Since the debut of the VictorReader Stream and the introduction of downloadable audio books from the National Library Service, the market for modern digital book and audio players has exploded. The Milestone 312 from Bones is the latest entry in this crowded market. In addition to the audio and book playback features typical of these units, the capabilities of the Milestone can be expanded with hardware and software add-ons including a color identifier, bar code scanner, and agenda program. Bones is highly regarded for their digital audio players, especially in Europe, where the Milestone is one of the most popular digital players. In this review, we put the unit through its paces, running version 3.20 of the firmware.

We've offered reviews of other digital book players in previous issues of AccessWorld. While we'll occasionally refer to these models for comparisons, you should consult these articles for thorough reviews of these products.

The Player

When compared to other units, perhaps the most noticeable difference in the Milestone is its relative lack of buttons: the unit has only six buttons for controlling its functions.

Those familiar with the Milestone 311 will recognize the layout of the buttons on the unit, as this latest model has a very similar form factor. With the unit oriented face up, five buttons form a plus sign on the upper half of the unit's face, each with a distinct tactile design. Play/Pause is the concave circular button in the center; to the left and right are two arrow-shaped buttons used for rewinding and fast forwarding playback as well as adjusting menu options. Below Play/Pause is the X-shaped Mode button, and above is the O-shaped Record button. A built-in monaural microphone is found in the top left corner of the device; the built-in speaker takes up most of the bottom half of the face.

The sixth button, Select, is solid and circular and protrudes slightly from the top of the unit. A USB 2.0 port and external microphone/line-in jack round out the remainder of the physical features on the top of the unit.

The SD card slot takes up much of the right side of the unit. The Milestone accepts high-capacity cards up to 32GB in size. A standard headphone jack can be found on the bottom of the unit while the RFID tag reader can be found on the unit's back side.

When compared with other players, the Milestone is both much smaller and lighter than its competitors. It measures 3.4 by 2.1 by 0.6 inches (just under 4 cubic inches), making it nearly a third smaller than the BookSense. It weighs a mere 1.7 ounces, less than half the weight of the PlexTalk Pocket and less than a third of the weight of the VictorStream.

What's in the Box

The Milestone package included a standard set of accessories typical for this type of product. In addition to the actual unit, the box included a mini-USB cable, ear buds, power supply, carrying case, printed manual, lanyard, and some sample tags for the Speakout RFID add-on (more on that feature below). Unlike the Milestone 311, braille reference or documentation was not included.

Documentation

The Milestone comes with documentation both in print and loaded on the unit itself. Manuals in several languages can also be downloaded from the Bones website in .txt, .pdf, and DAISY formats. The manual concisely explains the various functions of the unit and also includes a handy shortcut reference at the end of each section. While the manual is generally easy to understand, some sections could be better translated into more readable English.

Loading Content

The Milestone connects to a computer using the included mini- USB cable. Unlike other players, there is no specific folder structure for books, music, or other types of files. You can simply copy your desired files to the unit for listening. There is no special included software included for transferring popular formats to the Milestone, which might present a bit of a learning curve for beginning users who are unfamiliar with copying downloaded books and files between the computer and the device. In our tests, copying files to the included SD memory card was several times faster than copying the same files to the device's internal memory.

General Operation

The Milestone does not include a power switch; it is simply always available for use. Press the Play/Pause button to wake the unit from sleep mode, which takes less than five seconds. If no keys are pressed for 10 minutes, the device automatically returns to sleep mode. In our tests, the sleep mode did not considerably consume battery power.

In its basic form, the Milestone includes three main modes, toggled using the Select key. Pressing Select cycles between audio, books, and alarm. If other add-ons such as the Speakout RFID tag reader are installed, select will also cycle through these modes.

Audio

The Milestone groups any content that is not a DAISY book—i.e., .mp3, .wav, .aac, unprotected .wma, and text files—into the audio portion of the player. While in audio mode, you can browse through files and folders to locate the item you wish to listen to. Pressing the Record button toggles between the unit's internal memory and the SD card while the left and right arrows move through the list of files or folders. Pressing the Mode key selects a folder, while pressing Play/Pause plays the selected file or folder.

While playing, you can press the left or right arrow to move between tracks, or hold down an arrow key to rewind or fast-forward. A quick-jump feature allows for movement to a particular spot in a file, but there is no way to mark your place in a song or file.

Text files are read using a full complement of Acapela voices including Ryan and Heather for U.S. English. Unlike most other players, you can install several voices at once and switch between them at will. On the Milestone, the text files load and play with impressive speed. A test file including several hundred pages of text began playing immediately upon pressing the Play/Pause button. Unfortunately, the list of compatible text formats falls short when compared with other players; the Milestone currently does not support Microsoft Word, rich text, HTML, or braille files.

The Milestone's recording features are impressive and useful. Two recording modes are included, one for taking quick notes and a second for longer recordings. Recordings made using the built-in microphone were clear and easy to understand. A jack is included for connecting an external microphone or a line-in audio source such as a stereo. Several settings are included to control the recording quality and the included noise cancelation.

Books

The books mode allows for the playing of DAISY 2.02 book titles as well as books from the Audible website in both .aa and .aax formats. Bones is making an effort to increase compatibility for U.S.-based book formats, including recently-added support for downloadable books from the National Library Service.

Here, the key functionality is slightly different, with the Mode and Record keys acting as up and down arrows to change between various navigation modes (phrase jump, time jump, bookmarks, etc.) An additional option, the bookshelf, allows you to browse the book titles on your machine. The titles are announced while navigating and can be played with a press of the Play/Pause button.

Depending on the book format, options are included to jump to a specific page or section of a book. Page numbers are entered by holding down the Select key and then pressing the left arrow, Play/Pause, and right arrow keys to increment the hundreds, tens, and ones digits respectively. This is one of the areas where perhaps the lack of a numeric keypad creates some potentially cumbersome usability issues.

We were unable to play books from Bookshare, RFB&D, or the Internet Archive using the books mode on the Milestone. According to the company, some of these formats may be included in future upgrades to the device.

Alarms

This simple mode allows for the setting of an alarm for a specific time. You can set a one-time alarm or one that will go off every day, every weekday, or Monday-Saturday. The Milestone also includes a built-in countdown timer that can be set from 1 to 30 minutes. The setting of alarms was straightforward, using the same menu-driven interface found in the books mode.

Add-on Applications

The Milestone can be made more powerful through the use of add-on software and hardware.

The unit includes a built-in FM radio, which can be activated through an add-on. The radio includes 12 presets, a scan feature, and the ability to record your favorite station. Like other players, your headphones also act as the antenna for the radio, so they must be plugged in to use it. You can, however, plug in a pair of headphones and activate the unit's internal speaker concurrently.

Another available add-on is Agenda, a task scheduler and calendar. In addition to the basic tasks of scheduling and reminding you of upcoming events, Agenda can be used to schedule a recording using the radio or microphone at a specific time, or wake you up by playing a specified file. Both one-time and repeat events can be scheduled, and the program offers several modes for browsing through your agenda.

As mentioned previously, the Milestone includes a built-in RFID reader, used by Speakout, another available add-on. Speakout associates recorded personalized messages with RIFD tags so you can hear the message whenever the tag is scanned. The recordings are stored on the Milestone itself, not the actual tag. Speakout and the RFID reader can be used to label items or record personal reminders.

Two hardware attachments for the Milestone are also available. Fame is a color identifier and light probe that fits over the top of the unit; Woodscan is a barcode scanner that identifies food and other items.

Largely because of these extras, Bones calls the Milestone the "Swiss Army Knife of digital recorders." It's true that these options allow the user to customize the unit, though the price of acquiring all of the add-ons maybe prohibitive for some.

Battery Life

Bones rates the battery life of the Milestone at roughly 15 hours, though this will be shortened if using some of the unit's features, such as time compression in audio tracks. The unit can be charged either via USB or a wall outlet in about three hours. The unit includes a built-in rechargeable lithium polymer battery that cannot be removed.

Recommendations

While the Milestone has many strengths, there are some areas that could use some improvement. Some of the recommendations given in the September, 2006 article on the Milestone 311 still apply to this version. It's still not possible to lock the keypad of the unit while playing or set bookmarks in the audio player. In addition, no confirmation is given when deleting a file or group of files, a particular inconvenience when away from a computer.

While we appreciate the use of high-quality Acapela voices in the unit, the unit seemed unresponsive when compared to other players, often taking more than a second to hear any spoken feedback after a key had been pressed. While lower quality versions of the voices could be loaded on to the unit, this did not significantly improve the lag.

Bones may also wish to employ a United States-based company to better translate some of the spoken prompts and passages of the manual. For example, the time 9 PM is spoken as "9 o'clock in the night."

It's certainly a challenge to strike a balance between a simple keyboard interface and a rich set of features. In most instances, the six keys are sufficient to operate the device, though some commands require the use of two or even three keys pressed simultaneously, such as the combination of Mode, Play/Pause, and left or right arrow to erase groups of files. Though the quick reference guides at the end of each chapter do help a bit with using the keys, the lack of a help or training mode is problematic.

Most of these suggestions could be accomplished through software updates, and we are aware that Bones is actively working on future improvements for the player.

The Bottom Line

The Milestone 312 is a definite improvement on prior models from Bones. We were especially impressed with the unit's recording quality, size, and choice in text-to-speech voices as well as the available add-ons, many of which are unique to the Milestone. It's quite evident that a lot of thought was put into making the unit simple to use yet flexible for users.

The lack of available formats for books and audio content will be a deal breaker for some, and we look forward to the promised improvements from Bones to support additional common file types. While the add-ons provide a way for Bones to offer additional functionality, some users may opt for devices that include the some or all of the same functionality in their base prices.

The Milestone will likely appeal to people looking for a small-sized player with good battery life and a clear voice recorder. If you mostly listen to .mp3 music or NLS audio books, or if you prefer a simplified interface, the Milestone may be the player for you.

Product Information

Product: Milestone 312.

Manufacturer: Bones Inc., Zentralstrasse 68, CH-8212 Neuhausen, Switzerland; Phone: +41-52-672 28 25; website: http://www.bones.ch.

U.S. distributors

Price: $449 for standard functionality. Hardware and software add-ons available..

Regular readers of AccessWorld may have noticed that I have written several less-than-favorable evaluations of the Kindle e-book reader device from Amazon. Although my last review reported that the accessibility of this very popular reading device has improved incrementally with each new version, the Kindle is still not something I would recommend for people with vision loss. In addition, Kindle for PC, the application you can use to read Kindle books on a computer, was not designed to be compatible with screen readers or screen magnifiers. However, in early 2011, Amazon released the Kindle for PC with Accessibility Plugin, and this article will evaluate the accessibility provided by this software.

How It Works

Available for free download online through Amazon, Kindle for PC with Accessibility Plugin is certainly an improvement over the earlier versions of Kindle for PC.

The software facilitates screen reader access to all Kindle books, even if an author or publisher has not granted text-to-speech (TTS) functionality. You use your own screen reader such as JAWS or NVDA to access the interface for the software. For reading the actual content of books the application uses the Vocalizer speech synthesizer from Nuance, which features the Samantha and Tom voices. These voices will be familiar to users of the VictorReader Stream DAISY MP3 player from Humanware. However, the synthesizer doesn't perform quite as well as it does on the VictorReader Stream player, or even as well as it does on the actual Kindle device. Comparing the three tools (the built-in TTS on the Kindle device, Kindle for PC with Accessibility Plugin on a computer, and the VictorReader Stream DAISY MP3 player) reading the exact same book, we found that Kindle for PC with Accessibility Plugin frequently had trouble pausing appropriately at ends of sentences, especially when the sentence contained quotation marks, question marks, or abbreviations.

What many may find to be an even bigger problem is the lack of functional navigation. With Kindle for PC with Accessibility Plugin, it's not possible to navigate by paragraph, word, or character, which makes it impossible to check the spelling of a word. Although there is a keystroke command for sentence-by-sentence navigation, the software does not allow you to move from page to page this way; you must always manually turn the page. Also, if you move to the previous or next sentence to read it, the reader automatically continues reading the rest of the page, instead of stopping after reading the target sentence. Another issue is that the software does not recognize or report the graphics included in a book.

Accessibility of the Interface

We tested the interface with JAWS 12, Window-Eyes 7.5, NVDA, and ZoomText, and most of the interface elements were accessible using each of these tools, except for Window-Eyes. The interface functions much like a standard dialog box, as you use the Tab key to move between the various controls. There is also an accessible menu system for other items, and it also features several shortcut keys. Window-Eyes would not speak as you tab through the various controls of the main interface, so it could not access the bulk of the application's functionality. Therefore, I will be referring to JAWS and NVDA when discussing screen reader functionality in the remainder of this article.

Accessibility of Selected Features

Below is a discussion of the accessibility of selected features of the Kindle for PC-Accessibility application.

Choosing and Opening a Book

If you tab to the "Home" element, you have arrived at your book list. The right and left arrows scroll through the list; choose "Enter" to open a selected book. The "Archive" button allows you to access books you have purchased but not yet downloaded. If you have a Kindle device, this is where you will find books you have purchased on that device; if you open one of the books in the list, you will be taken to the same location where you left off reading on the device.

Search

The search tool works with screen readers and magnifiers to search for particular words or phrases within a book. Though the edit field where you enter the search term does not allow you to fix mistakes, the tool does return an accessible list of results. Using the arrow keys, select the instance you want and choose "Enter." You will be taken to the top of the page and will, unfortunately, have to read to find the actual term.

Table of Contents

Choose the Table of Contents from the Go To menu to hear the Table of Contents read aloud. If you use a screen magnifier you can use a mouse to click on the links in the Table of Contents and move to a desired section. It is not possible, however, to use a screen reader to activate the same links. One work-around for this limitation is to use the search feature to find the name of a particular chapter.

Bookmarking, Highlighting, and Notes

Some of the functions in this category can be used non-visually, and some are visual-only. You can set a bookmark with a screen reader, but highlighting and inserting margin notes are visual-only tasks that must be accomplished using a mouse. As far as accessing these marks after they have been set, there is a "Note/Marks" button that brings up a fully accessible dialog. From there, you can scroll through and move to any item, including highlights or notes that a sighted person may have inserted. This is the only non-visual way to access the marks—you are alerted only visually when you come upon one while reading a book.

Dictionary

Unfortunately the default dictionary tool is not compatible with screen readers, nor is it practical to use a dictionary that you might purchase from the Kindle Store, because these provide no easy way to search for the definition of a particular word. Searching for a word in these dictionaries only finds the occurrences of that word where it is used in a definition of another word.

Go To Menu

The Go To menu was completely accessible, and you can use it to go to the book cover, table of contents, the beginning of the book, or to a specific location in a book. You can also use this menu to go to your home screen with your list of books or to your archived items.

Shop in Kindle Store

When you choose this feature, you are taken to Amazon's Kindle Store in your default browser, where you can browse and search for books to purchase and download. This site is mostly accessible, but it can be difficult to determine which "Buy" button is associated with the book you want to buy. Also, the "Buy" buttons are improperly labeled "buy.digitalfeed."

Low Vision Accessibility

Kindle for PC with Accessibility Plugin has several features that will improve accessibility for a person with low vision. The "Show Font Menu" button allows you to adjust the font size up to 56 point, display the text in reverse polarity (white on black), and adjust the brightness and the number of words per line. The application also works well with screen magnification software.

ZoomText's text-to-speech features also worked well, including reading the actual content of a book. However, there is no ability to highlight the text as you read, which is a feature that could benefit some people with low vision as well as people with learning disabilities.

The Bottom Line

The Amazon Kindle store has nearly a million books for sale, and continued improvement in Kindle book accessibility is extremely important. Amazon has certainly done considerable work to keep moving the ball down the field, and Kindle for PC with Accessibility Plugin is definitely a huge improvement over what was available before. However, we still haven't seen a touchdown. For me, the lack of navigation choices is a real deal breaker. The inability to check the spelling of a word—of particular importance when reading for detail, such as when reading a textbook or school assignment—is another issue that must be addressed. They will also need to figure out how to make graphical images in books accessible.

That said, Kindle for PC with Accessibility Plugin is really getting close to achieving full accessibility, and even an old curmudgeon like me is getting a bit more confident that Amazon will resolve the problems mentioned here in the not-so-distant future.

Product Information

Product: Kindle for PC with Accessibility Plugin.

Vendor: Amazon.

Price: Free.

Available at: online through Amazon.

This product evaluation was funded by the Teubert Foundation, Huntington, WV. I would also like to acknowledge the contributions made to this article by Marshall University interns Mike Moore, John Lilly, and Ricky Kirkendall.

Computers seem to be getting more and more complex, and with new versions of Windows and Microsoft Office coming out every couple of years, it's easy to get lost in the shuffle. Sometimes performing even a basic task like checking e-mail or opening a file on your computer can be difficult because of the hard-to-read text and icons used by Windows and most computer programs. Fortunately, there are some steps you can take to make your Windows PC more accessible and to make sure that any new PC you buy is suitable for your needs.

This article will cover some basic tips for how to select and configure a PC to make it more accessible for users with low vision, including information on what to look for when buying a new PC, and how to change the display colors and increase the size of the on-screen text in Windows, Internet Explorer, and Mozilla Firefox.

Recommended Computer Specifications

When purchasing a computer, it's easy to be overwhelmed by the vast number of different setups and configurations that are out there. Even if you do find a helpful salesperson or friend, it can still be difficult to find out what kind of PC is best suited for people with visual impairments.

The Computer

We recommend that you purchase your PC from a trusted name-brand company like Dell, IBM, or Hewlett-Packard. Purchasing a PC from a major outlet ensures that you will get a dependable machine from a trusted seller. Also, these companies usually offer a warranty with good technical support (although often not for assistive technology), and you can be confident that they won't suddenly go belly-up tomorrow.

This article will focus on PCs, but you may also want to consider an Apple computer. Apple computers feature a built-in screen reader and screen magnifier at no additional cost. VoiceOver, the Apple screen reader, was recently significantly improved. Zoom, the Apple screen magnifier, offers up to 40x magnification, as well as options for high contrast colors or reverse video. Check out the accessibility overview page on the Apple website for more information.

Memory

The amount of memory, or RAM, determines how smoothly and quickly multiple programs will run on a PC. We recommend that you purchase a PC with at least 2 GB of memory, although 4 GB would be preferable. Screen readers and magnifiers both can take up a lot of memory, not to mention other memory-intensive applications you may want to run. If you like having several different programs open at the same time, it would be a worthwhile investment to get a large amount of RAM.

Hard Drive

The size of your hard drive determines how many files and programs you can install on the computer. The minimum hard drive size sold with most new computers is 320 GB, though you may sometimes see smaller hard drives in certain setups. This standard size is definitely large enough to install just about any type of assistive technology, as well as store a substantial quantity of files and documents. If you have a large collection of music or video files, you should check out some larger disk sizes and get something appropriate to your needs; hard drives are relatively inexpensive.

Processor Speed

Nearly all computers today are at least 2 GHz, and can be as high as 3.7 GHz. Although it's often tempting to go for the fastest computer available, in reality even the low-end 2 GHz computers are capable of running most types of assistive technology, as well as most other types of programs out there. You may also come across computer chips advertised as being "dual-core" or "quad-core," terms that refer to the number of processors in a given computer. A quad core machine has four smaller processors instead of one big processor, which makes for a faster computer, but is really unnecessary unless you do intensive work on your computer, such as video editing or programming.

Monitor

If you have some usable vision, look into buying a flat panel monitor that is at least 19 inches in size. If you have no usable vision, consider saving the money and not buying a monitor at all.

DVD/CD Drive

A DVD/CD-RW drive, which can read DVDs and CDs and write to blank CDs, is useful for using discs and backing up data. CDs are inexpensive and can hold up to 650 MB. If you would like a larger capacity data backup option, look into purchasing a DVD-RW, which can write to blank DVDs (up to 4.7 GB).

Ports and Slots

USB ports are the standard for PC connection, and are often used for assistive devices. Make sure the computer you buy has several USB ports. Serial ports, which are common in many older pieces of assistive technology, have disappeared from current computers. If you have a device that uses a serial port, you can purchase USB-to-serial converters that will allow you to connect your device to your PC.

Operating System

Microsoft released the latest version of Windows, Windows 7, in 2009, and there are a number of screen readers and magnifiers available for it. Windows 7 can be made accessible with the right assistive technology.

Video and Sound System

The integrated video and sound cards that come standard with most PCs are more than suitable for running assistive technology. A separate or high-end graphics or sound card is really only necessary if you do a lot of work with video files, or if you have a high-definition audio system.

Improving the Accessibility of Windows

There are a number of settings you can change in Windows to make the text and icons larger and easier to see. All versions of Windows use "themes," which set the color and size of the system text. This setting applies to the Start menu, the desktop, and My Computer and My Documents. The default theme uses fairly small type in a white-on-black scheme, but this can be changed to something that might better suit your needs.

In Windows XP, modify this setting by following these steps:

1. Open the Start menu and select Settings. Under Settings, open the Control Panel.
2. In the Control Panel, open Display
3. In the Display dialog box, select the Appearance tab, which is located in the row across the top of the window.
4. One of the items under Appearance is Color Scheme. There are four different high contrast color schemes to choose from. Keep selecting "H" until you find a scheme that works well for you, then select Enter.
5. There is a drop down menu directly underneath Color Scheme called Font Size, where you can increase the size of the text in Windows. If the settings you find here don't work for you, select the Advanced button and choose your own color combinations and text sizes.

Windows Vista and Windows 7 both have a feature called the Ease of Access Center, which replaces and improves the Accessibility Tools found in earlier versions of Windows. Follow these steps to open the Ease of Access Center:

1. Open the Start menu and select the Control Panel
2. In the Control Panel, open the Ease of Access Center. Once the Center opens, you can activate accessibility tools, such as Magnifier or Narrator, and change the fonts and colors used by Windows.
3. Select "Get recommendations to make your computer easier to use." This will bring up a wizard that will ask you a series of questions and automatically change the text size and color settings based on your answers.

In all versions of Windows, the changes made to the text size using the above steps will affect text created by Windows, which includes the Start menu, desktop, My Documents, My Computer, and the top title bar for all programs. It will not affect the size of text in webpages, Word documents, or most other programs. The changes to the color scheme, however, will carry over to web browsers and Microsoft Office, in addition to the desktop, Start menu, My Computer, and My Documents. Be warned, however, that there will still be some non-Microsoft programs that will use their own color scheme.

Improving the Accessibility of Web Browsers

There are ways to make sure that nearly every webpage uses high-contrast colors and larger text. To do so, follow the steps below for your preferred web browser:

1. Pull down the Tools menu and pick Internet Options
2. A new window should open up. In this new window, choose the "Accessibility" button by pressing Alt-E.
3. Check the boxes labeled "Ignore font styles specified on Web pages" and "Ignore font sizes specified on Web pages." Select "OK" in the dialog box and again in the Internet Options dialog box. This will return you to the page you were viewing.
4. Now, whenever you want to increase or decrease the size of the text on a webpage, pull down the View menu (Alt-V) and select Text Size (X). Here, you can choose any option, ranging from largest to smallest. If you select largest, all pages will display an enlarged text size (size will fluctuate from page to page).

1. Pull down the Tools menu and pick Options
2. A new window should open up. Choose the "Content" tab, which is located in the row across the top of the window.
3. Choose the style and size you prefer using the Default Font and Size drop down menus.
4. Select the "Advanced" button to the right of the Size drop down menu. In this new dialog box, make sure the box for "Allow pages to choose their own fonts" is unchecked. Select "OK."
5. Now, you should be back in the Content options for Firefox. Below the "Advanced" button there is a button labeled "Colors" where you can adjust the font and background colors used by Firefox. In the Colors window, choose the colors that you would prefer, and make sure that the box for "Allow pages to choose their own colors" is unchecked. Select "OK" to return to the webpage you were viewing.
6. The pages should now be using the fonts and colors you specified. You can increase the size of text on screen any time by hitting Ctrl +, or by going into View and selecting Zoom.

Closing Comments

These tips are designed to help you take advantage of the built-in tools offered by Windows and web browsers, and to make sure that any new PC you buy will be able to effectively run a wide range of assistive technologies. While changing the color themes and text size can go a long way towards making the text and icons on the computer easier to see, adjusting these settings still falls short of the accessibility and comfort provided by a standalone screen magnifier such as ZoomText. Experiment with your screen magnifier and the settings described here to find the best combination for your needs.

In this article, we discuss a selection of products of particular interest to seniors with vision loss, but useful to people of all ages.

The products covered here were selected based on the queries we receive most frequently at the AFB Information Center from older Americans who have recently been diagnosed with vision loss—such as age-related macular degeneration or cataracts—their family and friends, and professionals who may be new to the rehabilitation field. These consumers often have not received training in the use of adaptive technology, and frequently are not aware that adaptive products exist for performing certain everyday tasks.

If a product is sold by more than one vendor and is fairly easy to locate for purchase, we refrain from citing a specific vendor or brand. MaxiAids, Independent Living Aids, and LS&S Products are good resources to investigate for most of the common products. For unique products sold through a limited number of vendors, we provide more specific information.

As always, if you have questions or comments, please do not hesitate to call AFB's Information Center at (800) 232-5463 or e-mail us.

Tasks Related to Health and Well-Being

Many seniors have health concerns in addition to vision loss. There are a number of adaptive products available that can help seniors independently manage and monitor common medical health tasks including monitoring body weight, body temperature, and blood pressure, along with diabetes and prescription management.

Talking and Large Print Scales

There are many talking and large print scales on the market to choose from. Keep in mind that if you opt for a large print scale you usually must remain standing for the accurate weight to be displayed, and you should not bend down to read the display. If you have trouble seeing print from a distance, or if you anticipate that your vision will worsen over time, a talking scale may better suit your needs.

Talking and Large Print Thermometers

Clinical thermometers, many FDA approved, are also fairly easy to find. Talking models are more commonplace than large print varieties. You can choose among models that take temperature by being inserted in the ear or placed under the arm or tongue.

Talking and Large Print Blood Pressure Monitors

The September 2004 issue of AccessWorldevaluated several home blood pressure monitors and recommended options for those who are able to read larger fonts on a display as well as those who rely on speech output.

Accessible Blood Glucose Monitors

Seniors with diabetes will want to read past AccessWorld articles about accessible blood glucose monitors, such as the one in the January 2008 issue that compares several models.

Adaptive Technologies for Medication Identification and Management

Many seniors with vision loss are understandably concerned about confusing medications, missing dosages, and other important issues related to medication management.

Some people with vision loss use reliable low-tech strategies such as tactile markers (e.g., different textures of rubber bands) to differentiate between various bottles of medicine, or a large-print version of the standard seven-day pill organizer found at your local pharmacy or through vendors of adaptive products.

There are also technology-based products available that can go a step further with over the counter medication and prescription management assistance. The talking MedCenter System alarm clock organizes a month's worth of medications with four daily alarms. The verbal, visual, and alarm cues this calendar/clock provides will help keep you on track with your daily dosages.

The Talking Rx is a recording device that attaches to standard pill bottles and speaks prescription information aloud. Your pharmacist reads all the information into the device, and you press a single button to listen to it. You must purchase a separate device for each medication, but the devices are reusable.

A similar device is the ScripTalk Station, reviewed in the January 2009 issue of AccessWorld, which uses synthetic speech to read prescription label information aloud by scanning each bottle. ScripTalk Station is now free-of-charge to people with vision loss. Because the device uses synthetic speech, some people with hearing impairments may have difficulty understanding the speech output. For more information, contact the manufacturer, En-Vision America.

Tasks of Daily Living

This section will cover the three areas of daily life we are most frequently asked about at the Information Center: keeping track of information, cooking, and using the telephone.

Adaptive Writing Instruments and Writing Aids

While computers and electronic notetakers have revolutionized the way in which some people with vision loss take down information, many seniors are not comfortable using these devices and want to know about adaptations that will allow them to continue to hand-write notes.

Depending on your level of functional vision, 20/20 pens, which make bold lines, and bold-lined writing paper may be all that you need. If you prefer high contrast, you can find a pen or marker that writes in white ink at most office supply stores, and use it with black construction paper or other dark-colored writing surface.

A writing guide, which serves as a template for writing in a straight line, can help you fill out checks and envelopes and sign documents and full-page greeting cards. Large print calendars and address books are also available at stationery and office supply stores.

Caption: Signature guides assist with signing documents and filling out checks.

Voice Recorders for Information Management

If you are not comfortable hand-writing, taking down information by voice recording is a great alternative. With the large amount of recording devices out there, it can be a daunting task to choose one for a senior with vision loss. We recommend finding a device with a simple interface and just a few buttons on the keypad, so it doesn't take very long to learn to use it. Here are some examples:

With a recording keychain, you can push one button and record a simple message, usually around one or two minutes. Because these devices attach to your keyring, you'll always have yours with you when you're out and about. These recorders are great for shopping lists, for taking down the phone number of an acquaintance you meet while doing errands, or even for recording directions from your house to a favorite destination.

Another option is the Digital Memo Card recorder, sold by Future Aids, which is the size and shape of a standard credit card, conveniently fits into a wallet, and features a 90 second recording time.

A step up from these single-message recorders is the Voice Recognition Memo Book sold by Independent Living Aids. This recorder offers 60 subjects with 12 seconds of recording time each, and allows you to organize your recordings in four chapters divided by subject matter.

Braille

Senior citizens can absolutely learn braille—it is never too late to start! If you find standard braille materials difficult to work with, you might find jumbo braille easier to read—particularly if you have a medical condition, such as diabetes, that has limited the sensitivity in your fingertips. Jumbo braille uses larger dots that are much easier to distinguish by touch.

Future Aids sells a model of jumbo braille slate that even has slots for adhesive labeling tape, so you can make labels for canned goods, appliances, DVDs, VHS tapes, and CDs. While it's true that the majority of braille items are published and manufactured in standard braille, but several companies sell jumbo braille playing cards and a few books.

Cooking Aids

Are you famous for bringing the blackberry cobbler to every family reunion? Or do you bake chocolate chip cookies for your grandchildren when they visit each weekend? Do you worry that vision loss will cause you to give up your love of cooking? The good news is that there are so many adaptations for cooking that we can't possibly cover them all here. In fact, these gadgets are so useful to people with and without vision loss that they are extremely commonplace in all types of stores.

Below is a roundup of some of the most popular kitchen and cooking aids. If you don't find something you need here, we encourage you to do your own research—chances are good that a solution is out there.

There is a wide variety of large print and tactile print measuring cups and spoons on the market for measuring wet and dry ingredients. You may want to think about high contrast when buying these items, such as using a black or dark-colored measuring cup when working with ingredients that are light in color like milk and flour. Or, you can eliminate the use of cups and spoons altogether by using a talking kitchen scale. Many varieties of kitchen scales are sold through vendors of adaptive products; most models toggle between displaying weight in either grams or ounces.

The Talking Measuring Jug, sold by Independent Living Aids, displays weight in ounces, pints, milliliters, or liters. While designed for measuring liquid, you can also weigh some solids with it.

Many people with visual impairments use a liquid level indicator, a small device that attaches to most any container with prongs and emits an audible sound when the liquid nears the rim. No more worry about overfilling a cup of hot coffee while using this device.

Many gadgets have been created to deal with slicing, cutting, and chopping food. Many people with vision loss learn advanced skills that allow them to safely use a standard knife, but this takes time. If you've recently started to experience vision loss, expect to take some time to learn nonvisual techniques for safe cutting and knife handling. Until you've mastered the nonvisual techniques, we suggest an optimum protocol for safety.

A reverse contrast cutting board, for example, allows one with low vision to use either a white or black surface for cutting, ensuring the most high contrast option can be achieved. Think how much easier it is to see a white onion on a black surface as opposed to a standard white or wooden cutting board.

Steel-lined gloves will protect your fingers when cutting. No matter how many times you slip and the knife blade touches a finger, you will be safe from injury when wearing these gloves.

There are many cutting guides available—pie wedge templates, brownie square cutters, apple corer/slicers, banana slicers, etc.—which all provide uniform or creative slicing with a little extra safety.

There are two cooking websites of interest to chefs with visual impairment. Low Vision Chef is the site of a professional chef who now has macular degeneration. The site sells products that she has found that make cooking with low vision easier. Vision World Foundation is the parent company of Cooking Without Looking, the first TV show created for people with vision loss. Guest chefs who are blind or visually impaired come on the show to create their culinary specialties, giving tips on how to cook and bake, stay safe, and have fun in the kitchen. The 30-minute show can be viewed on the Vision World Foundation website. It also airs twice monthly on WXEL-TV42 PBS in Palm Beach, Florida, and is being prepared for national distribution for PBS.

Telephone Aids

Many seniors with vision loss fear being unable to dial their phone in an emergency. Many adaptations are available for standard landline telephones that address these fears.

Telephones with large keypads and/or large print numbers on the buttons are available in retail and specialty stores and catalogues. A variety of color schemes exist, such as white numbers on a black keypad, which you may find easier to see than the standard white keypad with black letters.

If you've lost some sensitivity in your fingertips, you may want to consider a phone that operates on voice commands. Several models of this type are on the market. Sighted assistance may be needed for the initial setup of these phones.

AccessWorld provides extensive and continuing coverage of cell phones and we encourage you to search our site for reviews. Designed with seniors in mind, the Samsung Haven, the Jitterbug, and Snapfon include features for both hearing and vision loss.

Recreation

We frequently field calls from seniors who have recently lost their vision and feel they must now give up all the activities they enjoy and lead a boring, grim life. This is absolutely not the case.

Caption: Tandem biking is enjoyed by many people with vision loss.

Adaptive Products for Crafts

Many of the crafts you enjoy as hobbies are possible to do with vision impairment, it just takes a combination of practice and the use of some adaptive products.

Horizons for the Blind sells a huge selection of craft books in alternate formats. Origami, plastic canvas, latch hook, knitting, and crocheting, are just a few of the crafts for which they offer large print or braille versions of commonly used patterns. The books also include instructions on making various items, such as potholders, refrigerator magnets, afghans, clothing, stuffed animals, and dolls.

Adaptations for sewing are also available, including needle threaders and pre-threaded needles. For measuring thread, cloth, and other items, a large print or talking tape measure can be just the right solution.

Games and Word Puzzles

When it comes to card games and board games, the old favorites—and some newer ones as well—have been adapted for the visually impaired. There is no reason why you can't continue to spend Friday nights participating in your poker tournament, or beating your grandson at checkers. The many card games sold in large print and braille editions include UNO, standard playing cards, and Phase 10. Board games are adapted in a variety of ways. Tic-tac-toe, checkers, Chinese checkers, and chess use tactile and high contrast versions of the standard playing pieces. For games such as Monopoly and Scrabble, large print and braille replace the standard print found on the gameboard and game pieces. There are also large print and tactile versions of dice and dominos on the market.

Large print versions of word searches and crossword puzzles can be found very easily, by visiting a local bookstore or vendor of adaptive products.

Adaptive Technologies for the TV

There is no reason to miss the next season of American Idol, your favorite soap opera, or the evening news just because you are experiencing vision loss. Some find that just replacing their old TV with a flat screen version allows for a clearer picture. You can also try a TV screen magnifier, which will provide around 2x magnification.

You may also want to adapt your TV's remote control. Most TV remotes today have rows and rows of tiny buttons that are not distinguishable by touch—this can be a major source of frustration when just trying to turn on the TV, change channels, or adjust the volume.

The Tek-pal universal remote has only 6 buttons, each over three-quarters of an inch in diameter, and is one of the easiest remotes to use. There is no setup—just install the batteries, and it will work with most any television. The On button is a circle, the Off button is a square, Channel Up and Down buttons are opposite-pointing arrows, as are the Volume Up and Down buttons on the other side.

Some adaptive remotes have the standard variety of buttons on a much larger keypad. Some of these models are also illuminated for easier use while watching TV with the lights off. There are also voice-activated remotes that may work well if you've lost some of your sense of touch.

The access items discussed in this article will hopefully help you regain some independence and help you increase your activity. Losing vision in no way has to mean losing out on life. Simple adaptations, an open mind, and a positive attitude can make all the difference.

Dallas, Texas, is home to more than a football team and a large, intimidating airport. If you are planning a trip to Dallas, a must-see place to add to your itinerary is the American Foundation for the Blind (AFB) Center on Vision Loss. Located at 11030 Ables Lane, the Center on Vision Loss promotes increased awareness, understanding, and knowledge in the following areas:

• Strategies for living with vision loss
• Information and products useful to consumers, family members, and professionals
• Resources

Opened in 2006, the Center on Vision Loss is a real-world laboratory through which the latest in products and environmental design are offered to people new to vision loss as well as to those who may be seeking new solutions to living or working as independently as possible despite vision loss. Every year, an average of 1,500 people visit the Center to learn about common causes of vision loss, the latest in environmental design, and assistive technologies.

The Center educates family members and professionals from a variety of fields about environmental and product modifications that can be made to enhance the independence of people with vision loss.

The Center hosts tours and produces seminars on an array of topics for a variety of professionals including home health workers, occupational therapists, educators, eye care professionals, and even interior designers. Many of the seminars held at the Center make their way to AFB Senior Site or to the AFB eLearning Center as webinars or podcasts.

One of the most unique aspects of the Center is Esther's Place, a specially designed and fully equipped model apartment. Each room includes appropriate and accessible products and appliances, designed or adapted for people with varying degrees of vision loss. The environmental design of Esther's Place includes different types of lighting and examples of the use of color and texture contrast and physical arrangement to enhance safety and promote independence in every area of the home.

Caption: Bathroom towels that highly contrast with their surroundings make them easier to see for people with low vision.

The information and examples of adapted living areas seen in Ester's Place will inspire you to make changes to your living space, which will increase your independence in your own home. The apartment is a showcase for educational tours and hands-on demonstrations to individuals and groups.

Caption: High contrast place settings make finding the plate, cup, utensils, and napkin easier for people with low vision.

The Center on Vision Loss also provides assessment services to developers and manufacturers of new products and designs, and often partners with AFB TECH, universities, and research groups to investigate, review, and test new technologies and consumer products. The Center is a testing ground for information published on AFB Senior Site, featured in another part of this issue of Access World.

In short, people take away hope and inspiration, knowing that there is life after vision loss.

For more information about AFB's Center on Vision Loss, or to schedule a tour, e-mail us at dallas@afb.net, or call (214) 352-7222.

If your doctor has told you there is nothing else that can be done to help your vision, you are not alone. There are over 25 million individuals in the U.S. who experience some form of vision loss.

Whether you are looking for information about an eye condition, trying to figure out how to fall-proof your home, searching for local services to help you or a family member or friend with living with vision loss, or even trying to figure out how to change a fuse, AFB Senior Site should be at the top of your list of resources. Now in its fifth year, Senior Site publishes extensive information about all aspects of everyday life with vision loss. While the site focuses on senior issues, many of the topics covered are helpful for people of all ages. Our Spanish-speaking readers can check out Senior Site en español.

Professionals seeking knowledge about working with individuals with vision loss may want to visit the eLearning Center to learn about our extensive course offering.

A Tour of AFB Senior Site

Accessibility

AFB Senior Site displays in a larger font than other AFB websites, but like the rest of afb.org, you can adjust the color, contrast, and font to meet your visual needs. Screen reader users can move repetitive links out of their way by pushing the navigation bar to the bottom of the page. By going to My AFB and registering as a Senior Site user, you can save these settings so you don't have to readjust them on your next visit. The media content on Senior Site is fully accessible, including over 70 videos, all of which are audio-described and include complete transcripts.

Connecting with, and on, Senior Site

While at My AFB you can also sign up for bi-monthly Senior Site tips. These tips provide useful information on a variety of topics—from taking medications safely, to cooking with herbs, to maximizing your lighting. You can also join our message boards.) and correspond with others about dealing with a particular eye condition, adjusting to vision loss, family situations, home adaptations, and more. AFB Senior Site is also on Twitter and Facebook. Follow us to get the latest news!

Navigating Senior Site

To help you find the information you need, we have published a site map, which is an outline of the entire site. Find the section or article you are interested in, and enter on the link—it's that easy! Senior Site also has a search function that covers all of afb.org.

Main Sections of Senior Site

The five major section headings are in the left column of the site. Here are some brief descriptions of what you'll find in each:

1. 1. Understanding Vision Loss

   Guides related to vision loss. Senior Site has informative articles and guides for the major eye conditions that affect older people, such as macular degeneration, glaucoma, and cataracts. These guides explain what is physically going on in each condition and also give you practical information about living with the condition. The macular degeneration guide also contains an audio lecture on the latest in medical treatment for both dry and wet types of the condition.

   Diabetes and vision loss. If you have diabetes, you will want to read this section, which covers the gamut of information on diabetic eye disease, healthy eating, exercising, monitoring, taking medication, and finding other resources. It is also available in Spanish.

   Vision simulations. To help your family understand your vision, suggest that they watch this short video that simulates vision loss related to common eye conditions.

   Hearing and vision loss. It's estimated that between eight and ten percent of older people experience both hearing and vision loss. Having problems with both vision and hearing can make everyday tasks difficult, but it does not have to mean a loss of independence or quality of life. Senior Site offers a series of videos) on the adaptive devices available to help you or a loved one cope with hearing and vision loss.

2. 2. Finding Help and Support

   Once you've learned more about vision loss, you may be ready to identify services that can help you live with vision loss. There are over 1,000 agencies across the country devoted to helping individuals and families adapt to living with vision loss. For many, these agencies are entryways to support groups, rehabilitation programs, product referrals, and countless other services and resources that provide the makings of a viable support network—the key to independent living. Use the AFB Senior Site Directory to locate help in your area.

   Overview of services. These agencies employ staff with special training to teach adaptive skills and techniques to help you and family members cope with living with vision loss on a daily basis and even continue to work or go back to work. You can find out more about these specialists by visiting this part of the site.

   Friends and family guide. Family members are often at a loss to know how to help when a loved one is diagnosed with vision loss. It seems that everything they do is wrong: they help too much or they don't do enough; they move things around and you can't find them. This guide can help you work through these situations together. It offers help with dealing with feelings as well as practical information related to solving and discussing every day problems related to vision loss, including when to stop driving.

   Personal stories. Senior Site offers a number of video testimonials by people experiencing vision loss. Listen to Esther and Gwen's story about how a mother and daughter worked through the mother's loss of vision.

   Eye Care Professionals. Despite their best intentions and efforts, eye care professionals often do not understand how to talk to patients who have vision loss. Eye care professionals are often unaware of services that can help their patients deal with vision loss. AFB has developed a special part of Senior Site that is just for eye care professionals. Please tell your doctor about it.

3. 3. Changing Your Home

   With vision loss, the home you have always lived in can suddenly become foreign to you. You can't see the steps or find the light switches, and the glare in the bathroom is really causing you problems. This section of Senior Site offers practical tips on how to make simple adaptations in your home to make getting around easier and safer, and also presents an informative video on home adaptations. You'll also find a home safety checklist to help you get started.

   Redesigning your home. A room-by-room redesign plan, including organizational techniques. You may want to check out the graphics that show good and bad contrast in the bath and kitchen areas.

   Lighting. Proper lighting is one of the most important design changes that you will want to consider. Senior Site offers a series of videos that addresses different types of lighting and their placement.

   Safety in the home. Preventing falls is a critical issue for anyone, but particularly as we grow older we may have balance or other physical problems that can increase the chance of a fall. Fall-proofing your home or living environment is one way to enhance your safety. Senior Site has developed a series of short, helpful videos related to preventing falls.

   Retirement living. If you are considering moving to a retirement living facility you will want to review our checklist) to determine what you should be looking for in terms of a "vision friendly" environment.

4. 4. Daily Living

   This section of Senior Site is packed with information you need for day-to-day living and full participation in your community, including:

   • Hints and techniques for cooking
   • Eating out
   • Reading and writing
   • Keeping track of medicines
   • Getting around
   • Handling your finances, including continuing to work

   A number of how-to videos accompany these articles, including must-see clips on applying makeup and preparing your favorite meal.

   You will also find two special columns in this section:

   The Home Repair series is written by Gil Johnson, a man with total vision loss. In his column, Gil shares his techniques for small repair jobs around the house. His article on replacing fuses is one of the most popular on the site, and he's also written articles on parenting and grandparenting and even woodworking!

   Esther's Insights is written by Esther Smith, who has macular degeneration. She covers a variety of topics such as using a cell phone, using a computer, fall prevention, and caring for pets. She will also answer your questions about living with macular degeneration. Just e-mail her at esthersinsights@afb.net.

   Products You Can Use. To help you find the products that have been developed to help people with vision loss function every day, AFB has developed a special product directory. Ordering products can often be difficult. To help you in your search, we have also developed a dynamic database that includes the toll-free numbers and web sites for specialty catalogs and manufacturers.

   Senior Site Tips. All of the Senior Site tips are housed in this section. You'll find quick and easy to follow solutions to problems and situations that confront people everyday. Print them out and give them to your friends, family members, and neighbors.

5. 5. Fitness and Fun

   If you have stopped participating in recreational activities or are reluctant to try new ones because of vision loss, this section is for you! Fully participating in fun pursuits such as curling up with a favorite book, playing cards with friends, or staying involved in a sewing circle, are still possible with a few modifications. Here are some of the articles you can enjoy in this section:

   Hobbies

   Games

   Using a computer

   Gardening, including container gardening

   Exercising, including balance and flexibility exercises, and all kinds of sports from tandem biking, to bowling, to golfing, and even skiing!

Thanks for taking this tour with us. We hope you will take the time to browse the site. To find out what users think about the site and how it helps consumers, family members, and professionals, listen to Senior Site Voices.

And if you have suggestions for new articles we can add, send us an e-mail at seniorsite@afb.net.

The Bureau of Engraving and Printing has launched a free mobile application to assist the blind and visually impaired denominate U.S. currency. EyeNote is a mobile device app designed for Apple iPhone (3G, 3Gs, 4), and the 4^th Generation iPod Touch and iPad 2 platforms.

EyeNote uses image recognition technology to determine a currency note's denomination, based on an image taken by the device's camera. Fifty-one percent of a note's front or back surface is required to accurately identify the denomination. EyeNote can denominate all Federal Reserve notes issued since 1996.

The app is available for download in the iTunes store; free updates to the app will be issued whenever new U.S. currency designs are introduced.

The EyeNote app is one of a variety of measures the government is working on to assist the visually impaired community with currency denomination. Additional measures under consideration and development include the Currency Reader Program; continuing to add large high contrast numerals and different background colors to redesigned currency; and possibly including raised tactile features on redesigned currency.

More information is available on the EyeNote website or through e-mail at eyenote@bep.gov.

Dear AccessWorld readers,

May is Older Americans Month. For almost 50 years, Older Americans Month has promoted the contributions made by elder citizens to American society and has raised the nation's awareness of this population's unique set of needs. Given that the population of aging Americans is rapidly expanding, we think it's important to discuss issues of particular relevance to older people, including those who experience vision loss.

Regardless of age, Americans with vision loss will rely heavily on technology, information, and access to resources to achieve and maintain independent, active, and engaged lifestyles. This issue of AccessWorld focuses on the technology and resources that may be most beneficial to those losing vision later in life, though there is plenty of information here that will be useful to people of all ages.

Darren Burton evaluates the Kindle for PC with Accessibility Plugin, which will be of interest to the avid readers among us. Morgan Blubaugh's article, "Tips for Buying a Computer and Optimizing its Display for Computer Users with Low Vision," provides information about what to look for when purchasing a computer, especially if you will be running screen reading and/or screen magnification software. If you don't need a full-fledged screen magnifier, but could still benefit from optimizing the display features, you will find step-by-step instructions in this article to do just that.

If you're concerned about staying connected to family and friends, read Morgan's evaluation of the Jitterbug J cell phone. Also in this issue, Morgan and Bradley Hodges evaluate Guide software, which is designed to provide an easier-to-learn and -use alternative to basic applications on both Windows and Mac computers. If learning to use popular e-mail or word processing programs is giving you trouble, Guide may be the solution.

The AccessWorld team is also happy to have Pris Rogers and Neva Fairchild, both from AFB's Center on Vision Loss, joining our roster of authors this month. Pris's article walks you through the treasure trove of online resources available at AFB's Senior Site, and Neva gives a tour of the Center on Vision Loss in Dallas, which among other things houses complete build-outs of an accessible apartment and office that provide walk-through, hands-on examples of how people with vision loss can work and live independently. If you live in or will be visiting the Dallas area, please call the Center to schedule a tour.

I would like to take this opportunity to welcome any new readers who may have found AccessWorld by linking through AFB Senior Site or other sites—we hope you will come back every month for your technology news!

Sincerely,

Lee Huffman

Editor-in-Chief

Dear AccessWorld Editor,

Recently, I read an article about a remarkable woman named Clara Barton. She started her teaching career as a teenager. She taught at a private school and received compensation from those who could afford to send their children to such an institution in the 1800s. She recognized there were many youth in her community who could not afford this type of education and began instructing them for free. It is estimated she helped over 600 students in this manner.

When the Civil War broke out, Clara volunteered making bandages out of sheets and towels for wounded soldiers. She was granted permission to go to the front lines. There, she prepared food, comforted the wounded, and searched for soldiers missing in action. Duty again called her to serve in the war between France and Prussia. When she returned to the United States, she established an organization known as the American Red Cross and served as president for over 20 years.

A few weeks ago, I had the opportunity to meet up with a friend I met at one of the many business meetings I attend throughout the year. I enjoyed getting to know this individual more. I have a passion for travel and seeing new places, so I asked my friend to show me around his hometown. He was great with directions and pointed out the various landmarks and reviewed with me the historical context of the places I was seeing. Near the end of my visit I asked my friend a simple question, "What kind of car do you drive?" The inquiry produced an unusual look on his face and he responded, "I don't have a car." For a brief second I thought he was one of the many in these tough economic times who was trying to trim his budget. He continued, "I don't drive." He proceeded to explain that he had a form of vision loss and there were some things he could not do.

Embarrassed and humbled, I searched the internet and my medical textbooks to educate myself on his diagnosis. My friend directed me to the AFB website. There I read articles and watched inspiring videos of those who have vision loss. I was touched. More importantly my "eyes were opened," and I began to realize that perhaps many of my patients could benefit from the information I was learning. As a physician, I am not a believer that I should do everything for my patients. However, I do need to provide my patients with all the tools necessary for them to maintain their health, age in their home, monitor their conditions, and improve their overall quality of life.

Few of us will likely rise to the level of developing the American Red Cross as Clara Barton did, but each of us has the ability to learn about others. We then have the responsibility to help within our sphere to improve the human condition. To AccessWorld, the American Foundation for the Blind, and all who are associated with this organization: Thank you. To my new friend who might be reading this: Thank you for helping a sighted person see even more clearly. I am forever in your debt.

Sincerely,

TK

Dear AccessWorld Editor,

Technology can already park a car for me. Collision radar is commonplace. GPS is nearly as ubiquitous as the cellphone. Forklifts "drive by wire" in most modern warehouses. So why can't my car take me where I want to go?

Well, it is more a question of sociology than technology. The short answer is that the rest of the American public will not give up control and allow their cars to [choose] the best path, speed, and lane in order to arrive at their destinations. Americans love the control.

The accidents on American highways during each daily commute are the proof of poor skill, decision-making, and control.

As long as people are insistent on being in the "driver's seat" they will never allow[…]computers[…]to decide the details of the trip. They will certainly not relinquish the controls and "leave the driving" to the car—no matter how much safer [and more] efficient[…]the trip may be.

A centralized grid with computer controls that monitor speed, traffic, and the intended destinations is possible with the tech we currently have. The practical application of such a system is, unfortunately I fear, a pipe dream.

Regards,

David

Statistics tell us there are 25 million people who report having difficulty reading standard print, even with glasses or contact lenses, in America alone. Those of us writing for AccessWorld have long memories and personal experience confirming the value of assistive technology in work and play, but what about the person with blindness or low vision who isn't "plugged in" to publications like AccessWorld, consumer organizations, or rehabilitation agencies? What about the individual who has never been to a technology-related conference or who doesn't work with technology as part of their daily lives?

I was curious to look into the lives of randomly selected people with visual impairments to see how their relationship to assistive technology might be faring. While in training with a new guide dog at Guide Dogs for the Blind in San Rafael, California, I realized I had a perfectly random sample of such individuals right there in training with me! There were nine people in the class, ranging in age from 24 to 74. Some had been blind since birth, and some were experiencing blindness as a relatively recent development in their lives. Their homes were as far away as Halifax, Nova Scotia, or as near as Santa Cruz, California, and their knowledge and/or use of assistive technology covered the entire imaginable spectrum. Below is what I found out about each class member's technology use and history.

Jim Edwards

Jim, 74, has a 20-year history with macular degeneration. While still employed as a bank vice president for commercial real estate loans, a job he held for 30 years, he used computers daily. As his vision deteriorated and his (not necessarily related) retirement occurred, his struggle to see the computer screen became monumental. He said he currently used his computer at home by increasing the magnification in Windows 7 to its maximum power, holding a 7x magnifier to the monitor, and reading character by character. At home, his wife read his e-mail to him and acted as a reader for his stock trading. Although he had received other low vision services from his community agency in Las Vegas, he said he was not interested in getting computer training from the same source—he couldn't quite fathom using a computer without sight. He did have a digital talking book player from the National Library Service for the Blind (NLS) and was enthusiastic about the books he received from NLS on cartridges. After attending a brief session on the VictorReader Stream, though, he concluded that that technology was more suited to younger people.

Caption: Jim Edwards poses with his new dog guide.

Caitlin Best

Caitlin Best, 24, has been visually impaired since birth (she was born prematurely), and has been a fan of technology since receiving her first computer in the second grade. After receiving a B.S. degree in managerial information systems, she landed a job in her hometown of Pittston, Pennsylvania, as an equal employment opportunity technician with the Toby Hannah Army Depot. Her first assistive technology was obtained just before entering college, when she received her first copy of ZoomText Xtra, a closed-circuit TV for desktop magnification, and a handheld electronic magnifier for portability. She still uses these same tools on the job. Tools considered indispensable when she packed for guide dog school were her laptop and iPhone, on which—besides checking stock quotes for Jim Edwards on a daily basis—she used Google, e-mail, games, and text messaging, and listened to music and audio books. Since three other people in the class were brand-new iPhone users, she became known as the iPhone guru of the group.

Dane Geer

Another power user was Dane Geer, 32, of Bakersfield, California, who teaches assistive technology at an independent living center. In fourth grade, Dane was introduced to his first computer using the DOS-based JAWS program. Today, he teaches JAWS, Window-Eyes, Kurzweil, OpenBook, and other applications. He has just begun exploring System Access from Serotek. Tools that came in his luggage as necessities at guide dog school were his laptop, iPad, iPod, and VictorReader Stream. On the computer, he uses both JAWS and MAGic. Similarly, on the iPad he uses both Zoom and VoiceOver.

Jenny Kennedy

Jenny Kennedy, 34, of Wichita, Kansas, was the Apple advocate in class. The mother of two small children, Jenny said she uses the computer daily for e-mail, researching information related to raising her children, completing online forms, and Netflix. Watching movies on her computer is a favorite family pastime. Jenny is a seasoned iPhone user, using it for frequent texting, recording, taking and sending photos, and listening to books from Audible.com. Along with her MacBook and iPhone, she brought to school her NLS digital talking book player and VictorReader Stream. Jenny had three separate GPS apps on her iPhone and was learning to use them while we were in guide dog training.

Linda Sheppard

Linda Sheppard, 51, of Nova Scotia, was the class member with perhaps the least exposure to assistive technology. Having lost her sight just 18 months ago due to Graves disease, she was still in the throes of learning how to do routine tasks with adaptive techniques. Prior to sight loss, she frequently used a computer for e-mail and to build her tremendous recipe collection. She had begun computer training with the Canadian National Institute for the Blind (CNIB). The only piece of technology she brought with her to school was the DAISY book player issued to her by the CNIB. When asked about a cell phone, she said, "I will never have a cell phone. Every building I go into has a phone, so why would I need to carry one?"

Nancy McMasters

Nancy McMasters, 51, of Bend, Oregon, was first exposed to assistive technology in the early 1990s. She had worked in a warehouse where counting boxes and matching shipping labels to order forms finally became too difficult for her to do with limited sight. With a large, high contrast (white on black) monitor, she landed a job in customer service as a sex educator sales associate for a company called Good Vibrations. After 11 years, she was laid off and is currently unemployed. To guide dog school she brought a laptop with a 17-inch screen that she uses for e-mail, and a Samsung smartphone on which she can send and receive text messages by using large font and high contrast. Other favorite computer tasks for her are researching anything that piques her interest and shopping for everything from dog supplies to shoes. Although she had been receiving services from a blindness related agency off and on for nearly 20 years, she said she had never heard of the NLS and was extremely enthusiastic about the many gadgets demonstrated by her classmates.

Katrina Widman

Katrina Widman, 48, of Toronto, Ontario, is a self-taught Window-Eyes user. Having lost her sight just a decade ago, she received assistance from Canada's Assistive Devices Program. She learned the Window-Eyes program by listening to the GW Micro tutorials that came with the software, and similarly learned to use her PlexTalk DAISY player and recorder by "pushing all the buttons. If it talks back to me, I learn what it does." Originally from Australia, Katrina says her computer is on all day at home, where she uses it for e-mail, keeping address lists, organizing a huge recipe collection, and shopping. She has ordered groceries onlne not only for herself in Toronto, but for her aging parents in Australia as well. She purchased an iPhone just two weeks before coming to class, and was already an avid iPod user. To class she brought a laptop, an iPod, and her new iPhone.

Bevie Heninger

Bevie Heninger, 63, was thrown into the world of employment and technology when her husband died in 1992. She learned to use Window-Eyes and became a licensed massage therapist. She maintained all records for her business on the computer and now, in retirement, continues to use the computer daily for e-mail, shopping, and recipe collecting. Four years ago, Bevie became an avid user of System Access, which is now her screen reader of choice. She raved enthusiastically about Serotek and about AccessWorld: "I love that publication," she said, adding that she learns much of what she uses in assistive technology from these pages.

Caption: Bevie Heninger poses with her new dog guide.

Bevie also used her computer to communicate with mission groups for two mission trips she took to Ethiopia and South Africa. Her purpose on both trips was to locate people who are blind to give them white canes. As a result of her experiences, she has founded an organization called Global Canes, which is dedicated to teaching orientation and mobility skills to missionaries who can, in turn, teach them to people who are blind in third world countries.

Bevie, too, was a brand-new iPhone user when she came to class. In addition to her iPhone, she brought with her a laptop running System Access and a VictorReader Stream.

The Author

I am, of course, the ninth class member. As has been the case when in guide dog class in previous years, I had the tools of my job with me. My netbook with braille display and scanner (which was never needed since all materials were provided in accessible formats) were set up permanently on my desk for writing my blog, checking e-mail, and working on articles in progress during snatched moments of available time within a fully packed training schedule. Also in daily use were a braille notetaker and portable DAISY book player.

Conclusion

In past classes, I have been one of only a few students using technology. In this 2011 class, seven of the nine students present brought laptops running JAWS, Window-Eyes, System Access, or ZoomText. There was one MacBook user, and five of the nine were using iPhones with VoiceOver or Zoom. The two remaining students brought their library-issued digital talking book players.

The knowledge and exposure to assistive technology varied widely among us, but if this random sampling of consumers with vision loss is at all representative of the entire population, people are discovering the value of assistive technology.

Not interested in whether their handlers had computers or smart phones or DAISY book players were the nine Labradors who were at our feet during the interviews. The article would not be complete without mentioning them: Graduating with Jim Edwards was yellow Labrador Mongo; With Caitlin Best was black Labrador Teka; with Dane Geer was black Labrador James; with Jenny Kennedy black Labrador Heather; with Linda Sheppard yellow Labrador Toren; with Nancy McMasters black Labrador Diablo; with Katrina Widman black Labrador Cancun; with Bevie Heninger yellow Labrador McGee; And with Deborah Kendrick black Labrador Flo.

Electing to use screen access technology—either a screen reader or magnifier—is a very personal matter. If you have considered the options and made your choice already, you are no doubt using your preferred method to read this article. Others may be in the process of choosing what, if any, assistive technology to use for their computer work, and still others may not be familiar with these technologies at all.

Most of us in the vision loss field are familiar with the leading screen access technology providers, AI Squared, Freedom Scientific, GW Micro and, most recently, Apple. The products sold by these companies provide comprehensive access to the operating system of either a Windows or Mac OS-based computer. For employment-oriented tasks, such as using Microsoft Office, these products are a requirement. For other tasks, learning either Windows or the Mac OS using keyboard navigation and/or screen magnification can be overwhelming.

Guide, from UK-based Dolphin Computer Access, attempts to provide an alternative strategy for performing many of the tasks for which a Windows OS computer is equipped. Here is how we described Guide in the March 2009 issue of AccessWorld:

"[Guide is] a comprehensive set of applications that replaces the customary programs that are commonly used with Windows, such as Internet Explorer and Microsoft Word. Its objective is to provide a consistent interface across more than 20 functions, rather than requiring you to learn the different interfaces of a separate web browser, e-mail program, personal calendar application, address book, and so on. Visually, Guide provides a simple, high-contrast proprietary interface. Numbers for each choice or option are associated with the function and can be entered directly from the keyboard. For example, if you want to send an e-mail message, you press 1. If you want to write a letter, you press 2. To navigate, you use the alphanumeric keys or the arrow keys. A voice-input option is also available at an additional price."

More than two years have passed since that article's publication, and the computing landscape has changed remarkably during that time. The desktop PC, once the dominant computer hardware product, has been surpassed by handheld devices such as iPads and powerful laptop and netbook computers. System Access To Go, a free Windows screen reader/magnifier, the NVDA screen reader, and Apple's VoiceOver and Zoom have made gains in popularity and have matured substantially in functionality and features.

Against this newly redrawn backdrop we revisit Guide and consider it for the newcomer to screen reading and/or magnification.

Documentation

The entire Guide manual is available on the Dolphin website in Word format. Dolphin Computer Access and the authors of this article recommend you either receive training or read the manual carefully before using the program as it can be a bit difficult to get started on. The manual is very clearly organized, is printed in 16-point font, and describes each of the menus and functions in detail.

Installation and Startup

After installation, you can set the Guide software to startup automatically when Windows starts. In testing, however, we found that the Guide program came on after the login screen, meaning if you have a computer on which you have to provide a login and password, the Guide software will not start until after you have logged in. This can present a significant hurdle for many who use the login screen, since they will have to perform this action without speech or magnification.

User Interface

The Guide interface is designed to allow you to accomplish nearly all of the common computer tasks within a single application. When you start up Guide, you will be presented with a simple and consistent text list of items, each of which takes you to a different application or another menu. Each of the items is presented in large high-contrast print and spoken aloud. In the Main menu, you are presented with the following options: E-mails, Letters and Documents, Access a Website, Scan and Read, Address Book, Play Audio CD or Mp3, Calendar, Voice Memos, and More Options. You can scroll among items by navigating with the arrow keys on the keyboard, using the mouse, or entering the number for the desired option.

Navigating the user interface with the keyboard is very easy, and, once you get used to the shortcuts, quick and efficient. Selecting F1 at any point will bring up a help menu that shows you the keyboard shortcuts for that menu. Using the mouse to navigate is not as smooth, since Guide does not allow you to adjust the cursor settings to make it easier to see.

Guide offers 20 color choices for the interface, allowing for a high degree of customization of text and background color. There is also an option to change the typeface for the text, though doing so can be a bit confusing. Choosing the option to change typeface brings up an extensive menu with all of the typefaces installed on your computer—which can easily number in the hundreds—without providing a preview option. The only way to see what each typeface looks like is to open the menu, make a selection, and then close the menu. Though this may be a nice feature for more advanced users who already know specifically what typefaces and colors work best for them, it would increase the program's usability to offer some preset options.

Guide does not provide the ability to increase the size of the type for all menus. You can press the F12 key at any time in the menus to increase the font size, but this setting does not carryover to other menu screens. If you prefer larger type, which many users of assistive technology do, you must manually increase the type size for each page of text. This is an unnecessary annoyance that could easily be fixed by creating a setting for a universal type size.

The synthetic speech that Guide uses is clear and easy to hear. A male voice, with a pronounced British accent, reads all text. We installed Guide on two computers and encountered a noticeable lag between each press of the arrow key on an HP desktop machine running Windows 7 with 2 GB of RAM and a 2.4GHz processor. This sluggishness made navigation slow and cumbersome. This sluggishness was not observed on a Windows 7 Dell desktop with 3 GB of RAM and a 2.9 GHz processor.

E-mails

Before using the e-mail option, you will have to set up an e-mail account. There are three ways to set up an e-mail account: You can import an e-mail account from Outlook Express (but not Outlook), you can manually input your e-mail settings, or you can use Guide's E-mail Wizard. The Wizard worked well when setting up accounts with online e-mail services such as Gmail, Yahoo Mail, and Hotmail, but did not work as well for professional e-mail accounts, which usually required manual input.

Letters and Documents

Guide features a basic word processor, which allows you to create and print text documents and open a limited number of PDF files. The word processor operates similarly to Notepad: it's very simple to use and easily allows the entering and moving of text. Basic formatting is possible using keyboard shortcuts, such as Ctrl+B for bold, and you can press F1 at any time to bring up a list of all available formatting shortcuts. Though you can insert images into your documents, overall the functionality is still very limited in comparison to a full-fledged word processing program like Microsoft Word.

Documents produced with Guide software are saved as proprietary GDoc files, which can't be opened by any program other than Guide. There is no method to import Microsoft Word files, making it difficult to use Guide with existing documents. Although it's possible to open Adobe PDF documents, this functionality is limited to those PDFs already organized in an accessible format, which is often not the case.

Access a Website

There is a zoom feature built into Guide's Web browser, which can be activated either with the mouse or with keyboard shortcuts. When compared to most screen magnifiers, Guide's zoom feature is extremely limited. While it does increase the size of images and the text, the zoom feature has trouble presenting pages that contain advanced tables or frames. For example, the AFB home page has two sidebars, one on the left and one on the right, with a main body area between. When you use Guide zoom on the AFB page, it increases the size of the two sidebars, and shrinks the size of the middle area until it disappears. If you use a high level of magnification, you would never even know there was a central section on the page.

There isn't a way to change the color of the text or background in the default web browser. It's possible to convert the page to text-only, which removes all images and tables, and then you can edit the size and color of the text, but this does not work well on all pages. It would be nice if there were an easy way to change the color and size of the text for the main page.

Additional Functions and Tools

Address Book
Play audio CD or Mp3
Calendar
Scan and Read
Scan and Magnify
Podcast
Internet Radio
Skype (you need to have Skype installed)
Games

This list indicates the depth of the applications included with Guide. The calendar is noteworthy. Because Dolphin is a UK company, some terms and day/date formatting follow British conventions. This is also noticeable when using the spell checker and in some other functions.

Despite some peculiarities, all applications were stable; given the large number of features this is an impressive accomplishment.

The Bottom Line

Because Guide requires the use of only the alphanumeric keys and arrows, beginner keyboard skill will allow someone to get up and running with the program, which is a definite advantage. However, the significant shortcomings of the program outlined in this review do not recommend Guide for most people with vision loss as even a first step toward full use of a computer.

We also would expect that any word processing program offered for sale in 2011 will be capable of opening documents and saving documents in the Microsoft Word format.

Finally there is the price, which will be prohibitively high for some people. Guide is available in the United States for $795; there is a "hands free" version available for $1,295.

Product Information

Product Name: Guide and Guide Hands Free.

Manufacturer: Dolphin Computer Access.

U.S. Distributer: EVAS
39 Canal Street
Post Office Box 371
Westerly, RI 02891.

Website: www.evas.com.

Toll Free: (800) 872-3827.

Alternatives

As mentioned earlier, several free access products have gained popularity and matured significantly in the past two years. Availability of training on the Apple interface with VoiceOver and Zoom is on the rise in many communities. System Access To Go continues to offer a downloadable, free, and comprehensive access tool for both nonvisual and low vision use of Windows-based computers. The System Access Mobile Network (SAMNET) offers a suite of applications that resemble many of those contained in Guide for the annual subscription cost of $129. SAMNET can be used with any Windows screen reader including System Access To Go.