Increasing the Accessibility of Public Access Computing

Introduction

The goal of this paper is to help libraries and other public access computing facilities develop, plan for, and/or expand the accessibility of their public access computers to patrons with disabilities.

This paper does not provide ready-to-go solutions for accessible computing; rather, it is intended to serve as a resource to help you make informed decisions appropriate for your unique situation. In terms of off-the-shelf or specially designed devices used by people with disabilities -- often called assistive technology -- in public computing facilities, one size does not fit all. Of the successful programs we have seen, all developed solutions that took into account staff knowledge, amount of support available, and patrons' needs.

While working in many libraries throughout the country, we at the Bill and Melinda Gates Foundation have heard from many librarians who are frustrated with the process of selecting and supporting assistive technology. The librarians want to serve the public well and make sure that all users have access to and are comfortable with their computers, but many are not sure where to start, or have made unsuccessful attempts to increase accessibility of computer resources in their libraries.

To be able to share some information with libraries about what is working and what is not, we created an online survey and invited librarians to take part. One of our respondents said they wanted, "A catalog of what is available (hardware and software) telling you what each item does in plain English (you can put the computer jargon in the back for the systems department to read!) with estimates of user difficulty, amount of staff help required, prices, cost to maintain, what it combines with, and so on, would be wonderful. It's a jungle out there."

We hear comments like this quite often, so even though we can't provide a solution for each and every need, this paper provides a starting point for those wanting to increase accessibility of public access computing for people with disabilities.

In developing this paper, we worked with the Washington Assistive Technology Alliance (WATA) to develop basic accessibility options on the computers we grant. Our information was gathered from WATA, an assistive technology survey that we conducted in the winter and spring of 2002, and from the Web. All of the quotes you read in this paper were taken from this survey. For more information on the survey questions and results, see Appendix D.

Know This Before You Start

Successful assistive technology applications take into account the needs of the users, as well as the context in which the technology will be used. Selecting technologies that serve many people in a public computing setting involves a different process and is more difficult than selecting technology to serve one individual. One survey respondent recommended, "Do a lot of research first, and find out what is most commonly needed by your patrons! It does no good to offer technologies that your patrons don't need or can't use, and you still need to offer the technologies that they need -- so you might as well find out what those are first.

Know Your Audiences and Their Needs

It is important to understand that the process of selecting appropriate assistive technology does not start with thinking about the technology you should acquire. Instead, the first step is to identify and learn about the people you would like to serve. Who are the people who already visit the library and could benefit from assistive technology? Who are the people who do not currently visit the library, but would gladly come in and use library resources if appropriate assistive technology was available?

Broad categories of patrons with disabilities include those with low vision, blindness, hearing and speech impairments, learning and cognitive disabilities, and mobility impairments. It is essential to think about people with disabilities in the broadest possible sense. Many patrons who could benefit from assistive technology would never identify themselves as people with disabilities. For instance, older individuals who have low vision or difficulty using their hands do not necessarily identify themselves as having a disability, but may benefit greatly from assistive technology.

When asked what advice they would give to a library planning to offer assistive technology, the most frequent survey response was to get to know the audience and their needs. Decision makers need a clear understanding of how technology meets the needs of specific audiences. For instance, while there is some overlap in the technology used, the needs of people with low vision are quite different from those who are blind; the needs of people with specific learning disabilities are very different from those of people who are blind or have low vision.

Improving services to patrons who already visit your library is often an effective and successful first step. Reaching patrons who currently do not use your resources requires research and a long-term outreach strategy. Getting the word out about the technology and training available to this category of users is an important part of developing an assistive technology program. Failure to understand your audiences and their needs leads to frustration, wasted funds and effort, and disappointment on the part of both librarians and patrons. Do not assume that patrons will simply show up when the technology is available. You might find, as some survey respondents reported, that:

"Dedicated assistive technology is rarely used."

"The setup is never used by patrons it is designed to serve."

"We find that even though we have the technology available patrons do not use it often."

Typically, technology solutions that are easy to support and use such as large monitors, large print labels for keyboards, and alternate types of keyboards and mouse devices, are the most widely used and appreciated by individuals with disabilities and senior citizens. These simple solutions will meet the needs of many people with low vision who have difficulty reading computer screens and regular print (including printouts from library printers), and those who have difficulty using their hands or performing tasks that require fine motor control (such as using a mouse or keyboard.) People with mobility impairments, including those who use power and manual wheelchairs, scooters, walkers, and other mobility aids may also be accommodated by easy-to-use technology solutions such as adjustable tables.

If you are ready to reach out to and serve patrons with moderate to significant functional limitations, you will generally need to provide higher levels of support and training for the librarians. The technologies that require a high level of expertise and support include screen readers; software and hardware for producing hard-copy Braille for blind users; screen magnification software for individuals with low vision; scanning and optical character recognition systems; software that provides support for reading and writing for individuals with specific learning disabilities; sophisticated head-tracking, eye-tracking, and mouth-controlled input; on-screen keyboards with switch and scanning options for input; and many others.

Before you make decisions on what kind of technology to acquire, make sure people in your community are interested in coming to the library to use these systems, make sure training on how to use the technology is available, and make sure the librarians will be able to provide sufficient technical assistance. As one respondent in the survey put it: "Don't go for all the bells and whistles [such as screen readers] unless you are sure that they are needed and will be used."

Once you determine the needs of the audiences you intend to serve, research the tasks patrons want to accomplish in your library. Will they be browsing the Internet, reading and writing e-mail, word processing, or scanning hard copy materials so that they could read it? Knowing the tasks will assist you with the selection of the appropriate assistive technology because the technology needs to work with the applications your patrons will use to accomplish their tasks. When talking to vendors, you can then ask whether their products work with those specific applications and when you test a demonstration or evaluation copy, you can test the technology using the application and tasks patrons will be performing.

Selecting Technology

Once you know your audience, their needs, and the tasks they will be performing you are ready to start researching specific assistive technology applications.

We recommend you start with assistive technology that is relatively easy to maintain; reliable; easy to connect, use, and support; and transparent or (better yet) beneficial to all library patrons. Often no-technology (just strategies, signs, and step-by-step guides) and light-technology approaches are the most used and most appreciated by both patrons and librarians.

They include:

• Large flatscreen monitor mounted on an adjustable monitor arm to assist those with low vision (and patrons or librarians who forgot their reading glasses).
• Easily adjustable furniture to allow wheelchair users and people with different body heights and sizes to adjust the station height and keyboard position.
• A high-quality laser printer capable of printing large print for patrons with low vision.
• A mouse alternative (a trackball or joystick) in place of or in addition to a regular mouse to aid those with limited hand mobility, shaking hands, and others who find using a standard mouse difficult.
• A small keyboard (similar to the size used on laptop computers) to assist those with limited hand motion, one-handed typists, and others who can benefit from reducing the distance to be covered on the standard keyboard (children often benefit from smaller keyboards as well).
• Specialized connectors that allow more than one keyboard or mouse to be connected to a computer.
• Keyboards with large-print key labels to aid patrons with low vision who do not touch-type.
• Easy to read and follow cheat sheets on how to use keyboard commands as an alternative to using the mouse for software such as Web browsers or word processors.
• FM listening devices and TTYs (also called TDDs for "Telecommunication Devices for the Deaf") for patrons who are hard of hearing or deaf.
• Customer service via e-mail to make it easier for those with speech impairments to communicate with library staff.
• Information on how to use accessibility options built into the operating system (and access to using those options) or preprogrammed user profiles that allow patrons to take advantage of the accessibility features (StickyKeys, FilterKeys, MouseKeys, ToggleKeys, SerialKeys, ShowSounds, High Contrast Mode, and so on).

The utility of selecting technology that is easy to use, maintain, and support is apparent from survey responses. Assistive technologies most used by patrons are:

1. large monitors (appreciated by all patrons)
2. alternate keyboards and mouse devices
3. adjustable tables

One respondent summed up this principle succinctly: "Keep it simple. Much assistive technology can be too complex for multiple users, leading to frustration with lack of progress."

Even if the staff is knowledgeable and up-to-date on various assistive technologies, it might make sense, as a first step, to consult with and inquire about experiences of organizations that provide public computing (such as other libraries, college and university computer labs, or community technology centers), organizations knowledgeable about assistive technology (such as Tech ;Act projects -- see links in Appendix A), and providers of assistive technology services (such as rehabilitation services businesses). It is also essential to seek advice from users with disabilities who are skilled in using the technologies of interest.

Whenever possible request demonstration copies of the technologies you are considering. Install the demos and try using them or invite patrons with disabilities skilled in using the technology to test them. This will help you identify problems that you might not have thought of, and you can ask additional questions before making the final decision.

Training and Technical Support for Librarians

Before purchasing technologies requiring a high level of support and expertise, it is important to understand the level of staff support and training that will be necessary for successful use of the technology. If resources for providing the training and support for the library staff are not allocated, the technologies may not get used.

Survey respondents listed the types of technology that require high levels of support and expertise (such as screen readers) as either "most used" or "least used." The difference there is in patrons' level of expertise or in the level of support provided by libraries. It is not possible to tell from the survey, but it is likely the libraries that listed this equipment in the "most used" category budgeted for staff time and technical support needed to acquire adequate knowledge of these technologies and adequate supports for the patrons. Alternatively, they may have spent time getting to know their audiences and determined that there are enough skilled users of the technology in the area and lower levels of staff support would not prevent patrons from using the technology.

The best resource for getting a realistic picture of staff time and the level of technical support necessary to support the assistive technology may be your fellow libraries. Participants in the survey offered the following advice:

"Talk to as many libraries as possible who already have [the specific technology you're considering] to get the real story."

"Talk to other libraries who have the technology you are considering to find out if you can afford not only the purchase costs but the staff costs, and if users need a lot of help."

Training for Patrons

Even if your assessment of the needs of patrons with disabilities reveals that there are enough skilled patrons to warrant purchasing specific assistive technology, you still need to consider training needs of the potential users. As one survey respondent put it: "Don't do too much unless you have personal individual support structures in place. Provide sufficient staff in support and training."

Some patrons who would very much like to use the assistive technology in your library are likely to have very little experience with using computers and will need considerable training and support. For instance, a user with low vision has to simultaneously use the computer (the operating system), an application (such as a word processor), and the assistive technology (such as screen enlargement software). This is no small task, and support from a person who is skilled in how users with disabilities interact with each technology involved is essential.

Approximately half of the survey respondents stated that their libraries have staff who troubleshoot and support assistive technology, but they do not provide direct user training. If you decide not to offer training, it is important to find out whether such training is available elsewhere in the community (for instance from community colleges) and refer patrons to that training. If training is not available, we recommend you approach a local community college or computer center and help them develop the training. Almost a third of respondents noted that lack of training is a problem because patrons do not know how to use the assistive technology that is available. However, only four libraries reported working with local resources to provide training on the specific technologies available in local libraries.

Most Commonly Used Assistive Technology in Libraries

Our survey indicated that there were a few assistive technology devices and applications that were most commonly found in libraries. Our sample size was small, so this list is not inclusive. We included the most popular products and what some of the librarians said about them. In answer to our survey question on the most and least used assistive technology, we received a wide range of responses.

Large Monitors - various manufacturers and vendors

Large monitors were the most frequently used assistive technology in our survey. Over 60 percent of our survey respondents indicated using large monitors to meet the needs of their patrons. Size varied, as some libraries used 19-inch monitors and some used 27-inch monitors.

Librarian comments:

"The most effective is the large screen monitor."

"19-inch monitors are very popular with all patrons."

"The combination of JAWS, large monitor, and Windows accessibility features were most often used."

"All patrons want the large monitors."

Alternative Input Devices

There is a wide range of alternative input devices available. Many libraries in our survey use a mouse trackball instead of a traditional mouse. See Appendix A for more information on alternative input devices.

ZoomText Xtra by Ai Squared

ZoomText Xtra is a screen reader and magnifier primarily used by individuals with low vision. See Appendix A for more information.

Librarian comments:

"ZoomText is probably the most frequently used program, since it is useful even for people who don't think of themselves as normally needing assistive technology."

"The ZoomText is available but we haven't seen any use during the past three years. Still, it is available."

"We find that even though we have the technology available patrons do not use it often. We do not offer training."

"Zoomtext [is most often used] because its basics are easy to learn."

"Most of our patrons can sit down by themselves and figure out how to use Zoomtext once they know it's there."

In our survey, Zoomtext was the most widely available third-party assistive technology software in libraries.

JAWS for Windows -- Professional Edition, by Freedom Scientific

JAWS for Windows is a screen-reading software program used by blind individuals. See Appendix A for more information.

Librarian comments:

"JAWS is probably the least used at this point."

"The JAWS program is used the most."

In some libraries, it was the most frequently used assistive technology, while others expressed frustration. Some would have rather spent the money on something more useful for their patrons. One librarian recommended:

"Before you buy JAWS, know that you will have a population who will come in and use it. We forgot our initial training since we didn't have anyone coming in asking questions. It's not one of those technologies you can sit down and figure out on your own very easily."

All the librarians responding to our survey who said that JAWS was their most used assistive technology had dedicated staff to train and support its use, or an active community resource that provided training inexpensively or for free.

MAGic -- Freedom Scientific

MAGic is screen magnification software with a speech option primarily used by individuals with low vision. See Appendix A for more information.

Librarian comments: Several librarians indicated that MAGic is used in their libraries.

"The main complaint with Magic is that the larger the text, the more distorted and jagged the characters appear."

Kurzweil 1000 -- Kurzweil Educational Systems

Kurzweil 1000 is an optical character recognition software for users who are blind. See Appendix A for more information.

Librarian comments: Several respondents to our survey indicated that they use the Kurzweil 1000 software in their libraries.

Kurzweil 3000 -- Kurzweil Educational Systems

Kurzweil 3000 is software designed to help people who have difficulties with reading and writing tasks (for instance, people with learning disabilities). See Appendix A for more information.

Librarian comments: Several respondents to our survey indicated that they use the Kurzweil 3000 software in their libraries.

Built-In Accessibility with the Windows 2000 Operating System -- Microsoft page

Microsoft provides accessibility products as part of the Windows 2000 operating system, as well as a great deal of information on its Web site. The applications listed below are part of Microsoft's Utility Manager and are included in addition to those options in previous versions of Windows: large icons, font sizes, large mouse pointers, etc. None of these applications are meant as a substitution for a commercial assistive technology program.

On-Screen Keyboard:

displays a virtual keyboard on the computer screen that allows the user to use a pointing device or joystick instead of the physical keyboard.

Magnifier:

is a screen magnifier. Magnifier provides a minimum level of functionality for people with low vision.

Narrator:

is a simple screen reader.

Librarian comments: Our survey respondents commented on both the Windows NT options to create large fonts and icons and the like (as in the Bigprint profile on the Gates Library Computer) and the Windows 2000 Utility Manager products. Over 50 percent of survey respondents indicating using Windows accessibility features on their public access computers.

"Gates [NT] computers' ability to change text size is not used as much as it should be because when you are in a program or game, the icons disappear."

"Windows accessibility features were most often used."

"Most [used are] accessibility features."

"Least [used] are different profiles."

"Most used is the Big-Print function and/or Windows font enlargement function."

"Least used are accessibility features in the Windows OS, both 95 and NT."

Conclusion

Increasing accessibility to public computing does not necessarily involve complicated and fancy assistive technology. The most appreciated products in our survey could be used by all patrons: large monitors, alternative mice and keyboards, and adjustable furniture.

There are, however, groups of patrons who require the use of relatively complex assistive technologies, and providing those technologies in your library can make all the difference for particular individuals with disabilities.

With careful research and planning, these more specialized solutions can significantly help libraries serve all members of their communities, including people with disabilities.

Developing a long-term strategy for addressing accessibility, taking small steps and starting with projects that are very likely to be successful, networking with other libraries and organizations in your community, including patrons with disabilities in decision making, and building on successes by publicizing achievements are all examples of strategies libraries have used to build public computing facilities that provide an important service to the community and are deeply satisfying to the librarians involved.

We hope that the information in this paper will contribute to creating accessible public computing facilities nationwide that can be enjoyed by both the patrons and librarians.

Appendix A: Assistive Technology for Public Technology Labs

Please Note: Inclusion of specific equipment and software does not imply product endorsement by the University of Washington Center for Technology and Disability Studies or by the Bill and Melinda Gates Foundation.

Switches and Adapters

• 2-Port KVM Switch (Linksys)
  Permits use of a keyboard, monitor, and mouse shared between two computers.
• Y-Mouse (P.I. Engineering)
  Allows simultaneous connection of multiple pointing devices.
• X-Keys (P.I. Engineering)
  Provides simultaneous connection of two keyboards.

Access for Blind and Low-Vision Users

Screen Enlargement Software

Allows enlargement of print on the screen, enabling the user to review a document with the text magnified to a comfortable size and with screen colors adjusted for best contrast. The user can use any part of the screen by scrolling up, down, or across.

• ZoomText 8.1 Magnifier and ZoomText 8.1 Magnifier/ScreenReader (AiSquared)
  ZoomText 8.1 Magnifier has screen enlargement only. ZoomText 8.1 Magnifier/ScreenReader also includes synthesized speech.
• Lunar, Lunar Plus, and SuperNova (Dolphin Computer Access)
  Lunar provides screen enlargement; Lunar Plus includes synthesized speech; SuperNova includes synthesized speech and Braille output.
• MAGic (Freedom Scientific)
  MAGic provides screen enlargement only. Magic with Speech includes synthesized speech.

Screen-Reading Software

Screen Readers work with most standard commercial applications and allow text to be read aloud to the user through synthesized speech or displayed in Braille using special hardware.

• JAWS for Windows (Freedom Scientific)
• Window-Eyes (GW Micro)
• Hal and SuperNova (Dolphin Computer Access)

Screen-Reading Applications for Reading the Web

• Connect OutLoud (Freedom Scientific)
  This application is based on JAWS technology. It provides speech output to aid users in surfing the Web, and sends and receives e-mail. It creates documents in the Freedom Scientific (FS) word processor. Deemed appropriate only if no standard screen reader is available.
• IBM (IBM Accessibility Center)
  Provides a simple, easy-to-use interface for navigating and manipulating Web page elements. Utilizes IBM's ViaVoice text-to-speech ( TTS) text-to-speech synthesizer for speech output. Works with Internet Explorer 5.5 or higher.

Braille Displays

Braille displays are typically hardware devices that can be attached to computers to allow users to display the text on the computer screen in Braille.

• ALVA Satellite (Alva Access Group)
  Designed to sit beneath a laptop for portability or under a standard keyboard for convenience. Several models offer a 70- or 80-character display.
• Focus (Freedom Scientific)
  Focus comes in two models: the 40- and 80-cell.

Braille Translation Software

Braille Translation Software works in conjunction with a Braille embosser to produce hard-copy Braille. The translation software converts print characters to their Braille equivalents and converts standard print formats such as paragraphs and lists to equivalent Braille formats.

• Duxbury for Windows (Duxbury)
  A multi-platform, multi-language Braille translator generally used for producing hard copy Braille.

Braille Embossers

Braille embossers work in conjunction with Braille translation software to produce hard-copy Braille. The embossing process makes significantly more noise in creating documents than does ink printing due to the impact made by the embossing head on the paper to create each dot. These devices are often available to a computer lab, but they are usually not housed there due to the noise.

• Romeo & Juliet Embossers (Enabling Technologies)
  Single-side or interpoint production (a method of spacing Braille on both sides of a page so that no dots counteract each other); tractor feed (allows for continuous printing).
• Braille Blazer (Freedom Scientific)
  Quiet and compact, produces high-quality Braille on many sizes of Braille paper, plastic labels, and even index cards. Not recommended for high-volume production.
• Versapoint Duo (Freedom Scientific)
  Produces single-side or two-sided interpoint Braille. Embosses up to 60 characters per second.
• Sighted Electronics (Sighted Electronics)
  A high-speed (340 pages per hour) Braille embosser that works with standard cut-sheet paper.
• (Sighted Electronics (Sighted Electronics)
  A double-sided (interpoint) Braille embosser using continuous tractor-feed paper.

Scanning/Optical Character Recognition ( OCR) Products

Used in conjunction with a commercial flatbed scanner, these products convert text from a printed page to a computer file that can then be read using synthetic speech.

• Open Book (Freedom Scientific)
• Kurzweil 1000 (Kurzweil Educational Systems)

Closed Circuit Television (CCTVs)

Many individuals who have some vision, but are unable to read standard size print, may find an electronic video magnification device called a Closed Circuit Television (CCTV) useful. We generally recommend a stand-alone inline unit in settings with multiple users. These units have a 14- to 20-inch video display on which materials can be magnified from 3 X to 40X standard size. They also include adjustments for foreground/background polarity, contrast, and brightness. A CCTV may be used for both reading and writing, making it an ideal solution for completing paper-based forms. CCTVs come in monochrome (black and white) or full spectrum color with color select features (which include various color combinations for the foreground and background). Placing a CCTV on a machine stand with wheels allows for portability.

Configurations include: split screen with a computer monitor so that you can see both the screen of the computer and the document you are reading under the CCTV; standalone CCTVS under which you can read and write.

• CLARITY Electronic CCTV Magnifiers (Solutions For Humans))
  Magnification is from 5x to 60x, with extremely high resolution. Clarity can be used with a standard TV, a high-resolution monitor, or a regular computer monitor.
• Telesensory (Telesensory)
  Monochrome; easy to operate with high contrast and brightness controls. The Aladdin Rainbow is a full spectrum color CCTV with color select options.
• Ergonomic Solutions (Access Ingenuity)
  Features an extremely crisp, no-flicker image; ergonomic components such as a wheeled adjustable stand for portability; adjustable monitor and reading table that accommodates individuals of varying stature, including individuals who are wheelchair users.

Auxiliary Items For Use With Closed Circuit Television (CCTV)

Large 19-inch monitor with flat screen. Examples include:

• Viewsonic E90F Flat 19-inch CRT
• NEC NEC Multisync FP955 19-inch CRT
• Ergomart (ErgoMart)
  (Source also listed in the Comfort Aids and Adjustable Furniture category. See below.)

Access for Mobility/Orthopedically Impaired Users

Alternative Input Devices

• QuadJoy
  A joystick-operated, two-button mouse that may be controlled by either mouth or chin. Mouse button activation can also be accomplished using the built-in 'sip and puff' switch, manually with the actual mouse buttons, or with a switch in conjunction with the external switch jack.
• Innovation Management Group, Inc.) (Innovation Management Group)
  A keyboard emulation software program that displays an image of the keyboard on the screen. Features include: word prediction/completion, key dwell timer, integrated verbal keys feedback, and smart positioning of the keyboard or panels off of the area in use.
• R. J. Cooper (RJ Cooper & Associates)
  A single switch scanning mouse emulation software program that works well with OnScreen keyboard emulation. By scanning first vertically and then horizontally, CrossScanner launches and controls all Windows functions and applications as well as OnScreen's keyboards and panels. Features include double-click and drag-and-drop.
• PRC Switches (Prentke Romich Company)
  A lightweight headset that translates head movement to the mouse pointer. A variety of switches can also be connected to emulate the mouse buttons.
• HeadMouse Extreme (Origin Instruments)
  A reflective dot worn on the forehead that translates head movements to the mouse pointer to allow hands-free operation of a PC. A variety of switches can also be connected to emulate the mouse buttons.

Voice Input

• Dragon NaturallySpeaking (Scansoft)
  A speech-to-text software program that allows users to speak to their computer naturally and at a normal pace of up to 160 words per minute without pausing between words. It supports multiple users, allowing each user to personalize vocabulary. NaturallySpeaking is fully integrated with MS Word 97/2000, with both programs providing Dragon NaturallySpeaking commands on the menu bar.

Word Prediction

(source also listed in the Technology for Users with Learning Disabilities category below)

• Co:Writer 4000 (Don Johnston, Inc.))
  Word prediction aids with the text entry process, especially when used in conjunction with an alternative input device. Co:Writer predicts words based on subject-verb agreement, grammar rules, user preferences, and word relationships.

Alternative Keyboards

• Low Profile Keyboard (Infogrip)
  A compact 101-style keyboard similar in size and feel to a laptop keyboard. It compresses the rows and columns into a more compact unit to eliminate wide borders. The keypad and function keys are embedded into the keyboard to cut down on size and key travel. The keyboard is lightweight and has folding feet that, when opened, give an elevation of about one inch.
• Large print keyboard labels (Infogrip)
  The characters on the large-print labels are .5" by .25", about three times larger than standard keyboard characters.
• BigKeys LX (Greystone Digital Inc.))
  This is the overall size of a standard keyboard but with one-inch square keys.
• Mini Keyboard (TASH)
  A smaller sized alternative keyboard. Membrane keys are less than .5" (1.3 cm) square and are closely spaced, permitting easy access. The keyboard surface is also very sensitive to allow users control over both keyboard and mouse functions.
• Intellikeys (IntelliTools)
  sA large programmable keyboard with a variety of overlays designed for individuals with limited fine motor control. Only light pressure is required to activate the keys. "Overlay Maker" (also available from IntelliTools) allows custom overlays to be designed for use with the Intellikeys keyboard.

Mouse Alternatives

• Expert Mouse (Kensington)
  A trackball with programmable buttons that provides an easy-to-use alternative to a standard mouse.
• Roller Plus Joystick (Penny & Giles)
  A joystick that operates like a mouse, but offers more user control than a traditional mouse. The buttons support click, double-click, drag, horizontal/vertical movement and speed adjustment.

Comfort Aids and Adjustable Furniture

• Fit Stations (Anthro)
  Adjustable furniture that easily adjusts for users with individualized needs and allows wheelchair users access.
• Ergomart (ErgoMart)
  Adjustable LCD Arms are especially useful for larger sized, flat monitor screens because users may easily position the monitor to best suit their needs. This is especially helpful for users with low vision.
• Arm Supports with Long Pad (ErgoRest)
  Supports the weight of user's arms and shoulders and reduces the workload on the neck, head, and shoulders while working at a computer. They can be adjusted to meet the needs of individual users. The supports move freely horizontally while the arm pads rotate in a 360-degree circle.

Technology for Users with Learning and Cognitive Disabilities

Word Prediction

Word prediction software assists individuals who have difficulty with letter formation, spelling, and grammar. It also aids in the physical task of writing and is useful for people who have difficulties using their hands or type very slowly. Word prediction feature is also included in the reading and writing programs listed in the "Scanning, Reading, and Writing programs" section below.

• Co:Writer Solo (Don Johnston, Inc.))
  A talking word prediction program that can be used with numerous word processing programs.
• WordQ Software (WordQ)
  A writing software that can be used along with standard word processing software. It suggests words for you to use and provides spoken feedback.

Reading Software

Reading software reads out loud using a synthesized voice to assist individuals who have difficulties with reading. Free or relatively inexpensive reading programs usually require users to paste the text to be read onto a clipboard. More sophisticated reading features are available in the reading and writing programs listed in section below.

• ReadPlease Products (ReadPlease Corporation)
  A reading program that reads text from computer screen. A free version is also available.

Scanning, Reading, and Writing Programs

These software packages use powerful Optical Character Recognition (OCR) to accurately recognize scanned text while retaining layout and color. A bi-modal approach (simultaneous highlighting text as it is spoken using synthesized speech) is used to aid the reading of scanned text. Contains traditional study aids such as highlighting, bookmarking, and text and voice notes to effectively enhance reading and learning.

• Read & Write (textHelp!)
  A talking word prediction program that works with any Windows-based program by adding a toolbar that "floats" on top of an open application window. It can be used with word processors, spreadsheets, databases, e-mail, and the Internet.
• WYNN 3.1 (Freedom Scientific)
• Kurzweil 3000 (Kurzweil Educational Systems)

General Recommendations

• Provide headsets for users who use voice output applications.
• Hearing protectors can be helpful to individuals who are easily distracted by noise in the facility.
• Label pre-programmed buttons on trackballs (example: for job seekers some of the buttons could lead directly to Web sites that provide a good starting point for exploring jobs).
• Provide easy-to-see signs that identify which kinds of technology is on each station and how to request more information about the software and hardware.

Appendix C: Publications with Additional Information

• Lazzaro, Joseph. Adaptive Technologies for Learning and Work Environments. Chicago: American Library Association, 1993
• Mates, Barbara. Adaptive Technology for the Internet €“ Making Electronic Resources Accessible to All. Chicago: American Library Association, 2000
• Rubin, Rhea Joyce. Planning for Library Services to People with Disabilities. Chicago: American Library Association, 2001

Appendix D

In the spring of 2002, the Bill and Melinda Gates Foundation Library Program sent out requests to several listservs and mailing lists for libraries to take our online survey about adaptive equipment. We had 50 responses.

Copyright 2003-2004 The Bill and Melinda Gates Foundation. Originally Published on WebJunction.