Tag: accessibility

Speaking with An Augmentative Device

Person using agumentative deviceMy 25 years old son is non-verbal. He uses his phone as his speech output device. He has worked hard to learn the software on his phone.  This software speaks the words that he types into his device.  He has used a variety of other speech output devices in the past.  There are many more options for speech output devices available now.  And, there are places like MassMatch (1 ) which can help each user to find the best choice.

When he was younger, family members and teachers would always be with him and speak for him. These days he still always with someone when he is out in the community.  But, now, he is interested in speaking for himself.  He also has the vocabulary and skills to speak for himself.

So, how does it go?  Well, it depends… Let me describe a common situation that shows how much effort it takes for my son to communicate in public places. Ordering fast food or in a restaurant is something that we all do. For my son, it is a chore. He must get the waiter’s attention. Then, he will order his food.  Most of the time, he needs to repeat his order.  e needs to repeat it more than one time. If the waiter stops and listens, it is easier.  but, most of the time, he needs to repeat his order.

Speaking in public is hard for many people. It is more difficult for someone who uses a speech output device. He shows us that many strangers do not choose to listen.  Our public places, malls, restaurants, outdoor spaces are noisy.  here is music, talking, traffic, and other sounds.  My son cranks up the volume on his phone. On a good day, a stranger will listen to his computer voice.  The pride my son takes in talking with someone is worth the effort. This photo shows my son speaking to us.  You may be in a place where someone is trying to speak with a device.  Please take the time to listen and respond. It only takes a little bit more time and the rewards are great.

(1) MassMatch

How to Call a Deaf Person on the Phone

person using video relay servicesI am a doctor, and I am deaf. A deaf person is someone who cannot hear most things. For example, I cannot hear your voice on my cell phone, but we can still talk on the phone!

If you need to talk to a deaf or hard of hearing person on the phone, it is important to ask him or her what is the best way. We may have a special phone number for you to call.

Some people use a special phone like a TTY/TDD or a Captel phone. You can call on any regular phone, and a person in the middle will type what you say on their special phone, so the deaf person can read it.

If the deaf person knows sign language, it is popular to use a video relay service. During a video relay call, you will talk to a sign language interpreter on your phone. The interpreter shows up on a video camera to the deaf person, and will sign what you said. I can use this app on my cell phone!

Through this phone technology, deaf people can call the doctor and talk to family. They can also call 9-1-1 in an emergency. If you are deaf or hard of hearing, you can use these services for free.

The Rochester Institute for Technology has a How To Guide about Video Relay Service (PDF)

Using Tablets to Talk!

Picture of school-aged girl sitting at table using tablet.Communication

There are some children who have difficulty talking. Using a tablet can help.  Finding the right tablet for each child is not easy. A specialist, called a Speech Language Pathologist (SLP), is like a doctor. A SLP meets with the child and watches the child playing. The SLP also speaks to the child. The SLP enables the child to play with different tablets. The purpose is to see which tablet the child likes to use the most. The SLP then asks the child to do a few tasks. The difficulty of the task levels go up to match the level of the child’s understanding. The
SLP has questions for parents as well. The SLP wants to understand how parents and their children talk to each other at home.
Once the SLP finishes meeting with the child, the SLP will write a report. Parents will receive a copy. If parents want to get a tablet for their child, parents and the SLP will work with each other for at least a month. They watch the child using the tablet at school, and then at home. The purpose is to see if the new tablet is really helpful for the child. Parents will take some data to share with the SLP.
Once a child has the right matching tablet, it is important for the parents to know how to use it. Training for parents is important. Parents need to know how to help their children. Many are afraid of allowing their children to use tablets. They worry their children will become dependent on a tablet and not vocalize any more.
For more information, contact Massachusetts Advocates for Children.

Why Visit a Museum?

kids touching baby head sculpturePersons with disabilities can:

  • Learn the past
  • Talk about big and small issues
  • Share ideas
  • Listen to others
  • Make things to share your ideas

The community gains:

  • A place for everyone
  • A place for everyone to learn new things together
  • A place to share ideas

I lead an organization called Our Space Our Place, Inc., an after school program for youth who are blind. We visit many museums. Our students learn about different cultures. They write stories and poems. They talk about the stories in art. They talk about their favorite paintings and sculptures with their families and friends. Taking a tour or making art opens new worlds.
For more information about museum programs for people with disabilities contact:

  • Museum of Fine Arts
    • Hannah Goodwin
    • Phone: 617-369-3189
    • TTY: 617-369-3395 or
    • Email: access@mfa.org

World Usability Day is a Platform for Stevie Wonder’s Call to Action

“Stevie Wonders addresses the audience during the 2016 Grammy Awards ceremony.” Legendary singer and activist Nina Simone believed that the role of artists goes beyond the art they create: “How can I be an artist and not reflect the times? That to me is the definition of an artist.” This idea came to life during the 2016 Grammy Awards ceremony when Stevie Wonder called for people of the world to “make every single thing accessible for every single person with disabilities.” While the American’s with Disabilities Act (ADA) outlaws discrimination against people with disabilities, there are still many areas of life that are inaccessible, including the digital world. Bias and negative attitudes continue to create barriers and limit expectations of what can be done to make a difference. So, what can we do? Being a reflection of the times is not just an artist’s duty, it is a responsibility we all share. The stuff we buy, the people we vote for, and the topics we discuss help to influence decision makers in government and business. In response to Stevie Wonder’s challenge, Chester Goad suggests 6 steps that each person can take. These are:

      (1) pay attention
      (2) be educated and educate others
      (3) be proactive, not reactive
      (4) avoid labels of “inspiration”
      (5) understand that disability is diversity
      (6) vet your creations.

One important opportunity for educating yourself and others is World Usability Day. On November 10th, 2016 advocates, students, professionals, government officials, and leaders will exchange ideas and showcase products with the goal of creating more user-friendly experiences in all areas of life, including education and technology. This year’s theme is sustainability. Just as Earth Day shows the world that the environment matters, World Usability shows the world that accessibility matters and that it is an important part of creating a sustainable future.
For more information about user experience (UX) design and Elizabeth Rosenzweig, the founder of World Usability Day, read Successful User Experience: Strategies and Roadmaps.

About the author Lauren Lange


Carl with his service dog Merrick
Carl with his service dog Merrick

As a person who has used a service animal for just over 15 years, I can tell you I get stopped constantly and asked a lot of questions. I once even got stopped by Bill Gates of Microsoft; he asked me if my guide dog was a bomb sniffing dog.

Below are answers to some of the most common questions I get asked.

  • People with disabilities who use guide or service dogs can go everywhere.
  • A service animal is a dog that is individually trained to do work or perform tasks for a person with a disability.
  • Examples of Service Animal include those who guide people who are blind, alert those who are deaf, pull a wheelchair, alert an individual to a seizure attack, remind one with a mental illness to take his/her medication, and much more.
  • A service animal is not a pet.
  • Do not touch the animal or give him/her treats without the permission of the owner.
  • Service animals are not required to be certified. If the person tells you it is a service animal, treat it as such.
  • A person is not required to carry proof of disability or to say why he/she requires the use of a service animal.
  • A service animal must be on a leash if local ordinances require that.  But a harness, special costume or muzzle are not required and are only present when needed for the animal to do its job.
  • If the animal is out of control or presents an active threat the handler may be required to remove it from the site.
  • A business is not required to walk or otherwise care for the animal.
  • If an individual asks that you hold a guide dog, and if it is appropriate to the situation, hold the leash not the harness.
  • Allergies and fear of dogs are not valid reasons for denying access or refusing service to people using service animals.
  • An Emotional Support Animal is not a Service Animal.
  • A Service Animal cannot tell when a traffic signal changes color.
  • A Service Animal does not always know where it is. It is up to the handler to know where he/she is at all times.
  • According to the Americans with Disabilities Act, (ADA), a service animal can only be a dog.
  • A business or service cannot charge a customer extra for having a service animal.
  • My service animal is still smart even if he doesn’t know how to give “paw”.
  • Yes, my dog likes to play fetch.

The next time you see a service animal, remember these answers and tips. Also, remember to ask the handler what you can and should do, and ask yourself how you would like to be treated if you had a service animal.

Communicating With People Who Use AAC

Image of an AAC screen
Image of an AAC screen

“In this country we are justly proud of the freedom of speech, that we can say what we want. But I think there is an even more basic freedom than the freedom of speech and that is the freedom to speak.” Stephen Hawking

What is AAC ?
As a speech-language pathologist, I have had the pleasure of working with many children and adults whose developmental disorders or traumatic brain injuries have rendered them without a voice. As a result, many communicate with the support of Augmentative Alternative Communication (AAC) systems. AAC is a way to enhance and support communication in people whose existing speech is not functional. AAC can be:

•    High-Tech

  •     iPads;
  •     DynaVox;
  •     Tobii Eye Tracking; or

•    Low-Tech

  •     DynaWrite
  •     voice output; or

•     No-Tech

  •     picture books;
  •     alphabet system

Communication Partners
I worked with Jen*, a former patient of mine who used a communication book with words organized in numbered columns and rows. Jen was a fast user. I was a fast learner. I pointed to each column and row. She would raise her eyebrows to say yes or wiggle her lips to say no. We would eventually land on the target word (“Column 6, Row 2, Word: Hi”). Just as there are communication breakdowns in a speaking conversation, there are those in a conversation using AAC too. There were times when I moved through the columns or rows too quickly, and completely missed Jen’s signal. She would get frustrated. Or, maybe she was tired that day and her ambiguous raised eyebrows looked more like a muscle twitch. I would get frustrated. No matter how many breakdowns or how long it took, we had an endless amount of patience for one another. We were communication partners. We wanted to hear what the other had to say.
*Name has been changed

“And he’s Dopey…He never talks”
Too often I have opened a patient’s file and read ancient medical reports saying, “Patient was unable to respond to my testing questions…Patient is diagnosed with Mental Retardation”. Fortunately, we have come a long way from those archaic testing methods! We know that even though an individual cannot speak, it does not mean that s/he does not THINK (contrary to the classic fairy tale). Across my work, I have had the honor of meeting smart people, who just happen to also be AAC users. They have written books, presented at conferences and produced short films. AAC users have a lot to share with us as long as we are patient and willing to listen.

3 Helpful Tips When Communicating With an AAC User
1.    Remember to Pause. As I have discussed throughout this blog, patience is important, especially when communicating with AAC users. Be sure to provide enough pause time to allow the AAC user to respond to your question or comment.
2.    Face the Speaker. There is more to communication than speech alone. We communicate with our ENTIRE body, using facial cues, hand gestures and body movements. Make sure to face the AAC user while s/he is speaking so that you incorporate all those non-verbal cues and gain a better understanding of his/her message.
3.    Reduce the Use of Questions. There is a sense of pressure to be the one to ask the questions and maintain the conversation. However, questions tend to demand the AAC user to talk and can make the conversation one-sided. Instead, you can elicit a conversation by making comments.

Suggested Resources
•    I Raise My Eyes to Say Yes, by Ruth Sienkiewicz-Mercer and Steven B. Kaplan
•    The Diving Bell and the Butterfly, by Jean-Dominique Bauby (there is a movie too!)
•    Radiolab- Mr. Bliss: https://www.radiolab.org/story/257194-man-became-bliss/
•    Praactical AAC Blog: https://praacticalaac.org/
•    Augmentative Communication Program at Boston Children’s Hospital Facebook Page: https://www.facebook.com/ACPCHBoston?ref=br_tf


As some of you have read in the paper lately, there is a battle going on over accessible sidewalks in the historic neighborhoods of Boston. This story starts back in 2007. Below are some of the highlights:

  • Starting in 2007, disability community filed over 500 sidewalk violations against Boston with the State
  • State fined Boston $500 a day for violations
  • Violations included lack of curb cuts and tactile warning strips for the visually impaired
  • Fines eventually totaled over $400,000
  • City of Boston, State, and disability community agreed to new settlement
  • Settlement included the following:
  1. Plan to bring 5,000 curb cuts into compliance over 15 years
  2. Fines would be waived if put towards renovations of accessible sidewalks
  3. New sidewalk policy created which included concrete curb cuts, yellow tactile strips, and no “new bricks”
  4. Formation of new city disability commission
Same sidewalk intersection with newly installed curb cut and tactile warning strip
Same sidewalk intersection with newly installed curb cut and tactile warning strip


While the new sidewalk policy worked for much of Boston, it was not enforceable for the historic districts, which included Back Bay, Bay Village, South End, and Beacon Hill. These neighborhoods all have historic commissions that need to give permission for work to be done on the sidewalks. These districts were opposed to the sidewalk plan. They did not like the materials being used for the curb cuts or the use of the tactile warning strips, and they felt the plan was not historic in nature. They wanted brick ramps and no warning strips. To try and address this issue, the following was put into place

  • A task force was put together that included people from the Mayor’s office, historic neighborhoods, and the disability community
  • Ramps at curb cuts would be shorter
  • Color of tactile strips would change from yellow to terracotta
  • Neither side was fully happy with compromise but felt it worked for both


  • City of Boston approached historic commissions with compromise
  • 3 of 4 commissions accepted compromise
  • Beacon Hill Architectural Commission denied compromise
  • Mayor Menino stepped down; Mayor Walsh elected

The City of Boston and Mayor Walsh decided to move ahead despite the fact they did not have approval of the Architectural Commission. The City did this because it knew that it would not only risk getting fined by the State again if it continued to delay the project but that it was also the right thing to do for people with disabilities. In a final meeting with the Beacon Hill Architectural Commission, the Beacon Hill Civic Association, and the residents, Mayor Walsh told people of his decision to proceed without their approval. He stated that construction would start in late summer and early fall.


Same sidewalk intersection with newly installed curb cut and tactile warning strip
Same sidewalk intersection with newly installed curb cut and tactile warning strip

Construction has started on the curb cuts in Beacon Hill. The Beacon Hill Civic Association has filed a lawsuit in Suffolk Superior Court stating that the Mayor has overstepped his jurisdiction by not getting the approval of the Beacon Hill Architectural Commission. At one point the Architectural Commission said the residents would pay for more expensive materials that would create ramps they felt were more historic in nature, but the city of Boston said no for several reasons. First of all, it would not be fair to the other historic commissions who had already agreed to the compromise. It also would not be fair to have different rules for different neighborhoods just because one is more affluent. Finally, the City of Boston and the Mayor’s Commission for Persons with Disabilities feel it is a civil right for persons with disabilities everywhere to have safe, full, and equal access to sidewalks.

Accessible Elections

Unless you live in Boston, it is a dull election season for many of us in Massachusetts. In my town we don’t have an election scheduled because there isn’t anything on the ballot. As a democracy geek, I feel most patriotic when I vote. I like the whole experience – connecting with my community, shaping my government, and the obligatory bake sale in the hallway.

cupcakes on an American Flag In case you had any doubts, there is absolutely no excuse for a polling place to not be accessible on Election Day! The Help America Vote Act (HAVA) falls short of requiring the PTA to offer gluten-free options at an election day bake sale, but it sets the legal standard for individuals with disabilities to have “the same opportunity for access and participation as for other voters.”

In Massachusetts, voters with disabilities are protected by the Massachusetts Voters’ Bill of Rights that states that a polling place, and a voting booth at each polling place, must be accessible. While the goal of these laws is to provide the same voting experience for all citizens, an individual with a physical disability that prevents him or her from voting at a polling place on Election Day may request an absentee ballot in Massachusetts.

Yet concerns about voting access were raised this past June at a conference of Massachusetts Disability Commissioners. Despite legal protections, individuals with disabilities still experience difficulty voting. The National Council on Disability’s “Experien Experience of Voters with Disabilities in the 2012 Election Cycle”report documents an unacceptable number of polling places that are not accessible, poorly trained election workers, and malfunctioning accessible voting machines.

While I don’t have a physical disability that limits my ability to cast my ballot, during the last election I entertained the idea of asking to vote using the AutoMARK Voter Assist Terminal to experience accessible voting. I am curious what it is like to use the AutoMARK, and how election workers might handle my request. Each polling location in Massachusetts has an AutoMark Terminal, and election workers are expected to be trained in working with individuals with disabilities, and how to operate the AutoMARK.

I didn’t ask to use the AutoMARK, but after voting I did spend time talking with a poll worker about the experience of individuals with disabilities at my polling location. The election official said that during every election the workers run a test procedure using AutoMARK before the polls open to make sure the machine is working. The worker said several years ago one voter with a visual impairment used the machine, but the voter didn’t like his experience and he has voted without it in subsequent elections. Apparently where I vote the AutoMARK is barely used.

“It’s as easy as 1-2-3” claims the manufacturer of the AutoMARK in a promotional video. It didn’t seem quite that easy, but using the AutoMARK didn’t seem any more difficult than using an ATM machine. The system primarily benefits visually impaired users, although the screen reading functionality can apparently assist someone with dyslexia. The AutoMARK is supposed to be equipped with a privacy screen, but I did not see the screen at my polling location.AutoMARK machine with a screen

While it may help some people, the AutoMARK is not a one-size-fits all equality machine that removes barriers to voting for all individuals with disabilities. I fear that all the focus on the AutoMARK will give election officials the false impression that on machine can address the varied voting needs of individuals with disabilities. As suggested in the National Council on Disability’s report, additional funding is required to ensure access to the election process in America.

What Does Accessible Mean to You?

As I began my Gopen Fellowship, I thought that describing what was accessible and what wasn’t would be simple. Just look at the architectural access code, right? Was I ever wrong.

The summer before my fellowship, I went on a family visit to an “unnamed to protect the innocent” cultural venue in Boston. Our family group included two children in strollers, one still in diapers, and an elderly relative with hearing loss, diabetic neuropathy and osteoarthritis.

We benefited from, and made use of, ramps, wide doorways, and accessible restroom stalls. But sometimes the needs of our group fell outside of the ADA Accessibility Guidelines, but still impacted our ability to enjoy the venue. We needed places to sit and rest, family restrooms and good lighting.

One size does not fit all

I realized that meaningful access is a lot more than compliance with access code and following regulations. I also realized that lack of access didn’t just affect people who identify themselves as a person with a disability.

Most elements in our environment are designed for an adult of average size without physical limitations. Those elements then need to be “adapted” for everyone else: children, people of differing heights, weights and abilities.

Universal Design

As I looked into this further, I began reading about “universal design.” It is defined as: “the design of products, environments, programs and services to be usable by all people, to the greatest extent possible, without the need for adaptation or specialized design.”

What a simple, elegant and revolutionary idea!

Access benefits everyone

When ramps and curb cuts were mandated by the Americans with Disabilities Act, many people perceived it to be a waste: a large expenditure to benefit a small number of people. Twenty years later, every parent with a stroller and every delivery person with a dolly takes them for granted. Closed captioning on television is used in noisy environments like bars and gyms all of the time.

Since one size does not fit all, it is important to “know before you go.” Finding out about accessibility is an interactive process: call, ask questions and send emails! A cultural venue is more likely to respond to an accessibility issue or need once they are made aware of it, so don’t be shy!

Nora Nagle
Nora Nagle, Guest Author