Designing 4 Disabilities

Editor's Notes

• #2: My thanks to Judy for inviting me to talk to you today. I will give an overview of an area of research that I have focissed on, namely Disability Informatics.
• #3: <number> First, a little bit on my background… I am a former post-doc fellow in Medical Informatics at OHSU From there, OHSU Webmaster for 5 years Moved to the OIDD to lead their research program in Technology and People with Disabilities I have a couple of great videos I would like to share with you, some may have already seen them The first is one that aptly describes what it is like to manage a large Web site like OHSU…
• #4: Before I continue, I have to warn you that like most people in a specialized field, I have a tendency to get a little carried away with the technology and its acronyms so I want take this opportunity to interrupt me for clarification should I use a term that you are not familiar with
• #5: <number> And this is equally applicable to acronyms Information Technology professionals such as myself are notorious for dropping acronyms like they are going out of fashion But I think they are equally rivaled by academics who will massage project titles until they create a catchy sounding name derived from the first letters of each word So…if you see “Alphabet Soups” that are not explained, yell “Acronym Alert”
• #6: <number> To be sure that someone explains them to you
• #8: Defining disability is fraught with conflicting statements, different use and definition of the same terminology.
• #10: The WHO tries to distinguish different terms; impairment vs. disability vs. handicap In reality, handicap Is an older term that has fallen out of favor, become politically incorrect. Disability has remained PC, but must be used in a person first manner. Person with a disability vs. Disabled person. Impairment is often used to describe a milder disability state, I.e. one that does not severely impact the individual enough to be legally disabled. Many people have impaired vision but today, assistive technology such as eyeglasses, contacts and the latest surgery can compensate or even correct the impairment.
• #12: So what about people with disabilities? Well it is a larger population than you might think. Disability is broadly broken down into physical, sensory (vision &hearing) and cognitive. In 2000 Census, ~50 million people in the US reported having a disability.That’s 1 in 5 or 20% of the population. The US Census Bureau defines disability as “a health problem or disability which prevents [you] from working or which limits the amount of work that [you] can do” - fairly inclusive. Interestingly, 14 million people over 65 reported a disability, That’s 42% of the seniors in the US. US Census statistics also showed that 8.1 million people have a visual impairment, with 1.3 million qualifying as legally blind. But 1.5 million of them are computer users The National Center for Health Statistics determined that ~20 million people or 8.6% of the US has a hearing impairment And it is estimated that ~15 million people, or 7% of the US have a cognitive disability. Closer to 20 million if you include mental health problems or diseases. Basically there are a large number of people with a wide array of disabilities within the regular population. These need to be taken into account when designing and creating content for the Web.
• #14: <number> So what is Disability Informatics? Informatics is the science of information use Medical Informatics- health care professionals Information Retrieval – Literature, Web Electronic Health Record (EHR) Radiological image Management Consumer Health Informatics- patients and consumers Disability Informatics- people with disabilities and those that provide services to them Health Care- Clinical Assessment / Evaluation Rehabilitation Occupational therapy Physical therapy Special Education Assistive Technology Replace function (Sensory, Physical) Train / Restore function (Cognitive) Wrote chapter in recent book in Consumer Health Informatics
• #15: So, why should we care about people with disabilities…
• #16: Tim Berners-Lee who should not need any introduction, recognized this in his vision for the Web in that it should be accessible to all, and not discriminate based on a person’s ability or disability. You would think that given that we are creating the Web in a post-ADA world, we would be sensitive to accessibility and careful to create an accessible environment from the start. And yet, due to a lack of awareness or concern about Web accessibility issues, we are re-engineering access barriers into the online world just as we did in the physical. [stats on the percentage of accessible Web pages on the Internet]
• #17: One of the main motivations for me for doing research in this area is really to address the increasing digital divide between those who have access to the online world in the information age and those who do not. Be it the general public trying to access health information in 1995 Or people with disabilities trying to access online information in 2002 The irony of it all is also that this results in inverse information accessibility as noted by an medical informatics colleague of mine, Gunther Eysenbach. Those who could most benefit from the information find it the most difficult to access it.
• #18: And one of the main motivations for me to be working in this area is really to address the increasing digital divide between those who have access to the online world in the information age and those who do not. People with disabilities represent one of the disenfranchised groups from the Internet. People with disabilities are less likely than people without disabilities to be online (43% v. 57%), and are less likely to be online from work (16% vs. 30%) because far fewer are working (Krane et al., NOD / Harris Poll, 2000) Paradoxically, the Internet has the potential for a greater positive impact on the lives of adults with disabilities because it provides resources and information, as well as opportunities for socialization and support.
• #20: Section 508 of the Rehab Act Title II requires State/Local Governments provide equal access to programs and services
• #21: Tyler v. City of Manhattan (1994) Student with a disability sued a university for failure to provide the reasonable accommodations needed to participate equally in school. The court decided that ADA had been violated, in part, because of its response to students on a case-by-case manner. Hooks vs. OKBridge (1999) Person with cognitive disability filed suit after his membership to a online Bridge Web site was terminated. Dismissed as OKBridge was unaware of the individual’s disabilty. National Federation of the Blind vs. AOL (2000) NFB filed against AOL based on public accommodation (Title III). Similar cases against Barnes & Noble and the Claire's Stores. All cases settled out of court. The UC Davis and UC Berkeley Settlement Students contended that their rights under the ADA had been violated by not providing reasonable help to deaf and hearing-impaired students. In court settlement, the two universities agreed to improve services for hearing-impaired and deaf students, to pay each of the five students in the suit $10,000, and to pay $1.1 million in lawyers' fees, but they did not admit fault. Southwest Airlines vs. Robert Gumson and Southwest Airlines vs Access Now (2002) individual who was blind sued under Title II since he was not able to effectively purchase an online ticket and that excluded him from special Web-only fares not available over the phone Surprisingly, the Judge ruled that the ADA public accommodation provisions apply only to physical spaces, such as restaurants and movie theaters, and not to the Internet. Martin vs. MARTA (Metropolitan Atlanta Rapid Transit Authority) Individuals sued MARTA claiming it failed to "make information available to people with disabilities" because they were unable to secure routes and schedules from their Web site (Title II - "effective communication”). MARTA countered that the plaintiffs could call for this information during business hours or ask ahead of their need and MARTA would print up Braille schedules. The Judge ruled that MARTA was, in fact, violating the provisions of the ADA. Spitzer Agreement (2004) New York State Attorney General Eliot Spitzer announced settlements with two major travel Web sites (Ramada.com, Priceline.com) that will make the sites far more accessible to blind and visually impaired users. National Federation of the Blind (NFB) vs. Target (2006) Settled out of court. $6million in damages, Target made website accessible
• #24: The principle of Universal Design
• #25: Universal design has 7 guiding principles Equitable Use: The design is useful and marketable to people with diverse abilities. Flexibility in Use: The design accommodates a wide range of individual preferences and abilities Simple and Intuitive Use: Use of the design is easy to understand, regardless of the user's experience, knowledge, language skills, or current concentration level Perceptible Information: The design communicates necessary information effectively to the user, regardless of ambient conditions or the user's sensory abilities. Tolerance for Error: The design minimizes hazards and the adverse consequences of accidental or unintended actions. Low Physical Effort: The design can be used efficiently and comfortably and with a minimum of fatigue. Size and Space for Approach and Use: Appropriate size and space is provided for approach, reach, manipulation, and use regardless of user's body size, posture, or mobility. These can equally be applied to the Web with the possible exception of #7.
• #31: >1990 – Terminal (TTY), Dial-up (Modems) 1990-5  Graphical User Interface (GUI) Images without text description Barrier to people who are blind 2000-5 Dial-up  Broadband (Cable, DSL) BB reaches critical mass in 2004 http://www.pcw.co.uk/news/1157453 - Nielsen / NetRatings - >50% US Households http://www.connectedhomemag.com/HomeOffice/Articles/Index.cfm?ArticleID=42357 - InStat/MDR - >20% Video without text description Barrier to people who are deaf Today  Media Convergence Rich, complex Web interfaces Barrier to people with cognitive disabilities
• #33: Wherever possible, normal text is preferred to images with text since they can be spoken, and also enlarged by the browser for low vision users. Using alternate text, or ALT tags, is one of the easiest steps to take to make images & animations accessible to the blind, particularly when an image is used as a hypertext link or an image map. The more challenging problem is appreciating the linear nature in which the voice browsers operate and that graphically pleasing pages are often difficult or impossible to navigate. However, with a little foresight is design, it is often possible to avoid this. Tables are also a source of confusion when read line by line but there are techniques for improving the “speakability” of these as well.
• #34: Problems due to color blindness can be discovered by simply viewing graphics in black & white to ensure sufficient contrast in the color value. This principle also provides a good indication of the readability of colored text on a colored background.
• #35: Problems due to color blindness can be discovered by simply viewing graphics in black & white to ensure sufficient contrast in the color value. This principle also provides a good indication of the readability of colored text on a colored background.
• #43: Understand limitations of validation tools
• #44: Validate code to W3C standards. Validate both CSS and HTML/XHTML The WAVE validator is useful to linearize tables A-Prompt is a free downloadable tool to validate and fix errors for an entire website Bobby is now owned and marketed by Watchfire – it’s use as a free tool is limited
• #48: Accessibility is an approach to design, not a stamp of approval Emerging standards continue to make the Web accessible – stay tuned to new tools and best practices Separating content from layout is an essential strategy for accessible design Competing standards and different ideas about “accessibility” are widespread – do your best! Avoid retrofitting by planning for accessibility
• #50: <number> A wealth of accessibility information exists on the web – find it using google.com WebAIM.org is an excellent one-stop source for accessibility information The National Center on Accessible Media is another excellent resource Making Educational Software and Website Accessible Regional ADA Centers: 1-800-949-4232