iPads bring accessibility to the disabled at a far lower cost

David Winograd
D. Winograd|11.04.10

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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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