Introduction to Accessibility for Phones, Tablets, Computers, and Smart Home Technology Megan Mahaffey, MOT, OTR/L, ATP Olivia White, OTR/L, C/NDT Objectives

● Participants will identify two built-in accessibility features of phones and tablets to be used by persons with disabilities. ● Participants will describe two assistive technology devices to be used by persons with disabilities to access a computer. ● Participants will identify three types of technology for clients to access their home environment safely and independently. What is Accessibility?

● Independent access to phones, tablets, computers, and home environment for individuals who are unable to achieve normal access due to an illness or injury ● Includes:

‐ Use of built in accessibility features on all devices

‐ Use of dedicated assistive technology devices connected to phone, tablet, or computer

‐ Use of commercially available products designed for people without disabilities

● Accessibility Sady

4 Types of Access

● Direct Selection: ‐ Voice ‐ Stylus ‐ Mouse emulator ● Indirect Selection: scanning & switch access

Phone & Tablet Access Low Tech Options

● Mouthstick stylus ● Stylus in a universal cuff ● iFaraday moldable ● Handizap ● Shapedad ● Pop Sockets ● Glove with finger cut off

iOS Devices

● Apple does not allow third party access so there are limited options for accessibility ● Built-in features ● Switch access if unable to use direct access method ‐ Requires external interface

‐ Bluetooth or hard wired

Built-In Accessibility Features for iOS

● Assistive Touch ● Touch Accommodations ● “Hey Siri” ● Automatic answer ● Compatibility with virtual assistants ● Switch Control ● Gestures ● Recipes ● VoiceOver

Interface for iOS

● Bluetooth ● Hardwired

- AbleNet Blue 2 - Tapio - Tecla-e - Hook+ (endorsed by - Power Wheelchair Apple) - AMAneo BTi ** Switch Control: iOS

1. Plug USB adapter into phone or 7. When you see activate new ipad. switch tap your switch.

2. Plug Tapio USB into USB 8. Give switch a name. adapter. (It may tell use Tapio isn’t supported, this is okay). 9. Select “Select Item” 3. Plug desired switch into Tapio. 10. Hit “Switch Control” to go back 4. Open Settings on or 11. Make sure scanning style is set ipad. to Auto 5. Go to General > Accessibility > 12. Can adjust auto scanning time Switch Control > Switches 13. When all settings are selected 6. Select Add New Switch > make sure to turn “Switch External Control” to on

Switches

Category Description Mechanical Activated by application of force Electromagnetic Activated by receipt of electromagnetic energy such as light or radio waves Electrical Control (EMG) Activated by detection of electrical signals from the surface of the body Proximity Activated by movement close to the detector, without actual contact Pneumatic Activated by detection of respiratory airflow or pressure (sip and puff) Phonation Activated by sound or speech Android Devices

● More options for connections and devices due to allowing 3rd party vendors ● Can be Bluetooth or hard wired: - QuadJoy - Glassouse - Power wheelchair - Tecla Shield/Tecla-e - Zerotouch Mount ● Compatible with 3rd party apps (Sesame Enable) Built-In Accessibility Features for Android

● Assistant Menu ● Easy screen turn on ● Touch and hold delay ● Interaction Control ● Switch Access ● Bixby, Google Assistant, S Voice ● Google Voice Access App ● Automatic answer ● Compatible with virtual assistants Switch Control: Android

● **These are general instructions for switch access for non-IOS devices. Each Android device may have slightly different features. ● Connect switch to device - Connect via USB or Bluetooth ● Go to settings  Accessibility Switch Access ● Select settings  Assign switches for scanning ● Choose type of scanning in movement & selection (auto scanning, reverse scanning or step scanning) ● Activate switch and select save ● Turn on switch access Mounting Apple Accessibility Story

iOS Phone Accessibility

17 Computer Access Windows Built-In Accessibility

● Ease of Access - Keyboard: Sticky Keys, Filter Keys, Toggle Keys, Onscreen keyboard - Mouse: mouse keys - Magnifier - Contrast - Size and spacing of font - Screen reader/Narrator ● Live Tiles ● Voice Commands ● Eye Control ● Cortana Mac Built-In Accessibility

● Voice Over ● Switch Control ● Keyboard: Sticky Keys, Mouse Keys, Slow Keys, Dictation Commands ● Dwell Software ● Siri Mouse Emulators Mouse Emulators: Head

● Head Mouse Extreme ● Tracker Pro Mouse Emulators: Mouth

● Quad Joy ● Integra Mouse ● Jouse ● Lip Sync ● GlassOuse Mouse Emulators: Eyes

● Tobii ● Inclusive Eye Gaze Computer Accessibility Accessories

● Hitch ● Quad Mouse ● Roller Mouse ● BIG Track Ball ● Key Guards ● Styluses ● Adaptive keyboards ● Dragon Case Study

MC is a 56 year old female with a history of Reversible Cerebral Vasoconstriction Syndrome (RCVS) with multiple small strokes resulting in a bizarre presentation with right homonymous hemianopsia, no right/left discrimination or directionality, poor topographical orientation, body awareness, position in space and left hemibody neglect. As well as a host of cognitive deficits. All of that led to a level of agraphia and alexia. Smartphone accessibility recommendations for MC are:

26 ●Trialed Siri for voice commands ●Trialed a Bluetooth ear piece that was voice activated. ●Trialed on left wrist providing tactile feedback of vibration for incoming phone calls, alarms, reminders, etc. ●Set up Call Audio Routing on iPhone to default to “speaker” and Auto Answer. Set up Do Not Disturb to allow only those listed under “favorites” to call. ●Used a flexible selfie stick to mount phone in her left field of view. She could then see the red button to end call.

27 Smart Home Technology

28 Smart Home Technology

● “A smart home is a residence that uses internet- connected devices to enable the remote monitoring and management of appliances and systems, such as lighting and heating” (Internet of Things Agenda, 2018) ● “A ‘Smart Home’ is the term commonly used to define a residence that has appliances, lighting, heating, air conditioning, TV’s, computers, entertainment audio & video systems, security, and camera systems that are capable of communicating with one another and can be controlled remotely by a time schedule, from any room in the home, as well as remotely from any location in the world by phone or internet” (Smart Home USA, 2018)

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30 ● Quadfather

31 Virtual Assistants

● ● Google Home ● Apple Homekit and Apple Homepod

32 Smart Outlets

● Wemo Mini ● iHome Smart Plug ● TP- Link Kasa ● Leviton In- Wall Receptacle

33 Smart Lighting

● Phillips Hue ● Lightify ● GE Link Bulbs ● TP- Link Smart LED Light Bulb ● Leviton In- Wall Switch ● iDevice Light Socket

34 Smart TV Control

● My Harmony Hub ● Amazon Echo Fire Cube ● Smart TVs ● Cable company

35 Smart Locks

● August Smart Lock Pro Connect * ● Kevo Touch to Open Smart Lock ● Schlage Sense Smart ● Ultraloq UL3 ● Nest x Yale Lock*

* combination 36 Smart Doorbells

● Ring Video Doorbell ● August Doorbell Cam Pro ● Nest Video Doorbell ● Arlo Audio Doorbell ● Skybell HD Wifi Video Doorbell

37 Smart Cameras

● Nest Cam IQ ● DropCam Pro ● Belkin NetCam ● iCamera Keep ● Amazon Cloud Cam

38 Smart Thermostats

● Nest Learning Thermostat ● Honeywell Lyric T5 Wi-Fi Thermostat ● Ecobee4 Thermostat ● Sensi Touch Wi-Fi Thermostat

39 Commercial Hubs

● Wink ● Echo plus ● Samsung SmartThings ● Insteon ● Phillips Bridge ● Harmony

40 Specially Designed Hubs

● Tecla e ● Housemate

41 Housemate Hub

42 Smart Buttons

● Flic ● Microbot ● Logitech pop smart ● Eve button (apple) ● Fibaro (apple) ● Echo buttons

43 Smart Shades

● My Smart Blinds ● Somfy shades ● Soma Smart shades

44 Door Openers

● Drive Medical Doormatic ● Open Sesame Door Systems ● Skylink Swing Door Opener

45 Extras

● Apple Watch ● Wemo Crock pot ● Mr. Coffee coffee maker ● Hunter Symphony fan ● Eight sleep mattress ● Ember coffee mug ● Nest protect smoke and carbon monoxide

46 IFTTT

● If this then that ● Allows different smart technologies that don’t normally speak to each other to speak to each other ● Free

47 Smart Home Considerations

● Thinking about bigger picture ● Remembering the commands ● Training caregiver/family member ● Security considerations (“listening”) ● Consider outlets/hubs proximity

48 Echo “Silver”

Saturday Night Live

49 Case Study

VR is a 33 year old male with a diagnosis of C4 ASIA A tetraplegia following a motor vehicle accident. Prior to his accident, he was living independently with his fiancée and four children. He was working full time as a truck driver, but has since been unemployed. He has poor upper extremity range of motion, strength, significant contractures in bilateral elbows, all of which impact his independence with ADLs and IADLs. He accesses his Android with the use of Automatic Answer (headphones required) and Google Assistant. Smart home technology recommendations for VR are:

50 ● Google Home to control all of his smart devices. ● Routines can be created on the Home App to turn off the lights, close the shades, and decrease the temperature to save energy when he leaves the house ●iHome iSP5 SmartPlug where he can turn on the fan through the app (or through Google Assistant) on his Smartphone to cool the room when he is feeling too warm ●iDevices Light Switch to control the brightness of his lights and turn them on/off through the Home App ●Harmony Hub: He can control his TV through the Harmony app or Google Assistant on his Smartphone to watch what he pleases ●August Doorbell Cam to use this camera at his front door to show who is knocking which improves his safety when he is home alone ●August Smart Lock to lock and unlock his front door through the August app on his Smartphone which allows him to be more independent and to enter/leave his home as he pleases ●Open Sesame is an automatic door opener that is accessed through a separate remote which allows him to enter and leave his home as he pleases (remote access only).

51 MU is a 52 year old female with a history of Multiple Sclerosis. She is working full time and lives alone. She has issues with her balance, light sensitivity & short term memory deficits impacting her independence with ADLs, IADLs and home management tasks. Her symptoms are worsened by heat and fatigue. Smart home technology recommendations for MU are:

52 ●IFTTT app on her Smartphone to adjust her Nest thermostat when she leaves work so it’s cool when she gets home. ●Amazon Echo Dot to use her voice to control her Phillips Hue White Ambiance Light Bulbs and Bridge to limit her need to get up to turn lights on and off. It also decreases her risk of falling since she can turn her bedroom lights on and off after she has gotten safely into bed. ●Amazon Echo Dot to use her voice to order heavier items from Amazon such as dog food, laundry detergent, bottled water, etc to decrease her fatigue while grocery shopping. ●Phillips Hue White Ambiance Light Bulbs and Bridge on a timer to gradually wake herself up and help her eyes adjust. ●Kevo Smart Lock to unlock her door easily with the touch of her finger. This helps her unlock her door quickly allowing her to spend less time in the heat and using less energy overall. ●Wemo Smart Plugs for appliances such as her curling iron & iron that would be dangerous if she forgot to unplug them. Using the IFTTT app will automatically turn off her Wemo Smart Plugs when she leaves the house and locks her Kevo Smart Lock.

53 References

Accessibility. (n.d.). Retrieved at https://www.microsoft.com/en-us/accessibility

Apple. (n.d.). Retrieved at https://www.apple.com/accessibility/

Android Accessibility. (n.d.). Retrieved at https://support.google.com/accessibility/android/answer/6006564?hl=en

Bondoc, S., Goodrich, G., Gitlow, L., & Smith, R.O. (2016). Assistive technology and occupational performance. The American Journal of Occupational Therapy, 70(Supplement 2), 7012410030p1-7012410030p9. http://dx.doi.org/10.5014/ajot.2016.706S02

Bryant, D. P., & Bryant, B. R. (2012). Assistive technology for people with disabilities. Boston: Pearson.

Cook, A. M., & Polger, J.M. (Eds.). (2015). Assistive technologies: Principles and practice (4th ed.). St. Louis, MO: Mosby.

Gentry, T. (2017). Practical, affordable smart homes for safety and improved function. OT Practice, 22(16), 8–13.

References

Global Initiative for Inclusive Information and Communication Technologies. (2015). Internet of Things: New Promises for Persons with Disabilities

Hooper, B., Verdonck, M., Amsters, D., Myburg, M., & Allan, E. (2018). Smart-device environmental control systems: Experiences of people with cervical spinal cord injuries. Disability and Rehabilitation: Assistive Technology, 13(8), 724-730.

If This Then That. (2019). Retrieved from https://ifttt.com iMore. (n.d.). Retrieved at https://www.imore.com/how-use-switch-control-iphone-and-ipad

Internet of Things. (n.d.). Retrieved at https://internetofthingsagenda.techtarget.com/definition/smart-home-or-building

Kinney, A., & Gitlow, L. (2015, June). A consumer-centered approach to evaluation assistive technology usability outcomes. Technology Special Interest Section Quarterly. 25(2), 1-4.

Limited Mobility Solutions. (n.d..) Retrieved at http://www.limitedmobility.solutions/

Smart Home Tech. (n.d.). Retrieved at https://patf.us/smart-home-tech-aging-in-place/

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● Megan Mahaffey [email protected] ● Olivia White [email protected]

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