iPad: Approach with Caution for people with disabilities

Universal/accessible design of the home from an occupational therapy and a construction perspective. This blog is part of a quest for cool, convenient, functional design that makes life safer, easier, and as maintenance-free as possible. It's about the lifestyle.

As I've stated before, when I recommend a product for my clients I do everything in my power to make sure that we are making a functional decision. That they are aware of the advantages and disadvantages and, if at all possible, they have tried a similar (if not exact) replica of the products they will be using on a (hopefully) daily basis.

The iP... (enter your ending here: Pad, Phone, Pod) products are no different. iP...s can be very useful for many reasons for people with physical or cognitive disabilities. Apps can be found for:
  • Environmental Control
  • Speech Generation
  • Social Stories
  • Note Keeping
  • Spelling
  • Accessible Book Reading
  • and ... Angry Birds!!! (and other fun games)
But before diving into the good, let me give you a few reasons why I may not recommend an iSomething. I hate being pessimistic, but I must for a moment. Don't worry, my cheery self will return soon. While I personally don't treat for diagnosis, but more the individual person's difficulties, generally speaking there are some diagnosis and/or symptoms that may flag the appropriateness of an iP...:
  • Ataxia (aka: difficulty with coordination)
  • Endurance issues (Multiple Sclerosis, Muscular Dystrophy, etc...)
  • the Non-Technology Abled
  • TBI
  • Severely Physically Disabled
Here's my reasoning:
In my experience, the iPad have 2 touches: a "do-it" (a "click") and a "linger". For the able bodied, it is easy to access apps, the keyboard, links online, or other items with a light, quick, 1-fingertip touch. Maybe even your knuckle, or in a pinch - your nose. If you want to move something on the screen, linger your finger on the desired object and it attempts to move, or drag, with your fingertip. The intuitiveness of the iPad's touch is built-in to the operating system. For people with intact neurological, orthopedic, and cognitive systems Apple has designed their product to work seamlessly with the way you think. But for someone whose ability to move or think has been altered, it's not always so easy.
For example, I was working with a young girl recently who had sustained a brain injury. She demonstrates difficulty moving her left arm, and she isn't talking. Her family is very active, so they were looking for a speech generating device that was
  • Portable
  • Light
  • Easy to program "on the fly"
She trialed the iPad, and at first it seemed like an obvious choice. The app she was using (Proloquo2go) was easy for her to access and simple to program, her mom liked it, and best of all? She liked it. We tried Scene Speak too, but she wasn't able to get the hang of touching invisible hotspots on a picture to make them talk.
But one day not long after she hung out with the iPad, using it for communication and spelling for probably an hour (with short breaks) straight. In the beginning she showed me that she was able to touch the icons and activate them without difficulty. But after an hour she began to fatigue. And instead of a light wisp, her touch became heavier. Not much, in fact I wouldn't have noticed it in other activities, but enough that the iPad began translating it as a "linger", not a "do-it". And communication grew frustrating. And there was not much I could do about it.
A family member wanted to see the Dynavox Maestro, so I pulled it out and asked this girl to push a few buttons. She did, and the Maestro worked for her - even in her fatigued, slower moving state.
The reason is simple:
  • Apple products are aimed for the general, able-bodied person.
  • Dynavox, and other device companies, are focused products. These companies have researched what needs exist for people with disabilities and have incorporated them into their products.
I'm not saying that the Maestro will work 100% of the time for this person. Nor that the iPad will not work. But, I am saying that I am glad I had the opportunity to show the advantages and disadvantages of each product to this girl and her family. It is so much more frustrating for people with disabilities to have difficulty accessing a product than you or I - especially one as hyped as the iPad - that it is in everyone's best interest to "approach with caution".
Back to this girl and the iPad - I could not customize the size of the icons in this app nor program the app to allow for a longer touch before activating the button, both actions which she could use. I definitely could not plug in a switch and allow her to access the app through switch scanning (although yes, you smarties, a few speech apps do have this capability, and more are likely to join. but more on this later.). These, to me, are huge drawbacks when attempting to "level the playing field" for people with disabilities.
On a side note, this is closely linked to the reason that the iPad is so affordable. The general public loves it. The dedicated devices for people with disabilities are so much more expensive because they are created with
  • hours of Research pertaining to the way people with disabilities move, think, and act
  • are devoted to a small population.
But anyway, let me go on to get these negative thoughts out. Autism. I've heard some people say that the iPad is the miracle worker for children with autism. I know in my heart that the iPad has helped these kiddos, and that is precious. Especially as the Autistic diagnosis lacks access and funding for necessary items, the iPad can provide affordable, reachable help for these children.
  • Watch the games and other extraneous items on the iPad.
Make sure that the iPad is used in a structured manner. Because once that child knows the iPad is for fun and addicting games, it may be very difficult to transition them to use the iPad for communication.
Other reasons that the iPad is the devil (oops. got carried away.) also exist.
  • The app that may have been useful today, may lack upgrading and support by the developer tomorrow.
Especially with EADL (electronic aids to daily living) apps that sometimes need infrared codes to communicate with your electronics in your home, extra caution should be exercised when researching and choosing apps.
So there. For the most part, the iPad is what it is. You can't fine tune it and most of the apps work within themselves, not across the device. This is changing, but as with anything caution should be exercised before jumping on the bandwagon. People with physical and cognitive abilities alternative to the general population should be aware that they may need either
  • Extra help by a Techie person (not to be confused with Trekkie)
  • Or having a good working knowledge of technology
is most likely necessary to get the iPad tailored for functional use.
Which reminds me, next week I have an appointment with a fellow with MS that bought an iPad. And is having difficulty with it...hmmm....and yes, I promise that in my next post I will explain some of the reasons why I would recommend an iPad, and the fun that you can have with it. And I won't mention Angry Birds once.

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