Rebooting This Blog — — Reorganization and Future


Welcome to another decade of “As Your World Changes” about adjusting to vision loss using technology, plus a few other topics.


I started this blog in 2007 to reclaim my authoring skills, including the essential tasks of writing and editing. “Print disability” is not a handicap when spoken reading and writing are available and one has the time and stamina to build necessary skills. However, writing required a monumental amount of work, concentration, and frustration, because no technology is effectively accessible all the time.


After venting about limited local facilities to help my vision rehabilitation, I got serious and learned what I needed through podcasts and disability expos like CSUN. By 2008, I’d experimented with many assistive devices and settled on NVDA screen reader on Windows and the mobile Levelstar Icon (now defunct). Local iPhone service arrived in 2012, after a miserable experiment with an Android phone. My directory of services is called “Talking Assistive Technology”, available on this website.


After getting up to speed on assistive technology, my computing background led me to dig into the “science of accessibility” expounded in articles driven by troublesome use cases. Thrilled by the opportunity to vote for a wise man in 2008, on an accessible voting system, I wrote up my experience, later retracted. Invitations to professional venues led to several position papers.


For ten years, I’ve advocated for the local facilities I was denied, and now may be coming to town. Stay tuned!


The purpose of this ReBoot is to:


Below are posts organized by ‘Adjusting To Vision Loss’ human factors, ‘Getting Up To Speed with Assistive Technology’ to drive that adjustment, ‘Espousing On Assistive Technology and Accessibility’ to salve my professional desires, and ‘Becoming a Local Advocate for Living with Vision Loss’, plus a few posts that needed a home.


Warning: the blog is riddled with rotted links, to be fixed in time. As I now hang out with other retired active writers, I’m horrified at my wordy earlier posts. As the passion for vision-related topics waned and as my world changed, I’m now absorbed in the craft of writing.


Thanks for visiting this blog. Your comments are welcome. Let’s see where this phase takes me, my writing, and the local transformation we’re undertaking.

Learning to Live with Vision Loss

Getting Up To Speed With Assistive Technology

Expounding On Accessibility and Assistive Technology

Accessibility

<UL

  • Web Inaccessibility: Are Muddled Use Cases the Culprit?

  • Is There A Killer App For Accessibility?

  • Hear Me Stumble: Web Accessibility Observations

  • Hey, Intuit! What You Got Against High Contrast?

  • Listen Up! Technology, Strategy, Materials for Non Visual Reading

  • Hypertext Considered Harmful! On To Structured Reading

  • Synthetic Voice Shock Reverberates Across the Divides

  • Literacy Lost And Found: Keystrokes, Pie Charts, and Einstein

  • My Accessibility Check: Let’s All Use Our Headings

  • The Techie Care-Giver Conundrum

  • My Accessibility Check: Images and Their Surrogates

  • Twitter Has Less To See and More To Hear

  • Amazon Kindle, Arizona State, What a Mess!

    Could Text-to-Speech Beat Kindle and Smart Phones?

  • Story: A Screen Reader Rescues a Legacy System

    Computing Related

    Accessible Voting And Assessing Government Accessibility

    I retract my voting zeal in deference to the Verified Voting argument requiring paper ballots. An unregulated and un-trustworthy votingregime is not worth privacy and independence of disable voters like me. Sad!

    Becoming AA Local Activist

    When I began losing vision to the point where I needed Rehabilitation, I scanned for centers of activity away from my home in Prescott AZ. State services were hard to find, not reacting on my time scale, and disconnected from the world I knew existed from pod casts and MDSupport. Eventually, I received orientation and mobility training in 2008 while I taught myself about assistive technology thanks to the CSUN Exhibit Halls, then meeting near LAX.


    Living in a “rural” “best place to retire”meant that I performed self-rehabilitation for my vision loss. Existing “blind centers” had closed and vision rehabilitation specialists moved to Tucson due to lack of referrals. Device re-sellers and low vision specialists came to town intermittently. While I was able to afford technology and to learn on my own, I’ve realized too few other area Vision Losers could cope as well. I began a concerted effort to collect links to resources and deliver demos of “Talking Assistive Technology” to an intermittent seminar on “Confident Living With Low Vision”.


    I hope to post more about the progress of a local grant at the Prescott Public Library, dubbed “You Too!”, launching in February 2018.

    Side Interests

  • Charles Bonnet Syndrome — A Public Service Announcement

    When Charles Bonet Comes Calling: A Public Service Announcement


    Here’s an experiment. Close your eyes and cover them until you see a blank screen. Your eyes may flicker a while then settle down. For some who are losing vision, sometimes this blank screen turns into a picture show. Our brains switch modes when our sight changes. We have a saying, “Charles Bonnet came calling!”


    The real Charles Bonnet was a natural scientist and philosopher in the 18th century. Bonnet studied his grandfather’s descriptions of animals and objects he “saw” despite dense cataracts. The name Charles Bonnet Syndrome (CBS) stuck for two centuries, joining the medical vernacular in the 1980s.


    However, few people losing vision learn about the condition, or believe what they read — until CBS visits them. It’s hard to imagine what our brains are doing unless they “show their work”. That’s the theory behind CBS. The brain’s vision processing area is busy tracking movement in the external world then informing the rest of our brains for action and storage. When fewer visual signals flow through the optic nerve, the visual activity keeps going, looking for something to work on. Other parts of the brain supply memories and patterns that cause visual fantasies. Another description is that CBS is like “phantom limb”, only more entertaining!


    A person with CBS now has a little secret about those visual illusions. Does one tell? Do you fear that you’re on the dementia or mental illness trail? For most of us, the condition is transient, internal, and pleasurable. Some suffer if their illusions interact with their external world, like seeing chorus lines of dancing figures, extra people, snakes, etc. Misdiagnosis threatens as most mental health practitioners don’t have CBS on their symptom and causes lists. Reports tell of CBS leading patients through psychiatric wards and useless prescriptions. Eye doctors have trouble finding the right time to talk about something they haven’t experienced and cannot treat. CBS is an orphaned condition, yet rational and natural for enlightened Vision Losers.


    Are you ready to hear about my internal visual world?


    One evening, relaxing on my deck, three faces swirled into my line of sight. Having read about CBS, I welcomed my visitors. But, they weren’t what I expected. Each resembled the bust of a statue, gray, molded, with vague facial features, hairlines, silent, just there. But, none was identifiable in my memory gallery of real human faces. These abstract images hung around a while, then swirled back into darkness. I felt no other sensation, knew I was watching an illusion, and soon became accustomed to their coming and going.


    A more emotional person might have dubbed them spiritual guides, reincarnations, aliens, or calls to artistic pursuits. I was fine with the simple CBS explanation, not that I told anybody outside my online vision group. Later in this first phase, the heads dissolved into masks with big eyes and huge teeth that slowly melted away. By then I was identifying persons in real life by stature, voice, and guessing rather than facial features. For me, These abstract images were simply illusions welcomed back into my inner world.


    Next came another common CBS format, something graphical. I often saw a calendar like chart with one date bold and standing out, frustratingly unreadable. Sometimes I saw a page of justified text, blurred, with a caption, also illegible. This image brought a reverie back to my early career fifteen minutes of fame for finding embarrassing errors in a text justification program published by a famous, elegant European computer scientist. Our dinner in Denmark is another story.


    The graphical images were annoying when they blocked other vision and disrupted my thoughts. Blinking and rapid horizontal eye movement usually dispelled the graphics.


    All my images until then had been colorless. Months passed,with more vision loss, then appeared, and reappeared, a single realistic picture. A bright yellow tall notepad filled the image, with two fleshy pink hands writing as if adding a note. OMG, this must mean something I’ve forgotten to complete my life!


    So, here’s my Public Service Announcement, offered to vision support groups and occasional tweets:

    “Vision loss can lead to visual illusions that are harmless, incurable,and dissipate over time. Look up the condition called Charles Bonnet Syndrome, and enjoy its visits.”

    Notes:

    Living Visually Impaired in Prescott Arizona — The 2016 Story

    Resources for ppersons losing vision in the region around Prescott AZ.

    Living Visually Impaired in Prescott Arizona — The 2016 Story


    If your vision is beyond correction by traditional medical and optical procedures, if you are anticipating this situation, or you are assisting someone like this, you need resources and training known as “Vision rehabilitation”.


    Good news! Technology and well known practices offer affordable techniques to reduce many vision limitations to inconveniences if you’re willing to tackle the learning curve. Bad news! Prescott is limited in its access to rehabilitation personnel, awareness of possibilities, and diffusion of people who can help each other.


    Below are resources collected by a Prescott resident who maintains vision loss coping skills after reaching legal blindness a decade ago. There’s plenty of room to improve the community resources. Please consider action, suggestions and collaboration for everybody losing vision in these days of abundant technology and information sharing.

    What is Vision Rehabilitation


    Useful techniques range from marking appliance settings by sticky dots through using a smart phone to read books, identify money denominations, and participate in social media. “Active Daily Living” refers to these sticky dot tricks and myriad organizational tasks formerly taken for granted. Serious safety concerns are addressed by “Orientation and Mobility Training” for climbing stairs, walking with the miraculous long white cane, and crossing streets. Gaining or maintaining computer communicationskills requires adapting to magnification or audio interaction or gesturing on a touch screen smart phone.


    Sensitive interpersonal skills come into play when a conversation partner must be identified by voice or when sighted assistance must be requested. All these are conquered by learning and practice, leaving only the misery of transportation until the day of civilized public transit or safe, affordable driverless cars.

    Where does one start recovering from vision loss?


    When the page text becomes wiggly or haze surrounds you or objects jump into your path, eye doctors may help for a while, but there’s no miracle cure for effects of aging, sunlight, and genetics. Struggling to drive, read, walk, recognize faces, or see computer screens tell you it’s time to find vision rehabilitation. Medical interventions (except for cataract removal) rarely restore vision. Don’t deny, bargain, get angry, or become dependent when it’s time to learn new ways of doing things.


    A great starting place is Macular Degeneration Support (mdsupport.org). You’ll find ongoing discussions about treatments, vitamins, iPads, good lamps, photography, travel, smart phones, and just about everything a Macular Degenerate lives with. We share secrets, such as the frequency of visual hallucinations called Charles Bonnet Syndrome. Guide books and tips abound. The community is international and multi-generational.


    Another great resource is the “Eyes on Success” weekly podcast interviews with vision loss survivors, eyesight professionals, technologists, hobbyists, sportsters, and employed workers. A friendly pair of retired scientists in Rochester NY, one blind and one sighted, have compiled a library of easy listening MP3 files and show notes.

    Where do I go for local help?


    Locally, here are resources beyond the vision medical professionals who do not customarily offer vision rehabilitation as described above. Veterans have great residential training in Tucson. Students grow through school disability services and special education programs. People seeking jobs have state Department of Economic Services special programs and assistance to work. Otherwise retired people must generally develop and implement their own rehabilitation programs.



    1. The ‘People Who Care’ nonprofit offers “Confident Living” introductions to topics in Vision Rehabilitation and Causes of Vision Loss. Limited transportation and other elder support services are also available. Six-week seminars are presented when funding is available.
    2. Georgeanne Hanna is a contact with and certified rehabilitation contractor for state services that also assist retired individuals. Her phone is 928-775-5857. Watch for Public Service Announcements. Orientation and mobility trainers can be imported at state expense upon request.
    3. The Disability Empowerment Center (formerly New Horizons Independent Living center) provides independent living services for people with various disabilities, and a transportation system based in Prescott Valley. Call and ask whether vision rehabilitation services are currently available.
    4. Yavapai Library Network sites have assistive computers for people who know how to use magnification and audio assistance. Contacts are available for the National Library service “talking books” program.
    5. YC OLLI (Osher Lifelong Learning Institute) offers occasional workshops on vision and hearing loss adaptation.
    6. Prescott Fine Arts Theater honors requests for front row seating for visually impaired people and companions.
    7. Lions clubs underwrite medical and optical services for low income persons and occasional publicized events. Clarification of their services would be appreciated in the comments of this website, especially to identify matches with needs expressed here.
    8. Warning!!! Former organizations now defunct include: Northern Arizona Vision and Hearing Loss, “old blind center”, Yavapai Association for Blind and Visually Impaired (YABVI), “new blind center”. Check out carefully Daily Courier articles for dates referring to services gone from the troubled trail of Prescott vision supporters.

    In summary, People Who Care Confident Living Seminars and state DES rehabilitation coordinators are the primary currently active resources. A mobile person losing vision should also consider relocating to gain a full multi-month training program from a facility such as Southern Arizona Association for Visually Impaired.

    What help is available from government?


    • AZ Department of Economic Services supports a local vision rehabilitation professional (see above), special services for vocational training, and limited assistive technology. An online directory is available.
    • In 2014 Prescott established Disability and Accessibility coordination mandated by the 1990 American Disabilities Act (A.D.A). Call the city information line or http://www.prescott-az.gov/accessibility/. The federal ADA.gov website expands on citizen rights, organization responsibilities, and procedures for grievance.


      Many cities have a Disability Services Coordination council based in the Mayor’s office, alas not Prescott, but maybe in Prescott Valley. Audio alerts for street crossing are available only on Willow Creed Road near Embry-Riddle but not downtown. Sidewalk barriers, icy patches, overhanging branches, and unsafe construction should be reported to City Streets and Code Enforcement (they do respond). Visitors to downtown Prescott should not expect comfortable, safe walking conditions.

    • with A.D.A. enforcement, airlines, banks, and hospitals have trained personnel for providing equitable services. PHX airport provides walking guides through TSA to your gate (tell before checking in). Notable within Prescott are bank “talking tellers” for automated cash withdrawal (e.g. Chase Bank). Checkout devices at stores are now equipped for accessibility and privacy, e.g. typing in a PIN, but may not be enabled or known to checkout personnel.
    • social Security offers documents and transmittals in electronic formats on CD.

    What do blindness support organizations offer?


    The following groups are knowledgeable about all aspects of vision loss and advocate for improvements that benefit people with disabilities. Organizations that accept charity contributions are not necessarily well informed about Active Daily Living, Orientation and Mobility, assistive technology, the A.D.A, or the interface between medical and social service systems (but they should be). “Helping the visually impaired” requires education, awareness of needs, and accountability.


    • The American Council for the Blind (ACB) and National Federation of the Blind (NFB) advocate and educate on blindness issues that benefit people with all kinds of vision loss. State affiliates hold annual conferences and support local chapters (but not currently in Prescott).
    • The American Federation for the Blind (AFB) has special websites for seniors and is affiliated with the Vision Aware service. A monthly newsletter evaluates technology
    • MDSupport.org specializes in macular degeneration with myriad free downloadable guides and an ongoing support mailing list.
    • Books and newspapers are available from Bookshare.org, with a library of over 400,000 fiction/nonfiction, adult/adolescent volumes readable on the website or downloadable to book readers. The NFB NewsLine offers national newspapers and magazines in various formats and reading services, available also through BookShare. National Library (NLS) provides narrated books played on free) devices.

    How about technology?


    • PC and Mac computers have built-in magnification and voice support. For Mac, VoiceOver is a click away while for PC a free NVDA package is easily installed. Various $1000 commercial products offer versatile magnification and audio with support and training. These “screen readers” enable a synthetic voice to speak web pages, documents, and buttons or typing. The technology is great, but the learning curve is steep and trainers are scarce.
    • Elegant hand-held devices can read books from NLS or Bookshare, notably Victor Reader Stream and BookSense. Amazon Kindle and Nook devices are not usable without sighted assistance.
    • The smart phone has put mainstream devices into the hands of people without full vision but with sufficient hearing. The iPhone, iPad, and iPod Touch have Voice Over built in to read buttons as fingers glide across the screen as well as text in mail and web pages. Book reader apps from Bookshare, Apple, NLS, Amazon enable downloading and listening to books, magazines, and documents.

    • Smart phone apps provide walking navigation, location awareness, remote identification of photographed objects, reading money, and other assistance. Many games and apps are fully accessible. Speech recognition increasingly replaces keyboarding. Apple devices (iPhone, iPad, iPod Touch) are fully accessible by voice (use Triple Click Home to start). Android devices lag Apple in both capabilities and training, varying across models and manufacturers. Verizon and Apple store personnel can assist in turning on these devices but only practice will determine whether they meet vision needs.


    • The blindness communities maintain a “Internet radio network” of interviews, demonstrations, and advice on all topics related to vision loss and especially technology. Accessibleworld.org, EyesOnSuccess.net, and Hadley.edu have highly informative weekly updates. These are MP3 files for subscription and downloading as podcasts via iTunes or podcatcher apps.
    • Hand-held readers also serve as recorders for presentations, memos, and bookmarks. Some also provide radios with audible controls.
    • Apps can remotely recognize and label record contents of files and food cans. Color identifiers, GPS systems, and talking thermostats exist to overcome daily eye sight annoyances. The coming Internet of Things offers in-home devices that recognize speech, read out device information, and operate remotely. Be sure you understand the surveillance capabilities of such devices as well as how failures can lock you out or inadvertently activate other devices.

    • Twitter social media is a river of news about technology and blindness under the keyword #accessibility and people like slger123 and all major vision-related organizations and federal agencies.

    See the “Talking Assistive Technology” page on this website for links to products.

    Where can I get more information on vision rehabilitation in the Prescott region?


    This web page is your current best bet for information. Its author is a legally blind technologist. She survived the sparse services available in Prescott by seeking resources for self-rehabilitation. She has attended national and state assistive technology exhibitions and visited vision rehabilitation centers in Tucson and San Diego. She’s a user of assistive technologies and a constant tracker of external services. Ask her anything about vision rehabilitation and she’ll find an answer.


    Please add comments with additional services, corrections, or opinions. Anyone interested in taking over this web page and keeping it up to date is welcome to the information compiled so far.


    Isn’t it time Prescott had full service vision rehabilitation for retired people with vision loss? Following the MDSupport motto “No one should leave an eye doctor’s office thinking their situation is hopeless”, vision loss is a journey of learning and adaptation and challenges that build on established rehabilitation practices and abundant technologies. Why can’t Central Yavapai have a branch of such a facility? Advocacy needed!!!

    Send corrections and additions to slger123@gmail.com or leave a message 928.445.6960.


    Links to Resources

    Other Posts in “As Your World Changes”

    This blog started as a way to reclaim writing skills. These earlier posts convey the spirit of a changing world as vision degrades and skills increase.

    Warnings About Web Misinformation


    • Web searches in Google, DuckDuckGo, Bing often link to misleading or outdated web pages. Sometimes links go to local white/yellow page directories driven by advertising.

    • The following organizations are defunct: Northern Arizona Vision and Hearing Loss Center; Yavapai Blind Center; YABVI Blind Center;; and related terms. There is no blind center on Washington Street, vacated in 2007. The phone number 928-778-0055 is disconnected. If you receive a brochure or read an article about this location, facility, or phone number, please correct the mis-informant. YABVI (Yavapai Association for Blind and Visually Impaired) appears to be a restructuring of a previous organization, now managed funds by a group of eye doctors.

    • No attempt is made here to assure accessibility of web sites beyond ascertaining content using Firefox with the NVDA screen reader. Some resources use PDF documents difficult to use with a screen reader.

    • Resources here focus on “vision rehabilitation” rather than medical treatments typically billed to Medicare or insurance. Vision Rehabilitation includes: Orientation and Mobility Training, walking with a long white cane and safely crossing streets; Active Daily Living, tricks and techniques for optimizing remaining vision in everyday life; reading newspapers and books; and using technology by magnification or voice interaction.

    National Level Organizations

    Vision Information and Support

    Federal Government

    Under the Americans with Disabilities act we can claim equal access to most resources. However, “civil rights are not self-enforcing”. The following websites address issues of equality and offer many paths to further public information.

    1. Disability.gov, connecting the disability community with information and opportunities drill down by state and topic, e.g. to Arizona and Transportation.
    2. White House Disabilities Coordination including monthly conference calls
    3. Federal Elections Help Americans Vote Act implemented by Yavapai County, supporting private and independent voting on site
    4. FCC 21st Century Communication Act covers cell phones,audio and video descriptions, and PLAN, the Personalized network for public safety alerts
    5. ADA.gov, the law, policies, enforcement’s.Dept of Justice and YRMC settlement on training citizen complaint invokes A.D.A. to change procedures and train staff

    State Level Organizations

    Government

    1. Directory of services from Department of Economic Security

    2. AZ Governor Council on Blind and Visually Impaired

    3. SunSounds Reading Services
    4. Assistive Tech Training Center (Cottonwood)
    5. National Library Service Talking Book Arizona contact

    Resource Centers

    1. SAAVI (Southern Arizona Association for Visually Impaired (Tucson), website describes full service vision rehabilitation
      Arizona Center for Visually Impaired (Phoenix)
    2. (PDF) ViewFinders Low Vision Resource Directory (PDF)

    3. VRATE, Vision Reabilitation and Asstive Technology Expo is held annually in Phoenix, free, excellent coverage of state-wide capabilities

    4. Arizona Assistive Technology Exchange

    Chapters of national organizations

    1. AZ Council for Blind azcb.org
    2. NFB (National Federation for the Blind) Arizona Resources

    Yavapai County and Prescott Area

    Government

    1. State Department of Economic Security Rehabilitation sustains local vision rehabilitation and coordinates orientation and mobility training.
    2. Prescott Public Library may have screen readers on notebooks and vision aware Computer
      Mentors. Also provides membership with National Library Service.

    3. City of Prescott Accessibility and disability coordination (A.D.A) Meeting the A.AD.A law!!!

    Nonprofit and other services

    1. Georgeanne Hanna Certified Vision Therapist and Certified Low Vision Therapist, georgeannehanna@gmail.com, phone 928.775.5857. Contact directly to arrange state rehabilitation services.

    2. Disability Empowerment (formerly New Horizons Independent Living) Center (Prescott Valley)
    3. “People Who Care Confident Living Seminar (

    Technology Assistance


    1. Verizon can turn on iPhone VoiceOver, Triple-click-home
    2. Best Buy sells Apple products with good accessibility (iPhone, iPod Touch, iPad) and Android tablets with unpredictable accessibility
    3. Chase (and maybe other) banks have “talking ATM” machines that read menus into earphones to dispense cash and perform other services.
    4. Yavapai College Osher Lifelong Learning Institute offers a track of technology courses.

    5. Prescott MAC and PC clubs have held programs on assistive technology


    Revised July 25 2016, slger123@gmail.com
    “As Your world Changes” article on “Living Visually Impaired in Prescott AZ” — 2016 http://AsYourWorldChanges.Wordpress.com

    Why is accessibility so hard? Glad you asked!

    Dear President of ACM Vint Cerf:


    In your article “Why is Accessibility so hard?” , you invited comments and received many valuable references and opinions from other non-members of ACM. However, anonymous comments like mine seem not to be appearing since submitted for review after November 8. I worked hard on this little piece and have some constructive suggestions along the lines of an important ACM computing themes, namely “computational thinking”. As a former member of ACM, thoroughly disgusted by the un usability of the ACM Digital Library and haphazard HTMl of acm.org, I was hoping to find a genuine thread of change. So, not knowing if my submitted comment below is stifled or just dropped off your radar of comment reviewing, here’s my advice anyway.

    Analyzing the computing field accessibility deficit

    Thanks for asking. My “As Your World Changes” blog has myriad suggestions for overdue change to accessibility practices within computing:

    My favorite resources — great reading

    As a late life vision loser,and ex-ACM member, I hope the previously commented resources expand your frames of reference. Please add my favorites:(1 Wendy Chisholm and Matt May, “Universal Design for Web Applications” book; (2) WebAim.org screen reader user survey, WAVE accessibility checker, and pages of excellent practical advice; (3) the “accessibility virtual water cooler” linked by #a11y and #accessibility on Twitter; (4) the iBlinkRadio Android and IOS app portal to podcast and communities for visually impaired tech users; (5) a personable informative Rochester-based Viewpoints radio/podcast on products and daily living tips for vision loss. at http://viewpointsplus.net

    Quintessential challenges: computational thinking and omitted requirement accelerating costs

    Why do some think accessibility is hard? The good news is that we have at hand the quintessential “computational thinking” situation and mental tools for tackling much of accessibility. The bad news is another quintessential situation: the software economics of increasing cost of re mediating a missing requirement. Furthermore, attitudes are exacerbated by ignoring maturing web standards and disengagement from high performing professionals with disabilities in the assistive technology industry. ACM has also fostered an image of social exclusiveness through its misguided touting of the wonders of the “NO BLIND ALLOWED” symbol CAPTCHA (as if these magically warded off intruders other than us). How much of the difficulty is social rather than technological?

    Remediation opportunity: learn by fixing your own website

    Luckily the remediation opportunities for learning through and fixing accessibility flaws are readily available. Start with typing your institution, personal, or favorite web page into http://wave.webaim.org. This free and instantly usable analyzer will highlight the semantic structure of the page meaningful to screen reader users like me. It’s highly likely you’ll also expose accessibility deviations from standards. Common zits are: unlabeled form elements leaving me wondering what to enter in the edit box; non informative link like “click here” that require reading the context; missing or mis-ordered headings that obscure the page outline, forcing me into tabbing among HTML elements linearly without a comprehensive outline for discovery and navigation; or graphics without descriptions as to purpose and content. Does your experimental analysis make you wonder why web developers didn’t follow even these simple rules of accessibility? If you’re accountable for the page, like this very one from acm, then how should you change your process, contractors, or attitudes if better accessibility is really a goal?

    Remediation Opportunity: Establish CSEdWeek challenges

    Here’s another experiment I’ve performed myself (see blog posts). Computer Science Education Week is a big publicity deal for prestige and recruitment into a presumably non-discriminatory profession. Are there at least minimal standards for accessibility of partner web sites? Is the language inclusive, at least recognizing that pedagogical tools like Alice are problematic and that CAPTCHAs on the contact page are offensive? A little bit of shame and accountability can be shared by all if we no longer act like accessibility is always hard but rather start fixing simple problems, learning along the way.

    Remediation Opportunity: Listen to people who daily conquer accessibility challenges

    One more opportunity is to cross the disability social engagement boundary and actually sit down with somebody who uses the wondrous technology available. You can familiarize yourself for freeze by installing the world class NVDA Windows screen reader, turning on VoiceOver on a Mac or IOS device (triple click home). Here’s a “computational thinking” experiment: can you gain the same information sighted or blind folded? Why not? what do you have to learn to communicate, hold in memory, sequence differently, or give up on? How do you feel when offered an unlabeled button? Where do you go to learn new Techniques and good practices (hint: applevis.com and iBlinkRadio app)? Really, visually impaired folks can talk, explain, and share their joy using technology as well as constructive frustrations. Just ask!.

    The Remaining Challenge after Remediation: absorbing complex information

    Ok,there is one class of challenging problem beyond myriad simple accessibility rules and negligent process instances mentioned. Complex data structures like tables are memory taxing without vision and graphs and charts and animations require alternative sensory representations. Again, this is computational thinking as in concrete or multiple representations of the underlying information and semantics. Why doesn’t ACM offer a prize for advances here, which also might help everybody better consume visual information?

    Take heart, all you future vision losers, as resources abound

    Finally, to the many of you who will be losing vision in late career or retirement? Take heart, there’s never been a better time! You must locate whatever vision rehabilitation services are available locally, like Lighthouse or Independent Living but don’t let the strange web of state and charity “helpers” limit you. Macular degenerates can find a veritable wikipedia of practical and emotional sustenance at http://mdsupport.org. The podcasted media of Main Menu ACBRadio, Seratech perspectives (iBlinkRadio), and the TechDoctor can ease you into product assessment and sharing the joys of now abundant mainstream products. An iPod Touch is a great “gateway drug” into this world if you haven’t already been bitten by the Apple bug. Becoming print disabled isn’t all bad, because you are now eligible for near free daily newspapers and libraries of thousands of easily downloadable books for synthetic speech reading on devices and apps far better than sighted users buy. Yes, there’s a monster learning curve, but we technologists are well positioned for this one more life adjustment. If we can now get our profession into the solution side rather than producing more generations of uneducated students accepting such poor role models as acm.org, then we might even be able to contribute better our valuable experience to a professional society that understands disabilities as computational thinking differences.

    summary from my decade of adjustment to vision loss using technology with class:

    get cracking on learning about accessibility by fixing simple, obstructive, instructive problems. Listen to accessibility professionals and high performing persons with disabilities who offer their spirited advice through social media. Only then will the goals of ACM style research be brought to fruition and we will identify the intrinsic difficulty of accessibility.

    Yours, in respect and hope for change, finally

    Susan L. Gerhart, retired visionary computer scientist and myopic macular degenerate
    slger123@gmail.com
    blog on adjusting to vision loss: https://asyourworldchanges.wordpress.com

    A Notable, Inimitable Woman: Helen Keller, 1880 – 1968

    Here is an outline of my research for a course on Notable Women last session at Osher Lifelong Learning Institute at Yavapai College. I was fascinated by the question: what happened to the rest of her life after the incidents portrayed in the “Miracle Worker” plays and movies. As my reading progressed to reveal her decades of activist publication and public attention, the deeper question became “how did she cognitively process so many other writings and human contacts into coherent and relevant materials that sustained her spirit and finances?”.


    speaking personally, as I’ve portrayed earlier in this blog, I have rewired my brain to read and write differently without using vision. Now, the Internet and trusty screen readers and RSS clients bring me loads of information, but I still find it difficult to organize even a small article like this post. Keller published many articles in popular publications like “Ladies Home Journal” but she also emoted some very fine rants on socialism, unions, suffrage, and disability civil rights.


    Answering my questions from the resources below, especially the New Yorker article, she: mastered French and German at Radcliffe; read European newspapers; always had personal assistants; selected topics of interest for her human readers to communicate by hand tapping, lip reading, or Braille translation; wrote sections on a Braille typewriter, assembled and edited with assistance; wrote and received copious letters in the style of the time; made friends with Mark Twain, Alexander Graham Bell, and the presidents du jour; traveled extensively; and generally got around a lot. Whew! But still, how does one assemble a model of the world coming without hearing or seeing? The New Yorker article portrays her cognitive functioning as much like poetry or highly flowery narrative. That is, she took in facts and physical object descriptions, asked questions, built a sense of her surroundings, and embellished with imagination constrained by her editorial assistants. Yet, there is such a difference experiencing the situation of labor unions from a film like “Norma Rae” and reading about sweat shops and factory safety mishaps. It still intrigues me that her reality matched sufficiently her colleagues and acquaintances that she could not only participate but also influence her times. Interestingly, some of that interaction came from a silent movie, vaudeville infomercial’s, and an attraction for press attention that vies with modern athletes and actors.


    Yet, that same cognitive generative process caused lifelong doubts in others about her actual abilities versus the influences of Teacher and other assistants. A bizarre accusation of plagiarism arose at age 12 when professional pride and pettiness ran amok over a misunderstanding of originality of a story she told in a letter. Now, today we cannot get college students to differentiate copy-paste research from critical thinking, so one wonders how a 12-year-old could really appreciate the social significance of separating what one is told, holds in memory, and retrieves as a story gift from copyright and issues of attribution.


    Well, anyway, if you wonder how minds work with different sensory limitations, take a look at the documentary on Youtube, the New Yorker analysis, and some of the cited oddball life passages.

    Background</h3

    Other facets not highlighted in documentary and popular bios

    Finally, I think HK would have been great on Twitter, with pithy, passionate expressions of her daily insights, frustrations, and relationships. Happy 5th birthday, Twitter and many thanks to Accessible Twitter for keeping me in touch with the world.

    What if Accessibility had a Capability Maturity Model?

    The field of software engineering made notable strides in the 1990s when the Department of Defense promulgated via its contracting operations a Capability Maturity Model supported by a Software Engineering Center (*SEI) at Carnegie-Mellon University. Arguably, the model and resulting forces were more belief-based than experimentally validated, but “process improvement through measurement” became a motivating mantra. For more detail see the over-edited Wikipedia article on CMM.


    This post is aimed at accessibility researchers and at managers and developers of products with an accessibility requirement, explicitly or not. Visually impaired readers of this post may find some ammunition for accessibility complaints and for advice to organizations they work with.

    The 5 Levels of Maturity Model

    Here are my interpretations of the 5 levels of capability maturity focused on web accessibility features:

    Chaotic, Undefined. Level 1

    Each web designer followed his or her own criteria for good web pages, with no specific institutional target for accessibility. Some designers may know W3C standards or equivalents but nothing requires the designers to use them.

    Repeatable but still undefined Level 2

    Individual web designers can. through personal and group experience, estimate page size, say in units of HTML elements and attributes. Estimation enables better pricing against requirements. Some quality control is in place, e.g. using validation tools, maybe user trials, but the final verdict on suitability of web sites for clients rests in judgements of individual designers. Should those designers leave the organization, their replacements have primarily prior products but not necessarily any documented experience to repeat the process or achieve comparable quality.

    Defined Level 3

    Here, the organization owns the process which is codified and used for measurement of both project management and product quality. For example, a wire frame or design tool might be not a designer option but rather a process requirement subject to peer review. Standards such as W3c might be applied but are not as significant for capability maturity as that SOME process is defined and followed.

    Managed Level 4

    At this level, each project can be measured for both errors in product and process with the goal of improvement. Bug reports and accessibility complaints should lead to identifiable process failures and then changes.

    Optimizing Level 5

    Beyond Managed Level 4, processes can be optimized for new tools and techniques using measurements and data rather than guesswork. For example, is “progressive enhancement” an improvement or not?” can be analytically framed in terms of bug reports, customer complaints, developer capabilities, product lines expansion, and many other qualities.

    How well does CMM apply to accessibility?

    Personally, I’m not at all convinced a CMM focus would matter in many environments, but still it’s a possible way to piggy back on a movement that has influenced many software industry thinkers and managers.

    Do standards raise process quality?

    It seems obvious to me that standards such as W3C raise awareness of product quality issues that force process definition and also provide education on meeting the standards. But is a well defined standard either necessary or sufficient for high quality processes?

    Example:
    An ALT tag standard requires some process point where ALT text is constructed and entered into HTML. A process with any measurement of product quality will involve flagging missing ALT texts which leads to process improvement because it’ is so patently silly to have required rework on such a simple task. Or are ALT tags really that simple? A higher level of awareness of how ALT tags integrate with remaining text and actually help visually impaired page users requires more sensitivity and care and review and user feedback. The advantage of standards is that accessibility and usability qualities can be measured in a research context with costs then amortized across organizations and transformed into education expenses. So, the process improvement doesn’t immediately or repeatably lead to true product quality, but does help as guidance.

    Does CMM apply in really small organizations?

    Many web development projects are contracted through small one-person or part-time groups. Any form of measurement represents significant overhead on getting the job done. For this, CMM spawned the Personal and Team Software Processes for educational and industrial improvements. Certainly professionals who produce highly accessible web sites have both acquired education and developed some form of personal discipline that involved monitoring quality and conscious improvement efforts.

    Should CMM influence higher education?


    On the other hand, embedded web development may inherit its parent organization quality and development processes, e.g. a library or IT division of a university. Since the abysmal level of accessibility across universities and professional organizations suggest lack of attention and enforcement of standards is a major problem. My recorded stumbling around Computer Science websites surfaced only one organization that applied standards I followed to navigate web pages effectively, namely, University of Texas, which has a history of accessibility efforts. Not surprisingly, an accessibility policy reinforced with education and advocacy and enforcement led small distributed departmental efforts to better results. Should by lawsuit or even education commitment to educational fairness for persons with disability suddenly change the law of the land, at least one institution stands out as a model of both product and process quality.

    Organizations can define really awful processes

    A great example of this observation is Unrepentant’s blog and letter to DoJ about PDF testimonies. Hours of high-minded social justice and business case talk was represented in PDF of plaint text on Congressional websites. Not only is PDF a pain for visually impaired people, no matter how much it applies accessibility techniques, the simple fact of requiring an application external to the browser, here Adobe Reader, is a detriment to using the website on many devices such as my Levelstar Icon or smart phones. My bet is that sure enough there’s a process on Congressional websites, gauged to minimize effort by exporting WORD docts into PDF and then a quick upload. The entire process is wrong-headed when actual user satisfaction is considered, e.g. how often are citizens with disabilities and deviant devices using or skipping reading valuable testimony and data? Indeed, WCAG standards hint, among many other items, that, surprise, web pages use HTML that readily renders strings of texts quite well for reading across a wide variety of devices, including assistive technology.

    The message here is that a Level 3 process such as “export testimony docs as PDF” is detrimental to accessibility without feedback and measurement of actual end usage. The Unrepentant blogger claims only a few hours of work required for a new process producing HTML, which I gratefully read by listening on the device of my choice in a comfortable location and, best of all, without updating the damned Adobe reader.

    Quality oriented organizations are often oblivious about accessibility

    The CMM description in the URL at the start of this article is short and readable but misses the opportunity to include headings, an essential semantic markup technique. I had to arrow up and down this page to extract the various CMM levels rather than apply a heading navigation as in this blog post. Strictly speaking the article is accessible by screen reader but I wouldn’t hire the site’s web designer if accessibility were a requirement because there’s simply much more usability and universality well worth applying.


    I have also bemoaned the poor accessibility of professional computing organization websites>. Until another generation of content management systems comes along, it’s unlikely to find improvement in these websites although a DoJ initiative could accelerate this effort.

    CMM questions for managers, developers, educators, buyers, users

    So, managers, are your web designers and organization at the capability level you desire?


    How would you know?

    1. Just sample a few pages in WAVE validator from WebAim.org. Errors flagged by WebAim are worth asking web developers? do these errors matter? how did they occur? what should be changed or added to your process, if any? But not all errors are equally important, e.g. unlabelled forms may cause abandoned transactions and lost sales while missing ALT tags just indicate designer ignorance. And what if WAVE comes up clean? Now you need to validate the tool against your process to know if you’re measuring the right stuff. At the very least, every manager or design client has a automated feedback in seconds from tools like WAVE and a way to hold web developers accountable for widespread and easily correctable flaws.
    2. Ask for the defined policy. would an objective like W3C standards suffice? Well, that depends on costs within the organization’s process, including both production and training replacements.
    3. Check user surveys and bug reports. Do these correspond to the outputs of validation tools such as WebAim’s WAVE?
    4. Most important, check for an accessibility statement and assure you can live with its requirements and that they meet social and legal standards befitting your organizational goals.

    Developers, are you comfortable with your process?

    Level 1 is often called “ad hoc” or “chaotic” for a reason, a wake up call. For many people, a defined process seems constraining of design flexibility and geek freedom. For others, a process gets out of the way many sources of mistakes and interpersonal issues about ways of working. Something as trivial as a missing or stupid ALT tag hardly seems worthy of contention yet a process that respects accessibility must at some point have steps to insert, and review ALT text, requiring only seconds in simple cases and minutes if a graphic lacks purpose or context, with many more minutes if the process mis-step shows up only in a validator or user test. Obviously processes can have high payoffs or receive the scolding from bloggers like Unrepentant and me if the process has the wrong goal.

    Buyers of services or products for web development, is CMM a cost component?

    Here’s where high leverage can be attained or lost. Consider procuring a more modern content management system. Likely these vary in the extent to which they export accessible content, e.g. making it easier or harder to provide semantic page outlines using headings. There are also issues of accessibility of the CMS product functions to support developers with disabilities.


    In the context of CMM, a buyer can ask the same questions as a manager about a contractor organizations’ process maturity graded against an agreed upon accessibility statement and quality assessment.

    Users and advocates, does CMM help make your case?

    If we find pages with headings much, much easier to navigate but a site we need to use lacks headings, it’s constructive to point out this flaw. It seems obvious that a web page with only an H4 doesn’t have much process behind its production, but is this an issue of process failure, developer education, or missing requirements? If, by any chance, feedback and complaints are actually read and tracked, a good manager would certainly ask about the quality of the organization’s process as well as that of its products.

    Educators,does CMM thinking improve accessibility and usability for everyone?


    Back to software engineering, getting to Level 5 was a BFD for many organizations, e.g. related to NASA or international competition with India enterprises. Software engineering curricula formed around CMM and government agencies used it to force training and organizational change. The SEI became a major force and software engineering textbooks had a focus for several chapters on project management and quality improvement. Frankly, as a former software engineering educator, I tended to skim this content to get to testing which I considered more interesting and concrete and relevant.


    By the way, being sighted at the time, I didn’t notice the omission of accessibility as a requirement or standards body of knowledge. I have challenged Computing Education blogger and readers to include accessibility somewhere in courses, but given the combination of accreditation strictures and lack of faculty awareness, nothing is likely to happen. Unless, well, hey, enforcement just might change these attitudes. My major concern is that computing products will continue to be either in the “assistive technology ghetto” or costly overhauls because developers were never exposed to accessibility.

    Looking for exemplars, good or bad?

    Are there any organizations that function at level 5 for accessibility and how does that matter for their internal costs and for customer satisfaction as well as legal requirements?


    Please comment if your organization has ever considered issues like CMM and where you consider yourself in a comparable level.

    Vision What do Vision Losers want to know about technology?


    Hey, I’ve been off on a tangent from writing about adjusting to vision loss rather on a rant about and praise for website accessibility. Also absorbing my blogging efforts was a 2nd run of Sharing and Learning on the Social Web, a lifelong learning course. My main personal tutors remain the wise people of #a11y on Twitter and their endless supply of illuminating blog posts and opinions. You can track my fluctuating interests and activities on Twitter @slger123.

    To get back in action on this blog, I thought the WordPress stat search terms might translate into a sort of FAQ or update on what I’ve learned recently. Below are subtopics suggested by my interpretations of the terms people used to reach this blog. Often inaccurately, some people searching for tidbits on movies or books called ‘twilight’ might be surprised to read a review of the memories of an elder gent battling macular degeneration in the 1980s. Too bad, but there are also people searching for personal experience losing vision and on technology for overcoming limitations of vision loss. These folks are my target audience who might benefit from my ramblings and research. By the way, comments or guest posts would be very welcome..


    This post focuses on technology while the next post addresses more personal and social issues.

    Technology Theme: synthetic speech, screen readers software, eBooks, talking ATM

    Terms used to reach this blog

    • stuff for blind people
    • writing for screen readers
    • artificial digital voice mp3
    • non-visual reading strategies
    • book readers for people with legal blind
    • technology for people with a print-disability
    • apps for reading text
    • what are the best synthetic voices
    • maryanne wolf brain’s plasticity
    • reading on smart phones
    • disabled people using technology
    • synthetic voice of booksense
    • technology for legally blind students
    • audio reading devices
    • reading text application
    • synthetic speech in mobile device
    • the use of technology and loss of eyesight
    • installer of message turn into narrator

    NVDA screen reader and its voices

      Specific terms on NVDA reaching this blog:

    • NVDA accessibility review
    • voices for nvda
    • nvda windows screen reader+festival tts 1
    • videos of non visual desktop access
    • lag in screen reader speaking keys
    • nvda education accessibility

    Terminology: screen reader software provides audio feedback by synthetic voice to users operating primarily on a keyboard, announcing events, listing menus, and reading globs of text.


    How is NVDA progressing as a tool for Vision Losers?
    Very well with increased acceptance. NVDA (non Visual Desktop Access) is a free screen reader developing under an international project of innovative and energetic participants with support from Mozilla and Yahoo!. I use NVDA for all my web browsing and Windows work, although I probably spend more hours with nonPC devices like the Levelstar Icon for Twitter, email, news, RSS as well as bookSense and Bookport for reading and podcast listening. NVDA continues to be easy to install, responsive, gradually gaining capabilities like Flash and PDF, but occasionally choking from memory hog applications and heavy duty file transfers. Rarely do I think I’m failing from NVDA limitations but I must continually upgrade my skills and complaint about website accessibility (oops, there I go again). Go to:

    The voice issue for NVDA is its default startup with a free open source synthesizer called eSpeak. The very flexible youngsters living with TTS (text-to-speech) their whole lives are fine with this responsive voice which can be carried anywhere on a memory stick and adapted for many languages. However, oldsters often suffer from Synthetic voice shock” and run away from the offensive voices. Now devices like Amazon Kindle and the iPod/iTouch gadgets use a Nuance-branded voice quality between eSpeak and even more natural voices from Neo Speech, ATT, and other vendors. Frankly, this senior citizen prefers older robotic style voices for book reading especially when managed by excellent firmware like Bookport Classic from APH. Here’s the deal: (1) give eSpeak a chance then (2) investigate better voices available at Voice and TextAloud Store at Nextup.com. Look carefully at licensing as some voices work only with specific applications. The main thing to remember is that your brain can adapt to listening via TTS with some practice and then you’ll have a world of books, web pages, newspapers, etc. plus this marvelous screen reader.

    Apple Mania effects on Vision Losers

    Translation:What are the pro and con arguments for switching to Apple computers and handheld devices for their built in TTS?
    Good question. Screenless Switcher is a movement of visually impaired people off PCs to Macs because the latest Mac OS offers VoiceOver text-to-speech built in. Moreover, the same capabilities are available on the iPhone, iTouch, and iPad, with different specific voices. Frankly, I don’t have experience to feel comfortable with VoiceOver nor knowledge of how many apps actually use the built-in capabilities. I’m just starting to use an iTouch (iPod Touch) solely for experimentation and evaluation. So far, I haven’t got the hang of it, drawing my training from podcasts demonstrating iPhone and iTouch. Although I consider myself skilled at using TTS and synthetic speech, I have trouble accurately understanding the voice on the iTouch, necessary to comfortably blend with gesturing around a tiny screen and, gulp, onscreen keyboard. There’s a chicken-and-egg problem here as I need enough apps and content to make the iTouch compelling to gain usage fluency but need more fluency and comfort to get the apps that might hook me. In other words, I’m suffering from mild synthetic voice shock compounded by gesture shyness and iTunes overload.


    My biggest reservation is the iTunes strong hold on content and apps because iTunes is a royal mess and not entirely accessible on Windows, not to mention wanting to sell things I can get for free. Instead of iTunes, I get my podcasts in the Levelstar Icon RSS client and move them freely to other devices like the Booksense. Like many others with long Internet experrience, such as RSS creator and web tech critic Dave Winer, I am uncomfortable at Apple’s controlling content and applications and our very own materials, limiting users to consumers and not fostering their own creativity. Could I produce this blog on an iPad? I don’t know. Also, Apple’s very innovative approach to design doesn’t result in much help to the web as a whole where everybody is considered competitors rather than collaborators for Apple’s market share. Great company and products, but not compelling to me. The Google OS Android marketplace is more open and will rescue many apps also developed for Apple products but doesn’t seem to be yet accessible at a basic level or in available apps. Maybe 2010 is the year to just listen and learn while these devices and software and markets develop while I continue to live comfortably on my Windows PC, Icon Mobile Manager and docking station, and book readers. Oh, yeah, I’m also interested in Gnome accessibility, but that’s a future story.

    The glorious talking ATM

    Terms used to reach this blog

    • talking ATM instructions
    • security features for blind in ATM


    What could be more liberating than to walk up to a bank ATM and transact your business even if you cannot see the screen? Well, this is happening many locations and is an example for the next stage of independence: store checkout systems. Here’s my experience. Someone from the bank or experienced user needs to show you where and how to insert your card and ear buds plug. After that the ATM should provide instructions on voice adjustment and menu operations. You won’t be popular if you practice first time at a busy location or time of day, but after that you should be as fast as anybody fumbling around from inside a car or just walking by. Two pieces of advice: (1) pay particular attention to CANCEL so you can get away gracefully at any moment and (2) always remove ear buds before striding off with your cash. I’ve had a few problems: an out of paper or mis-feed doesn’t deliver a requested receipt, the insert card protocol changed from inline and hold to insert and remove, an unwanted offer of a credit card delayed transaction completion, and it’s hard to tell when a station is completely offline. I’ve also dropped the card, sent my cane rolling under a car, and been recorded in profanity and gestures by the surveillance camera. My biggest security concern, given the usual afternoon traffic in the ATM parking lot, is the failure to eject or catch a receipt, which I no longer request. But overall, conquering the ATM is a great step for any Vision Loser. It would also work for MP3 addicts who cannot see the screen on a sunny day.

    Using WordPress</h4

    Terms:

      >

    • Wordpress blogging platform accessibility >

    • wordpress widget for visual impaired

    Translation: (1) Does WordPress have a widget for blog readers with vision impairments, e.g. to increase contrast or text size? (2) Does WordPress editing have adjustments for bloggers with vision impairment?


    (2) Yes, ‘screen settings’ provides alternative modes of interaction, e.g. drag and drop uses a combo to indicate position in a selected navigation bar. In general, although each blog post has many panels of editing, e.g. for tags, title, text, visibility, etc. these are arranged in groups often collapsed until clicked for editing, if needed. Parts of the page are labeled with headings (yay, H2, H3,…) that enable a blog writer with a screen reader to navigate rapidly around the page. Overall, good job, WordPress!


    However, (1) blog reader accessibility is a bit more problematic. My twitter community often asks for the most accessible theme but doesn’t seem to converge on an answer. Using myself as tester, I find WordPress blogs easy to navigate by headings and links using the NVDA screen reader. But I’m not reading by eyesight so cannot tell how well my own blog looks to either sighted people or ones adjusting fonts and contrasts. Any feedback would be appreciated, but so far no complaints. Frankly, I think blogs as posts separated by headings are ideal for screen reading and better than scrolling if articles are long, like mine. Sighted people don’t grok the semantics of H2 for posts, h3, etc. for subsections, etc. My pet peeve is themes that place long navigation sidebars *before* the contnent rather than to the right. When using a screen reader I need to bypass these and the situation is even worse when the page downloads as a post to my RSS clinet. So, recommendation on WordPress theme: 2 column with content preceding navigation, except for header title and About.

    Books. iBooks, eBooks, Kindle, Google Book Search, DAISY, etc.

    Terms

    • kindle+accessibility
    • how to snapshot page in google book
    • is kindle suitable for the visually impaired?
    • how to unlock books “from kindle” 1
    • is a kindle good for partially blind peo 1
    • access ability of the kindle

    I’ll return to this broad term of readers and reading in a later post. Meantime, here’s an Nytimes Op article on life cycle and ecosystem costs of print and electronic books. My concern is that getting a book into one’s sensory system, whether by vision or audio, is only the first step in reading any material. I’m working on a checklist for choices and evaluation of qualities of reading. More later.

    Searching deeper into Google using the Controversy Discovery Engine

    You know how the first several results from a Google search are often institutions promoting products or summaries from top ranked websites? These are often helpful but even more useful, substantive, and controversial aspects may be pushed far down in the search list pages. There’s a way to bring these more analytic pages to the surface by easily extending the search terms with words that rarely appear in promotional articles, terms that revolve around controversy and evidence. Controversy Discovery engine assists this expanded searching. Just type in the term as you would to Google and choose from one or both lists of synonym clusters to add to the term. The magic here is nothing more than asking for more detailed and analytic language in the search results. You are free to download this page to your own desktop to avoid any additional tracking of search results through its host site and to have it available any time or if you want to modify its lexicon of synonyms.
    Some examples:

    1. “print disability” + dispute
    2. “legally blind” + evidence Search
    3. “NVDA screen reader” + research Search
    4. “white cane” + opinion Search
    5. “Amazon Kindle” accessibility + controversy Search

      Feedback would be much appreciated if you find this deeper search useful.

      Adjustment themes: canes, orientation and mobility, accessibility advocacy, social media, voting, resilience, memories, …

      Coming in next post!

    Honoree for 2010 Ada Lovelace day = Accessibility Advocate and Educator Wendy Chisholm


    finding ada is a movement in the name of 19th century programming theorist Ada Lovelace to acclaim the accomplishments of women in computing. Wendy Chisholm is a computer scientists well recognized in her field of accessibility and web design. I’d like to use this post to not only express my appreciation for her work but also to call attention to the accessibility field as a worthy versatile career path.


    Chisholm’s co-authored book Universal design for web applications blends technical experience from w3c standards, snippets of programming patterns, and a deep respect for human differences. This book explains the rationale for many standards recommendations such as (my favorites) structure and semantics in headings. The now established design process of progressive enhancement is explained with strong admonitions to separate content from presentation and how to do that systematically. Many tools and checklists enable quality control over both process and product. In other words, this book is parallel to software engineering texts teaching essential knowledge and skills for professional web designers, as well as those that produce technical writings and organizational profiles in web format.


    Web Accessibility for Everyone Podcast provides a profound insight into why accessibility matters so much for addressing individual differences, some designated by society as disabilities. Indeed, Wendy take the issue to the level of world peace. An example is the difficulty, using a screen reader, of finding routes in a public transit time table, typical in PDF or web pages. Indeed, the whole area of reading visually represented data is helpfully addressed in the book and a motivator for Chisholm’s computing interests. Wow, this podcasts would be a great entry point for computer science students and professionals — play it at your next brown bag lunch or design meeting.


    Personally, I learned much from the book to codify my study of accessibility, as both a screen reader user and a programmer myself. I cringed often at the awful web gimmicks I used, such as layout tables and, horrors, blink. Living through and using the first generations of HTML has instilled many bad habits and , sorry, blinded us to bad practices. but, now, there’s no excuse for not gradually removing these warts and thoughtlessness that perpetuate barriers in a world where daily life and employment depend on rapid, accurate, and complete access to information from web sites. I’ve ranted here in prior posts about the decade old and now harmful qualities of computing websites such as ACM, CRA, and many Cs departments. Recently http://women.acm.org was proudly announced with good content from Turing award winners and women’s contributions to computing. but one quick pass with my screen readers showed lack of real structure and proper use of semantics as well as an egregious absence of labeled form elements. A compliance analyzer, like a static checker, http://wave.webaim.org confirmed these and more errors. what’s missing here? Mainly an accessibility statement identifying practices from web standards and a regimen of testing like I did in seconds. Hello, ACM, buy yourself this book and work with staff to get yourself up to snuff.


    so, thanks Wendy, for providing such great educational content in an inspiring social context that rules the daily life of vision Losers like me.

    Stumbling Around .gov Websites: Good, Bad, and Goofy

    Recently, attention returned to concern about
    the role of accessibility in the U.S. government transparency movement. While gov website operators might well deserve a good grade for effort, most sites have obvious failings that experts and users repeatedly point out. In this post, I show some of my personal problems and suggest corrective actions. Visually impaired people can hear a realistic experience with a capable, free screen reader to better understand how websites respond to an intermediate level visually impaired, task oriented user. Sighted readers and accessibility specialists are urged to consider alternatives to reduce causes for stumbling around.

    Hear me Stumble Recording

    Download MP3 recording (38 minutes, 17 MB) trying tasks at whitehouse, disability, data, and recovery .gov. Starting with some typical tasks, I get into each website far enough to identify and stumble over some problem, then later come back and analyze the cause in both the website and my own practice, written up below. These little experiments are certainly not definitive because someone more experienced with the website might take a very different route or the proper screen reader action just might not occur to me at the moment. So, listen if you’re patient and interested to these 4 segments and follow along in your browser to perhaps grok what I’m missing in the recording.

    For the record, I was using Windows XP, Firefox 3.5, NVDA RC 09, and PlexTalk Pocket as recorder.

    The BLUF — great availability of useful information but fall short of
    excellence in usability

    BLUF=bottom line Up front

    The Obama administration has unleashed an enormous flow of energy and
    information for citizens to use for their personal lives, political causes, and
    general improvement of society. I really appreciate the nuggets of
    explanations dispensed in RSs feeds and twitter streams, amplified by social
    media communicators interested in technology and organizations with a special
    thread of accessibility. I offer these stumbles as the only feedback I can
    provide, hoping my analyses eventually reach into the administration and d.c.
    government apparatus. My stumbles are not flat on my face, fallen and cannot
    get up, but rather trips over seed bumps, unnecessary traversals around hazy
    obstacles, and stops to reconsider the surroundings to decide my next safe
    steps. Just like real physical life, these stumbles absorb way too much energy,
    often discouraging me from completing a task. Informed by my own experience
    building interfaces, databases, and websites plus software engineering methods
    of testing, use cases, complexity measures, and design exploration, I truly
    believe each stumble indicates a serious design flaw. The good news is that
    while my stumbles may partially track with vision loss and continuing learning the rules of accessibility and assistive technology,
    of the ‘curb cut’ principle suggest corrections will smooth the
    way for other, abled users who are also troubled with usability difficulties
    they cannot understand without the accessibility and usability framework.

    Summary of my stumbles on typical .gov tasks

    1. Website: whitehouse.gov

      Task: Find a recent blog post received by RSS

      : stumble: Post was not in recent list, didn’t know how to use archives, didn’t trust search

      Follow up: Navigated around November archive, eventually found links to previous articles

      Suggestions: Factor archives, Use landmark pattern for list sections

      Comments: Now has a text only version but similar navigation problems

      Grade: C. Text Only site isn’t much of an accessibility improvement, please work on organizing this mass of information. RSS feeds more useful than website. Also, use your clout to force social media services to become accessible, too.

    2. Website: Disability.gov

      Task: Discover information about public transportation in local community

      : stumble: Found ” Transportation” main topic but could not reach specific information

      Follow up: Read “how to use” and eventually figured out info organized by state

      Suggestions: “See sidebar” isn’t sufficient so data needs better organization

      Comments: Site content is effectively transmitted by RSS and Twitter. good survey can help improve site

      Grade B: Good process, but not yet organized properly or communicating website use

    3. Website: data.gov

      Task: Trial download of a data set using search form

      : stumble: Very hard to understand search form components distracting headings and social media,

      Follow up: Eventually got search results, but unsatisfactorily

      Suggestions: Start over

      Comments: Only for wonks on salary, not advised for citizens

      Grade: Incomplete, do over, or adapt expensive recovery.gov interface and data management

    4. Website: Recovery.gov

      Task: Find recovery funding projects in Arizona

      : stumble: Locating form for query and then results

      Follow up: Found the form under non descriptive heading, easily set query, drilled down past top of page to text version of results table

      Suggestions: Make the “Track the money” foremost part of page, submerging feature awards and website data

      Comments: $10M+ project needs more usability and accessibility input

    Individual Website Analyses

    whitehouse.gov — this National Landmark needs ARIA landmarks

    I don’t visit this site often but I do read occasional blog and press briefings in my Levelstar Icon RSS client. One article caught my attention, about encouraging Middle Eastern girls, and seemed worth a tweet to my followers with similar interests. But I needed a good web address so set off to navigate myself through the site.

    I was surprised to find a link to an “accessible” version, not sure what that mean. It turns out to be “text only” which doesn’t mean much to me if the navigation is the same as a screen reader is abstracting from text decorations anyway. Hence, I was faced with a branching decision with no criteria for which branch to take, somewhat confusing.

    As usual to refresh or familiarize myself, I take a “heading tour” to learn the main sections of the site and target the section for my task. Soon, I find the “blog” section but the article list is mainly on President Obama’s Asian trip, not reaching back as far as the article I wanted was a few days old. I declared a “Stumble” by not knowing how to use the archives, needing to train myself and wander a bit more off recording.


    Following up later, I found myself confused about the organization of past material. I took the November link but ended up in more heaps of videos, blog posts, briefings, etc. Eventually, I got to blog article lists and found the web construct that linked to past articles, looks like “previous 1 2…. next”.


    Answer: DHS Secretary Janet Napolitano blog post on ‘Meeting female students in Abu Dhabi’

    To analyze a bit further, let’s separate accessibility from usability. This task seemed to take a little more effort than needed, because I stumbled around learning the archive information architecture and list results patterns. Nothing in the screen reader or the HTML seemed problematic. Headings helped, not hindered. Perhaps this is a stubble that can only be prevented by more practice, but it’s possible we have a jumble of website content that could be factored to make paths easier to follow.

    Traversing a list divided into sections is a common pattern, often intermixed with links to articles and media. The list of blog posts was indeed an HTML list that could be followed by items, but got strange at the end the next-previous section is labeled with something like LSQUO, which makes no sense in a screen reader. This construct is also easy to miss using links rather than items. Could this pattern be


    standardized (see below)?

    Duh, why didn’t I just use the website Search? Unfortunately, I have a deeply ingrained mistrust of site searches, mainly from getting gobs of results that don’t help. Like, how would I know the rules for making a good search query? Is it “Napolitano Abu Dhabi” with quotes where, and default being conjunction? And these words are not the easiest names to type correctly, so is there spelling correction? Well, it turned out “Napolitano” (2nd try) turned up the article about 4 results down but with the same search result bar construct. OK, I’m convinced to bring Search back into my website explorer toolkit. and will work to overcome bad experiences from past generations of website searches.

    Overall, I grade myself as a B with my improving mental map of the site, but definitely prefer using the content by RSS feed, i.e. getting blog and briefings spoken from mobile device. Sorry, but whitehouse.gov still gets a C in my ratings, mostly from the need to have a stellar, near perfect website to model for not only .gov but also community, state gov, professional associations, universities, etc. Only 10 months into the website, the amount of content, useful individually, may grow into a giant heap of links that drive citizens away. Regarding accessibility, I simply don’t see the rationale for the text only site and recommend looking ahead to using better overall structure with landmarks (see below).

    Disability.gov is very useful but maybe convoluted?

    Disability.gov is a regular in both my RSS feed list and Twitter tweetroll. The site has a general framework of disability needs and resources. New resources and classes of resources per day of the week are routinely broadcast. I have a warm feeling when I see these, like somebody is actually looking out for me in that great USG bureaucracy.

    For some local surveys, I anticipate needing data and examples of regional transportation systems supported by public and disabled communities. Ok, I know I’m delusional that a conservative wealthy retirement oriented city will even consider such a thing as services for economic, environmental, or social reasons. But, hey, there’s a sliver of hope. Indeed, this is a typical way the USG can foster citizen innovation through better and more transparent data.


    The website navigation sidebar is straightforward with tasks and information topics. In the recorded session, I picked Transportation and then got stuck. I had a page headed Transportation, nice, with topic overview, but no real information, just a use the sidebar. Ok, but how? why? After, in my follow up, I figured out that information was organized by state, which makes sense, but wasn’t explicit when I stumbled.

    Choosing Arizona from the state list, I found a number of resources, none of which lead directly to the Tri-city Prescott area. Tucson was well represented, but I knew that, been there, seen the buses, and vision services. Overall, I found this site satisfactory, with an encouraging amount of information, but I’m still somewhat befuddled about the relationship between topics and sidebar and details.

    At one point, I was presented with a survey. Sure, I’ll give you feedback, thanks for asking. As usual, I didn’t know how long the survey would take, like how many questions. First accessibility glitch was that required fields were designated by some symbol not read by a screen reader in normal mode, probably an asterisk *. That meant I had to switch into listening more punctuation in the screen reader or just answer all questions. Silly, why not say REQUIRED, rather than use a little symbol. Next, I couldn’t figure out the form of answers, which turned out to be radio buttons labeled 1 to 10 and NA. Ok, that’s a lot of tabbing but not overwhelming, as I whizzed through the questions. Then, came a switch to some combo boxes for answers. Annoying, suggesting the survey wasn’t vetted by many people using screen readers, but not really too bad. Do other gov sites have comparable surveys? They should.

    Overall, I rate myself and disability.gov with a B. I need more practice, and the website developers need more feedback. But really, I know they’re trying, and somebody will likely read this blog. Good job, and I truly appreciate the resources, framework, and the RSS and tweets.

    data.gov for wonks, not citizens


    Oh, my, this site is annoying. The headings are sparse and inappropriate. There’s a sideline off to social media sites that aren’t accessible and in the way. A link says “Click here” which indicates deprecated thinking and cluelessness about hyperlinking.

    The main purpose of this site is a distribution point for datasets collected from various government agencies distributed in XML, CSV, and other formats usable in spreadsheets and statistical analyzers. Great, but the form is a mess.

    I tried to query fo ex ampler datasets, any topic, from National Science Foundation. The agency list is long, painfully, with check boxes. That’s about 40 tab or next line key strokes to get to NSF. Then I found the Submit button. Not so good, which I learned by reading “No search results” at the bottom of the page! Most important effect of a search is to know if it succeeded, produces results, geez! What did I do wrong? Do I need to select format and make an explicit query? Ok, tried that with term “computers”, All Categories, All Agencies. Got 2 results this time, both on illegal exports, spooky and uninteresting.

    Argh, I gave up. I’m sure this site will eventually be useful for policy wonks willing to train and practice, but I, an ordinary citizen with a research background, didn’t feel like I could get much out of here. Sadly, the form’s long list of check box agency names uncoordinated and un searchable was painful. But worse was not getting direct feedback about number of or absence of search results combined with uncertainty about the query actually executed. I had little confidence in either the site or myself as searcher, but, luckily, I don’t forecast any personal need for data.gov. Sayonara.

    So, I rate this sucker a big Incomplete with good intents but pretty clueless about accessibility and usability. Hey, download NVDA and try this out yourselves, data.gov designers. There are lots of ways to design forms and search results. Back to the design stage, please Now that recovery.gov is launched at great expense, perhaps some of the interface and data management functionality can be used to refresh data.gov, but who am I to reorganize .gov :-)..

    Recovery.gov Usable but Cluttered

    Well, it wasn’t fun but I can use this website. The big problem is clutter. I go here to “Track the Money” and cannot find the form to do so. Uh, oh. Plenty of stuff about the site itself, some of the big featured expenditures, but where’s the form. Oh, there it is, under heading “Data, Data, and More Data”, cute but not obvious. This time, I decided to drill down on National Science Foundation awards in Arizona. Unlike data.gov, the agency selection was single choice reached by the convention of first letter, N, and a few key strokes to make the selection. All right, but now what?

    So, the search seems successful yielding another page with lots of accessibility and agency clutter at the top I had to listen through. Back and forth a bit, I found the link to text presentation of the data, accompanied with a blue map.

    Looking for text data, same boring junk at the top then up comes the table of rows of actual data. It’s hard to navigate by row and column, some columns have no real information, like I know I asked for ” National Science Foundation”, read in every row. But painfully working row by row I can find an interesting item like $80K created .17 job –wow! Indeed, the award details is there and readable and interesting.

    The big problem with this iteration of Recovery.gov is that the website is in the way. I definitely do not plan to post anything on MySpace social media service but I have to listen to or bypass this silly text and thought too often to learn what’s on a page. It just seems goofy to send a Recovery dataset to a “friend” on a social network, although it could be relevant in a mature Twitter thread. If the gov goal is to incorporate social media into its normal workflow, then there are big questions of stability, accessibility, and much more of these profit-seeking, ad-driven enterprises.

    I give myself an A for conquering this site, although I’m still stumbling around tables of data. Recovery.gov gets a B for assembling this information in readable form, although not in dataset forms as relative to missions like data.gov. In other words, it looks like a lot of page scraping to identify trends. My suggestion is simple: get the “Track the money” form front and center and press the website, social media, and features into the background. Overall, better than I expected, although the recording and further use leave a feeling of irritation, like having to sweep off a desk of junk to find a phone to get the information needed. Like, just give me control and let me track the money myself. I’ll be back.

    General Suggestions for Improvement

    It’s Time to Bring Landmarks to .gov

    I’m getting spoiled by really accessible websites like AccessibleTwitter and BookShare that use the ARIA landmark feature to structure pages and search results. For example, the .gov sites could be separated into (1) agency logo and babble, (2) navigation, (3) main content, (4) reference to other gov sites and external services. Bookshare shows how to organize search results integrated with the next-previous results page bar.


    Indeed, this brings up the issue of consistency among .gov websites, which could be kind of nice and helpful. Not meaning to squelch individuality of agencies or artistic license or experimentation with diversity, but a citizen wanting a simple answer to an information question isn’t as impressed with decorations as with ease of use, especially on return visits. And visually impaired users especially appreciate predictability, a trait shared with most human beings, when confronted with pure tasks. With all due respect,most visits to gov websites are not for tours through marble halls or to expand social networks to include anonymous civil servants, but rather to get a piece of info as fast and readable as possible.

    Should gov sites link to inaccessible social web services? NO!

    All gov 2.0 buzz seems to involve social media, as in Twitter, Facebook, and sometimes Flickr and MySpace. But the accessibility of most of these sites is way below that of the .gov sites. Can a website assert it is accessible if it links to patently inaccessible services? I think not. The good news is the movement toward alternatives like Accessible Twitter and accessible versions of YouTube. These should be mentioned in accessibility statements. Or, better yet, no links to unless these billion-dollar enterprises raise their accessibility levels to the acceptable status demonstrate by these alternatives. Perhaps there should be a warning label on sites known to be poorly designed or not for the newbie. The US government uses its clout for diversity, why not also for accessibility?


    After spending several hours on these websites, knowing a lot myself about social media, the focus on social stuff seems rather silly considering the weight of the data involved. Am I, is anybody, going to post a link on MySpace or Facebook of a significant query and insight? I doubt it. Rather, these sites give an impression of trying to be oh, so cool, gotta get our stuff out to the fan pages on Facebook. Gimme a break. From a screen reader user, this is just pure clutter in the way of your main mission, stuff I have to listen to redundantly and irrelatively. Try it yourself and determine what value is really added from social media service references so prominently in users’ faces/ears. Even scarier, if gov agencies are adopting these inaccessible, unstable services for actual business, the traditional discrimination policies must come into play, as well as questions about judgement. For example, Twitter is a great news medium, but its rules can, and do, change at any moment.

    How about a gov BEST and WORST practices competition?

    I personally don’t get any value, but rather irritation, from the skip links and text size adjustments. First, the skip links are often just plain wrong, often enough to mistrust and not worth a false link and recovery. Text size adjustments are relevant to those who need large fonts not supplied by browser adjustments. Pages with good headings and landmarks don’t require skip links. Pages that aren’t crowded with text don’t need on-page text size adjustments.. To me, these are accessibility decorations that amount to screen reader noise. It’s rather jarring to find major inconsistencies among gov websites, e.g. text-only at whitehouse.gov but not others, different HTML form patterns, and greatly varying degrees of conventional accessibility.

    As complained about in the whitehouse.gov blog lists, there’s a common pattern that might be nicely standardized. A list of, say 100, items is divided into sections with a bar of links: previous, 1, 2, … next. If you’re drilling down through several pages of results, getting easily into this bar is important. A landmark is a natural way of identifying results.

    Does every search form have to be constructed differently? Above tasks required me to figure out the subdivisions of forms (usually not labeled) and then the form elements. There’s probably a special class of gov site users who can whack their way through a form down to a data set in no time. But the ordinary citizen has to struggle through understanding then mastering the form, finding results, and interpreting answers, which can take hours. How about an award for government service by providing a superior form that other sites can emulate? And give those web designers a bonus or promotion, too!

    Sum up, getting better? Yes or No?

    Overall, although using these sites made me rather grumpy, the trend is toward better accessibility, more usability, and genuine transformation of how citizens use USG data. My wishes are:

    1. Work on clutter and removal and helping users find direct paths to important data, i.e. work on the most significant use cases.
    2. Designers and maintainers of these website should listen to recorded TTS of their pages and contents for several hours to really appreciate the clutter effect of featuritis, accessibility decorations, and social media silliness.
    3. Cut down on the social media crap and rethink what really matters. Yes, these services are useful but really, do they deserve so much prominence? Will they still be here 3 years from now?
      It just seems incongruous to think of sharing recovery datasets with ad-hungry “friend” oriented services. Most serious is the hypocrisy of declaring accessibility on a gov website when these lucrative services so actively ignore accessibility and force visually impaired service users to volunteer developed accessible alternatives.

    4. The most important use of this data is not visible to most citizens. Namely, RSS feeds are the best way for someone to monitor these sites, scanning article titles, downloaded to a mobile device, with rare visits to actual websites. How can the USG foster better offline use of important government developments?
    5. Is there a “curb cut” effect from feedback like this? I hope so, that fixing stumbles precipitated by accessibility bumps and usability gaps will help everybody.
    6. Finally, a cautionary warning I just heard from my CNN news feed. Many recovery awards seem to have fallen into fallacious congressional districts, making the whole record keeping of job data questionable. Apparently citizens reporting award data don’t know what congressional district they belong to (I’m AZ ONE, I think, maybe). Now, data base developers and instructors know, there’s a TRIGGER for that. Zip codes usually map to unique districts but that might not be a requirement or implemented yet. Just saying.

    Related Posts

    Disabled? Sorry, *NO* insurance for you!

    In line with current U.S. rumblings about our massively messed up health care system, here is my personal diatribe against insurance profiteering, and appeal for attention toward disability services. I don’t usually post negative stuff or rants, but we’re all angry and my story of disability resilience is part of the record submitted in support for a public option. Other Vision Losers may find comparable experiences and those not yet disabled may gain some insight about life becoming disabled in early retirement before Medicare in these dark ages of private insurance.

    Note: there are many local geographic references, with some Prescott AZ Resources for Visually Impaired.

    Background

    I have myopic macular degeneration, a lifelong progressive deterioration from birth or growth spurt causing elongated eyeballs and correctable near-sightedness until too much retinal atrophy. My last sliver of good vision left in 2005 taking driving, print reading, face recognition, and surrounding detail into a swirling world of haze. Glaucoma onset at age 60 now costs about $800/year in standard meds that control eye pressure. I have had no other treatments since 1998 with cataract removal following extensive surgery for retinal detachment in 1993. I currently have 3 retinal exams per year with the usual tests.


    I am single, not a veteran, did not seek employment after job termination in 2005, preceding my eligibility for employment-based disability benefits by about 6 months. I easily qualified for social security disability at age 63 when I was using COBRA health insurance at about $7000/year.


    I have basically provided my own rehab and general disability support, easily totaling over $15,000 out of pocket. Following legal blindness in 2006 I retrained myself in computer use and began seeking orientation and mobility training (OMT) for navigating with a white canes and crossing streets. After applying to AZ social services, I waited over a year for this critical safety and independence training with only one trainer in the county, who quit from low pay. Eventually, after crying at a local low vision information group, a school special educator gained state certification and provided a few lessons and a $35 cane. I am truly grateful for the trainer who kept me moving forward when I was becoming home bound. Second Sight local rehab and People Who Care provided low vision overviews but covering information I had already learned myself.

    Health “Insurance” to Susan: Sorry, you own your disability until Medicare.

    At end of COBRA in late 2006, I found it difficult to get response from United Healthcare (in Florida) on continued coverage but expected costs over $10,000. AARP insurance rejected me outright because of the 3 glaucoma meds which they would be forced to cover. My professional organization, IEEE, had just suspended its health insurance offerings. I was surprised to find no possible configuration of insurance for an otherwise fit pre-medicare retiree. Turning to a local broker, I found the only choice, at $3500/year, with Blue Cross of AZ which demanded waiver for related eye condition costs. Note that I would have become eligible for Medicare 2 years after admission to social security disability which turned out to be just after I reached age 65 anyway. Isn’t it ironic that the deterioration of a few body cells at the wrong time can alter one’s retirement resources by so many factors?


    Like many people independently “insured”, I but down visiting doctors in expectation that any condition occurring after start of insurance would be considered pre-existing, i.e. subject to rejection or rescission. I was basically only covered for accidents. Ironically, my inability to gain OMT increased my chance of accidents out walking or getting around. Indeed, in 2004, a decorative rock near the Prescott court house sent me to the ER for five stitches at about $1000. Inevitably, disability increases medical costs, even for insured people, if the social context, the physical environment, and safety training are minimal or nil.


    One effect of visual disability is the extreme difficulty of getting usable health insurance information. I’m as Internet adept as anybody, with email since 1977, but the Medicare, prescription drug, and health insurance websites and documents are painful to use, requiring hours of work and absorption of information in memory. Now, I’m good at web stuff, but filling outh pages of forms is beyond my ability, hence I resorted to a local broker to do this for me, accepting their offerings and trusting their advice. Note that I do have personal helpers, in-house teenagers, but not up to handling complex medical forms I cannot read to check. I also felt that prescription drug policies were partially hoax as I could not find a way to match 3 standard glaucoma meds with 165 choices all couched in weasel words. A consumer protection action could well be applied to make all policies simple enough that even a visually impaired non-Ph.D. had a chance.

    My Personal Feelings

    1. The Medicare disability gap, no help for two years, is outrageous. Here is a mature individual adapting their personal life, trying to maintain productivity and independence, seeking but finding only minimal social services, with this gap at the worst possible moment. Who thought of that torture for the permanently disabled?

    2. Social services: rehab are available only if you’re working, want to work, veteran, in school, or really poor. Near retired are on your own. I called everywhere to find OMT and get in touch with local low vision education resources. I was willing to pay for a consultant to guide me at a faster pace, but no such person existed. There were none when I needed them, nada, just a waiting list. Eye doctors refer to low vision specialists, located in Phoenix, who pushes exorbitantly expensive optical devices. Instead, being a technologist myself, I attended an accessibility exhibition in L.A., found podcasts and product demos, and, at a cost of nearly $15,000, assembled my own assistive technology regime. I also began writing a blog at https://asyourworldchanges.wordpress.com to share my experiences with others in the same boat.


      Just imagine how hard it’s going to be on both the services and citizens as more baby boomers lose vision and need both mobility and computing re-training? There are standard occupational and educational training programs but the jobs are ill-paid, yielding much better services in coastal cities. How many low vision people, other than me, will you see walking around Prescott, although an estimated 9000 in Yavapai County?
      At this point, the most valuable service I’ve received is that $35 cane and a few lessons at crossing streets that, of course, lack audible signals or driver warnings. I truly believe that white cane is my ticket to the only freedom I can have. There is no viable public transportation, So I’m often using taxis if rides are not available. And notice that the Community Center, within walking distance of my home, has no sidewalk access.


      In contrast, before the recession, I was formulating plans to move to Tucson where SOAVI offers regular services comparable to Lighthouse in major cities and welcomed my computing expertise as a volunteer. Retirement-rich Prescott is incredibly service-poor.
      I regret that so few other low vision people in the Prescott area can receive comparable training. I also note that there is no computer training I am aware of nor any exposure to assistive technology comparable to the audio reading, book services, and more available to veterans and students. As a technologist, I found my own resources, and I am proposing such information through courses at OLLI at Yavapai College.

    3. How it feels to be a citizen deprived of health insurance “choices”.
      • Not health but rather,
        corporations insurance. They determine the risk pools, not the forces of demographics and society. Some person pushed around the paper to deny me coverage for my pre-existing condition and, at AARP, of any insurance. Managers and policy makers determined that, no matter what else about my health, I would reduce profits in annual exams. I’ve read that about 400,000 health corporation employees spend their working hours paid by premiums to deny insurance to citizens in order to pass profits to shareholders and corporate bosses. This is as evil a form of capitalism as could be imagined with no innovation, public service, or redeeming values, just pure profiteering.

      • Even more insulting, as a “self-pay” I got to fork over for the full rate rather than any reduction negotiated among doctors and insurers. Luckily, I had only year and a half of routine exams for my “pre-existing condition” but lived in fear of a major treatment that could run into $10,000s.

      • I am appalled at state politicians and tax payers who refuse resources to
        our system of social services so starved of trained rehab people that low vision individuals sacrifice safety and independence that probably lead to higher medical costs, e.g. $1000 when I tripped over a decorative rock down town Prescott.

      • I also resent second class status as a citizen who has for nearly 20 years supplemented family members in and out of personal difficulties, but now becoming taxpayers. I was a willing safety net, but there’s no net for me.

      • A visiting friend recently got excited at the national anthem played at the square, but I could find no feeling of national loyalty, only sorrow for myself and the many other disabled people I know who, with great resilience, overcome disability but always end up with less financially and more aggravation and deprivation from lifetime medical services. You own your pre-existing condition, so it goes, but why should the U.S. support a medical industrial complex that profits from exclusion of persons with disabilities.

      • Finally, I know all too many people who remain mired in companies they dislike, submitting to discriminations practices, enslaved due to health insurance.

    Recommendations

    Abolish the profiteering, paper pushing, intrusive health insurance companies and provide full support for a public option. No country can claim it is “good and great” when its health care system is rotten and wasteful at the core. Why fight terrorism abroad and still facilitate slavery and profiteering from illness and disability in the home system?


    Additionally, extend the notion of health support to include the social services, rehab specialists, training centers, and public support that keeps people with disabilities productive and not needing more costly medical services. Just adding 3 more rehab people to the Prescott area would add, what, maybe $300,000 or about one middle-class house or a $1 more taxes. Now, realize that everybody will be disabled eventually and these specialists are even more essential.


    Note that the disability I describe is a “social construct” as much as an individual condition. I have rather resiliently responded to my condition with great personal growth while the insurance and social services have constituted far more challenge and distress. I have only faced the full force of this dysfunctional system for about 10 of the 15 years of my progressive disability while many others have a lifetime. I have come out with a sense of service to others exhibited in my blog writing, advocacy in social media, and participation in lifelong learning distance education opportunities at Yavapai College.


    Fix the system by abolishing private health insurance, acknowledging that this impoverished dogma of capitalism is far worse than any possible replacement that serves all the people. Apply the funds, after retraining insurance paper-pushers, to building a disability friendly society that, like the curb cut, will improve lives for everybody.

    Addendum: So now we know, sorry,, the nation cannot afford health insurers!

    Many U.S. citizens have lost our innocence about capitalism watching the fiasco of Wall Street bailouts and, now, the role of the medical-industrial-government complex in our personal lives and 1/6 of the national economy. So, it’s now established baseline that acceptable universal health care can be provided for 3% overhead, i.e. Medicare. And, facts vary, but let’s assume premiums carry 20% overhead, including profits to shareholders, bonuses to executives, salaries to underwriters (i.e. those who deny insurance or claims), adjusters who hassle doctors and their administrators over claims, processors who actually do work comparable to the Medicare 3% overhead. Oh, yeah, also lobbying, lawyering, and the usual industry hobnobbing at expensive places. All this, when in many locations there are near monopolies or few competitors. And more along the lobbying vein are the subsidiary think tanks that produce reports to influence legislators.

    Can the U.S. economy actually sustain 20% versus 3% overhead costs? Wouldn’t we be nuts to continue such a costly system? Well, not if it were geared toward innovating and modernizing health care records and studies of comparative treatment effectiveness. But that’s not happening, at least for the benefit of the citizenry. No innovation, inhumanc3e denial of services, isn’t this just pure profiteering?


    Here’s a counter-proposal if U.S. citizens cannot give up on capitalism in its most appropriate context, as argued by NYTimes columnist Paul Krugman. Knowing 3% overhead is the baseline, allow 5% of premiums for profit private companies. That’s all, covering administration, executive salaries, and dividends. Sorry, insurance industry investors, and I’m probably one somewhere in my diversified portfolio. Profits have been inflated, costs have not been controlled, it’s time for reparations after the war on those with pre-existing conditions. But won’t the health industry go nuts and up their charges? Well, let the insurers and health care providers go to negotiating like other claims, rather than allow the insurers to have the final call. Now, let’s slice off another 1% of premiums into a fund to improve healthcare delivery, doctors’s lives in underserved districts, the social service gap I’ve described. Isn’t that a better trade-offhann corporate bonuses or deniers’s salaries?

    Bottom Line: If the for-profit insurers’ cannot even come close to a current public option, i.e. Medicare, the country cannot afford to subsidize their dogmatic capttalism. For those who cannot abide government-run systems, give a private option capped at a reasonable level of 5% overhead, stripped of denial privileges and forced to innovate and streamline to survive.

    Contact

    August 19 2009
    Susan L. gerhart, Ph.D.
    https://asyourworldchanges.wordpress.com
    blog “As Your World Changes”, ‘Adjusting to vision loss with class, using technology’

    slger123@gmail.com