The mobile phone: central station for tele-care, tele-health and communication

The mobile phone is always with us. No matter where we go, most of us have the mobile in the pocket. So it seems a logical next step to integrate functions of tele-care that older and sick people sometimes heavily rely on for their safety. Indeed, some of the tele-care equipment providers exhibiting in November at the TSA Conference in Birmingham do offer feature phones equipped with SOS buttons, that either allow to call the emergency services or pre-assigned contacts in the phone book. And some advocate the extension of tele-care services via smartphone apps. This later aspect however rises a number of questions. 

What is the difference between tele-care apps and health apps? 

There are no established definitions yet, but the US Food and Drug Administration (FDA) has made a first step by issuing a "final guidance for developers of mobile medical applications, or apps, which are software programs that run on mobile communication devices and perform the same functions as traditional medical devices". In this guidance, the FDA specifies that it " intends to focus its regulatory oversight on a subset of mobile medical apps that present a greater risk to patients if they do not work as intended" because "the majority of mobile apps pose minimal risk to consumers".

In practice this means that the FDA will regulate mobile apps that 

• are intended to be used as an accessory to a regulated medical device, or
• transform a mobile platform into a regulated medical device

The FDA will not regulate apps that 

• help manage conditions without providing specific treatment suggestions
• help track the user's health information
• facilitate access to information about certain conditions and general health information
• monitor a patient's medical condition and help communicate this information to the health care provider
• automate simple tasks for health care providers
• enable patients or providers to interact with Personal Health Records (PHR) or Electronic Health Record (EHR) systems

A detailed explanation on which kind of apps will not fall under FDA review can be found on the webpage Examples of Mobile Apps for which the FDA will exercise enforcement discretion.

Barely standards, no regulations 

Still, the world of smartphone apps to date is the wild west. No established authority controls the quality or reliability of health apps. No regulations or internationally accepted guidelines exist on the minimum requirements for apps that can have an impact on the user's health. Apart from the FDA as one of the first government agencies to attempt formalising a regulatory approach to apps, some sort of quality control by peer review emerges in specialised areas. Websites like iMedical Apps (http://www.imedicalapps.com/) for instance offer regular reviews of apps by experts in the field, in this case healthcare professionals; while myhealthapps.net lists apps that have been "selected by 456 distinct patient groups, disability groups or empowered consumers as their favourite apps. The reviews from these groups are supplied for each app, as well as weblinks to the groups themselves."

In this context, one of the participants in the Workshop "Integrating Apps so that they apply to you and me" held during the TSA Conference, asked a very pertinent questions: "When your tele-care app does not work, who are you going to blame? The developer of the app? The mobile phone manufacturer? The operating system? The tele-care equipment manufacturer? Who?" 

The overall tenor of workshop participants who partly came from network operators, partly from tele-care equipment manufacturers and partly from national agencies, was that they are very interested in the idea of employing apps as extension of or help in tele-care but that they are worried about quality control and liability. Guidelines or quality labels would certainly help. 

Exploiting the competitiveness of human nature

In the world of fitness, smartphone apps have been taken up very rapidly. The challenge to sticking to goals, the support via the community of all the people who also use the app to improve their life, are motivating factors. Some workshop participants whose background was in rehabilitation pointed out that it might be worthwhile to think about how to transfer this competitiveness and playfulness witnessed in fitness apps also to tele-care apps in order to help people engage more actively and give them incentives to follow instructions to possibly improve their condition.

Discussing mobile accessibility over lunch in the European Parliament

On 27 November 2013, MEP Dr. Ádám Kósa invited policy makers, industry and representatives of European disability organisations to a lunch event entitled "With GARI and the Real Time Sign Language App to a more accessible European Union". The intention was to discuss openly what industry is already providing in terms of accessibility features of mobile telecommunication devices, how persons with different disabilities are using these features, what from their perspective is still missing and how European policy can contribute to making mobile accessibility a success. 

The Hungarian Member of the European Parliament Dr. Ádám Kósa said: "I have a disability that you can’t see but I have no communication problem." Deaf persons like him have for decades been excluded from telecommunications, but this has changed thanks to the advent of smartphones. "Nowadays, I feel fully included in the communication of society. Thanks to new technologies, thanks to apps, and certain programs which help me. At the same time, we haven't achieved full accessibility yet," he continued. 

Together with his colleague MEP Werner Kuhn, Dr. Kósa proposed last year the project of a real-time sign language application to the European Commission. The idea is to facilitate communication of deaf and hard of hearing persons with the European Institutions by providing a platform independent application offering real-time sign language interpretation as well as captioning. The budget for the realisation of the project has been approved and the European Commission has launched a call for tender, which has already been closed but the winner has not been announced yet. The Commission’s call for tender referred to the design of a total communication system, combining in a coherent and coordinated way voice, real-time text and video in order to be able to have access to sign language at the same time. The platform will in a first time be hosted by the Commission but there will be pilot services with the different institutions. Ideally, the platform would be ready to be tested for the European Parliament elections in May 2014, and if it works well would be taken up also by Member States in order to facilitate access to their institutions. 

Mrs. Inmaculada Placencia-Porrero, Deputy Head of Unit for Rights of Persons with Disabilities within the Directorate General for Justice, spoke about the Commission's plans for the European Accessibility Act and the influence that the UN Convention on the Rights of People with Disabilities has had already in policy discussions.  After the European perspective on accessibility, the Mobile Manufacturers Forum (MMF) took the floor to provide an update on the Global Accessibility Reporting Initiative. Following this Jean-Daniel Ayme, Vice President, European Telecom Operations at Samsung Electronics and Robin Christopherson, Head of Digital Inclusion at AbilityNet both demonstrated what mobile accessibility translates to in real life for users with a disability using either a Samsung or Apple device.

The list of accessibility features that are included in devices is certainly getting longer and longer. Relatively simple features such as the flash light, can give visual alerts for the deaf, while integrated sensors can tell the blind user if the light is switched on. Other features such as adaptive sound, where the user can test their own hearing with the mobile phone and adapt the sound accordingly opens new ways to customise the device for all users, including those with a hearing impairment. As one of the speakers reminded the audience - all of us can be temporarily disabled - whether by injury or an unfavourable environment - and in these moments we all benefit from the mainstreaming of such features. 

Mobile accessibility has certainly advanced quite rapidly in the last decade and work still continues. One can only imagine what the devices of tomorrow will offer.

Read here the press release by MEP Dr. Kósa: http://www.kosaadam.hu/news_display/smartphones_for_people_with_disabilities/

Mobile Service designed for the Blind

As accessibility gains in importance in the public debate and many governments have legislated on minimum requirements to grant access to services for persons with disabilities, one new operator in the United States has turned the tables, designing his service to cater specifically to the blind and vision impaired community. We talked to Robert N. Felgar, general manager of Odin Mobile to learn more about the motivation and the business case for a network operator focusing exclusively on blind and vision-impaired customers. 

What was your motivation to create an operator dedicated to the blind?

Robert:  For me a business has to satisfy two criteria: (a) it has to provide substantial public benefit, and (b) it has to be economically interesting.  It is hard to motivate oneself and others if a business does not have an important mission.  However, a business with an inspiring mission is not sustainable if it does not generate a reasonable profit. 

What sets you apart from traditional operators and their accessible services?

Robert: Our entire focus is the blind and visually impaired.  Serving this community is not an afterthought for us, it is our sole focus.  We are determined to sell the most accessible devices in the world and to improve the customer experience with one-on-one training sessions for certain devices, providing accessible user guides in welcome emails, provide usage alerts through text messages as well as IVR* messages and offer rate plans that are attractive to a lower income demographic.  We also donate a percentage of our revenue to organizations dedicated to the blind and visually impaired.  

Is there really a business case for accessibility?

Robert: There are approximately 6 million Americans who are significantly visually impaired.  This is a large market.  If Odin Mobile is able to attract a modest percentage of these consumers, it will be a sustainable business.  To do this we need to differentiate ourselves from the primary operators and offer blind and visually impaired consumers handsets and services that others do not. 

What is your biggest challenge? 

Robert: The biggest challenge is reaching blind and visually impaired consumers.  Traditional marketing is not possible.  As a result, Odin Mobile needs to market through associations with substantial numbers of blind members.  In addition, we will market through organizations and governmental entities that provide rehabilitation services to the blind.  This type of marketing requires substantial relationship building and takes time, effort and patience. 

How is the feedback so far? 

Robert: Feedback so far has been encouraging.  Consumers have commended us on our efforts and organizations have been supportive and eager to form marketing partnerships with Odin Mobile.  I anticipate forming partnerships with the major associations and organizations dedicated to the blind in the United States.  As long as Odin Mobile offers real value, there will be support.  The key is to identify that value. 

What are your next steps/projects?

Robert: We have many plans.  Soon we will be selling the Nexus 4 with our unique instructional package and the widget developed by IDEAL Group. This widget highlights on the home screen eight applications that may be particularly useful to people who are blind or visually impaired.  With Talkback, the Android tool for eyes-free use, the user can explore the widget by touch.  As the user moves his or her finger over an application, Nexus 4 announces the application’s name, describes its purpose and guides the user to the Google Play™ Store app if he/she wants to install it. 

Next, we will be selling a basic mobile phone manufactured by gold GMT, a Swiss company.  In the meantime, a number of states, including California, have programs to subsidize telecommunications equipment for the disabled.  We are working on participating in that and other state programs.  This is important because many people who are blind are also low income.  As a result, affordability is an important component of any service. 

If you would like to know more about Odin Mobile's offer and service, please have a look at the website: http://odinmobile.com

*Interactive Voice Response

It is not as much about hearing as it is about communicating

A common misconception is that getting a hearing aid enables people to simply hear again. As the wearing of hearing aids is still considered by many users a stigma, it has been reported that people are getting hearing aids on average a decade later than they actually need them*. This means that their hearing has already degraded and they need to learn how to make sense of the information that they get from their hearing aid. When getting the hearing aid, they need to work with the hearing aid technician to manage their remaining physical capacity of hearing (individual audiogram), their subjective hearing capabilities, their hearing environment and finally their personal objectives (whether they want/need to function in a private or professional environment, whether they need to talk on the phone a lot etc.). 

Many people are still disappointed, because getting a hearing aid does not guarantee a return to 'normal' hearing as they once enjoyed. It gets even worse when they pick up the phone and notice that it does not work well together with their hearing aid. "We have all the technical elements needed for successful integration of hard of hearing people in the working place and of course for giving them the capabilities to communicate on the phone", said one of the participants in the recent HÖRKOMM workshop in Berlin. "But the issue is that people are not informed enough about what is technically feasible today, they do not know who to ask, and then of course there is also the problem of financing it."    

How do phones work with hearing aids? And what is the M- and T-rating? 

In general, hearing aids use their microphone to pick up sound waves in the air and convert the sound waves to electrical signals. The signals are amplified as needed and converted back to audible sounds for the user to hear. The quality of this acoustic coupling is qualified for phones by their M-rating (M=microphone). The hearing aid's microphone, however, does not always work well in conjunction with telephone handsets. The acoustic connection between hearing aid and handset can be distorted and surrounding noise can interfere.

One of the most common technologies of avoiding these problems and making phones work with hearing aids is inductive coupling by using a telecoil. The telecoil in the hearing aid converts the magnetic fields generated by telephones into sound and allows the volume control of a hearing aid to be turned up without creating feedback or "whistling" on the phone. The higher the T-rating of the phone, the better they work with hearing aids in the telecoil setting. For the hearing aid user it is important to verify that the telecoil in the hearing aid is activated and that the device is set to telecoil mode. Telecoils are also used to interface with other assistive devices and an additional benefit is that they can easily be made available in public spaces. Places such as railway stations, service kiosks, churches and many tourist attractions have installed induction loop systems that in conjunction with the telecoils, magnetically transmit sound to hearing aids and cochlear implants. 

Mobile phones with M3/T3 rating comply with the US standard for hearing aid compatibility and the best currently available reach M4/T4 ratings. However, the subjective hearing of the user as well as his/her hearing environment play a major factor and some users may feel that they can better communicate with a phone that has a lower M/T rating. The only way to tell which mobile phone will work best for a person with hearing aid is to test the devices together in different settings.**

A newer technology for transmitting the audio signal directly into the hearing aid is bluetooth. There are two issues with this technology: it necessitates the pairing of devices and bluetooth is more power intensive (as compared to hearing aids) than the hearing aid which shortens battery life. The advantage is that bluetooth is an industry standard. Some of the hearing aid makers are also experimenting with near field communications (NFC) which would have the potential to become a standard for the interface between hearing aids and other audio devices, including the mobile phone.  

Elaborating guidelines for the successful integration of the hard of hearing in the work place

HÖRKOMM is a project financed by the German Federal Ministry of Labour and Social Affairs with the objective of developing guidelines for the successful integration of hard of hearing employees at the workplace. In the framework of this project, a workshop took place on 4 November 2013 in Berlin, Germany bringing together representatives from the hard of hearing community, hearing aid and mobile phone makers, federal inclusion bureaus, and hearing aid technicians, to discuss how to make telecommunications more accessible for the hard of hearing. The conclusion was that we have the necessary technological means but that there is an overwhelming lack of information among users and hearing aid technicians. A further barrier is of course the financing of the technical solutions. 

* All participants at the HÖRKOMM workshop on 4 November 2013 in Berlin, including hearing aid technicians, hearing aid manufacturers as well as several representatives of associations for the hard of hearing in Germany, seemed to agree on this statement. 

** Information on M- and T-ratings is available only the GARI database only for models marketed in the US. 

What is the mobile accessibility feature you are missing today?

Mobile accessibility is an evolving concept that continuously changes with technological advancements of new models of mobile phones and tablets coming to the market. For this reason, the MMF is carrying out its second stakeholder review of the accessibility features listed on GARI. The review process has been started this week, and we invite you to give us your feedback on the relevance of currently listed features and which new features you would suggest we include. 

When looking at the features listed in GARI, it has to be kept in mind that GARI serves also as reporting tool for manufacturers in countries where accessibility regulations are in place. Some features such as the capability of receiving/sending SMS might seem unnecessary to mention but for the sake of satisfying regulations, it is still listed as an explicit accessibility feature on GARI. 

Also important to consider is the global character of GARI. When suggesting new features, ask yourself whether they are relevant only in your country or across borders as well.

The current list of 110 features is easily accessible via www.gari.info. Under advanced search, you find all the features listed for mobile phones and tablets:  http://www.gari.info/findphones-advanced.cfm

Some of the features that we are already considering are:

• HD Audio: Device offers high-quality audio sound
• Head and/or Eyes Recognition: Can the user give commands via head and/or eye movements? 
• Copy and Paste: Does the device support a copy and paste functionality?
• Assistive Touch: Is there assistive touch capability on the device, such as tap on screen controls requiring only one finger, for tasks that would typically require more complicated handling? 
• Response to Prosthetic Device, Pointing Device or Stylus: Do buttons and screen respond to a prosthetic device, pointing device or stylus? A prosthetic device is an artificial device that serves as a replacement for a body part.
• Braille Display: Does the device support a braille display?
• Screen View Enlargement: Does the screen enlarger work with all the views, including the web?

Deadline for comments is 29 November 2013. 

Please do consider that the more concrete you are in your suggestions the more likely it is that we can integrate your input. A perfect way to provide your suggestions would be to specify: 

• The Proposed Feature
• A Proposed Description of the Feature
• The Type of Response Required (Yes/No or other response)
• Any Technical Note or Reference

Examples and use cases are very welcome!

More details on background and objective of the GARI feature review as well on how to submit your comments can be found here.

GARI participating in the workshop "Integrating Apps so that they apply to you and me", 12 November, Birmingham

Smartphone apps are primed to open new dimensions of accessibility and of helping people to customise mainstream devices to their needs - at relatively little cost and time effort. But concrete information on user numbers and user patterns are amiss. According to a recent survey only 28% of European and only 17% of North American mobile phone users would be actively using apps. A market research report published two weeks ago on the other hand, talks about 95 million adults in the US alone that are using their mobile phone to gather health information or use health tools on the phone. However, neither in the survey nor the market research report can there be found any indication about how many of the users are older or effected by any kind of disability.

For this reason, the workshop "Integrating Apps so that they apply to you and me" that is taking place at the 2013 International Telecare and Telehealth Conference (11-13 November, Birmingham, UK) invites participants to reflect on how to make the access to apps easier for senior citizens and disabled users, how to remove barriers and how to ensure basic accessibility of these apps. 

We will be part of the panelists and discuss with the participants of the workshop how GARI can be used to provide broad information on and access to accessibility apps.

If you would like to participate in the workshop or have ideas that you would like to share, let us know!

Here is the link to the workshop registration. 

Accessibility for people with cognitive disabilities

While it is fairly straight forward to understand what accessibility means for the vision or hearing impaired as well as people with restricted mobility, it is less evident what it means for people with cognitive disabilities. Generally speaking, cognitive disabilities are defined as "…any sort of cognitive disorder that impairs understanding and functioning". In this category fall autism, dyslexia, Alzheimer's disease, dementia, attention deficit disorder and many more. The severity can range from mild impairments such as bad memory and trouble focusing to profound comprehension difficulties. 

In this respect, mobile apps can be a great help to assist in every day tasks, as well as in training and learning. Functional training provided by apps can centre around memory, problem solving, attention, math comprehension, verbal comprehension, visual comprehension etc. Important points of references for users of these apps are clear indication of progress, explanatory failure messages that help recovery from errors, automated reminders, consistent navigation and simple, clean design. 

The CapturaTalk app for example helps people who have difficulties in reading and/or note-taking as well as supports those that suffer from poor file management and organisation. MyTalkTools can be used in speech therapy and supports the communication of needs and desires for those that have a hard time expressing themselves. And the Way of Life app can support the maintenance of structure by allowing to follow a detailed daily schedule and keeping track of the person's habits. 

These are just a handful of examples for mobile apps that can help people with cognitive disabilities to train and improve as well as to structure their days and communicate with their entourage. 

For more details on accessible apps, have a look at the new GARI accessible apps section: http://www.gari.info/findapps-results.cfm

Communicating in sign language via the mobile phone

While communication via telephone was made possible through relay services, and the first generations of mobile phones enabled communication via text messages, the advent of video telephony revolutionised telecommunications for sign language users. It is amazing to see how skilful sign language users minimise their gestures to fit the small screen and in which speed they communicate. 

Smartphones furthermore now offer a panoply of apps that range from sign language dictionaries to sign language study apps and access to content in sign language. Then there are the instantaneous sign language interpretation services that allow us to include a sign language interpreter in the telephone communication and enables communication between deaf and hearing people. 

Seen all together, these developments, suggest that we have come a long way for making telecommunications more usable for deaf and hard of hearing persons, however there is still much to do. 

Here at the GARI project, we are also very interested to learn how deaf and hard of hearing utilise mobile phones in every day life. Particularly what features or apps are most important for you. So if you are deaf and would like to share your story, please get in touch!

Why do we need sign language videos?

With the revamp of the GARI website, we wanted to make the database itself as accessible as possible. In this vein, we added to the number of written national languages our first sign language translation: ASL - American Sign Language. You can see it online at http://www.gari.info/sign-language.cfm, where Heather Dowdy, the chair of our Accessibility Working Group is explaining the GARI site and project.

Perhaps not surprisingly for those that don't sign, we often heard the question: "Why do you need sign language videos? Can't deaf people just simply read the written text?" 

To answer this question, one needs to know that for persons who are born deaf or hard of hearing, or who experienced hearing loss in early childhood, sign language is the mother tongue and the written national language is their second language. 

So one global language for the deaf then? Unfortunately it is not this simple either. There are at least as many sign languages as there are written national languages. There is American Sign Language for the United States overall, Auslan in Australia, JSL in Japan, ISL in India, BSL in the UK, DGS in Germany…. with many local varieties and dialects. Estimates are that there are about 200 sign languages used around the world today (not counting the local varieties).

To cover at least some of the most used sign languages and make GARI's content accessible to as many deaf and hard of hearing persons as possible, we are looking for national and local deaf communities that could help us provide more sign language videos on GARI. 

If you are a proficient sign language user and would like to help us in this respect, please drop us a line at sabine.lobnig (at) mmfai.info - we are looking forward to hearing from you!

Pushing accessibility in app development

August has been a busy month for mobile accessibility: an international conference, a new accessible app challenge and the pre-launch of the new GARI website in Australia all have worked towards raising awareness of the issues and encouraging the development and uptake of more accessible devices and apps. 

On 14-15 August, the M-Enabling Australasia 2013 conference brought together local and international experts on accessible technologies, mobile service providers, developers, manufacturers, retail and business groups, regulators, policymakers, and civil society. The focus was on access to mobile technology for persons with disabilities and senior citizens. 

At the conference, MMF Secretary General Michael Milligan presented the new GARI website, which now features an expanded search feature covering mobile phones, tablets and apps. The new GARI can be found at http://www.gari.info and is already available in 5 written languages  and 1 sign language for starters, with other written languages being completed.

Just one day before the event, the  Australian Human Rights Commission and the Australian Communications Consumer Action Network (ACCAN) announced their new accessible app challenge called "Apps For All". The aim of the challenge is to create better access to mobile technology for the millions of persons with disabilities as well as senior citizens that are still missing out on the mobile digital revolution. 

The issue is that many developers do not know about or do not follow the accessibility guidelines provided by mobile platform owners including Apple, Google and Microsoft. It is important that accessibility is built into the app from the very beginning. It starts with properly labelling buttons so they can be read by screen reading software used by people who are blind or vision impaired, to innovative apps specifically designed to improve the lives of people with disability or the elderly, ACCAN writes. 

The challenge will award apps for mobile phones and tablets in the following categories:

• Most accessible mainstream app

• Most innovative app designed for people with disability

• Most accessible children's app

• Most accessible game app

Prizes and entry deadlines will be announced at a later date with the winners to be revealed at ACCAN's annual conference next year.

Similar competitions furthering accessible and accessibility app development are the US FCC's Chairman's Awards for Advancement in Accessibility and Vodafone Foundation's Mobile for Good Europe Awards 2013.

M-Enabling Summit: GARI being presented in Sydney

From 14-15 August 2013, the M-Enabling Australasia 2013 Conference and Showcase will take place in Sydney. This first Australasian edition of the M-Enabling initiative follows events in Washington D.C., San Francisco and Milan and looks at mobile technology as potential game changer for people with disability and senior citizens. 

The M-Enabling initiative wants to encourage access and inclusion through usable, accessible and affordable mobile equipment and services - the perfect stage to present the new GARI. 

On Thursday, Michael Milligan, Secretary General of the MMF, will showcase the new GARI website in the session "Mobile accessibility: The manufacturers’ perspective" (11:30-12:45) and explain about the new sections of the database that in this version also includes information on accessible tablets and apps. 

We hope to give people a first feel for the new site and motivate them to use GARI as soon as it is officially launched. We also hope to get honest feedback and to understand what people need when they come to GARI. 

If you are in Sydney next week, please come and talk to Michael, have a look at the new site and let us know what you think!

And of course, do let us know which accessibility apps you like and use and want to see in GARI's brand new app section! 

Interview with Daniele Marano: Accessibility is quality and not just an add-on

Daniele Marano is project coordinator at the Hilfsgemeinschaft (Austrian Association in Support of the Blind and Visually Impaired). He talked to MMF about what accessibility means for the vision impaired and what they would expect from manufacturers.

What are the most important considerations for making mobile phones and tablets accessible for blind or vision-impaired users?

The group of disabled users is quite heterogeneous. For example blind and vision impaired users should be considered differently since they have specific requirements. Blind users rely on speech output while vision-impaired users need functions like: zoom to enlarge the display and the characters, adapt the style of fonts or adjust the level of contrast or the combination of colours.

It is important that devices can be personalised because often people have multiple disabilities. Especially elderly people may have low vision and experience reduced dexterity, for example. For them touch screens are a challenge as these screens need a certain skilful handling. As our society is getting older and older, most of us will experience one or more disabilities in our lifetime. This makes the customisation of devices even more important. Special mobile phones for seniors have tried to solve the problem, but we need more studies about the real requirements of elderly people in regards to mobile telecommunication devices.

What are the most typical use cases for blind and vision-impaired users of mobile phones?

As mentioned above, we need to divide visually impaired users into those who have no visual capacity and those who have limited visual capacity – that accounts for very different requirements.

Only a few years ago people with visual disabilities using the older generation of mobile phones with keypad had to buy and install an expensive special software. So they had to pay both for the mobile phone and additionally for the software. I think that time is over but this was still the case until a couple of years ago.

At that time, from the side of the manufacturers there was no consideration at all for the requirements of blind and partially sighted users. Now, we can see a trend to include accessibility features in mainstream products. But industry needs to include extensively in all products accessibility features like screen readers and speech output for the blind and zoom functions for the vision impaired. It is relatively easy to integrate these functionalities into mainstream products. There just has to be the will to do so.

Mobile access to Internet is becoming more and more popular. Is this also true for blind and visually impaired people? Or is it for them still easier to access the web via a computer supported by assistive technology?

I would say it is true that for the moment blind and vision-impaired people still prefer computers, but that is because up to today there is – without mentioning any name – only one manufacturer that allows the blind and vision-impaired to use mobile devices in a comfortable way. So the market is dominated by one manufacturer that has assistive technology integrated in his devices. The problem is that their products are a bit expensive, and also that older people experience difficulties in using these new technologies like smart phone devices. So it can be said that it is still a greater challenge for the blind and vision-impaired to access the internet from a mobile phone than from a computer. However, we do see the potential of mobile phones to allow access to Internet for people who do not have a computer at home because a computer with assistive technology is also very expensive.

Many manufacturers are now providing a number of accessibility features. But even if they offer information on these features, the information does not seem to reach the consumer. The Austrian Association in Support of the Blind and Visually Impaired is offering their members workshops to explain about the accessibility features of their mobile phones. Were do you get the information from?

First of all, allow me to challenge your statement that many manufacturers are now providing accessibility features. I do not believe that this is true as such, or it is not known at least as you say.

Now to your question: where do we get the information from? Usually, not in a shop. Because the people in the shops are not very knowledgeable about accessibility features. I cannot really quote a comprehensive source about accessibility of mobile devices. We have our insider mailing list of blind and vision-impaired users, but we do not have any real time information about new models etc.

I do think that industry should inform more about accessibility features in their products. They provide a lot of information about how many million pixels the camera has, but it is never indicated if the device is easy to use. We must also consider that products must not only be accessible by disabled persons but also usable by all in a design for all spirit. Both accessibility and usability bring advantages for everyone. One part of users needs it, for the other part of users it can be comfortable to have it as well.

In terms of where to find the information, we are working on making GARI the source of information for everything around accessibility for mobile devices :-)

I welcome the initiative of GARI as a platform of information and exchange around the world of mobile devices

What would be your recommendations to app developers in regards to making their apps accessible?

That depends very much on the operating system for which the apps are developed. Developers must program apps in conformity and respect to the accessibility guidelines. It would be worth considering the introduction of an accessibility seal of devices and software.  But not always hardware and software can be considered separately in terms of accessibility. Accessibility must be an integral part of mobile devices and not just a secondary feature.

What would you wish for from the manufacturers?

The technology and the systems are constantly developing. It is important that accessibility develops at the same pace. There is the risk that with the appearance of new technologies, accessibility solutions must be redefined. Therefore it is important that accessibility becomes an integral part of the conceptual thinking.

I do think that a new consciousness of the needs of users has emerged but sometimes we still experience a lack of consideration. From the packaging, to the charger and the plug, we need to take into account the differences of users to make the handling of the device easy. Software is another issue, there are different kinds of possibilities and settings and so on. But manufacturers should put accessibility on the forefront, not just have it as a plus. Accessibility is an added value of the product, not just a courtesy for a small group of people who need it. Accessibility is quality.

Accessibility features need to become part of the mainstream product and not be offered in separate packages, at separate costs with separate assistive technologies. Accessibility is not an add-on but an integral part of the product.

What kind of developments do you expect over the next coming months?

We see that the technological development is incredibly quick. For our target group of blind and partially sighted users, speech command can certainly be further developed. Speech command on mobile devices has great potential.

Generally speaking, the interface man-machine can be improved. The use of smartphones for instance is still somewhat complex.

GARI presented to South African Disability Consultative Forum (SA DCF)

On 31 May 2013, MMF presented the Global Accessibility Reporting Initiative to the SA Disability Consultative Forum which appreciated the initiative. Organisations represented in the forum expressed interest to utilise GARI and to support the further development of GARI by spreading the news and by participating in the yearly stakeholder review at the end of 2013. Already prior to this meeting Vodacom SA, the biggest mobile network operator in South Africa and present in many other African countries, included a link to GARI on its website which is a huge step forward in the African context.

The South African Disability Consultative Forum (SA DCF) is a young institution aiming at bettering the inclusion of people with disabilities by developing their personal and economic potentials via accessible mobile communication equipment: During 2011 ICASA, the SA Telecom Regulator organised a National Summit for people with disabilities and all organisations related to disability issues, network operators, manufacturers and service providers. At this summit the disability sector requested that ICASA establish a Disability Forum with the aim to consult with organisations active in this field and all other relevant stakeholders on disability and telecom matters. The forum then provides feedback and advice to ICASA .   

 

As a result ICASA established the Disability Consultative Forum in 2012. The executive team and the members of this forum consist of organisations, manufacturers, network operators and service providers. The forum was officially launched on 10 May 2013.

Apps can make the in-accessible accessible – Ofcom accessible apps day

On 17 May 2013, the UK regulator Ofcom brought together a wide range of people with varying degrees of background in accessibility to discuss the status of accessible apps development.

Robin Christopherson from AbilityNet gave a great presentation on the potential that accessible technology constitutes for the disabled as well as the “temporarily bodily abled people” as the American disability community seems to call the non-disabled, because “for a lot of people, there is at least some time in life when everyone has some sort of disability”.  

Himself blind, he demonstrated in an amazing way how skilful he handles his smartphone and tablet, not being any less fast with these devices than any other user. “If you design inclusively, you level the playing field,” he said.

Paul Porter from RNIB, also a blind user, demonstrated how painful and frustrating it is when apps do not provide basic accessibility. However, when accessibility is built in the right way, it can tremendously improve the life of disabled persons. “If people ask the right questions about accessibility, you turn up getting more usable products,” said Peter Abrahams from Bloor Research. Indeed, more and more people regard accessibility as a proof of product quality.

“It is all about choice, about options for input and output technologies,” according to Robin Christopherson. “What are options for abled bodied people, can be life changing for disabled people.” Fortunately, the days of having low-volume, high-cost assistive technologies seem gone, and advances in accessible technologies come on a monthly basis.

Ben Shirley’s presentation on advances in speech recognition of course showed that there are still areas that do need substantial improvement before these technologies can be widely deployed at low cost.

All the same, many important players in the market invest in ensuring their services are accessible. While Gareth Ford Williams and Ian Pouncey from the BBC’s accessibility team explained about their efforts in making the iPlayer truly accessible for as wide a range of people as possible, Michael Day presented British Telecom’s Next Generation Text Service (NGTS) app that is intended to be complementary to text relay services and should enable hearing and speaking impaired users to communicate much more conveniently.

Ben Foster from the UK NGO Patient Services demonstrated the practical aspect of how apps can make the life of patients easier. The organisation offers a variety of apps - from helping people manage their medical conditions to apps that facilitate the setting up of doctors’ appointments and the filing of prescriptions.

The MMF was very happy to have the opportunity during this seminar to present the new GARI and invite all participants to name the accessible apps that they think should be included in GARI’s soon to come new section on accessible apps.

In response to questions from the audience about how accessible apps can best be made known by users, Richard Orme from RNIB replied that “when accessible apps come out, people notice fast and use them and talk about them and tell their friends”.

In this sense, please do let us know when you stumble upon new accessible apps and think that they should be included in GARI’s accessible apps section!

Presentations of the Ofcom accessible apps day will soon be available on the Ofcom website: http://www.ofcom.org.uk/

9 May – Global Accessibility Awareness Day

On 9 May, many events around the world celebrate the Global Accessibility Awareness Day. Jennison Mark Asuncion and Joe Devon, the organisers of the GAAD talked to us about their initiative and accessibility in mobile communications.


What is your background in accessibility and what was your motivation to organise the Global Accessibility Awareness Day? 

Jennison: I’ve been working in the private sector supporting digital accessibility since 2001. Apart from that, I’ve also been researching postsecondary students with disabilities and their ICT use in Canada with the Adaptech Research Network since 1997.

My motivation for helping organize GAAD, outside of Joe, who inspired this event with his famous blog post back in November 2011, is a desire to make the domain of accessibility, “accessible” to the designers, developers and others who are rolling out amazing apps at rapid speed. Rather than seeing accessibility as the killjoy, I think that depending on how digital accessibility is introduced into a discussion, making apps accessible can be seen as an innovation challenge worth pursuing.

Joe: Technology has empowered so many users. And so much effort has been put into making web pages pretty, even if they are on old versions of browsers. Yet something as fundamental as making a web page accessible to someone who cannot use a mouse or see a screen is simply not on the mind of the typical developer. Not because they don’t care about their craft. But because they are unaware that something such as a screen reader even exists, or that someone may actually be using just a keyboard to interact with their site! My motivation is to make accessibility part of the conversation, as it should be. I have no background in digital accessibility. However as someone who works in technology, this matters to me. I saw the gap and wanted to try and do something to address it in some way.

What outcomes do you expect? 

Jennison: If we can get even a few people who know nothing about digital accessibility, asking questions, becoming interested in learning more, having at least one perception change, and walking away with an appreciation for at least one of the digital accessibility issues facing people with different disabilities, we’ve met our goal.

Joe: I agree 100% with Jennison. I’m especially hoping that core developers, involved in work that touches front end products, are among those who are interested to learn more.

Why should we care about accessibility of ICT in general and mobile phones in particular? 

Jennison: I know few who will deny that ICT plays a role in almost every aspect of our lives. As a subset of ICT, smartphone technology, at least for the minute, is the flavor of the day. Who knows what will be the next big thing. I really believe strongly that unless and until we get things right with ICT accessibility, and by extension, mobile phone/app accessibility, the needle regarding such areas as the underemployment of people with disabilities will not move significantly.

Joe: Most of the world is using mobile phones with flashlights to navigate in the dark and membrane keyboards to keep out the dust. Android devices are pushing into many countries now. Access to data means improved living standards.

What are the most important initiatives in accessibility to ICT right now? 

Jennison and Joe: The great news is that there is a lot happening in pockets of digital accessibility. The open source community is doing some amazing things, the continuing evolution of the NVDA screen reader is but one example. Mobile apps are empowering folks with developmental and other disabilities. Social media has definitely opened up new lines of communication between the design/development related technology communities, the community of people who work in digital accessibility, and end-users with disabilities.

These conversations are in themselves helping bring awareness and are making some of the right things happen when it comes to ICT accessibility. Take GAAD as an example. Had it not been for Twitter, I (Jennison) in all likelihood wouldn’t have stumbled upon Joe’s blog post that inspired this global effort we’re driving together.

Finally, while it should not be seen as the primary reason by any means, legislative developments, such as aspects of the AODA (Accessibility for Ontarians with Disabilities Act) in Canada, the Proposal for a Directive of the European Parliament and of the Council on the accessibility of public sector bodies' websites, and the CVAA (The Twenty-First Century Communications and Video Accessibility Act) in the USA are helping ICT accessibility move forward. The reality is that sometimes people need legislative encouragement to motivate them.

Where do you see regulations in accessibility going? 

Jennison: I believe regulations in accessibility in the digital space will continue evolving and more countries will adopt such regulations, as more consumers with disabilities demand the same opportunities (real or perceived) that ICT promises to us all. All eyes will certainly be on the Americans with Disabilities Act come this summer, as movement to get web accessibility (hopefully digital accessibility to be more inclusive of tomorrow’s technology) much more explicitly referenced.

Will it be easy? Regulatory matters never are.

What developments do you expect to see in accessibility of mobile phones over the coming months?

Jennison: I can tell you what I hope to see, more choice in accessible mobile phones for people with different disabilities, period. Like with anything else, there is always a danger when choice is not an option and when people with specific disabilities are forced to become dependent on any one product/model.

Joe: Agreed.

What advice do you have for designers and developers of mobile apps?

Jennison: The major mobile platforms have developed guidance on how to make apps accessible to people with disabilities, and the W3C is undertaking efforts around mobile accessibility, don’t ignore these authoritative sources. Opt to use toolkits that have taken efforts to make widgets accessible, such as jQuery Mobile. Test your mobile apps for accessibility with actual end-users with disabilities. Finally, for those who opt to use a tool that generates code for multiple mobile platforms, as part of your selection process, ask the vendor what has been done to assure that the code produced will be accessible and usable by people with disabilities, and let their responses guide your vendor decision. Choosing one of these tools that does not generate accessible code ultimately means that developers will have to go back into the code and manually fix things, if that is even possible. This ultimately defeats the purpose of using such tools, namely, saving time and cost.

Joe: User testing prior to putting an app out there is key. It’s really the same whether you are developing an app for mobile or the web. It shouldn’t be left to users with disabilities to have to file bugs after the fact.


Have a look at the GAAD website to find an overview of events organized around this day and to find out how you can get involved too: http://globalaccessibilityawarenessday.org