iPads bring accessibility to the disabled at a far lower cost
It's only been half a year since its introduction, but the iPad has already become a major player in the field of assistive technology, helping disabled people communicate. A number of studies are underway (and many more are in the planning stages) to offer much-needed data on the effectiveness of the iPad and other iOS devices in this area. A few days ago, The New York Times ran a piece about the implications of the iPad to the disabled community.The Times tells the story of Owen Cain, a victim of a degenerative disease called spinal muscular atrophy. He acquired the disease as an infant, and there is no known cure for it. Although his parents bought him a number of computer devices to make his life more pleasant, they were all failures -- until he met the iPad.
With his arms in slings, Owen was able to touch an icon on an iPad and run Gravitarium, an inexpensive app that plays soothing music while displaying colorful stars. It doesn't take lot of strength to swipe a page or tap a button on the iPad -- certainly less than if a device had hard buttons. Now, Owen is using Proloquo2Go to communicate, reading books such as Alice for the iPad (shown in the video after the break), and his repertoire of app-enabled abilities is growing. Interacting with the iPad has improved Owen's life to a large degree.
Assistive technology devices usually cost thousands of dollars and only do one thing. Their unifunctional design is what allows them to be covered by Medicaid. If a device can do more than one thing, it's not covered, no matter how much less it costs or what it can do. This has littered the closets of the disabled with technology that is often big and clunky and really didn't do what was needed in the first place. Nancy Miracle, president of Digital Miracles, the creators of the Digit-Eyes app for the blind, says the shelf life of one of these devices is under two years, and people wind up with many of them.
The price of an iPad is many times less than the cost of the usual assistive device. In reviewing Proloquo2Go, a US$189 app, I found that competing unifunctional devices cost between $2000 and $8000. Owen's iPad cost $600.
One of the beautiful aspects of the iPad is that you don't have to know exactly what you want it to do. Most apps are cheap, and many free or lite versions of complex software are available so a caregiver can experiment before deciding what would be best. Another advantage is that new apps are coming out at breakneck speed; many of them can benefit the disabled, so the therapeutic virtues of the iPad grow over time. This is in direct opposition to the usual world of assistive technology.
Another reason the iPad has become so popular as an assitive technology device is that Apple had the foresight to build accessibility right in. Usually, devices need to be refit for the disabled, but with a strong suite of built-in accessibility features, Apple has already done much of the heavy lifting. Representative Edward J. Markey (D-Mass), who has co-written the 21st Century Communications and Video Accessibility Act, states that "three quarters of communication and video devices need to be adapted for blind and deaf people... Apple is an outlier in making devices that are accessible right out of the box." For those with more dexterity, in a real sense, the iPad and smaller iOS devices have turned the field on its ear. Unfortunately, legislation has not kept pace.
It's time for US legislation to catch up with technology and have public assistance cover multifunctional devices. Doing so would put pressure on many of the current assistive technology providers, but the pressure has already affected American taxpayers who, if laws change, will be hit up for far less money far less often. I can't see an iPad having a two-year shelf life, so I don't believe that replacing an iPad with another unit that will do more will be a likely scenario in the assistive technology market (since money is usually tight). Plus, although new features are bound to come out in later releases, the base functionality of the iPad will remain. I also see the iPad replacing a bunch of very expensive single-purpose devices that people with differing disabilities often have to acquire at the same time. A thorough revision of US legislation on assistive technology funding issues is more than in order.
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It's only been half a year since its introduction, but the iPad has already become a major player in the field of assistive technology,...
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I read this article shortly after it came out and was fascinated by it. I am designing training materials for Home Care Aides and the other day I went to a patient's home who has Spinal Cord Injury to learn more about his needs. When he came to the door in his wheel chair his lap was occupied with a iPad and around his neck was a iPhone. Near the end of the interview I said I was a fan of the products and asked how he felt about them and utilized them. He had a huge smile and described how both devices let him use his strong finger activate the features and type. Going everywhere with the phone. He liked using Dragon Dictate for instant messaging as well as writing reports for school (he was college age).
He also talked about liking the iPhone and a App that is produced by the county's transit department that lets him know where the bus is and when it will be stopping at the stop he is at. Gives him real-time data including emergency changes in the schedule. He is not dependent on calling a call-center (which does not exist in this region) to get this data.
I'd like to add that the screen the iPad is using is a capacitive one, which is different than the resistive screen most AAC devices have used in the past. Many devices including cell phones are now coming out with capacitive screens. Besides Apple's offerings, tablets and phones running Google's Android operating system also provide similar and in some cases superior access when compared to Apple's IOS.
When determining whether any device is appropriate, please consider the means of access the individual will use, as any form of technology will have its limitations.
Russell Dwiggins
Believe Ability Inc.
Randy,
I just saw an article on MacNN: (http://www.macnn.com/articles/10/11/04/mic.stand.attachment.supports.apples.tablet/) describing the "iKlip" that lets you take your iPad on stage. It's an iPad holder for microphone stands so artists can use it while performing. You should be able to modify the stand with no problem or make your own stand so you can attach the iKlip and it's only $40!
See:http://www.ikmultimedia.com/iklip/features/
HTH, Hank
Great piece, but I think you're wrong that the iPad and other iDevices won't have a working life of only a few years - especially if you're depending on accessibility features Apple invents. Already we have bunches of old iDevices that run the most recent version of iOS but can't use all of it's features - I have an iPod Touch (second generation, I think) that won't run VoiceOver, won't use voice commands, and doesn't have the ability to use the other accessibility features like screen zoom and high contrast mode. I haven't found an app that it absolutely won't run yet but some are getting very slow. Luckily I have an iPad I won in an online contest which does have these features and is much slicker with the larger apps, but that's serendipity rather than good planning.
And to the guy who suggested that disabled people who can't afford appropriate multi-function devices should have to depend on charity, I'm not American but I heartily disagree. We're having similar debates down here in Australia with regards to bureaucracy routinely funding expensive single-function devices but not much cheaper multi-function devices that have the ability to replace them and do other stuff too. I would contend that (a) all of the advantages you listed for having a charity could be obtained by a government department, and (b) people with disabilities should not have to depend on "the kindness of strangers" and all the uncertainty that is associated with a charity which may or may not get sufficient contributions in a specific year to help all of the people that need helping. Also, there will always be people with disabilities such that they can't use these devices (eg at the moment there's no possibility of people who need eye-gaze devices being able to use an iPad, and almost no possibilities for switch users) and so the government bureaucracy for funding Very Expensive Disability-Specific Devices will not be able to be eliminated.
Ricky
"(a) all of the advantages you listed for having a charity could be obtained by a government department"
- To a certain extent, yes... except that the government has less incentive to push for cost savings (if the budget is running dry for Medicare, run up the deficit or put in a call to your Senator buddy - if the budget is running dry for a charity they have to get creative to spend wiser or to raise more money, or else they might not be able to fulfill their mission to help as many people as possible, or they may be overshadowed by a different charity who can fulfill a similar mission more efficiently).
Also, the positive PR would never spin the same way (whether fair or not, it's the truth). I'd guess that a YouTube video clip saying how great it is that Charity X is using donated money to provide these nice Apple machines with incredible capabilities to disabled people would generate much happier feelings toward Apple as opposed to a similar video about Medicare covering the costs. When a charity does it, it's generous and inspiring; when the government does it, it's neither of those things (I can hear the outcry - "I can't afford an iPad, why is the government buying Apple products with my tax dollars!!!" - not positive feelings for Apple.) Of course, there probably wouldn't be a YouTube video for Medicare iPads, there would probably be a scathing article talking about the wasted dollars in a bloated program... again, no happy feelings for the Apple brand.
"(b) people with disabilities should not have to depend on "the kindness of strangers" and all the uncertainty that is associated with a charity which may or may not get sufficient contributions in a specific year to help all of the people that need helping."
- Disabled people should also not have to depend on a government who takes money from others by force and may or may not provide reimbursement for someone's specific needs when next year's legislative body runs the numbers for the appropriations bill... but since being disabled typically means someone has higher medical costs combined with lower productivity, they have to depend on someone. In my opinion (and I understand people disagree, and reasonably), it is better for everyone to have charities providing this need. Charities are not perfect and won't ever be able to help every single person, but neither can the government. The difference is that when I give to charities, I feel happy; when I get taxed, I feel pissed; when someone is helped by a charity, they feel grateful; when someone is helped by government programs, they're more likely to feel entitled (though, of course, not always).
"Also, there will always be people with disabilities such that they can't use these devices (eg at the moment there's no possibility of people who need eye-gaze devices being able to use an iPad, and almost no possibilities for switch users) and so the government bureaucracy for funding Very Expensive Disability-Specific Devices will not be able to be eliminated."
- I agree completely, which is why I mentioned that a discontinuation of government funding should occur "(as long as a reasonably priced iPad, or similar, alternative functionality exists)". Though my ideal world would be one in which even those expensive devices with no alternative can be reasonably provided by charities, I know we're not there yet. For devices and functions mentioned in this article, we're there; this could work.
The Times piece was published on October 29, 2010 -- I'm sure I've already commented on it at some forum or other.
TUAW -- lot of catching-up to do.
I have a daughter, now 50, who has been afflicted for most of her life with learning disabilities, epilepsy, and inability to speak clearly, The special school she attends provided her with a fairly heavy and clunky Windows-based device for her to work with (costing medicare $5000.00.)
By accident, I happened on an iPad app called Proloquo2go. After much research, we bought the app ($189.00) and gave her her own iPad...she is thrilled beyond belief. Proloquo2go does require a lot of set-up, but her sister is working on that.
The special school is now interested, and asking us about it.
Corrections:
I missed that Proloque2Go was mentioned in the article...my bad!
Also, I should have said Medicaid, not Medicard.
I don't see this so much as an opportunity for Medicaid to start funding multi-function devices like this... instead I see this as an opportunity for Medicaid to stop funding devices in general (as long as a reasonably priced iPad, or similar, alternative functionality exists). The rationale for assisted funding is that the costs are prohibitive, I don't really see that as the case as much with the iPad.
Sure there will still be people who need assistance, but I know I'd be happy to donate to a charity involved with putting iPads in the hands of the disabled.
- A charity could potentially generate enough product movement to convince Apple to provide a discounted rate.
- A charity could negotiate another rate decrease in return for the positive PR.
- A charity could possible negotiate further rate reduction due to tax deductions for Apple's participation in such a program.
- A charity could work with software vendors to arrange volume licensing deals.
- A charity could reduce (eliminate?) the bureaucracy and headache involved in the current system.
All in all, I think a charity would provide a lot more bang for peoples' bucks than a minor tweak of current legislation.
Just thought of another benefit... a charity could actually hire developers to create assistive programs for FREE!
November 04 2010 at 11:37 AM Report abuse Permalink rate up rate down Replyjust for clarity's sake, owen didn't acquire spinal muscular atrophy as an infant. it's a congenital inherited disease, like dmd, md, etc. he started to show symptoms and was diagnosed as an infant, but he had the disease all along.
November 04 2010 at 11:03 AM Report abuse Permalink rate up rate down ReplyContact rjcooper.com and see what they can rig for you or use a windows tablet with a different kind of touch screen.
Another issue not mentioned in the article is the fact that parents and people with disabilities can waltz right into an Apple store and leave minutes later with an iPad. For the Medicaid-funded devices you need to go to a general practitioner, get a referral to a speech language pathologist who then needs to do a thorough assessment. Then there can be a prescription for the device which is then handed over to the Medicaid Durable Medical Equipment folks who spend 6 months to a year reviewing the case. And then, maybe then, the child or person with a disability might be allowed to receive a $3k - $25k device that only does one thing. Which process would you rather follow? Which process makes more sense from a public policy standpoint?
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