What Is Assistive Technology and How Does It Work?

In the ear hearing aid
In the Ear Hearing Aid. Credit: Maica, Getty Images

"Assistive technology" is a broad term used to refer to multiple types of aids used to help adults and children with disabilities in their daily lives. Assistive technology doesn't need to be high tech. Assistive technology could be something that doesn't use much "technology" at all. Pen and paper can serve as an alternative communication method for someone who has difficulty speaking. On the other end of the spectrum, assistive technology could include extremely complicated devices, such as experimental exoskeletons and cochlear implants.

This article is intended as a basic introduction to assistive technology for individuals who are not experiencing a disability, so we won't cover every type of assistive technology used in every situation.

Universal Design

Universal design is the concept of building things that are useful and accessible for those with and without disabilities. Websites, public spaces, and phones can all be created with universal design principles in mind. An example of universal design can be seen at most city crosswalks. Ramps are cut into the curbs at the crosswalk to enable both people walking and those using a wheelchair to cross. Walk signals often use sounds in addition to visual signals to let people with vision impairments know when it is safe to cross. Universal design doesn't just benefit people experiencing disabilities. Crosswalk ramps are useful for families pushing strollers or travelers dragging wheeled luggage.

 

Visual Impairments and Print Disabilities

Visual impairments are extremely common. In fact, 14 million Americans experience a visual impairment to some degree, although most people just need the assistive technology of eyeglasses. Three million Americans have visual impairments that cannot be corrected with glasses.

For some people, it isn't a matter of a physical issue with their eyes. Learning differences like dyslexia can make it harder to read text. Computers and mobile devices like phones and tablets have provided a growing number of innovative solutions to help with both visual impairments and print disabilities. 

Screen Readers

Screen readers are (as it sounds) apps or programs that read back the text on the screen, usually with a computer-generated voice. Some visually impaired people also use a refreshable braille display, which translates the computer (or tablet) screen into a quiet braille readout. Neither screen readers nor braille displays are a panacea. Websites and apps must be made with accommodation in mind in order to read properly in screen readers and alternative displays. 

Both Android and iOS phones and tablets have built-in screen readers. On iOS this is called VoiceOver, and on Android, it's called TalkBack. You can reach both through the accessibility settings on the respective devices. (If you try enabling this out of curiosity, it may take several tries to disable it.) The Kindle Fire's built-in screen reader is called Explore by Touch. 

Smartphones and tablets with touchscreens may seem a curious choice for the visually impaired, but many people find them easy to use with the accommodation settings enabled.

Generally, you can set up the home screen on both iOS and Android to have an evenly spaced number of apps at fixed locations on the screen. That means you can tap your finger on the right location of the screen without having to see the icon. When Talkback or VoiceOver is enabled, tapping on the screen will create a focus area around the item you have tapped (this is outlined in a contrasting color). The phone or tablet's computer voice will read back what you just tapped "OK button" and then you tap it again to confirm your selection or tap somewhere else to cancel it. 

For desktop and laptop computers, there are a wide variety of screen readers.

Apple has built VoiceOver into all their computers, which can also output to braille displays. You can turn it on through the Accessibility menu or toggle it on and off by pressing command-F5. Unlike phone TalkBack and VoiceOver, it's actually pretty easy to enable and disable this feature. Recent versions of Windows also offer built-in accessibility features through Narrator, although many Windows users prefer to download more powerful screen reading software such as the free NVDA (onVisual Desktop Access) and the popular but expensive JAWS (Job Access With Speech) from Freedom Scientific

Linux users can use ORCA for screen reading or BRLTTY for braille displays. 

Screen readers are most often used in combination with keyboard shortcuts rather than a mouse. 

Voice Commands and Dictation

Voice commands are a great example of universal design, as they can be used by anyone who can speak clearly. Users can find voice commands on all recent versions of Mac, Windows, Android, and iOS. For longer dictation, there's also Dragon speech recognition software

Magnification and Contrast

Many people with visual impairments can see but not well enough to read text or view items on a typical computer screen. This may also happen to us as we age and our eyes change. Magnification and text contrast help with that. Apple users generally rely on the MacOS accessibility features and keyboard shortcuts to zoom to portions of the screen, while Windows users prefer installing ZoomText.  You can also separately adjust your browser settings to enlarge the text on Chrome, Firefox, Microsoft Edge, and Safari or install separate accessibility tools for your browser. 

In addition (or instead of) enlarging the text, some people find it more helpful to increase the contrast, invert the colors, turn everything into a grayscale, or enlarge the size of the cursor. Apple also offers an option to make the mouse cursor larger if you "shake" it, meaning you wave the cursor back and forth.  

Android and iOS phones can also magnify text or change the display contrast, although this may not work well with some apps. 

For some people experiencing a print disability, e-readers may make reading easier either by adding text to speech or by changing the display. 

Audio Descriptions

Not every video offers them, but some videos offer audio descriptions, which are voiceovers that describe the action going on in the video for people that cannot see it. This is different from captions, which are text descriptions of the words being said. 

Self-Driving Cars

This is not a technology available to the average person today, but Google is already testing self-driving cars with unaccompanied blind passengers.

Hearing Impairments

Hearing loss is extremely common. Although many hearing people tend to think of partial hearing loss as "hard of hearing" and full hearing loss as "deaf," the definition is much fuzzier. Most people who identify as deaf still have some degree of hearing (it just may not be enough to understand speech). This is why amplification is a common assistive technology (essentially what hearing aids do.)

Phone Communication and Hearing Loss

Phone communication between a deaf and a hearing person can be done in the US through a relay service. Relay services usually add a human translator between the two people in the conversation. One method uses text (TTY) and the other uses streaming video and sign language. In either case, the human translator either reads the text from the TTY machine or translates sign language to spoken English in order to relay the communication to a hearing person on the phone. This is a slow and cumbersome process that involves a lot of back and forth and necessitates in most cases that someone else is privy to the conversation. The exception is a TTY conversation that uses speech recognition software as the mediator. 

If both users have a TTY device, the conversation can take place entirely in text without a relay operator. However, some TTY devices predate instant messaging and texting apps and suffer some shortcomings, such as being limited to a single line of all-caps text without punctuation. However, they are still important for emergency dispatchers, as a deaf person could make a TTY call without having to wait for a relay service to translate the emergency information back and forth

Captions

Videos can use captions to display the spoken conversation using text. Open captions are captions that are permanently created as part of the video and cannot be moved or altered. Most people prefer closed captions, which can be turned on or off and altered. For example, on Youtube, you can drag and drop closed captions to another spot on the screen if the captions are blocking your view of the action. (Go ahead and try it). You can also change the font and contrast for captions. 

  1. Go to a YouTube video with closed captions. 
  2. Click on Settings
  3. Click on Subtitles/CC
  4. From here you could also choose auto-translate, but we're ignoring that for now, click on Options
  5. You can change a number of settings including the font family, text size, text color, font opacity, background color, background opacity, window color and opacity, and character edge style. 
  6. You may need to scroll to see all the options. 
  7. You can reset to defaults from this menu as well. 

Nearly all video formats support closed captions, but in order for closed captions to work properly, someone must add the caption text. YouTube is experimenting with auto-translation using the same voice-detecting technology that powers Google Now voice commands, but the results are not always fantastic or that accurate. 

Speaking

For those who cannot speak, there are a number of voice synthesizers and assistive technologies that translate gestures into text. Stephen Hawking may be the most famous example of someone who uses assistive technology to speak.  

Other forms of augmented and alternative communication (AAC) may include low-tech solutions like laser pointers and communication boards (as seen on the TV show Speechless), dedicated devices, or apps like Proloquo2Go