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AT for the 21st century and beyond

Over 10 million people in the UK have some form of physical or sensory disability, and that number is rising steadily with the country’s ageing demographic profile. More than 65% of disabled people are over 65, a minority are born disabled.

This fact, combined with the continuing explosive growth of new technologies – mobile services, internet and mobile technologies – means that no one can ignore the issues surrounding the assistive technology and access to online services.

Since 1995 organisations have been required by the Disability Discrimination Act (DDA) and later by the Equality Act, which replaced it, to make reasonable adjustments to their websites and IT systems to allow customers and employees to access them.

In the public sector the Disability Equality Duty, introduced in 2006, goes further; requiring authorities to draw up policies relating to all aspects of disabled access.

However, the evidence is that despite tougher laws, many disabled people are still excluded from taking part in our increasingly digital economy, with disastrous results in terms of their ability to work and live independently.

Businesses are losing out too: disabled people represent a market worth at least £240bn per year, according to estimates by the Institute of Employment Studies.

With disabled adults of working age only half as likely to be in work as non-disabled people, their exclusion is also a waste of skills.

The degree of assistance that people need in using IT varies enormously. However, solutions need not be complicated or too costly. Sometimes access will involve providing special purpose software or hardware, but in many cases it will be a matter of adjusting off-the-peg systems so that they are more comfortable to use.

Users may need help to set up systems, but in many cases users will be able to make changes themselves through built-in accessibility features. Users who have difficulties seeing or whose body movements are limited need most assistance.

Talking devices that use screen reader software and programs that magnify text or allow users to adjust the appearance of information are invaluable to people with sight problems or who suffer from dyslexia.

Those with physical difficulties may require other ways of entering data and controlling a system than via a conventional keyboard or a mouse. A variety of alternative devices are available to plug into desktop systems including trackballs, switches and adapted keyboards.

What technologies will enhance the lives of disabled people in the future?

In the main they are technologies that are going to affect everyone, but disabled people have their own particular take on these developments and possibly stand to gain a lot more.

3-D printing is already being widely used as a cheap means of producing custom built adaptations for wheelchairs, orthotics and other assistive devices.

Wearable technology such as glasses, watches and clothes promises a much more intimate relationship between digital services and disabled users. Instead of bulky input devices such as keyboards, wearable computing can be controlled through gestures and eye movements.

Driverless cars promise the freedom of the road to those who can’t drive a car today because they cannot see well enough or manipulate the controls. “Too many people are underserved by the current transport system. They are blind, or too young to drive, or too old, or intoxicated,” says Google’s founder Sergey Brin.

Robots are likely to make a big impact on disabled people’s lives in terms of providing care and the kind of services previously only available from other humans.

All of these technologies and lots more besides are going to be needed as the world’s population ages rapidly. Between 2000 and 2050, the proportion of the world’s population over 60 years old will double from about 11% to 22%, according to the World Health organisation.

Among these people the greatest causes of disability are visual impairment, dementia, hearing loss and osteoarthritis. Older disabled people will put massive strain on our ability to care for these people. Technology will be vital in supporting them and enabling them to live safe, fulfilling lives.

John Lamb

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Raising the awareness of assistive technology

Assistive technology has come of age when members of parliament decide the time is right to set up a group dedicated to the field.

The All-Party Parliamentary Group on Assistive Technology is composed of members of both houses of parliament and supported by outside organisations such as BATA.

The Group aims to disseminate knowledge, generate debate and facilitate engagement with assistive technology.

The timing is spot on since this small, vital and ingenious area of technological endeavour is entering a perfect storm of change.

From the north, the chill winds of austerity and cuts are still blowing and are likely to continue to do so for some time.

Despite falling prices, disabled people continue to struggle to fund the equipment that in many areas of life is vital for accessing digital services.

From the south, balmier winds are blowing. The apps revolution and plunging manufacturing costs mean that the range of assistive technology available to disabled people has never been greater.

Assistive technology even looks prettier and is certainly more available, as increasing numbers of mainstream manufacturers incorporate assistive elements into their products.

Hearing aids connected to the internet, spectacles that can identify people’s faces and driverless cars are just some of the innovations that promise to give disabled people greater independence.

Further turbulence is being injected into this high tech weather system by difficulties in developing assistive technology and persuading people to try out new things.

Although there is no shortage of bright ideas coming forward it is becoming more difficult to bring them to market as money and expertise becomes scarcer.

It is also important to manage expectations. Often people can have exaggerated ideas about how quickly and easily AT can deliver. It requires support, training and proper supervision to be effective.This is doubly so when 65% of disabled people are offer 65.

The outlook for assistive technology in the Palace of Westminster looks bright but outside the Westminster bubble, however, the weather is much more changeable.

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Switch Access

For those who have little or no manual dexterity and fine motor skills switch access is an alternative to using a keyboard.

What is a switch? Essentially it is like using a light switch. It is just an “on/off” device that toggles between those two actions. Switches can be simple round plastic coloured discs and can be either wired or wireless.

What is important is there needs to be an interface between the switch and the computer. A programmable switch box such as Crick’s USB Switch Box (£99) is one such device. The Switch Box allows keys on a keyboard such as the space bar and enter keys to be programmed to work as a switch.

 

Some physical disabilities require a method of keeping the device in place such as a felt-back board which switches can be velcro’d to like the Maxcess Tray. Clamps that fix to tables and wheelchairs may also be needed.

Having a reliable means of access is important for switch users. Also it is important to consider the eye-level view of the user – to see what they see. Lastly , there needs to be good posture that works in the best way for the condition of the user

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Unleashing true potential through AT

In the UK, the government has made great strides in improving the lives of the disabled from an early age. The government’s Disabled Students’ Allowances and Access to Work schemes ensure that those with dyslexia continue to be supported throughout their life.

On the downside, those with dyslexia can often fail to self-identify, meaning they can go undiagnosed for many years, potentially struggling in silence with the condition.

To underline the consequences of this situation, research by the World Literacy Foundation found that illiteracy costs the UK economy more than £81 billion each year. Employers must therefore begin to encourage an open culture in which workers can unashamedly declare their dyslexia – if only for the benefit of the wider UK economy.

In fact, the longer it takes to intervene to diagnose literacy difficulties, the greater the cost, not just financially, but socially as well. Analysis by the Department for Education showed that pupils who entered secondary school with very low literacy skills had an exclusion rate five times that of pupils who were more able to read and write, while studies by Dyslexia Action have demonstrated that there is an over-representation within the UK prison population of those with literacy difficulties and dyslexia.

If you add to these alarming figures the unfortunate number of students who leave education with poor results and poorer self-esteem because of their dyslexia, it’s clear that those with literacy difficulties risk being pigeonholed and led to believe they are inferior from an early age. We must act now to intervene early and ensure literacy difficulties are identified and acted upon swiftly, so as to save the development of more pernicious issues further down the road.

Encouraging or helping an individual to self-identify can be a catalyst for change in a person’s life and bring about a huge benefit psychologically as they begin to navigate issues they had perhaps struggled with before. Every provider of assistive technology knows the transformative effect it can have on a person with dyslexia, a SEN student, a struggling reader or writer, a person with low literacy levels or an EAL learner, helping them to be more independent and engaged learners, whilst allowing them to better reach their potential.

Tools such as text-to-speech can benefit struggling readers with comprehension and understanding. Mind mapping software can assist with brainstorming and the management of complex information for those who struggle with organisation. Screen masking features can tint the screen to make it easier to read for those with Irlens syndrome or simply provide contrast for ease of reading and audio making tools allow for greater independence to learn on the go.

Assistive technology is just one enabler for those who suffer from literacy difficulties, but it’s certainly the most cost-effective method by saving the cost of additional teachers. Most importantly, students should never feel they are a ‘special’ or ‘unusual’ case. In aid of this, assistive technology equals the playing field by allowing students to participate in class at their own pace, whilst playing to their strengths.

Above all, assistive technology makes for more confident and happier individuals, emotionally happy and more ready to grip life’s chances. BATA is a key organisation to provide support and information for those looking for suitable AT resources to suit individual needs.

Like Richard Branson, Steve Jobs and Jamie Oliver, who have dyslexia, there is an innovator in each of us – and identifying the right AT support may just be the first step in unleashing true potential.

Elaine Crawford

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Ensuring a safe and more satisfying old age

Everyone experiences impairments to their sight, hearing, cognitive powers and mobility as they get older: over 65s represent the largest group of disabled people.

Fortunately there is a growing range of assistive products that enhance the capabilities of older people and enable them to live more independently. Many assistive features are now found in mainstream consumer products.

Magnification systems help combat sight loss and enable people to continue reading despite poorer vision.

Modern hearing aids that eliminate background noise are essential to help people overcome hearing impairment, as are smartphone-based text relay services that turn voice into text for those who are profoundly deaf.

Technology can also assist people with dementia, safeguarding them by means of tracking systems and acting as a prompt, reminding them of the information they need to live independently. Voice recognition is a boon for those who can neither use a keyboard or push buttons.

Most people prefer to continue living in their own homes, if they can, rather than move into care institutions. Assistive technologies and sensors in the home that monitor people’s movements lead to an increased sense of safety and security at home and reassurance for relatives.

They can also play an important role in making the best use of scarcer manpower in a time of reduced budgets for social care.

Unfortunately, assistive technology is not always well understood by those involved with caring for older people. There is a lack of readily available information and not enough attention is paid to training care professionals in the application and management of technology.

Of course, technology is an additional cost for older people and although prices have been coming down in recent years more could be done in this area.

Some technology is available through Government schemes – wheelchairs and adapted cars, for example – but more needs to be done to make more assistive technology available free or at a low-cost.

Product and software designers must aim to follow universal design principles, including assistive features in products that are designed for everyone to use.

They must put themselves in the place of older people, simulating disabilities if need be, and testing their designs with older users.

Simplicity of design is the key to creating products that can be easily used by those who may not be familiar with technology. Designers must also bear in mind the need to keep costs as low as possible.

Developments are in the pipeline which could make life easier for many seniors.

Sympathetically designed care robots will augment human carers and provide round the clock attention for housebound older people. Driverless cars will keep others mobile for much longer, enabling older people to live more independent lives.

The widespread use of telecare systems to monitor and raise alarms will enable many more older people to live at home and lower the cost of their care.

At the same time all of these innovations must be carefully designed to avoid depersonalising and isolating the vulnerable people who use them.

John Lamb

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New VAT guidelines on the way

New guidance on which assistive technology products and services can be zero-rated for VAT will be coming soon from HMRC.

Member Ian Litterick of iansyst has been working with HMRC to write updated guidelines for both companies and VAT officials.

The guidance will make it clear for the first time that mobile devices can be sold zero-rated for VAT, if they meet certain conditions.

“Computer devices and systems are increasingly being used as aids to disability,” writes Litterick, who won a landmark VAT tribunal case in 2016 when he argued that a mobile phone was part of the CapturaTalk application he sold and should be supplied to disabled users without VAT.

“Most are general use products which may be useful for disabled people but are designed to be used by disabled and non-disabled people alike including desktops, laptops, tablets, smart phones and ereaders,” Litterick continues in the draft guidelines.

“Such products can be bought VAT free when they are sold as part of an assistive technology system.

“This involves pre-installing specialist software specifically required by the disabled individual making the purchase, which enables the complete system to be defined as designed solely for use by that disabled person.”

The VAT relief does not extend to the separate purchase of download software licenses that are not pre-installed as part of an AT system.

These will be treated as e-services, according to EU law, and liable to standard rated treatment, unless the software is supplied as physical goods, in other words on a disc or other storage device.

Read the draft guidelines in full and email your comments to Ian Litterick.

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Speaker launches All-Party Parliamentary Group for Assistive Technology

BATA is one of the founding members of a newly formed All-Party Parliamentary Group for Assistive Technology and will be at the forefront of changes in policy in this area.

APPGs are an informal group of members of both Houses of Parliament who join together to pursue a particular topic or interest.  Members of the group will be advocates in parliament, act as ambassadors, and raise awareness of the assistive technology agenda in the UK.

The APPG for Assistive Technology was launched on Monday 6th March by Speaker of the House, Rt Hon John Bercow and included contributions from Seema Malhotra MP, Lord Holmes of Richmond MBE, Hannah Rose, an assistive technology user, and Neil Heslop OBE who is Chief Executive of Leonard Cheshire Disability.

The event was sponsored by Microsoft.

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NHS takes stock of campaign to give disabled patients greater access

Adoption is the priority for NHS’ Accessible Information Standard: delegates look for more stick and carrot at AbilityNet conference

By John Lamb

Sign language users visiting Noble’s hospital on the Isle of Man are handed an iPad connected to a video signing service when they arrive, to enable them to communicate with hospital staff.

This striking example of how technology can overcome the barriers to communication encountered by disabled people using health and social services has up until now been a rare one.

A 2009 report by RNIB found that then the majority of blind and partially sighted people were not consulted about their information needs,. The study claimed that 95% of those given personal health information by their GPs were not asked which reading format they required it in.

It is a problem NHS England is now taking seriously. For the past six years it has been working on how to remove the blocks that make it difficult for disabled people to access care.

Some patients struggle to read or understand vital information relating to their treatment. Others have difficulty using the online and telephone services the NHS increasingly relies on to book appointments, carry out consultations, deliver prescriptions and communicate the results of tests.

In future the health service will depend much more on digital communications as patients’ vital signs are monitored remotely and their care is managed electronically.

In a bid to make these channels inclusive, the NHS introduced a legally binding standard in August last year to push GPs and hospitals into making their services more accessible.

The Accessible Information Standard (AIS) is intended to ensure patients can communicate effectively with both health and social services.

As a result large print letters, audio recordings, Braille print and sign language interpreters are now much more likely to be in use in surgeries, clinics and hospitals in England.

Care providers are required to follow a five step plan that involves identifying the communication needs of a patient, recording them, flagging up what is needed to staff, sharing that information and finally ensuring a patient’s needs are met.

“We understand that we need to work with people who need information in different formats, people who use BSL or read Braille for example, and groups and organisations with expertise in producing or promoting accessible information and communication,” said Sarah Marsay, Public Engagement Account Manager at NHS England (pictured above), who runs the AIS project.

Recently Marsay commissioned a review to find out how well the standard is working. Professionals, patients and suppliers were polled on their views, with the intention of revising the standard in the light of their feedback by July.

“Adoption has not been universal it would be naive to say anything different,” she told a recent conference organised by IT charity AbilityNet to debate the standard.

“Our review is looking at the impact (of the standard) and any adjustments that are needed. Then we will reissue the specification and implementation guidelines,”

While delegates were generally agreed AIS was a robust standard, many were concerned that it was not being adopted widely enough. There were calls for greater efforts at enforcing the law, despite the fact that AIS is included in all NHS contracts.

“Can the standard be delivered?” asked British Assistive Technology Chair Antony Ruck, who led a session on how AIS should reflect the role of digital technology in enabling patient communications. “It is a matter of will and capability.”

Others felt more could be done to emphasise the economic benefits to health organisations.

A decision to exclude websites from the standard drew fire from some of the 60 people who attended the event at the headquarters of the British Computer Society. Although patients may be directed to a website as a way of making information more accessible, sites themselves are not covered.

“That is another piece of work,” explained Marsay. “AIS does not set out accessibility standards for an NHS site but of course they are not unrelated. A website can be an opportunity to provide accessibility: it can be an alternative to the phone and certainly be more accessible to people using screen readers.”

Accessibility is a complex business. One delegate from the London Borough of Camden, which runs a call centre fielding enquiries from people using a whole range of services, was concerned to know how to flag up disabled people when they called in.

Dr Howard Leicester MBE, a long-time campaigner for better patient services, underlined how important the standard was to specific groups of disabled people.

“The life expectancy of those with learning difficulties is lower than the rest of the population because of their communication problems, while sight impaired people often miss appointments because they cannot read the letters they are sent.”

However, technology was itself a barrier to implementing the standard. GP systems, for example, need to be upgraded to include routines for recording and flagging up patients’ communication needs. Not all suppliers had done that.

Others saw non-technical barriers to adoption of the standard. Andrew McCracken of charity National Voices said there were “great pockets of good things going on. But it is not just a question of technology there are bigger barriers: cultural and political barriers.”

Jean Irvine OBE, IT Accessibility Champion, was convinced the standard was fine. “It is all about implementation and that requires that all of the bodies come together and put the patient first.”

William Danckwerts, of Panlogic, a company that builds government solutions, also said the standard looked to be a robust model. The question was how to drive adoption; perhaps through a kite mark system.

He pointed out that some services were not accessible at the moment because of new devices and services. “If we are not careful we will become less rather than more accessible,” he warned.

“Before the introduction of the standard there were lots of road shows and good literature,” said Mike Page of RNIB Business. “We were expecting (GP) surgeries to get in touch but we have only had 20-25 enquiries.

“People have adopted their own best practice. We need to measure where we are today and how we can progress.”

Although there is clearly some way to go before the Isle of Man experience is the norm for disabled patients in England, there is no lack of determination to get there and in as short a time as possible.

Both BATA and AbilityNet will be lending their weight to this all-important project.

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BBC highlights experiences of disabled people as workers and consumers

The BBC is exploring the experiences of disabled people in the workforce and as consumers in a week of special news coverage entitled Disability Works.

Coming from across the UK and around the world, the stories will focus on the experience of disabled entrepreneurs and employees. They will examine how different businesses are innovating to help disabled people and look at the power of the purple pound in the UK and global economy.

Graeme Whippy, a consultant and speaker at BATA’s AGM, was one of the first people to feature in the coverage. He talked about the barriers disabled people face in work.

As part of the week, BBC News is reporting from Mumbai where a UK company is hiring blind people as perfumers, and from Wales where a farmer paralysed after a car accident has been able to continue working, thanks to a specially adapted tractor.

They are also reporting on how the fashion industry has responded to disabled consumers and hear from the South African firm employing disabled welders.

The main day of output is Wednesday 22 February when reports appear across all BBC News output.

The broadcaster has also announced a £1 million scheme to recruit, train and develop journalists with disabilities, both visible and hidden.

Over the next year, twelve new positions will be created in BBC News’ Mobile and Online teams. The roles will range from broadcast journalists to assistant editors, with the successful applicants working across a wide range of content.

The first of the posts will be advertised shortly. Details will be available on the BBC Careers website.