The Evolution of Assistive Technology into Everyday
Products
NZ ICT Innovation Conference
September 2010
Rotorua
Presented by Nicolas Steenhout
This document is licensed:
Creative Commons
Attribution-NonCommercial-NoDerivs 3.0 Unported License
Introduction
There are many everyday products that evolved from technology developed
by, or for, people with disabilities. There are also many cases where these
everyday products are later used or refined to be used by people with
disabilities. Other products were designed in parallel – technology finding
uses both for specialised assistive technology and in everyday products. This
paper looks at some technologies and concepts used by people with
disabilities, and how these technologies and ideas have grown from, or with
assistive technology.
Many of these technologies have become so usual to us that we rarely stop
and consider where they come from, and how they could be used differently.
By examining what has been happening, we may conceive solutions for all,
using existing technologies in new ways, or developing new technologies
altogether.
Contents
Universal vs. Disability Design .........................................................................2
Thinking Outside The Box................................................................................5
Margaret Pfrommer..........................................................................................6
Typewriter / Keyboard......................................................................................7
Speech-to-Text ................................................................................................8
Text-to-Speech ................................................................................................9
iBOT - Segway...............................................................................................10
Eye Gaze .......................................................................................................12
Brainwave ......................................................................................................14
What Next? ....................................................................................................15
References ....................................................................................................16
Defining Technology
Before discussing “assistive technology”, it is important to consider the
definition of “technology”. It is entirely too easy to limit one’s understanding of
that word to “computers” or computer-related topics, when in fact the concept
of technology is much broader than that. Wikipedia defines technology as
follows:
“Technology can be most broadly defined as the entities, both material
and immaterial, created by the application of mental and physical effort
in order to achieve some value. In this usage, technology refers to tools
and machines that may be used to solve real-world problems.”
(Wikipedia, n.d.)
This paper focuses on tools and machines (and their relevant software) used
to resolve problems or eliminate barriers.
Assistive technology is, therefore, tools, machines, and software helping
people with disabilities resolving issues related to their disabilities. Thinking in
terms of assistive technology, people often think of designs limited to/for
people with disabilities. It would be better to consider universal design
instead, as a way to expand the symbiosis between technology used by/for
people with disabilities and everyday products
Universal vs. Disability Design
The topic of Universal Design could take up many papers in and of itself. It is
important to discuss it briefly when we look at disability-related technology
moving into everyday products. Universal Design is defined as:
“broad-spectrum solution that produces buildings, products and
environments that are usable and effective for everyone, not just
people with disabilities” (Wikipedia, n.d.) [emphasis added]
Truly universal design is when disability-related solutions move into everyday
use or are incorporated into everyday products, and further development of
these solutions become the norm for everyone. A prime example of this
process is kitchen utensils with big handles.
2
Kitchen Utensils
It is now possible to purchase kitchen utensils
such as vegetable peelers, can openers, or
graters with extra large handles. These
products are available in almost every shop,
and can even often be found at your local
supermarket. These large handles make the
utensil easy and comfortable to hold, especially
if you use them for long periods. It can also
reduce cramping. Many people are preferring
these utensils over the ones with smaller,
“regular” handles.
These utensils are, in fact, becoming the norm,
and people don’t realise that these handles are
the direct descendants of assistive technology
for people with impairments affecting their
hands. For instance, quadriplegics with limited
hand functions or people with arthritis have
been using a special foam tube to mold over
their utensils to make it easier to grab or hold
these utensils.
Peelers and graters with builtup handles
Eating utensils with foam
tubing around the handle
This is a good example of assistive technology
moving into everyday use products, as well as
universal design.
Pull-Down Kitchen Shelves
Kitchens are often not very friendly to
wheelchair users. One particular issue is
cabinets with shelves that are too high to
reach. One design becoming more popular is a
pull-down shelf, where the entire shelf is able to
easily be brought down, and stowed back in its
place.
These shelves are beginning to be used by
people who are naturally too short to reach the
shelves. It can also benefit children who won’t
be tempted to climb the bench to reach into the
shelves.
3
Pull-Down kitchen shelving
Automatic Door Openers
Most larger stores and shopping malls now
have automatic door openers. Not necessarily
designed for wheelchair users, they do benefit
people with mobility impairments, people
carrying many bags, pushing prams, etc.
Automatic Door Opener
Double-Drawer Dishwasher
Fisher & Paykel offers a double-drawer
dishwasher. In the space normally occupied by
a single drawer dishwasher, they put two
drawers, independent of each other. This is
beneficial for many people:
•
Individuals who only have small loads of
dishes
•
Individuals with impairments who have
reaching issues
•
Individuals who for religious reasons
wish to wash dishes used for meat, and
those used for vegetables separately
Fisher & Paykel double-drawer
dishwasher
This kind of design becomes truly universal,
benefiting many groups.
Curb Cuts & Ramps
Curb cuts and ramps are not really technology
per se but are a good example of universal
design.
Curb cuts, also known as curb ramps, were
initially implemented to allow wheelchair users
to get on or off the sidewalk. Now, parents
pushing prams, or children on skates have an
easier time with street corners as well.
4
Curb cut at a street corner
Ramps are often an after-thought, added to the
design separately, or at the back of a building
or a structure. This example shows an effort to
integrate the ramp with the stairs.
Unfortunately, while the concept is interesting,
the implementation is problematic. Wheelchair
users would have difficulty using this ramp, but
so would any other person using it –
inconvenient and dangerous.
Ramp designed to wind
through flight of stairs
Problems With Some Designs
There can be conflicts between solutions for various barriers. For example,
some curb cuts, much favoured by wheelchair users and parents pushing
prams, cause a problem for people relying on guide dogs that were trained to
cross streets from corner to corner: If the curb cut encompasses the entire
street corner, the dog has nowhere to aim and may become confused and
lead its charge in the middle of traffic.
The ramp winding its way through the steps could be problematic for people
with low vision: the steps are not designed properly and it could be easy to
miss seeing the steps or the ramp.
Universal design, unless carefully planned, may not be so universal after all!
Thinking Outside The Box
Plato is usually credited with the saying “Necessity is the Mother of Invention”.
This concept is well understood by most people with disabilities. People with
disabilities arguably encounter more barriers than people who don’t have
impairments. One can ignore some barriers, but the majority of barriers need
solutions. It is necessary (or at the very least highly preferable) to come up
with ways around the barriers of daily life.
A lot of assistive technology is the result of the solutions “invented” to
eliminate or reduce barriers. One example among many is the invention of the
“offset door hinge”. These hinges allow the door to swing away from the door
frame, hence expanding the clear opening width. This allows some wider
wheelchairs to get through, where the frame is wide enough, but the door
itself could get in the way with a regular hinge.
5
Offset door hinge
Another example is that of MaryBeth G’s wheelchair footrest. MaryBeth uses
a power wheelchair because she has Cerebral Palsy (CP). One of the issues
with her CP is that one of her feet keeps turning out. Another issue is that her
legs are very short, requiring “paediatric footrests”. The footrest of her
wheelchair was designed to support a foot that would point straight forward,
not turning out. As a result, her foot would twist itself off the footrest of her
wheelchair. MaryBeth dealt with this problem for over a decade – asking her
wheelchair vendors what her options were to find a solution. One day she
spoke to me about the issue and pointed out that “if only the footrest was at
an angle...”. We discussed drilling a hole in the support for her footrest, at an
angle, and mount the footrest. This was a relatively simple solution to a
problem that had existed for a long time.
Margaret Pfrommer
Margaret Pfrommer
Photo Dr. Childress.
Margaret Pfrommer was a disability rights’ activist. She died in 1998 at the
age of 61 (Ritter, 1998). Margaret contracted poliomyelitis as a child and was
paralysed “from the neck down”. She required a ventilator to breathe. I had
the pleasure of working with her for many months.
She controlled her power wheelchair with a “Sip and Puff” controller. This
device is used by many individuals who have impairments affecting both their
legs and arms. Christopher Reeve was perhaps the best known person to
have used a Sip and Puff controller on his wheelchair (Kluger, 2002).
6
Margaret was the first to use such a controller, which was developed at the
University of Chicago in the late 1960’s (Little, 1996). This technology has
now been used by quadriplegics to sail solo around Britain, Australia, and to
cross the Atlantic (“Disabled Sailor | Disabled and Productive,” n.d.). The Sip
and Puff technology is not one that has made its way into every day use, but it
is a significant advance in technology for people with disabilities.
Margaret was also instrumental in the development of communication aids
such as text typing or environmental controllers such as book page turners.
She also used a voice-controlled telephone exchange and worked as a
receptionist using this device (Childress, 2002).
Typewriter / Keyboard
People have tried to invent machines to write for a very long time. There were
many different designs that led us to where we are at today. In fact Acocella
suggests as many as 52 different designs led to the typewriters we know
today (2007). One of these designs was the Hansen Writing Ball, invented by
Reverend Rasmus Malling-Hansen. His “typewriter” was the first typewriter to
be commercially produced, and was even a commercial success in Europe
(Wikipedia, n.d.).
Hansen Writing Ball Keyboard
Mr Malling-Hansen was, at the time of the invention, the Principal at the
Danish Royal Institute for the Deaf (Wikipedia, n.d.). According to John Lee
Clark, his motivation was: “to find a way for [the Deaf students] to write as fast
as they fingerspelled” (2010). One of the major designs of early typewriters
was aimed at people with disabilities. Arguably this design benefited the
evolution of they keyboard to what we know today.
It is interesting to note that many other keyboards using a circular shapes
have been developed, notably some made by PCD Maltron. These
keyboards intended for one handed typing use the “inside” of a ball, instead of
the “outside”. The Colchester Museum describes the keyboard:
“The special shape and layout of this keyboard matches the natural
hand movement of people who touch type with one hand.” (“Exhibition
Objects,” 2007)
7
PCD Maltron Left-Handed Keyboard
Speech-to-Text
Speech-to-Text (or Speech Recognition) applications, as the name implies,
allows a user to speak to a computerised device, and process the voice into
commands usable by the device. One of the primary reasons for developing
this was to give greater access to people with disabilities, such as Margaret
Pfrommer. From there, other applications were quickly built upon.
One of the best known software for Speech-to-Text is Nuance’s
NaturallySpeaking, formerly known as Dragon Dictate. This application allows
not only the dictation of text into documents, but also allows full control of a
PC, including creating/opening/saving/closing files and starting applications.
This is ideal when you are unable to use your hands to control your computer.
Nuance is now marketing several different specialised versions of their
software, including some specifically for professionals working in law wishing
to do dictation. They don’t need to send anything for transcription, they can
just “talk and it types” (“Dragon NaturallySpeaking Legal,” n.d.). Businesses
also benefit from this. Nuance also has specialised medical software for
transcription, as well as systems that allows “physicians [to] dictate their
‘medical decision-making’ in their own words using the fastest, most accurate
speech-recognition product, ever. Review medications or lab results with a
single voice command and dictate your comments directly into your EMR.”
(“Nuance Healthcare Solutions Real-Time Speech Recognition,” n.d.).
Speech-to-Text is also used for military aircraft pilots (planes & helicopters) to
reduce their workload. While accuracy and consistency are not yet sufficient
to use the technology for critical functions such as weapons handling, other
cockpit functions can be controlled by speech-to-text applications (Eurofighter,
n.d.; Wikipedia, n.d.)
I was made aware of an interesting use for Speech-to-Text software by a
friend of mine who is Deaf. She told me that her local church had several
Deaf or hard-of-hearing parishioners. The church could not afford to hire sign
language interpreters, but even had they been able to, not all people who
couldn’t hear the sermon were fluent in sign language. The church used a
donated laptop and overhead projector to project the output of
NaturallySpeaking onto a big screen. The priest was then able to talk to his
parishioners, using his usual microphone, which was connected to the laptop
(Boos, 2003). It is a relatively simple and inexpensive solution to a disability-
8
related barrier, using an everyday product which had its origin in assistive
technology.
Another area of use for speech recognition is in home automation. One can
control the volume of music piped throughout the house, the temperature, the
lighting, the curtains, and any number of other aspects of being comfortable at
home. Using speech recognition, it is even possible to control these things
from a remote location (Milward, 2006) – Go on holiday and control
opening/closing of curtains and lights, music, TV, giving the impression of
someone being there, or turn on the heater or air conditioner on the way
home from work with a phone call (HAL, n.d.). This kind of automation also
benefits people with disabilities. It is a “win” for everyone.
Speech recognition is increasingly used in automobile entertainment systems,
allowing drivers or passengers to control the radio or video in cars (Geyer,
2010). Ford’s system is called “SYNC” and allows you to “make hands-free
calls, control your music and other functions with simple voice commands”
(Ford Vehicles, n.d.).
Speech recognition is also a great part of hands-free telephony. With many
phones it is possible to speak to the phone and initiate calls, or even conduct
online searches. I remember a colleague who was quadriplegic and had this
functionality in his phone in 2003. It caused much hilarity as he hadn’t
programmed it quite properly and every time he mentioned my name in a
discussion, his phone would call me. Despite these kinds of hiccups, the
advantages to him were tremendous. This is yet another example of assistive
technology moving into everyday use, and those products being used by
people with disabilities to increase independence.
Text-to-Speech
Text-to-Speech, or speech synthesis is not new. There are legends of Pope
Sylvester II having built a “talking head” that could answer questions by
saying the words “yes” or “no” as far back as the late 900’s or early 1000’s. In
the late 1700’s bellows-operated machines could “speak” vowels. In the late
1960’s, “proper” computer speech synthesis was completed (Wikipedia, n.d.).
These efforts were not in the realm of assistive technologies.
Yet a significant part of more recent growth of text-to-speech software came
from developing “screen readers” for people with visual impairments. These
screenreading applications allow someone who is blind or has poor eyesight
to have the computer “read” what is on the screen. The application “JAWS”
by Freedom Scientific is probably the best known such screenreader, but
other applications such as Windows Eyes or Orca are also available. These
complex applications allow interaction not only with text in a document, but
also with all menus and controls on the computer itself.
Text-to-Speech technology in combination with GPS technology is used in
many navigation assistants used by drivers, such as Garmin, NavMan or
TomTom (Garmin, n.d.; Navman, n.d.; TomTom, n.d.). These hands-free
devices allow hands-free operation would not be possible without the
improvement in speech synthesis / text-to-speech triggered by work on
screenreading applications.
9
Other applications using GPS and speech synthesis were developed primarily
as navigational assistance for people with visual impairments, such as
Loadstone GPS, but can be used by anyone, regardless of level of sight
(Loadstone GPS, n.d.). Loadstone is available for Symbian/Series60 phones.
There are many other like applications such as Trekker, Wayfinder Access,
etc (Wapedia, n.d.). There even is an application that combines GPS
directions with “augmented reality”, available for Android devices.
“Once started, The vOICe for Android continuously grabs and sounds
snapshots from the camera. Each camera snapshot is sounded via a
polyphonic left-to-right scan through the snapshot while associating
height with pitch and brightness with loudness. For example, a bright
rising line on a dark background sounds as a rising pitch sweep, and a
small bright spot sounds as a short beep. This approach allows for
sounding arbitrary images while largely preserving the image content
as needed in sensory substitution for the blind.” (Seeing With Sound,
n.d.)
Ford SYNC, mentioned in the Speech-to-Text section of the paper, will also
speak out loud incoming text messages.
“With the touch of a button, SYNC will read incoming texts to you in an
easy-to-understand voice. SYNC is even smart enough to translate
commonly used phrases and emoticons such as "LOL" and :). And for
your convenience you can easily text back one of 15 generic
responses.” (Ford Vehicles, n.d.)
Text-to-Speech has also been used in game development. Dez Lang tells
how he was getting frustrated by repetitive actions that didn’t really move his
project forward, and how it resulted in him using text-to-speech to ease his
workload (2003). It is also conceivable that major games might use text-tospeech and advanced speech synthesis to reduce the reliance on voice
actors. This could give more flexibility in gaming experience for the
individuals playing the game – a greater range of options and dialogue could
open up based on their actions in the game.
iBOT - Segway
I met Dean Kamen in 1999 at the National Council of Independent Living
convention in Washington DC. He was demonstrating a wheelchair that could
balance on two wheels. He had invented a “balancing technology” based on
the gyroscope. This wheelchair could also climb stairs, curbs, or go over
terrain often not passable by other power wheelchairs. It was named “iBOT”,
and produced until 2009, by Johnson & Johnson (Wikipedia, n.d.). At a cost of
over US$26,000 this wheelchair was not as successful as it could have been
simply because most people who could benefit from it could not afford the
device.
10
iBOT wheelchair balanced on two wheels
Kamen “recycled” the gyroscope technology and gave the world the Segway,
“a two-wheeled, self-balancing electric vehicle” (Wikipedia, n.d.). While the
iBOT was not a commercial success, the technology driving this device was
used in a tool that is used everyday by people all over the world, including
many police departments.
Segway PT used by a police officer
An interesting aspect of the iBOT-to-Segway development is that the Segway
is now used a lot by people with disabilities, notably leg amputees. Disability
Rights Advocates for Technology (DRAFT), a US-based non-profit
organisation began Segs-4-Vets, a programme distributing Segway vehicles
to US Veterans who lost one or both legs at war.
11
Double-leg amputee Leonard Timm with veterans on Segway PTs
Used with permission from the Stars and Stripes © 2008, 2010 Stars and Stripes.
Eye Gaze
The study of eye movement or gaze tracking is not new. Some of the early
concepts came out in the 1800’s, with the “modern” work done by Yarbus in
the late 1950’s. (Wikipedia, n.d.). Today, eye gazing or gaze tracking is used
in many different environments, for people with disabilities, and for the general
public.
Communication is one of the main uses of eye gaze tracking for people with
disabilities. This technology is used for people with Locked-In Syndrome, a
condition in which a person is aware and awake but cannot move or
communicate due to complete paralysis of nearly all voluntary muscles in the
body except for the eyes (Wikipedia, n.d.). They are able to use their eyes to
point at letters or pre-determined phrases on a board. This is often done with
the assistance of a human helper who interprets the phrases for the individual
who has a disability. More and more, computer-based applications “speak”
these phrases for the individual. Such technology was being investigated to
allow Stephen Hawking greater communication freedom in April this year
(Fox, 2010). Until now, Mr. Hawking has been selecting letters by hand, and
later by twitching his cheek.
12
F-Shaped heatmap / reading pattern
Image © Jakob Nielsen 2006. Used with permission.
Arguably one of the best known uses of eye gaze tracking in the web
development community is to see where visitors look first on a website. This
has led to what many refer to as the “F-Shaped” pattern which was discussed
at length by Jakob Nielsen (2006).
Canon EOS 5D – Features eye gaze focusing.
Eye tracking was used for a while in Digital Single Lens Reflex cameras, in
particular the Canon EOS 5. The concept was excellent – helping the focus of
the camera based on where you were looking through the viewfinder. But the
feature never really took off. It has been suggested that this is already a “thing
of the past” (Brendant, 2008).
13
Lexus LS460 – Features eye gaze tracking for safety.
Lexus offers safety features in some of their cars, notably the LS460, which
use eye gaze tracking to determine whether a driver is focusing on the road or
possibly falling asleep (New Car Net, 2006). One might see it as an “antifeature”, but for people who are driving long hours at night, being alerted by
the car before falling asleep and driving off the road is a huge benefit.
Vertegaal, Dickie, Sohn & Flickner suggested a design for an “Attentive Cell
Phone” – a device that could detect if you’re already in a face-to-face
conversation, and could then control the phone’s behaviour for you e.g.
sending calls to voicemail (2002). Again, this may or may not be behaviour
you want controlled by a device, but the concepts can be used and re-used.
In 2000, a group of Finnish academics proposed “iDict” a Gaze-Assisted
translation aid which analyses where the eye stops on the page and suggests
definitions of words (Altoonen, Hyrskykari, Majaranta, & Räihä, 2000). While
this has not come through as a commercially available system, it would be
easy to see how it would help people learning foreign languages, children with
learning disabilities, or people recovering from brain injuries.
Brainwave
Over the last few years we have seen more and more ways to interact with
computers using only our thoughts. This technology wasn’t developed merely
for people with disabilities, but the application of the technology is beneficial to
many people with various disabilities. The same person who has Locked-In
Syndrome and communicates with eye gaze systems could control
environmental systems to increase independence. They could control
wheelchairs, lights, doors, email, etc.
This sounds like science-fiction, but science-fiction is here!
In April 2009, it was announced that Adam Wilson from the University of
Wisconsin-Madison was able to send several tweets by “thinking about it”
(Kirkpatrick, 2009). Mr. Wilson wore a cumbersome cap with electrodes that
were able to “grab” his thoughts and translate them into simple instructions for
the computer. For the curious reader, that first tweet was:
“USING EEG TO SEND TWEET” (Wilson, 2009)
14
Better yet, Emotiv Systems has a “simple” headset that is used for controlling
computers, environmental controls, and can also be used for gaming. These
functionalities are demonstrated in the video “A headset that reads your
brainwaves” on TED Talk by Tan Le (Le, 2010). These headsets are
relatively inexpensive, retailing at US$300 each.
The EPOC neuro-headset by Emotiv Systems
What Next?
There has been ongoing development of tools / technology to handle barriers
for people with disabilities. These technologies often migrate from a
“disability-only” use to a wider use by “everyone”, in everyday situations.
There are many situations where the technology wasn’t specifically designed
for people with disabilities, but where it can be used by everyone.
What comes next? One can imagine an improvement of existing technology.
Looking at the EPOC neuro-headset, it is easy to imagine a reduction in size
of such a headset, and the development of more applications to be used by
all. A doctor who 20 years ago had to get his notes transcribed by a 3rd party,
and can now dictate these notes directly to the computer with an application
such as Nuance NaturallySpeaking would be able to simply think his notes.
The same hardware and application could be used by quadriplegic to
manipulate their environment and gain independence. Perhaps advances in
this technology will allow us to do away with the headset altogether. It is
conceivable that a silicon chip implanted in the brain could be used for this
kind of control. Professor Naweed Syed of the University of Calgary just
published his research about such a silicon chip implanted in a brain and
being able to interact directly with brain cells through the chip (Calgary
University, 2010).
One hopes that the concepts of Universal Design will be adopted by everyone
involved in designing new tools & technologies. Such a paradigm shift would
likely increase the synergy – providing better solutions and more of them at a
reduced cost. Everyone benefits.
15
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