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Presenter(s)
Mark Uslan, Managing Director
American Foundation for the Blind
Technology and Employment Center at Huntington (AFB TECH)
949 3rd Ave., Ste 200
Huntington, WV 25701
Phone: (304) 523-8651
Email: muslan@afb.net
Darren Burton, National Program Associate in Technology
American Foundation for the Blind
Technology and Employment Center at Huntington (AFB TECH)
949 3rd Ave., Ste 200
Huntington, WV 25701
Phone: (304) 523-8651
Email: dburton@afb.net
Taine Duncan, Intern
American Foundation for the Blind
Technology and Employment Center at Huntington (AFB TECH)
949 3rd Ave., Ste 200
Huntington, WV 25701
Phone: (304) 523-8651
Email: duncan39@marshall.edu
The American Foundation for the Blind Technology and Employment Center at Huntington (AFB TECH) evaluates the accessibility of products for use by blind and visually impaired persons. This presentation will report on findings on three product evaluation projects: Home Blood Pressure Monitors, Cell Phones, and Office Equipment.
Home Blood Pressure Monitors (HBPM)
Approximately one third of the nearly 20 million people in the U.S. that have diabetes also have a visual impairment. Endocrinologists, the physicians who treat people with diabetes, have told us that in managing diabetes, maintaining proper blood pressure is as important as maintaining proper blood glucose levels. Studies have shown that people with diabetes are twice as likely to develop high blood pressure and that more than 50% of people with diabetes actually do have high blood pressure.
A person with diabetes has two to four times the risk of heart disease and stroke, and more than three-fourths of people with diabetes eventually die of a heart attack or stroke. However, tight control of blood pressure can reduce these risks and the risks of other complications of diabetes, including the deterioration of vision from hypertensive retinopathy, macroaneurysms, optic neuropathy, and vitreous hemorrhages. In addition to the health problems related to diabetes, nearly 1 in 4 adults have high blood pressure.
Self-monitoring with an HBPM is an important step in maintaining healthy blood pressure. With the knowledge frequent home monitoring provides, a patient and physician can better manage hypertension with proper medication and exercise. Frequent self-monitoring provides much more information to work with than the occasional check at the doctor's office, and it avoids what researchers call "white coat syndrome. Studies have shown that white coat syndrome-the tendency to exhibit higher blood pressure in the presence of a physician-can lead to the mistreatment of persons who suffer from this phenomenon.
To test their accessibility to people with visual impairments, we acquired 11 home blood pressure monitors that are approved by the U.S. Food and Drug Administration and recommended by the British Hypertension Society. The test group included 4 meters from Omron Healthcare, 4 from Microlife USA, and 3 from A&D Medical. Only one of the monitors, manufactured by A&D Medical, features speech output.
We evaluated the accessibility of the monitors by assessing the following six areas:
• Visual display: Can a person with low vision read the information on the screen?
• Quality of speech output (talking monitor only).
• Control buttons: Can a person who is blind or has low vision easily identify and activate the buttons?
• Documentation: Are the manuals available in alternate formats?
• Positioning of the cuff: Can a person who is blind or has low vision easily position the cuff properly?
• Battery replacement: Is it easy to change the batteries tactually?
Results show that all the monitors we evaluated feature low-contrast, black-on-gray LCD displays. Some people with low vision would be able to read the displays because of the large fonts, which ranged in size from 56 points to 82 points. Others might not be able to read the displays because of glare, low contrast, and the lack of color and backlighting. The speech output on the talking monitor is produced by an easy to understand recorded human voice. Most of the buttons on the monitors are well designed, easy to distinguish and identifiable by touch. We found the manuals for the nontalking monitors only in print and in PDF computer files. The PDF files were not designed to be accessible using a screen reader, such as JAWS or Window-Eyes, but they worked fine with the ZoomText screen-magnifier software. We found no manuals in Braille, audiocassette, large print, or accessible electronic formats. We found it easy to place the cuff properly on the arm with all the meters we evaluated. All the monitors use four AA batteries. Once you learn how to locate and open the battery compartments, it is easy to replace the batteries.
Cell Phones
For the past 2 years, AFB TECH has been tracking the evolving trends in the accessibility of cell phones. We have evaluated several cell phones on the market to determine accessibility for blind or visually impaired users, and to see what cell phone manufacturers and service providers are doing to comply with what is commonly referred to as Section 255. Section 255 of the Communications Act, as amended by the Telecommunications Act of 1996, requires that cell phone manufacturers and service providers do all that is "readily achievable" to make each product or service accessible.
As we reported at this conference last year, our 2003 evaluation work showed 4 of that year's top of the line cell phones to be severely lacking in accessible features. However, 2003 also saw the emergence of TALKS and Mobile Accessibility, 2 software products from Europe that can be installed on certain cell phones to provide speech output for accessing screen information.
In 2004, we continued our work evaluating upgraded versions of TALKS and the new Mobile Speak software, which is produced by the makers of Mobile Accessibility, its less robust predecessor. We evaluated TALKS and Mobile Speak on the Nokia 3650, 3660, and 6620, which are 3 of the limited number of phones that feature the Symbian operating system and are compatible with third party software products. We also evaluated 3 other cell phones that feature varying degrees of speech output right out of the box without the need to install third party software: the Owasys 22C from Spain, the Samsung SPH-a660 and the Toshiba VM 4050, also marketed as the Audiovox CDM 9950.
Again, as we reported at this conference last year, we first created a questionnaire to survey people who are blind or visually impaired to determine which features they would most like to be made accessible. This resulted in the "Sweet 16," a list of 16 features that we then evaluated on each phone to determine whether or not a blind or visually impaired person could access the features and noted the barriers to using them. Evaluation methods included judging the ability to tactually identify keys, determining the ability to navigate menus, and assessing the readability of the displays.
Our results show that the TALKS and Mobile Speak software products show real promise for making cell phones accessible to people who are blind or visually impaired, as they provide clear speech output to allow access to nearly all of the phones' features and functions. However, although the Nokia phones were properly designed to accept the TALKS and Mobile Speak software, their keypads and other control buttons were not designed to be easily identified and operated by touch. Also, the software is expensive, with TALKS priced at $295 and Mobile Accessibility priced at $229, which is on top of the price of the phones themselves, which can run between $100 and $300.
The Owasys 22C also shows promise as it was designed from the outset specifically for blind and visually impaired users. It features speech output to access all the phones functions, and it also has the most tactually identifiable keypad that we have evaluated so far. However, it has far less features than most of today's cell phones, and it is currently available only in selected European countries.
The Samsung and Toshiba/Audiovox phones are promising in that the speech software is built directly into these small clamshell-style phones. However, the speech is very limited and provides access to just a few features, such as signal and battery strength.
After 2 years of analyzing cell phones, we have seen the environment change from one in which no accessible phones existed to one where we are seeing the beginnings of true accessibility. In addition to the phones mentioned here, other manufacturers are reportedly developing phones with speech output, including LG and Motorola. Also, Cingular, a national service provider announced a limited offer in late 2004 to rebate the full cost of TALKS to blind and visually impaired customers. However, the industry still has a long way to go to meet the requirements of Section 255, and more manufacturers and service providers need to step up to the plate and provide more accessible choices for their blind and visually impaired customers. The fact tht the phones and software that we have evaluated do exist does show that it is "achievable" to provide an accessible cell phone.
Office Equipment
The AFB TECH project to evaluate the accessibility of office equipment is a new initiative that commences in the fall of 2004. In the first phase of the project a survey of small businesses will be conducted to determine what office equipment they use and expect new employees to be able to operate. The products targeted for evaluation will be selected from the information gathered from the survey. Those products that use small screen visual displays will be of special interest because of the difficulty these interfaces present to people who are visually impaired or blind. The products will be acquired in the winter of 2005 and results will be presented at CSUN 2005.
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