Computer Access Technology for Aging and Cognitively Impaired Individuals

1. Computer Access Technology for Aging and Cognitively Impaired Individuals Dan Smith Laura Luckow Gaynor Hines VA Blind Rehabilitation Center

2. The Problem: Access Technology is Now a Goal for Veterans Regardless of Age • Imagine teaching your Grandfather, Grandmother, or cognitively impaired student how to use JAWS, ZoomText, Window Eyes, Magic, Etc.

3. Why would it be difficult? • Lack of exposure to computer technology and concepts • Difficulty with sensory integration—too much input • Difficulty remembering shortcuts & multi-step processes • Slow and tentative typing, difficulty using a mouse • Peripheral neuropathy • Impaired hearing • Diminished or impaired memory…………………

4. How do we in the VA find the best fit for technology? • VIST Assessment • Application Screening and telephone Interview • Goals assessment on admission • Typing assessment • Identification of Technology to meet goals

6. Access Tool Suitability

7. Demographics of a VA Blind Rehab Center • Contrasting populations on a wide continuum • Still many aging WWII and Korean Conflict veterans • Increasing concomitant disabilities with aging • Viet Nam Era veterans reaching retirement • More young Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) traumatically injured.

9. Veteran’s Stated Goals for Training • Send and receive e-mails • Write a letter or document • Browse the Internet to respond to “For more information go to WWW…” • Download NLS Books • Manage my finances • Scan pictures • Use Skype

11. Failure is not an option • Solutions Explored • Teach ZoomText or JAWS • Simplify and repeat, repeat, repeat • Provide extensive custom step by step reference material • Partially meet their goals • Provide scan and read OCR device • Provide a simpler choice • VoiceNote • iPad, iPhone • Guide or Guide Hands Free • CDesk • SAMNet

12. Guide and Guide Hands Free Access Solution • Formerly produced and marketed by Software Express • Now a product of Dolphin Technologies • USA Dealers -- EVAS • Guide ~ $800 • Guide Hands Free with Dragon Preferred ~$1500

13. Guide TM • Runs on Windows XP or Windows 7 • Suppresses most of Windows messages and clutter • Menu-driven: Simple step-by-step menus • Requires recognition of menu choice rather than memorization of complex keystrokes or multiple steps • Native combined magnification and speech output

14. The Guide Main Menu

15. Guide meets veteran goals • Writing Letters and Documents • Email Communication • Internet Browsing • Simple Contact Management • Calendar with Reminders • CD, MP3, DVD Player • News Feeds: FOX News, CBS News, Etc. • Scan and Read Printed Material • Magnify Handwriting and Pictures • Access NLS Book Download

16. Deciding who will benefit from Guide Instructors recommend using the Guide software instead of interacting with Windows for some veterans. The following challenges can be indicators to teach Guide:

17. Guide Assessment (Cont.) • Displays short-term memory problems. • The complexity of the GUI environment is difficult for the veteran. • The veteran has difficulty navigating and orientating the physical keyboard and hotkey combinations. • The veteran shows evidence of frustration or discouragement of his progress.

18. Assessment for Guide Hands Free • Medical reason why typing is not possible • Above indicated assessment results • Guide HF still requires reasonably consistent speech patterns • Consistent speech cadence • Memory for speech commands • Patience • Willing to play with the toys in the sand box

19. Case Studies, Mr. R • Goals • Refresh all training from previous computer program • Create documents and envelopes • Scan and read documents • Send, reply, and forward e-mail • Access the internet and save favorite sites

20. Case Studies, Mr. R (Cont.) • Why Guide? • The complexity of the GUI environment was very difficult for the veteran • The veteran had difficulty navigating and orientating the physical keyboard and hotkey combinations due to stroke • The veteran was becoming frustrated due to lack of progress

21. Case Studies, Ms. E • Goals • Use email for correspondence as secretary for a national association • Create envelopes and labels • Scan and read documents and letters • Access the internet for limited searches

22. Ms. E (Cont.) • Why Guide Hands-free? • Neuropathy in fingers made typing impossible • She did have patience to learn and was willing to play with the toys in the sand box

23. Ms. E (Cont.) • Challenges • Speech patterns posed an issue in teaching Guide HF • Memory for speech commands was marginal

24. A Quick Look at CDESK CDesk Personal $395.00 , CDesk Mobile $595.00

25. Why Choose CDesk • More Mouse friendly with options for keyboard shortcuts. • Provides more complete word processing options (Open Office) • Provides easy access to Digital Book Downloads (BARD, NLS, Bookshare) • Less expensive software

26. A Quick Look at SAMNet

27. SAMNet Menu Continued

28. Why Choose SAMNet • Internet based environment that is readily tested and updated • Very easy access to e-mail • Specially adapted access to various internet sites and features, i.e., news, described video service, blogs, movies, podcasts, and sports

29. SAMNet Continued • Free to Veterans • $129.00 per year for general public • Can be used with enlargement or screen reading software for PC Desktop access at user’s cost • Free 30 day trial

30. Demonstration • E-Mail and Internet Demonstration • Guide • Guide Hands Free • CDesk • SAMNet

31. Resources Guide, Guide Hands Free EVAS WWW.evas.com 39 Canal Street Post Office Box 371 Westerly RI 02891 (401) 596 3155 CDESK AdaptiveVoice LLC.  www.adaptivevoice.com 25286 Adelanto  Laguna Niguel, CA 92677  (949) 436-7760

32. Resources (Cont.) System Access Mobile Network Serotek Corporation www.serotek.com 1128 Harmon Place, Suite 310 Minneapolis, MN 55403 (866) 202-0520

33. Thank You! Thank you for attending this IAER Conference session!