With Disabilities Enlist Technology in the Quest for Access
a history professor at San Francisco State, has had rheumatoid arthritis
since her early 30s. Today, at 62, the stiffness in the joints of her
hands is so severe that Felstiner can barely sign a check or type an
e-mail message longer than, "Sure, let's meet at 5."
Still, Felstiner, a nationally recognized expert on women and genocide,
is a prolific writer. She is at work on her second book, contributes
frequently to scholarly journals, and generates a steady output of memos,
letters of recommendation and reports.
Felstiner accomplishes most of this without lifting a pen or touching
a keyboard. For the past two years, she has used Dragon NaturallySpeaking,
a speech-recognition program that converts the spoken word to text.
Writing this way is frustratingly slow, she says. Each correction involves
as many as 10 verbal commands that Felstiner utters into a headset microphone
attached to her computer. But it's vastly preferable to anything else
"For me, this is wonderful," Felstiner said. "It's enabled
me to be independent, and that's the name of the game."
Felstiner's experience is an example of how adaptive technologies are
helping students, staff and faculty with disabilities at San Francisco
State gain full access to campus life in startling ways.
Some devices, like Felstiner's speech-recognition program, rely on highly
sophisticated technologies; others are as simple as a height-adjustable
keyboard drawer for people who need to type standing up.
The first step toward acquiring a piece of adaptive technology often
begins at SFSU's Disability Programs and Resource Center, which each
semester serves about 700 students and 70 faculty and staff members
who have disabilities that include vision and hearing impairments, chronic
conditions such as HIV/AIDS, and cognitive and psychiatric problems.
Adaptive technologies can be expensive. The University's refreshable
braille display, a device that allows blind people to read text on a
computer screen, carries a price tag of about $10,000; screen-reading
software such as JAWS, which converts text to speech, costs up to $900
to license. With an annual budget of about $1 million, the Center can't
afford to buy everything.
"But if somebody comes in and needs something and we determine
it's a reasonable accommodation, we'll work within the University to
find the resources to pay for it," said Gene Chelberg, the Center's
The University's most extensive collection of adaptive computer technologies
is located in the Maurice K. Schiffman Room in the lower level of the
J. Paul Leonard Library. Here, behind a locked door with a card-swipe
entry, are computer programs such as ZoomText, which magnifies the text
on a computer screen so that it can be read by people with vision problems,
or OPENBook, which converts scanned images to speech for people who
are blind or have cognitive problems reading the written word.
On this afternoon, Nanako Yamada, 24, a graduate student from Japan who
lost her sight at age 10 due to glaucoma, is in the Schiffman Room proofreading
a paper on the refreshable braille display. Distributed by Pulse Data
HumanWare, the Mod 80 Braille Terminal has the shape and look of a keyboard.
But running along the bottom are 80 braille cells, which together represent
one line of text on the screen. Each cell consists of eight tiny pegs
that rise and lower as the cursor moves across a line of text.
Yamada runs a slender index finger from left to right along the braille
pegs as she proofreads her paper. Her finger stops on a cell where she
has found a grammatical error. She reads it aloud. "Therefore, parents
should know what their child learn -- it should be 'learns.'" She
quickly corrects the error.
Yamada, a special education major, said the braille display improves the
quality of her schoolwork. More importantly, it helps her be self-sufficient.
"I used to ask my friends to edit my papers for me. They're nice
and they didn't mind, but I prefer to do things for myself," she
Born without lower arms, Alan Fisk, a career counselor at San Francisco
State, wears prosthetic arms with hands made of stainless-steel hooks.
Fisk types "the two-fingered way." It's slow but it gets the
job done. His bigger concern is moving the cursor. When mouse technology
came along, Fisk found he could grasp the device using both hands but
doing so fatigued his arms.
Trackball mouses were better but not ideal. Fisk can manipulate the trackball
with the eraser ends of two pencils that he grasps in his hands. But in
order to type, he has to release the pencils then pick them up again to
use the trackball. Fisk knew there had to be a better way.
SFSU's Go-to Guy
Fisk called Ray Grott, a nationally known expert on adaptive technologies
who runs the University's Rehabilitation Engineering Technology Program.
Grott is SF State's go-to guy for people with disabilities who need customized
equipment. Handy with a table saw and welding torch, Grott built a viewing
platform with a tilting base so that people in wheelchairs can look up
at the celestial display at San Francisco State's planetarium. When an
instructor lost the use of his vocal chords, Grott set him up with a text-to-speech
software program so that a voice synthesizer in a laptop computer could
read his lectures in class.
For Fisk, Grott figured that the best solution would be a touchpad. He
experimented with different brands and models before finding the Cirque
Corporation's GlidePoint touchpad, which bears up under the friction of
Fisk's metal hooks. Grott made Fisk a tilted, plastic base so that the
touchpad sits at the proper angle for his hands.
"People's needs are very individual," Grott explained. "Even
when off-the-shelf products exist you have to customize them to suit the
Last year, Paul Longmore, a history professor at San Francisco State,
turned to Grott for help with a problem.Childhood polio left Longmore,
with a paralyzed left arm and limited use of his spine and right arm and
hand. For many years, Longmore gave lectures standing up. Recently, due
to mounting fatigue, he decided to remain seated in his motorized wheelchair
and read his lecture notes -- which he types using the same voice-recognition
system as Felstiner -- from a laptop computer.
There was one hitch. Since Longmore could use his right hand only with
great difficulty, he would have no way to scroll up and down or open a
new document. Longmore got on the phone. "Hey, Ray, got any ideas?"
Grott knew that Longmore had considerable mobility in his legs and feet.
He located a foot pedal that would connect to Longmore's laptop through
a keyboard port. The pedal has three switches; Grott programmed one to
scroll up, another to scroll down, and a third to toggle between documents.
In the HSS building, where Longmore teaches "American Colonial History,"
the pedal sits on the floor near his left foot. Longmore can reach it
easily without glancing down, much in the way that a driver reaches for
a clutch pedal.
"It's working out great. It's just making lecturing a lot easier
because I can sit down and see my notes and not have to worry about turning
pages," Longmore said.
No Easy Solutions
Technology alone can't solve all problems. Sensitivity on the part of
instructors and classmates is nearly as important. Take the situation
of Angela Palmer, a graduate student in rehabilitation counseling who
has Usher's Syndrome, a condition characterized by vision and hearing
Palmer uses a guide dog to get around campus. To aid her hearing, she
wears a cochlear implant, an artificial hearing device that is surgically
inserted into the inner ear. But even with the implant, Palmer would have
difficulty hearing her professors were it not for an assistive listening
device loaned to her by the Disability Programs and Resource Center.
For the most part, the device, which is called PhonicEar, works great.
In Palmer's class on substance abuse, for example, her professor, Janet
Buchholz, speaks into a lapel microphone that is clipped to her blouse
or jacket. A slim cord connects the microphone to a small FM radio transmitter
that Buchholz carries in the pocket of her slacks. The transmitter sends
Buchholz's voice to a tiny receiver in Palmer's jeans pocket. From there,
it goes to a speech processor clipped to Palmer's waistband. The processor
converts Buchholz's voice to electrical impulses and dispatches them up
to Palmer's cochlear implant.
The assistive listening device makes it possible for Palmer to hear Buchholz
just fine. Hearing what other students say is not as easy. While a second
microphone is passed around during class discussion, many students forget
to use it or can't be bothered.
That's frustrating and unfair for Palmer, who is shut out of the conversation
because she has no idea what her classmates are saying. "It's like,
OK, pass the mike! Pass the mike!" Palmer said. "It makes me
feel kind of isolated."
But Palmer isn't the only one who misses out when her classmates don't
use the microphone, said Anthony Moy, a staff member at the Disability
Programs and Resource Center. Since Palmer can't join in the discussion,
her classmates don't get the benefit of whatever she might have to say
on the subject at hand, he said.
"This is an issue of access for all students, not just disabled students,"
Moy said. "Let's say the student who is being excluded happened to
be Albert Einstein. Who is not benefiting now?"
Finding the right adaptive technology can be a never-ending process. The
minute one problem is solved, another can take its place. That's what
happened to Felstiner, who damaged her vocal chords by overuse of the
speech-recognition program. Today, her voice is so weak that she cannot
talk to someone in another room in her small Palo Alto home.
When Felstiner first started losing her voice, she panicked. She makes
her living talking in front of groups of people. What if she couldn't
do that anymore?
Felstiner found a solution in a classroom voice amplifier, which, like
the PhonicEar, operates on FM radio signals. During class, Felstiner wears
a lapel microphone clipped to her blouse, and a small, black transmitter
hangs on a strap around her waist. Her amplified voice comes out of two
bookshelf speakers connected to a radio receiver/amplifier.
Jumping Emotional Hurdles
Seeking out adaptive technologies can be emotionally difficult for people
who haven't used them before. For many years, Patty Wright, a counselor
and instructor who has multiple sclerosis, refused to use a wheelchair
or even a cane because she was afraid of being stigmatized.
Instead, Wright said, she bobbed and weaved when she walked down the sidewalk.
Getting to a meeting in another building on campus required so much physical
exertion that she arrived soaked in sweat.
"Finally, one of my colleagues said, 'What looks more disabled, you
sopping wet and disheveled or using a wheelchair?'" Wright recalled.
Today, Wright zips around in a motorized wheelchair, which is owned by
the University and loaned to her for campus use.
Wright said she still battles an image problem but she's thrilled with
her chair. It's a sporty-looking, candy-apple red with adjustable speeds
and a cup holder for her coffee.
"The technology is there," Wright said. "The biggest obstacle
is accepting the help. Ninety-nine percent of it is just getting past
that psychological barrier."
Gene Chelberg: Seeking the All-Access Pass