Transcript from "Expanding What it Means to Be Accessible: Addressing the Workplace Technology Needs of Users with Cognitive Disabilities" The webinar was recorded on Thursday, December 11, 2014.

The following is a transcript from "Expanding What it Means to Be Accessible: Addressing the Workplace Technology Needs of Users with Cognitive Disabilities" The webinar was recorded on Thursday, December 11, 2014.


Good afternoon everyone and welcome to today's webinar on workplace technology for people with cognitive disabilities. I am Richard Crespin and I am the CEO of CollaborateUp. I will be serving as your moderator today. Here at CollaborateUp we specialize in accellerating collaboration on important issues like this one and that's why I'm honored to be with you today as your moderator. In that role, I'll be playing traffic cop making sure our panelist share their great information with you but more than that I am here to make sure you get your questions answered and your issues addressed. This is your webinar. Many of you have joined us for our previous webinars and we're glad you're joining us again today and that you continue to find these webinars useful. We have an incredible panel of experts today and I want to get right to the discussion but let me just start with a couple of quick housekeeping items and accessibility information.

Most of you are joining us today through the Adobe connect platform and are hearing the audio by voice over IP through your computers. The audio is also available over phone line for those of you would like to listen to today's event in that way. We're live captioning this webinar and you can follow along within the captioning window at the bottom of the screen. You can find the captioning link in the e-mail reminder the the you received yesterday. We will also be accepting questions during today's discussion. You can submit your question by typing them into the Q&A window on your screen.

If you are on Twitter you can submit comments and questions to us via @PEATworks or hashtag #peatworks. The title of today's webinar is expanding what it means to be accessible. Why expanding? We know that accessibility begins in the field of architecture and largely for people with mobility impairments such as wheelchair users. In technology, it first meant adding features that are useful to people with limitations in vision or hearing. Only recently have we widened the circle to include probably the largest segment of people with disabilities, those whose success with technology is jeopardized by poor cognitive design in areas like memory, language, learning and attention. Everyone encounters challenges in these dimensions, especially in our work lives. I know I do. We will be asking you later about poor cognitive design in your workplace technology so get ready to identify your least favorite gadget or apps. We know you have them. That universal experience was not translated into accessible technology guidance until just a few years ago. As we learn from our panelists who will tell us what they're doing to help us play catchup so that we can also begin to understand what caused the delay and how to address those larger issues. With that introduction I would like to ask Julia Bascom to tee up our discussion by giving us some context about the task at hand. Julia?

Thank you Richard and good afternoon everyone. First I want to make sure I'm using this technology correctly. Am I on?

You are. Thanks Julia

Today we are going to be talking about online and workplace technology accessibility for people with cognitive disabilities. As many of us know using the web and other technology can also be complicated for people with intellectual disabilities, traumatic brain injuries or other similar conditions. Interfaces and content can be overly complicated and difficult to navigate. And encountering a poorly designed application can affect the workplace productivity of all users not to mention a cognitive or developmental disability. There is a lot that can be done and that is being done to address these issues and this gets to the heart of what universal design is all about. Techniques and processes used to make technology more accessible for more people with cognitive disabilities can make technology more accessible for everyone. To begin addressing this critical issue the Autistic Self Advocacy Network, my employer, works jointly with PEAT to host an online dialogue in 2013 in which participants discussed how they use the Internet for employment purposes, what barriers they face, and what can be done to ensure accessibility. In 2014, we produced a report which examines the data from the dialogue, reviews common themes and suggest potential next steps for research policy and programs. And finally we developed a tip sheet for employers and technology providers outlining concrete common sense next steps they can take to increase online cognitive accessibility in the workplace for their employees and users. All those resources are currently available on the PEAT website, We are looking forward to discussing this and other facets of these topics today with our very esteemed panel. There's a lot to cover so let's get right into it. I will hand it back to you Richard.

Thank you so much Julia. This is a really fascinating topic and as you said I know we have a lot to cover. I know our other session cochair Jim Tobias really wanted to help us kick off the discussion and I'm not sure if Jim has been able to join us yet. We will try to bring Jim into the conversation along with Julia as we bring our panelist into our conversation as well. Before we do that, before we get to our panelists and presentations, I do want to make sure that you understand that this is your webinar. You and your virtual voice rightt from the very beginning. I want to start off by asking an audience polling question. If we can please bring up our first audience pulling question. I really want to get your perspective in this conversation. The first question we want to ask you is how do you approach the issue of accessible technology? Your choices are as a user, developer, technology, employer, more than one, one of the above or no vote? Hopefully you will select one of those options. While we are waiting for the poll to complete I want to bring in our panelist and give them an opportunity to introduce themselves. Our first panelist is Peter Blanck. With the Burton Blatt Institute at Syracuse University and the author of eQuality: The Struggle for Web Accessibility by Persons with Cognitive Disabilities. Welcome Peter. Tell us a little bit about yourself and your work.

Thank you Richard and thank you for the opportunity to participate in this great form. As a person with family members with intellectual disabilities and as an employer of people with intellectual disabilities, I have been very fortunate to work with the Coleman Institute for cognitive disabilities over the last several years and recently they have commissioned the book you referenced, eQuality: The Struggle for Web Accessibility by Persons with Cognitive Disabilities which is just out. There's a picture of it on the screen now. My background has been as a University Professor, as a PhD psychologist, and as a lawyer trained in litigation, to work and research on some of the earliest cases and testified before Congress early on after the ADA was passed about the extent to which the web should be available to persons with disabilities and as I said, it is certainly a pleasure to participate in this forum.

Thank you Peter, I can tell already you will be a treasure for us today. Lisa Seeman from the Cognitive Accessibility Task Force at the Web Accessibility Initiative. Lisa, tell us a little bit about yourself if you would please.

Sure. So I am chairing the cognitive and learning disabilities project, COGA for short. It is a W3C task force. W3C makes web standards like HTML – stuff like that and it works with working groups such as WCAG. Many of you will be familiar with as the group that put out the document that has been adopted as the basis for most accessibility legislation worldwide. We're looking into what the state is and what the what can be done for the future. Putting together a roadmap and more techniques and identifying the different issues and seeing what we can do to make the world better. I also work for Athena ICT doing the same kind of thing. And we have just signed with IBM so we will be looking at how we can put all this stuff for cognitive accessibility and personalization into their products. So that is what I'm doing with my time.

Beautiful, thank you Lisa and when we bring you back and for the discussion if you could get a little closer to your mic so that we can hear your a little bit clearer but thank you so much for that and we're looking forward to having you as part of our discussion today. Our third panelist is Greg McGrew the laboratory coordinator for the assistive technology partners at the University of Colorado Denver. Good afternoon Greg, how are you doing today.

Good. Thanks for having me. My background is in rehabilitation engineering and that has included work in job accommodation for people with all kinds of disabilities. Currently, and in the past five years, I've been coordinating work at our product testing laboratory and assistive technology partners at the University of Colorado Denver. And our focus is rehab engineering, research center that we currently have is on technology for people with cognitive disabilities. And most of our lab work is focused on usability and products used by people with cognitive disabilities. As I said, I also have a background in job accommodation for people with disabilities and much of that work in ICT here and Colorado's division of vocatinal rehabilitation.

Terrific, thank you so much Greg. Our final panelist is Emily Shea Tanis. Shea is the associate director of research at the University of Colorado Coleman Institute for cognitive disabilities. Shea, give us a little bit about yourself please.

Thank you so much for having me and I want to thank PEAT for putting this wonderful webinar on. I'll be very brief. My name is Shea Tanis and I'm at the Coleman Institute for cognitive disabilities were our goal is to integrate advances in science engineering and technology to promote quality of life for people with cognitive disabilities. Part of my role is to help guide the research here as well as act as a networking agent to connect developers organizations and industry leaders with the cognitive disability community. My personal background is that I have a PhD in special education. Also a family member, a sibling of a man with traumatic brain injury am part of what is called a sibling leadership network which is a national network of siblings with people with disabilities looking to advance work services. That is my background and again thank you for having me.

It is our pleasure. Thank you for being here. We want this to be a real conversation not just with panelists, but with you in our audience. To that end if we could please bring up the results of our poll, I would love to see how you folks respond. To our first pulling question. So it looks like we've got an interesting breakdown here for almost half, about 42% are more than one of the above. A nice quarter of you are looking at technology issues as an employer, another 20% designers and about 12% of us are users.

I think that will really help from our conversation for panelist to think about these different audiences in different types of folks we are on the call today. Todays session, we want this to be a dialogue with our esteemed panelists and we will try to keep those — the formal presentations really tight and brief so that we can get into a dialogue and I hope that you will join us from our — audience members join with us and Jim and Julie, I hope you will join us as well as we get through our discussion today.

In fact, to reemphasize the fact that this is your webinar not our webinar, I would like to ask one more pulling question before we dive into our panel discussions. This time we want to know are you aware of or have you experienced cognitively inaccessible technology in your workplace? Yes or no? And while we're waiting for for those results, I'm going to give the warning signal here to Peter that we are going to bring you up for our first presentation here.

We will see how these results pan out but I'm going to guess it will end up in the 80/20 range. In terms of those of you who have — well over three quarters of you have experience cognitively inaccessible technology in the workplace. And we will come back and revisit this pulling question but Peter Blanck from the Burton Blatt Institute over to you.

Peter Blanck, Burton Blatt Institute

Hello. I will be tight and brief to use your words Richard, which is hard for a professor and especially hard for a professor who is a lawyer I will do my best in about six minutes. So, some of what I was going to say today appears and I blogged that I wrote that is on the PEAT website which for these guys can refer you as well as the book I wrote. About three years ago, I was giving a lecture at the Coleman Institute Shea's boss Bill Coleman and the founder of the organization kind of threw a gauntlet down and asked me if I would continue my studies in the litigation efforts I've been conducting to examine whether or not there is a right under law to the web for in terms of equal use for people with cognitive disabilities. Now the obvious question is of course yes. Three years later and several hundred pages of books later which you can see my mother will buy most of the copies but she may leave a let few left over for other people to buy, I've examined that question. I have examined how one man named Ali who works, who has an intellectual disability and a print disability how he had struggled to work with the company's intranet system and I will focus my remarks on employment since they will be rather brief but in the book and elsewhere talk about a range of other aspects of web accessibility for persons with cognitive disabilities.

A gentleman who had a print disability that he wanted a promotion and he had to go through an online hiring process and there were strict time constraints to solve the questions and answer the questions and there was a lack of sensitivity and a lack of technology sensitivity since because his screen reader could not keep up as well to his need to request a reasonable extension of time even though arguably he was quite qualified to pursue that position. Other people for example, Michael who is an attorney who works for the United States government who has print disabilities, learning disabilities and who is blind as well. He like many other employees wanted to telecommute from home on certain days and unfortunately the government intranet service and the agency's online remote security systems were not compatible with this screen reader software and made it very difficult for him to use the systems.

These types of stories Richard and the other people on the phone, really form the fabric, really form the impetus for my work and of course by relationship with my family members and as an employer myself, to try to understand the extent to which people with a range of cognitive disabilities, which is undoubtedly a very broad category, have equal and full access to the web. Now this is a transformative time in many ways for our country and for employers. It's certainly transformative because we have new laws, the communications and video accessibility act, the so called CVAA, which covers a whole host of accessibility to mobile and desktop devices, interestingly to date, the thrust of that law has been focused on individuals who are blind and individuals with hearing impairments who are of course of equal rights and equal importance to address by there has been relatively less focus on individuals with cognitive disabilities. We have of course the international treaty, the convention on rights for persons with disabilities, and a whole article, article nine and that treaty is focused on those issues, we have just entered into the United States the so-called Marrakesh Treaty which is meant to reduce copyright restrictions on e-books so they can be used across borders. And all of these activities, all these legal transformations are taking place in an environment which we have a participatory Web, so called Web 2.0 for mobile is mobile is the rule, everybody has handheld devices or tablets and everything is in the cloud. And in another organization I work on with Gregg Vanderheiden, I am President of an organization called Raising the Floor USA which was meant to address these sorts of issues for individuals with print disabilities around the world. So we have this huge inflection point of technology plus civil rights plus a transformative time in the employment relationship.

New work force opportunities, new ways of doing business. New ways of working from home and elsewhere and the ways of transmitting your wares. Your business wares, and what I argue Richard in the book is that those companies that capture and become a part of this new web cloud-based mobile medium can translate that into the way they approach their work and employees will be the companies that will survive in the future. And I don't have much time, and again we are going to hear a lot about this from the other participants but basically, in the area of cognitive disability, if we just focus on that for a second, our studies and other studies show that people with cognitive disabilities generally find traumatic brain disorder post-traumatic stress disorder, epilepsy, by far have the highest poverty rates compared to other disability groups, more segregated and tend to have their space more stigma terms of their efforts in the workplace and interestingly of course they have among the lowest employment rates as compared to other people with disabilities. So what you have here is an untapped labor force that increasingly is going to want to work in this virtual workplace environment and a workforce that has now been essentially raised on the web. This is a new generation of individuals who do not know what it is like not to have a web in which they operate. They participate in in economic and social activities in which they vote and shop and so forth. Richard, you to me when I have about 30 seconds left.

You've got about 30 seconds left.

Okay. I will summarize by saying since the web has been burst which was in 1990, when Tim Berners Lee wrote the first serious proposal about the web and interestingly which coincided with George Bush signing the ADA in 1990 on the White house lawn, there has been a vision for the web as a means for democratic participation in society. Simply put as I is testify before Congress in written and argued in legal cases from NFB vs. Target to CNN, we can hardly not live in this world today without having full and meaningful access to the web. Since I'm out of time, the questions I would leave you with which I and others are prepared to answer are for people with cognitive disabilities? What is full and equal enjoyment of the Web mean for those individuals and why does inclusion of people with cognitive disabilities in the web and workforce why well that bode for the benefit of everybody involved employers individuals with disabilities and their family members? How is Richard for tight and brief?

That was fantastic. What I'm hearing from you is that we are living in inflection point. I love that word. We are undergoing civil rights transformation, and a legal transformation. We have this opportunity to access a labor force in the form of these folks who have these cognitive disabilities. That cannot be unleashed because of these transformations. And your proposition here is that employers who take advantage of these transformations can essentially steal the march on the competition by essentially being the first to market and first to tap that labor force. Is that true?

Their shareholders will be very happy because why would any employer want to exclude from their workplace or from their mall or any retail center those tens of thousands of individuals who as my great friend used to say, whose dollars are as green as anybody else's and who actively want to engage in this competitive workforce. I should add that I will be quiet, cognitive disability is — not necessarily related to a lower level of intelligence, a lower level of interpersonal skills and so forth. There are different ways of communicating and different ways of interacting and that is why what we will hear about today with regard to transforming web content is so bored and so that it is usable and comprehensible.

I really thank you for that Peter and I do want to come back to your who what why questions. Where they are cognitively disabled, what constitutes inclusion and why it will benefit of us. But, let's hold those questions for a second. I want to bring Lisa into the session. Lisa it is your turn.

Lisa Seeman, Cognitive Accessibility Task Force, W3C Web Accessibility Initiative (WAI)

Thank you. Am I loud enough now? So, I am really thankful to be here with you. We're working within the W3C to look at this topic and address this topic as best we can and that means techniques for inclusion, and identifying gaps and making recommendations on things like that. So we are first looking at eight different groups of people with cognitive disabilities and the kind of issues are memory related issues for instance. And the key term here is it's all localize. Some users such as myself, I am dyslexic. I don't have a visual memory and I have very impaired auditory memory and I am always meeting new people even if they are members of my family and there is a problem in these areas that has affected my ability to read growing up and things like that. And other related issues. But there are things that aren't affected such as my general intelligence. Dementia patients for instance, also have problems with memory. But different problems – they will have initially problems with short-term and working memory.

The different user group when you say cognitive disabilities you can mean one part the brain is weaker and other parts are stronger. Kind of true for all of us, but more so with people with cognitive disabilities. We want to enable the parts that work well to get the most out of everybody and help everybody participate as much as we can. To be able to adapt content, where we are not creating barriers, relying on functions that are weak. Another big one for instance is attention span and focus. These are also good examples of things that affect everyone to some extent. People with cognitive disabilities, that is the biggest group of disabilities out there. It is absolutely huge and there is also the cognitive decline that occurs from aging and the actually the aging communities are the richest group. 70% of disposable wealth in the States is in the hands of the aging. It's not that people's dollars are as green its that's where the dollars are and people are ready to plan their cruise and they can't use your website to do it.

And that is proven, there are good statistics out there that show as people age and start developing these issues, they are half as likely to complete a task such as a purchase. So you are losing their business. On the one hand you've got this huge market and so many people with difficulties with cognitive disabilities and on the other hand the web is becoming more more ubiquitous in every way. There is a web of things that start to happen, TV remotes, your heater, your phone systems, these are all web technologies, ICT technologies and people that make design choices that block people from using them. My father has Alzheimer's. We got him a new TV with lots of channels and it came with three remote controls. He has a problem turning this thing on and he can't change the channel. If the TV interfaces had the old metaphor – dial one for the volume, the second dial was the TV channels and there was on/off switch, he could use it, but because of the design choices you need somebody – a caregiver to turn on and off the television. That is crazy and we are going to be doing that with the heating system. On one hand you've got huge potential for more people to be doing more things, more citizens communicating, more online learning, all these options that are available but if we don't identify how to make an interface that is inclusive, then we need to help people with more caregivers and that is just an insane choice to be making. And we're going to be losing all that business from a business perspective.

This conversation is focused on the workplace so just some interesting statistics. A study showed 35% of entrepreneurs in the US are dyslexic. The study had some interesting reasons. One was that they might find it harder to find a normal job and it's the mother of necessity, necessity is the mother of invention – sorry, so you need a job you create your company. And also ADHD is common for entrepreneurs and thought leaders. And these are people who you want on your team. Other strong points are the experience of the aging community. And another thing is that if your designers, if your team, the people in your office don't understand your market and your market includes people with cognitive disabilities, it just does. If you don't understand your market you are not going to be able to sell to your market. Those are a few reasons why diversity is a win/win/win/win. What we are doing on the task force is looking at user groups, the technologies and we're seeing where the gaps are. We're seeing where we have techniques, where wee don't have techniques, etc. And from there we will build a roadmap of recommendations and a techniques document. Where we are right now is we're just finishing up the first of the user research going through a different diverse user group. Down syndrome, dyslexia, Alzheimer's, aphasia, we are getting a real diverse look and what we might end up with in the end we are going to try and have recommendations that are simple that everybody can put into their website. If they want to be more inclusive. Looking at techniquest that works for some people an not for others and ways to make there's going to be doing simple things, complex things, we're going to look at specific issues such as awful phone menus, press one for this and press two for that and you can't hold onto all that material and you end up getting thrown off the line. At least I do.

So an example of simple techniques, what recommendations we might come out with. You know, use symbols to help emphasize the structure, such as good headings, bullet points, making it easier to follow. Those are just good usability and accessibility techniques. And they certainly help for people with cognitive disabilities. So someone with dyslexia might want less words and someone with Alzheimer's who has been reading their whole life and is a very literary person, learning new symbols can be difficult, but the word, that is easy. Sometimes you use one and sometimes you want the other and you could put both recommendations together or you could have an adaptive system so those are the kinds of conclusions we are coming out with, and that's me done. Thank you.

Thank you for at that information and for your generosity of being willing to be in communication with our audience. But if your presentation what I'm hearing our number of things I want to highlight here in touch my understanding of. I think you did a great job of starting to answer Peter's question of who are people with cognitive disabilities so we can start to get a really good picture of who these folks are. And you really zoned in on the why question. Why we should do this because there is a big market here. Big business, big money behind this both in terms of the fact that there are customers out there, whether it is the aged or others who have money to spend, but also there is cost savings to be incurred here as well and it comes down to a series of design choices that we are making design choices and our systems and products on other things that are potentially unnecessarily limiting, and if we can make better design choices we can open up our market and save ourselves some money and put more money in our bottom line. Am I on the right track here?

Absolutely, I couldn't agree more. I think that's what accessibility is really. It is when people make design choices that lock out others. When you put in those steps and people who can't do those steps are suddenly locked out. But when you don't, there was never a problem. So we build systems based on what we think our users are like so we're trying to to put together what really your users are like. If you think about the aging, often people develop disabilities as they age especially cognitive but they finally got their — their money, they want to learn something new, they want to go and improve, but personally the last time I tried to book a trip online and the session timed out and lost all my choices and when it was time to go back on and it was so confusing, I went back and called my travel agent and just pay the $100 commission because it just wasn't worth my time. You are losing people. And what a waste.

Before we move onto Greg, Peter I just want to go back to you quickly. Do you agree with how Lisa framed up who are people with cognitive disabilities and do you agree with my framing of these issues — or is it something else?

I agree and I would just add a caveat that we all are cognitive beings. We all have cognitive abilities and disabilities and I believe what we're really talking about is personalization in a way that the underlying code and design enables people to maximize the ways in which they can use the web. And then it doesn't become an issue of blind, deaf, learning disability, dyslexia. It becomes an issue of how are we able to maximize the ways in which we can get at the information? This is not an idea that is unique to me. One of my partners is a guy named Gregg Vanderheiden, who is building a system called the global public inclusive infrastructure which essentially is meant to allow people to use devices anywhere in a one size fits one capability as opposed to a one-size-fits-all. And Jutta Treviranus in Canada is a major proponent of that as well.

I think that is a wonderful framing there. One-size-fits-one and and I think is the promise of Web 2.0 and some of these technologies is this mass-customization concept. So with that I want to bring Greg McGrew into our conversation here. Gregg, give us a little bit of what is going on for you, and some of your insights if you would.

Greg McGrew, Assistive Technology Partners (ATP), University of Colorado-Denver

Thanks Richard. I am Greg McGrew and I'm the product testing lab coordinator at assistive technology partners which is part of the University of Colorado Denver. Could I get the next slide please? So a lot of the work that we're doing right now is supported by the engineering research grant that we have through aNIDRR. We are just in the process of completing a five-year grant looking at technologies for people with cognitive disabilities and there are a number of research and development projects as part of that. At the same time, we are starting our next five year iteration of the grant and the usability test labs is playing a major role in both of those grants. The grant we are just about to finish is testing 50 different AT consumer products. We're taking mild to moderate cognitive disabilities and test each with about 8 to 12 participants and I will — give you the next slide please. Given the number of tests involved and just basic operational tasks associated with successful use and this broad-spectrum of products.

So, this is just a screen shot of the usability test offered called Morae. The idea here for usability testing is basically to ask real individuals and real users of a product to use the real product in a real way. And to capture them going through the scripted set of tasks with that product and determine what issues and problems they have particularly with the user interface that may create barriers for them to se the product successfully or possibly enhance their ability to use the product. Next slide.

While we are not in any way shape or form completely finished compiling and analyzing our data there are a number of issues that have come forth that we will be reporting on associated work. Has to do with the actual process carrying out usability testing with this population and what we've learend by doing so. There's not a lot of usability testing done for cognitive disabilities. And so we feel like we're plowing some new ground with everything involved in this project. We've founnd that just from a recruiting standpoint, having relationships with different disability organizations and advocacy groups has really helped us tremendously to identify and coordinate testing with a large number of adults with cognitive disabilities. There are also a number of good survey instruments to measure user perceptions and usability satisfaction and we apply those but what we found is we need to alter some of the language to make the questions clear and understandable by some of the folks who participate and also during pre and post test interviews about the user's experience with the product, you have to constantly be aware of tendency for some participants who want to provide the answers that they think we want to hear. And we found that it is important for us during this process to go back and reiterate and we are not really concerned with their particular performance and are not evaluating the answers they provide to this test but we are real interested in the product. What works for them and what doesn't.

Regarding product design issues, there are a number of things that we have come up with the more information here to come. But it is apparent that when a large number of participants are faced with too many choices for action. For example, there are too many buttons that you choose from than continue on with the process of using the product. Often times, users have a tendency to freeze up or have difficulty proceeding — they just don't know what to do and they are overwhelmed by the number of choices that are in front of them. And that can be very distracting. And confusing for them. And we found this to be the case even within those user interface items, the buttons are labeled in such a way that they could understand and recognize it. You know, that's the volume, that's the power, that is the channel up. We tested number of small electronic devices also like thermometers and blood pressure measurement devices and that provided information by speaking – for example your body temperature is 97 degrees. As opposed to having it just show up on the screen. Surveys that we conducted after some of these tests indicate that users by and large really like products that speak to them. They are very much in favor of products that provide them information verbally as opposed to those that don't. Another thing we have found that — touchscreen devices. They are becoming ubiquitous. Everybody is faced at some point in their life now as they go about their daily business using some type of interacting with some type of touchscreen device. So that type of user interface can pose some problems, not just for people with cognitive disabilities but for people in general.

The nice thing about a touchscreen device is a touchscreen really allows that product display the power and breadth of its function and interacting with that sometimes leaves something to be desired and sometimes and creates frustration and distraction for the user in particular if they have cognitive disabilities. A couple of things associated with that. I live in Colorado. The environment is very dry. A lot of people have dry skin. Dry skin can make a very difficult to make a touchscreen device act appropriately or respond to particular actions. Also, touchscreen devices you are often calibrated in the discrimination between the tap motion and the swipe motion and you know the swipe motion is so fine that the device is often confused by what users are trying to do. Tap or swipe. And the result is one is very different from the other. Next slide.

In this upcoming five-year rehabilitation engineering research grant in the last one we were testing 15 different products – assistive technology products and consumer products, but we found it difficult over that five years to stay ahead of the curve with regard to new products that came on the market. And so we wanted to make sure that we did that as best we can in terms of testing new and emerging technologies in these upcoming years. So we're looking very hard at a lot of touchscreen devices. Certainly smart phones and tablets and in particular apps that people with cognitive disabilities may find useful such as medication reminders, appointment reminders, and we're also going to look at wearable devices such as smart watches other kinds of wearables that are coming out and down the line two or three years from now we will be looking at smart home systems. And what types of user interfaces they bring to the table and how folks with cognitive disabilities are able to use those effectively and once again, what works for them and [ Indiscernible ]. And finally we also are looking at Google Glass or something like Google Glass. The jury is still out on that. There's a lot of pushback on that technology in terms of whether people in general are interested in using it. We want to wait and see if that is going to be around. I suspect that it will be. Another project we have associated within the next five years is developing and using a simple tablet user interface simulator where we can design a vast variety of user interface configuration, different button types, use different colors, label them differently whether it is with an image or text, or it is with an icon, and we want to design some testing around that using interface simulators to look at common types of user interface features that are out there now, and look deeply at what works for folks and what doesn't. And so more on that as we [ Indiscernible ]. With that I will turn it back to you.

Excellent, thank you Greg. We have heard from Peter and Lisa about the potential for tapping new markets and new pools of talent by working better, designing better for people with cognitive disabilities but what I'm hearing from you is that new technologies like touchscreens and other things like that is that while they present a big opportunity, they also present some challenges and that we really need to think differently and think more deeply about how we would go about doing usability testing and it sounds like you guys are breaking some new ground there in terms of how we look at usability testing both from a profit point of view as well as a design point of view. Will your work produce recommendations for people who want to do their own usability testing?

Yes, that is going to be part of it. I feel like in terms of the testing we have done with folks with cognitive disabilities using a method of usability testing with this population, I think we have learned quite a bit about how to plan and approave and carry out testing. To get really good, valid user information with these populations. And we will be reporting on that in the coming months.

Excellent. I feel like we have been getting a number of questions in from our audience members already and I do want to continue people to that chat function. I've seen some great dialogue going back and forth the some of our presenters and with audience members themselves so please do make use of that tool and Greg, we have a question that I want to go ahead and direct to you. The question is how do you classify or group people with cognitive disabilities for testing devices?

We started out looking at adults with mild to moderate cognitive disabilities. And we were looking at them across diagnoses. This would include people with traumatic brain injury, learning disabilities, developmental disabilities as well. And we realized there's a broad variation in abilities and how that disability manifests itself in these groups. We identified individuals who we felt like have the capacity to use the product independently, whether it was a fire extinguisher, whether it was a medication reminder, individuals for certain products if they had it, if there was text involved that they had to be able to read that text and understand it, recognizing that that was not ideal in terms of really categorizing and characterizing the disability groups we have been looking at and for this next five-year grant we enlisted the help of a neuropsychologist to help us identify and refine those groups. That's how we do it.

Excellent, thank you very much for that. One last question before I move on to shake, Lisa so we got a question if you can provide links to the studies that you referenced on dyslexia or ADHD and entrepreneurs. If you have those, if you can some is over to us we will get those posted up for folks to see. With that I really want to bring Shea into this conversation. Shea, thank you for being so patient. It is your turn now.

Emily Shea Tanis, University of Colorado Coleman Institute for Cognitive Disabilities

Thank you. I actually have the luxury here of being the cleanup hitter. You have had some wonderful presentations from friends and colleagues here from the Coleman Institute and we're thrilled to have them online. But what they have done some nicely is set up my conversation which is very nice. Richard, you wanted to know some of the statistics of who we are talking about and Peter put that out there from the very beginning here, some statistics we have out of the Coleman Institute. Here are some statistics on who we talk about as those with cognitive disabilities. It's a very large proportion, almost 30 million people. That's about 9% of our US population here in 2013. People who have a cognitive disability and as Lisa talked about this is a growing population. We are talking about the longevity Revolution and those in our aging population as well as those wounded warriors that we are seeing coming back with some traumatic brain injuries and some cognitive disabilities. So this is a growing population. Next slide please.

As we talk about employment of this group, you as employers on the line, as those who are looking for jobs, even with all of the policies in place, the advocacy and empirically validated outcomes, we're seeing some of the decline in the employment of workers especially with intellectual and developmental disabilities. Statistics here show it is a trend line of 37 years that, statistics we have been looking at, and we started to see a peak in 2009 and now it's coming down. We're seeing a decrease in employment. That is something to pay attention to and as we have highlighted these are a great group of participants in the labor force. I will talk a little bit more about what they can do to contribute even more so to your business and to your projects and advocacy here. What can we do about dealing with the employment, what can we do in your workplace? The first thing we talk about is changing the culture of this person to environment. Even though cognitive disability can be a central nervous system impairment, what we really know is to understand it and we have to look at the environment in light of a persons strengths and weaknesses. What needs to be recognized is this ability is truly a natural part of the human experience. Something that everyone will experience at some point in their life whether you have a broken arm, or you are too exhausted from the night before, your opponent, everybody experiences this. It is not so much tied to modality or to a diagnosis but it's a natural part so we need to think of it in that context. Technology becomes this critical support for people to enhance their functioning and to improve this person to environment fit. When I am tired, I tend to forget things. I have a wonderful Outlook that reminds me of all of my appointments. That is a technology that has improved my environment and what we know is that if you can well match these technologies, you can really reduce and even eliminate some of these functional limitations that we see.
Although we have looked at physical and sensory adaptations historically, we haven't really looked very closely at those cognitively accessible technologies and those aspects and accommodations that have to address the cognitive capacity. Next slide please.

So when we talk about cognitive accessible technologies and this is something you should all utilize. This is probably the only slide I will read directly through because it's really important. The requirements and technology materials that are cognitively accessible and those that incorporate these design features. To ensure that people are able to access those environments. It's an important thing to look at when we talk about their memory and learning and visual perception cognitive feed. These are all characteristics that allow cognitively accessible technologies to support someone in the workplace and in their living environment. The Coleman Institute – one of the things that we do and Julia was so kind to highlight it at one point in some of the things she had addressed was — I believe it was online in the PEAT blog posting was our Coleman Institute cognitive disability database where we are looking at some of the cognitive technologies for folks with disabilities and utilizing all of the information out there. It is something unique that we have to allow it as a resource for folks who are looking to understand that and we will have some great information coming from the team from Greg's team as well as Lisa's team that will be able to add some of the information to this database. Next slide please.

Through PEAT, they categorize employers so what can employers and technology providers do to help enhance the cognitive accessibility? It is looking at embracing the person to environmental fit. So much of what we know right now is there are attitudinal barriers and part of that is what prevents folks from being hired and maintaining employment as well as looking for accessibility features. When we embrace the person to environment fit it takes a different context. That is something that an employer or technology provider can do is to somewhat shift that focus, shift that mindset to really embrace this model and philosophy. We look at exploring those technologies and that is exactly what Greg and his team is doing which is wonderful. We encourage everyone to look at all of the research and the things that they are doing there to give you information about also employing people with cognitive disabilities and this means from the very beginning embracing all of those folks with cognitive disabilities into the workforce and into your setting. To be able to put provide you with user centered products and I talk here about user centered products and service design but we want to go a little further than that. We want to look at not the developed user center but this philosophy of participatory design. And that necessitates inclusion of folks at every stage of design and launching an evaluation so it's not just a evaluation of a prototype of it begins at the very start of brainstorming and adaptation of any development of devices or products and services. And building partnerships.

Not only do you want to have folks hired but building partnerships with those organizations such as the autistic self advocacy network, self-advocates becoming empowered and family organizations that provide you with information that you may be looking for. I can say as a family member myself, I can go into a product office to see a new product and within moments tell you what the barriers will be for my brother with a traumatic brain injury. That is the value you have by including folks. It saves a lot of trouble and provides that greater market value to a large population. And then we talk about meaningfully integrating principles of technolgoy and information access.

When that is — PEAT has a wonderful guide for accessible technology action steps guide for employers that they have on their website and I encourage you to look at that. One of those steps is that it talks about having a technology initiative. One of the things that you can do is integrate these principles of technology and information access.

With our partners, many of which are on the phone, the Burton Blatt institute as well as the assistive technology partners who are co-authors and collaborators on what we have called the rights of people with cognitive disabilities to technology and information access. What this really is is a statement of principles that builds upon the history of the community integration of rights of people with intellectual and development disabilities as well as with cognitive disabilities as a whole to allow people to have the access that they deserve. That they rightfully deserve. You can go to the next slide.

There is an abstract right here, I'm not going ot read through it, but also information for you to look at the statement. We say that it's been endorsed by 190 national and state organizations. Since I did this, we are up to 209. But it is growing. Some of the endorsers – next slide please – that you'll see here some of our initial collaborators in developing this is the Autistic Self Advocacy Network, the American Association on Intellectual and Developmental Disabilities. The American Network of Community Options and Resources, the Consortium of citizens with disabilities technology task force and so on and so forth. You can see a list there.

What we know is because you have heard frequently is the term ubiquitous. That really is what technology is. The reality is that we cannot perform our jobs without utilizing technology – I'm using it right now for multiple. I'm using multiple forms of a right now with the on the phone, using my glasses to read my PowerPoint as well as during the webinar. It is hard to recognize a world where we don't have it, but for many folks with congitive disabilities, that is the world they are facing. That is why we have developed this rights to people with technology and information access. For you to be able to share and understand that this is a movement that we need to recognize because this population being so large will be left behind without having this access available to them. And we see this as a movement and we're making history in at least Colorado and multiple other states are involved in doing this. The Colorado house state Senate unanimously passed this as a joint resolution for the state of Colorado. It just exemplifies the importance of this topic in being able to to make sure that all of it has the access that we need to be able to function and thrive in society today. That was my very short presentation. You can go to the next slide.

We're so lucky to have the partners that are on the line today with Lisa and Peter and Jim and Greg. We are thrilled to build and to participate in the things that they're doing and the Coleman Institute is here to help catalyze and integrate both the advances in technology as well as support those with cognitive disabilities to be part of a conversation. We invite you to contact us and we are happy to help and support any of the things that folks are doing to help make this a realization. Thank you.


Thank you. That was very informative. I want to connect a couple of dots here if I could before we — as we actually open of our — conversation here. Shea, you pointed out that disability is in fact part part of the human condition. And Lisa also noted that unlike some other disabilities, everyone experiences limitations in memory, comprehension other areas of cognition at all times. I'm interested to know where both of you tink there are overlaps between these special gaps in guidelines that we have been discussing and just a general approach to cognitive usability. Lisa if you want to take that first? Or Shea, either either one of you.

Go-ahead Lisa, I will let you take that.

You may have gone on mute?

Sorry, it crashed, so I reloaded the page and it worked again. So, I missed the question.

No worries. My question was that I think in both of your presentations, both you and Shae you point out that unlike other disabilities, everyone experiences at one time or the other limitations in memory comprehension or other areas of cognition and I'm interested to know from both of you how you see the overlap between the gaps and guidelines, what you're working on Lisa and the general approach to cognitive disability.

First of all, I'd like to point out that it's the same with physical disabilities in that there are people who need glasses when driving. People who need glasses all the time. People who are low vision and people who are legally blind. And no vision whatsoever. And take something like a visual memory, you will have people who have a strong visual memory. People with a weak visual memory and people who have no visual memory. So you can't really compare the continuum. The people who are disabled are in a place where it's not just difficult or annoying, they can do it because it doesn't matter how many flash cards you put in front of me, I will not learn to read flashcards because I don't have a visual memory. The same is true with all kinds of issues with cognitive disabilities. There is a continuum that is considered normal and then people who are off the continuum in this localized issue. So, although there is a big overlap because things that don't depend on a visual memory, that is good for anyone with a weak visual memory, that is not the same thing. There is a point where something becomes a disability that disables you from that participation. I would like to — I felt a need to clarify that although a lot of things are usability issues for everybody, they become I think accessibility issues and it's not a question of trying again. It's not going to work. So I guess that would be my take on that. On that issue.

Shea, what are your thoughts?

I'm sorry, as we start to look — Lisa did a nice job of describing this, but as we look at kind ofthe accessibility piece and where — your direction was — and correct me again Richard as we move forward, was to really address where they cognitive disability part lies in usability.

That's right.

And so there are different features, there's usability, accessibility, and there are barriers that have to be looked at within each of those features. And for a person to really have to access you have to look at it from a different capacity such as usability application and fish you can have accessibility as Peter has noted in the chat here. You can have accessibility but it's not the same as usability. We really need to look at different aspects within each of those and some of the standards that are going to be able to be developed both out of Lisa's group as well as Greg's group will address some of the actual usability along with those usability testing standards.

Thank you both. Greg, I know you are on our front lines here of usability in terms of testing. What is your view on this? Do agree with Lisa or Shea or do take a different viewpoint on how we should be looking at the field generally? Greg, are you still with us? He may be on mute.

Usability of a product for people with cognitive disabilities oftentimes is used differently than accessibility. There is an overlap there in terms of somebody with a cognitive disability being able to actively use a product. That's larger or I would say for people who don't have cognitive disabilities. The barrier smaller for them to do the — [ Indiscernible ] I think usability is probably [ Indiscernible ], more of a critical issue.

I'm afraid you are a little muffled there at theend, but I think I heard you say usability of more of a critical issue for people with cognitive disabilities?

I think usability or lack of usability can quickly turn into a lack of accessibility issue.

We've got and Greg a question for you from our audience here. Wonder if there has been any research done on touchscreens in the workplace and I think this may perhaps go to your point about usability becoming an accessibility issue. Has anybody looked at say touch panels in the conference room and controlling the entire space like a smart home.

Somebody had mentioned, I believe it was Shea, that someon had done some work with touch screens in a work environment. The issues with the touchscreen interface itself, how sensitive it is, how it is calibrated in terms of that sensitivity. I'm not sure — I haven't seen much in terms of studies done to look at that for folks with disabilities. However I know that there's produce detachable touch screens by and large the majority of touchscreens are not that design. Work hard to develop algorithms and signal processing capabilities to fine-tune those products the more sensitive and more active, however in some cases for folks who sensitivity may not be enough. So long to get back to the ideal situation with the interface. Something that individual with a specific — whom I think for that.

Thank you for that. I want to maybe shift gears here little but. Building off of what you just said, but also take us back to the original conversation that Peter opened up for us about the transformation that we are undergoing in terms of laws and regulations and the employment relationship. Peter your booki eQuality is among other things a very carefully drawn history of accessibility laws and regulation in the context of changing technologies and new and more expansive definitions of disability. We seem to be on a merry-go-round here of constantly having to adjust an update our legal requirements either toe frequently or sometimes too slowly or too reactively. Can we get off this merry-go-round? If so, how do we get off this merry-go-round?

I think that is a very good point Richard. Number one, 25 years from now, we won't be talking about accessibility or usability or situational components. Those will be terms of the past. We will have auto-personalization in the clouds and those employers that get ahead of the curve on this and I would add there are no cases that have been brought by individuals with cognitive disabilities successfully to deal with discrimination in the workplace. I was pro bono cocounsel in the NFB vs. Target case and in the Natioanl Association of the Deaf in California versus CNN. If employers are thinking to get ahead of the curve now is the time to think about personalization for all in the ways in which you can adjust your so you maximize participation for all individuals. And so to some extent, I think the technology is going to outpace this discussion in some ways that is optimistically the case. The challenge for employers will be to keep with that technology. And you are seeing it already. voluntarily for example the largest hiring website in the country voluntarily reconfigured their whole website with usability components and accessibility components. Why? Because they make money every time they place an individual who has a job. Everybody is going to have different cognitive abilities and different strengths and limitations so to the extent that employers can capture the market as has been said several times, they will remain successful.

Excellent. So thend do we have the opportunity for — what you are saying is we make the right choices and we think perhaps differently about how we use technology, we can overcome some of the legal and regulatory barriers if we take this mass personalization approach.

Yeah, I wouldn't characterize personally the regulatory and legal barriers as predominant. I would say most of it is attitudinal and cultural until we address the basic attitudinal stigma facing individulas cognitive abilities and disabilities, it's going to be hard to move forward.

Excellent point, thank you very much and on that point a question from our audience numbers for Shea and probably for all of us here on a panel. Shea, one person asked one challenge in the workplace is that individuals with cognitive disabilities are frequently hesitant to disclose their disability due to stigma. Just as I think Peter just pointed out here, attitudinal issues here and this is one of them. Concern it will reduce the chance of being hired or promoted. Do have any suggestions on how to empower people to self disclose and identify appropriate reasonable accommodations particularly as it relates to technology?

That is a fantastic question. Fantastic question. I do want to bounce off of Peter's last remark however that we cannot ignore it was in your question, we cannot ignore these attitudinal barriers of hiring folks. One of the most recent reports that actually came out of business case for hiring people with disabilities it's a report that as we look at those folks being as the employer perspective, what they are telling us and what we now know from the research is that it is these attitudinal barriers that are preventing hiring practices and preventing folks from being able to be hired. Actually, ODEP introduced the employer engagement strategy to rebrand the image of employees with disabilities through some of this marketing and psychological approaches, which I think is important for people to look at an address. I know we have some — I think this is actually, even though it is one I can address, I do feel that a great person to address this question is if Julia is still on able to respond I think she is more of an expert on this than I would be. Is Julia on?

I am. Can you repeat the question? I got a little lost in all of it.

The question has to do with the fact that people have cognitive disabilities can feel a stigma and are concerned about disclosing the fact that they have a disability and are therefore seeking whatever accommodation they would need. How do we deal with that stigma and what recommendations do you have for people with cognitive disabilities for self disclosing and seeking reasonable accommodation?

I think that is very true. Peter also spoke to this earlier. Physical barriers are generally easier to deconstruct them these deep-seated attitudinal barriers that we face. There is no easy soundbyte I can give here. Disclosure is deeply personal and there are different risks in different situations. One of the things that is exciting is as we move towards a future where technology in general defaults to something that is more individualized, more customizable with a bigger emphasis on usability and the consumer experience, a lot of cognitive accessibility needs can be addressed to an extent through that kind of thing. So it becomes less notable that I might have my laptop set up a certain way and be using certain programs or text to speech and speech to text for example because so do other people around me regardless of whether or not they have a disability. We have seen a similar thing in terms of people who use dedicated devices to communicate or for example communication aids. As more more apps become available on tablets to support peoples communication instead of having to haul around a very bulky device that is tied to disability, people are able to pull out a tablet or a smart phone and that helps reduce stigma for a lot of people. But ultimately at the end of the day, the only way to make disclosure safe for everyone and the only way to really prioritize breaking down the barriers that people with disabilities face is to combat stigma and that is something that will take quite some time. But at the end of the day it is what has to be done.

Excellent. Other panelists? Greg or Peter? Your thoughts on this?

Frame it for us again Richard? You have done a very good job at that. I know we're getting close to the end of the time anyway.

Yes. I will try to be brief. The question is recommendations for people with cognitive disabilities on self disclosing and seeking accommodation when they meet stigma.

Without giving you legal advice, given the experiences I have seen not so good in pre-disclosure I generally suggest to people get the conditional job offer and then disclose. I have seen too many people with epilepsy for example who disclose in the interview process and then they some way find that it doesn't work out. I just think the stigma card is very strong here. Others may agree or disagree.


I agree. I've had similar experiences. But I still would opt to disclose because you need an accommodation in the workplace. So I would say if you have the option of choosing a job, disclosing is a good way to make sure you are in right place.

I was saying from a timing point of view. From a timing point of view, that's all I was saying. You definitely should disclose for an accommodation, but not too quick.

I am disagreeing with you because I'm saying that you want a place that won't not offer you the job because of your — because of who you are. If you're going to a place and — that would be my take. The kind of place —

I would agree in an ideal world. I would agree.

And so if you have that luxury of more than one job offer, disclose early on in the process and let people weed themselves out as bad employers. The other thing I wanted to point out as a ray of hope is that if we have — and I think we will have people trying to accommodate their users, their market. Then, the disclosure for accommodation is going to be less of an issue. Your market is almost exactly the same as your employees. Most people don't want to disclose disabilities. A lot of people with cognitive disabilities haven't even faced up to their condition. So they are not going to say, yes I have Alzheimer's, give me the interface for people with Alzheimer's. They might say give me the interface, I have a headache. Industry is going to be solving these problems of different preferences that will have different labels that somehow will map to different disabilities but not quite so directly. And I think industry will sell this for the users and their market and then by default for their employees.

Think very much for that. I want to get one less question before we run out of time here. I think if Jim is on the line, this might there a good question for them. I welcome anybody. One of our audience members asked how far has the committee on cognitive technology, in standards development? Jim, or Julia, if either of you wants to answer the question or if any of the panelists have input on that.

That would be a great response.


Yes. I am part of that committee and I can tell you that that work is still certainly in its infancy. A structure and a framework, for standards development technology for people with cognitive disabilities and it has been addressed and the issues have come forward and also our testing as well as existing research has started to populate those standards in a draft sort of way, but there is a lot of work to do and I would encourage anyone who feels like they are interested in the process to indicate their interest because I know that the committee is still looking.

Thank you Greg. We have reached the end of our time. We are going to need to wrap up. I hate to do it but this has been such a riveting discussion. I do want to let those of you who don't know much about PEAT. It is a partnership unemployment and accessible technology and is a multifaceted initiative promoting the employment retention and career advancement of people with disabilities through the development adoption and promotion of accessible technology. PEAT is funded by the US Department of Labor Office of Disability Employment Policy and is managed by the Rehabilitation Engineering and Assistive Technology Society of North America (RESNA). Guided by a consortium of policy and technology leaders, PEAT is the only entity of its kind that brings together employers technology providers thought leaders and technology users around the intersecting topics of accessible technology and employment. I think all of the group served by PEAT not to mention the rest of us have heard a lot that is help their understanding of this issue today. We always strive at PEAT to provide information that is understandable and usable and we hope that we have done that here today for you. For those of you would like to view this webinar again were tell others about it an archived version of this webcast will be available on in the very near future. Stay tuned to PEAT for more great information including more of webinars to come. You can follow PEAT on Facebook and Twitter for updates, thank you so much to our incredible panel, Jim, Peter, Lisa Greg and Shae, you have been great and we appreciate your taking the time to share your incredible knowledge with our community and finally, thanks to you our audience for joining us we hope you enjoy it until next time thank you. I am Richard Crespin and this is the end of our webinar.

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