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Analysis of European AT market
and usage: State of the art survey
by Karel Van Isacker (EPR)
People with disabilities in Europe
Before going into detail on the actual status and size of the AT
industry in Europe, and on the satisfaction of end-users with the
provided solutions, a good understanding of the actual size of the
population having a long-standing health problem or disability
(LSHPD) is necessary to grasp the mere extent of the potential end-
user market which the AT industry faces.
Disability market size
With a total population of 501 million (http://epp.eurostat.ec.europa.eu,
1 January 2010), an estimated 45 million people in Europe have a
LSHPD, being 16% of men and women aged 16-64 in the EU as a
whole (data extracted from the 2002 EU Labour Force Survey (LFS)
and the 2004 EU Statistics on Incomes and Living Conditions).
Because of the various definitions of what disability stands for[1], this
percentage varies from around 6% to over 30% between the Member
States (see Figure 1).
Important is that 33% of the people with LSHPD reported at the same
Figure 1: Prevalence of long-standing health problem or disability (LSHPD),
LFS 2002. The different types of LSHPD are shown in Figure 2.
time that they are not restricted in the kind or amount of work they
could do or their mobility to and from work. However, again, these
figures vary largely (10-50%). This difference seems to be directly
linked to the level of prosperity and the assistance available. Taking
the aforementioned into account, approximately 10% of all men and
women aged 16-64 are restricted in the kind (over 9%) or amount
(under 9%) of work they can do, their mobility (around 5%) to and from
work, or some combination of these.[2] In terms of employment, of
those that are considerably restricted in their ability to work, 28% were
in employment, while for those that are not restricted in their ability to
work, this is estimated at 68%.
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Table 2: Probability in reporting a work restriction by type of health problem or disability, LFS 2002
These barriers to employment must be kept in mind when looking at the proportion of people
with disabilities (the sum of those in the labour force -employed and unemployed- and those
who are out of the labour force -such as inactive people with disabilities reported by the admin-
istrative registers-) in the total population. Striking is that in more than half of the countries, the
share is below 2%, while some others are much higher.[3] This is linked to different definitions
per country of what disability stands for and how it is defined per country.
Figure 3: Share of people with disabilities in total working-age population, 2005
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These numbers of people with disabilities are to increase, because many assistive technology
devices are allocated to the elderly . These needs will only increase with an ageing European
1
population. The 2008-based national population projections EUROPOP20082 projects the
share of people aged 65 years or over in the total population to increase from 17,1% in 2008 to
30%by 2060[4]. This is equally reflected in the old-age dependency ratio (the projected number
of persons aged 65 and over expressed as a percentage of the projected number of persons
aged between 15 and 64) which will reach almost 55% in 2060, from a little more than 25% in
2010 (see Figure 4).
Figure 4: Projected old-age dependency ratio, http://epp.eurostat.ec.europa.eu, 1 January 2010
A core element in understanding AT would be to have consolidated figures on the usage of AT
by each of the identified groups, including the aged. Unfortunately, such in-depth studies do not
exist as will be pointed out later in this deliverable at hand. However, what do exist are partial
national studies from within the EU and beyond. These will offer a first insight into understand-
ing the usage of AT, and the satisfaction level at present of end-users using these AT.
Before addressing the usage of AT by and the satisfaction of end-users with their AT, the next
sections will look in more detail to the structure of the European AT industry which causes in its
very origin already some barriers to end users.
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European AT industry
The AT industry in Europe is complex and is characterised by a large number of products, a
large number of SMEs, different service provider systems (public health systems, public social
systems, private organisations and associations dedicated to the AT sector) that are used to
get AT ICT products to the end-users with disabilities, and different reimbursement schemes
by national and local authorities.
Fragmented AT market with a complex buying process
HEARING AT COMMUNICATION
AIDS ECS SOFTWARE DEVICES
BRAILLE
CONSOLIDATED MARKET: READERS FRAGMENTED MARKET:
+ LOW
Fewer, larger companies VISION
Many small companies
each with strong , stable with low market share
market share
Figure 5: AT ICT Product group summary comparison on fragmentation, Analysing and federating the
European assistive technology ICT industry, Final Report, March 2009
The fragmentation of the AT market is largely explained by the fact that local legislation neces-
sitates a customised approach (e.g. many different national and local reimbursement
schemes) and the fact that AT ICT is often developed in a local language, thus serves as an
important barrier between the different country markets of the EU AT ICT industry. AT software
products providers are as a result often very small, and have both a limited product offering
and geographical scope.[5]
This fragmentation is different per AT application area (see Figure 5), with the greatest degree
appearing in the AEGIS‘ core focus, namely the AT software area (due to the language cus-
tomisation issue that is necessary for each geographical market) and communication devices
solutions (due to mainly individual solutions which result in few economies of scale for compa-
nies). Braille reader companies often diversify into low-vision products which are used by a
wider and larger market, and hearing aids are mostly made by big sized companies such as
Philips and Siemens. Environmental Control Systems (ECS) are using both mainstream solu-
tions (consolidated market) and adjust them to the specific needs of end-users (fragmented
market).
Buying AT is usually a complex decision, involving actors from various sectors (see Figure 6).
While the person with disability often plays (or should at least play) a core role (demand),
many other individuals are frequently involved in the selection and purchase of a product
(family members, nursing staff, therapists, physicians, case workers, funding agencies and
companies, other rehabilitation engineering personnel, and an assortment of other interested
care providers). The 2009 European assistive technology ICT industry survey pinpointed each
of these actors with their main role in the EU AT market. In italics, some of the actors‘ roles
have been commented by us:
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Supportive legislation
The European AT industry has –just as its counterparts in the USA and Japan- benefited from
the fact that in recent years legislation has been put in place, supporting the uptake of AT by a
large number of public service providers. The main EU legislations affecting AT and accessibil-
ity in general are:
the legislation to directly subsidise or otherwise support the purchases of assistive tech-
nology for disabled end-users (see national and local reimbursements schemes),
EU legislation ensuring that all public procurement purchases of goods and services
must be accessible (EC Public Procurement Directive 2004 / 18 / EC (‗the Directive‘) on
the coordination of procedures for the award of public works contracts, public supply con-
tracts and public service contracts)2,
and anti-discrimination laws that protect the rights of people with disabilities, especially in
terms of their access to goods and services (the Treaty of Amsterdam amended the EC
Treaty by introducing a new anti discrimination provision in Article 13 in the EC Treaty,
addressing among others to combat discrimination based on disability, while the Frame-
work directive outlaws discrimination on the grounds of disability[6]).
AT databases
Providing an overview of all produced AT software solutions and communication devices
would bring us too far. However a good reference point is the EASTIN database (http://
www.eastin.info), which is a network of resources related to assistive technologies and com-
bines the assistive technology resource databases of 7 European countries. According to
EASTIN, almost 40.000 assistive products are available in the EU.
Below is an overview of some European AT databases 3. The Danish, German, Italian, Dutch,
Spanish, UK and Belgian databases have been consolidated into EASTIN, while most of them
are also member of the International Alliance of Assistive Technology Information Providers
(http://www.ati-alliance.net).
Country (*participates to National databases
EASTIN)
Denmark* Hjælpemiddelinstituttet http://hmi.dk/
Germany* Rehadat http://www.rehadat.de
Italy* Siva - Servizio Informazione e Valutazi- http://www.portale.siva.it
one Ausili
Netherlands* HANDY-WIJZER http://www.handy-wijzer.nl
Spain* CEAPAT - Centro Estatal de Autonomía http://ceapat.org
Personal y Ayudas Técnicas
UK* DLF – Disabled Living Foundation http://www.dlf.org.uk
Belgium* Kenniscentrum Hulpmiddelen http://www.koc.be
Austria HANDYNET http://handynet-
oesterreich.bmask.gv.at
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These national and even regional legislations regarding the reimbursement of AT (and in some
cases also training like in The Netherlands), and resulting different delivery models also are –
as mentioned before- root cause for the lack of a common EU market, resulting also in small
companies that sell rather locally instead of EU wide. A striking example is the case of Austria
[7] with its many regulations, which are very different and depend on the purpose of the assis-
tive technology (at work, education, everyday life, etc.) and on the local authority: the allow-
ances for assistive technologies are a responsibility of the provinces, or local institutions (Fond
Soziales Wien) while there are also some federal regulations (Federal Social Office- Bundes-
sozialamt). The result is that in an individual case, access to AT is supported and regulated by
different institutions.
Barriers for the AT industry and its end-users
To conclude, we will summarise a number of barriers linked to AT software that have been
identified in 2 recent studies on the European AT ICT industry[8]:
About 80% of the software that is available for AT applications is available only in English,
while a majority is also only available in the local language of the manufacturer. However,
language differences also necessitate that a local presence is necessary for the training or
installation phase of AT by the wholesalers, dealers, importers or retailers.
A lack of a coherent social policy for subsidising/reimbursing assistive technology products.
End-users are largely unaware of the available AT solutions and this is also identified by the
aforementioned European AT ICT industry survey as an important barrier to the develop-
ment of the AT business in the EU.
While in some countries specialised agencies exists to assist people with disabilities in mak-
ing their choice (e.g. Danish Centre for technical aids for rehabilitation and education, MO-
DEM for communication devices in Belgium, Kenniscentrum Hulpmiddelen in Flanders, Bel-
gium), in the majority of the EU countries this is lacking or badly organised (experience of
the staff of these agencies and the possibilities for trying out AT before purchasing differ
greatly).
The different interpretations of national service provider systems at the regional level cause
barriers as it further fragments the national market into regional markets, and results in dif-
ferent price-settings, even within a country.
Distribution of AT still mainly goes through the traditional rehabilitation centre channel and
related care sector, as well as specialised AT entities (for example the ONCE Foundation).
There is a lack of dedicated training in Assistive Technology products and their capabilities
(e.g. for technical experts, but also for end- users). In addition, there is a need to promote e-
learning for training purposes (including the development of learning materials that can be
used across borders).
European research and innovation on Assistive Technology is rather poor, caused mainly
by the insufficient size and the fragmented nature of the national markets. These prevent a
sufficient return on investment for manufacturers or research institutes active in AT develop-
ment.
Assistive devices are often purchased through tendering. These (often hard to obtain) pro-
cedures are hard to follow for foreign producers or distributors who have no local distributor.
High purchasing costs for end users are reported as a major barrier for wider deployment by
disability organisations.
While most countries have regulations which ensure that costs of workplace adaptations
for people with disabilities can be partially and sometimes fully financed, in general, little
use is made of these possibilities. The main reasons are ignorance of what is available,
and the administrative burden.
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In Greece, according to research by the National Observatory of Information Society (2007,
latest figures), only 4 in 10 people with disabilities seem to be aware of AT solutions that meet
their accessibility needs in using ICT. 11% of non-users of ICT with disability believe that their
disability prohibits them from using AT and 9% that there is no suitable AT for their needs. Non
-use of ICT is further attributed to lack of digital skills for 23% of non-users with disability, while
45% of all participants with disability believe that using ICT and AT requires a high level of
digital skills. Figures also show that the levels of use of ICT among regular users with and
without disability are very similar, while disabled people acquire access to ICT at a more in-
creasing rate than the general population.5
In a number of cases, tests had been conducted using the Quebec User Evaluation of Satis-
faction with assistive Technology (QUEST)6 methodology in Canada, the USA and The Neth-
erlands. However, these were often limited to proving the concept that QUEST is a usable tool,
and not really to already extract actual data reflecting actual satisfaction with AT.
Despite the limited data that was found, what was collected sheds a light on some of the most
poignant issues that AT users face. These will be highlighted in following overviews of col-
lected survey data in Malta, Spain, The Netherlands, the UK and the USA.
Malta
Between 2003 and 2005, the Foundation for Information Technology Accessibility (FITA)
started conducting a study on ICT and disability[9]. The questionnaire was compiled by four
hundred and forty five (445) individuals with a broad range of impairments, including persons
with multiple disabilities. The survey covered six types of impairments that could impact com-
puter use: intellectual, mobility, hearing, visual, mental health, hidden/other. Independently
from the type of impairment, the survey contained the following types of questions: computer
know-how, computer use and computer accessibility.
The types of impairment were the following:
Mobility 37% (163)
Visual 9% (41)
Hearing 6% (28)
Mental Health 3% (14)
Intellectual 21% (94)
Multiple 18% (79)
Other 6% (26)
The study was the first large scale attempt (and so far only one in Malta) at studying the use of
technology by people with disabilities.
Some findings:
94% of the individuals used a computer, the majority (62%) being male.
76% indicated they had a computer at home, the majority again being male (72%).
Only 24% used the computer also at work (males accounted for 67%).
49% indicated they had followed a computer course in the past 5 years, of which 69%
indicated it consisted of a basic computer course (so not adjusted really to the usage
combined with AT).
55% mainly used MS Office applications, 35% using spreadsheets like MS Excel and
66% using MS Word. Males accounted for the majority of the users.
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43% users also used the computer from graphics design, males again taking the majority.
65% users did use educational software.
60% did also carry out research on the internet.
75% did play games on their computer, 63% being male.
64% did listen to MP3 (listening to music and audio books), of which 64% males.
47% used the computer less than 2 hours per day, 44% 2-8 hours per day and 8% over 8
hours per day.
26% indicated they needed assistive technology to be able to use a computer (of which
70% males).
Asked about the price, 38% indicated the computer was quite expensive to them.
Assistance for the computer is in 39% of the cases provided by the computer supplier.
While these results are only coming from one country, and are rather old (2003-2005), they do
match to a large degree the data collected in the AEGIS partner countries as will be highlighted
in the findings of the field studies.
Spain
A 2007 study[10], with a total sample of more than 1500 ICT users yielded following results (see
Table 5).
Usage of assistive technologies Yes No
Users with visual impairments 67% 28%
Screen readers with PC 76% (mainly JAWS) 24%
Screen readers with mobile device 63% (Talk as the most used and
closely followed by Codefac-
tory's Mobile Speak)
Screen magnifier with PC 13% (Zoomtext, followed by 87%
Magic 8, and Windows Zoom)
Screen magnifier with mobile 6,45% (Mobile Magnifier and
Zooms)
Magnifying glasses, enlarged fonts 14,52%
and special glasses
Users with hearing impairments 49% 50%
Webcam 55%
FM devices and magnetic loops 17,22%
Mobile devices (with video calls 37,2%
and text messaging) and subtitling
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Users with hearing impairments 49% 50%
Webcam 55%
FM devices and magnetic loops 17,22%
Mobile devices (with video calls and text 37,2%
messaging) and subtitling
Users with motor impairments 30% 68%
Hands-free wired-device 53%
Hands-free Bluetooth device 20%
Awls, trackballs and writing sticks 27%
Users with cognitive impairments 37% 52%
Screen readers 4%
Augmentative Alternative Communication 4%
Table 5: Usage of assistive technologies in Spain (Deusto Foundation study)
The degree in usage of AT per disability group is quite different, and again is also reflected
by the data collected in the AEGIS partner countries as will be highlighted in the next chap-
ters.
In terms of the users‘ satisfaction with the offered AT, following results were gathered:
Visual impairment Hearing impairment Cognitive impairment Physical impairment
AT offer Enough 45,5% Enough 52% Enough 21% Enough 32%
Not 51,5% Not 48% Not 79% Not 68%
enough enough enough enough
Table 6: AT offer satisfaction in Spain (Deusto Foundation study)
All groups indicate in most cases with a majority that there is not enough (satisfying) AT of-
fered for them. The following table (Table 7) also looks at the percentage of usage for ICT
based AT for some disability groups. The percentages are in fact quite low, and contradict at
first sight with the previous table where all groups indicated there was not enough
(satisfying) AT being offered. However, this could indicate that the AT that is being offered
does not satisfy the actual needs of the people with disabilities, hence their refusal to use
them. This reasoning seems to be justified by another study[11] that revealed that 58% of
the consulted professionals consider that the persons they support are not provided with the
required ATs, and the other professionals consider that the ATs used are not sufficient for
them. This issue will equally come back in the USA data further on.
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Type of impairment Type of AT used Percentage of persons that use them
Hearing and speech impairment ATs for communication 89%
Visual impairment ATs for reading 50%
Cognitive impairment ATs for communication 50%
Table 7: Usage of AT in Spain (Deusto Foundation study)
Another poignant issue regarding AT satisfaction is the following: In 2001, a total of 1,824 en-
quiries were received at the AT information area in the CEAPAT-IMSERSO. 64,47% of them
were related to ATs for information and communication services (access devices for computers
– 33,42%, specific computer applications – 20,66%, aids for manual writing and reading – 3,18%,
telephony communication (including telecare) – 0,96%, aids for face to face communication –
21,53%), the proportion in which these enquiries of specific products become real acquisitions
cannot be evaluated. However, the most frequent causes that are put forward by users there for
not acquiring the AT are the high price of the products and, in second place, the previous train-
ing needed to use some of the technologies that are not easy, and require a professional to
train the user to manage and use these devices. The fact that most of the products are imported
also increases the final price in Spain.
The Netherlands
A study[12] was performed into user satisfaction and the non-use of 14 categories of assistive
technology7 provided by health care insurers, using a sample of feedback from 2001 and one
from 2003. The total number of respondents was 2272. Some aspects of the survey are of inter-
est to our project, namely the (non)-usage of auditive aids, optical aids and aids for communica-
tion, information and signalling.
Following data was collected:
Actual use of the assistive device
% who
% who compared to expected use
ever used
use the
assistive the assis-
tive de- % more % (about) % less
device as much
Category of assistive device number regularly vice8
auditive aids 219 94% 100% 25% 68% 8%
optical aids 135 92% 73% 32% 56% 12%
aids for communication, 81 83% 58% 41% 54% 6%
information and signalling
Table 8: Use of assistive technology per category (The Netherlands)
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The survey concluded that the level of abandonment varied between the various categories of
assistive devices. A big majority (more than 90%) still used the assistive device regularly. Only
a very small proportion of the respondents had never used the assistive device. This is most
frequent for aids for communication, information and signalling. It is however exactly on these
last 3 groups of aids that AEGIS project is focussing. The survey also indicated that overall AT
that are easiest to obtain are the ones most abandoned. Furthermore, the study revealed that
non-use arises less frequently among people with repeated provision, compared with first-time
users of AT. Possibly the expectations of first time users with regard to the effect of the device
are higher.
UK
A 2005 survey[13] that took place in the UK identified the types and mix of technology
(hardware and software) provided to 455 post-secondary students with dyslexia under the
UK‘s Disabled Student Allowance (DSA), and determined the students‘ satisfaction with, and
use of, the equipment provided and to examine their experiences with training.
The majority of the students received a recording device, text-to-speech software and concept
mapping tools in addition to a standard computer system. 90% of the participants were satis-
fied or very satisfied with the hardware and the software that they received. 48,6% received
training, with 86.3% of those expressing satisfaction with the training they received. Of those
that were offered training but elected not to receive it, the majority did so because they felt
confident about their IT skills.
A 2002 study [14] among 186 people with disabilities by AbilityNet highlighted a number of is-
sues with respect to the usage of AT by end-users in the UK. Following findings are of interest
to AEGIS:
Around two-thirds of the respondents who used the Internet said that they needed AT to
access it. Their interest was quite broad as Table 9 demonstrates.
45% of those who needed AT to access the internet specified that they needed voice rec-
ognition, while 28% indicated the need for keyboard adaptations, and 24% mouse adap-
tations. Around 20% needed speech output systems, mainly screen readers. Other adap-
tations needed were magnification or special colours, and software for dyslexia.
78% of the respondents who considered that they needed assistive devices did have
aids, equipment or adaptations available, but 43% of them experienced problems using
them, while some others did not have available what they thought that they needed, or
were awaiting an assessment or looking round for what they needed.
A whole range of problems were identified regarding the usage of voice recognition sys-
tems and screen readers, where compatibility issues were raised.
A lack of (local and accessible) training after delivery was raised in almost every area,
with users often depending on charity organisations to help them out.
Table 9: Internet activities of respondents
(AbilityNet survey, 2002)
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The cost of AT also came back as a core barrier. AT has not benefited from the economies of
scale (and competition) which have greatly lowered computer costs elsewhere. In fact, cost is
also likely to be a greater disincentive for disabled than non-disabled people, as they generally
have lower incomes, and may also have to purchase assistive devices on top of a computer.
This was also confirmed in the 2006 Network 1000 report[15] that pointed out that the prohibi-
tive cost of specialist equipment for visually impaired people did create a barrier.
USA
A USA study on the usage of AT by people with sensory and mobility impairment[16] drew data
from a study of 24 subjects (12 with visual impairments, 3 with musculoskeletal impairments, 7
with nervous impairments (including cerebral palsy, multiple sclerosis, and postpolio syndrome,
and 2 with other syndromes including learning disability) who had been administered the Que-
bec User Evaluation of Satisfaction with assistive Technology (QUEST), as well as the Psycho-
logical Impact of Assistive Devices Scale (PIADS). These outcome measurement instruments
were designed to measure satisfaction with assistive technology devices in a structured and
standardised way.
Following outcomes were detected:
There is a need for increased awareness, training and resources to procure AT. Espe-
cially training was considered a major issue to ensure optimal and consistent use of AT,
and change the occurrence of AT abandonment.
Blind or visually impaired users were much more adaptable towards AT.
Finally, it was also highlighted that AT‘s are often unknown to end-users.
In October 2009, WebAIM conducted a survey[17] of preferences of screen reader users,
based on 665 end user inputs. Some of the findings are striking and presented below:
The reason why a certain screen reader is selected (JAWS, Window Eyes, VoiceOver,
System Access or System Access To Go, NVDA, ZoomText, Hal, Supernova) was mostly
because of existing comfort and expertise in using it (42,9%), while support (7,1%) and
cost (5,9%) were of less importance.
Only 24,2% took a training course, with 72,9% being self taught.
Only 34,7% purchased their own their screen reader, the rest being offered by various
supporting programs (government, school, employer), and only a minority of 3,9% using a
pirated version. This can also explain why many users are from the very beginning trained
to use a specific screen reader. In the case of for example the Lighthouse for the Blind of
Greece (Φάρος Τσφλών της Ελλάδος), they train their students/members mostly with the
more affordable HAL screen reader, which also has a 30 days free trial period. As a result
HAL also has a large user group in Greece, while this screen reader is less used in other
countries.
In terms of usage of browsers with the screen reader, a diversified number of browser ap-
plications and versions is used, with 74,9% stating that JavaScript was not disabled in
their web browser:
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Price
High purchasing costs for end users are reported as a major barrier for wider deployment
by disability organisations.
Prohibitive cost of specialist equipment for visually impaired people does create a barrier.
Mismatch between needs end user and offered AT
End users are not provided with the required AT, resulting in a high percentage (up to
30% in the USA[18,19]) of obtained ATs being discarded within a year.
AT that is being offered does not satisfy the actual needs of the people with disabilities,
hence their refusal to use them.
According to some survey, almost half of the end-users experience problems using AT.
This mismatch between the needs of the end users and the actual AT they are being offered
can be directly linked to the poor assessment of consumer needs and preferences. The Match-
ing Person and Technology (MPT)[20] model and accompanying assessment instruments, first
presented in 1989, are one way to counter this gap between the user needs and what is being
provided to them. MPT was successfully applied also in research studies in the USA[21,22],
Canada and Europe[23]. The MPT Model incorporates the assessment of three primary areas
[24]:
determination of the milieu/ environment factors influencing use;
identification of the consumer's personal and psychosocial characteristics, needs and
preferences,
and description of the functions and features of the most desirable and appropriate tech-
nology.
On the other hand, end-users (especially people with vision impairments) also appreciate AT:
Blind or visually impaired users are much more adaptable towards AT.
Free or low-cost screen readers (such as NVDA or VoiceOver) are seen as a viable alter-
native to commercial screen readers.
Social media is used by people with vision impairments (in the USA that is).
AT has enabled people with vision impairments to explore the internet by using a wide
variety of browsers with their screen readers, with most having JavaScript enabled.
Free or low-cost screen readers (such as NVDA or VoiceOver) are seen as a viable alter-
native to commercial screen readers.
Screen readers are also increasingly used mobile phones or mobile handheld devices.
While there are problems with accessing the internet due to accessibility issues (e.g. use
of CAPTCHAS), high numbers of people with vision impairments do access the internet.
Many users are from the very beginning trained to use a specific screen reader
(influenced equally by what organism is providing for the funding), and this has to be con-
sidered when looking at data as this will reflect also why certain screen readers have
high user percentages and some not. Quality and price of the screen readers should be
considered only as a 2nd reason.
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![ISSUE 6 PAGE 27
Endnotes
1. Around 70% of assistive devices prescribed in Sweden go to people aged over 65. (Source: Provision of As-
sistive Technology in the Nordic Countries, Second Edition, NUH - Nordic Centre for Rehabilitation Technol-
ogy, May 2007).
2. Important in this ongoing work is also ETSI‘s Specialist Task Force 333: European Accessibility Require-
ments for Public Procurement of Products and Services in the ICT Domain (EC Standardization Mandate M
376, Phase 1), http://portal.etsi.org/STFs/STF_HomePages/STF333/STF333.asp. The outcome of this is the
ETSI Technical Report 102 612 (downloadable via http://portal.etsi.org/STFs/STF_HomePages/STF333/
tr_102612v010101p.doc), that sets out the results of the ETSI part of Phase I of the M 376 work, and charac-
terises the public procurement of ICT products and services; provides a listing of existing functional accessi-
bility requirements; identifies gaps where no accessibility requirements exist; provides a list of relevant exist-
ing national, European and international standards and technical specifications; and gives proposals for
standardisation work for the development of requirements and award criteria that still do not exist or that are
not yet standardised.
3. In the USA, similar databases have been established, such as ABLEDATA's database of over 33.000 assis-
tive products from over 4.000 companies
4. Source: VAPH, Jean-Marie Vanhove
5. Source: Disability Now, Nikos Voulgaropoulos, Anna Evangelinou, Eleni Strati
6. QUEST has been used with older people, adults, adolescents and also children (as documented by Sonya
Murchland and Helen Dawkins in ―Development and utility of the QUEST 2.1 Children‘s Version‖, 2007)
7. It must be mentioned though that the study did not outline what it understood under AT. These may as well
be hardware or software or combined solutions.
8. Calculated on the group who did not use the assistive device regularly at the time of the survey.
9. Accessible Rich Internet Applications
References
[1] For a full explanation, please see: Definition of Disability in Europe, A Comparative Analysis, A study prepared
by Brunel University, September 2002
[2] Men and women with disabilities in the EU: statistical analysis of the LFS ad hoc module and the EU-SILC, AP-
PLICA & CESEP & ALPHAMETRICS, Final report, DG Employment, social affairs and equal opportunities, April
2007
[3] Study of compilation of disability statistical data from the administrative registers of the member states, Study
financed by DG Employment, Social Affairs and Equal Opportunities, Contract no vc/2006/0229 – EUR 363,268.42,
Applica & Cesep & European Centre, Final Report, November 2007
[4] http://epp.eurostat.ec.europa.eu (Population Projections) EUROPOP2008, convergence scenario, national level
(04 November 2008)
[5] Analysing and federating the European assistive technology ICT industry, Final Report, March 2009, Jennifer
Stack, Leire Zarate, Carmen Pastor, Niels-Erik Mathiassen, Ricard Barberà, Harry Knops, Hugo Kornsten
[6] EU ANTI-DISCRIMINATION LAW, General Editor: F. G. Jacobs. Advocate General, The Court of Justice of the
European Communities, 2005
[7] Measuring Progress of eAccessibility in Europe (MeAC), as mentioned in Report on policy and DfA,
DfA@eInclusion deliverable D2.2b, 2008
[8] Access to Assistive Technology in the European Union, A study prepared by Deloitte & Touche, EC, Directorate
-General for Employment and Social Affairs, Unit E. 4, June 2003; Analysing and federating the European assistive
technology ICT industry, Final Report, March 2009, Jennifer Stack, Leire Zarate, Carmen Pastor, Niels-Erik Mathi-
assen, Ricard Barberà, Harry Knops, Hugo Kornsten; MeAC - Measuring Progress of eAccessibility in Europe, As-
sessment of the Status of eAccessibility in Europe, Main Report, Bonn, October 2007
[9] L-Informatika l-Komunikazzjoni w d-Diƒabilità, Information Communications Technology and Disability, Study
Report, Foundation for Information Technology Accessibility (FITA), 2005
[10] Aurtenetxe Jon Leonardo; Ibáñez , Mónica; Lezaun, Zuriñe. ―Usage of mobile devices within the Population
with Disabilities‖. Deusto Foundation 2007
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![ISSUE 6 PAGE 28
References
[11] Abril, Dolores; Aparisi, J. Enrique et all. ―White Paper, R&D at service of the persons with disabilities and
the elderly‖. CERMI (Spanish Committee of Representatives of People with Disabilities) 2003
[12] Non-use of assistive technology in The Netherlands: A non-issue?, B. P. J. DIJCKS, L. P. DE WITTE, G.
J. GELDERBLOM, R. D. WESSELS, & M. SOEDE, iRv, Institute for Rehabilitation Research, Hoensbroek,
The Netherlands, Disability and Rehabilitation: Assistive Technology, January-June 2006; 1(1-2): 97 – 102
[13] Use of assistive technology by students with dyslexia in post-secondary education, E. A. DRAFFAN, D.
G. EVANS & P. BLENKHORN, School of Informatics, University of Manchester, Manchester, UK, Disability
and Rehabilitation: Assistive Technology, March 2007; 2(2): 105 – 116
[14] Disabled people and the Internet, Experiences, barriers and opportunities, Doria Pilling, Paul Barrett and
Mike Floyd, CS Foundation, 2004
[15] Opinions and circumstances of visually impaired people in Great Britain: report based on over 1000 in-
terviews, August 2006, Graeme Douglas, Christine Corcoran, Sue Pavey, Visual Impairment Centre for
Teaching and Research (VICTAR), University of Birmingham
[16] Computer-Related Assistive Technology: Satisfaction and Experiences Among Users With Disabilities,
Mary Burton, MS, Els R. Nieuwenhuijsen, PhD, MPH, OTR, and Marcy J. Epstein, PhD, Asst Technol
2008;20:99-106, 2008 RESNA
[17] Screen Reader User Survey Results , http://webaim.org/projects/screenreadersurvey2/, WebAIM, as
accessed on 28 December 2009
[18] Outcomes of assistive technology use on quality of life. Scherer, M.J., 1996, Disability and Rehabilita-
tion, 18(9), 439-448
[19] Predictors of assistive technology abandonment, Phillips, B., & Zhao, H., 1993, Assistive Technology, 5,
36-45
[20] The Matching Person & Technology (MPT) Model Manual, third edition, Scherer, M.J., 1998, Webster,
NY: The Institute for Matching Person & Technology, Inc.
[21] The Matching Person & Technology (MPT) Model Manual, third edition, Scherer, M.J., 1998, Webster,
NY: The Institute for Matching Person & Technology, Inc.
[22] Measuring subjective quality of life following spinal cord injury: A validation study of the Assistive Tech-
nology Device Predisposition Assessment, Scherer, M.J. & Cushman, L.A., 2001, Disability & Rehabilitation,
23(9), 387-393
[23] Predicting satisfaction with assistive technology for a sample of adults with new spinal cord injuries,
Scherer, M.J. & Cushman, L.A., 2000, Psychological Reports, 87, 981-987
[24] Predictors of Assistive Technology Use: The Importance of personal and psychosocial factors, Marcia J.
Scherer, Ph.D., Caren Sax, Ed.D., CRC, Alan Vanbeirvliet, Ph.D., Laura A. Cushman, Ph.D., John V.
Scherer, M.S.E.E., 2005, Disability & Rehabilitation, 27(21), 1321-1331
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AEGIS Newsletter n° 6
The document discusses the sixth issue of the AEGIS newsletter, focusing on assistive technologies and their usage based on a survey. It highlights the importance of user-centered design in developing accessible tools and technologies, along with insights from an interview with a user on the challenges they face. Additionally, it provides details about AEGIS projects, including the development of open accessibility frameworks and prototypes aimed at improving accessibility in various technology domains.
More Related Content
AEGIS Newsletter n° 6
- 1. AEGIS Open Accessibility Everywhere: Groundwork, Infrastructure, Standards I S S U E 6 M A R C H 2 0 1 1 Editorial At a Glance The AEGIS Consortium is pleased to announce the sixth issue of its News- letter. The special focus of this issue is on the findings of our survey on Acronym: European Assistive Technologies and their actual (non-)usage. As usual, AEGIS updates are provided about current AEGIS accomplishments and proto- Full Title: types. Open Accessibil- AEGIS is not only about technology, but also about people and how their ity Everywhere: needs can be met. This is why this issue features an interview with one of Groundwork, In- our users. frastructure, Standards Finally, the full details of the 2nd international AEGIS Conference and User Contract No: Forum are provided, together with a wide range of social media that will al- low those can not participate in person, to still follow it via one of the many FP7-224348 platforms available such as Facebook, Twitter, etc. Start Date: Please feel free to contact us for any further details, comments, or just to September 2008 share your experiences in the above fields of interest. End date: February 2012 The AEGIS consortium AEGIS (Open Accessibility Everywhere: Groundwork, Infrastructure, Standards) is a research project funded by the European Commission, working in the area of accessibility and independent living. AEGIS devel- ops an Open Accessibility Framework (OAF) consisting of open source accessible interfaces and accessibility toolkits for developers, alongside accessible applications and open source assistive technologies for users. AEGIS will produce this framework through user research and prototype The Project is co- development with current and next generation ICT. This should deeply funded by the embed accessibility into future ICT for the open desktop, rich Internet ap- European plications, and mobile devices. AEGIS results will be referred to standards Commission, organisations where appropriate, and made available under open source 7th Framework licenses to the greatest extent possible. Programme
- 2. PAGE 2 You said… Interviews with AEGIS user (Lourdes González Perea, Direc- tor of Accessible Technologies at Technosite). What is the profile of your disability? I have visual impairment, blindness. What is your experience in the use of computers, mobile phones and the Internet? I consider myself as an advanced user of these technologies. For ex- ample, I started to use the computer when I was 13 years old. I also had a mobile phone when almost none of my friends had. I guess my needs of communication made me getting interested in technology al- though, in general, we use a lot of technology in my family. A few years ago, about 1998, in my house we had 4 computers and a television, when in Spanish households it was just the opposite. Can you explain how important are support technologies in your day to day? They have a great importance. Thanks to them I can use the same technologies as people who do have the ability to see. What are the main difficulties that you encounter as a user of assistive technologies? The main difficulty is that they are specific to each device: operating system, etc. If we had the assistive technologies in the "cloud", we would not have to do so much investment in them (I mean not only fi- nancial investment), taking the time to install, configure, learn how to use, etc. Which are the main barriers that have been observed in the current solutions? Are all assistive technologies available? Are they affordable? No, not all of them are available. For example, although it takes too much time talking about the accessibility to DTV, we still do not have a solution. The price is also a barrier. Maybe in Spain it is not so much, as we have the support of ONCE (National Organization of Spanish blind people) covering our adaptations when we are training or working, but this situation does not happen in other countries. AEGIS - FP7-224348: find more info at http://www.AEGIS-project.eu/
- 3. ISSUE 6 PAGE 3 Luckily, some manufacturers are betting on it and we are aware of it. For example, I have a mobile phone that brings its assistive technologies integrated; I also have a speaking voice recorder, etc. These are devices that I haven‘t had to buy at a specific store for people with disabilities. In addition I have to say that there is also a lack of awareness among users about what the existing assistive technologies are and, of course, this is also a barrier. Illustration: Lourdes González Can you comment on the quality/reliability of any of the assistive technologies you know? Yes, I usually use Jaws screen reader, and VoiceOver on my iPhone. Both assistive tech- nologies are very complete for me. They cover perfectly my needs. There are also free and quality assistive solutions, as the screen reader NVDA. How do you think AEGIS could have an impact on the availability and afforda- bility of current assistive technologies? By focusing on the design of solutions that fit standardized technologies and contributing to the diffusion and dissemination. AEGIS - FP7-224348: find more info at http://www.AEGIS-project.eu/
- 4. ISSUE 6 PAGE 4 Specifically, what do you think about the Odt2braille prototype? I consider it is very useful, especially for people who can see and are interested in printing a document for a blind person. Currently, the prototype has areas for improvement, but the basis is very good. What are the main advantages that you find in the prototype? The main advantage is that it is not necessary to know Braille to print a text in Braille for a blind person. How do you think this will benefit blind people? It will help to the spread and diffusion of Braille, but it is also true that Braille printers are ex- pensive, so the institutions of a certain magnitude will be the only ones to be able to use this solution. Do you miss something in the prototype? What features or functionalities should be improved? Yes, the software is not accessible to blind people. I mean, OpenOffice does not work well with the most used screen readers in Spain; Jaws and other programs cannot be used by this group. In addition, some errors occur when printing the text, I mean, the printed text is not totally faithful: I found some problems with the number of the pages, the titles or the lines. What do you think of this new approach of integrating Braille in a mainstream word processor (In contrast with existing Braille editors that are typically stand- alone applications)? It seems to be a very positive solution. Do you think odt2braille is mature enough to be used for production purposes? Not at the moment. I believe it can be used in educational centers and it could be very use- ful, for example, if the blind person could learn and adapt to the limitations of the software. Do you think that Odt2braille will be adopted by the community of people with visual impairments? If the indicated improvements are incorporated, yes. AEGIS - FP7-224348: find more info at http://www.AEGIS-project.eu/
- 5. PAGE 5 AEGIS delivers ... The Tecla Access tools: read about our latest developments Illustration: Tecla logo 1. Tekla is now Tecla Access From now on, ―Tekla‖, our project to develop a set of open software and hardware tools that facilitate access to mobile devices for people with mobility impairments, will be called ―Tecla Access‖ (with a ―c‖) to avoid confusion with another product. 2. Tecla will soon support voice input and voice commands The latest version of Tecla Access 0.4.5 (alpha) for Android was re- leased last month. This version incorporates a more intuitive way to configure self-scanning speed thanks to the helpful suggestions by Mats Lundälv. But that is just the beginning. Work is currently underway to add the ability to write text and control the device by speaking into the microphone. Yes, voice input and voice commands are coming to Tecla Access. In the meanwhile, you can download Tecla Access from the Android Market at http://bit.ly/Tekla4Android. Please install the Tecla App today, and feel free to send your feedback so we can keep improving it! 3. Tecla Access & DAISY Reader at the DevCSI Accessibility Hack Day Our friend Steve Lee was kind enough to share the results of the eBook Reader accessibility project at the DevCSI Accessibility Hack Day (http://bit.ly/kh4Mi8), which took place in Birmingham, UK this past June. The project consisted on using the Tecla Access App and Shield to enable switch access to Julian Harty's open-source DAISY eBook Reader (http://bit.ly/jrCebz). The DevCSI team published a great video of Julian's talk including the demo he made at the end of the event (http://vimeo.com/25856062). You can re-live the highlights through Kirsty Pitkin's comprehensive post at the DevCSI site http://bit.ly/o2Io2v. 4. Earlier this month, a Tecla Shield prototype was spotted at the Transfer Summit/UK in Keble College, Oxford (http:// transfersummit.com). Take a look at the picture here: http://bit.ly/ nk1Mh2. It is great to see that word on the Tecla Access Project is quickly spreading around! AEGIS - FP7-224348: find more info at http://www.AEGIS-project.eu/
- 6. ISSUE 6 PAGE 6 LWUIT - Mobile Accessibility Highlighting some of the AEGIS mobile accessibility work, Oracle presented ―Mobile Accessi- bility with LWUIT‖ at JavaOne 2011, announcing and demonstrating AEGIS research work that builds accessibility support into LWUIT (Lightweight User Interface Toolkit), which is used to create mobile applications for Java ME. LWUIT has already become a standard for writing Java ME applications, and this research work supports using LWUIT for creating accessible mobile applications for the Java ME platform. In the context of AEGIS research project, following work has been done: Definition of initial accessibility API for Java mobile, largely mirroring the Java SE ac- cessibility API defined in javax.accessibility package; W3CWeb Accessibility Initiative's ARIA specification for metadata tags in this mobile accessibility API (e.g. using the ARIA state properties for the the states that UI controls can be in); Accessibility API using a Broker pattern is implemented: providing a separate Broker class that is optionally loaded into the Java mobile runtime alongside the LWUIT applica- tion, and which implements the accessibility API on behalf of the LWUIT component; An inter-process communication Accessibility Bus MIDlet that handles event tracking and forwards accessibility API calls from assistive technologies to the application (which then get handled by the Broker); Several "test" assistive technologies: Java mobile versions of the perennial desktop favorites ―Ferret‖ and ―Money‖ (as well as their Java Access Bridge counterparts ―Java Ferret‖ and ―Java Monkey‖ for the JavaSE accessibility API); Specifically: Mobile Ferret can listen for a variety of events, and will show event changes expos- ing ARIA property names; Mobile Monkey presents a tree view of all of the UI components on the screen, with automatic updates as the screen changes and the ability to provide detailed info on the selected component; A screen reader prototype, which uses cloud-based text-to-speech to voice LWUIT ap- plications for blind users; Development of a set of LWUIT themes for users with vision impairments - including Large Print black on white, Large Print white on black, and Large Print yellow on black (with some white) - all tested with users with vision impairments. AEGIS partners contributing to this work include Oracle, CERTH, Fundacion Vodafone Spain, and the University Polytechnic Madrid. For more information, see the JavaOne presentation at: http://blogs.oracle.com/korn/ resource/21761_Leitne_Korn_publish.pdf and see a video showing the prototype screen reader working with the stock ―UI Demo‖ LWUIT application at: http://blogs.oracle.com/korn/ resource/LWUIT_screen_reader-quicktime.mov. AEGIS - FP7-224348: find more info at http://www.AEGIS-project.eu/
- 7. ISSUE 6 PAGE 7 Illustration: Screenshots highlighting AEGIS mobile accessibility work JavaFX 2.0 released Part of the AEGIS work to build accessibility into rich Internet applications (RIA) is focused on Oracle's JavaFX technology. At JavaOne 2011 Oracle released the JavaFX 2.0 SDK - a major update to the JavaFX platform. This release includes initial support for keyboard operation of JavaFX applications, and CSS-based theme support. This support is largely implemented by the stock JavaFX UI components in the javafx.scene.component package. Additional accessi- bility support is being developed for future release of the JavaFX platform. More information and download: http://javafx.com. AEGIS - FP7-224348: find more info at http://www.AEGIS-project.eu/
- 8. PAGE 8 Analysis of European AT market and usage: State of the art survey by Karel Van Isacker (EPR) People with disabilities in Europe Before going into detail on the actual status and size of the AT industry in Europe, and on the satisfaction of end-users with the provided solutions, a good understanding of the actual size of the population having a long-standing health problem or disability (LSHPD) is necessary to grasp the mere extent of the potential end- user market which the AT industry faces. Disability market size With a total population of 501 million (http://epp.eurostat.ec.europa.eu, 1 January 2010), an estimated 45 million people in Europe have a LSHPD, being 16% of men and women aged 16-64 in the EU as a whole (data extracted from the 2002 EU Labour Force Survey (LFS) and the 2004 EU Statistics on Incomes and Living Conditions). Because of the various definitions of what disability stands for[1], this percentage varies from around 6% to over 30% between the Member States (see Figure 1). Important is that 33% of the people with LSHPD reported at the same Figure 1: Prevalence of long-standing health problem or disability (LSHPD), LFS 2002. The different types of LSHPD are shown in Figure 2. time that they are not restricted in the kind or amount of work they could do or their mobility to and from work. However, again, these figures vary largely (10-50%). This difference seems to be directly linked to the level of prosperity and the assistance available. Taking the aforementioned into account, approximately 10% of all men and women aged 16-64 are restricted in the kind (over 9%) or amount (under 9%) of work they can do, their mobility (around 5%) to and from work, or some combination of these.[2] In terms of employment, of those that are considerably restricted in their ability to work, 28% were in employment, while for those that are not restricted in their ability to work, this is estimated at 68%. AEGIS - FP7-224348: find more info at http://www.AEGIS-project.eu/
- 9. ISSUE 6 PAGE 9 Figure 2: Distribution of LSHPD by type in the EU, LFS 2002 Looking at the disabilities that account for this, and considering the relevance to the AEGIS project, following data from the LFS is important (not all the categories as set forward by the project are addressed by the LFS, especially then the people with learning difficulties): Impairment EU average Arms or Hands 6,5% Legs or Feet 11,4% Back or Neck 19,4% Difficulty seeing 4,5% Difficulty hearing 2,1% Speech impediment 0,4% Table 1: Distribution of people with disabilities (aged 16-64) by type, LFS 2002 A large percentage of the people with disabilities do experience severe barriers in their em- ployment. The detailed overview shown in Table 2 outlines the probability in reporting a work restriction linked to a disability, provides an idea of the extent of the faced barriers (these can be various, and be linked to the need for adjusted alarm systems in the working hall, to the need for AT ICT usage in the working environment). AEGIS - FP7-224348: find more info at http://www.AEGIS-project.eu/
- 10. ISSUE 6 PAGE 10 Table 2: Probability in reporting a work restriction by type of health problem or disability, LFS 2002 These barriers to employment must be kept in mind when looking at the proportion of people with disabilities (the sum of those in the labour force -employed and unemployed- and those who are out of the labour force -such as inactive people with disabilities reported by the admin- istrative registers-) in the total population. Striking is that in more than half of the countries, the share is below 2%, while some others are much higher.[3] This is linked to different definitions per country of what disability stands for and how it is defined per country. Figure 3: Share of people with disabilities in total working-age population, 2005 AEGIS - FP7-224348: find more info at http://www.AEGIS-project.eu/
- 11. ISSUE 6 PAGE 11 These numbers of people with disabilities are to increase, because many assistive technology devices are allocated to the elderly . These needs will only increase with an ageing European 1 population. The 2008-based national population projections EUROPOP20082 projects the share of people aged 65 years or over in the total population to increase from 17,1% in 2008 to 30%by 2060[4]. This is equally reflected in the old-age dependency ratio (the projected number of persons aged 65 and over expressed as a percentage of the projected number of persons aged between 15 and 64) which will reach almost 55% in 2060, from a little more than 25% in 2010 (see Figure 4). Figure 4: Projected old-age dependency ratio, http://epp.eurostat.ec.europa.eu, 1 January 2010 A core element in understanding AT would be to have consolidated figures on the usage of AT by each of the identified groups, including the aged. Unfortunately, such in-depth studies do not exist as will be pointed out later in this deliverable at hand. However, what do exist are partial national studies from within the EU and beyond. These will offer a first insight into understand- ing the usage of AT, and the satisfaction level at present of end-users using these AT. Before addressing the usage of AT by and the satisfaction of end-users with their AT, the next sections will look in more detail to the structure of the European AT industry which causes in its very origin already some barriers to end users. AEGIS - FP7-224348: find more info at http://www.AEGIS-project.eu/
- 12. ISSUE 6 PAGE 12 European AT industry The AT industry in Europe is complex and is characterised by a large number of products, a large number of SMEs, different service provider systems (public health systems, public social systems, private organisations and associations dedicated to the AT sector) that are used to get AT ICT products to the end-users with disabilities, and different reimbursement schemes by national and local authorities. Fragmented AT market with a complex buying process HEARING AT COMMUNICATION AIDS ECS SOFTWARE DEVICES BRAILLE CONSOLIDATED MARKET: READERS FRAGMENTED MARKET: + LOW Fewer, larger companies VISION Many small companies each with strong , stable with low market share market share Figure 5: AT ICT Product group summary comparison on fragmentation, Analysing and federating the European assistive technology ICT industry, Final Report, March 2009 The fragmentation of the AT market is largely explained by the fact that local legislation neces- sitates a customised approach (e.g. many different national and local reimbursement schemes) and the fact that AT ICT is often developed in a local language, thus serves as an important barrier between the different country markets of the EU AT ICT industry. AT software products providers are as a result often very small, and have both a limited product offering and geographical scope.[5] This fragmentation is different per AT application area (see Figure 5), with the greatest degree appearing in the AEGIS‘ core focus, namely the AT software area (due to the language cus- tomisation issue that is necessary for each geographical market) and communication devices solutions (due to mainly individual solutions which result in few economies of scale for compa- nies). Braille reader companies often diversify into low-vision products which are used by a wider and larger market, and hearing aids are mostly made by big sized companies such as Philips and Siemens. Environmental Control Systems (ECS) are using both mainstream solu- tions (consolidated market) and adjust them to the specific needs of end-users (fragmented market). Buying AT is usually a complex decision, involving actors from various sectors (see Figure 6). While the person with disability often plays (or should at least play) a core role (demand), many other individuals are frequently involved in the selection and purchase of a product (family members, nursing staff, therapists, physicians, case workers, funding agencies and companies, other rehabilitation engineering personnel, and an assortment of other interested care providers). The 2009 European assistive technology ICT industry survey pinpointed each of these actors with their main role in the EU AT market. In italics, some of the actors‘ roles have been commented by us: AEGIS - FP7-224348: find more info at http://www.AEGIS-project.eu/
- 13. ISSUE 6 PAGE 13 Governmental and legal organisations: their objective is to create policy and legal frame- works for determining what products are considered AT, as well as how these products are financed and provided to end-users – the applied policies are highly heterogeneous as is shown in the annexed reimbursement schemes, directly linked also to the different purchasing models of the end-users which are outlined further on. Information service and training organisations and providers: they add knowledge to the value chain in order to make informed decisions, as well as to support professional and user development and competences – such organisations are not always well organised, lack often well trained personnel, and few have even undergone an appropriate AT train- ing. Financing organisations: they finance AT products and their related services on national, regional, local government levels – this is again very heterogeneous as is again shown in the annexed reimbursement schemes. Technology oriented organisations: AT research is largely dependent on the fundamen- tal R&D from other technology sectors while at the same time being led by the specific needs of the disabled and elderly populations. Professional and end-user organisations: They represent and are advocates for their end -user members, and also at as lobbyists, equally involved in the policy making process. AT ICT industry organisations: They are mostly composed of SMEs due to smaller na- tional markets, fragmented by language – a European umbrella organisation grouping the entire AT industry is missing, although recommendations have been made in this direc- tion (see the 2009 European assistive technology ICT industry survey). Figure 6: The variety of actors who participate – directly or indirectly – in the AT ICT industry, Analysing and federating the European assistive technology ICT industry, Final Report, March 2009 AEGIS - FP7-224348: find more info at http://www.AEGIS-project.eu/
- 14. ISSUE 6 PAGE 14 Supportive legislation The European AT industry has –just as its counterparts in the USA and Japan- benefited from the fact that in recent years legislation has been put in place, supporting the uptake of AT by a large number of public service providers. The main EU legislations affecting AT and accessibil- ity in general are: the legislation to directly subsidise or otherwise support the purchases of assistive tech- nology for disabled end-users (see national and local reimbursements schemes), EU legislation ensuring that all public procurement purchases of goods and services must be accessible (EC Public Procurement Directive 2004 / 18 / EC (‗the Directive‘) on the coordination of procedures for the award of public works contracts, public supply con- tracts and public service contracts)2, and anti-discrimination laws that protect the rights of people with disabilities, especially in terms of their access to goods and services (the Treaty of Amsterdam amended the EC Treaty by introducing a new anti discrimination provision in Article 13 in the EC Treaty, addressing among others to combat discrimination based on disability, while the Frame- work directive outlaws discrimination on the grounds of disability[6]). AT databases Providing an overview of all produced AT software solutions and communication devices would bring us too far. However a good reference point is the EASTIN database (http:// www.eastin.info), which is a network of resources related to assistive technologies and com- bines the assistive technology resource databases of 7 European countries. According to EASTIN, almost 40.000 assistive products are available in the EU. Below is an overview of some European AT databases 3. The Danish, German, Italian, Dutch, Spanish, UK and Belgian databases have been consolidated into EASTIN, while most of them are also member of the International Alliance of Assistive Technology Information Providers (http://www.ati-alliance.net). Country (*participates to National databases EASTIN) Denmark* Hjælpemiddelinstituttet http://hmi.dk/ Germany* Rehadat http://www.rehadat.de Italy* Siva - Servizio Informazione e Valutazi- http://www.portale.siva.it one Ausili Netherlands* HANDY-WIJZER http://www.handy-wijzer.nl Spain* CEAPAT - Centro Estatal de Autonomía http://ceapat.org Personal y Ayudas Técnicas UK* DLF – Disabled Living Foundation http://www.dlf.org.uk Belgium* Kenniscentrum Hulpmiddelen http://www.koc.be Austria HANDYNET http://handynet- oesterreich.bmask.gv.at AEGIS - FP7-224348: find more info at http://www.AEGIS-project.eu/
- 15. ISSUE 6 PAGE 15 Country (*participates to National databases EASTIN) France Handicat – Handicaps et aides tech- http://handicat.com niques Ireland Assist Ireland http://www.assistireland.ie Portugal Catálogo Nacional de Ajudas Técnicas http:// www.ajudastecnicas.gov.pt Sweden Sök i Webb-HIDA http://80.80.24.87/ Table 3: National databases with AT information, Analysing and federating the European assistive technology ICT industry, Final Report, March 2009 Purchase of AT by end-users If we are to look at the satisfaction of AT usage, a first understanding should be to capture how AT is being purchased by or ―prescribed‖ to people with disabilities. The various delivery models can be grouped in 3 groups: 1. The medical oriented model: starting point is the handicap where the physician initiates nec- essary procedures and must approve the need for listed and reimbursed AT based on medical arguments. 2. The social oriented model: This system is based upon national legislation and local and de- centralised execution. The consumer oriented model: The end-user has direct contact with a retailer in order to get his/ her AT product. These procurement models also go together with the different reimbursement schemes (see Annex 1) applied by every country as depicted in Table 4. Where this is strongly regulated, of- ten the social oriented model can be observed (e.g. Belgium), whereas poorly regulated coun- tries often use the consumer oriented model because the end-user has to undertake all the nec- essary actions (e.g. Greece). Table 4: Procurement models by country for the five AT ICT product groups selected, Analysing and federating the European assistive technology ICT industry, Final Report, March 2009 AEGIS - FP7-224348: find more info at http://www.AEGIS-project.eu/
- 16. ISSUE 6 PAGE 16 These national and even regional legislations regarding the reimbursement of AT (and in some cases also training like in The Netherlands), and resulting different delivery models also are – as mentioned before- root cause for the lack of a common EU market, resulting also in small companies that sell rather locally instead of EU wide. A striking example is the case of Austria [7] with its many regulations, which are very different and depend on the purpose of the assis- tive technology (at work, education, everyday life, etc.) and on the local authority: the allow- ances for assistive technologies are a responsibility of the provinces, or local institutions (Fond Soziales Wien) while there are also some federal regulations (Federal Social Office- Bundes- sozialamt). The result is that in an individual case, access to AT is supported and regulated by different institutions. Barriers for the AT industry and its end-users To conclude, we will summarise a number of barriers linked to AT software that have been identified in 2 recent studies on the European AT ICT industry[8]: About 80% of the software that is available for AT applications is available only in English, while a majority is also only available in the local language of the manufacturer. However, language differences also necessitate that a local presence is necessary for the training or installation phase of AT by the wholesalers, dealers, importers or retailers. A lack of a coherent social policy for subsidising/reimbursing assistive technology products. End-users are largely unaware of the available AT solutions and this is also identified by the aforementioned European AT ICT industry survey as an important barrier to the develop- ment of the AT business in the EU. While in some countries specialised agencies exists to assist people with disabilities in mak- ing their choice (e.g. Danish Centre for technical aids for rehabilitation and education, MO- DEM for communication devices in Belgium, Kenniscentrum Hulpmiddelen in Flanders, Bel- gium), in the majority of the EU countries this is lacking or badly organised (experience of the staff of these agencies and the possibilities for trying out AT before purchasing differ greatly). The different interpretations of national service provider systems at the regional level cause barriers as it further fragments the national market into regional markets, and results in dif- ferent price-settings, even within a country. Distribution of AT still mainly goes through the traditional rehabilitation centre channel and related care sector, as well as specialised AT entities (for example the ONCE Foundation). There is a lack of dedicated training in Assistive Technology products and their capabilities (e.g. for technical experts, but also for end- users). In addition, there is a need to promote e- learning for training purposes (including the development of learning materials that can be used across borders). European research and innovation on Assistive Technology is rather poor, caused mainly by the insufficient size and the fragmented nature of the national markets. These prevent a sufficient return on investment for manufacturers or research institutes active in AT develop- ment. Assistive devices are often purchased through tendering. These (often hard to obtain) pro- cedures are hard to follow for foreign producers or distributors who have no local distributor. High purchasing costs for end users are reported as a major barrier for wider deployment by disability organisations. While most countries have regulations which ensure that costs of workplace adaptations for people with disabilities can be partially and sometimes fully financed, in general, little use is made of these possibilities. The main reasons are ignorance of what is available, and the administrative burden. AEGIS - FP7-224348: find more info at http://www.AEGIS-project.eu/
- 17. ISSUE 6 PAGE 17 Studies on AT usage and satisfaction A global standard for statistics on the use of AT products is lacking. Instead we need to resort to information from a number of countries to gain an understanding of the usage of AT in Europe. To establish this, we contacted a wide range of stakeholders with following 2 questions: were they aware of any surveys or data that captured the usage of AT by end-users, as well as were they aware of any survey or data availability on the actual satisfaction of end-users with these AT. Among many others, following organisations and their members were contacted: AT sector AAATE - Association for the Advancement of Assistive Technology in Europe ATIA - Assistive Technology Industry Association FAST - Foundation For Assistive Technology EASTIN - European Assistive Technology Information Network Service providers EASPD – European Association of Service providers for Persons with Disabilities Design for all EDeAN - European Design for all eAccessibility Network EIDD - Design for All Europe ECA - European Concept for Accessibility End-user organisations EDF – European Disability Forum European Blind Union WFD - World Federation of the Deaf WBU - World Blind Union In addition, independent AT researchers and experts were contacted (face to face meetings) with the same request, e.g. in Belgium (Mr. Jean-Marie Vanhove from Kenniscentrum Hulpmid- delen / VAPH, Mr. Harry Geyskens from the Belgian Confederation for Blind and People with Low Vision, Mr. Luk Zelderloo from EASPD), UK (Mr. David Banes from AbilityNet, Prof. David Brown from Nottingham Trent University, Mr. Steve Barnard from HFT), Greece (Mr. Nikos Voulgaropoulos from Disability Now) and the USA (Mr. Gregg Vanderheiden from RtF, and Mrs. Marcia J Scherer, President, Institute for Matching Person & Technology (USA), Professor of Physical medicine and Rehabilitation, University of Rochester Medical Center). The feedback and results that were collected indicated that actual research is in fact very limited to non-existent and in most cases only consist of snapshots provided by small scale local sur- veys. Most European countries also do not even have actual numbers on how many people are using AT. In the case of Belgium for example, a rough indication can only be given for Flanders of 3.778 successful applications4 that were made in 2007 for receiving financial support in pur- chasing supportive communication means. However, this number as such only collects those that went through one specific organisation, while others might purchase it via other channels or are being provide with this by service providers. These numbers also do not indicate what spe- cific AT was applied for. AEGIS - FP7-224348: find more info at http://www.AEGIS-project.eu/
- 18. ISSUE 6 PAGE 18 In Greece, according to research by the National Observatory of Information Society (2007, latest figures), only 4 in 10 people with disabilities seem to be aware of AT solutions that meet their accessibility needs in using ICT. 11% of non-users of ICT with disability believe that their disability prohibits them from using AT and 9% that there is no suitable AT for their needs. Non -use of ICT is further attributed to lack of digital skills for 23% of non-users with disability, while 45% of all participants with disability believe that using ICT and AT requires a high level of digital skills. Figures also show that the levels of use of ICT among regular users with and without disability are very similar, while disabled people acquire access to ICT at a more in- creasing rate than the general population.5 In a number of cases, tests had been conducted using the Quebec User Evaluation of Satis- faction with assistive Technology (QUEST)6 methodology in Canada, the USA and The Neth- erlands. However, these were often limited to proving the concept that QUEST is a usable tool, and not really to already extract actual data reflecting actual satisfaction with AT. Despite the limited data that was found, what was collected sheds a light on some of the most poignant issues that AT users face. These will be highlighted in following overviews of col- lected survey data in Malta, Spain, The Netherlands, the UK and the USA. Malta Between 2003 and 2005, the Foundation for Information Technology Accessibility (FITA) started conducting a study on ICT and disability[9]. The questionnaire was compiled by four hundred and forty five (445) individuals with a broad range of impairments, including persons with multiple disabilities. The survey covered six types of impairments that could impact com- puter use: intellectual, mobility, hearing, visual, mental health, hidden/other. Independently from the type of impairment, the survey contained the following types of questions: computer know-how, computer use and computer accessibility. The types of impairment were the following: Mobility 37% (163) Visual 9% (41) Hearing 6% (28) Mental Health 3% (14) Intellectual 21% (94) Multiple 18% (79) Other 6% (26) The study was the first large scale attempt (and so far only one in Malta) at studying the use of technology by people with disabilities. Some findings: 94% of the individuals used a computer, the majority (62%) being male. 76% indicated they had a computer at home, the majority again being male (72%). Only 24% used the computer also at work (males accounted for 67%). 49% indicated they had followed a computer course in the past 5 years, of which 69% indicated it consisted of a basic computer course (so not adjusted really to the usage combined with AT). 55% mainly used MS Office applications, 35% using spreadsheets like MS Excel and 66% using MS Word. Males accounted for the majority of the users. AEGIS - FP7-224348: find more info at http://www.AEGIS-project.eu/
- 19. ISSUE 6 PAGE 19 43% users also used the computer from graphics design, males again taking the majority. 65% users did use educational software. 60% did also carry out research on the internet. 75% did play games on their computer, 63% being male. 64% did listen to MP3 (listening to music and audio books), of which 64% males. 47% used the computer less than 2 hours per day, 44% 2-8 hours per day and 8% over 8 hours per day. 26% indicated they needed assistive technology to be able to use a computer (of which 70% males). Asked about the price, 38% indicated the computer was quite expensive to them. Assistance for the computer is in 39% of the cases provided by the computer supplier. While these results are only coming from one country, and are rather old (2003-2005), they do match to a large degree the data collected in the AEGIS partner countries as will be highlighted in the findings of the field studies. Spain A 2007 study[10], with a total sample of more than 1500 ICT users yielded following results (see Table 5). Usage of assistive technologies Yes No Users with visual impairments 67% 28% Screen readers with PC 76% (mainly JAWS) 24% Screen readers with mobile device 63% (Talk as the most used and closely followed by Codefac- tory's Mobile Speak) Screen magnifier with PC 13% (Zoomtext, followed by 87% Magic 8, and Windows Zoom) Screen magnifier with mobile 6,45% (Mobile Magnifier and Zooms) Magnifying glasses, enlarged fonts 14,52% and special glasses Users with hearing impairments 49% 50% Webcam 55% FM devices and magnetic loops 17,22% Mobile devices (with video calls 37,2% and text messaging) and subtitling AEGIS - FP7-224348: find more info at http://www.AEGIS-project.eu/
- 20. ISSUE 6 PAGE 20 Users with hearing impairments 49% 50% Webcam 55% FM devices and magnetic loops 17,22% Mobile devices (with video calls and text 37,2% messaging) and subtitling Users with motor impairments 30% 68% Hands-free wired-device 53% Hands-free Bluetooth device 20% Awls, trackballs and writing sticks 27% Users with cognitive impairments 37% 52% Screen readers 4% Augmentative Alternative Communication 4% Table 5: Usage of assistive technologies in Spain (Deusto Foundation study) The degree in usage of AT per disability group is quite different, and again is also reflected by the data collected in the AEGIS partner countries as will be highlighted in the next chap- ters. In terms of the users‘ satisfaction with the offered AT, following results were gathered: Visual impairment Hearing impairment Cognitive impairment Physical impairment AT offer Enough 45,5% Enough 52% Enough 21% Enough 32% Not 51,5% Not 48% Not 79% Not 68% enough enough enough enough Table 6: AT offer satisfaction in Spain (Deusto Foundation study) All groups indicate in most cases with a majority that there is not enough (satisfying) AT of- fered for them. The following table (Table 7) also looks at the percentage of usage for ICT based AT for some disability groups. The percentages are in fact quite low, and contradict at first sight with the previous table where all groups indicated there was not enough (satisfying) AT being offered. However, this could indicate that the AT that is being offered does not satisfy the actual needs of the people with disabilities, hence their refusal to use them. This reasoning seems to be justified by another study[11] that revealed that 58% of the consulted professionals consider that the persons they support are not provided with the required ATs, and the other professionals consider that the ATs used are not sufficient for them. This issue will equally come back in the USA data further on. AEGIS - FP7-224348: find more info at http://www.AEGIS-project.eu/
- 21. ISSUE 6 PAGE 21 Type of impairment Type of AT used Percentage of persons that use them Hearing and speech impairment ATs for communication 89% Visual impairment ATs for reading 50% Cognitive impairment ATs for communication 50% Table 7: Usage of AT in Spain (Deusto Foundation study) Another poignant issue regarding AT satisfaction is the following: In 2001, a total of 1,824 en- quiries were received at the AT information area in the CEAPAT-IMSERSO. 64,47% of them were related to ATs for information and communication services (access devices for computers – 33,42%, specific computer applications – 20,66%, aids for manual writing and reading – 3,18%, telephony communication (including telecare) – 0,96%, aids for face to face communication – 21,53%), the proportion in which these enquiries of specific products become real acquisitions cannot be evaluated. However, the most frequent causes that are put forward by users there for not acquiring the AT are the high price of the products and, in second place, the previous train- ing needed to use some of the technologies that are not easy, and require a professional to train the user to manage and use these devices. The fact that most of the products are imported also increases the final price in Spain. The Netherlands A study[12] was performed into user satisfaction and the non-use of 14 categories of assistive technology7 provided by health care insurers, using a sample of feedback from 2001 and one from 2003. The total number of respondents was 2272. Some aspects of the survey are of inter- est to our project, namely the (non)-usage of auditive aids, optical aids and aids for communica- tion, information and signalling. Following data was collected: Actual use of the assistive device % who % who compared to expected use ever used use the assistive the assis- tive de- % more % (about) % less device as much Category of assistive device number regularly vice8 auditive aids 219 94% 100% 25% 68% 8% optical aids 135 92% 73% 32% 56% 12% aids for communication, 81 83% 58% 41% 54% 6% information and signalling Table 8: Use of assistive technology per category (The Netherlands) AEGIS - FP7-224348: find more info at http://www.AEGIS-project.eu/
- 22. ISSUE 6 PAGE 22 The survey concluded that the level of abandonment varied between the various categories of assistive devices. A big majority (more than 90%) still used the assistive device regularly. Only a very small proportion of the respondents had never used the assistive device. This is most frequent for aids for communication, information and signalling. It is however exactly on these last 3 groups of aids that AEGIS project is focussing. The survey also indicated that overall AT that are easiest to obtain are the ones most abandoned. Furthermore, the study revealed that non-use arises less frequently among people with repeated provision, compared with first-time users of AT. Possibly the expectations of first time users with regard to the effect of the device are higher. UK A 2005 survey[13] that took place in the UK identified the types and mix of technology (hardware and software) provided to 455 post-secondary students with dyslexia under the UK‘s Disabled Student Allowance (DSA), and determined the students‘ satisfaction with, and use of, the equipment provided and to examine their experiences with training. The majority of the students received a recording device, text-to-speech software and concept mapping tools in addition to a standard computer system. 90% of the participants were satis- fied or very satisfied with the hardware and the software that they received. 48,6% received training, with 86.3% of those expressing satisfaction with the training they received. Of those that were offered training but elected not to receive it, the majority did so because they felt confident about their IT skills. A 2002 study [14] among 186 people with disabilities by AbilityNet highlighted a number of is- sues with respect to the usage of AT by end-users in the UK. Following findings are of interest to AEGIS: Around two-thirds of the respondents who used the Internet said that they needed AT to access it. Their interest was quite broad as Table 9 demonstrates. 45% of those who needed AT to access the internet specified that they needed voice rec- ognition, while 28% indicated the need for keyboard adaptations, and 24% mouse adap- tations. Around 20% needed speech output systems, mainly screen readers. Other adap- tations needed were magnification or special colours, and software for dyslexia. 78% of the respondents who considered that they needed assistive devices did have aids, equipment or adaptations available, but 43% of them experienced problems using them, while some others did not have available what they thought that they needed, or were awaiting an assessment or looking round for what they needed. A whole range of problems were identified regarding the usage of voice recognition sys- tems and screen readers, where compatibility issues were raised. A lack of (local and accessible) training after delivery was raised in almost every area, with users often depending on charity organisations to help them out. Table 9: Internet activities of respondents (AbilityNet survey, 2002) AEGIS - FP7-224348: find more info at http://www.AEGIS-project.eu/
- 23. ISSUE 6 PAGE 23 The cost of AT also came back as a core barrier. AT has not benefited from the economies of scale (and competition) which have greatly lowered computer costs elsewhere. In fact, cost is also likely to be a greater disincentive for disabled than non-disabled people, as they generally have lower incomes, and may also have to purchase assistive devices on top of a computer. This was also confirmed in the 2006 Network 1000 report[15] that pointed out that the prohibi- tive cost of specialist equipment for visually impaired people did create a barrier. USA A USA study on the usage of AT by people with sensory and mobility impairment[16] drew data from a study of 24 subjects (12 with visual impairments, 3 with musculoskeletal impairments, 7 with nervous impairments (including cerebral palsy, multiple sclerosis, and postpolio syndrome, and 2 with other syndromes including learning disability) who had been administered the Que- bec User Evaluation of Satisfaction with assistive Technology (QUEST), as well as the Psycho- logical Impact of Assistive Devices Scale (PIADS). These outcome measurement instruments were designed to measure satisfaction with assistive technology devices in a structured and standardised way. Following outcomes were detected: There is a need for increased awareness, training and resources to procure AT. Espe- cially training was considered a major issue to ensure optimal and consistent use of AT, and change the occurrence of AT abandonment. Blind or visually impaired users were much more adaptable towards AT. Finally, it was also highlighted that AT‘s are often unknown to end-users. In October 2009, WebAIM conducted a survey[17] of preferences of screen reader users, based on 665 end user inputs. Some of the findings are striking and presented below: The reason why a certain screen reader is selected (JAWS, Window Eyes, VoiceOver, System Access or System Access To Go, NVDA, ZoomText, Hal, Supernova) was mostly because of existing comfort and expertise in using it (42,9%), while support (7,1%) and cost (5,9%) were of less importance. Only 24,2% took a training course, with 72,9% being self taught. Only 34,7% purchased their own their screen reader, the rest being offered by various supporting programs (government, school, employer), and only a minority of 3,9% using a pirated version. This can also explain why many users are from the very beginning trained to use a specific screen reader. In the case of for example the Lighthouse for the Blind of Greece (Φάρος Τσφλών της Ελλάδος), they train their students/members mostly with the more affordable HAL screen reader, which also has a 30 days free trial period. As a result HAL also has a large user group in Greece, while this screen reader is less used in other countries. In terms of usage of browsers with the screen reader, a diversified number of browser ap- plications and versions is used, with 74,9% stating that JavaScript was not disabled in their web browser: AEGIS - FP7-224348: find more info at http://www.AEGIS-project.eu/
- 24. ISSUE 6 PAGE 24 Browser % of respondents IE8 32% IE7 26,2% Firefox 3+ 18,8% IE6 12,7% Safari 8,3% Opera 0,3% Other 1,7% Table 10: Screen reader usage by visually impaired in USA, WebAIM survey 2009 Those without disabilities were much more likely to use Firefox than those with disabilities, and this is largely caused by compatibility issues between different kinds of screen readers and the respective browsers. Free or low-cost screen readers (such as NVDA or VoiceOver) were seen as a viable al- ternative to commercial screen readers by 47,8%, while 19,7% disagreed. 50% used a screen reader on a mobile phone or mobile handheld device. Only 29,4% did use Braille output with their screen reader. 42,1% was unaware of ARIA9‘s landmark functionality Screen reader users did identify following problems (most difficult/confusing first): CAPTCHA - images presenting text used to verify that you are a human user (28%) The presence of inaccessible Flash content (22%) Links or buttons that do not make sense Images with missing or improper descriptions (alt text) Complex or difficult forms Lack of keyboard accessibility (10%) Screens or parts of screens that change unexpectedly Missing or improper headings Too many links or navigation items Complex data tables Lack of "skip to main content" or "skip navigation" links Inaccessible or missing search functionality AEGIS - FP7-224348: find more info at http://www.AEGIS-project.eu/
- 25. ISSUE 6 PAGE 25 In terms of social media that is used, following results were collected: Social Media Tool % of Respondents YouTube 51,3% Blogs 47,7% Facebook 42% Twitter 38,2% LinkedIn 13,4% MySpace 9% Table 11: Social media usage by screen readers, WebAIM survey 2009 Conclusion regarding AT usage and uptake AT has definitely broadened the world for many people with disabilities, especially then through the usage of the internet. However, a number of problems have been identified, and are enlisted below that cause a slower uptake of AT: AT industry issues: Local language versions of AT software are missing (often English). Compatibility problems arise with AT (voice recognition and screen reader software) and hardware. European research and innovation on Assistive Technology is characterised as poor, caused mainly by the insufficient size and the fragmented nature of the national markets. Policy issues: Incoherent social policy for subsidising/reimbursing assistive technology products. Lack of specialised agencies and staff to assist people with disabilities in making their choice. End-user issues: Awareness End-users are largely unaware of the available AT solutions (albeit that people with vision impairments seem to be very well informed about available AT). There is a lack of (local and accessible) dedicated training in AT products and their capa- bilities (e.g. for technical experts, but also for end- users), resulting in end users having AT they cannot use to a full extent, or in some cases not at all. Previous training that is needed to use AT, and that requires a professional to train the user to manage and use these devices is often lacking. AT that are easiest to obtain are also the ones most abandoned. Non-use arises less frequently among people with repeated provision, compared with first- time users of AT. AEGIS - FP7-224348: find more info at http://www.AEGIS-project.eu/
- 26. ISSUE 6 PAGE 26 Price High purchasing costs for end users are reported as a major barrier for wider deployment by disability organisations. Prohibitive cost of specialist equipment for visually impaired people does create a barrier. Mismatch between needs end user and offered AT End users are not provided with the required AT, resulting in a high percentage (up to 30% in the USA[18,19]) of obtained ATs being discarded within a year. AT that is being offered does not satisfy the actual needs of the people with disabilities, hence their refusal to use them. According to some survey, almost half of the end-users experience problems using AT. This mismatch between the needs of the end users and the actual AT they are being offered can be directly linked to the poor assessment of consumer needs and preferences. The Match- ing Person and Technology (MPT)[20] model and accompanying assessment instruments, first presented in 1989, are one way to counter this gap between the user needs and what is being provided to them. MPT was successfully applied also in research studies in the USA[21,22], Canada and Europe[23]. The MPT Model incorporates the assessment of three primary areas [24]: determination of the milieu/ environment factors influencing use; identification of the consumer's personal and psychosocial characteristics, needs and preferences, and description of the functions and features of the most desirable and appropriate tech- nology. On the other hand, end-users (especially people with vision impairments) also appreciate AT: Blind or visually impaired users are much more adaptable towards AT. Free or low-cost screen readers (such as NVDA or VoiceOver) are seen as a viable alter- native to commercial screen readers. Social media is used by people with vision impairments (in the USA that is). AT has enabled people with vision impairments to explore the internet by using a wide variety of browsers with their screen readers, with most having JavaScript enabled. Free or low-cost screen readers (such as NVDA or VoiceOver) are seen as a viable alter- native to commercial screen readers. Screen readers are also increasingly used mobile phones or mobile handheld devices. While there are problems with accessing the internet due to accessibility issues (e.g. use of CAPTCHAS), high numbers of people with vision impairments do access the internet. Many users are from the very beginning trained to use a specific screen reader (influenced equally by what organism is providing for the funding), and this has to be con- sidered when looking at data as this will reflect also why certain screen readers have high user percentages and some not. Quality and price of the screen readers should be considered only as a 2nd reason. AEGIS - FP7-224348: find more info at http://www.AEGIS-project.eu/
- 27. ISSUE 6 PAGE 27 Endnotes 1. Around 70% of assistive devices prescribed in Sweden go to people aged over 65. (Source: Provision of As- sistive Technology in the Nordic Countries, Second Edition, NUH - Nordic Centre for Rehabilitation Technol- ogy, May 2007). 2. Important in this ongoing work is also ETSI‘s Specialist Task Force 333: European Accessibility Require- ments for Public Procurement of Products and Services in the ICT Domain (EC Standardization Mandate M 376, Phase 1), http://portal.etsi.org/STFs/STF_HomePages/STF333/STF333.asp. The outcome of this is the ETSI Technical Report 102 612 (downloadable via http://portal.etsi.org/STFs/STF_HomePages/STF333/ tr_102612v010101p.doc), that sets out the results of the ETSI part of Phase I of the M 376 work, and charac- terises the public procurement of ICT products and services; provides a listing of existing functional accessi- bility requirements; identifies gaps where no accessibility requirements exist; provides a list of relevant exist- ing national, European and international standards and technical specifications; and gives proposals for standardisation work for the development of requirements and award criteria that still do not exist or that are not yet standardised. 3. In the USA, similar databases have been established, such as ABLEDATA's database of over 33.000 assis- tive products from over 4.000 companies 4. Source: VAPH, Jean-Marie Vanhove 5. Source: Disability Now, Nikos Voulgaropoulos, Anna Evangelinou, Eleni Strati 6. QUEST has been used with older people, adults, adolescents and also children (as documented by Sonya Murchland and Helen Dawkins in ―Development and utility of the QUEST 2.1 Children‘s Version‖, 2007) 7. It must be mentioned though that the study did not outline what it understood under AT. These may as well be hardware or software or combined solutions. 8. Calculated on the group who did not use the assistive device regularly at the time of the survey. 9. Accessible Rich Internet Applications References [1] For a full explanation, please see: Definition of Disability in Europe, A Comparative Analysis, A study prepared by Brunel University, September 2002 [2] Men and women with disabilities in the EU: statistical analysis of the LFS ad hoc module and the EU-SILC, AP- PLICA & CESEP & ALPHAMETRICS, Final report, DG Employment, social affairs and equal opportunities, April 2007 [3] Study of compilation of disability statistical data from the administrative registers of the member states, Study financed by DG Employment, Social Affairs and Equal Opportunities, Contract no vc/2006/0229 – EUR 363,268.42, Applica & Cesep & European Centre, Final Report, November 2007 [4] http://epp.eurostat.ec.europa.eu (Population Projections) EUROPOP2008, convergence scenario, national level (04 November 2008) [5] Analysing and federating the European assistive technology ICT industry, Final Report, March 2009, Jennifer Stack, Leire Zarate, Carmen Pastor, Niels-Erik Mathiassen, Ricard Barberà, Harry Knops, Hugo Kornsten [6] EU ANTI-DISCRIMINATION LAW, General Editor: F. G. Jacobs. Advocate General, The Court of Justice of the European Communities, 2005 [7] Measuring Progress of eAccessibility in Europe (MeAC), as mentioned in Report on policy and DfA, DfA@eInclusion deliverable D2.2b, 2008 [8] Access to Assistive Technology in the European Union, A study prepared by Deloitte & Touche, EC, Directorate -General for Employment and Social Affairs, Unit E. 4, June 2003; Analysing and federating the European assistive technology ICT industry, Final Report, March 2009, Jennifer Stack, Leire Zarate, Carmen Pastor, Niels-Erik Mathi- assen, Ricard Barberà, Harry Knops, Hugo Kornsten; MeAC - Measuring Progress of eAccessibility in Europe, As- sessment of the Status of eAccessibility in Europe, Main Report, Bonn, October 2007 [9] L-Informatika l-Komunikazzjoni w d-Diƒabilità, Information Communications Technology and Disability, Study Report, Foundation for Information Technology Accessibility (FITA), 2005 [10] Aurtenetxe Jon Leonardo; Ibáñez , Mónica; Lezaun, Zuriñe. ―Usage of mobile devices within the Population with Disabilities‖. Deusto Foundation 2007 AEGIS - FP7-224348: find more info at http://www.AEGIS-project.eu/
- 28. ISSUE 6 PAGE 28 References [11] Abril, Dolores; Aparisi, J. Enrique et all. ―White Paper, R&D at service of the persons with disabilities and the elderly‖. CERMI (Spanish Committee of Representatives of People with Disabilities) 2003 [12] Non-use of assistive technology in The Netherlands: A non-issue?, B. P. J. DIJCKS, L. P. DE WITTE, G. J. GELDERBLOM, R. D. WESSELS, & M. SOEDE, iRv, Institute for Rehabilitation Research, Hoensbroek, The Netherlands, Disability and Rehabilitation: Assistive Technology, January-June 2006; 1(1-2): 97 – 102 [13] Use of assistive technology by students with dyslexia in post-secondary education, E. A. DRAFFAN, D. G. EVANS & P. BLENKHORN, School of Informatics, University of Manchester, Manchester, UK, Disability and Rehabilitation: Assistive Technology, March 2007; 2(2): 105 – 116 [14] Disabled people and the Internet, Experiences, barriers and opportunities, Doria Pilling, Paul Barrett and Mike Floyd, CS Foundation, 2004 [15] Opinions and circumstances of visually impaired people in Great Britain: report based on over 1000 in- terviews, August 2006, Graeme Douglas, Christine Corcoran, Sue Pavey, Visual Impairment Centre for Teaching and Research (VICTAR), University of Birmingham [16] Computer-Related Assistive Technology: Satisfaction and Experiences Among Users With Disabilities, Mary Burton, MS, Els R. Nieuwenhuijsen, PhD, MPH, OTR, and Marcy J. Epstein, PhD, Asst Technol 2008;20:99-106, 2008 RESNA [17] Screen Reader User Survey Results , http://webaim.org/projects/screenreadersurvey2/, WebAIM, as accessed on 28 December 2009 [18] Outcomes of assistive technology use on quality of life. Scherer, M.J., 1996, Disability and Rehabilita- tion, 18(9), 439-448 [19] Predictors of assistive technology abandonment, Phillips, B., & Zhao, H., 1993, Assistive Technology, 5, 36-45 [20] The Matching Person & Technology (MPT) Model Manual, third edition, Scherer, M.J., 1998, Webster, NY: The Institute for Matching Person & Technology, Inc. [21] The Matching Person & Technology (MPT) Model Manual, third edition, Scherer, M.J., 1998, Webster, NY: The Institute for Matching Person & Technology, Inc. [22] Measuring subjective quality of life following spinal cord injury: A validation study of the Assistive Tech- nology Device Predisposition Assessment, Scherer, M.J. & Cushman, L.A., 2001, Disability & Rehabilitation, 23(9), 387-393 [23] Predicting satisfaction with assistive technology for a sample of adults with new spinal cord injuries, Scherer, M.J. & Cushman, L.A., 2000, Psychological Reports, 87, 981-987 [24] Predictors of Assistive Technology Use: The Importance of personal and psychosocial factors, Marcia J. Scherer, Ph.D., Caren Sax, Ed.D., CRC, Alan Vanbeirvliet, Ph.D., Laura A. Cushman, Ph.D., John V. Scherer, M.S.E.E., 2005, Disability & Rehabilitation, 27(21), 1321-1331 AEGIS - FP7-224348: find more info at http://www.AEGIS-project.eu/
- 29. PAGE 29 See you there! ―Accessibility Reaching Everywhere‖ AEGIS Final Workshop and International Conference, Brussels, Belgium, 28-30 November 2011 The AEGIS project organises its final Workshop and 2 nd Interna- tional Conference entitled ―Accessibility Reaching Everywhere‖ on 28-30 November De- cember 2011 in Brus- sels, bringing together both end-users (people with disabili- ties) as well as plat- form and application accessibility develop- ers, representative or- ganisations, the Assis- tive Technology indus- try, and policy makers. Illustration: Entrance to Diamant building Since 2008, the AEGIS consortium (comprising companies such as Vodafone Foundation, Research in Motion, Oracle, and research groups from Cambridge University and Katholieke Universiteit Leuven, etc.) has been de- veloping an Open Accessibility Framework – comprising open ac- cessibility interfaces, user interface components, developer tools, end-user applications and prototype accessibility solutions for desktops, rich Internet applications and mobile devices. These events comes ahead of the European Day of People with Disabilities that is marked by the European Commission via a pol- icy conference on 1-2 December, in close cooperation with the European Disability Forum (EDF). The workshop on 28 November will focus on the realisations of the AEGIS (Open Accessibility Everywhere: Groundwork, Infra- structure, Standards) project and provide attendees the opportu- nity to try out all outcomes of the project. The demonstrated prod- ucts offer barrier-free access to desktop, mobile and web applica- tions, are open source based and will be freely available. AEGIS - FP7-224348: find more info at http://www.AEGIS-project.eu/
- 30. ISSUE 6 PAGE 30 Time Topic Presenter(s) 9.00-9.30 Registration EPR 9.30-9.45 Welcome Jan Spooren - EPR 9.45-10.00 AEGIS concept & realisations Maria Fernanda Cabrera Umpierrez - UPM 10.00-10.30 List of demos Peter Korn - Oracle 10.30-11.00 Coffee break 11.00-12.00 Round-table discussion users (FONCE, EPR) experts (TECHNOSITE, NTU) key developers (UCAM, CVUT, SU-DART, KUL) industry (RIM, FVE) Chair: Peter Korn - ORACLE 12.00-13.00 Rich internet applications (demos) with chair: Dionysia Kontotasiou, discussion CERTH-ITI Haptic RIA maps (Dionysia Kontotasiou, CERTH-ITI) MooTools UI components (CERTH-ITI, FhG, AOL) Accessible jQueryUI Components (CERTH-ITI, FhG, AOL) WAIARIA implementation on UI toolkits (CERTH-ITI, FhG, AOL) CMS demonstrator (CERTH-ITI, FhG, AOL) Accessibility Advisor (Jan Vystrcil, CVUT) NetBeans Plugin (Jan Vystrcil, CVUT) 13.00-14.00 Lunch 14.00-15.15 Mobile applications (demos) with discus- chair: VFE (Jon Azpiroz) sion Dasher for Android (Patrick Welche, UCAM) Dasher for iPhone (Patrick Welche, UCAM) Accessible Contact Manager and Phone Dialer, Java version (Maria Fernanda Cabrera Umpierrez, UPM, Jon Azpiroz ,VFE) Accessible Contact Manager and Phone Dialer, Android version (Maria Fernanda Cabrera Umpierrez, UPM, Jon Azpiroz ,VFE) Accessible RTT for mobile (Maria Fernanda Cabrera Umpierrez, UPM, VFE) Tekla Onscreen Keyboard (and optionally Tekla Bluetooth Shield) (Jan Richards, OCAD) CCF for Android (Mats Lundälv, SU-DART) AEGIS - FP7-224348: find more info at http://www.AEGIS-project.eu/
- 31. PAGE 31 15.15-15.45 Coffee break 15.45-17.00 Desktop applications (demos) chair: KUL (Prof. with discussion Jan Engelen) GnomeShell Magnifier (Jan Richards, OCAD) Concept Coding Framework for LibreOffice (Mats Lundälv, SU-DART) Odt2braille (Bert Frees, Christophe Strobbe, KULeuven) Odt2daisy (Bert Frees, Christophe Strobbe, KULeuven) Accessibility Checker for LibreOffice (Bert Frees, Christophe Strobbe, KULeuven) eSpeak TTS Engine (Language Enhance- ment) (Jerry Dimitriou, SILO) OpenGazer (Patrick Welche, UCAM) 17.00-17.15 End of workshop The workshop language will be English. The conference on 29-30 November will gather a wide array of experts and users in the area of Assistive Technology to discuss scientific and policy developments in accessible technology; showcase relevant projects and initiatives in the area of assistive technology. Time Topic Presenter(s) Day 1 08.30-09.30 Registration 09.30-09.45 Welcome EPR 09.45-10.15 AEGIS concept and realisations UPM, ORACLE 10.15 – 11.00 Personalities' address Mr. Paul Timmers, EC Mr. Jo Vandeurzen, Flemish Minister of Welfare (TBC) Ms. Helga Stevens, Belgian MP 11.00-12.00 Opening exhibition by Minister + coffee AEGIS - FP7-224348: find more info at http://www.AEGIS-project.eu/
- 32. PAGE 32 Time Topic Presenter(s) Day 1 12.00- Round-table with stakeholders 13.00 Karel Van Isacker (Chair) Peter Korn – ORACLE (Technical) Gregory Smiley – NOKIA (Industry) Greg Fields – RIM (Industry) Wim Moeyaert – Werkgroep Vorming en Aktie (end- users) Clayton H Lewis – Coleman Institute for Cognitive Dis- abilities (Research) Gregg Vanderheiden – NPII/Cloud4ALL (Research) Press representative (tbc) 13.00- Lunch (+ Exhibition) 14.00 14.00- Parallel sessions 1 & 2 16.00 Mobile applications Jon Aspiroz - FVE (Chair) ACCESSIBLE Workshop Kostas Votis - CERTH-ITI (Chair) 16.00- Coffee break (+ Exhibition) 16.30 16.30- Parallel sessions 3 & 4 18.30 International Research and ini- Jutta Treviranus – tiatives IDRC (Chair) Gregg Vanderheiden - NPII ARIA and Developer needs and Jan Vystricil – CVUT wants (Chair) 18.30- Cocktail (+Exhibition) 19.30 AEGIS - FP7-224348: find more info at http://www.AEGIS-project.eu/
- 33. ISSUE 6 PAGE 33 Time Topic Presenter(s) Day 2 08.30-09.00 Registration 09.00-09.45 Key-note speech Jan Albers (former EPR president and CEO of Foun- dation Rehabilitation Lim- burg, NL) 09.45-10.15 Coffee break (+ Exhibition) 10.15-12.15 Parallel sessions 5 & 6 A. OSS and standardisation Prof. Jan Engelen – K.U.Leuven (chair) B. Accessible content Desktop applications Patrick Welche – UCAM (chair) 12.15-13.30 Lunch (+ Exhibition) 13.30-15.30 Parallel sessions 7 & 8 User needs and wants Karel Van Isacker – EPR (Chair) Accessibility overall Maria Gemou – CERTH-HIT (chair) 15.30-16.00 Coffee break (+ Exhibition) 16.00-17.30 Concertation event with FP7 or related pro- Jose Angel Martinez Usero - jects on accessibility: AsTeRICS, GUIDE, FONCE (chair) HaptiMap, MyUI, VICON, eAccess+, ETNA, Maria Gemou — CERTH-HIT ATIS4all, ACCESSIBLE, CARDIAC and (chair) VERITAS. 17.30-18.00 Wrap-up of conference Peter Korn — ORACLE Towards the future Maria Fernanda Cabrera - UPM Award ceremony for Best presentation, Best paper and Best poster in the spirit of AEGIS. 18.00 End of conference
- 34. PAGE 34 Contact us PROJECT COORDINATOR TECHNICAL MANAGER Dr. Maria Fernanda Cabrera Peter Korn Umpierrez Accessibility Principal & AEGIS Technical Manager ETSI Telecomunicacion Universidad Politecnica de Ma- Oracle drid 500 Oracle Parkway Cuidad Universitaria s/n Redwood City, CA 94065 28040—Madrid U.S.A. Spain Tel. +1-650-506-9522 Tel. +34 (610) 349820580 Fax: +34 (6498) 20580 E-mail: peter.korn@oracle.com http://blogs.sun.com/korn E-mail: chiqui@lst.tfo.upm.es Subscribe to our newsletter Requests to subscribe to or unsubscribe from this Newsletter should be directed to info@AEGIS-project.eu with the subject ―subscribe newslet- ter‖ or ―unsubscribe newsletter‖. All issues of the Newsletter may also be downloaded at the project web- site: www.AEGIS-project.eu Subscribe to our Social Media services Conference website - http://aegis-conference.eu/ Twitter - http://twitter.com/aegisproj TweetWall - http://aegisconf.tweetwally.com/ (use #aegisconf to post your tweets) Facebook - http://tiny.cc/aegis SlideShare - http://www.slideshare.net/aegisproject AEGIS video - http://tiny.cc/aegisvideo AEGIS - FP7-224348: find more info at http://www.AEGIS-project.eu/