Increasing independence and freedom with high tech aids and devices.

An extremely disproportionate amount of information is gathered through the use of visual and auditory senses as compared with the other senses. In this age of information, people that have visual or auditory impairments are at a serious disadvantage when it comes to accessing information. Lack of information can lead to decreased independence and diminished opportunities. This disadvantage can be alleviated through the use of high tech adaptive equipment that allows a deaf-blind person to access information and expand avenues of communication.

The devices discussed in this article are used by persons who are deaf-blind but can also be used by those with other disabilities. Some of these devices where developed with primarily one type of user in mind, but later were found to be suitable for people with other disabilities.

Most of the equipment below are regularly used by individuals who are blind or visually impaired. Following the description of each type of device is a list of distributors. See Table I for the addresses and phone numbers of distributors.

Computer Access

Until recent technological advances the computer had been primarily a visual media; now, information is frequently presented through both auditory and visual means. But for individuals who are deaf-blind, visual or auditory means of accessing a computer are difficult, if not impossible. Two modifications enable a person who is deaf-blind to access a computer: braille and magnification.

A braille access device is a peripheral device that is connected to a computer. It acts as a monitor for a braille reader. Instead of looking at a computer monitor, the user of the braille access device feels the information in braille. There are some fundamental differences between print and braille which affect the use of a braille display: braille letters are considerably larger than normal sized print text and refreshable braille cells (the braille is produced by raising and lowering pins to produce braille cells) are a relatively new technology. Due to these two factors, braille displays provide the user with less information than a typical visual monitor. Most braille displays have one line of braille cells, approximately 80 characters in length. Some less expensive models have less than 80, while a few have more. Conversely, the typical computer monitor has 25 lines of text with 80 characters per line. This means that a typical braille display can only display approximately 4 percent of the information that a standard computer monitor can at any one time. To overcome this disadvantage, braille access devices are manipulated with a memory resident program that allows the braille user to access all areas of the computer monitor. Another difference between braille and print is the use of graphics. With a braille access device, only letters, numbers, punctuation, and some standard symbols can be displayed. Graphics cannot be converted to braille because there is no standardized system for depicting graphics in braille. This means that some graphically based programs may not be accessible to a braille user. However, some programs that are graphically based do have text that is braille accessible.

There are also some braille access devices that can be used independent of a computer. This type of device is sometimes called a braille notetaker, in that it allows the user to type and save information. These braille access devices are portable and have various functions and uses, including: basic word processing, transferring files to and from a computer, scheduling, calculating, and simple data storage. Some distributors of computer braille access devices are Baum, Blazie Engineering, HumanWare, and TeleSensory Systems.

An ink printer is used to produce printed copies of the braille user's work for sighted associates; and a braille embosser is used to produce a hard copy in braille. A braille embosser is basically a braille printer that creates braille text on paper. This allows the braille reader to have a permanent copy of his/her work. Some distributors of braille embossers are American Thermoform, Baum, Blazie Engineering, Enabling Technology, HumanWare, TeleSensory Systems, and VTEK.

A magnification system allows a computer user with poor visual acuity to read the computer monitor. The magnification system magnifies everything that appears on the monitor. The typical range is from 2X to 12X magnification. The approximate size of normal sized screen text is 1/4 inches in height and 1/8 inches in width. If the text is magnified four times, the height becomes approximately 1 inch and the width approximately 1/2 inch. Although it is now easier to see the information on the screen, we can now only see 1/16 of what is normally visible on the screen. To overcome this obstacle, magnification systems have a controlling program that allows the user to maneuver the magnified area so that he/she is able to access the entire screen in segments. Some distributors of computer magnification systems are AI Squared, Computer Conversation, HumanWare, Microsystems, and TeleSensory Systems.

Print Access

A tremendous amount of information - unfortunately not directly accessible to everyone - is produced in print (i.e., daily newspapers, letters, bills, and office memos). In the past, individuals who were deaf-blind needed someone else to interpret/read printed material for them. The new technology changes this.

With the aid of a closed circuit television system (CCTV), an individual with poor near acuity (unable to read printed material) can now read just about anything. A CCTV consists of two primary components: a video camera and a television monitor. The video camera is focused on the printed material. The video image can be manipulated in various ways to produce an enlarged image. Magnification capabilities for these devices typically range from 2X to 48X. With maximum magnification, these devices can magnify a single letter of standard sized print to nearly cover a 14-inch diagonal screen.

CCTV's have different capabilities and uses. Some features include the ability to alternate between digital and analog display modes, inversing screen colors, blocking a portion of the screen, underlining, and variable focus and magnification. Most CCTV's are tabletop versions that are used in one place. Some of these tabletop CCTV's come with a reading tray that allows the reader to easily move the printed material. Portable CCTV's are also available. With a portable CCTV, the video camera is either hooked up to a small portable television monitor or can be connected to a regular television or computer screen. Portable CCTV's allow a user to access print in various settings (i.e., home, school, stores, or at the worksite).

Some CCTV's can be connected to a computer monitor so that the same screen can be used for both the computer and the CCTV. With the press of a button the user can alternate between the computer image or the CCTV image. This allows users to stay focused on one screen and not have to turn their heads, try to refocus at a different screen, and finally locate the information they want. The process of continually having to adjust to two separate monitors can be exhausting. With some CCTV's, the computer image and the CCTV image can be displayed simultaneously in a split screen mode in which the user can determine which area of the screen will display the computer monitor image and which area will display the CCTV image. A typical arrangement would display the computer image on the top half of the monitor and the CCTV image on the bottom half; but this can be modified. Some distributors of CCTV's are HumanWare, Optelec, Seeing Technologies International, and TeleSensory Systems.

Another means of accessing print material is through the use of optical character recognition (OCR). With OCR, a scanner (a device similar to a copy machine) takes an image of the material and deciphers the printed text. The information is then stored in a computerized format, where it can be accessed with any of the computer access modes discussed earlier. With this new technology individuals who are deaf-blind need not have to wait for a person to interpret printed material for them, but can now read their own mail, newspapers, or other printed materials. Individuals who are blind or have reading disabilities can use OCR scanners with a voice output to access print. The accuracy of OCR is heavily dependent on the quality of the text being scanned. Text in a standard font that is produced by a laser printer is quite easy, while text that has been copied several times or smudged might cause errors in the recognition process. If the print is clear there will be relatively few errors, but if the print is smudged or otherwise distorted there will likely be more errors. Because handwriting is highly variable, it poses a problem. The postal service uses OCR technology to sort mail. If the postal service's machine is unable to recognize the address (which occurs frequently), the mail must be sorted by hand. Some distributors of OCR scanning systems are Arkenstone, Kurzweil, and TeleSensory Systems.

Telecommunications

People who are deaf access the telephone through the use of a telecommunications device for the deaf (TDD), which works by converting letters typed on a keyboard into a series of beeps that can be transmitted over the phone line. A TDD on the other end of the phone line then converts the beeps back into print. Two TDD users can communicate by typing their information back and forth. When a TDD user wants to call a hearing person who has no TDD, a relay service is available. The relay operator acts as an interpreter between the TDD user and the hearing person. Information the TDD user types to the relay operator is then voiced to the hearing person, while everything the hearing person voices to the relay operator is typed to the TDD user.

Usually, regular TDD's cannot be easily read by TDD users who are visually impaired. To correct this, a large print TDD display is available, with illuminated characters measuring approximately 1 inch in height, thus enabling individuals with poor near acuity to read. Ultratec is the distributor for the large print TDD. For those who read braille, TDD's with braille displays are available to allow access to the telephone by people who are totally deaf-blind. Two of these braille TDD devices on the market use a refreshable braille system, while another device embosses the TDD information as hardcopy braille on paper. Blazie Engineering, Enabling Technology, and TeleSensory Systems are distributors of TDD's with braille output.

Braille Telecaption

Because television produces only auditory and visual information, this medium is not initially accessible to individuals who are deaf-blind. But through the use of a device called the braille telecaption decoder television is made accessible to people who are deaf-blind. Most television programs are closed captioned for the deaf. This means that, with the aid of a small device, a written transcript of all auditory information (everything that is said and additional auditory information like music and other sounds) can be displayed at the bottom of the screen. The braille telecaption decoder reads the captioning information and converts that into the series of beeps used by TDD's; thus, people who can neither see nor hear are able to enjoy television by using TDD's with braille displays. Dewtronics is the distributor of the braille telecaption system.

Case Histories

Mary, a 45-year-old woman with Usher syndrome, was born deaf and lost vision due to retinitis pigmentosa. For the past 25 years she has raised her children and taken care of her family. Approximately 5 years ago, she had to learn braille because her vision was rapidly deteriorating. A little over a year ago, she began using a computer for the first time with the aid of a braille access device. Now she is enrolled in college and plans to become a teacher. She uses her computer to do school work, read class notes typed by a volunteer notetaker, and to access an online computer service. Mary also accesses television with the aid of a braille telecaption decoder.

Brian, a 28-year-old male with poor visual acuity and a severe hearing impairment, was laid off from his factory job because he could no longer see the parts he worked with. He was unemployed for several years. He received training with a CCTV, computer magnification, and data entry. After completing training, he was employed at a large social service agency where he does data entry and has mailroom duties.

Tyrone, a 35-year-old male with Usher syndrome, grew up culturally deaf (i.e., American Sign Language was his primary language and he attended a school for the deaf) and had many deaf friends. He loved to call his friends using his TDD. When his vision deteriorated to the point that he could no longer read the visual display, he needed his wife to interpret all of his phone calls. This new dependence upon his wife bothered him. After purchasing a TDD with a large print display, he could once again use the phone without asking his wife for assistance. He has begun learning braille and will receive training with a TDD with a braille display for when his vision deteriorates to the point that he is no longer able to read the large print display.

Summary

Technology has changed many people's lives. In some cases, it has helped people who are deaf-blind do things that neither they nor others thought they could. Technology has allowed them to overcome seemingly impossible barriers.

For additional information on the specific devices, please contact the following distributors directly Table 1 is a list of distributors of the various types of equipment discussed in this article. Also, some agencies that may be helpful in providing additional information regarding issues such as training, funding, and products are listed in Table 2.

     Table 1
     Manufacturers/Distributors and Additional Resources

* AI Squared
P.O. Box 669
Manchester Center, VT 05255-0669
[phone]

* American Printing House for
the Blind
1839 Frankfort Avenue
P.O. Box 6085
Louisville, KY 40206
[phone]
Toll-free, [phone]

* American Thermoform Corporation
2311 Travers Avenue
City of Commerce, CA 90040
[phone]
Toll-free, [phone]

* Arkenstone, Inc.
1390 Borregas Ave.
Sunnyvale, CA 94089
[phone]
Toll-free, [phone]

* Baum USA
17525 Ventura Blvd.
Suite 303
Encino, CA 91316-3843
[phone]
Toll-free, [phone]

* Blaize Engineering
105 E. Jarrettsville Rd.
Forest Hill, MD 21050
[phone]

* Dewtronics - Nelson R. Dew
P.O. Box 308
Ghent, W.VA. 25843
[phone]
[phone] (voice)
[phone] (TDD)

* Enabling Technologies Co.
3102 S.E. Jay Street
Stuart, FL 34997
[phone]
Toll-free [phone]

* HumanWare, Inc.
6245 King Road
Loomis, CA 95650
[phone]
Toll-free, [phone]
FAX: [phone]

* Kurzweil Computer Products
9 Centennial Drive
Peabody, MA 01960
[phone]
Toll-free, [phone]

* Microsystems Software
600 Worcester Road
Framingham, MA 01701
[phone]
Toll-free, [phone]

* Optelec U.S., Inc.
6 Lyberty Way
P.O. Box 729
Westford, MA 01886
[phone]
Toll-free, [phone]

* Seeing Technologies International
40 Executive Blvd.
Farmingdale, NY 11735
[phone]
Toll-free, [phone]

* Telesensory Systems Inc.
455 North Bernardo
P.O. Box 7455
Mountain View, CA 94043
[phone]
Toll-free, [phone]

* Ultratec, Inc.
450 Science Drive
Madison, WI 53711
[phone] (voice/TDD)
Toll-free, [phone]
FAX: [phone]

* VTEK
1625 Olympic Blvd.
Santa Monica, CA 90404
[phone]

     Table 2
     Agencies

* American Association for the
Deaf-Blind
814 Thayer Avenue
Silver Spring, MD 20910
[phone] (TDD)

* American Foundation for the Blind
3602 Northern Blvd.
Long Island City, NY 11101
[phone]
Toll-free, [phone]

* Computerized Books for the Blind
33 Corbin Hall
University of Montana
Missoula, MT 59812
[phone]

* DB-Link: Information Clearinghouse
Teaching Research Division of
Western Oregon State College
345 North Monmouth Avenue
Monmouth, OR 97361
[phone]

* Gallaudet University
Deaf-Blind Program
800 Florida Avenue NE
Washington, DC 20002
[phone]
[phone] (TDD)

* Helen Keller National Center
111 Middle Neck Road
Sands Point, NY 11050
[phone] (voice)
[phone] (TDD)

* Library of Congress
National Library Services
for the Blind and Physically
Handicapped
1291 Taylor Street, NW
Washington, D.C. 20542
[phone] (voice)
[phone] (TDD)
Toll-free, [phone]

* Lighthouse, Consumer Products
Division
36-02 Northern Boulevard
Long Island City, NY 11101
[phone]
Toll-free, [phone]

* Maryland Technology Assistance
Program
2301 Argonne Drive
Baltimore, MD 21218
[phone] (voice/TDD)
Toll-free, (800) TECH-TAP
(voice/TDD)

* National Federation of the Blind
Technology Center for the Blind
1800 Johnson St.
Baltimore, MD. 21230
[phone]

* Perkins School for the Blind
175 North Beacon Street
Watertown, MA 02172
[phone]

* Recording for the Blind
20 Roszel Road
Princeton, NJ 08540
[phone]
Toll-free, [phone],

* TRACES Project
345 North Monmouth Avenue
Monmouth, OR 97361
[phone]

Mr. Belanich is Senior Instructor in the Communications Learning Center at the Helen Keller National Center for Deaf-Blind Youth and Adults, Sands Point, NY.