Directed Study Module CS4042, University of Limerick, April 2010

Technologic Designs,
Systems and Devices for
Disabled Interaction
Authors:
Kathryn Conway, 09006094, Kathleen Berns, 0847461,
Maire Kirby, 09004709, Andrea Harte 09001944

April 2010

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 Systems and Devices for Disabled Use

Abstract:

We use devices everyday to communicate with each other as well as for

pleasure and practical reasons. Social network sites such as Facebook and
Twitter are popular so much so that you can now update them via the mobile
phone wherever you are The mobile phone itself is a much used device.
Without it one would find it very difficult to communicate and meet up. If you
are disabled these devices may not be easily accessible and therefore
assistance or adaptation may be needed to enable their free use. In this
essay we examine what being a disabled user in today’s society may involve
with a look at some of the various devices and aids that are currently in use
and available. In this essay we looked at certain scenarios where technology
has worked in favour of the disabled. We have also discussed the vast
amount of technology available and technology that is in the process of
becoming available. We stress the importance of usability of the user and how
it has the possibility to change someone’s life. The importance of
individualisation and it costs is also explored with a glance at the possible
future of devices their use, adaptations and developments. By covering
specific areas such as education, web, personal case studies and modern
technology, designs and future developments we hope to introduce some
thought to these systems and devices.

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 1. Introduction

2. Education and Devices

2.1 In an Educational Institute

3. Individual Case Studies

3.1 Web Applications

3.1.2 Visual Impairments

3.1.3 Hearing Impairments

3.1.4 Severe Disabilities

3.2 Education

3.2.1 Cerebral Palsy

3.2.2 Down Syndrome

3.3 General Computing

3.3.1 Victor

3.3.2 Ben

4. Web and Devices

4.1 Software

5. Modern Technology, Designs and Future Developments

5.1 Individualism

5.2 Examples

5.2.1 The Peregrine Glove

5.2.2 Telethesis

5.2.3 Phantom Omni

5.2.4 Bionics and Thought

6. Conclusion

7. References

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 1. Introduction

We use devices everyday to communicate with each other as well as for

pleasure and practical reasons. Social network sites such as Facebook
and Twitter are popular so much so that you can now update them via the
mobile phone wherever you are The mobile phone itself is a much used
device. Without it one would find it very difficult to communicate and meet
up. If you are disabled these devices may not be easily accessible and
therefore assistance or adaptation may be needed to enable their free use.
There are many forms of social interaction some of which if you are unable
to get out you can interact with on line (online game playing, social sites
etc.) and we look at some of the various devices and aids that are
available. Also looking at how they are used, developed and generally
available together with the need for individualisation. Through the
covering of devices used in relation to diverse areas such as education,
web, together with individual case studies ending with new and future
developments, disability and accessibility is focused upon.

2. Education and Devices

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 3. Individual Case Studies

3.1 Web Applications

“The power of the web is in its universality. Access by everyone regardless

of disability is an essential aspect”

Tim Berners-Lee, W3C Director and inventor of the World Wide Web

“In the United States, over 8 million people are blind or visually impaired
[US Health 1997] (McCracken and Wolfe 2004)

3.1.2 Vision Impairments

The web is so visually orientated that is poses difficulties for many people with
a range of different visual impairments. The most severe clearly being total
blindness but also less apparent conditions such as low vision, colour
blindness and health conditions such as epilepsy in which case seizures can
be aggravated by visual stimuli.

The Tate Museum of Modern and Contemporary Art put in place an

application on their website for the visually impaired following an email they
received from a visitor of the museum who was born blind, The I-map is “an
online art resource designed for visually impaired people with a general
interest in art, art teachers and their visually impaired students” (tate.org)

The application does not function by examining an entire piece of art at once,
“it introduces detail in a carefully planned sequence gradually building towards
an understanding of the work as a whole” (tate.org) The device works for the
visually impaired as it allows people to take in information at a slow pace
giving them time to picture, imagine and think about the piece of art more

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 clearly. Resources include a text only commentary (accessed by a screen
reader) and PDF raised drawings to download.

Caro Howell, the curator of the website states “It’s a complete vindication of
the site. Its not a blind person saying this is very visual so its pointless, but
saying its interesting so he’ll keep plugging away at it” (sean.co.uk)

3.1.3 Hearing Impairments

Following an intensive search into access to the web and use of web
applications for the deaf an interesting survey emerged, which was carried out
by Dr. Tracey Skelton (Loughborough University) and Dr. Takao Maruyama
(Leeds University). The survey questioned the deaf and hard of hearing on
their interest, usability and what they generally like or dislike about the internet
in relation to their disability.

The Distribution of Age (%)

(users = 276 & non-users = 103)

20.3
0-24 yrs 5.8
23.9
25-34 yrs 5.8
19.6
35-44 yrs 16.5
Users
16.3
Non-users
45-54 yrs 17.5
13.0
55-64 yrs 24.3
6.9
65 yrs and older 30.1

0 5 10 15 20 25 30 35

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 *Bar chart taken from power point presentation of the survey (deafskills.co.uk)

As illustrated in the bar chart the amount of deaf Internet users is far greater
than that of the non-users in the three younger age brackets (0-24 yrs, 25-34
yrs, 35-44 yrs) This shows that the use of the Internet is just as common
among deaf users as it is with non-deaf users as in both groups generally the
older the person the less familiar/reliant with the internet. This is due to
assistive technologies that aid the deaf with obstacles they may run into while
surfing the web for example, subtitles and video captions.

The people surveyed gave positive opinions towards their views and personal
experiences using the Internet.

Adam, age 36 – “It means they’re more equal to hearing people, they get
access to the same information access to jobs and sport, things like that. So
it’s definitely been a big improvement for the Deaf community”
(deafskills.co.uk)

Derrick, age 34 - “If you think about it the aim of the Internet, email, chat
rooms, are based on communication and passing information, and for deaf
people they can communicate using web cams – it is so easy to do that with
MSN chat as well – it is really important for deaf people and I think that the
Internet achieves its aim in that way.” (deafskills.co.uk)

3.1.4 Severe Disabilities

Specific case studies show that even people with severe disabilities can get
the same use out of the web as able people by simply using alternative and
assistive input and output methods such as alternate keyboards, voice
recognition, joysticks and trackballs, speech output and screen readers.

T.J Parker’s abilities and life changed dramatically following an accident that
left him paralyzed from the neck down and with permanent breathing
difficulties. “He woke up a few days later in hospital with a respirator helping
him breath and two vertebrae […] fractured, leaving him paralyzed from the
neck down” (McCracken and Wolfe 2004 pp. 210-211)

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 Since his accident T.J has become a self-taught computer programmer and
web developer. He operates his computer using speech recognition and a
head mouse. “The head mouse is a device that tracks a dot at the end of his
nose” (McCracken, Wolfe 2004 p. 227) Using his computer he can also
operated devices in his home such as lighting and heating and most
importantly his assistive technology enables him to continue to play games
with his daughter.

3.2 Education

The benefits and issues of assistive technology for educational development

and growth in children are shown in numerous case studies carried out on
children over long periods of time. The individual case studies of children with
different condition also show the variance in the technologies required in
separate cases.

3.2.1 Cerebral Palsy

Anne is a child who was born with cerebral palsy and discovered technology
at the young age of one. She started gradually at first using switches and toys
at home, until her speech therapist encouraged her parents to introduce her to
computers when she was two years old, as she knew it could benefit her
educational and communication development. Following this suggestion Anne
began using a device with was operated using a head-switch “to encourage
cognitive skills and beginning scanning skills” (Hutinger et al 2010)

After two years Anne’s progress was evaluated and some changes were
made to her system. She was uncomfortable using her head-switch at school
so her computer was fitted with a hand operated switch instead, she was also
supplied with more devices thanks to her health insurance to aid her
development such as the Liberator (a wireless keyboard), speech synthesizer
and a range of adaptive puzzles. However there have been some barriers to
Anne’s technological advancement for example “physical fatigue, behavior
problems, occasional lack of interest” (Hutinger et al 2010) but the overall
success of her educational development due to these assistive technologies
overshadows any problems encountered along the way. Her parents state,
“She is happy, communicating, doing well—she is a different child” (Hutinger
et al 2010)

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 3.2.2 Down Syndrome

Dusty had Down syndrome and her use of assistive technology was for
education and communication. She started using technology at a very young
age using software which, explored numbers and the alphabet. In later life a
word processing program with large print, speech output and word prediction
gave her the ability to write. “Technology is highly motivating and it can bring
out the best in people” (Alliance for Technology Access 1994)

3.3 General Computing

3.3.1 Victor

Victor had cerebral palsy and was nonverbal he was unable to operate
conventional technology as his only physical control was his eyes and a single
switch he could activate with his head. Through developments in assistive
technology Victor was able to communicate by scanning a series of choices
as the computer cycled through them and making a selection by using a
switch. The system then prints out his message on a narrow ticker tape.
(Alliance for Technology Access 1994)

3.3.2 Ben

Ben who was a journalist never used computing technology until he lost his
vision, assistive technology such as vocally activated computers and word
processing software that read what was on the screen aided him in doing a
job where the abilities to read, write and edit are essential. (Alliance for
Technology Access 1994)

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 4. Web Applications for disabled

4.1 Background

From my research of web applications for disabled I have found out the difficulties that
disabled people have with accessing the internet safely, if at all. I studied three papers in
depth, “Designing Universal Access: Web Applications for the elderly and disabled”,”
Wireless Internet interface for Person with Physical Disability” and “A Framework for a multi-
robot assistance system”.

I discovered the different disabilities that were affected; visual disabilities, hearing
impairments, physical disabilities, cognitive and neurological disabilities and many more.

4.2 Papers researched

I will now discuss the first paper I studied, “Designing Universal Access: Web
Applications for the Elderly and Disabled” by Robert Johnson and Simon Kent. This paper
discusses how the Internet informs us on how the Internet is becoming an extremely popular
medium for companies and organisations to advertise, communicate and deliver information
to the public. They also address the issues relating to the usability of web applications for
elderly and disabled users and investigate various ways in which it can be improved, and
whether doing so will affect usability for younger and more able users.

In “Wireless Internet Interface for Person with Physical Disability” they discuss how
technologically assistive devices are increasingly playing more important roles in the lives of
people with disabilities. Using a conventional keyboard for Internet access is prohibitive for
people whose hand co-ordination and dexterity are impaired by ailments such as
amyotrophic lateral sclerosis. To assist people with physical disabilities in using the Internet,
they designed and implemented and easy-to-operate wireless input interface using Morse
code as an adaptive communication tool. Moreover, an adaptive Morse recognition process
is introduced. After two months practice on this system, three participants with physical
disabilities could conveniently gain access to the Internet. The Morse code is a single switch
input system. For disabled users, it is difficult to maintain a stable typing rate; the automatic
recognition of Morse code is difficult. Therefore, a suitable adaptive application method is
needed. A least-mean-square algorithm was method was formed to adaptive Morse code
recognition or people with impaired hand co-ordination and dexterity. Four processes are
involved, space recognition, tone recognition, adaptive processing and character recognition.

The third and final article I studied was “A Framework for a multi-robot assistance
system”, this work aims at modeling a system which allows the disabled person, to give a
mission to a team of robots and to determine the whole process leading to its execution.
They separated the actor: active element subjected to the stimulus (the user and its
request), the objective form: object designed in the mind of the actor, the object: element
satisfying and corresponding to the satisfaction of the stimulus. The system is based on a

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several levels diagram for a design directed towards a multi-agents system. In this paper,
they mainly described the four stages of the mechanism that lead to the trajectory
determination of the robots group. These steps use a Veronoi’s generalized graph and a
wave front algorithm. The computation of the configuration space for a robot group and an
adaptation of the group trajectory allow the group to be formed and reach the final position.
For disabled people, the user must be able to take part in the control system, its
management and in certain cases to take part in its design. Moreover, the user wishes to
have permanently information on the evolution leads us to consider the system design as a
participative system.

These participative aspects will involve:

• The Human-System interface (HSI)

• The request input seen as a set of

remote services carried out either in individual or collective way by the robots,
• User intervention in the
construction of the request solution,
• A way to act directly on the robots
or on the mission scene in the event of modification, breakdown or execution failure.
• Always-available information on the
system state. The system design will call upon several levels of abstraction [ Arkin et
al.1999],.

4.3 How to make a website more accessible:

I also did some online research into how websites could make their sites more accessible to
those who are disabled:

• Use larger fonts

• Use colours that are compatible with the disabled, for example, strong, bright colours.
• Audio reading on the website,
• Easier linking to other parts of the website.
• Make blocks of information more readable by breaking them up into smaller chunks.

While I was doing this research I was also confronted with some problems that people with
disabilities come across while browsing the Internet:

• People who are deaf may not detect sensitive information being said aloud.
• People who are hard of hearing may not realise the volume of the audio.
• People with physical disabilities are not able to block sensitive information on the
screen like an able person would be.

4.4 Assistive Technologies and Adaptive Strategies formed:

The following assistive technologies and adaptive strategies have been formed:

• Alternate keyboards: hardware or software devices used by people with physical

disabilities, that provide an alternate way of creating keystrokes that appear to come
from the standard keyboard.

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 • Braille: a system using 6-8 raised dots in various patterns to represent letters and
numbers that can be read by the fingertips. Dynamic Braille involves the use of a
mechanical display where dots can be raised and lowered dynamically to allow any
Braille characters to be displayed.
• Scanning software: is adaptive software used by individuals with some physical or
cognitive disabilities that highlight selection choices. A user selects a desired item by
hitting a switch when the desired item is highlighted
• Screen magnifiers: used primarily by people with low vision that magnifies a portion
of the screen for easier viewing. At the same time screen magnifiers make
presentations larger, they also reduce the area of the document that may be viewed,
removing surrounding context.
• Screen readers: Software used by individuals who are blind that interprets what is
displayed on a screen and directs it either to speech synthesis for audio output or to
dynamic Braille.
• Speech recognition: used by people with some physical disabilities to hands and
forearms as a method in some voice browsers.
• Speech synthesis: can be generated by screen readers or voice browsers, and
involves production of digitized speech from text.
• Tabbing through structural elements: some accessibility solutions are adaptive
strategies rather than specific assistive technologies such as software of hardware.
• Text browsers: an alternative to graphical user interface browsers. They can be
used with screen readers for people who are blind.
• Visual notification: an alternative feature of some operating systems that allows
deaf or hard of hearing users to receive a visual alert of a warning or error message
that might otherwise be issued by sound.
• Voice browsers: Systems that allow voice-driven navigation, some with both voice-
input and voice-output. And some allowing telephone-based web access.

References:

- www.w3.org Accessed: 4/4/2010

-Simon Kent and Robert Johnson, Springer-Verlag, London, UK. Designing Universal
Access: Web Applications for the Elderly and Disabled, Issue 9, Number 4, October
2007. Pages: 209-218.

-Yang Cheng-San, Yang Cheng-Huei, Chuang Li-Yeh, Yang Cheng Hong. Wireless
Internet Interface for person with Physical Disability.

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 5.Modern Technology Designs and Future Developments

5.1 Individualisation

As we are all individuals so too are our needs. It is our individualisation

that makes us who we are. The cost of individualisation of devices is
prohibitive in most cases but thankfully as we are in modern times we are
able to incorporate virtual world with real world to help reduce the
individualisation costs.

There are devices which are in everyday use that can be adapted for use
by people with disabilities, specialised devices involving muscles and
nerves for movement, devices for increasing the likelihood of repetitive
exercised being undertaken to help recovery as well as devices under
development in relation to thought making them move. Examples of these
devices are below.

5.2 Examples

These examples include a modern gaming device which is adaptable for

use by the disabled, a device for use by someone severely constrained in
their movement, another devices used especially as a method of getting
patients to practise their exercises at home while having fun and lastly a
device in true bionic style.

5.2.1 The Peregrine Glove

The Peregrine Glove (http://theperegrine.com/product developed for

players within gaming competitions. This device is based on the military-
specified mitt device and wires you into a keyboard. The glove’s layout
involves a five point area on each finger which could be mapped to
movements and calibrated for size of area. It also contained a bar pad
across the palm. This device could be adapted for use by persons with
poor motor skills or stiffness in their hands to exercise and play at the same
time. It can be programmed to perform certain actions through calibration
and key mapping software which could be adapted to make it harder or
easier as the users improved. It would also mean that the user would be
able to participate with different types of activities that involved a keyboard
and computer and hand movement. This is just a small device open to
adaptation and further development.

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 5.2.2 Telethesis

Technology has advanced so that both the virtual world and the real world
combine as a tool for individualising devices for assistance. Telethesis is the
name given to devices that are multi-linked, articulated, worn and physically
controlled by the user. The use of both virtual and real worlds helps to
maintain reasonable costs for the customising of a device as a one- of- a- kind
(Song, P et al., 1999 ). The most important aspect of all devices is its
individualism as there are so many different abilities within a disability one
design will not fit all.

Kazerooni, 1990 refers to such a type of device mentioning that though

powered by voluntary actions of the user it would still need some sort of
stabilisation to take into account involuntary actions such as tremors, spasms
and vibrations. These stabilisers would be actuators and would act like human
muscles while set to filter out the interferences.

Using virtual reality with robotics and input from multi-disciplinary parties has
increased the possibility of individualisation being more economical. Milgram et
al, 1994 described virtual reality as a synthetic world where the user appears to
be inside and can have interactions within. The designer would work virtually;
building a virtual world with a virtual device and virtual user, incorporating
information received from the various doctors, carers, therapists and the user,
testing in many simulated environments saving money on producing numerous
prototypes.

Peng Song et al, 1999, presented such a programme for a head controlled
feeding aid and painting tool. These devices relied upon the users head
movements to power them. The head was the input subsystem; the device was

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 the effector subsystem and the apparel / robotics the coupling system. Using
the virtual world and the real world together enabled the designer to try out
many various designs in numerous settings before production of a device, thus
reducing costs. As the device could also be viewed from an aesthetic
perspective with pulleys, links and cables related to in the real world (combining
worlds) it helped with the best possible appearance.

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 5.2.3 Phantom Omni

Another example of devices being adapted for use is the Phantom Omni
which is a hepatic device with six degrees of function and gives force
feedback in three dimensions Lovquist, E et al. 2009 Comprising an
extending arm with a pointer like tool which lifted and changed the cards or
objects within the virtual world.

This device was used with games scenarios in the virtual world which was
used in rehabilitation for people who have suffered strokes. In the
development of the device it was recorded from participants that the use of
the device in a game scenario kept their interest up and they forgot they
were doing exercise just got so involved with the game.

It could also be controlled with the degree of difficulty and weight according
to needs and preset by the therapist with increasing levels as the patient
progressed.

Patients who used it forgot they were doing exercises and enjoyed the goal
and fun aspect of it.

5.2.4 Bionics and Thought

The Bionic Age is here and is now being used to develop the merging of
human and machine. Bionic limbs are being built controlled by the power
of thought alone. This is the future - the development of the next
generation of prosthetic limbs. Dirk Ahlstrom,2010 In America Prof.
Richard Weir and his team are pushing this development forward. We will
have a bionic man or woman in the future – making the movies a reality
(The Six Million Dollar Man, I Robot). This research is taking place in

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 Chicago and has evolved into the building of a mechanical arm with
movement through the means of thought. The initial prototype, Proto1
featured in the National Geographic and the second prototype Proto 2,
more advanced, has just been finished. The control for movement of these
two prototypes is based on both electronics and “targeted muscle re-
innervations”. Through the use of the remaining nerves that used to control
the hand and arm movements and the muscles which act like a biological
amplifier for the nerves means the hand / arm can be controlled by thought,
the same way that we do it naturally.

The goal in all this work it to provide arms which potentially over time could
provide 22 degrees of movement depending on the correct nerve endings
being found and wired up to the remaining muscle. Prof. Weir believes that
this means offers the possibility of developing permanent limb
replacements lasting a lifetime.

6 Conclusion

Communication is very important as everyone needs to be able to do this

with ease so whether one has a physical, mental or both type of disability it
is double important as it also helps maintain involvement within the
community.

Virtual reality and reality can work together to benefit the individualisation
of devices. With the advances of technology, designs and devices
individualisation is becoming more of a realistic reality.

It is becoming easier for disabled users to interact with others through the
internet and increases the availability and access to a wide education.

Through the covering of devices used in relation to diverse areas such as

education, web, together with individual case studies ending with new and
future developments, disability and accessibility is focused upon.

Having focused upon devices in relation to education, web,

individualisation and case studies the understanding of disability issues
has been addressed.

We hope we have manage to give you an insight to the importance of

technology in today’s world and how important it is that it is made
accessible for all.

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References Section 3:

- Daniel D. McCracken, Rosalee J. Wolfe, and With a Foreword by Jared M.

Spool - User-centered Website Development: A Human-computer Interaction
Approach (2004) pages 210,211,227

- www.tate.org/imap Accessed: 10/04/2010

- www.sean.co.uk Accessed: 10/04/2010

- Presenters: Dr. Tracey Skelton (Loughborough University) and Dr. Takao

Maruyama (Leeds University) Project Team: Tracey Skelton, Takao
Maruyama, Dr. Phil Levy (Sheffield University) and Prof. Gill Valentine (Leeds
University) - The Role of the Internet in D/deaf People’s Inclusion in the
Information Society
Date: Unknown

- www.deafskills.co.uk Accessed 11/04/2010

- Author: Patricia Hutinger, Joyce Johanson, and Robert Stoneburner

Title: Assistive Technology Applications in Educational Programs of Children
with Multiple Disabilities: A Case Study Report on the State of the Practice

Source: Journal of Special Education Technology v13 p16 – 35 Spr ’96

- Computer Resources for People With Disabilities: A Guide to Exploring

Today's Assistive Technology by Alliance for Technology Access (1994) -
Chapter 2

References for section 4

- www.w3.org Accessed: 4/4/2010

-Simon Kent and Robert Johnson, Springer-Verlag, London, UK. Designing

Universal Access: Web Applications for the Elderly and Disabled, Issue 9,
Number 4, October 2007. Pages: 209-218.

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 -Yang Cheng-San, Yang Cheng-Huei, Chuang Li-Yeh, Yang Cheng Hong.
Wireless Internet Interface for person with Physical Disability.

References for section 5

http://theperegrine.com/product/ last accessed 10/04/2010

Song, P, Krovi V, Kumar V, Mahoney R, Design & Virtual Prototyping of Human-

Worn Manipulation Devices, Proceedings of the 1999 ASME Design Engineering
Technical Conferences, September 12 -15, Las Vegas, Nevada, pp 5 – 7.

Kazerooni H., 1990, “Human Machine Interaction via the Transfer of Power and
Information Signals”, IEEE Trans. Systems, Man and Cybernetics, Vol SMC-20, No2,
pp 450 – 463

Milgram et al, 1994, “Merging Real and Virtual Worlds”, Proceedings of

IMAGINA'95, Monte Carlo, Feb 1- 3 1995, pages 218 - 230

Lovquist, E & Dreifaldt U, Research Signpost, Virtual Haptic Rehabilitation –

Processes and Developments (pp 15 – 17)

Ahlstrom D., 2010, The Irish Times, dated March 25, 2010, page 19

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