Wednesday, October 17, 2007

The Coming Crisis

Doom and Gloom! There, we got it out.

Actually this article is about hope and promise and a better life for everyone, but the background is not very encouraging. And without the background, the discussion doesn’t make much sense.

Here’s the basic premise. Vision loss and age are inextricably linked. There are eight million visually-impaired people in the U.S. and 80% are age fifty or greater. This shouldn’t come as a big surprise. As we age our bodies deteriorate and the eyes are specifically vulnerable to diseases like:
• Macular degeneration
• Diabetic Retinopathy
• Glaucoma
• Cataracts
• Corneal opacity

The current assessment is that 800,000 people age 65 and older in the U.S. are totally blind. By 2015 it will be 1.5 million and by 2030 it will be 2.4 million.

The cause is simply the aging of the population. As the “Baby Boomers” hit retirement the graying population will increase dramatically and the prevalence of blindness will likewise increase. We can and are making great strides in attacking various causes of blindness, but we can’t stop people from getting older.

Certainly everyone knows this “graying” is occurring. From AARP to Social Security there is a great deal of planning and marketing going on relative to the sharp growth anticipated among the nation’s elderly. But there has not been a lot written about what this means to the nation’s blind services structure. For the most part, and in most states, different organizations manage issues regarding the elderly and those pertaining to vocational rehab. But when it comes to dealing with the newly blind, many of the issues are the same and the resources in place are not sufficient to respond to the coming need.

As things stand today, seniors losing their vision are going to be hard-pressed to maintain their independence. And this is a real shame because today, with the availability of resources of all kinds over the Internet, there is no reason for a blind person not to live independently. The digital lifestyle means liberation for people with blindness and low vision and baby boomers, like no aging group before them, are well versed in its benefits. Yet the supporting agencies are not prepared to help them make this transition.

What are the benefits? Here’s a list we’ve compiled:
• Community: individuals can interact and share information and experiences with other like-minded individuals at will
• Awareness: The Internet provides nearly instant access to news and information of all kinds. People using this source of information are significantly better informed and aware of world events than those who do not have access.
• Information: The Internet is the best single reference source for information of all kinds. With the aid of a search engine, a user can access the vast library of government publications plus an even larger library of private information sources. There are few, if any, subjects that cannot be successfully researched via the Internet.
• Employment: Computer usage is virtually essential for any meaningful employment in the modern world. Via the Internet, persons can not only be employed but often work from their homes.
• Entrepreneurial activities: The Internet makes it possible for any individual to sell goods and/or services to a worldwide market.
• Education: A computer and computer skills are essential for modern education. Via the Internet, a person can pursue a wide range of educational opportunities ranging from acquisition of technical skills to completing high school, to acquiring a bachelor’s degree, master’s degree, and/or Ph.D. from accredited online universities.
• Entertainment: Via the computer and Internet one can enjoy virtually any desired entertainment from described DVS’s or downloads of popular movies to thousands of Internet radio channels, to games of all types, and all manner of hobby-related forums.
• Health services: Self-care, healthy living programs, health coaching and ask-the-doctor information is all available on the Web.
• Shopping: From necessities to luxuries, one can buy anything via the Web, all without leaving the comfort of one’s home.
• Finance: Online banking, investing, loans – almost any financial activity can be carried out over the Web
• Creative arts: Writing and music are two creative activities that the blind can enjoy using digital technology.
• Counseling: Online support groups are available for a wide range of issues from grief-management to depression to cancer survival.
• Spiritual: Whatever your path, the Web has resources to support you ranging from virtually all conventional religions to a huge array of less conventional spiritual paths.

The simple ability to stay connected to family and friends via e-mail is enough to make being online worth it to most seniors. Add Internet-based telephone services like Skype and people can stay connected to loved ones around the world, for peanuts. But today, in the world of conventional assistive technology, it costs the elderly person (or the supporting agency) several thousand dollars and weeks or months of study – with all the necessary transportation – just to be able to send and receive e-mail. That’s insane.

And it’s unnecessary.

Nationwide, blind services organizations march lockstep to the beat of conventional screen reader technology. That is their sole solution to blind accessibility and no matter the situation they apply it. As the saying goes, “when your only tool is a hammer, every problem looks like a nail.”

But as good as conventional screen readers are, they are without exception complex and difficult to learn. They are expensive and they require weeks or months of training to achieve proficiency. Once proficient, a blind person can do amazing things. But most elderly people or new users lack the core technical skills to master conventional screen readers and agencies lack the resources to purchase the high priced software and training required.

But in fact, for the cost of rehabilitating a single blind person with conventional screen reader technology, an agency can deliver full accessibility to four to six blind people who are not looking to become computer professionals. Assuming a conventional screen reader cost about $1,000 and requires about $3,000 in training for the user to achieve proficiency, Serotek’s System Access Mobile cost $499 and a user can be trained in about two to ten hours. You do the math.

Moreover, using Serotek’s RIM (Remote Incident Manager) or Remote Training and Support the user can be trained over the Internet, with no need to travel and take up class room space. The service agency can provide one-to-one, on-screen tutoring with the trainer and the student both working from the comfort and convenience of their own homes.

Logic would suggest that state agencies and local rehabilitation organizations would welcome tools like System Access Mobile and RIM with open arms. With them they can help more blind people for less money. How can they not be excited?

But logic doesn’t take into account inertia. The entire organization is structured for conventional screen readers. That’s how budgets are developed; that’s where training skills are concentrated. There may even be a vague fear that if it is that easy to give newly blind people accessibility, training jobs will be in danger. Of course, nothing could be further from the truth. Even with the six-fold (or greater) multiplier effect that System Access delivers, the demand will continue to exceed the supply as the population ages.

Unfortunately, the person with the least say in this decision is the newly blind person. He or she basically gets what’s he or she is given as decided by the professionals. The result is that people in need of accessibility tools are hugely underserved. A mere handful of blind people (perhaps eight to ten) end up with the ability to access the digital lifestyle out of every hundred or so who need accessibility help. And that is extraordinarily costly. A blind person without accessibility consumes far more resources in terms of personal care, medical care, social services, and welfare than a blind person with full access to the digital lifestyle. And, sadly, the person without access lives a much more enclosed life and is more apt to fall prey to depression. Without accessibility, blindness is a prison sentence; with it, it’s a minor inconvenience.

There is, of course, no incentive for the producers of conventional screen reader technology to make their products less expensive and easier to learn. This isn’t a “free market” where they must compete head-to-head against alternate solutions. Rather it’s a captive market where the buyer has no choice. The in-place infrastructure has a bias towards maintaining the status quo, even at the expense of the nation’s ever growing population of newly blind elderly people. We on the outside can call for a level playing field, where consumers can make their own informed choices, but those who have control of the playing field have no interest in making this a fair contest.

At Serotek we believe that when you can’t win through evolution, it’s time to start a revolution and we have one in the making. When an infrastructure does not serve the people it was created to serve, it’s time to look for ways to make the infrastructure irrelevant. We have been pushing the technology envelope for six years and our latest product, System Access to Go, available directly over the Internet on demand, may be the catalyst for change.

We are working with a number of people who have the interest of the individual blind person at heart. We are close to making an announcement that we believe will simply change the way accessibility happens – to the benefit of all. We invite you to stay tuned. But in the meantime, don’t hesitate to rock the boat. Change won’t happen unless we work to make it happen. “Information without accessibility is tyranny!” Where the heck is that tea?


Anonymous said...

Roger Fordham: The upcoming crisis
I don't know the solutions. All I know are the questions.
Most sighted folks haven't the faintest idea what a screenreader is, or what it does. From a blindness perspective, this is difficult to take on board. Never-the-less, it's true. It therefore follows that for people who know not any better, one screenreader is the same as another; if it reads what's on the screen, what's all the fuss about. And when competitors boast that ther particular model of screenreader works better, faster, more efficiently, etc. etc. than somebody else's does, most people outside, who really don't give a damn anyway, will simply put it all down to marketing hype, which, except for Serotek, I have to say, it very largely is. Thus, people who control budgets will only dole out money to the best hyper, for the irony is, the psychology goes, if it's cheaper, it can't be as good. The fact that Samon is the best of the lot will pass them by, because they won't, or don't, know the differences between the products anyway. How one overcomes these paradoxes I don't know. Perhaps it's a question of degree. If one in 100 takes it on board, perhaps that's a success story. All one can do in the end is bash on. It's not sufficient for the blind community to know the differences; really what would make a difference is if say Bill Gates wanted to incorporate Serotek's ideas into the next generation of computer software, without, of-course, Serotek being subsumed into Microsoft. Now that really would make people sit up and take notice. But how such a thing is to be achieved is quite beyond me.
And I agree totally with Mike. If you can't afford 12 dollars a month, it may sound arrogant to say so, but it's not worth the problem's solution, and 129 dollars a year is very little in real terms, in fact peanuts for a commercial company. And I fancy that may be a bit of the problem, Serrotek under sells itself.
Cheers for now

Anonymous said...


There isn't any reason why using computer software should be as hard as the conventional screen reader vendors make out it is. If something is difficult to use then it's a design issue and not a training issue as Eric Damery would have us believe. A word processor is more complex than the typical screen reader yet very few people receive formal training in how to use a word processor.

I think there is another factor to the systemic problem that Mike describes. The processes that blindness organisations employ were designed to meet the needs of blind people ten or twenty years ago. For example, the processes assume that people have a large amount of surplus time that they can devote to training. As blind people increasingly become employed and as the number of people in employment who are going blind increases the amount of spare time that the average blind person has is decreasing. If someone is trying to keep their job whilst they are losing their vision can they really afford three or four weeks off to receive training on how to use a screen reader or to go and train with a guide dog? The way blindness services are delivered is looking increasingly out of place in the modern world and may even be a barrier to employment and greater participation by blind people in the community.

Anonymous said...

I've just realised one assumption that it would seem that the blindness agencies are making. It looks as though they consider life to stop or be on hold when someone loses their vision. This gives the individual the spare time needed to undertake all the training and fit in with the processes laid down by the blindness organisations. This idea that life stops imposes a barrier between the pre and post vision loss eras of a person's life. A barrier blocks things and doesn't allow them to pass. So, it's hard for some elements of a person's life to span from the pre vision loss era into the post vision loss era. All these processes that assume people have a great deal of spare time make vision loss more devastating than it has to be. In order to meet the time requirements of training and the other processes laid down by blindness organisations people have to give up aspects of their lives, and this can include jobs and other elements of life that consume large amounts of time. Maybe the way that these processes, such as rehab, screen reader training, and guide dog training, are currently designed adds to the devestating effect that vision loss has on someone's life.