also mean stories, information, or knowledge that has direct practical and even entertainment value. Even if this content isn’t directly useful to schools, it may be invaluable to education.

A successful technology solution will be built from the ground up to support content. But where does the content come from? The Web will not easily reach the poorest 1.5 billion people who lack electricity. But suppose we could magically make the Web actually accessible “World Wide”– what content would be helpful?

Language

Serving the needs of disabled children in the poorest regions of the world requires content in thousands of languages. A look at Wikipedia’s article count by language demonstrates the problem. English speakers can find millions of Wikipedia articles, but very few children understand English. Meanwhile, the 8 million Twi speakers of Ghana are served by 65 articles.

What if we had a massive effort to translate English content on the Web to thousands of other languages? Would the problems, questions, and interests of children in remote rural areas be satisfied by the content on today’s Web?

Local Content: Web 2.0 Without Electricity

The solution to this problem (already learned with the Web) is to ensure technology is serving content production as much as consumption, and further, to turn consumers into producers. Examples of producers include district government agriculture experts, local nurses, concerned mothers, and disabled children with something to say (all of them).

To connect content producers with consumers, we need distribution. This presents another requirement for technology projects: affordable digital distribution. Mobile communication networks should be leveraged when available and affordable (which varies drastically across impoverished regions of the world), but the greatest scalability will be achieved using additional means of distribution, especially at the local levels.

Collaboration Is Critical

Content producers are the key. Technology can provide the tools.

But none of this is possible without collaboration among technology developers, development practitioners, funding organizations, governments, and content producers. No single NGO program can do this work, and no single product will provide a comprehensive tool.

Literacy Bridge, the organization I founded in 2007 to work on these problems, set out to design a rural audio computer based on the above principles.

• The device is designed for access to audio knowledge.
• At high volumes, it can be produced for less then USD 10.
• It can be powered by locally available batteries.
• It interactively quizzes students and provides them feedback.
• It allows anyone to make a recording and share any audio recording with others using device-to-device copying. Literacy Bridge is also now working to allow audio recordings to be uploaded and downloaded to the Web using basic mobile phones and voice networks.

After a year of field observations and a growing dataset of results, we are more convinced than ever that this is the right approach towards improved access to education for all. We see our technology and our programs as a couple pieces in the puzzle; and, we continue to search for partners with other pieces and who are dedicated towards solving this puzzle.

The first fundamental barrier in the developing world to overcoming disabilities is that we are missing the human capacity we rely on in other parts of the world – the support workers, interpreters, sign language teachers and others. Existing low cost technology can help substitute for this. The XO Laptop, mobile phones and others are suitable low power, low cost hardware and far lower cost than classes ($15/month > 12 months = 1 OLPC) and interpreters for those who would struggle to afford either.

What we are lacking is high quality (preferably creative commons or similarly licensed) localized content for both children and adults, such as interactive video sign language courses. Often we lack localized text to speech software. Because parents often can’t afford or can’t find the resources they need to communicate with their children they often find themselves completely excluded, and such frustration can easily foster worse problems.

Using blended learning we can make far more effective use of those limited human resources that we do have, so that classes can be supplemented by more effective self study. Some NGOs are making efforts to provide classes, but they all fall far short of what’s needed.

Here in Afghanistan, a self-instructional sign language application running on the OLPC or other hardware is envisioned that will support parents, children and teachers to learn to communicate with each other. Braille could follow. Our Persian E-Speak has a some work left to go. This will provide the lowest cost most accessible option for people Recognizing psychological disabilities for what they are will likely require cultural changes and shifts that took generations to realize in developed countries.

The hardware is there, the technology exists, with HTML5 we can make platform independent materials that can work on devices from phones to normal desktops to OLPC to PDAs. What we really need is the will, vision and resources to glue it together the content and get it out to those who need it.

NVDA, NonVisual Desktop Access was first released in 2007. Originally it was a private initiative, but it was quickly picked up by industry as a promising alternative for screen readers. Since 2007, NVDA received tremendous recognition at international conferences and forums. Today, it is a very well-know application among screen reader users in the United States. Many people are switching from their old reader to NVDA.

Currently, NVDA is able to work with the most popular applications, such as Internet Explorer, FireFox, Microsoft Office applications, Adobe Reader, and Windows components. The developers constantly expand the supported applications and improve current support as well. One of the greatest strengths of NVDA is supporting the latest release of Mozilla Firefox. The latest technologies are used and recognized, even methods which other screen readers often struggle to catch up with.

The current biggest problem of providing blind people with screen readers is the pricing, where NVDA could become a very low cost alternative. While the software itself is free, education and distribution would require some funds for a wide distribution.

NVDA as a competitive alternative

NVDA is backed up by the generous financial support and recognition from major software and internet companies, including Mozilla Foundation, Adobe, and Yahoo! Given that NVDA meets the expectations from users and supporters, this recognition allows to predict that future support will be granted to the project, and the development will continue.

Screen readers, similar in functionality and effectiveness to NVDA are extremely high priced, around the $1000 range, which are not considered to be competitive in developing countries.

The NVDA project, is also aware that there is a high demand for an affordable screen reader to be used in the international market. Currently, NVDA supports over 20 languages, which puts it ahead of other freely available screen readers.

As NVDA is an open source product, it provides the ability to contribute code according to individual, or country specific needs, unlike other alternatives.

The NVDA project also maintains extensive support resources, where users and developers can discuss the screen reader, make suggestions and even volunteer to support the project even by financial contributions, or by program enhancements. This allows ambitious developers to implement new ideas. With the spread of this screen reader, it is expected that more contributions will be added, including the translation to other languages.

The Down-sides of NVDA

The default sound of NVDA is provided by ESpeak, which is not the best reading voice. However, users can install other voices and easily change their preferences to it. This allows the using of any third party voices, which is an easy integration of other languages.

While NVDA has an unparalleled development curve, there are still some bugs and requirements which need to be worked on, however, these do not cause major usability issues.

Implementing NVDA in Developing Countries

It is not possible to distribute NVDA to people in need on its own, as the intended recipients would not be able to use it right away. While NVDA has a talking installation program, somebody who solely relies on a screen reader needs to be able to start the operating system to install it. Also, we have to take it into consideration that much of the intended audience does not have previous screen reader experience, therefore they will have difficulties using the computer as well.

It would be recommended to start providing non-computer related training materials to intended users, both about using a computer, and the screen reader as well. The best format of such materials would be either Braille, or audio resources.

Conclusion

Overall, NVDA as a screen reader is comparable to other screen readers in usability and effectiveness. However, as it is easily adaptable to other languages and is freely distributable makes it a favorable choice in developing countries.

Tom Babinszki of Even Grounds, Accessibility Consulting, recommends NVDA

Right now, some initiatives run by departments of education and most initiatives run by NGOs spend some of their very limited resources on software-based assistive technologies such as screen readers or virtual keyboards that are extremely expensive. As a result, a very small minority of kids with disabilities get access to technology and then they do, they become dependent on software that they, their families, and future prospective employers cannot afford. Such an approach is just as ineffective whether one is talking about software that runs on PCs, netbooks, or cell phones since the best-known cell phone assistive technologies are extremely expensive.

Obsessed with the difficulty of bringing affordable solutions to developing countries I made a comparison in 2006 between brand-name entry-level PC prices in 2006 and in 1997, and the cost of the most widely used screen reader for the blind also between 2006 and 1997. Correcting for inflation the change was a drop of more than 80% in the price of the computer and an increase of over 20% in the cost of the screen reader (and this was before netbooks became fashionable). It became clear to me that if I was going to have any chance of increasing access to technology and education to the blind in developing countries in any meaningful way, it would have to be by focusing on software since industry was already doing an excellent job in reducing the cost of hardware.

Donations or heavily discounted proprietary software is not a solution since, as mentioned above, it simply postpones tragedy. it creates dependency that will block access to educational and employment opportunities as soon as the student needs to upgrade his or her assistive technology or install it in new machines. The solution I found is to identify free and open source software (FOSS), that until recently few people knew about, and make it easy to access, use, and share.

This gave origin to the F123org project, an initiative recently recognized with an award from the Inter-American Development Bank to install everything a blind individual needs–including operating system and office applications–on a USB drive. While I am proud of this concept, I bring it up to illustrate a point, once the building blocks such as word processor, screen reader, and speech synthesizer, are available freely for anyone to copy, modify, and improve, foundations, companies, NGOs, and individuals will find ways to use these technologies effectively. the real obstacle is not hardware costs, it is the lack of awareness of the benefits of supporting and using FOSS assistive technology solutions.

The idea of using a USB drive as a hard disk, to install and use any software one needs, is not mine alone. I have heard of others doing the same in various contexts in China, England, and Germany just to mention a few places. Good ideas are easy to come by, the real challenge is either developing or building on software such as Orca, eSpeak, Dasher, and for that matter, Open Office. Once a government, foundation, or any entity interested in helping persons with disabilities is wise enough to require that any public procurement or research funds have FOSS licenses as a requirement, the impact of any investment they make is multiplied many times over. Let us use examples such as eSpeak and Dasher to illustrate.

eSpeak is an open source speech synthesizer that was quickly adopted for use with screen readers such as Orca and other applications such as Asterisk, in platforms ranging from PCs to netbooks and cell phones, in languages ranging from Spanish to Turkish and Swahili. Dasher, a software used to make data entry more efficient for those who cannot use a conventional keyboard, was also widely adopted with an equally vast impact despite the relatively limited resources invested in its development. Today, the impact of the limited resources available to the F123org Project is also dramatically increased given our ability to use those FOSS solutions without any restriction to help people in more than seven countries.

Companies, governments, NGOs, foundations, or individuals interested in using or contributing to assistive technology that is truly decentralized, scalable, affordable, and resilient should not for the most part worry about hardware, and should focus resources on free and open source software, open communication protocols, and open file and other standards so that bringing education to hundreds of millions of kids with disabilities will be within our reach.

In the developed world there are numerous technologies to help the blind and visually impaired “read” books, periodicals, and Web based content via computers and mobile devices. Advances in Text To Speech, Braille interfaces, and navigable audio books allow millions to access information in ways not previously possible. But software and hardware for the visually impaired often runs into the thousands of dollars.

The major roadblock to accessing digital content in the developing world, where more than ninety percent of the world’s visually impaired live, are affordability and access. A more affluent, English speaking resident of India with a desktop computer or smartphone has access to much of the print disability technology and content available in the developed world. But this is not the case for the wide majority of the poor. Their visual learning is often restricted to what others care to read to them and to what content is available locally in hard copy form.

Blind and visually impaired children are at a distinct disadvantage in school without the visual aids and technology that many children in the West now take for granted.

Mobile solutions for visually impaired

With such a high rate of adoption in the developing world, cell phones offer a potential solution to address the challenges of content access and learning for the visually impaired. Much screen reader and book reading software for the visually impaired on mobile phones already exists. Code Factory’s Mobile Speak and Nuance Talks are available for Symbian, Windows Mobile, and RIM mobile platforms. Their mobile software packages are also available in numerous languages. Pioneers like T.V. Ramen of Google are developing innovative screen reader and geo navigation technologies (e.g., Eyes Free) on Android platforms.

A variety of Optical Character Regognition (OCR) and object recognition software for cell phones also exist, allowing the user to point a cell phone camera at written material or an object to have it read or verbally identified . Examples include the Knfb mobile OCR reader and LookingAid Mobile by iVisit.

The mobile vision field is advancing quickly just as mobile phone price points are coming down. Hence the time is right for the emergence of an “mDisability” sector to target reading and learning opportunities for less affluent print disabled communities worldwide.

Barriers to mDisibility adoption

Before jumping in with both feet, however, a number of practical challenges must be addressed.

First, the above mentioned (mostly) smartphone solutions are still not affordable and/or available for the wide majority of the poor in the developing world. So over the short term leveraging mobile for the visually impaired will require screen reader and voice recognition technologies being built directly into low cost feature phones. They must be accompanied by design improvements to assist the handicapped user. Over the long term, and as smartphones become more affordable and widespread, there are also opportunities to make use of existing screen reading technologies for higher end Nokia, Android, and Apple phones – not to mention their downloadable apps.

Beyond technology and device barriers are some additional challenges.

The first is copyright. Depending on the country, copyright protections may prevent access to books and periodicals for free or at a low enough cost for many. Unlike in the United States, where access to books and periodicals is often free for the visually impaired, many countries still do not allow for such accommodations. Without the widespread availability of low cost content, a mobile device with reading capabilities is useless to the print disabled poor.

Second, because the current diversity of reading file formats is not standardized across regions and devices, many will be unable to read content even if openly available and cheap.

Third, even where books and periodicals are made available in appropriate formats, digitized versions may not yet exist. Even in the USA, free content does not include the cost of reading hardware, software, and subscription fees charged by some digital library distributors.

Finally, and perhaps most important from an educational perspective, is the integration of mobile learning tools with relevant learning processes and curricula. While having access to books and periodicals is one thing, guided and productive learning for the visually impaired student is another. Schools and other educational institutions will need to not only make their content available, but tie that content directly to locally and linguistically appropriate learning systems.

mDisibility holds hope and promise

Overall, mDisability offers unprecedented educational pathways for the print disabled and visually impaired citizens of the global South. Imagine visually challenged children and adults having 24/7 access to up to date books and periodicals and specially designed learning software on their phones? How many millions more could be educated and enjoy the benefits of leisure reading if local content in local languages was made readable anywhere, anytime?

The vision to bring millions of visually impaired individuals into the mainstream reading community, literally allowing them to carry learning in their pocket, is a grand one. But the march of mobile and advancements in mDisability might just point the way.

Paul Lamb is a Man on a Mission

Assistive information and communication technologies can allow those with disabilities to learn and grow, indistinguishable from any other child. But we have to ask three questions about them in our context:

1. Which assistive technologies are appropriate for the developing world?
2. How might they be implemented in resource constrained environments?
3. And what would their impact be on the children that use them?

Especially since you could even argue that educational systems are often impaired themselves – lacking budget, expertise, and will power to recognize that assistive technologies exist and should be employed for the betterment of all.

For February’s conversation, the Educational Technology Debate will explore low-cost assistive information and communication technologies, and how they might be utilized to increase the learning outcomes of children in the developing world.

We’ll dive into the issues and concerns with the help of several thought leaders on the subject; Cliff Schmidt, Fernando Botelho, Mike Dawson, and Paul Lamb. Your thoughts and opinions are always welcomed in the comments below. In addition, if you have deep knowledge on the subject, please email us a Guest Post of your thoughts.

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