Friday Finds for July 21 2017
The start of each article is marked with an asterisk. Using the find/replace feature of your word processor, type in the asterisk (shift plus numeral eight) then hit enter to jump between articles.
1 walkpro from Embro
2 Test your Knowledge of John Dillinger
4 Gigabyte Announces Tiny PC
5 Accessible Textbook Options for Students Who Are Blind or Visually Impaired
6 Blindness and Medical Facilities, Take One
7 Blindness and Medical Facilities, Take Two
8 Accessing Quality Technology Assistance
10 WALKING THROUGH THE FOG
Articles start next
*1) Walk Pro from Embro
There is a mp3 file available at the link below.
It was too large to send as an attachment.
The world’s smartest travel aid for the visually impaired is here. From spotting irregularities, dropoffs, inclines and lot more.
*2) Test your Knowledge of John Dillinger
Q1. Who was John Dillinger?
Answer: Born on June 22, 1903, John Dillinger is perhaps the most well-known Depression-era bank robber in America. Johnnie “the Jackrabbit” was trouble pretty much from the beginning. In his youth, Dillinger ran around with a gang called “the Dirty Dozen” who would play pranks and commit petty thefts throughout the neighborhood.
As Dillinger grew into his late teens and early twenties, those pranks and petty thefts turned to drinking, drug use and grand theft auto. In July 1923, Dillinger stole a car to impress a girl on a date and when he narrowly escaped arrest, joined the Navy the next day. John made it through basic training, but he didn’t have the discipline for military life and though he was assigned to the U.S.S. Utah (the same ship that sunk at Pearl Harbor), Dillinger literally jumped ship and returned home, where he was later dishonorably discharged.
Q2. How Many Bank Robberies Did the Dillinger Gang Pull-Off?
Answer: 14 total, as well as various store and police station robberies. The press made a myth of the Dillinger Gang, giving him a Robin-Hood-like ethos who took from the greedy banks that had suppressed middle America during the Depression. In an infamous Dillinger tale, a farmer had gone to the bank to deposit his earnings, only to encounter a robbery in progress. Dillinger asked the man “Is that your money or the bank’s?” and when he replied it was his, Dillinger replied, “Keep it. We only want the bank’s money.”
Q3. How Were Police Tipped Off to Dillinger’s Whereabouts?
Answer: Dillinger spent most of the first three weeks of July 1934 holed up in a Chicago apartment with Polly Hamilton, his current girlfriend, and Polly’s friend Anna Sage, a Romanian-born brothel owner whose birth name was Ana Cumpanas. When the FBI’s reward money for the capture of Dillinger reached $25,000, Sage agreed to alert the G-men to Dillinger’s location in return for a share of the reward money and some help to avoid deportation to her native Romania. After being invited to join Dillinger and Hamilton for a trip to the movies on July 22, 1934, Sage began preparing a pre-theater dinner of fried chicken but excused herself, ostensibly to run out and buy some butter. While out at the store, Sage contacted FBI Chicago bureau chief Melvin Purvis by phone and told him of Dillinger’s plans for the evening.
At 10:30 p.m., Dillinger, with his two female companions on either side, walked out of the movie theater and turned to his left. As they walked past the doorway in which Purvis was standing, Purvis lit a cigar as a signal for the other men to close in. Dillinger grabbed a pistol from his right trouser pocket as he ran toward the alley. Five shots were fired from the guns of three FBI agents. Three of the shots hit Dillinger, and he fell face down on the pavement. At 10:50 p.m. on July 22, 1934, John Dillinger was pronounced dead in a little room in the Alexian Brothers Hospital.
Q4. What Was the Name of the Theater and the Movie Playing That Night?
Answer; Dillinger’s ill-fated night out at the movies was spent at the Biograph Theater, where he and two female companions took in a showing of Manhattan Melodrama, a gangster flick starring Clark Gable, William Powell, Myrna Loy, and Mickey Rooney in one of his earliest motion picture roles. The FBI had earlier been alerted to the fact that Dillinger was going out to the movies that night, but it was uncertain whether he was headed to the Biograph or across town to the Marbro Theatre, which was showing a film starring Shirley Temple. That Dillinger opted for the gangster film came as little surprise.
During World War II the U.S. government used 260 million pounds of instant coffee.
Flavored coffees are created after the roasting process by applying flavored oils specially created to use on coffee beans.
In 1670, Dorothy Jones of Boston was granted a license to sell coffee, and so became the first American coffee trader.
In 1727, as a result of seedlings smuggled from Paris, coffee plants first were cultivated in Brazil.
Milk as an additive to coffee became popular in the 1680’s, when a French physician recommended that cafe au lait be used for medicinal purposes.
Roasted coffee beans start to lose small amounts of flavor within two weeks. Ground coffee begins to lose its flavor in one hour. Brewed coffee and espresso begins to lose flavor within minutes.
*4) Gigabyte Announces Tiny PC
The Raspberry Pi has proved itself to be a versatile little computer, and you can get them for pocket change. It’s a bit light on power, though. Now, Gigabyte is preparing to launch a similar device called the GA-SBCAP3350. Yeah, it really needs a better name, but this slightly larger micro-computer offers more power and modularity than the Raspberry Pi
The GA-SBCAP3350 measures 146 x 102mm, which is nearly twice the size of the Raspberry Pi at 85 x 56mm. Gigabyte’s board looks more like a PC motherboard, and in some ways it works like one. It is still much smaller than even mini-ITX form factor boards, which measure 170 x 170mm. Gigabyte built this board with a Copper PCB design and a large aluminum heat spreader on the underside. This will allegedly allow for better thermal performance and longer life.
This board doesn’t actually come with everything you need built in, which some might consider an advantage. You can add your own RAM to the board thanks to the single DDR3L SO-DIMM slot (it can handle up to 8GB). There’s also a mini PCIe slot for plugging in an mSATA SSD drive. Next to that is a second slot to accommodate a half-length Wi-Fi card. There are two standard SATA connectors as well.
At the heart of Gigabyte’s mini computer is an Intel Celeron N3350 CPU (Apollo Lake family), which is a dual-core chip clocked to 1.1GHz with turbo boost up to 2.4GHz. This is not exactly a blazing fast GPU by mainstream computer standards, but the Raspberry Pi 3 is much more modest with its Broadcom quad-core ARM chip. The x86 architecture on the GA-SBCAP3350 allows you to run more powerful software and operating systems. The CPU is soldered to the board, so it’s the one thing you can’t upgrade.
The GA-SBCAP3350 comes with a ton of I/O ports as well. You’ve got two USB 3.0 plugs on the back, plus four more USB 2.0 connections available via pin headers on the board. There are dual gigabit Ethernet ports. For video, you get both VGA and HDMI, and the HDMI can do 4K resolution at 30Hz.
So, the GA-SBCAP3350 is sort of in between the Raspberry Pi and a “full” PC motherboard. Gigabyte seems poised to market this board to businesses, but anyone interested in building a tiny PC might be interested. We don’t yet know the price or launch date, the latter of which will probably determine how popular this device is with hobbyist tinkerers.
*5) Accessible Textbook Options for Students Who Are Blind or Visually Impaired
For anyone reading this article, the phrase “back to school” is likely to be rich in associations–going to a new school, taking new classes, finding the right classroom on the first day of the new school year. For blind students, making sure they have textbooks available in an accessible format is definitely part of the challenge of starting a new year. As I reflect on my own back-to-school experiences spanning many years, I can’t help thinking about how much the landscape has changed with regard to textbook accessibility. Technology has made more textbooks available to the blind than at any other time, and in a variety of formats. Today, it is easy to transport reading material without needing to carry a heavy backpack full of braille volumes–yes, I did that as a high school student. Today, braille, electronic, and audio material can coexist with ease, often in the same electronic file.
In this article, we will take a brief look at the various options available to blind students, and provide some resources for locating these materials.
1. Learning Ally:
Having Someone On Your Side When You Need Accessible Textbooks
For 70 years, the non-profit organization known today as Learning Ally has provided recorded textbooks for thousands of students who have a print disability. Back in the late 70s, I actually remember receiving textbooks from what was then known as RFB (Recording for the Blind, and later RFB&D, Recording for the Blind and Dyslexic) on reel-to-reel tape. All of the young people reading this may want to Google that phrase later. When I was in college during the 80s, I vividly recall boxes of cassettes containing many hours of recorded audio and, in some cases, volunteers playing musical excerpts on a piano in order to get the material across to me in an accessible manner. All descriptions were vividly–sometimes painstakingly–described, as was the case for charts and graphs. There is probably no way to know how many thousands of hours have been put in by volunteers all across the United States, reading everything from literature to complex scientific reference books aloud.
Eventually, books were moved to electronic formats, and it is now possible to download content to a specialized player or app that can handle DAISY content, or via the mobile apps provided by Learning Ally. Along with recorded audio,
Read more about Daisy content here:
it is sometimes possible to read the text of the book as well, and all Learning Ally books are marked up in such a way that students can navigate by page, section, and subsection within a book. This is most helpful when needing to quickly look up material. Gone are the days of switching out cassettes and fast-forwarding to the desired content within a textbook.
Membership in Learning Ally costs $135 per year, but it may be possible to receive assistance if you are unable to pay the cost of membership.
Accessible Textbooks in PDF Format
For the past 20 years or so, I have taught a Music Appreciation class at a local community college. While some of the textbooks I have used over that time have been available from Learning Ally, others have not been. Also, if a textbook is available, it is often not the latest edition of the book. This may work for a student, although it is not ideal, since page references change from edition to edition, and material is updated, added, and deleted over the years. For me as an instructor, it was necessary for me to always use the latest edition of the textbook I was teaching from, so I reached out to the publishers, and requested an electronic copy of the text. Almost always, I was provided with PDF (Portable Document Format) files of the text. PDF files are commonly used because the format makes it possible possible to package text and images in files that are not terribly large. While this is great for the sighted community, PDF files can be challenging for people with visual impairments.
In a best-case situation, the blind student will receive PDF files that have been marked up in such a way that text does not appear out of place–columns being run together, or picture captions inserted in odd places–and material hyperlinked to other parts of the text, or the Internet. Often, however, PDF files will not be properly formatted for the best reading experience with a screen reader. In this case, the student will have to make the best of the situation. If the text is clear, and if pictures are properly captioned, then the lack of hyperlinks may be only an inconvenience. If text is out of order, and certain parts of the text such as the buttons on a diagram of a piece of electronic equipment are not labeled, things can get a bit more complicated.
Sometimes, a PDF file will contain an image of the text in a book, but not the actual text itself. Think of taking a picture of a grocery list, rather than typing the list into the notes application of your phone. In this case, OCR (optical character recognition) software may be required to convert the image in the PDF file into text that can be read by a screen reader. Today’s OCR software, whether specialized for the blind or mainstream, is increasingly able to produce quality results from an image such as that found in a PDF file.
I have found book publishers to be quite willing to assist me in obtaining electronic copies of their text, when they became aware that I was blind, and why I needed the textbook in electronic format. Often, publishers offer their books in a format that must be read by software they provide. This software is often not accessible to screen readers, and the publishers must be made to understand the problem. This sometimes takes time and patience. Remember to be clear, concise, and courteous when talking to textbook publishers. You may be the first blind person with whom the representative on the other end of the line has ever spoken.
2. Obtaining Textbooks From Bookshare
For years, Bookshare has been a place where blind people have been able to obtain books of all types, including textbooks for students. In the beginning, Bookshare received books from volunteers who scanned and proofread books that were then placed on the website. Today, although volunteer scanners and proofreaders are still a vital part of the service, many works are now obtained directly from the publisher. It is also possible to request books that can be scanned, proofread, and placed on Bookshare to be enjoyed by all.
It costs $75 to join Bookshare for the first time, and $50 per year thereafter, but students can use the service for free as long as they are in school.
Bookshare provides ebooks in a variety of formats including DAISY, electronic braille files, and EPUB , which allows for easy reading of books on any number of mobile devices,
Read more about EPUB format here:
both mainstream and blindness-specific. Bookshare books are text only, and do not contain an audio option.
Other Resources for Obtaining Accessible Textbooks for People Who Are Blind
Although not primarily intended for this purpose, the National Library Service’s BARD (braille audio reading and download) site sometimes contains books that are used in the school setting. Books on music, psychology, and computers are just a few possible topics. It is likely that the latest edition of a textbook might not be available, but there might be enough useful material available to get a student started in the right direction.
It is sometimes possible to find books in hard-copy braille from places such as BARD. When I was in college, I found an agency that produced braille volumes for me at a nominal cost. The problem I found was that the books took up a lot of room, and became out-of-date in just a few years. I personally would not spend a lot of money having books produced in braille today, unless it was a topic such as math that I really wanted to be able to explore in a way that only hard-copy braille would allow.
One of the textbooks I used when teaching my music appreciation class used VitalSource, a provider of eTextbook content to distribute their book to me. I eventually obtained the book in PDF format, so I didn’t use the site for long. My brief experience was quite pleasant, however. I was able to move around the book with no problem, and content was hyperlinked in a way that provided easy access to the Internet and other parts of the text.
Amazon, Google, and Apple are all actively providing electronic texts on a daily basis, and each of those companies is showing an increased commitment to, and understanding of, the needs of those who have a print disability. It would definitely be worth checking out any or all of these options when looking for an accessible electronic textbook.
How to Find Accessible Electronic Textbooks
With so many accessible textbook options available these days, it is important to have a resource that will pull all of this information together in one place, making it possible to find out whether a textbook is available in an accessible format, and where the book can be obtained.
1. The Louis database from the American Printing House for the Blind is one such resource.
It is possible to easily search the database for a desired textbook. Detailed search results are provided, ensuring that you are in fact looking at information related to the book you are interested in. You can view the book’s table of contents, see what formats are available–sound, braille, etc.–and know where to go in order to obtain the title.
The Bottom Line
Although it is still possible to come across a needed textbook that is not available in an accessible format, it is less likely today than at any other time. Publishers, content providers, and the blind community are all working together to make as many titles accessible to the blind as possible. If I were to go back to school today, I would be less stressed about trying to find available accessible textbooks than I would have been a few years ago. If the professional staff who work at schools across the country and the students with visual impairments who attend those schools are willing to work together, they should be able to work out the necessary accommodations to access required printed material. When those materials are not available, publishers will hopefully be willing to do their part to meet the needs of the visually impaired student.
Here’s hoping that any future updates to this article are able to provide even more resources for obtaining accessible textbooks for students with visual impairments.
Source for article:
*6) Blindness and Medical Facilities, Take One
Advocating for Yourself in an Emergency Medical Situation: Advice for People with Visual Impairments
One morning I was standing in my bathroom about to get into the shower and prepare for my day when my world literally turned upside down.
One moment, I was standing, mind racing about my clothes, my work schedule, my coffee, my dog–and the next, I had the sensation that my thigh had been struck by a large object and I was instantly on my back on the cool tile floor. I knew immediately that I could not stand up. Slowly, carefully, I scooted backward out the door and across the bedroom, where I could reach a phone and call 911.
The paramedics talked to me on the phone. They told me they’d have to break down a door to rescue me and asked me to choose front door or back.
I heard breaking glass, men’s voices, and, before long, I was placed on a stretcher and carried down my very steep stairs to the cold outdoors and the waiting ambulance.
“Two things I need you to get,” I told them. “My guide dog and my iPhone.”
Later, there would be a stretch of hours when I remembered none of this, but in that window of crisis, with no one but me to advocate for me, I gave clear directives. I told them how to fasten my golden retriever’s guide harness and told them where the iPhone and its charger were located. In the ambulance, I called my daughter 1,000 miles away so that someone knew where I was going.
It turned out that my left femur, the longest bone in the body, compromised by cancer a decade earlier, had snapped and displaced. I spent eight hours in the emergency room, during which time my surgeon explained to me that serious reconstructive surgery was scheduled for the next day. A metal plate about eight inches long would be screwed to my bone and wired to my hip. The recovery period, during which I would be unable to bear any weight on that leg, would last about three months.
Nothing To Do with Blindness
Like many AccessWorld readers, I am a seasoned veteran of blindness. I mastered my alternative techniques long ago and think about blindness very little, if at all.
I live alone, manage my own home and work life, travel independently with a guide dog or white cane, and have a delectable array of technological tools to make everything from writing a book to color-coordinating a room manageable without sight.
My injury had nothing to do with blindness. My getting to the phone in a familiar environment didn’t either. Directing the paramedics to get my dog and phone was, if anything, easier for me as a blind person because I know how to use my words to describe objects and their locations.
Once I was in that hospital, however, my familiar ground was gone. My daughter had immediately called two close friends who met me at the emergency room and they told me that, from my blurred state of shock with morphine added, I repeatedly asked, “Where am I and how did I get here?”
Of course. As blind people, independence is deeply rooted in our ability to take control of our own lives. Essential to taking control is the basic awareness of “Where am I and how did I get here.”
I was in the emergency room for eight hours before a room in the Joint and Spine Center of the hospital became available. About halfway through that time, my brain cleared and I became aware that I needed to be alert, to be my own advocate.
While my blindness and hearing impairment are inconsequential to me on a daily basis, they were front and center to these medical professionals who did not know me. Advocating for myself was a matter of survival.
My gratitude is abundant for many things that occurred that traumatic day, but two particularly fortunate facts were that I was in a large, flat room rather than on a staircase when my femur fractured, and that my hearing aids were in my ears. Without them, communicating with paramedics or emergency medical personnel would have been next to impossible.
I had been in shock. I was in excruciating pain. I was told not to sit up or move my leg in any way as I could further displace the broken parts. Time and an IV drip of medication gradually returned my lucidity and I knew communication was key.
A first step toward self-advocacy was to ensure that my hearing aids could stay in my ears before, during, and after surgery. Without them, I explained, I might miss questions or information in preparation or recovery. Permission was granted. As it turned out, I never took both hearing aids out throughout my three-week hospital stay. Not being able to see people come and go, I knew I needed to hear them.
Next was establishing a certain style of communication with staff. While being transported to my hospital room, I began what would be my signature survival tool throughout my stay: engaging each person in dialogue and asking questions. What floor are we going to? What is the room number? What is the name of each drug you are asking me to take and what is its purpose? (I happen to have a high sensitivity to all medications, so many routine doses were adjusted in these preliminary conversations, which helped me maintain clarity while also building relationships with medical staff).
And about that medical staff. When you are in the hospital, a steady stream of people come and go, with shifts constantly cycling nurses, personal care assistants, doctors, physical therapists, occupational therapists, social workers, and housekeepers on and off duty. They might wear different colors and/or name badges, but for me, a blind person who doesn’t have particularly stellar voice recognition skills, asking people to identify themselves was another key factor in maintaining my quality of care and wellbeing.
At the foot of my bed was a monitor that displayed various kinds of constantly updated information specific to my treatment. Information is essential to advocating for oneself. The kinds of information updated at the foot of my bed included the name of my nurse and personal care assistant, my schedule of physical and occupational therapy, meal times, and special events available to patients (such as healing touch or yoga.) It was all right there for me to read at any time, but in print and therefore completely unavailable to me.
Keep it Light
Whether you are an introvert or an extrovert, keeping a running dialog going in this kind of situation is, integral to survival. Sometimes I asked questions in a straightforward way: “Can you put a note in my chart for staff to identify themselves when they come in? I’m good at being blind, but never did very well in the voice recognition department.” Or, “Can you read my board to me? They haven’t put one up in braille yet.”
In other words, I was clear about my needs, but tried not to communicate those needs in any way that might be perceived as strident or critical.
I was there, as you recall, because my femur had fractured. I had had serious reconstructive surgery, and had to learn new skills like how to transfer safely from the bed to the wheelchair and from the wheelchair to the toilet or shower bench, how to stand up on my one good foot when necessary and not lose balance, and much more.
Even though my being there had everything to do with my leg and nothing to do with my blindness, rare was the nurse or aide who did not ask, “So, exactly what can you see?” Again, I tried to keep it light, but doing so and remaining patient wasn’t always easy.
I frequently said things like, “I see with my hands. If you put my hand on it, I will see where it is.” If accompanied by a relevant demonstration, that explanation was generally pretty effective.
I quickly learned to make sure everything I needed was within reach before a newcomer left the room. If a technician came to draw blood and moved my laptop out of the way to reach my arm, even though it was six inches away, that laptop was essentially invisible to me. I learned to make quick checks to locate the emergency call button, my iPhone, laptop, and water pitcher each time I returned to my bed or wheelchair from the bathroom or the physical therapy gym, or after any staff person had come to call. When moving about is next to impossible and a needed object has been moved from, say, the table on the left side of the bed to the table on the right, locating it is problematic for someone who can’t see. I found that by routinely checking and interacting with staff about this environmental checklist, people learned and became much less likely to inadvertently move objects from one place to another.
Payoff in Wellness
While it might sound a little exhausting (and sometimes it can be), my continually engaging in conversations with all those responsible for my care enabled me to focus on getting stronger and getting well. Even while rooted in a hospital bed, unable to move without assistance, we can still advocate for ourselves, control our own environments to a point, and thus maintain our independence. The physical therapist who was at first troubled that I had no physical eyesight was laughing with me as I “drove” my wheelchair down the hall. Staff who began noticing that I was constantly using my laptop and iPhone eventually caught on to texting me my therapy schedule every evening as an alternative to expecting me to read that inaccessible monitor at the foot of my bed.
The doctor who discharged me told me that I was being released at 18 days rather than the anticipated 24 because I was “so fiercely independent” and determined “not to allow a disability be a disability.” Interpret that as you will, but I believe what actually facilitated my speedier release was that by advocating for myself, I took the emphasis off my blindness and put it where it belonged: on my accident, surgery, and recovery. The payoff was that many members of the medical team learned something about blindness in the process and I was able to get home for Christmas!
*7) Accessing Quality Technology Assistance
Getting the Most out of Sighted Computer Assistance: How to Help the Helpers
In the June issue of AccessWorld we published a letter from a reader who sought the best ways to help sighted people assist you with computer issues when you use a screen reader like JAWS. Some of our best article ideas come from you, our readers, and this is definitely a topic we felt was worthy of an in-depth look.
Read the letter here:
So keep those ideas coming, and read on as we attempt to offer some useful advice on this often-perplexing topic.
Exploring New Software
You may have received training in using your screen reader, and perhaps Microsoft Office and a few other popular applications, but in nearly any work or school environment there will be other software packages you’ll need to learn and use. Unfortunately, the trainer or other individual who is an expert in this new software may know next to nothing about screen readers and how they work.
If you are scheduled to be trained on a new software package for work or school, there’s a lot you can do in advance to prepare yourself. Don’t wait until that training session to open the software for the first time. If you can, get an advance copy, a guest login, or download the demo if it’s available.
If you are preparing for a group training session, contact the training specialist ahead of time. Inform him or her that you will be attending the session and that you will be using the software with magnification, speech, braille, or any combination, depending on your particular circumstances. Inquire if it would be possible for you to preview his or her notes and/or presentation slides. Even if the training is going to be one-on-one it’s a good idea to alert the trainer in advance. If you’ve had a chance to check over the software (see below), compile a list of questions about both access and the application itself, and forward it to the trainer a day or two before your session. It’s far more likely that the trainer can answer your concerns if given the opportunity to do a bit of research ahead of time rather than being asked on the spot.
With any new software, use your screen reader’s navigation keys to “scope out” the terrain. “Begin with the Tab key, which often moves you from application control to control,” suggests Steven Kelley, CVRT, CRC, Vision Rehab Therapist with The Iris Network in Portland, Maine. “Also review the screen from top to bottom using the Up and Down Arrow keys and your screen reader’s mouse review keys. Try to construct a mental map of what’s where, such as the fact that the last control you reached using the Tab key is actually located near the upper left of the display.”
Explore the menu structure. Most applications include a Help tab. Check for a “keyboard commands” option, or perform a Help search for the term.
Alternatively, you can find comprehensive lists of keyboard commands for most popular applications online. Kelley suggests you begin your search at the RNIB keyboard shortcuts guide for help with Windows.
Other handy keyboard resources list keyboard shortcuts for the Statistical Package for the Social Sciences (SPSS),
and for a Salesforce Console .
Perform a search for any other software by entering its name and the term “keyboard shortcuts” into your preferred search engine to find more.
Now that you have a list of keyboard commands, copy and paste the list into a word processing document, or create a braille keyboard guide. “Don’t try to memorize the entire list right away,” Kelley advises. “Identify which keyboard commands you will use the most as you explore the software and start with those. Add a few new commands every day, or as you need them.” Keyboard commands are very much like new vocabulary words. Use them three or four times and they are yours forever.
Many software accessibility issues come from unlabeled graphics and inaccessible controls. Modern screen readers enable you to label these controls with text that makes sense to you. What does that particular control do? If you can’t figure it out from context, why not just give it a try and invoke it with your mouse-click hotkey? Review the subsequent screen and you may just be able to determine the button’s function. Happily, very few software packages include controls with the unlabeled function: “Blow up this computer and make it never work again.”
Get Help Before you Get Help
Most screen reader users are aware that both Apple and Microsoft offer special phone lines dedicated to assisting users of their respective operating systems’ accessibility features. Both tend to view their mission in extremely broad terms, however. Both companies have implemented easy ways for their accessibility support representatives to connect to remote computers so they can view the problems and offer solutions. If you are faced with an application screen that does not speak at all, or unlabeled controls you really need to familiarize yourself with, give them a call and ask for help deciphering and labeling.
You can reach the Microsoft Accessibility Answer Desk at: 800-936-5900.
You can reach the Apple Accessibility Hotline at 877-204-3930.
The Be My Eyes remote assistant
and BeSpecular mobile app
are also useful resources when trying to decipher a confusing screen element or hardware switches and buttons on a new physical device. Be sure to document what you learn as soon as possible. It’s amazing how quickly a trio of controls can turn into a game of Three Card Monty, with you left wondering which control is under which button.
Kelley recommends picking a good time for your initial software exploration. “Expect that things are not going to work perfectly the first time,” he notes. “Is the beginning of your day the time when you will become the least frustrated, or do you work better at the end of the day when you can more easily put frustrating things aside for the day?”
Lastly, if you’re waiting for technical support for help with an application error, document all you can about that error ahead of time. If there is an error message, write down the message text. Can you duplicate the error with a specific series of steps? If so, document those steps so you can demonstrate the error. Use your keyboard’s Print Screen key to capture your display and then paste the screenshots into the same document where you write down the steps causing the glitch.
Also note any message text and error number. Do a Google or Bing search for the error. You may be surprised to learn there’s a simple fix or workaround that does it require help after all.
Optimize Your Screen
One issue many trainers have, and so do other people who may be helping you, is that they are not viewing the same screen that you are. Remember, screen readers often buffer information and present it in a way that makes it easier for you to access and navigate. “When you say you are near such and such a word, that may just be your text or virtual cursor,” says Kelley. “The mouse pointer, which is where the sighted person may be looking, may be on the opposite side of the screen, or even off screen.” Luckily, most screen readers offer a way to highlight your work space. For NVDA, you’ll need to download and install the Focus Highlight add-on, available from the NVDA Community Addons page.
JAWS version 18 Build 2945 for May 2017 and later now offers Visual Tracking, which is turned on by default. macOS VoiceOver users can press CTRL + Option + Command + F10 to toggle a “Caption Panel” on and off.
Lastly, before you begin a training or support session, ensure that the window you’re working on is maximized and is the only application window that is open. Otherwise you may be asking someone to help you with a postage-stamp sized window overlapped by several other data windows.
Going One on One
According to Kelley, when it’s time for that one-on-one training session, “It’s crucial that you find a way to put yourself in the driver’s seat of your training session. Introduce your screen reader and how you use it to interact with a computer.” Consider offering a brief screen reader demo. Show the trainer how the screen reader works, how you use it to write and edit text, navigate a webpage, fill out forms, and perform other routine tasks.
Select an installed voice and speech rate you feel will be comfortable for your trainer to understand. You may enjoy using Espeak at chipmunk speed, but just as you will become quickly confused and frustrated with a trainer who steps in and starts performing mouse clicks, your trainer will feel equally confused and overwhelmed if the voice you are working with sounds like gibberish to him or her.
Many instructors attempt to teach by demonstration. He or she may grab your mouse and begin clicking hither and yon. Insist that you be allowed to issue the commands, noting. “I learn best when I can work hands-on.”
If you haven’t already found a list of keyboard hot keys, ask the trainer to help you compile a list. Explore all of the top-level menus and controls with the trainer. “Ask the trainer to help you to develop a mental map of the application interface,” Kelley suggests. It’s useful to know the control you need to use can be reached with repeated presses of the Tab key. It’s even more useful to know you can quickly access that same control by pressing Alt + J, or the CTRL + End key followed by a single Shift + Tab.
“If the control is difficult to locate, ask the trainer to help you move to spots just before and after that control,” Kelley advises. “At least now you will know it’s somewhere between them.”
Make use of your screen reader’s quick navigation keys to move from heading to heading, or from list to list, but don’t be afraid to ask the trainer for a unique word or character string that appears near to where you wish to navigate. Then use your screen reader’s Find command to move your mouse cursor to that position. If there are unlabeled buttons and other controls, ask the trainer to help you label them. Also remember that often a button that is unlabeled may include its function inside the tag, or at least enough of it to offer up a much-needed clue. For example, an “Export to CSV” image control may be unlabeled, but the tag may include the string “CSV,” which is the extension name of a generic spread sheet file. Knowing this, you may be able to use your screen reader’s Find command to locate the string and the button it marks.
If you’re working over the phone with a trainer or tech support rep, they may inadvertently say something like, “OK start out by pressing the green button.” Explain to the support technician that you are sight-impaired and using a screen reader. Offer a brief description of how a screen reader works, and when they reply, “Our application doesn’t support a screen reader,” assure them that in nearly all cases, the screen reader merely passes the normal program information along–it does not affect the way the application works.
Remember, frustration can go both ways. You may be frustrated that the tech-support person does not understand a screen reader. That support person may be equally frustrated that you don’t understand why you cannot work things the way he or she has been trained to assist. “If all else fails, ask to speak to someone else, perhaps a supervisor,” advises Kelley.
With all your new computer knowhow, eventually there will come a time when you are asked to help a family member or other sighted person with their computer problems or issues. There are two things to remember here:
Their page will not be laid out the same way as yours. What you are accustomed to finding at the end of the bottom of a webpage may actually be on the top right in a different color on theirs. So use control names as much as possible to describe what they need to do, and remember, they may not know that CTRL S saves a document; they are used to doing this with a mouse click.
Your screen reader announces the names of the various icons, such as Save, Cut, and Paste. The sighted user will see only graphical icons, and if they are very inexperienced they may not know what each image means. Usually, if you hover the mouse pointer over an icon, a tool tip will appear describing the icon’s function. If not, show them how to turn on Narrator or VoiceOver briefly to hear what the icon does.
Although we have focused mostly on computer use, many of these tips, especially the last section above, also hold true for mobile help as well. Show a sighted person how to temporarily turn on VoiceOver or TalkBack, and they may be able to decipher that emoji that’s so tiny on the screen, it’s difficult to tell if their friend is asking them to “grin and dog it” or “grin and bear it.”
*8) Self-Advocacy in the Healthcare System
Blindness and Medical Facilities, Take Two: More About Advocating for Yourself in a Medical Situation
In the March issue of AccessWorld,
I wrote about an unplanned hospital stay and the lessons I gleaned from that experience. Two surprises ensued: first, I wound up returning for an even longer hospital-and-rehabilitation tour of duty and, second, I found out that many readers wanted to talk about navigating medical situations as people with visual impairments or blindness. Here, then, is what we might consider the second part of the medical adventure, in which I’ll share some of my own experience along with what readers and others have to say. The outcome, we hope, will be some useful preparation for all of us for the next stressful medical encounter.
My Repeat Performance
My initial hospital and rehab adventure began with the sudden snapping of my left femur. The bone had been weakened several years earlier by radiation and aggravated eight months earlier by hip replacement surgery. A prosthetic hip is like a ball on a stem. The stem is inserted into the femur, the longest bone in the body. The procedure is akin to threading a peg into a pipe, and my “pipe” was fragile and broke unexpectedly. The repair that was done involved an eight-inch metal plate and several wires. After eight weeks of mobility in a wheelchair, an x-ray determined that the bone was broken yet again, the metal plate was at a very unhealthy angle, and all wires were broken.
The original incident with follow-up hospital stay was in Ohio. The failure was discovered in Florida. Consequently, finding a surgeon in Florida to do the reconstruction was the best plan. I did find a surgeon who specializes in hip and leg reconstructions, and he took my case. Some might find the medical details gruesome and some might find them fascinating. If you are the first sort, skip the next paragraph!
Since the femur had broken at exactly the point where it needed to connect to the prosthesis, repairing it at that juncture (as the first surgeon had done) wasn’t the best plan. The new surgeon’s approach was to tear out the now ten-month-old prosthesis (no easy feat) and replace it with one that had an extended “stem.” The typical hip replacement stem, when inserted into the femur, ends near the top of the thigh. My new one ends at mid-thigh. In addition, a cadaver bone was placed over the section of femur most damaged by radiation and fractures (about 2.5 inches). And finally, the entire bone was wrapped in heavy cable to hold it in place.
This second surgery meant spending one week in hospital followed by several in a short-term rehabilitation facility. In Ohio, I had a network of friends who visited every day and kept my spirits high and my focus off medical issues. This time, however, I was in a state where I knew virtually no one and thus had few diversions and no one to help me navigate the unfamiliar human or mechanical terrain.
The night before my surgery, I found genuine solace in Googling the hospital and surgeon. When I found the hospital on a “100 best” list compiled by a major news organization and the surgeon identified as a respected teacher and innovator in his field, my optimism regarding outcome soared!
In the operating room, I made sure everyone knew I wore hearing aids and secured approval to keep them in. I explained that, because I am completely blind, I obtain much vital information by hearing. Without the hearing aids, that would not be possible.
My first day after surgery was spent in the intensive care unit. Once I was aware of my surroundings, I realized that my space wasn’t separated from the rest of the unit at all. The only thing between me and staff, visitors, and other patients was a curtain. Consequently, it was impossible for me to distinguish whether people were talking to me or to someone else. It sounds silly, but when you are already vulnerable and unable to move, this kind of thing adds yet another layer of stress and vulnerability.
The one piece of technology I had with me even in ICU was my iPhone. I’m not sure whether I made many calls or sent messages during that phase, but I clearly remember the sense of connection it gave me to have a working phone in my hand.
Once I was returned to the orthopedic floor, I connected my laptop as well.
Because the greatest problems connected with blindness are, as much in a medical facility as anywhere else, mostly related to myth and misunderstanding, I came to appreciate my technology in its ability to function as a bridge to understanding. A nurse or aide or physical therapist who might at first see a blind person as strange will generally relax a bit upon seeing a tablet or smart phone or other device that is so familiar. Being a bit geeky, in other words, was an advantage in this environment.
Of course, my access technology had plenty of practical uses as well. In addition to continuing to do my job after the first few days, my technology solved a variety of small problems.
In the short-term rehab facility, I continued to find random pages of print on the foot of my bed, the chair, the table. Usually, the KNFB Reader app identified these for me as a calendar or note about my recovery plan. When no one responded to my call light (which happened frequently), I took to wheeling myself to the doorway of my room and scanning the hall with TapTapSee to see if there were any staff nearby.
What Others Have to Say
We heard from AccessWorld readers who wanted to use the article to post in medical employee areas or as a handout in college classes. Most importantly, however, we heard from readers who had experienced the “blindness meets medical situation” up close and personally, either for their own health crisis or that of a loved one. The input was unanimous: everyone wants more information on this topic and more of a road map for navigating and advocating in these troubled waters.
One reader who wrote to us was Nancy Irwin, an access technology instructor in South Carolina. Her husband, Billy Irwin, had gone to the emergency room more than once and each time was perhaps more stressful than the one before it. Both Nancy and Billy are blind.
Although they had gone together one of those times, the worst was when he went alone in an ambulance. Upon arrival, Billy was seated in a wheelchair, checked in, and pushed aside. Unclear about his surroundings or what might happen next, he was neglected for three hours. When he vomited on the floor, he says staff was angry with him.
Nancy caught up as soon as she could, and both reported that once he had someone with him, the situation was somewhat diffused. The couple began communicating with one another and others around them. Other patients, they say, became involved in advocating for a guy who was just plain sick, like everyone else waiting, and who needed additional information due to blindness.
When Billy was admitted, trays of food were sometimes delivered without any verbal information announcing the fact.
Both say that the more they interacted with nurses, the more manageable the situation became, but it was never easy.
Ironically, Billy works as an emergency manager for amateur radio operators in the area, disseminating emergency information to police, fire, and medical responders, so he is no stranger to the emergency scene.
“The problem,” Billy says, “is that people just have no idea how to deal with a blind person. They need training and they need exposure to real blind people.”
The only marginally “accessible” piece of technology made available during Billy’s hospital stay was the combination TV remote and call light. The button marked with the braille “n” on the remote was the one that would summon a nurse. Ironically, the remote was not otherwise accessible, but the couple did contact a nurse who spent the time to familiarize them with it.
Lisa Salinger, an access technology trainer and administrative assistant for BlindAlive, has been navigating another kind of medical facility experience. When she realized one morning that her housemate and friend was having a stroke, she called 911. After the hospital stay, her friend was moved to a rehabilitation facility for therapy and Lisa was the family member who came day after day to bring food, encouragement, and companionship. Gradually, Lisa taught at least some nurses and nursing aides how to interact with blind people.
Finding printed menus, calendars, or notes on her friend’s bed, Lisa took pictures to read them with her iPhone app.
At times, when there was no one available to assist with a medical procedure in time, Lisa motivated staff to respond by offering the alternate choice that they teach her how to perform the task needed.
Similarly, when Billy Irwin grew tired of waiting for staff to disconnect his IV pole every time he needed to use the bathroom, he found someone to teach him how to disconnect it himself.
Like Lisa and Billy, others find workarounds to getting things done in a medical facility and/or gradually gain the attention and respect of one or two staff members who will provide needed information or hands-on demonstration. Sometimes, though, the “soft” approach isn’t sufficient.
Tom Tobin, an Ohio fundraising professional and AccessWorld reader, recalls a time when medical professionals had to be dismissed because there was such a lack of respect. When he was having his insulin pump installed over 20 years ago, the attending physician showed such a lack of regard for the patient’s ability to manage and understand his own diabetes that Tom fired him and found another.
That Mind-Body Connection
Every stress-filled example readers have shared with me struck at least one chord with my own experience. From not knowing food was in the room when you are starving, to missing the printed information shouting at you from all directions, to being a visitor and finding the elevator buttons do not have braille on them–each minor frustration interferes with wellness. Healing the body is assisted or hindered by the patient’s state of mind, and when a patient feels discounted or ignored due to low vision or blindness, the quality of their care is diminished.
So … what can we do to make interactions with medical facilities more acceptable?
Advocate, Advocate, Advocate
One thing most of us as visually impaired people can do is talk! I was so unprepared for what happened when first transferred from the Florida hospital to the short-term rehab facility that I was temporarily traumatized. I was delivered, via wheelchair, to a room and left. No orientation or familiarization. No assurance of someone coming back in some amount of time. I had no idea where my belongings were, where the call light or the room phone were, or where I was! I wasn’t very strong yet nor was I adept at propelling the wheelchair from place to place. Eventually, I reminded myself that I could think, that I needed to be my own cheerleader/advocate and, slowly, tentatively, began moving about the room to explore. Suffice to say, the situation improved from there, but there were many more moments of this variety. The longer I was there, the stronger my conviction that I needed to depend on myself to get what I needed. Usually, this was accomplished with a smile, but sometimes, the gentlest among us need to get a bit tougher. Once I began exploring my environment and getting outdoors (propelling a wheelchair without benefit of white cane is a learning experience in its own right), my attitude improved dramatically. My desire to get out of rehab probably expedited my recovery!
A Little Help From Your Friends
There was a stark contrast between my hospital experience in Ohio, where I had the support of friends, and the one in Florida, where I was pretty much alone. If you know ahead of time that you are going to be in a hospital or medical facility, try to line up support from family and friends in advance. Even a casual friend or acquaintance will look out for your individual needs more than relying exclusively on staff who have dozens of other patients needing attention.
Use Your Technology
I kept my iPhone with me at all times and usually my laptop or braille notetaker as well. This kind of technology can serve as tangible evidence that you are more like than unlike the medical staff with whom you are interacting. Asking about any technology in the room was beneficial, too. As the Irwins pointed out, once they found someone willing to provide a verbal/tactile tour of the remote, they were able to enjoy TV shows and thus connect in another way with staff as well.
Explain Those Techniques
When I began using a walker in physical therapy, I asked when I could use it on my own time, in order to build strength and practice. For several days, my request was denied. Finally, I realized it was blindness related. The therapist was afraid to allow me to practice walking without assistance for fear I would crash into a wall or trip over a chair. Patiently, tediously, I explained how I navigate a familiar environment. I had to demonstrate repeatedly–“I touch the wall to confirm my location …” and “I touch the door frame before turning to confirm that I am allowing sufficient space for the walker and me …” and so on. I found myself explaining frequently about muscle memory and echolocation, but the payoff was improved interaction with medical professionals and decisions based on recovery rather than misconceptions about blindness.
Use Your Power
You or your insurance company is paying for your care. If the care is compromised by misunderstandings about your ability as a person who is blind, change it. If your cellular service was inadequate, you would change companies. If a medical situation becomes absolutely untenable, change it as well.
Being in a medical facility where others control many of your simplest activities is stressful for everyone. Adding blindness to the mix increases confusion on both sides: the patient with the visual impairment needs additional information and the medical professional often come to the bedside with ill-conceived notions of a blind patient’s capabilities. There is a profound need for training in these facilities. Perhaps some readers will pick up this challenge and initiate trainings in their communities. In the meantime, be your own advocate, take a friend or family member if possible, and depend on your technology to keep you connected and help bridge the gap between you and your medical team.
See the attached audio file.
*10) WALKING THROUGH THE FOG
In 1803, an English pharmacist named Luke Howard forever changed the way we talk about clouds.
He helpfully suggested that clouds be classified into three groups.
Layered clouds he called stratus. Fluffy clouds he named cumulus. And the high feathery ones he labeled cirrus.
More than 200 years later, meteorologists and schoolchildren alike still use Howard’s terminology.
In 1896, the International Cloud Atlas (there really is such a thing) determined that there ought to be ten classifications.
The atlas has never threatened to kick Howard to the curb. But it quite likely introduced a common English phrase.
The ninth entry on the ICA’s list of cloud categories is the plump, pillowy “cotton ball” clouds that dot the typical summer sky – a picture that elicits such a feeling of well-being or elation that someone can be said to “be on Cloud Nine.”
Clouds may look substantive. But there’s really not much to them.
Stanford professor James Trefil points out that an ordinary cloud, which may have the dimensions of several football fields, contains only about 25-30 gallons of water. That’s “about enough to fill a bathtub,” he reports.
Every time you stroll through a bank of fog, you’re in the midst of a cloud that for one reason or another hasn’t taken flight.
Trefil observes, “If you walk 100 yards through a typical fog, you will come into contact with only about half a cubic inch of water – not enough to give you a decent drink.”
But think of the power of those few water droplets.
They have the capacity to blind our vision, ground our air traffic, and even momentarily separate us from each other.
Spiritual fog is equally daunting.
When we can’t see God, or what God is up to, we can feel paralyzed. Everything stops. Such uncertainty definitely doesn’t feel like being on Cloud Nine.
But whenever you find yourself blanketed by a fogbank, literally or metaphorically, you can have this important assurance: You will get through this.
Fog lifts. No earthbound cloud is a match for the sun.
And our deepest uncertainties about God’s direction for our lives won’t last forever, either – if we are willing to wait and trust.
That’s because no spiritual cloud is a match for the Lord of heaven and earth.
— Authored by Glenn McDonald