>> Hello, I'm Emma Smith and I'm an occupational therapist working with jumpstart occupational therapy at the University of British Columbia. Today loop the Jacobite alternative access to mobile technology for computing, education and environmental control.
>> Just to get us started, I want to mention that I have no relationship to constitute a conflict of interest with this. Any reference and make two specific products should not be considered an endorsement.
>> We have a few learning outcomes today that we will try to achieve. The first is that at the end of this, I want to be able to have it describes three ways that mobile technologies can be used to control the environment for individuals with disabilities. Following that, I hope you will be able to describe three different access methods which can be used by individuals who have difficulty accessing a touch interface and to finally I would like you to be able to apply and understanding of alternative access for mobile to face for three case studies will be reviewing.
>> I have one real goal for today. That is to bring you, pouring we think that access to environmental controls and mobile devices for individuals with disabilities might be a little overwhelming. I want you to get to the point where you think it is possible, it's exciting and it's full potential. I think they're great things here and I want you to think that, too.
>> We will talk about a few things. The first thing we will talk about is what I am actual meaning by mobile technologies. Then we will talk about what are the capabilities of mobile technology and what they can actually do. Then we'll get into the meat of it which is the access to mobile technology and how somebody can actually use these devices. Finally, we will go through a few case studies. Hopefully, by the end of that, we will be able to achieve the objectives attacked about at the beginning.
>> What is mobile technology?  Where these devices we're talking about?  They are devices you probably use every day. When you look at these pictures, you will see Apple devices. On screen there, you'll see an Apple iPad as well as iPhone. Those are mobile technologies. You also see some android tablets and phones there on the right-hand side which are also considered mobile technologies. Anything like a tablet or smartphone, it is not we will be talking about in terms of what mobile technology actually is back at the bottom, will see a series of smart watches. Is our new addition to the mobile technology line of. I think this really adds to our capabilities in terms of mobile technology.
>> When we think about what this capabilities are, there is a huge range of capabilities. We will talk about these more in depth as we go through the slides. Some of the things you might think about, everyday computing, access to email, texting, or maybe it's to play came in your phone. Those are everyday computing types of things. Communication, access to augmentative and alternative communication or speech generating devices. Environmental controls and I'll talk a little bit more about environmental controls in the next few slides. There's a lot of potential. Health monitoring devices. We'll talk more about those as well.
>> I wanted to talk to you about environmental control options. For many of the clients that we work with who have difficulty with physical access and that environmental control options become critical. We have lighting available tickets one way we can and control iron environment by turning on and off our lights. We can do that for a tablet or smartphone. We have the capability to do this through our lifestyle. They almost to the system to turn the light both on and off. The nice thing about the light bulbs, they can be used in any fixture. You just use that light bulb like you would any other type of and you connected to your device. We also have light switches we can be Wi-Fi enabled. They can be used in place of a regular switch. Then their eyes motion detection, dimming switches. We have lots of control over our lights using alternative switches as those hardwired interloper with the option to control lights plugged into our outlet to LA control. We can get a small device which is Wi-Fi enabled and that gives us access to a lighting.
>> Will set the option to control some things around heating and safety. These would be things like Wi-Fi enabled thermostat, the one on the scene screen is the Nass. It's probably the most well-known. It allows you to control things like heat or cooling in your home. We also have access to Wi-Fi enabled security systems. This might be security systems that you would already have installed, like motion detectors or door or window detectors. You can turn on or off using the Wi-Fi system or using your Wi-Fi device. MAS of something like it came at the front door so you can actually see who is coming to ring your doorbell and you can use that as a security system. They can of the access to your phone or tablet.
>> Finally, we have things like water heaters. Why would I need old water heater that is mobile enabled?  Issue access to things that you might not otherwise. Being able to change the heat setting on that water heater through a Wi-Fi device may be useful to you.
>> We have many more options because of things like doors and windows. We can actually now control the lock on our front door, the deadbolt lock using a Wi-Fi enabled device. One of the great things with these they can require proximity to door to the activated or a code which means that for some of our users, we might have  they may be using a wheelchair and not have physical access to the deadbolt. They can have it opened for them. We can also give access to caregivers who can be given a code which can be access to the file. The person they are working with those that necessarily need to actually let them in the door.
>> We also have options for Wi-Fi enabled door of respect for Dorking open automatically when you switch on your phone. There is also Wi-Fi enabled doorbells. Thinking that Windows?  You have access to blinds and window so we can open and close the blinds using Wi-Fi enabled devices. That means we get access to your cell phone to this blinds and curtains but it also means we can set those particular settings. We can say, if I get home at 7:p.m. and is after sunset, please close the blinds. Your device can do that for you. You can do it based on your geolocation but also based on where you are at the time and the time of day, or things like sunset. So we have lots of options for how we manipulate an embankment to a Wi-Fi enabled device and put specific settings in place to control it.
>> Of course, one of the things we are more familiar with would be things like entertainment. Our stereos are our speakers. We may be using Bluetooth stereo speakers in our home. This is something we're familiar with. Stereos and speakers are one option. We also have the capacity to control or television or video store is why don't the tablet as well as gaming. Then, appliances. The same where I think it is some entertainment value from my perspective, but they are useful tools from some of our clients. We now have Wi-Fi enabled slow cookers and appliances and dishwashers. You can set settings without having to actually access the device itself and change things as you go about your day. If you can turn the dishwasher of the free came home, or you could set the temperature on the other without actually being there. There's a number of options which could make a significant impact on your life.
>> In order to get this environmental control, there are some ways we need to do integration. If you are an iOS or ethyl device user, you have never coquette built into your operating system. Home kit allows you to operate with how could enabled devices. Your Apple device, whether through voice access, touch or switch, you're actually able to control those devices in your home. Certainly, those are not the only ones. You could use Amazon echo to do the same thing. In the to make sure that any devices you getting to the home are compatible with the FSA  interface for a certain devices that are compatible. They might not necessarily synthesized expect less, the thermostat I should earlier. You might think about something compatible with nest. These aren't necessarily the only devices on the market, many factors have come out with into patient facing so it's worth doing a little bit of homework to determine what those are what they are compatible with in terms of what you have and home are what you're planning on purchasing. [ Captioners Transitioning ]
>> You have a lot to options. They are doing a lot at the moment, engaging people to create recipes or systems. And it allows you to use a cross platform, as more advices become [Indiscernible] . Next we have held monitoring -- health monitoring and many of you do this by your step count. Or how many strokes you push on your Wiltshire. -- Wheelchair. There is also Bluetooth enabled pressure caps. -- Blood pressure caps. They can do something with Apple to monitor their health. So you can understand what is happening to your health. You can monitor nutrition and food intake. They can look at your weight, they have a smart scale or food scale, this will allow you to look at the weight of the food you are weighing the and -- and here are cool options. There are blue to -- Bluetooth water bottles. This will measure how much water you consume during the day. And this is and we can also look at our sleep pattern. We can use this through a smart watch for that bit -- or Fitbit and we also have air purification. And this can also be helpful when working with the people we work with. Now that you know everything the device can do we will go over how you can achieve that. You can do this with a touch. You can tap or swipe or pinch. I want you to keep this in mind as we move forward because this is critical. We can also use voice, and this is virtual assistants. There is something that people might use every day.
>> We have a real issue. The primary issue, these features of the device are designed for hand use. We have a lock screen on our device that we have to tap in order to use them. We also have a fingerprint sensor. But think about someone who cannot move their arm. We also have menus. We need to think about if our clients can use the menus, if they do not have access to the device in a typical way. One way and -- these apps are not all the art --
>> These apps are not designed for alternative access. There are great options built-in to it. But they may not be compatible with Switch or voiceover. So we have to consider the apps that we are using and to make sure they will work for our clients.
>> There are lots of options for mobile device access. And this screen gives you an overviews on what they look like. We will start with touch. This is more typical. We start with touch and this is the most typical design. It is a, -- it is a tap and swipe like moves. This is an IOS and Apple devices. We also might use a stylus and not necessarily with their fingers and that is on the typical five. Android and Windows devices, a mouse is typical. We also have access to keyboards. Being able to set up keyboard shortcuts. And again this is typical. We have boys access by -- boys -- voice access. IOS and android have switch options. This is the less typical line. I will tell you there is a caveat, there are a lot of features for visual impairment and I will not go over them because it is a different action. As I refer to things related to visual impairment, but I will focus rather on physical impairment. First I will talk about device accessibility features and general device features. You will see IOS, this is the operating system for Apple devices and android for every other smart phone with the exception of a Windows device. Motorola and Samsung will using android base [Indiscernible] . In each of these operating systems we have specific device features. On IOS, they have done a great job in building inaccessibility. One feature is, call audio routing. If you have a user with limited physical flexibility but a good voice you may want to connect this to the earpiece. We also have LED flash for alerts. And the LED will always activate and this will be how -- helper for those who have hearing disability. Next we have a way the user interacts with the screen. When we are teaching someone new skills we want to make sure they do not get to lost inside of the menu structure or settings so they do not accidentally change some of the settings. Text replacement, you can spell out a sentence, like the weather is great today and you can only -- you can use just three characters. I can use my name, and the at symbol and my number. And it diminishes, -- the amount of time they have to interact with the devices. You can put restrictions on the device to make sure that the settings do not change. And we can change the auto lock setting. On android, high contrast test. There are a lot of visual features, and you want to consider that for somebody who has difficulty seeing.
>> I will highlights guided access, text replacement and predictive. First I will talk about direct access. This is access to the device in the way it was intended to use. For the Apple it is touch only or boys activation -- voice activation. And that is really great. We use direct access because it is most normal device -- use of the device. But we need to modify it. And this means we have a more [Indiscernible] . We may have access to a wider range of apps. This is for a person who has a disability in mind -- and modifying the direct access we can address some of the challenges, that some of our clients may have. And of course there are limitations. It might be difficult for them to do all of the actions. Things like pinch and zoom might be more difficult. May not address all of our needs. It may introduce new hardware like a stylus. It might be a new function that somebody would have to learn. There is a learning curve for some that we need to consider. Some of our clients have difficulty learning. So you would have to think about the best option. Modifying direct access. You can use something like a stylus. Or if you have clients who have difficulty [Indiscernible] . You can use a glove, and cut off all of the fingers. This will give you targeted access without the hand getting in the way. There are third-party keyboards and keyboard settings. This will help them get specific access. Or maybe it is a client that you work with that typically has used a keyboard in the past, and this allows them to get the same access as they did before. So using keyboards can be great. Third-party keyboards are keyboards on screen and replace what you typically use. You can use Swipe, where'd you do not have to target the individual key. You can get Swipe for IOS. And this allows you to have even more options when looking at keyboards. You have assisted touch -- on IOS. This will give you an alternative for the touch option. We talk about keyboards as a parochial. If you have a client that is using a specific keyboard or mouse you can connect them to the android device and window devices to make sure they can continue to use the device they have access to. Apple does not have flexibility and accessing all of the keyboards. There is one God buys -- there is one device on the market that will give you a Bluetooth device, and you can get connection to your phone which is a huge difference. And the person will be able to access this consistently.
>> In terms of simple assisted devices. I will go through a few challenges. And how you can solve a problem. First we have hand positioning, where the hand might be in the way or touching the screen. You can use gloves. And this will allow them access to a specific point. You can do this on a knuckle or another area. You can use splints, so you have only the finger. Another challenge, the fingers have good targeting position. But maybe the angle of the finger that touch the screen -- and in this case we might provide alternative devices like stylus, or glue on a glove. We can do this cheaply and simply for our clients. And of course we talked about Paris fuels -- peripherals. And this means they have greater range. And you can interact with the system with your keyboard. You have the ability to do the things like open and closing a screen through the keyboard without touching the device itself. There are some devices that can detect -- connect any keyboard to the device.
>> I am sorry but my screen was just not coming up but I think it is there now. I think we're good I just had a blank screen.
>> If you want, you can start from the beginning of the slide if you would like.
>> And other peripheral that might be used , would be a mouse and this is for android and Windows. It can be done in a variety of ways. We can get a Bluetooth mouse, or you can get a hardwired mouse. If you have a Bluetooth -- USB port you can connect it through that port using the adapter. Or you can do it through the interface device. What is great the apostle -- what is great the possibility of using any device for your client. If they are used to using and mouse with their PC they can continue to use a mouse with this mobile system. And that is a great mobile and access system. There is voice access. If you have a clear speaking voice you can interact. Depending on the operating system, you can use Google or Cortana. There are specific things that the device can do through speech. But there are things that are limited by speech. You might want to consider what it means for your clients. You can do things like, send an email. But let's say you want to navigate with -- within a website it may not work. There are apps that provides specific voice options like Dragon. This is great when we are using this for dictation or sending a text. I always recommend that you have a backup. 
>> And the next option is Switch. This allows you to control the entire device with one or more switches. This is great for somebody who has limited mobility. You can use a variety of switches. This is anything that your client might be used to using. It could be a button, lever, or sensor. It could be a sip and pop. -- puff.
>> For those of you who are not familiar, it is completed by using the electric circuit. It will send a signal to the device we are using. As you can see in this example, when we click on this device it will turn the device on. This is similar to the tablet and the phone. When we think about Switch access we are to give a single or multiple switch use. And the ideal device depends on the user's capabilities and the intended use of the switch.
>> As I said switches cannot be plugged directly into the device. They will talk through the device through the interface. And that interface engages with the tablet in a way that the tablet understands the fall. -- phone. There are many in number -- they have switches that you can use with your client. Make sure that you know that you have the right interface device for your tablet or cell phone.
>> When we think about the Enterprises -- interface available. We have wireless and wired. With wireless we have the capacity to charge the device. This is something that you want to think about. Is this something that the client can charge at the end of every day. You have to make sure that the wireless device will pay her with the divine -- paired to the device your client is going to be using. The wire device means there are no charging requirements. And you do not have a challenge associated with pairing. With a wire device it means you can plug it into the tablet or cell phone. And some of those devices have a charge through device. And you want to make sure that you have enough data repower to last throughout the day -- because you do not want them to lose access to their device when they needed. -- need it. I will go through something now. If you use the iOS device and you want to practice, I recommend that you use the accessibility shortcuts to turn it on and off. This goes with all of your clients that you are working with them on with the caregiver. Having easy access way to turn this on and off is important, to make sure that the client gets the support they need from the caregiver. I will show you a video on how to turn the device on. As you see on the screen is a quick video. And this video is on -- how to turn on the accessibility shortcuts. Scroll down to general accessibility. Scroll all the way to be bottom. When you get to the bottom you will see accessibility shortcuts. You are going to click on that. You are going to make sure that switch control is check and I recommend that you do not check anything else. When you triple click though home button, switch control will turn off. And this is important, if you are not used to using switch control, you may get stuck. And that is why our recommend a shortcut. And now that we got that out of the way we will talk about the switch access options. I will focus on iOS, because they have the most robust options regarding mobile devices. And we will talk about the android later on. IOS has three forms of switch access. We have items scanning. Which scans one item at a time in it is very simple but slow. Items scanning has a second option, which is called grouping items. You can do a group of rows. You will select a row that your item is located in. And once you select the row, it will [Indiscernible] and it is more complex to use but it is  fast and efficient. The third option is different. This is called cross scanning, and this will target a specific area on the screen by bringing a [ MUSIC ]  across the screen -- by bringing a vertical bar across the screen. And this requires the most attention from the user.
>> This system has trained two, -- this system has a lot of complexity but what is really cool, it has great potential. If you can learn to harness this complexity you can harvest a lot of flexibility. But I do urge you to keep this simple. Make sure it is as simple as it can be for your client. It is all about your learning and make sure that you are competent in using these devices. 
>> I will switch to a nether video that will show you the complexities. As this video loads you will see, how complex the system can be. I want you to keep this in mind as you watch this. We have multiple menu structures. And you can get lost in those menu structures. And there is too much that is going on for the user. Here you can see we have two pages of menus. And these are things that you will probably not used day to day. When we're looking at these complexities we want to think about, what functions are going to be the most important?  And what functions are they going to actually use?  As you can see there is a lot going on. This gives you a sense of what those menus can look like and the level of complexity. And if you have a high complexity or high need user. For most of our users, that complexity is too much. It is better if we can look at a simple solution. I will switch to another video. And this video is going to show you a simple solution for iOS. You can see that we have -- here we will select the column that we want. This is called Otto touch -- auto touch. And this makes a big difference for most of our clients. And the way we get to this [Indiscernible] is with their own competence . So that we understand all of the different features and I do urge you to practice and play with your device. To make sure that you understand the options.
>> In iOS 10 we have updated switch control features. And keep in mind that iOS seven all have switch control features. If you are watching this at a later date, and if it is after the fall of 2017 there might be more features that we you will not see today.
>> We have had control and a full screen control -- we have many interesting options. It will set the entire screen to be a switch so any time you touch the screen it will behave as if a switch was hit. You may want to try it out. But first do the accessibility shortcut. But this will help with training. You can target the screen. If they can get the hand over to the screen, maybe that is all you need so you do not need a very expensive switch. And switch control is programmable through the main menu. There is scanning or point scanning that I showed you earlier. You can have with or without voiceover. There are a lot adjustments. We have hold link and [Indiscernible] and I will  talk about those with the next few slides. And keep in mind that these will change with updates. The first thing that you are seeing, the capacity to turn the switch and troll on and -- switch control on and off. The next one is to set up your switches. Go to settings and you can set up your switches. The following one is called, recipes. This is a way to get your device to do things consistently when you execute a particular action. This can be done within a specific app. You can do things like change -- turn the page. For timing, which is the next section. We have a bunch of different features. Auto scanning time. How much time does it take to move to the next item. What you are saying -- seeing, auto scanning is activated. You have auto scanning, menu scanning and switch scanning. You will see there are three different codes. There are different timing functions for that three different codes. Dwell time. You use a scan would you do not have a switch. Or you were not going to do the auto. This is how long it will take the switch to the well there before it moves on --. If someone is going to be using auto scanning, it will pause to allow the person to collect themselves. You can have moved repeat. What is great about iOS each switch is explained inside the accessibility system. So if you do not understand what it means you can get a description. There are also resources, that I will post at the end of the presentation.
>> Next we have tap Behaviors. Auto tap , will advance if you hit the button. And you have, always. It will immediately go to the item. And the menu will uproot -- at peer at the end. And it prevents the menu to come up. Always Keyboard keys. This allows you when you are using the keyboard that menu does not pop up. There is also option for switch stabilization. This is where you can hold the switch in order to activate. Or ignore repeated access to the switch. This is when a person accidentally touches the switch multiple times. You can set the gliding cursor. We can turn on and off the sound effects and speech. We can select the menu items that we want. Think about the menu that came up earlier. We do not need to have all those functions all of the time. We can include just the functions the client might need. Next we had group items. As well as visual changes and I always recommend using a larger cursor because it is easier to see. And make sure that a contrast with the background. We can also save jesters. -- save chesters.
>> This is item scanning. You can do individual scanning and roll -- row column. On the next when you can see point scanning. This is the cross scanning that I talked about. It brings a vertical bar across with the horizontal bar. You are able to refine the horizontal bar.
>> Why would I choose iOS?  It has campout ability to -- it has compatibility with existing environmental controls. It has more communication apps for your clients. And of course we always have to consider our clients and their needs and their preference. The potential for increasing the complexity as they become familiar with the device. And to reduce the complexity, for the client who does not need the complexity or handle the complexity. Your device can be imported into a backup so you do not have to set up a new device as well. Thinking about and trade. -- Thinking about android. The android has integrated switch access in Lollipop 5.0.2 but you do not have full access by -- you do not have full access to all of the options in the device. And this may not work for everyone. There are benefits to the android. One of those is that you can build apps within android. There are apps available that are built for switch access and they are robust but we do not see this with Apple. Next we have potential for mouse use with a blue to connection -- Blutooth connection. There is the use of what is called a Launcher. This allows you to use a device in a way that is simplified or clients who are not familiar with technology. This is great for younger clients and for older device -- older clients because of the simplicity.
>> In terms of the switch options that are available. We have auto scanning option. You can turn it on and off. We have the option to set up a switch to go to the next area or the previous area. You can activate clicks. You can scroll forward and backwards. As well as notifications. They are specific about the exact things that the switch can activate as opposed to Apple that allows you access to the full device. Visual interface and it can be difficult to see. As I mentioned. There are no grouping of items. And this may change. Activation can be hit or miss. You will find that you will not get everything you need when you hit the switch. It is new for Android and they are still working on the system. This is a quick video and it will show you the use of the android switch system.
>> As you can see this is a Android screen. You can see that the interface is not as robust with the Apple system. There is a single scanning item. And it does click through. And there are a few other things on my screen, one is Launcher which is a good thing. So you do have these options available to you. Android interface is a little different. It does bring up a menu but it is not as polished as the Apple.
>> I mentioned Launcher earlier. This is Big Launcher. You can choose what goes into the six boxes. So you can set up a tablet or the cell phone exactly how you would like it to be for the user. This is great for individuals that might need simplification or their device -- or their device.
>> Why would I choose Android?  First it is the easiest, and access to all in one. If you want to touch or mouse android will give you those options. And it is easier to do the -- apps. And you have more potential for app development. The big feature is the cost. Android is typically less than the Apple. You can also have mouse integration which can be powerful. You have Windows service tablet and they are becoming more and more sophisticated. You can use this through USB access for head mouse access. You can also use software like Dragger and Cross Scanner. You can get access to the window on a tablet. And making it work with life is a very important consideration. Not everyone who needs switch access uses a will chair -- wheelcahir.
>> For mounting you need to consider how the person is going to access the device. Do they have a good line of sight?  What is the cost of the mounting options?
>> Will chair integration -- -- my first case study was a teenager that had a lot of extra movement and had difficulty with [Indiscernible] but she would accidentally  moved because of the extra movement she would [Indiscernible] . She was using her device is a communication device for day to day activity. We moved her to an Apple device because they gave her the cool factor of being 18. At -- of being a teen.
>> This was a sip and puff driver. We did not want to interfere with the mode switch on his wheelchair. 
>> He was able to use more complexity but he wanted to use email, calendar and a browser. And again we use the Apple device. That was because we had they death that complexity for him -- we had the depth of complexity for him. He specifically asked not to use the sip and of -- puff.
>> We had a teen crew fatigue easily so we did not want to introduce anything that were caused more fatigue. We wanted to be able to modify his device. We got him a android, so he could activate the Bluetooth on his tablet. He liked the android interface. There are a variety of resources. This is the switch guide. This is a very helpful resource. And this was a resource that I created which is called IOS Switch Guide. I suggest that you look at what will work for you. We also have a resource called Hands Free. And we have RJ Cooper also has a great website. And they have a number of resources that you can access. You can also follow on YouTube. And if you are having any kinds of difficulties somebody probably has a YouTube video for you. And of course if you have any questions you may contact me. I do welcome any kind -- questions. I hope that you enjoyed this presentation. And I look forward to speaking with you soon.
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