Pennsylvania Tech Accelerator Webinars

TOM DIAGOSTINO: Good afternoon, everyone, and thank you for attending this session. Today's session is called Assistive Technology Basics, where we will be discussing supporting and enabling technologies to empower all of us. This presentation is coming to you from TechOWL and the Institute on Disabilities at Temple University.

On the screen, I have three logos. I have the Pennsylvania Tech Accelerator logo through the Institute on Disabilities at Temple University. We also have the Temple University College of Education Institute on Disabilities logo, as well as the TechOWL logo on the bottom of the screen.

So an accessibility check before we get started with this session. We are going to be providing image descriptions of all of the images on the slide. We also have ASL interpreters who are making the session accessible to all of us with ASL. In addition, we have a CART captioner who is captioning.

So you're able to turn on your captions, and we have a CART captioner professionally captioning this session. And also if there's any other accommodation that you need during this session, please do let us know. You're able to message myself or Alanna in the chat with any needs that you might have or any questions.

On the slide, I have four images representing the four accessibility features that we have on this presentation. Image descriptions, ASL interpretation, CART, and other accommodations.

So why are we here? So we are here because of a program called the Tech Accelerator program. This is a program in the Commonwealth of Pennsylvania that is funded by ODP, the Office of Developmental Programs, and OLTL, the Office of Long Term Living. Because of these funders through-- or because of these programs, we are able to provide a really robust series of events and series of resources to the whole Commonwealth of Pennsylvania around supportive technologies.

So this Tech Accelerator first is providing robust training and resources to build capacity in the entire Commonwealth for people who work with those who have disabilities or are involved with those who have disabilities, or even disabled people themselves. So this is in the form of webinars as well as asynchronous learning modules, which I will speak on in the next slide.

There's also different evaluations and research going on on this theme of supportive technologies in the state. They're also going to be hosting technology summits in 2025. And again, this project is made possible by Pennsylvania Department of Human Services through funding from the American Rescue Plan Act.

To find out more information about the Tech Accelerator program, you're more than welcome to visit the Institute on Disabilities website for the Pennsylvania Tech Accelerator program. If you Google Tech Accelerator Temple University, you will easily find that link. It's the first link.

So the Tech Accelerator program's webinar series is a monthly webinar series for the next 18 months. So that starts this month, today, July of 2024, and it goes until December of 2025. We're going to be meeting monthly every third Thursday of the month from noon until 1:00 and from 4:00 until 5:00. So today, for example, we presented this exact same presentation from noon until 1:00, and we're presenting this exact same presentation right now from 4:00 until 5:00. So you can choose what time works best for you.

For all of our sessions, we strive to be as accessible as possible. Our presentations will be screen reader accessible, the slides that we send out afterward for your records. We also will have ASL interpreters every session. We will have CART captions every session. We will also verbally describe the images on slides. And you have the ability to request additional accommodations if needed. We will also be recording one of the sessions that day, and we will publish them afterwards with the transcript and the slides.

ALANNA RAFFEL: Tom, can you make sure that both the interpreters have co-host? I think you have to do it because you're the host.

TOM DIAGOSTINO: I believe they do.

ALANNA RAFFEL: Someone doesn't.

TOM DIAGOSTINO: Oh. One moment. Perfect. Awesome.

So the lectures that we're going to have for the Tech Accelerator, we have three confirmed for the next three months and some topics in the future that we're going to explore. So today is assistive technology basics. Next month in August, we're going to be talking about built in accessibility tools for everyday devices, things that we have. And the third session that's confirmed is in September.

We're going to have a panel discussion from a group of people who utilize ODP and OLTL services called A Day In The Life, Work, Home, and Community, where they're going to share about their experience using receiving services and getting assistive technology from OLTL, ODP, and resources like that.

Other topics that we're going to provide is augmentative and alternative communication, some remote support topics, topics around tools for specific needs and employment independence. Also some recreation and regulation in the community topics.

All right. So now that we've got through some of the PA Accelerator information, we're going to get into the session. So I would love to introduce myself and my co-presenter, Alanna. So my name is Tom. I've worked at TechOWL for the last five years. My title is Senior Assistive Technology Coordinator, and I'm incredibly passionate about accessibility, digital accessibility, and the work that I do here in assistive technology. And Alanna.

ALANNA RAFFEL: Hi, everyone, I'm Alanna Raffel. I'm an occupational therapist and assistive technology specialist here at TechOWL. Was an OT in lots of different settings, including rehab, hospital, outpatient, early intervention, schools. And so now I love thinking about my work as an OT in a different way. Here is a picture of Tom and I at a workshop with Swoop from the Eagles.

TOM DIAGOSTINO: Great. So this webinar is designed to help you. So first we're going to define the term assistive technology. We've talked about that term quite a bit. And we're going to then identify different assistive devices along a continuum to address a variety of options and needs. We're then going to identify a wide range of supportive technologies, and end the presentation talking about how you can utilize Tech Owl services and programs moving forward.

ALANNA RAFFEL: All right. So a little bit about us at Tech Owl. First, I'd also love to hear who has been involved with TechOWL before? Who has heard of TechOWL? Who's never heard of TechOWL? So just let us in the comments in the chat right now if you've heard of TechOWL, have used TechOWL services, never heard of it. We'd love to hear and see what everyone's level of involvement has been so far.

And while you let us know that, I'll tell you a little bit more about us. So TechOWL stands for Technology for Our Whole Lives. So owl is the mascot of Temple, of course. But we also say it stands for Our Whole Lives because we serve everyone across the lifespan. We are the state Assistive Technology Act program for Pennsylvania.

Every state and territory has a program. There's 56 of them across the country. And we all do some similar kinds of activities. So even though we're based at Temple University, we're based at the Institute on Disability, we're an outward facing program. That means we serve everyone across the Commonwealth. And that includes people at Temple, too.

This picture is from a project called Disabled And Here to increase authentic disability representation and stock photos. I'll put the link to that in the chat. It's always a great resource to have as well. And no one has let us in the chat whether they've heard of us yet or not, so I'm going to just assume you've all heard of us a little bit. Oh, someone says they say they love TechOWL. OK, great.

TOM DIAGOSTINO: Wait, we know Shelley. Hi.

ALANNA RAFFEL: Also assume most of you have heard of us a little bit maybe. But let us know. Maybe you've never heard of us before. And we're happy to share a little bit about what we do.

TOM DIAGOSTINO: Great. A little bit more about TechOWL. We're federally funded and state funded. We're a non-profit organization. We also believe or view disability through a social and holistic model. We believe that we can make our environment more accessible. We can incorporate technologies to make our environment more accessible.

But also the holistic model. We truly believe that pain is pain and sometimes we need to respect that. There are limitations and there are boundaries and barriers that we experience as people. And so we try to combine some of these different models of disability in our work. But most importantly, through these models, we are centering the disabled experience in everything that we do and everything that we promote. Genuinely, we are just here to educate, inform, and empower Pennsylvanians about all areas and all topics of assistive technology.

On the screen, there is an image of a person using a VR headset, Virtual Reality headset. I believe they were exploring a zoo. And a student who was interacting with this person is also modeling augmentative and alternative communication with the iPad that's sitting in front of them.

So this is a map of Pennsylvania. Oh, sorry. So this is a map of Pennsylvania. TechOWL, we serve the whole Commonwealth. Pennsylvania is a massive state, so we strive to make our resources localized. We have nine centers across the state with TechOWL staff. Our main office is in Philadelphia at Temple University. And this main office serves the five counties around Philadelphia. So that's Philly, Bucks, Montgomery, Chester, and Delco.

However, if you live in Pike County, which is where I'm from, that part of the state, you would go to your local resource at United Cerebral Palsy of Northeast PA. So I'd love to in the chat where everyone else is from in the state of Pennsylvania, if you are, what county you're from. And just know that wherever you are in the Commonwealth of Pennsylvania, you have a local representative in your region that will help you connect to tech owl and other resources in the area. We have a Delco. So you're our local. And if you're not in Pennsylvania-- yeah, absolutely.

ALANNA RAFFEL: While you're telling us where you're from, I'll share a little bit more about the AT Act programs. And I also popped a link in the chat if you're not from Pennsylvania, how you can find your AT Act program. Someone from [INAUDIBLE]. Great. So all 56 state programs do some of the same things. So no matter where you are in the country, your state AT Act program-- paused for a second for a swap.

Awesome. So no matter where you are in the country, you'll have access to some of these programs that all state programs do. So we all do device demonstrations. That means we meet with people either one on one or in a group or with their team or their family to show them different kinds of devices, help them problem solve, compare and contrast things, and just help people figure out what works best for them. There's a little graphic of a communication device there. We do a ton of device demonstrations with regard to augmentative and alternative communication, AAC.

All state programs do some kind of equipment lending. In Pennsylvania, we mostly do ours via UPS. So you go on our website, techowlpa.org/library. You browse our options. You can search things. Put them in your cart. Check out. It gets shipped to your house for free with a prepaid return label. And that's the way that we allow people to try things out in Pennsylvania. We also have some things on site here at our community space. If you're local to Philly or the area, you can come here and check things out and borrow things from here as well.

Every state program has some kind of equipment donation. So here in Pennsylvania, we have about 12 partner programs across the state that take in equipment. Things like walkers, wheelchairs, durable medical equipment, and other tools that we take and give back out to people in the community. Here in this region, in Philadelphia area, we have our stuff back in that room there. And so you can stop by our community space to drop things off and pick things up.

And we all do presentations, training, technical assistance. So things like this where we teach people about assistive technology. All the state programs are trying to educate people about assistive tech and all kinds of devices.

TOM DIAGOSTINO: Awesome. So we've been using this term assistive technology. So what is assistive technology? Also, it is known as supportive technology or enabling technology. There's a few terms that we can throw around. So assistive. Oh, you got this one, Alanna.

ALANNA RAFFEL: What are assistive technology devices? The technical definition that's used in legislation is an item or a piece of equipment that is used to increase, maintain, or improve the functional capacities of individuals with disabilities. Basically, tools that make life easier, safer, or more independent.

So while we're starting to think about assistive technology and all of these kinds of devices, feel free to put something in the chat that you think is assistive tech. What's something that you think is assistive tech? Maybe it's something you've seen, something you use, something a client uses, a family member. Give us one example of supportive technology that you can think of.

It might even be like something you see in the room around you. I don't know. Take a guess. We'll give it a couple of seconds and then we'll tell you the answer. All right. Go ahead.

TOM DIAGOSTINO: Cool. So as you're thinking of some assistive technologies too, let's talk a little bit about why we're saying this term assistive technology. So really, the term assistive technology comes from legislation. So the Technology Related Assistance For Individuals With Disabilities Act of 1988, also known as the Tech Act, provided this term in a comprehensive definition in law of assistive technology, which promoted its development and dissemination. So that's why we have this term assistive technology.

And also, most funding streams like insurance, waivers, even the IEP and IFSP use this term and definition to financially support the purchase of assistive devices. So that's why this term assistive technology is so important.

However, in more common days and also as we kind of transform in our field, there are other terms as well that we're going to be using interchangeably. So those terms are adaptive equipment, assistive device, supporting technology or supportive technology, enabling technology, tools, gadgets, gizmos.

Language is a tool that we use to communicate meaning. So please use the term that feels best and most comfortable with you. Throughout this presentation, we're going to be using all of these terms interchangeably, but know that in a lot of cases, when you're looking for funding, the term assistive technology has a definition and also has a financial power to it.

ALANNA RAFFEL: All right. So when we're considering adaptive devices, we're really thinking about what the person wants or needs to do. So while it may be sometimes helpful to know someone's diagnosis, maybe that could help me understand what their prognosis looks like or it might help me reflect on other people I've worked with that have similar conditions, ultimately, that's not the most important information to me. I want to know what do you want to do? What do you need to do? What's working? What's not? What are the barriers? So it's really more about the functional need.

I always say Tom and will get messages on social media. Often that'll say something like, hey, I have ADHD. What should I do? What app should I get? Or something like that. Or my sister has cerebral palsy. What should I get her? Unfortunately, that's not enough information for us to share some ideas. I wish I had some magic answer, but I don't.

We really need to know what are you trying to do? What do you want to do? What do you need to do? And what's not working? What is the barrier? And there's some pictures here of all the kinds of activities that we might help with. A toothbrush, a t-shirt, getting dressed, playing tennis, using a computer, using a phone. So really want to know what's working, what's not, and how can I help you access this activity?

TOM DIAGOSTINO: Great. So now let's get the conversation going. Please get your chat box open. I would love to know in the chat if you believe that straws, plastic straws, would be considered supportive technology, using that kind of definition of assistive technology that we described earlier. Do you think that this could support a person with disabilities? Cool. We got a yes. Anyone think no? Two yeses. Yeah, absolutely.

So plastic straws very much can be assistive technology if you struggle maybe closing your lips around a cup. Maybe you struggle lifting a cup right to your mouth. And so a straw gives you more access to liquid. Maybe you struggle with the sensation or the sensation of cold liquid is overwhelming on your teeth or lips and you want to bypass that. There are multiple ways in which a straw can be assistive.

ALANNA RAFFEL: What about a fidget spinner or some kind of fidget tool? Is this considered assistive tech? Is this enabling? What do you think? You can put yes or no. I think all those responses are from before.

All right. Someone said yes. Awesome. So yeah, I think this can be assistive tech. We're really just looking for things that help a person with a disability do something that they maybe would have trouble with otherwise. So if you have trouble learning, listening, focusing, and this helps you do that, great. That's assistive technology.

TOM DIAGOSTINO: And the last one. So this one is a little interesting. This is a KitchenAid stand mixer. So this is something that you might see in a kitchen or really any place. Do you think that this could be assistive or is this more just a generic thing that we all have? Yeah, what do you think in the chat?

Yeah, we got a couple yeses. I agree. I think this could absolutely be assistive for a person who might not be able to hold a hand mixer, for example, or mix something like making whipped cream or meringue. If you need it for meal prep, this could absolutely be assistive. But for some people, this is generic technology.

So within this whole assistive technology field, we see the incorporation of generic devices that can really be assistive for someone. Thank you, Alana. So this is an example of a generic device that could really be assistive for a person, again. So that is something that we run into all the time. And so again, with straws as well, very generic, but could be assistive. So that's how we have to think in regards to adaptive technologies.

So now let's take this knowledge of assistive technology and apply it to this concept called the assistive technology continuum. This also is sometimes written as the continuum of considerations. So that's another thing that you might find this as well online.

So the assistive technology continuum is just a continuum of how we can conceptualize technology in low or light, medium, and high tech. So the first category in this continuum is light tech. Light tech is free or inexpensive. It's readily available. It doesn't require much training to utilize, and it's not really overly complex.

So on the screen, I have a pencil grip as an idea. Does anyone else have any ideas of some low or light tech devices that could help a person with disabilities? I always like to think of this as the types of devices that you can find at the dollar store, for example. And maybe the DIY hack. I know a few people on this call who are educators, so I'm sure you have some ideas.

Yep, clamps. You can find some clamps at the dollar store and use them to hold things. A reacher. I've actually seen reachers at CVS. I would consider that in this category as well. I always think too any DIYers, I'm a big DIYer, so built up pool noodle. You can cut some pool noodle and wrap it around a spoon so you have a bigger grip. Things like that is this category.

So moving into mid tech, this is a little bit more complicated. It's like a lower cost, but not dollar store level. It may require some training and ongoing support. And it's somewhat sophisticated. It's not 1,000% intuitive. On the screen, we have an image of an ergonomic keyboard. So yeah. So what other devices do you think might fit in this range? This is the harder of the three categories to fit, this big gray area. Yeah, maybe one or two examples of things that might fit in this category of mid tech.

Yeah, larger key pads. Absolutely. Larger buttons. That totally works. I think for me in this category, I like to talk about maybe noise canceling headphones, audiobooks, maybe even some apps on our phone could be really assistive and really helpful.

And then we get high tech. I feel like of the three, this is the easier one because these are things that are kind of very extravagant. So in the high tech, we're really thinking of expensive devices. We're thinking things that require a bit of training. And they're usually a little bit more sophisticated.

So on the screen, we have an image of Stephen Hawking. So Stephen Hawking is in a power chair that is very customized to his body. He also is using a communication device to generate speech. So what other devices have you might seen in your work or that kind of fit this category of high tech?

Yep, eye recognition keypad or eye tracking on the computer for sure. I think maybe in this category an accessible button for the door to open the door. That's very expensive. Yeah. Wonderful. So now let's put the principles to practice. I believe we're right at the 30 minute mark, so maybe our two interpreters want to switch. Wonderful.

So the AT continuum. So let's put principles to practice. So let's use these concepts of light, mid, and high tech to maybe generate some ideas around art making. So what are some kind of light tech ways in which we can make art, making art, more accessible?

AI art. Honestly, I'm going to save that for the high tech. I think AI art is a new, interesting concept. I love that. But I feel like that's very high tech. I don't know if anyone uses Paint, but I know Paint now has a really interesting AI tool, which is awesome. Yeah, built up crayons. Anything that you can build up with a foam or a pool noodle. Absolutely.

So I have some examples of low tech stuff here. So I do have, as Shelley mentioned, a foam thing, a foam roller that you get at the dollar store. I love cutting up pool noodles. I also have this interesting 3D printed paint brush holder. We 3D print those here at Temple. So happy to send that to anyone if they see use for that. There are also some ergonomic paint brushes you can purchase on Amazon. This is just an example of just ergonomic paint brush. There are also easy hold universal cuffs. It's a silicone cuff. Really intuitive, easy. It's pretty inexpensive.

And then we get mid tech. I think this is the harder of the three, again, categories. But mid tech, we have things like an easel. An easel set up for this person. This is actually the image is from a really great disabled business owner, Janey. She has a company called Paper By Janey and she creates stationery and other art that she sells online.

On the lower part of the screen, we have the Guided Hands device. This is a device out of Canada made by a college sophomore, which is super awesome. This device uses the larger gross muscles in your shoulder to write and to navigate a tablet, iPad, or painting, accessing art. Especially if you are a person that maybe doesn't have much strength or control or stability of your wrist and arm, this allows you to use your shoulder to navigate that plane where the paper is.

And some higher tech devices that we have here. Getting back to the AI art. So we have a head stick that's very customized. Speaking of AI and computers, Paper By Janey, her company, this is Janey and this is how she does her graphic design. So she uses something called a GlassOuse, which is a head tracking mouse.

So there's a little light that connects to that Bluetooth to the computer. And so she's using her head to navigate the mouse. And she has that attached to a bite switch. And so she's biting down on that little thing in her mouth, and that is the click function. So Janey uses that to do all of her graphic designs for her stationery company.

And then also on the bottom of the screen, we have a power chair which has a paintbrush attached to it, which just seems really fun, a little messy, but fun can sometimes be messy too. So this is just an example in practice of the AT continuum.

But really, regardless of where you kind of are falling on this AT continuum, the most important part is that the tool reflects your need. So it doesn't matter if it's light tech or if it's high tech. If the assistive device is fitting your need, that's all that matters. The image on the slide, the four images on the slide, is of two people using noise canceling headphones, one person using a earbud for noise canceling, and then the fourth image is of bone conduction headphones.

All right. So now we're going to be discussing examples of supportive technologies for people's specific needs. So all of the devices that you're going to see from here on out are all devices that you can request to borrow from our assistive technology lending library.

So the first category of device is moving and controlling the environment. So I have six images on the screen. I'm going to start from the top left, go over, and then I'm going to go bottom left to right. And this is going to be for the next subsequent slides as well.

So first, we have Guided Hands, like we showed in the continuum slide. Guided Hands is amazing. We have one on site. We have one or two in our inventory. It's a really empowering tool. The second image is smart home technology. We have smart home tech kits that people can borrow to test out if smart home tech can benefit them in any way.

We also have this Obi Dining Robot. It's a robot feeder. So there are four bowls you can set up with four different foods. And the first button that you press, there's two buttons, is the scan button. So that scan button scans the plate. So you can choose what bowl you want to pick from. And then the other button is the button where you select and then the arm comes down, picks up the food, and brings it to your face so you can eat. So if you don't have the ability to feed yourself, this is a robot that can feed you. Oops.

The last image on that top part is the Xbox adaptive controller. In our community space, we have the Xbox as well as the PlayStation and Nintendo Switch adaptive controllers. But in our inventory, we have the Xbox. This amazing kit also comes with an Xbox. So you don't need an Xbox to borrow this. And this is a really great tool and incredibly interactive and customizable. We also have some ADL stuff. So an adaptive nail clipper we have as well as different types of adaptive utensils. This is the Liftware level spoon, but we have other types of weighted spoons as well.

The next category we have is hearing technology. So on the top left, we have a pocket talker. It has a little microphone and it comes with a headset so you can have a one on one conversation. We have amplified doorbells that also flash. We have the Contego listening system. It is designed to have one speaker with multiple receivers. There's also headphones.

We have bed shaking alarm clocks. We have the BeHear personal amplifier, which bluetooths to cell phones. And we also have bone conduction headphones, which is really great for anyone that has internal ear hearing loss or inner ear hearing loss. Also, it's really great to multitask your ears. A lot of people who are blind actually like bone conduction headphones because they can hear their phone's directions as they're navigating the outside, but they also still have the ability to hear what's going on around them. So they can multitask their ears while using their phone as the directions. So again, this falls into both hearing and vision.

So speaking of vision, we have a bunch of vision tools. So the first two images on the left side of the screen, the top one is the Envision Glass, and the bottom one is the OrCam MyEye. Both of them use artificial intelligence as well as optical character recognition to read text, as well as identify objects and people in the space.

Interestingly, with the Envision glasses, the Envision glasses has an app that can attach to it where you can remote someone in to your camera so that they can see what's happening. And so you can remote someone into your glasses and they can see your surroundings and have a conversation and potentially act as a sighted guide.

We have many types of magnifiers as well. The top part of the screen, we have a handheld magnifier, digital magnifier. We also have larger ones that kind of can sit on a table. We have desktop magnifiers, which is the largest one. We also have different types of Braillers. So Braille label makers. We also have refreshable Braille displays. So the one we have down here is the BrailleSense.

We have a bunch of sensory tools. We have liquid motion bubblers, compression vests, noise canceling headphones, various fidgets, and different types of weighted lap pads. In our inventory, we have a kit that you can borrow a bunch of different sensory tools depending. Sometimes it's important because you don't know quite what tool is going to work best for you, since sensory can be so multifaceted. So we have this kit so that you can test out a whole bunch of different options.

And lastly, we have a ton of communication tools. We have some mid tech kind of single use devices like the GoTalk and the QuickTalker. These ones are really, really great, especially for just quick, easy, click one thing, it says one word type deals. We also have the talking buttons. The BIGmack switch is the one that we have on the slide. So this is a button that you press and then it creates speech. You can record multiple messages as well on the BIGmack.

And we have some very high tech devices. So we have the Accent 1,400. We also have the accent 1,000. We also have the iPad with Skyle on it, which is a eye tracking technology. In addition to what you see on the screen, we have a bunch of iPads and we're able to remotely launch most AAC apps. So we have subscriptions to most of the major competitors in AAC. So Lamp, Proloquo, TouchChat, GoTalk Now, CoughDrop, and those larger apps. Wonderful.

So now we're going to talk very specifically about all of the ways in which you can get, learn, and explore assistive devices with Tech Owl. So this is the program part of the presentation.

So let's talk first about exploring technology. So the best way, like the biggest way I think we can explore assistive technology is through borrowing from our lending library, our assistive technology lending library. This is amazing, because it gives you that hands on experience to know if that device is going to work for you or not. Our lending library, like all of the devices you just saw that I mentioned, you can borrow any of those on our website. The loans are between five and nine weeks long. So five weeks is for most everything in our library except for iPads and Chromebooks.

The reason why iPads and Chromebooks are nine weeks long is, one, we have a lot of them. So we don't really have any issues with inventory. And two, speech pathologists who are trying to apply for funding for an AAC app, they need an eight week long trial. And so to accommodate the need of the community, we allow nine week loans for our AAC apps for that purpose.

This is free for all Pennsylvanians. You just need a Pennsylvania address. We will mail you through UPS the item. And inside of that box is going to be a prepaid return label. So when you're done with your five to nine week long loan, you can even reuse the same box and you can just put that prepaid label on there and send it back.

If you don't have the ability to get to UPS store, we can schedule a pickup with you. And if you don't live in Pennsylvania, again, every single state has a lending program. So this is across the United States, all 56 programs. The image on the slide is of a person holding a box probably received by UPS.

So in our inventory, if you see that the item that you're looking for is not there, we do have a Suggest A New Library Item button. Sometimes the system might be difficult to use, and you might not have the right search terms, and that's totally fine. So if you put a suggest a new library item, we're happy to reach out to you to tell you stuff that we might have that could fit that need. But if it is something that is new and interesting, we're really excited to continue to expand our inventory.

Another way to explore assistive technology is through a community space. So Tech Owl was very fortunate to receive funding to open this amazing community space right on campus. It is at 1392 Cecil B. Moore Avenue. It's across the street from our main office, which is where I'm currently at. And it's also just outside of the Cecil B. Moore SEPTA stop. So if you're in Philadelphia, it's right off of a major Broad Street line SEPTA stop.

In this community space, we have a makerspace where we 3D print assistive technology. We have an accessible gaming station where we have a PlayStation, an Xbox, and a Nintendo Switch, all with adaptive controls. We have room to do demos. We have a ton of equipment there as well. Not as much as our inventory, our centralized inventory of devices, but we do have a lot of devices.

We also host many types of workshops and events. We have a sensory space for people to regulate in case they need to just come in and sit down and relax. In the back, we have our used equipment storage area where people can receive used equipment donations. People can also donate used equipment if they no longer have a need for the equipment that they have in their home. And we also have our mobility equipment lending. So we have wheelchairs, walkers, and things like that that people can borrow from us. We're just going to take a break to switch interpreters. Wonderful.

Awesome. So now we are going to talk about learning about technology with Tech Owl. So first, you received the loan from the lending library. How are you going to know how to use it? So Tech Owl provides consults and demonstrations of all things assistive tech. In these consults, we can talk about potential technologies that might work for you. We can talk about also different programs that we have. We can get you signed up for programs and things of that nature.

These demonstrations will also, you'll receive a written email kind of describing the visit, describing the different types of things you can borrow, and we usually will always give next steps. The image inside is of me demonstrating a 3D printed magnifier and the built in magnification feature on an iPhone with a group of people who had various levels of vision.

TechOWL also has AC services. So we are lucky to have four speech language pathologists here at TechOWL, and we provide general AAC consults and speech consults like that. We do not provide speech therapy through any of our programs. We are in addition to speech therapy. So we do have our general consults. We recommend to have those consults with the speech team. If possible, if at all possible. We have a birth to three EI program as well, where we provide consultations for like little, little ones.

And we have some adult programs which are through ODP. Specifically the Just SO speech services program, which is specifically for ODP consumers as well as the Philly IDS consumers program. To find out more information as well, we have a link on the slide. You'll be getting these slides soon, next week, with the transcript and the recording. So I will send all this information to you. Do not worry. We have on this slide, we have an image of a person attending a Zoom meeting.

We also provide technical assistance, which we help people just make things more accessible. So we can provide recommendations to improve accessibility on your website or potentially a flyer or any digital imprint. We also will do some physical space assessments. So the image on the slide is of a physical space assessment that we did for the Temple University's honors program. We can help people understanding emergency preparedness to be inclusive of those with disabilities and preparing for emergencies. We also can help with just general inquiries around being more accessible and how that looks.

And last but not least, getting devices from the TechOWL program. This is a really amazing part of our program. We're able to provide people with free devices and that's just wonderful. So the first program that I want to highlight is our used equipment program, which is now based out of our community space. This used equipment program provides people with used, secondhand equipment that works really well, typically.

We have 12 locations across the Commonwealth that also can facilitate this program. So you don't need to be located in Philadelphia to utilize this program. We accept donations specifically of mobility devices such as manual wheelchairs. We at Philadelphia don't accept power chairs. Some people do across the state, and we can recommend other programs.

We also accept walkers, crutches, and canes. There are DME, Durable Medical Equipment, that we accept, such as shower chairs and commodes, and other assorted assistive technologies. So these are all things that we accept as donations and that we also have. You can check out our most up to date inventory on our website.

We also have a robust 3D printing program called CreATe Together. This program, we have three pillars to this program, so we have an easy, quick device catalog that anyone can request a device from. There's about 30 items on that catalog. You fill out a form and say what of the 30 devices you would like. And we are able to send that out to you via mail. It's very easy for us, because we're able to stockpile and print when the demand is low so that whenever someone requests something, we're able to quickly get you the device you need.

We have capacity to do some individualized projects. On the screen, I have an image of a little girl walking with a PVC walker that we were able to make with some OT students. Commonly, our individualized projects are surrounded in augmentative communication, and so we make key cards, custom key cards for people's augmentative communication devices.

And lastly, we love having maker events. This is where we can get people in a room for about three hours and make a bunch of devices. Typically, we're making Switch adapted toys, which we give out throughout the year, but predominantly we do a big adapted toy drive around the holiday season where we give families with children who could use Switch adapted toys a Switch adapted toy for free. So we do about 150 to 200 toys a year around the holiday season. And this is an image of me leading a Switch adapted toy workshop.

The next program that I want to highlight is our free phone program, which is wonderful. It provides people with smartphones and landline phones that have the accessibility features needed for a person to use their phone if they struggle using their phone in a traditional way. The phones that we have in this program are notably iPhone 13, Samsung phone, Google Pixel phone. We have a MiniVision, which is designed for people with low vision. We also have many different adapted landline phones.

This is a program that we facilitate through the state, specifically funded through the PUC. So there is a lot of paperwork involved in this program since we facilitate it through the state. So we're able to help you walk through that application process. But there is an income threshold of 200% of the poverty threshold, which is around $30,000 for a single person. On our website, you're able to find more information about family size and income and see if you qualify. If you have any questions, you're more than welcome to also just reach out to us directly.

There is the iCanConnect program, which is the deaf blind equipment distribution program. We're very passionate about this program as well. This is a program we facilitate through the state. It is specifically for people who have both vision and hearing loss. There is an income requirement as well.

And basically, if you just know anyone who has both vision and hearing loss combined, send them our way so that we can get them connected to this amazing program. It provides one on one support and training with devices. It also allows a wide range of devices that we're able to fund for that person. On the screen, there is an image of a person who received equipment from this program. They're playing with an iPhone and a tablet.

And we have a scholarship through tech owl called the Del Sordo fund. This is a last resort funding source, which provides $400 of financial assistance for the purchase of assistive technology. This fund, we need to know that you also have tried other funding sources. So if waiver funding does not work, if insurance is not working, if other funding sources are not working, we need to know that you tried those avenues and then you can apply to us.

This is also a one time only so that you use this once and that's it. You're not allowed to use this a second or a third time. Some things that we were able to fund through this is a magnifier, a wheelchair battery, a sip and puff video game switch, which is also known as a quad stick, and a Roomba vacuum.

All right. So we made it to the end of the presentation. We are on time, thankfully. So now I just want to ensure that you have the ability to reach out to us and to continue to follow along on our journey, especially as we continue these presentations month by month.

So TechOWL's main office, we're at Temple University. We are a program of the Institute on Disabilities. And our main number is 800-204-7428. You can reach out to our general email at any time, techowl@temple.edu. Also on our website, there is a chat function. So during office hours, 8:30 to 4:30 Monday through Friday, you're able to talk to any one of us. We are always monitoring the website chat. So if you have a quick question, feel free to also chat us on the website. Our community space is located at 1392 Cecil B. Moore Avenue.

And the Institute of Disabilities, Their phone number is 215-204-1356. Their email is iod@temple.edu. And you can visit their website as well, disabilities.temple.edu. You can also follow us on social media. TechOWL specifically has a really robust program and a large, large following. So especially on Facebook, Instagram, and TikTok. So would love for you to follow along to learn more about assistive devices. Also follow the IOD, @IODtempleU.

And now that we are at the end, I do request that you please fill out this survey. There's a QR code on the screen as well as a bitly. I will put the link in the chat in one second. I'm going to let you all do the QR code. We are required by the state to prove that we do these presentations, and so it would be amazing if you could take one minute to give us your feedback on this presentation.

And if anyone has any questions, you're welcome to write them in the chat. Or if you would prefer to speak them, you're allowed to unmute yourself. I'm going to stop recording now so that our questions are not in the recording.

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We have a 1 click autoinstaller which you will find in your SiteGround account. The first step would be to create the subdomain and then proceed to the autoinstaller tool

And if any questions arise, you will be able reach out to support team directly from the account.

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Check with technical team from your account once you've installed it...

TOM DIAGOSTINO: Awesome. Hi, everyone. Thank you for joining. I think we're going to have some people rolling in as well. So we'll make sure that we get people in as the session continues.

But today, we're going to be talking about built-in accessibility features for everyday tools that we have. So we're really going to be focusing on smartphones, but it could also be extended to tablet use as well. On the slide, we have a few logos. We have the Pennsylvania Tech Accelerator logo from the Institute on Disabilities. We also have the Temple University Institute of Disabilities logo based in the College of Education and Human Development. And we have TechOWL's logo, which is a program of the Institute on Disabilities.

A little bit about the accessibility features that are going to be present during this presentation today, first, we're going to be describing our images. So as you noticed, I described the images in the previous slide. We're going to be describing the images throughout this presentation to ensure that everyone knows what is on the screen. You don't have to see what's on the screen.

We also are so fortunate to have two amazing ASL interpreters for this presentation today. And for the recording of this presentation, we will have ASL superimposed on the video. We have CART captions on this video. We will also be be getting this video professionally captioned for the recording. And if there's any other accommodations that anyone needs on this call, please let us know. You can also type in the chat any questions you have throughout this presentation and we'll be happy to answer those.

On the slide, I have four images representing the four accessibility features that we have in this presentation, that being image descriptions, ASL interpretation, CART, and other accommodations. So, Alanna, tell us why we're here.

ALANNA RAFFEL: Yeah. So why are we here? So this is our second live-- well, second today, but also our second chunk of live webinars as part of the Pennsylvania Tech Accelerator, which is a project that was made possible by Pennsylvania's Department of Human Services through funding from the American Rescue Plan Act. So we are facilitating this grant. We're going to tell you all about the kinds of things that we're doing through this project.

TOM DIAGOSTINO: And we have three logos on the slide. The logos are the American Rescue Plan Act logo, the Pennsylvania Tech Accelerator logo, as well as the Pennsylvania Department of Human Services logo.

So this large kind of project that we're working on, we are calling the Tech Accelerator program. And in this initiative, there are six major components to this initiative. These presentations are just a part of one of the larger six initiatives.

Those initiatives are enhancing technology resources throughout the state, developing a readiness evaluation program and tool, advancing technology for statewide assessment and planning, to execute statewide technology solution providers and assessments, to build capacity through online trainings-- webinars, just like this one-- and regional centers, and to plan and execute a statewide technology summit. So a large event, which is going to be happening in March of 2025. On the slide, I have six icons representing the six main functions of this Tech Accelerator initiative.

ALANNA RAFFEL: So our webinar series, as I said, this is the second month that we're doing this. We're doing 18 months of webinars. It's every third Thursday. Are we already at the third Thursday of August? That's confusing.

TOM DIAGOSTINO: Isn't it wild?

ALANNA RAFFEL: OK. It's every third Thursday at 12:00 PM and 4:00 PM until December 2025. That date threw me off for a second, too. So this is our second month that we're doing this.

Every month, we do it two times in the day. We want everyone to be able to access these, as many people as possible. So we do one at 12 o'clock and one at 4 o'clock. But we also are recording the webinars to put them up on the Institute on Disabilities website. So you'll have access to the slides, you'll have access to the recordings, you can look back at the content if you want to make sure that you're registered for future webinars, you can find all of the information at bit.ly/patechaccelator, and I'll pop that link in the chat momentarily.

TOM DIAGOSTINO: Awesome. So to tell you a little bit about us, the two presenters for this presentation today, my name is Tom DiAgostino. I have worked at TechOWL for about-- a little over five years now.

And I am a person who is very passionate about accessibility on my phone and tablet because I use accessibility features for my personal self and my personal disabilities, as well as supporting people in my life and my family with their accessibilities, because our phones can sometimes become the most important tool in our day to day lives. So I'm very excited to be able to share some of my personal experience as well as a variety of accessibility features on our phones. And Alanna?

ALANNA RAFFEL: Yes. And my name is Alanna Raffel. I'm an occupational therapist and assistive technology specialist at TechOWL. I'm just love thinking about accessibility in all kinds of ways, so excited to share this with you. I think like every OT and every clinician and every person should have some information about all of these different features.

I wish this was something I learned about in OT school. So maybe some OTs are getting some of this content in school. I did not. But it's fun to learn about and really important and impactful for many people. So this is a picture of Tom and I with Swoop from the Eagles.

TOM DIAGOSTINO: Cool. So today, we're going to be talking about basically adjusting our phone settings to make it easier to use. We want to help people turn their phone into a tool that helps them better see, hear, and enjoy the world around them. And last, we're going to talk about some resources through TechOWL and otherwise to help support you acquiring a phone that fits your needs as well as adjusting your phone to fit your needs.

ALANNA RAFFEL: A little bit about us, I don't know how many of you all are familiar with TechOWL, but a little bit about our organization. So TechOWL stands for Technology for Our Whole Lives because we serve everyone across the lifespan with any kind of disability experience. We represent the state Assistive Technology Act program for the Commonwealth of Pennsylvania. So every state and territory in the US has an Assistive Technology Act program, so there are 56 of them. And we serve the whole state of Pennsylvania. And you'll see a little bit more about what that means.

We are based at the Institute on Disabilities at Temple University. We're part of the College of Education and Human Development. So we're based at Temple, but we serve everyone. We're an outward-facing organization. That includes Temple, of course, but everyone in Pennsylvania can use our services.

And of course, we may have some folks from other states on this call. So you also are welcome to learn from us, to connect with us. There may be certain things that will refer to your state organization to help you get access to some resources, but we're happy that you're all here. And I'll pop that link in the chat.

The picture here is a bunch of people with disabilities using mobility equipment hanging out on a roof. This picture is from a project called Disabled and Here that seeks to increase disability representation in stock photos. And I'll put a link to that in the chat as well because it's a great resource.

TOM DIAGOSTINO: Awesome. A little bit more about TechOWL is we are a federally and state funded nonprofit organization based here at Temple University in Philadelphia. We view disability through both a social and holistic model. We believe that we can make our society more accessible for all, but also we respect that people have pain and limitations, and that's just a very real reality, right?

We also want to center disabled people in the middle of the conversation. We want to center everything around people who are using the devices. We also are here to educate, inform, and empower Pennsylvanians about assistive technology. So in any way we can help you in the state of Pennsylvania, we will.

The image on the slide is from our ACES program. Our summer ACES program happens every two years. Augmentative communication users can come to Temple University and learn more about their device and get to talk to others who use AAC and explore different, amazing things.

This person is exploring a VR headset and exploring like, I think a zoo in like Spain or something. And the graduate student who's working with him is exploring that with his AAC and monitoring the experience on another iPad. So it's a really interesting, amazing experience, and we always combine different technologies.

ALANNA RAFFEL: So as I mentioned, we serve the entire state of Pennsylvania. And that means that we have assistive technology resource centers across the state. So Tom and I are based in Philadelphia at Pennsylvania's Initiative on Assistive Technology, so the kind of TechOWL mothership. But we have folks throughout the state-- some of them are on this call-- who help support our consumers across the state. Tom and I aren't going to be able to support folks in Scranton and Pittsburgh as thoroughly as someone in those areas could.

So if you are in a different part of Pennsylvania, not just the five-county region near Philadelphia, then you may connect with an assistive technology resource center near you who can provide services and consultation and help you find assistive technology that works for you. So lots of different regions here. And this is on our website. I'm going to actually pop the link to that in the chat as well.

So if you live elsewhere-- and this is actually a great moment to say, I would love to hear where everyone's from. So take a moment and pop your location in the chat. Let us are, you from Pennsylvania? Which county? Where are you?

Tom's in Philly, so am I. So we'd love to hear where everyone is from. It's nice to get a sense of where everyone is joining us from. And I'll share the link in the chat so you can find your ATRC.

TOM DIAGOSTINO: Awesome. As we're receiving your locations, I'm going to talk a little bit about the AT Act program. And the thing that every single AT Act program does. So like Alanna said earlier, there are 56 Assistive Technology Act programs in the United States. Every single state and territory has one. And we all are required to do very similar things.

So these are the four things that all of us are required to do. First is demonstrating devices. We all have an inventory of devices. And we are mandated to teach people about how to use them, what exists, how to acquire them. So that's something that all AT Act programs can help you do.

Secondly, we all have some type of equipment lending program. So you can borrow a device to test it out, to see if you like it, if it works for your disability, if it works for you in general. It's so important when we're investing into these devices to really know how to use those devices. So this equipment lending and this device demonstration is an integral piece to all AT Act programs.

The third program to share is we all do some type of equipment donation. So we have wheelchairs, walkers, canes, crutches, commode chairs, shower chairs, and things like that that we take in donations for. Many states-- every state does this, and we have 12 regional centers that do equipment donations for us in Pennsylvania.

The last thing is we all do some type of education. So that could be a presentation or a training like this or a technical assistant. So helping someone just be more accessible or helping an organization understand accessibility and accommodation. So on the slide, I have four icons, all representing the four different aspects that every single AT Act program does.

ALANNA RAFFEL: So let's jump into talking about technology and the changing role of technology. We know that 75% of older adults have used the internet and 61% have a smartphone. This is based on research from the Pew Research Center. 72% of adults with disabilities in the US own a smartphone.

And really, this is important because the internet and internet access is more like a utility now than a luxury. It is necessary to access your medical records and apply for jobs and pay your bills. And there are many reasons that having access to technology and internet is essential to our daily lives.

And being online can have many social and emotional benefits. I think we all know that. There's a picture here of an older adult on his phone, on his computer. And so we think technology is really powerful, obviously. We think all kinds of technology are powerful, but this is something that we really think everyone deserves access to. So let's talk more about that.

TOM DIAGOSTINO: So I'm going to launch a poll really quickly, and I would love to know what type of device that you use. So specifically, I would like to know what phone you use as well as what tablet you use. But I have to find where this poll is. Here it is.

All right. So the poll should be launched, so you all should be able to answer. We only have 14 participants, so I think-- and there's like six of us that are from the same institution. So for those who are here participating, if you could please answer those questions, that would be great.

Awesome. So we have six responses. I feel like-- oh, now we have 10 responses. Cool. Yeah. I'll give it like maybe two more seconds then to see if people can finish up.

All right. I'm going to end the poll. We have 11 responses. I'm going to share the results. So as you can see, this is an iPhone-heavy crowd. We have 9 of the 11 people who responded who use iPhones and two people use Androids. So this presentation will be balancing between both iPhone and Android kind of accessibility features. So I'm glad that we have some Android users here.

And when it comes to tablets as well, it's a very similar kind of breakdown. A lot of Apple tablet users versus Android tablet users. So again, we're going to try to strike that balance between Android and iPhone. I'm going to stop sharing. Cool.

So we're going to get started talking about built-in accessibility features. So the accessibility settings on phones are incredible because they're free. On many smartphones and tablets, assistive technology in general is really expensive. So to be able to have this item that's in our lives to have free accessibility features that can help us see better and hear better and experience our environment in a more accessible way is amazing.

Your phone also can be customized in so many ways to your needs. And so that's what we're going to be exploring today. On the slide, there's a little accessibility icon. That accessibility icon is very universal on phones. And so you might see this on your phone, and that's exactly where your accessibility features will be.

ALANNA RAFFEL: So where do you change the settings? It's always in the Settings. So you might see an icon with little gear. The one on the left is for iPhone. The one on the right is for Android. And that's where you'll find all these different settings.

So we're actually going to jump into a bunch of different settings that you might want to test out. If you are not using your phone to watch the Zoom, you might want to go to your settings right now and open it up so you can kind of follow along with us and check out all different kinds of settings. If you're having any issue finding that, let us know.

Quick Android disclaimer, Tom mentioned this a little bit, we're going to be sharing a little bit of both, but iPhones are much more consistent. So there's really like one kind of iPhone operating system. And so we can show you things on iPhone, and we know that everyone with an iPhone will kind of have a similar experience.

Android operating system is much more varied. And so it's a little bit hard to show like, this is what it looks like on an Android, because it's sort of different depending on what kind of device you're using. But we are here to help you.

If you want to set up a time to do a consult with us or problem solving, one-on-one training, especially if you have an Android, but either way, we're here to support you and help you figure these things out. So even if we don't totally jump into every single detail of any of this, especially for Androids, we're here to work with you and figure that out. And there's a bunch of Android phones and little Android robots on the screen.

TOM DIAGOSTINO: Awesome. So Alanna is going to kick it off with hearing tools.

ALANNA RAFFEL: Yes. OK. Fantastic. So we're going to share a bunch of different settings features with you. Again, you'll have access to all of this and time to explore. And we're here to help you work this all out. So we're just going to share a bunch of stuff.

So the first tool that we want to share is live captioning. Live captioning allows you to display automatic captions across all apps. On iPhone, you can actually turn on live captions for FaceTime. It's not 100% accurate, but it's a tool that can be used.

And here, it just tells you on Android how to turn live captioning on and off. You press the volume button, and under the volume controls, you tap Live Captions. So that's one way to interact with captions.

There's a picture here of what live captioning looks like on iPhone. There's a picture of the ocean and it says, I feel so relaxed when I'm near the ocean. So I'm actually going to open up my phone right now, I encourage you to do the same. In Settings I'm typing in Live Caption.

It's easier for me. Sometimes I just type things in to the Settings to find it. I'm turning on Live Captions in beta. And now my microphone is listening to me and it's saying everything, it's typing everything that I'm saying right now. So live captions, it's a tool that can be used during a conversation if you want to see some captions that are helpful.

You can also pair your hearing devices with your phone. So if you use hearing aids, you can turn on hearing aid compatibility to improve audio quality, take calls. In Android, its Connected Devices in Settings.

Another cool feature that your phone can do is sound recognition. So your phone can listen for certain sounds in the environment and notify you. So there's a ton of different sound options like alarms, animals, household sounds, and people. And the way you turn that on is in Accessibility.

So this first video will show you what it looks like. It's just me scrolling through Sound Recognition. if you want to start that one, Tom, I'll kind of talk through it.

So it's me scrolling down to Sound Recognition, turning that on. And when you click sounds, you can choose which ones you want to turn on. So I turned on a fire alarm, siren, smoke alarm, I'm scrolling down. Now I'm turning on the alert for water running.

And so now, you'll see you in the next video, I brought my-- I turned on the alert for water running. I brought it into the bathroom and turned the water on. And you'll see that it alerts me about the water running. So yeah, it says water running. A sound has been recognized that may be water running.

So this is not 100% accurate. And I don't recommend using it for emergency purposes. Like this shouldn't be your main smoke alarm if you are deaf or hard of hearing. This is an extra tool. But it can even be used for things like glass breaking or things like that, just an extra reminder, a feature on your phone.

And a few more hearing tools. So we have things like Real Time Text where you can use text to communicate during a phone call. I can call someone and be texting them so they can see on their phone in real time what I'm texting them. Maybe I am not able to talk right now, or for someone who's hard of hearing, and they can see in real time. So not just when you press Send, but actually every-- in real time while you're typing.

There's Flash Notifications. You can set your device to flash its camera flashlight or the screen to alert you of an incoming notification rather than a sound or vibrate. And then Sound Amplifier, which is native actually on Android phones, you can use this with headphones to filter and amplify the sounds in your environment or your device. And this is a photo of what Sound Amplifier looks like on Android.

So that's built into the Android device. Often, people prefer Android for hearing tools and iPhone for vision tools. But iPhone, you can try downloading a Sound Amplifier app. It's just not built into the operating system.

TOM DIAGOSTINO: All right. So now I'm going to take over and talk a lot about vision tools. So specifically when talking about vision tools the iPhone is incredibly helpful with screen readers because it's consistent across many iOS devices. So screen readers are aspects to a phone or a tablet or computer that can help a blind person or someone who has low vision interact with the device by using touch that also provides some type of spoken feedback.

So on iPhone, this is Voiceover. And on Android phone, it's typically considered TalkBack. And they both are gesture-based kind of ways in which you can navigate. So by swiping over, the phone will go from app to app to app, and then you can double-tap to then select. You can also navigate by link with the two-finger gesture. There are many different types of gestures you can use to control your screen reader on your phone.

In addition, there are many ways that you can change the display and text size on your phone. You can make the text bold or larger. You can reduce transparency to increase legibility. You can increase color contrast. You can invert contrast, as well, to have dark mode on your phone, which is what I currently have. As you can see, my phone is dark with white text. That just works better for my eyes.

There's also color filters for color blindness, which can be helpful if someone is colorblind. I don't have that on my phone, but I should try it because I am colorblind. And so you see here, we have some images on the screen to show you bold text on the iPhone-- the differences between the first image on top and the second image on bottom is that the text on top is not bolded and the text on bottom is bolded.

We also have the ability to zoom in on your iPhone. So this is not zoom like the app, this is literally to zoom or to magnify your screen on your iPhone. So you can turn on zoom to magnify the entire screen. The gesture to do that, if you have it enabled, is to double-tap with three fingers on your screen, which then it will just like magnify your screen.

Or you could drag your three fingers down and move it across the screen. And that also kind of triggers your phone to enable zoom. But to do that, you have to enable zoom on your phone first to recognize that gesture.

And lastly, we have spoken content. So spoken content is something that I use every day. This allows you to read on your phone. So you can also actually hear typing feedback, too. So you can enable that to-- when you type, you hear the letters that you're typing feed back to you. So the recording that we have on this slide is of that. So I'm going to play that recording so you can see this example of spoken content.

[VIDEO PLAYBACK]

- Tap H I T H I S I S.

[END PLAYBACK]

TOM DIAGOSTINO: So this is super helpful if you need to hear kind of auditorily what you're typing. In addition, you can use spoken content and accessibility to read what's on your screen. So you can select and highlight a chunk of text to have that then get spoken back to you.

So when you highlight and select, you have Copy/Paste, but then one of the options is to Speak. And then it speaks to you. The other way that you can do this is you could do Speak Screen. So I have this currently on my screen right now. And I can use my two fingers and swipe down-- whoopsies-- this gesture is a little hard.

SCREEN READER: Speak screen on. Swipe down with two fingers from the top of the screen to hear the content of the screen. Speech controller off. Highlight content. [INAUDIBLE]

TOM DIAGOSTINO: Whoopsies. Ah, stop. OK, so that's Speak Screen on my phone. I just swipe down with the two fingers and it's just reading everything on my screen. My favorite hack with this is that I can read Kindle on the Kindle ebook app. I can just make my Kindle ebook into an audiobook by just swiping down and having it read. I also do this with PDFs.

There's, additionally, for Android, you have spoken assistance, which reads the keyboard aloud. Tap Accessibility button and then you could use a shortcut as well with the two-finger swipe or the three-finger swipe for TalkBack. I find that the spoken content on the iPhone is significantly more dynamic than what I've experienced in Androids.

All right. And Alanna is going to take over with some of that physical access.

ALANNA RAFFEL: Yes. All right. And I hope-- I know this is kind of a lot of information. It's so, ugh, much going on. It's all there, and we're happy to share lots of resources so you can kind of review this stuff. And we'll make sure we can answer your questions at the end.

So Assistive Touch is a feature that allows you to create custom gestures and to be able to access all of these kind of important things that you might not be able to access otherwise. So especially if you have trouble pressing physical buttons or doing kind of multifinger gestures-- sometimes there's complicated multifinger gestures-- this little Assistive Touch menu, which usually on your screen looks like that-- in the red box, it looks like a little black circle. And then you press it to open up the control center and all these other options.

It allows you to have all of these custom options for interacting with your phone. So that's native to iPhone. On Android, you can download an assistive touch app.

Some more touch tools-- some touch accommodations that you can set up. For example, you can turn on ignore repeat. So multiple touches are treated as a single touch. Maybe if someone has a tremor and they're accidentally clicking letters too many times, it would just act like one touch. And there's things like Back Tap, which is when you double or triple-tap on the back of your phone to perform actions quickly.

So, for example, I have mine set up to turn the camera on when I back tap my phone. So let's see if it works. Aha. OK. So for me, I double-tap the back of my phone with two fingers twice. This is very meta to like have my camera looking at me right now. Great thing that it makes your life a little bit easier, especially if there are some other access difficulties.

Some more physical and motor tools are Switch Control, which allows you to use switches to control your phone rather than the touch screen. So maybe you're letting it sequentially scan and using a switch to select something or using two switches to scan and select. So there's a photo here of switch scanning on an iPhone. So it's showing you-- it's allowing you to select the row when it gets to the row that you want. And then you select the row and then it allows you to select the icon that you want. And so for someone who can't have direct access with their phone, this allows you to interact.

There's also Head Tracking on iPhone and Camera Switches on Android, which basically same thing. It allows you to navigate your phone with your head and a few simple facial gestures. So it takes practice. I recommend checking it out if you're interested in getting good at it or helping someone else with it. I've been practicing with it. So if you turn this on, you can move a mouse around your screen and then raise your eyebrows or smile or open your mouth to select. So you can browse, select apps, and it's using your front camera to do all of that interaction.

And then we have Voice Control and Voice Access. So it's called Voice Control and iPhone and Voice Access on Android. This is basically allowing you to use your voice to interact with your phone, to open apps, to navigate, edit text. So there's a little photo here of the different kinds of things you can say in Voice Control, things like open blank application, or open control center, go home, go back, go to sleep.

And you can also work with what's on screen by saying things like show grid, show names, tap a number, tap an item name, or long press an item name. And we're going to show you a video of what that looks like. So you'll hear my voice interacting with Instagram using a number grid.

[VIDEO PLAYBACK]

- Start listening. 17. Scroll down. Scroll down. 10. 17. Scroll up. Scroll up. 26.

[END PLAYBACK]

ALANNA RAFFEL: So that's just me looking at the grid, using the numbers to choose what I want to open and interact with. And there's lots of other voice commands that you can use. You can do a little training in your phone to practice using all these different commands. It's very cool.

TOM DIAGOSTINO: All right. And so now we're going to talk a little bit about some cognitive tools and accessibility features that we can enable on our phones. So first, we're going to talk about assistive access on the iPhones. So there is a way in which you can adjust the apps so that they are larger and contain like core features that can be customized.

So again, as you see on the screen, we have seven apps that are kind of isolated as these are our core apps and they're big, they're highlighted, they're bold. This offers a much easier way for us to navigate our phones. As we navigate, we see we have a million apps. It's really complicated, especially if these phones can be overwhelming to some people. So you can use this type of assisted access to limit the cognitive load that you have on your screen.

Also, there's ways in which you can have specific actions. So on the second image, this is for an Android phone. You can also have add images to like, call daughter for like common actions. So having Action Blocks that allow you to then have things in your day. So we have call my daughter with a picture of my daughter. We have call to-- car to doctor. So getting your doctor's appointment. So you have these different Action Blocks on the Android phone to just help with that cognitive load, making your phone the appropriate tool to allow you to kind of like navigate your day and environment.

Some other cognitive tools. So there's Accessibility Shortcuts. So on iPhone, the Accessibility Shortcut is to triple-click the side button. There's a list, actually, in your Accessibility app of many different shortcuts that you can enable with that triple-click. So what I personally have triple-clicked as my shortcut is a magnifier because I often demonstrate to people with low vision the iPhone's magnifier.

So if I click my side button three times, what's going to pop up is this magnifier, which I have currently set on a yellow color contrast. But I can change many aspects of it. I can zoom in and zoom out. So this is the iPhone's digital magnifier that's enabled on all Apple devices. So you can do that with your triple-click, but there's many other things you could use that triple-click for in that Accessibility shortcut.

Android, they also have accessibility apps. So you could choose shortcuts as well on your Android phone. There's Guided Access on iPhone or Screen Pinning for Android. So this keeps your phone in a single app. So it allows you to control the features that are available on that.

And then there's also amazing voice assistants that you could utilize. So Siri is the voice assistant for iPhone. Android, you can enable Google Assistant as well. So you can ask Siri or your Google Assistant questions. You can set calendar reminders. You can ask to call someone. You can even say, where's my phone, if you don't know where my phone is.

You can set timers. You can send text messages, make phone calls, turn on the flashlight, and things like that. This is a really very, very intuitive way to interact with your phone and to do many actions without necessarily needing to navigate your phone screen. You could just use your voice to then navigate.

The amazing thing about Siri, as well, that I like to say is that Siri learns your voice. So if you're a person that might have a complex speech pattern that most technology might not understand you, Siri is quite good at learning your voice because you have to train Siri when you first set it up with your voice, which is a really great feature as well.

Awesome. So do we have time, do you think, Alanna, to do this activity? Great. So we would love for everyone in the audience to choose one of the accessibility tools to try out. And so we have here all of the accessibility tools we just mentioned throughout this presentation. So whatever kind of area of interest that interests you the most, whether that's hearing, vision, touch tools, physical/fine motor, or cognitive, take a moment, explore that, and then tell us in the chat what you've done and what you think of it.

ALANNA RAFFEL: Yeah. So we'd love to hear what everyone tries out. So maybe pop in the chat what you are trying. What are you planning to try? Have you tried live captioning? That's a fun one to try.

I think it's also fun to try-- I will say, if you're trying Assistive Access or Android Action Blocks or Guided Access, you want to make sure you know how to exit those features. When you put that on, it's really like limiting what your ability to interact with your phone is.

So if you put on Guided Access or Screen Pinning, it's just putting you in one certain app. So you want to make sure that how to exit. Sometimes it's like a triple-click. If anyone gets stuck in an app, let us know.

TOM DIAGOSTINO: Yeah.

ALANNA RAFFEL: Turn on Sound Recognition. Yes. Great. You've been scared that you won't hear your apartment fire alarm. Thank you for to-- yeah.

TOM DIAGOSTINO: Great.

ALANNA RAFFEL: I was going to say, like, let me turn on a fire alarm right now so you can test it, but I won't do that. Emily loves [INAUDIBLE]

TOM DIAGOSTINO: Spoken content.

ALANNA RAFFEL: --spoken content. So helpful to have a built-in text-to-speech program on the phone. Absolutely. Sharon, said I made my font bigger and I can read it without my glasses. Love it. Love it.

TOM DIAGOSTINO: That's wonderful. Yes.

ALANNA RAFFEL: Live Captions is very cool. Yes. Did anyone try Back Tap? That's cool. I love that one. That feels like [INAUDIBLE].

TOM DIAGOSTINO: I want to set the Back Ta up on my phone now.

ALANNA RAFFEL: It's really cool. It's kind of magical.

TOM DIAGOSTINO: Great.

ALANNA RAFFEL: Sound Recognition, nice.

TOM DIAGOSTINO: So we would also love to know in the chat, now that we're in the chat typing away, what are some of your favorite apps that you like to use? We're going to now transition into talking about apps, but we'd love to hear if you're using any apps right now that are assistive or help you. Sound recognition, Back Tap.

Oh, yeah. Yeah. If you have your wallet on the back of your phone, that might not work. Otter.ai for meetings is a great app. We actually have that in our presentation, which is great.

Perfect. Well, as you're also typing, I want to be cognizant of time. Alanna is going to take it away with the apps, so.

ALANNA RAFFEL: All right. So I'm going to share a bunch of apps again. Grab a couple of these that you think are interesting. And also, we love to hear about other apps, too. So if you have apps that you think are good for these kinds of things, pop them in the chat. I'm sure everyone would love to see them.

So some apps for hearing include Rogervoice, which transcribes phone calls. This app is free for people with hearing loss, but you do need to confirm eligibility through the FCC's telecommunications relay service. So you'll see when you download the app, it'll ask you for all those different things. But if someone has hearing loss, they would qualify for this.

Ava is an app that provides live captions and transcripts, and it captions who said what. It does text-to-speech with a natural voice, so that's a great option to have. Live Transcribe, which is free on Android-- and there are paid versions on iPhone-- this app can caption in 70 languages, but it does require Wi-Fi or a network connection.

And finally, Otter.ai, as Emily mentioned, is an automated meeting note-taker, which does real-time transcription. And there are free versions that allow you to use 300 monthly transcription minutes and 30 minutes per conversation. So something that-- a great example of something you can test out and see if you like it before you pay for something.

Some apps for seeing include Seeing AI which Tom and I talk about all the time. We think this is such a cool app. It does a ton of different things. It can speak short text in real time.

So there's a video of a guy demonstrating this. He's in a cab and he's using Seeing AI, the short text feature of Seeing AI, while he's in the cab, just holding up his phone and is reading out to him all the different stores that he's passing and signs on the street. So it can kind of just, in real time, capture all the different things that it's seeing.

It can do color and currency identification. It can recognize saved faces. So I think Tom us saved in mine. If I like hold it up to his face, it'll tell me who I'm looking at. You can ask-- if it's capturing a photo, you can ask more specific questions about it.

It recognizes handwriting. It's a really cool app, and it's free on both iPhone and Android. So we always recommend using that as kind of your first line of defense before you maybe purchase something more complicated.

TapTapSee is another similar app that uses image recognition, and it's pretty user friendly. It does, however, require voiceover or screen reader to be on. So this would only be for someone who's using a screen reader.

Be My Eyes is a great app that I'm sure many people have heard of. It connects blind and low vision users to sighted assistance. So it calls a volunteer. I've taken Be My Eyes phone calls before. It's really fun. So if you are not blind or low vision, you might want to be a volunteer on this app, and you can answer someone's questions, help them figure something out. There's also an AI beta version of Be My Eyes, which can provide descriptions of images and scenes without having to connect to a volunteer.

And finally, Aira is a service that connects blind users to a professional sighted assistant. So someone who's paid. It's a little bit more formal, professional, if that's a service that you'll be needing a lot, and maybe if you need it for more private documents or things like that. That is free for five minutes a month, or you can pay for a service plan.

Some apps for memory, these are things that I personally use all the time. So things like Alarmed, which would allow you to set reminders for when you arrive or leave a specific location. I think that is, to me, like one of the most amazing things about smart technology, is being able to have it to tell me things at a certain time. Like to me, that is so powerful that I can have my phone remind me of something when I'm leaving the house or when I arrive to work.

Reminder with Voice Reminders can do recurring reminders. And this is cool. It can use your own voice or a song. So you can have your voice remind you of something, or a loved one's voice remind a person to do something, take their medicine, or something like that. That can kind of be an important feature of a reminder.

Remember the Milk is a cool app that can send reminders via all kinds of platforms, like email, text, Twitter or mobile apps. And it breaks tasks down into subtasks in a really helpful way.

And the Medisafe medication management app allows for family scheduling and tracking, and it integrates with Apple Health and Google to track all different kinds of health features. But it does this whole family scheduling thing, which is really cool. Oh, Kurt. yeah, that's cool. Remember the Milk.

And finally, some apps for organization. I'm like always trying out different apps for organization. I always love hearing about what people use. There are things like Recipe Keeper, which allows you to search by name, ingredient, and course, and it has a built-in shopping list.

Todoist, which is a task tracker that's very easy to navigate. It can create daily lists, custom lists. I really like to use native functions on my phone. To me, something that's native is the most helpful tool, typically, so I don't have to like add an additional thing into my brain. So I often am using the Notes app on my phone.

And you can even use Siri to add things to the Notes app. And so maybe the Notes app in your iPhone is what works best. There's pictures here of the Recipe Keeper app with lots of different yummy-looking food, and the Todoist app as well.

TOM DIAGOSTINO: Awesome. So now we're going to end off this conversation talking about TechOWL programs, how they can help you, specifically around getting access to a phone or a tablet. So the first program that I want to highlight from TechOWL is our assistive technology lending library.

This is a place where you can borrow equipment to see if it just works for you. Specifically, we have a lot of iPads. And so if you're considering getting or acquiring an iPad and using that for its accessibility features, you are welcome to borrow one from us for nine weeks. Our iPads are uniquely loaned for nine weeks long. Everything else pretty much in our inventory is five weeks long, But. Because we have so many iPads, we extend that to nine.

This is a free program for all Pennsylvanians. So you can go through our library as well to see if there's any other devices that you might want to utilize. We can get on a call with you or meet you in the office to demonstrate that device, maybe even set up some of these accessibility features that we demonstrated today.

And if you don't live in Pennsylvania, again, don't worry. This is something that every single state and territory does. Every state and territory does some type of equipment lending program. So there is a link in on the slide, but I believe Alanna already put the link in the chat earlier to find your local Assistive Technology Act program.

Another program that we have is called the Free Special Phone Program, which is exactly how it sounds. We are able to get people access to a smartphone and/or a landline phone for free. This program currently provides an iPhone 13 and, I believe, a Galaxy 11. I can't remember the Samsung that we offer.

But this program is wonderful. It works with people who have disabilities like hearing loss, vision loss, cognitive disabilities, and physical disabilities to get access to a phone and the accessibility features that they need. This program does have an income requirement of 200% of the poverty threshold, which is around $30,000 for a single person. But if you have a larger family size, you can go to our website to look to see the family income breakdown if you qualify for this program.

So this program also is only providing you the phone itself and not the service that comes with the phone. So you need to provide your own service for the phone once you receive it. You can apply online. If you have any questions, you are more than welcome to reach out to anyone at TechOWL, and we are happy to assist you to apply to this program.

Another program we have is called ICanConnect. This program is designed specifically for people who have a combination of vision and hearing loss. It's a fantastic program to get people phones, tablets, laptops, refreshable Braille displays, any equipment that will allow that person to interact with a computer and telecommunication.

So this program not only provides you with the devices, and multiple devices, but it also provides you with one-on-one support and training to learn how to use the device, which is so important, especially if you have to integrate so many aspects like a screen reader, a refreshable Braille display, the tablet.

There's just a lot that goes into that. And so having that one-on-one support is so, so important. So if you know anyone, or if you yourself are deaf-blind, please, please reach out to us. This is a program that I personally try so hard to push out into the world.

And last we have the Del Sordo Fund. So this is a $400 mini-grant that we provide at TechOWL. And it is a last resort funding source. So you have to have already tried other funding sources, and you have to tell us what other funding sources you've tried or looked into that just don't work out for your specific need. And this is $400 to purchase an assistive device.

So this is also, again, another income requirement. So it's 400% of the poverty threshold, has to be your individual income, so-- which is around $60,000 per individual. And again, you can go to our website to see the family size breakdown.

Some devices that we've been able to fund through this program are things like a digital magnifier, a Roomba vacuum, a wheelchair battery, and a Quadstick, which is a sip and puff switch to help you play video games. So these are just some of the things that we've helped fund through this scholarship. But, yes, if you are a person who is looking for financial assistance and you want this one-time only, last resort funding source, this is an option for you through TechOWL to fund the device you need.

So please, stay in touch with us. We are doing-- as we said, we are doing these webinars every month. But we also are all over the place on social media. We have so many events at our community space. We have events throughout the state.

So we really want you to follow along on our journey and to keep learning about assistive technology with us. So you can follow us on social media at TechOWLPA, that's for TechOWL-specific social media accounts. You're also welcome to follow the IOD, iod@templeu-- or @iodtempleu

On TechOWL's social media account, you'll see both Alanna and myself, and we always post about upcoming events that are happening. Anything else on this slide before we go to the--

ALANNA RAFFEL: No, I just realized it's not templeu, it's just iodtemple.

TOM DIAGOSTINO: IODTemple I think is their Facebook.

ALANNA RAFFEL: Oh, got it.

TOM DIAGOSTINO: Yeah. I know. I get confused with their handles.

ALANNA RAFFEL: Got it.

TOM DIAGOSTINO: Great. So we made it to the finish line, everyone. Thank you so much for coming along on this journey. I would love for everyone to please, if you're not using your phone, you could use this QR code to access the survey. Alanna is also going to put the link in the chat for this survey to please take this survey.

We need to prove to the state that we do these demonstrations and that we do these presentations. So we would greatly appreciate your feedback, first and foremost, and also for-- to continue showing that we're doing amazing work that we're doing. I'm going to turn off the recording now and open up the floor for questions. So give me one moment to stop the recording.

CAITLIN MCKENNEY: Welcome, everyone. Thank you all for joining us today for November's Tech Accelerator webinar. Our topic this month is Alternative and Augmentative Communication, or AAC Apps. This session is being recorded and the video will include picture-in-picture ASL translation, as well as a full transcript. You'll be able to access that on our website at disabilities.temple.edu, where you can also register for future webinars.

TechOWL has a wonderful series of 18 topics running from July 2024 through December 2025, and each one is offered the third Thursday of the month at two times, 12:00 and 4:00. This series is part of the Tech Accelerator Program. This is an initiative funded by the Office of Developmental Programs and the Office of Long Term Living, here in the Commonwealth of Pennsylvania. It is made possible through funding from the American Rescue Plan Act.

The Pennsylvania Tech Accelerator Project includes five major focus areas-- training and resources to build capacity for stakeholders, readiness evaluation to develop tools for successful adoption of remote supports and assistive tech, statewide assessment to plan and benchmark a technology-first systems change, a provider survey to assess technology awareness and resources among providers, and finally, two technology summits, which will be live events hosted in Philadelphia and Pittsburgh this coming March to enhance awareness of tech solutions.

You can learn more about all of these fantastic projects on our website, and I will post that link in the chat as well. So without further ado, I'd like to introduce today's speakers, Hali and Cassie, two of the wonderful speech language pathologists on the TechOWL team who have joined us today to share their expertise on communication apps.

HALI STRICKLER: OK. Hi, everyone. I'm going to go ahead and share some slides to get started. So while I'm getting this pulled up, I do want to give a little disclaimer. Later in the presentation, we will be taking the slides down and then sharing our iPad screens with the Zoom. Sometimes, as with any technology, that can be a little glitchy. There might be a little bit of a delay. We may have to stop sharing and then reshare depending on how the connection is cooperating with that. So just bear with us when we get to that point in the presentation.

Also, feel free to type any questions or comments that you have throughout in the chat. We will keep an eye on that, and we'll try to make sure we answer any of those throughout the presentation. Especially if they're related to a particular app or a feature that you might want to see when we're doing the demo, let us know so we can make sure we're giving you the information that you're looking for and you want to see today.

So before we jump into more specifics, just to go over a couple acronyms, so we're all on the same page with some of the terms you might hear us use. AAC-- that stands for Augmentative and Alternative Communication. There's a slide, as well, dedicated to a more specific definition of this term, but we're using it as an umbrella term for all forms of communication other than oral or spoken language. Talking speech. So using devices.

For our purposes today, AAC is really going to refer to those specific AAC apps that we're going to take a look at. And while we will be focusing on mostly iPad-based iOS apps, there are also apps that are available on other platforms such as Android. Microsoft tablets. Some other types of products as well. But we're going to be focused more on the iOS-based apps assistive technology.

You might hear us say AT. So AAC is a form of assistive technology that, of course, is specific for communication. You might also hear us talk about DD or ID. So developmental disability. Intellectual disability. SGD-- that stands for Speech Generating Device. Now, speech generating devices are AAC systems that somebody might use. Not all speech generating devices are iPad-based. But again, since we're talking about apps, the ones we're focusing on today are going to be speech generating devices as iPads, or iPads as speech generating devices.

Another thought, too, to keep in mind is that even though some of the software and apps that we're looking at are specific to iPads, some of the layouts and organization of the software is also available on other platforms and devices as well. So some language organization options are going to be available on non-iPad based products. non-iPad-based speech generating devices. And then also, SLP, like myself and Cassie. And then our two other SLPs on our TechOWL institute on Disabilities team. SLP stands for speech language pathologist or speech therapist.

So some of our learning objectives today. This is just the main goals that we hope you take away from our presentation. We want you to be able to recall at least three AAC apps that are available from the TechOWL statewide lending library. The majority of the apps that we're going to be showing today are some of the most popular. Not just that folks borrow from the lending library, but also in the wider AAC world.

Of course, there are so many more out there, and we have lots of other AAC apps available to borrow from the lending library, and you can always request new apps as well to be able to borrow and try out. For the ones that we discussed today, we're hoping that you'll be able to take away some basic programming and basic understanding of the apps. How to make those edits and adjustments and customizations to them.

And then we also hope that you'll be able to describe and compare and contrast some of the different elements about the specific apps. So describe a difference between, two or a couple of the different AAC apps that we talk about today to help you make determinations for either yourself or the person that you support in finding the best fit of an AAC app.

So just some disclaimers that we do like to give before any presentation. We are speaking from the perspective of speech language pathologists. We like to consider ourselves AAC specialists, but it's also important to note that some of the perspectives of the people that use these products, of AAC users, will be maybe different than some of the things that we say.

So if you're seeking more information, especially on the use of these devices in a person's everyday life-- that it's good to seek out that information from AAC users so that they can share their lived experiences, so you can get a more holistic picture of what it's like to use this equipment or to see if it's a good fit for you, or again, that person that you might support.

You're also going to hear us use a variety of identity first and person first language. And we do that to accommodate both preferences. So for example, you might hear us say AAC user or person who uses AAC. Another example, you might hear us say person with autism or autistic person.

So what is AAC? So I talked a little bit about it, but here's a more in depth definition. So again, AAC stands for Augmentative and Alternative Communication. Those two A words, we kind of break them down. So augmentative is the devices or the equipment that might add to somebody's speech. And then alternative is used instead of somebody's speech.

So in a lot of cases, some folks might be using these devices to do one or the other, or they might be using these devices to do both. Every person is different, and their needs for AAC are going to look different as well. But overall, AAC-- it really can be any form of communication beyond oral speaking or talking. So things like gestures, facial expressions, whether you send a text or an email. Maybe you wrote a note on a piece of paper. Gave a thumbs up. Those are all forms of AAC.

We all use forms of AAC throughout our day. Throughout our communication. Some of us just use more than others. So here on the slide are also a few examples of different types of AAC systems. When we talk about AAC devices and systems, we tend to use a hierarchy to describe these things. So we use phrases like light and low tech devices, mid, tech and then high tech.

Even though we talk about them on a hierarchy, that doesn't mean that somebody has to master the low or the light tech before they can move up to a high tech device. Sometimes that is the strategy that works best for a person, but sometimes somebody might go right to a high tech system.

So an example of a low or light tech AAC system would be like the one here on the slide, the paper-based printout. That's actually just a printout of screenshots from a high tech system, but on a paper-based layout. Laminated. Put in a binder. Other types of light tech might be individual picture cards with Velcro.

Sometimes you might hear people use the word PECS to describe that. PECS is a formal protocol, but a lot of folks will tend to use that as a phrase to refer to those individual cards that somebody might have.

Other devices that kind of come next in that hierarchy are those mid tech systems. So those are the two systems on the bottom towards the left. So the big red button, that's called a BIGmack. And then the green one with the four images, that is a GoTalk device. These are mid tech systems, and they get that classification because they have batteries and they have recordable speech on them.

So when you're using both of these systems you would record somebody else's voice. And then when the person goes and either activates that button or presses a button on the GoTalk one, then it will activate whatever that recording was.

Things to keep in mind when using these types of systems is that sometimes the voice output doesn't always match the speaker. So for example, maybe a 15-year-old high school student who identifies as male, they're not going to want to sound like me in most cases. So the voice that's coming out of the device might not match the identity of the individual. So that's just one of those-- every device has pros and cons. That's a con with maybe one of these systems sometimes.

Now the next kind of side of devices would be our high tech systems. Those are going to be your more specialized-- think computerized devices. Tablets. So those are the two on the far right. The upper right side is a Tobii Dynavox Eye Gaze device. So this is a computer system that basically reads somebody's eye movements. It has a camera built in to do that. And the person will then be able to use their eyes essentially as the mouse to activate the icons-- the buttons on the computer screen to share their messages or to navigate the system.

The one on the bottom right is an iPad in a case with an AAC app on it. So there are all kinds of different AAC apps that can come on iPads, and we're going to take a look at some of those. So when we're talking about our AAC apps, regardless of what the app is-- and keep in mind too, that some of these concepts and key words here can be used beyond just apps to greater AAC software on maybe like that Eye Gaze device we looked at as well.

These are just some terms that you might hear us talk about, and they're words that are used when we're looking at our AAC systems. So I'm also going to just hold my iPad screen up, too, just so we can take a better look. So this app on both the slide as well that I'm holding up is the TouchChat app. And this is a word power vocabulary set.

We're going to do more of a deep dive in a little bit of this one. But just to talk about some of the terms and the parts-- so this top bar here, that's blank. It's white in this particular case. This is a speech display bar. So whatever message that I've constructed--

AUTOMATED VOICE: I--

HALI STRICKLER: I'm just going to type one out.

AUTOMATED VOICE: --love--

HALI STRICKLER: I love--

AUTOMATED VOICE: --going--

HALI STRICKLER: Going. I don't know. Home.

AUTOMATED VOICE: --home.

HALI STRICKLER: My message that I constructed is now here. And now I can press it and activate it so it can then speak. One thing to note about the speech bar is, if I don't clear it and use my clear button up at the top, everything that I've said and typed out all day will then be activated if I accidentally hit this. So it's always good to clear your message so that you can say something new without re-repeating yourself all day long.

So those are features that you might see on lots of different devices. So not only is there a clear bar here in this particular layout. There's also another clear bar on the system elsewhere. So that locate or that clear bar or that speech display bar might look a little different depending on what your system is, or it might be located in a different spot. A lot of these things can be customized and set up based on a person's preferences or needs.

Other things, too. We have a Home button. So each device is really-- or app is going to really have a starting page. So think of that as your home page, like you would on maybe your computer or your cell phone. There's always a starting point. So if I'm somewhere else in the app-- let's say I'm on this page to talk about money. In here, there's a house button. That's then going to take me back to my starting point or my home page.

Other words that we might use are folders. Folders are going to be buttons, basically, that when you touch them or select them, it opens up another page with related vocabulary. So for example, when I do Groups, it brings me to all kinds of different groups or categories. If I select this one that says Art, now it opens up a folder and a page that has all kinds of different words related to art vocabulary there.

Another thing that you're going to hear us say a lot today too is core vocabulary. So a lot of AAC apps and systems are based on the idea of core vocabulary. Core vocabulary are high frequency, everyday words. They make up about 80% of what we say, and they can be used across multiple contexts. So they're not words that are dedicated for one specific activity or conversation topic. They can be used across a lot of different contexts.

So for example, those are going to be words that a lot of your verbs. Some of your pronouns. Prepositions. Those are going to be some of your core vocabulary examples. In a lot of systems, you're going to see some of that core vocabulary available on the home page. So for example, with this particular layout, you have words like I want. Stop. Go. Eat. I like. And then some of our pronouns here. Those are examples of core vocabulary within the device.

So, too, we also want to talk about what these iPads look like in terms of funding. So there's a phrase called bundled iPad. Bundled iPads are basically an iPad that can be purchased using insurance funds. So there are companies that are dedicated for speech generating devices to be durable medical equipment, meaning that medical insurance will pay for the particular device.

You can't just go and get an iPad at Target or Walmart or Amazon and then have insurance reimburse you or purchase that equipment. It has to go through one of these specialized, vendors. And these specialized vendors will have their own unique names for their product. But at the end of the day, their product is going to be an iPad with a communication app and a case.

So another thing, too, to mention about when you're getting them through vendors is some vendors are going to sell more apps or have more variety and selection with what you can choose between. Other companies are going to only sell maybe their dedicated product.

So for example, when we look at some of the ones here on the slide, the Quick Talker Freestyle, that is an iPad product sold by the company AbleNet. Their company allows you to choose from a variety of different apps. But then the next one is the PRC via iPads. That is from the company PRC-Saltillo. You're going to be limited to their specific app products.

Same thing with the next one-- is the Tobii SC tablet. That's from the company Tobii Dynavox. You're going to be limited to their software, TD Snap, on that one. Next up we have the TalkPad Wego edition from the company Talk to Me Technologies Smartbox, now that they've merged. And you're going to have the choice there. They have some proprietary software, but they also can sometimes cover other apps as well.

So when you're looking to get equipment or devices funded, your choice and who you can go with might be limited or dependent based on what app that you're selecting. Sometimes you'll be able to go with one company and have a lot more choices. Other times, you may only have one or two options. So that's something to think about when you're maybe starting the funding journey after you've identified which app is a good fit for you.

And so now for the fun part. We're going to do some app demo here. So we do have some slides, but we're going to skip the slides so we can share our screen and you can take a look at some of the different apps live. So just bear with us. This is the part where it might get a little messy with sharing our screen and making sure all the tech works. And if anyone has any questions while we're getting the apps shared and set up, please feel free to type those in the chat.

So the first app that we're going to take a peek at once the screen sharing decides to work-- here it is-- is Proloquo2Go. So Proloquo2Go is-- I like to say it's one of the more original AAC apps. So back when the iPads first came out, this was one of the apps that was available. So you might see a lot of folks using the system and be familiar with this layout and organization.

Also, keep in mind that when we're looking at some of these, you're going to see a lot of similarities between the devices. Some of the pictures might look similar. Some of the layouts and organization are going to look similar. And also, a lot of these devices too can be completely customized. So right now when we're looking at Proloquo, I just downloaded it and I turned it on and I set it up. I didn't do any customizations or major edits here. But this can be completely customized based on the person's needs.

If they need more buttons, they can have more buttons. If they need less or we need to hide some, that can absolutely be done. If we need high contrast, meaning we need to change the background of the icons or the borders, the text, all of those types of things in a lot of these apps can be edited and changed. That also being said, sometimes, depending on the app, some of those editing features might be limited. It really just depends on the particular app.

I will say that a lot of the big hitters in the AAC app world kind of steal ideas from each other. If we were having this conversation when apps first came out. There were a lot more deal breakers of features between app A, app B, and app C. Nowadays, a lot of the apps do have similar features in terms of customizations and editing.

So right now, when we're looking at Proloquo, it has stick figure pictures. It doesn't have to have stick figures. You can take photos directly from the app using the camera. It's integrated into the system. You can import them from your camera roll of the iPad or from the internet. You can do that with a lot of other apps, too. So this can be completely customized. Doesn't just have to look like this.

But what's nice about this app, too, is that Proloquo also has different levels for the vocabulary. So right now, we're looking at advanced. There's also an intermediate level, and then a basic one. So if I click on Basic, this simplified my screen a little bit and took some of those words and moved them into folders. So it made things a little easier to navigate. So somebody can communicate by tapping on the folder they want. If they open Food, now they can talk about their different food choices.

It's really easy to add more vocabulary in here. So I can go to my little pencil button down at the bottom and tap that, and it pulls up my editing mode. I can add an individual icon, or I can add a folder, meaning that when I tap it, it's going to move to somewhere else. To show you what I mean by that, when I tap on McDonald's, you'll see it has that manila folder shape. Now it opened up my McDonald's order here on the screen.

But I want to go back and I want to add a new button. So right now, we have ice cream. Maybe let's add brownies. So if I start typing in-- oh, it's giving me other words-- brownie, it'll fill in the blank for me. It'll predict what I'm typing out with words related to those letters. But if I didn't like this particular picture, I could maybe take a look and see more symbols that are built in to the system. Or if I actually wanted to take a photo of the particular brownies that I like to eat, you can take a photo of that and import that into your device.

And, of course, it decided to freeze because it's connected to the computer. Oh, there we go. It caught up. So now I have my new button for brownies. So if you can't hear the output on the screen, it might be because of the screen sharing. But take my word for it. When you touched it, it talked and it said brownies. But somebody could build a sentence. They could request, or they could say they're all done. [INAUDIBLE] built into this particular page. You can have more words in here. You can have less. This can be super customized to the needs of the individual.

Another thing, too, with Proloquo2Go as well is if we have our built in grammar turned on, we can access our conjugations of verbs and pronouns-- so our other parts of speech, by just holding down that particular verb. And that will open up in a pop-up, which is a nice feature for somebody who is generating their sentences and wants that more advanced grammar in here as well. Proloquo2Go also can be set up for some bilingual features. So you'd be able to access it here. If I had it set up for Spanish, there would be a little button here that has my language, and I can tap it and it'll switch into that other language. So there's some great features that are built in to the system.

The next app, unless anyone has any questions about Proloquo2Go-- the next one we're going to take a look at is GoTalk NOW. So GoTalk NOW comes in a couple different versions. Right now, I'm showing you the GoTalk NOW Lite version. So that just means that I can only have a certain number of pages on my system. So a page meaning this is one page. This is two pages. I think you can have up to maybe four or five-ish pages on the free version, but that can be a really great start for somebody to see if this app is a good fit.

The full paid for version of the app-- that one, I believe it's under $200-ish, if I'm correct. That version of the app, then you can have more pages based on the capacity of your iPad. So with this app-- I tend to recommend this one a lot for people that really want a fully customized system. There are other page sets or layouts that you can use or pay extra to have access to, but a lot of the folks that I work with, they choose this app so they can have something that's completely unique to themselves.

That being said, it's a little more work up front to get it programmed initially off the ground running. It doesn't. It comes as a completely blank slate, and we have to build our pages and our folders for that person. So we hold this Home button down, and it'll take us back to this main starting point. You have a couple different options here, but the main areas to focus on are Player. That's going to be the speaking mode. So when I want to use this app to communicate, I need to make sure it's in Player mode. Otherwise, if I'm in Page Editor, it's not going to necessarily talk to me. It's going to be set up for me to make those adjustments and customizations.

So you'll see here I have lots of real estate on the screen to add buttons. I tap these little toggles, and you'll see that I can have buttons ranging from one on the screen all the way up to 49. Compared to some of the other apps with GoTalk, we're a little more set with the numbers that they provide here. So that does limit us with what our grid size or the number of icons that are available at once-- what they look like.

I'm going to change it to four. I can show you how quick that was. Now these are all pages or buttons that I've already pre-programmed. That's why it filled in the blanks so nicely. But we would have to create our own. And you would do that just by tapping on the screen. And I can add my text. I could change this text in here. I can drag it around. I can make it bigger. I can make it smaller.

What else is nice about this, too, is we can add in multiple photos on the page. I can make some of them big again. Small. Change the sizes, which is a nice customization feature. So then the way that that looks when I'm in the speaking mode-- I can tap on my activities, and now it opens up my choice board for all my different activities here. And this can be, again, customized to whatever the person wants. And we don't have to have the same four button option on every page. If I have more activities I can choose from, I can have more buttons and icons available on here as well.

You can also flip through the device, kind of like pages in a book, rather than having to only access it through individual icons on the screen. So I can use the arrows to flip through the pages. If maybe using those categories as a starting point is hard, but flipping through is a little easier for me to navigate, that can be an option for somebody as well.

Another feature here, too. Right now, this is just one big picture. I'm going to go back into our editing mode so you can see what I'm talking about. We can have a visual scene display. So this creates basically these blue boxes on the screen. Those are hotspots that, when it's in the talking mode, if I tap where that hotspot is, it will then say whatever message I have programmed and recorded.

So you could use this for different routines. You could use it to label the parts of the bus or whatever image you have in here. You could use it with maybe somebody who likes music. Maybe they like the song, Wheels on the Bus. Maybe you're working in early intervention and wanted to teach that cause and effect with learning how to access the tablet. That can be a way to also use other features within the app. Doesn't just necessarily have to be for that face to face communication. You can use the built-in features for other things as well, but that is also a nice feature within the GoTalk NOW app.

And then the next one I'm going to pull up-- bear with me. So this one is going to look like a lot, and it is a lot. But for the right person, it can be a really good fit. So this app is called LAMP Words for Life. And so right now, you see I have less buttons on the screen, and there's a lot of white space here. What's specific or special about this app is that every word in this system has its own pattern and its own location. The idea is that the person learns to navigate their system through muscle memory for those particular words.

So when I turn off this particular feature I have on, which we'll talk about in one second-- when I turn what's called Vocab Builder off, now you see LAMP in its full glory. This is all of the language and all of the words that you have access to in this system. What makes this system a little different from some of the other apps is that this grid size-- I think there's real estate on here at once for 80-something icons-- is you can't change the button size. You have to be able to access these smaller buttons. And that can be a deal breaker from some for some folks-- that these buttons can be really small and hard to navigate size wise.

But when you learn how to use this system, all of the buttons are located in the same spot. Except, I noticed that my one screen is not set up in the way it should. So I'm going to pull up another copy of it. One second. So in this screen here, you see all of these icons, the bright green ones. These are all of, basically, your verbs and your conjugations of these verbs. You'll see that we have-- the past tense is in its own little spot right here. No matter what verb I'm saying to actually generate that verb, it'll be in this spot.

So, for example, if I want to say go, I find this icon. And now go is there. If I want to say went, it's in that past tense location. Now, if I'm looking at another verb like, let's say, eat. It's down here at the bottom. Eat is in that same spot there. And then ate, past tense, is there. So you learn the pattern for your words in your parts of speech.

Other words are stored in certain locations. So when we have our root-- think of it as our root word here is eat on this page, and it opens up a folder or a new page that has all kinds of vocabulary related to sensory stuff related to foods. A lot of our categories are located up here along this top row. So we have all of our different categories of types of foods. If I want to talk about snacks, I can tap that one. And now it opens up my more specific snack words.

So there's a lot of pattern based learning that goes into this. And one of the ways that folks use LAMP to make it a little easier to learn different words-- what I'm going to do is I'm actually going to make a copy so we can practice with some of our editing. I'm going to go in here and I'm going to turn on this feature called Vocab Builder. And when I turn this on, it basically takes everything away and makes it a little easier.

And I can have a specific word list. I'm going to add the word play. I'm going to add more. I'm going to add bubbles. And maybe I'm going to add ball. And now when I hit Done, all of those words are going to go away except for the ones that I want to talk about and that I want to use. So this can help somebody now learn that pattern. There's less going on on the screen, so I can learn that muscle memory. My toys. Bubble.

So one of the things too with this is even though it looks like a lot, there's less hits involved than maybe some of the other systems. Some other systems, you might have to go through multiple folders, multiple layers to find the words you want. With LAMP, you really-- 1, 2, 3 hits in most cases to find the particular word that you're using. And you can pair your words together and generate sentences and utterances as you gain more words, get more practice, and get more familiar with your system. So for the right person, this can be a really good fit.

OK, so I'm going to pass things over to Cassie. I'm going to stop sharing. And if anyone has any questions, feel free to ask those now while we're getting things switched over.

CASSANDRA CALLIA: Thanks, Hali. Just give me one moment to share my iPad screen, and we're going to jump into talking about our next app. Here we go. All right, so we are going to talk about the next app, which is called Grid. Grid is a really unique app in the sense that it gives us the capability to do many, many things and have access to language in many formats.

What I mean by that is, in the previous apps that we just saw, we looked primarily at grid-based vocabulary. Something that looked like this that had different grid options with different words on the home page. And this is a great fit for a lot of folks. There are a lot of grid-based language files in the Grid app. This is an example of Super Core, which is a core vocabulary-based app that, upon first glance, looks similar to some of the other ones that we've seen.

However, you'll notice that the home page of Grid is actually also a grid of other apps and other language systems. So, for example, you can have access to a keyboard for somebody who might be using text to speech or typing to send or communicate a message. They would have access to this vocabulary file within the Grid app.

You might also have somebody who might benefit from more pragmatically-based organization for their language. So this is Voco Chat, which is a vocabulary file in the Grid app that's organized by-- it's organized pragmatically, which helps people walk through a conversation by determining what buttons come next based on the last button that they pressed. So I just clicked, something is wrong. I might say, I don't feel well. And then the next icon that comes up is words about what might be wrong. So this could be a really good fit for somebody who really needs to focus on communication in the moment, rather than using some of those core vocabulary words that are on the homepage of some of the other apps.

Grid is also super easy to program. So this is an example of the Vocabulary for Life page file in Grid. This is folder-based, so you'll notice that the homepage is a lot of folders. But let's say that I'm ready to add a word. I am looking at my places. And when I open the Places folder, the yellow words are going to be that core vocabulary. The sentence starters. And then the rest of the vocabulary on here is words specific to places.

So if I wanted to add a word on any of the Grid page sets, I would click the three buttons on top. Edit grid. And then I'd be able to click on a blank button, write, and speak. And let's say I want my new place to be-- oh, I don't know. Maybe Target. I do like Target. Let's see if they have a good picture for Target. Here we go. Target. I click Done, Finish Editing. And there's my new button for Target. So regardless of which page set you look in the Grid app, the editing is exactly the same.

The other nice thing about the Grid app is it has some accessible media and internet browsing capabilities. So it has an accessible web browser. It has access to accessible Facebook and accessible Twitter. Grid also has games, which is one of my favorite ways to encourage cause and effect. If you're just starting a device with somebody and looking to get buy-in from themselves or the team, you can play a game that is not necessarily [INAUDIBLE], but to intend to learn to interact with the device.

I could talk about Grid all day long, but the last thing I'll say about Grid that makes it unique is that you can add grid sets at any time. So you can see that Smart Box has a variety of grid sets that come pre-made, including those accessible apps that I discussed earlier, as well as different symbol and text-based communication apps. But you can also browse the online Grids inventory.

So people make grids online for different purposes, and they share them out to the community. So you can have access to boards that somebody else made. Here's one of a Ukrainian and English medical communication board. You can click that and have it download right on your app. You can also create your own and remote edit from the Grid website too. Really cool app. Very versatile for a lot of different people.

The next app we'll look at is called TouchChat. TouchChat is a very popular and common app. It has the proprietary language system called WordPower, and this is an example of the WordPower 42 basic SS page set. That means that it has 42 buttons on the page, and it uses symbols as the primary mode of communication. But the WordPower page sets also have text-based-- hence WordPower, capabilities as well.

What I hear a lot of people say that they like about the TouchChat app specifically is that it does something unique, which is that it links pages. So if I want to make a sentence, I will click on the [INAUDIBLE] I. I'll click on the next word. You'll notice that the page changed so that it's all verbs. I'll say, love. Let's see. What do I love? I love eating. I love eating peanut butter. So you can see that as I go to create my sentence, the page changes in anticipation of what the next word might be. So this can be really great for people who are working on creating sentences to facilitate putting words together to request or ask for things or share information.

It should be noted that this app, like all of the other apps, is very customizable. You'll notice these are stick figures. They can be real photographs. You can upload real pictures of people or places that the individual likes to go, as well as changing the buttons on the screen. So this is 42 buttons. There are some more simple page sets called MultiChat 15 that are just 15 buttons on the screen. And this is more phrase-based. So each of these buttons is a [INAUDIBLE] that will help you still build a sentence, just with less icons on the screen.

Editing is also a breeze with the TouchChat app. Let me pull up [INAUDIBLE] pages. Here we go. Let's add a drink. I'll click Menu at the top right. Edit Page. And then just click on a blank button, Edit this Button, and add in whatever drink I'm thinking about. I like Diet Coke. Let's see if they have that on here. Let's see. Here we go. Oh, I like these picture options. Easy. I click Done. My new button is right there. So people find this one easy to program, easy to navigate, and look at aesthetically. It is color coded. Great app.

Yeah, let's keep moving. The next app I'm looking for-- my iPad is very disorganized. I apologize-- is TD Snap. TD Snap is another really robust communication system. You'll also notice that this one is color coded by parts of speech. The center of the board from the yellow to the orange icons are going to be your core vocabulary words. And then the pink folders on the side are where a lot of those nouns are going to live in different folders.

So if I were to open up the Feelings folder, I would be able to see all of my feelings words. And you'll notice that there's no core vocabulary in this folder. It's really just that specific folder's vocabulary, organized by itself. So in terms of sentence creation, it's going to be more individualized. Looking for each button and navigating into the right folder, versus the pages changing like they do in TouchChat.

One of my favorite things about TD Snap is the Topics folder over here. So this yellow-orange bar contains some more navigation. They have a QuickFires folder with easily accessible words that you might need to say. And the Topics folder, I find a lot of people really enjoy for creating topic-specific phrases. So if somebody is less concerned about individual words and wants to be able to engage and participate in an activity using phrases, we can create a Topics folder for them.

So on the Readings Topics folder, you'll notice that all of these buttons when I press it-- well, maybe you can't hear it, but it says a phrase out loud instead of a single word. So this can be really great. If somebody is out in the community and wants to order something at their favorite restaurant, we would be able to program phrases in that Topics folder for McDonald's, so to say. Or, I also like they have jokes in here, too. We all need to be able to tell jokes.

Finally, the unique thing about TD Snap is the built-in behavioral supports. It has a visual timer that can be run concurrently while the app is going. It has a little first-then board that you can create and edit for somebody to have reference to, as well as many schedules and social narratives and scripts. It's important to note that while these behavioral supports are up and active on the app, you're not able to access the rest of the vocabulary, so that is a consideration when using the behavioral supports that are integrated in the TD Snap app.

TD Snap recently-- so this is their Core First page set. But TD snap recently released an Express page set which looks significantly different than Core First. An Express page set is based on those folders. Like the topics folder, each folder opens up different vocabulary related to that concept. And this is meant for contextual communication. Quicker, in real time communication for somebody. This is a brand new release, so very exciting to have something slightly different for folks that maybe don't need access or aren't able to access all of the vocabulary in the Core First page set.

I'll talk briefly about Avaz, which is the third app that I'll be talking about. Avaz looks again very similar to many of the other apps that we've looked at today. You'll notice that it does have the core vocabulary, which is in that orange-red color on the home page, as well as different folders containing specific vocabulary related to that topic.

A few things that make Avaz really different than other apps-- number one is the use of tone up here at the top. So typically when you press a button on an AAC device, it will just say the word in the voice that you choose. But Avaz uses machine learning, I believe, to change the tone of the voice so that you can make it whisper. You can make it sound angry or excited, which is really, really great, and a wonderful way to help people engage and really express themselves with this app.

The second feature that makes Avaz unique is that when you press a button, it will visually get larger on the screen to indicate that it was selected. This can be a really nice visual cue for people who are just beginning to use AAC, or to help people know that they selected the right message.

And the last thing I'll say about Avaz is that you can create new pages really easily. Programming is a breeze with Avaz. So if you wanted to create a new page, you could click Edit Words. Let's actually open up a word right here. Add New. I want to add many words at once. And instead of going through and creating a button for each word, I could type in a word. A couple words. Biscuit, ketchup, If I could spell, and egg. We'll click Save, and it created those three buttons for me right away. You can do the same with folders. You can, of course, go in and change the button if you want a different picture. But it makes editing really easy, and folks really like that feature about this app.

Finally, we'll talk really quickly about Predictable, which is a text to speech-based option available in our lending library as well. Predictable is keyboard-based. There are several different keyboards you can select from. You'll notice that when you start typing, Predictable uses word prediction at the top in this blue bar to help you create your message even faster.

And then the other neat thing about Predictable is that it also has symbol support. So you can see that we have some various folders with symbols in them. And these are programmed with phrases based on the category. The folder that you've clicked on. This is all completely customizable. You can type your message and then save it in a folder and use that symbol support for added support if you so choose. So that's Predictable in a nutshell. Really cool app. And I'm going to toss it back to Haley.

HALI STRICKLER: OK. So I'm going to reshare my slides so we can take a look at a few more things before we wrap up today's session. OK, there we go. So we want to take a look at just some free apps that are available. So if you already own an iPad, these are some options that you can download and try out and see if they are a good fit, or at least be an option to get started for a no-cost method. You can also request to borrow these from our lending library at TechOWLs as well.

So here we have Weave Chat and ChatterBoards. And then we also have a couple more options. Cboard. GoTalk Lite, which-- we did look GoTalk as well. So a lot of the same features in the full version are available on the free version. But the free one, the lite version, can be a good placeholder to get you started. And then SoundingBoard. So these are just some examples of other apps to consider.

A lot of the main AAC apps, or the more popular ones that we did take a look at during the demo, though, they do come with a pretty hefty price tag, some of them right out of pocket. So a lot of them-- The heavy hitters range from about $150 up to almost $400 plus tax, depending on the particular app. So that is a hefty price for a lot of people to pay out of pocket. So that is why there are insurance options to get these types of devices funded for folks.

So a few more additional resources, just to talk a little bit more about TechOWL and AAC. If you ever have any AAC-related questions, you can absolutely reach out to us. We can be a great resource to help you get started on. Answer some questions. Or if you borrow an AAC device or an iPad with apps on it from the TechOWL lending library, we're happy to meet with you and answer questions. Go over some of that basic programming, and provide some troubleshooting support with that device you borrowed.

We do also have some specific project contracts that do offer some more additional services for individuals who are eligible for those programs. For example, we have a program for adults 21 and older who receive services through Philadelphia Intellectual Disabilities Services, as well as through Philadelphia Early Intervention for assistive technology and AAC. And we also have our Just SO Speech Services program for consumers of Pennsylvania Office of Developmental Programs, or ODP.

And Just SO is short-term online speech services. And neither of these programs are direct ongoing speech therapy. But they can be a great way to get some information about AAC and navigating that AAC funding process, if that's what's needed and recommended for the individual. Even for folks that may not be eligible for those programs, if you are a Pennsylvania resident, you can meet with us again for that device demonstration. A video chat. While we're not going to give formal recommendations, we can answer some of those questions you might have on that more informal basis. Just have a conversation about AAC. Where to get started.

We also have our ACES program-- Augmentative Communication Empowerment Supports. We have a slide for that in just a few. And then our aaccommunity.net website is a great way to stay up to date, see more initiatives that we're offering, as well as find more information about our AAC-related services and programs.

This is just a slide on borrowing from the lending library. If you go to techowl.pa.org and hit the Borrow tab, that'll take you to the lending library. If you are borrowing an iPad and you want apps, there will be a notes section text box when you go to check out, and that's where you'll type the names of all the apps that you want to request.

If you want to learn more about AAC, we also offer our AAC Essentials, which is an online asynchronous learning modules. These are free. You can take them at your own speed and get a free certificate at the end of your learning. And our ACES program-- we are offering this again on this coming July in 2025. So this is a program for young adults at least 18 and older. They get they get to come to campus, take classes on communication, get some coaching and supports, participate in different types of leisure activities, maybe like adaptive recreation, adaptive art, listen to speakers.

Every ACES looks a little different depending on the cohort and their needs and their goals. But this is a great program to get more training and support for young adult AAC users. And our application is live online, so check out the techowl.pa.org website for that. And the program is one week at Temple's main campus in Philadelphia. You also don't have to be a resident of Pennsylvania to be able to attend. Anyone is welcome to attend. There is an application process, though. So just keep that in mind.

And then here's TechOWL's social media. General contact information. Contact information for the Institute on Disabilities. Cassie and I, as well as many of our other colleagues-- we work at the Institute, even though we're part of the TechOWL program. TechOWL is a subprogram of the Institute on Disabilities at Temple University, so there's lots of great initiatives supporting and working with individuals with disabilities there. So lots of great projects to check out.

And then we just ask that you complete the survey. So if you hold your phone up and scan the QR code, that will take you to a survey just to let us know how we're doing. What other information that you might want in the future as well. And it looks like Caitlin did put the survey link in the chat for us. And so if anyone has any questions, please feel free to let us know. We're happy to try to answer those for you. And if you think of something down the road, please do feel free to reach out to us at TechOWL and the Institute. If there's no other questions, Caitlin, I'll pass it back to you.

CAITLIN MCKENNEY: -- Wonderful. Thank you so much for joining us all this evening. These resources will be sent out in a follow-up email as well. And we hope you join us again in December for an AAC funding session. Have a good evening, everyone.

HOST: Thank you so much for joining us today for December's Tech Accelerator Webinar. Our topic this month is funding for alternative and augmentative communication, or AAC devices. And this session is being recorded. The video will include picture in picture ASL translation, as well as a full transcript. You can access that video on our website at disabilities.temple.edu. I will put that link in the chat as well.

That website is also where you can register for future webinars. So TechOWL has a wonderful series of 18 topics running from July 2024 to December 2025. Each is held on the third Thursday of the month, and is offered at two times, 12:00, noon, and 4:00 PM.

The series is part of the Tech Accelerator program, which is an initiative funded by the Office of Developmental Programs, and the Office of Long-Term Living here in the Commonwealth of Pennsylvania. And this is made possible through funding from the American Rescue Act. The Pennsylvania Tech Accelerator project includes five major focus areas, training and resources to build capacity for stakeholders, readiness evaluation, to develop tools for successful adaptation of remote supports and assistive technology, statewide assessment to plan and benchmark a technology first system change, a provider survey to assess technology awareness and resources among providers, and finally, two technology summits, which will be live events hosted in Philadelphia, and in Pittsburgh this coming March to enhance awareness of tech solutions. You can learn more about all of those fantastic projects at our website at disabilities.temple.edu using the link in the chat.

All right, I'm going to turn it over to our speaker this month, Hali, for finding and funding AAC. Thank you, Hali.

HALI STRICKLER: I'll introduce myself in the meantime. So, like Caitlin said, I am one of the speech language pathologists and AAC services coordinators at the Institute on Disabilities at TechOWL program at Temple University. We are a part of Temple's college of Education and Human Development. And so today, we're going to be talking about finding and funding AAC. If you have any questions, feel free to put those in the chat, and I'm going to try to keep an eye on that while I'm talking at you for the next hour or so.

Just some disclaimers that we like to give before we do any presentation, so I am speaking from the perspective of a speech language pathologist. I consider myself someone who specializes in AAC, but I am not a person who I identify as someone with a disability, and I am not an AAC user. So kind of that being said, it's good to seek out the perspectives of disabled folks and AAC users for a more comprehensive and holistic viewpoint about these types of topics and information as well.

So a lot of the information I'm going to be giving today is based on my experience as a professional in this field, not as a person with lived experience. So just keep that in mind. And then we-- and I'm going to be using a variety of identity first and person first language throughout the presentation.

I do this to accommodate both preferences for each type of language. So you might hear me say AAC user. And you might also then hear me say person who uses AAC. A few other examples, autistic person, person with autism, disabled person, person with disability. So again, we do that to include and accommodate both preferences for each type of language.

So just to break down the terms that I've already probably been using a little bit, and that you've probably heard, we're going to be focusing on AAC. So you're going to hear that phrase, or that acronym a lot. AAC stands for augmentative and alternative communication. We'll go more into that definition, and what AAC is briefly on the next few slides.

We are also going to look at AT, and talk about AT, that's assistive technology, so any of those tools that a person with disabilities might use to complete a task, or participate in an activity that they want to. You might also hear me use things like DD or ID to refer to developmental mental disability or intellectual disability. And then one of the big ones we're going to be talking about today is SGD, so speech-generating device.

We're going to be using that kind of as an umbrella blanket term to refer to the physical AAC type devices, but you might also hear me say AAC device to refer to a speech-generating device. So I might use those types of terms interchangeably, but just know that not every form of AAC is a speech-generating device. And then also, SLP, that stands for speech language pathologist, or speech therapist like myself.

So just to go in a little bit more about what is AAC. Again, AAC stands for augmentative and alternative communication. So we kind of have two points there. So it's augmentative, meaning, that it can add to someone's speech, or it can also be alternative. So it's used instead of someone's speech.

And some folks might use their AAC in a combination of those types of ways. It's not just an either/or type of thing for every person. Some people may be able to use their oral speech some of the time, but then they might not be able to use it other parts of the time. So that might be when they use a device to supplement their existing speech.

So AAC does include any other type of communication method beyond oral speaking, oral speech or talking. So this can include things like gestures, facial expressions, pictures, symbols, sending an email, giving a thumbs up, or sending an emoji over a text. Those are all forms of AAC. And we all use AAC in our daily lives, but some of us just use AAC a little bit more than others.

On the slide we also have some visual examples of different types of systems. When we talk about AT and AAC specifically, we tend to use a hierarchy ranging from low and light tech, to mid tech, and then up to high tech. That being said, a person doesn't have to work their way through the hierarchy before they graduate, or move on to the next level. So somebody doesn't have to start at a low tech device or system, and then move up to that high tech.

Some people might start with a high tech system, and some people might decide to just stick with a light tech, paper based AAC, and that's OK. One's not inherently better than the other. One's just better for the individual. And so that's all on an individual basis.

So here on the slide, we do have an example of a light tech paper based system. So that is the little flip book that you see. On the bottom row towards the left and in the center are two examples of mid tech devices. So the one with the red button is called a BIGmack. And then the green device with the four images, including the cat and the ball, this is an example of a GoTalk device.

So both of these require somebody else to record their voice, their speech. And then when the person using the device activates the button, or presses the picture, then that recording will be voiced. So those are examples of mid tech devices.

And then on the right, in the top corner and in the bottom corner are two examples of high tech systems. So the one on the top right is a Tobii eye gaze device, so eye gaze meaning that somebody is using their eyes basically as a mouse. So a camera picks up and tracks their eye movements, and then they're able to use their eye gaze and eye movements to control that screen and make their selections on the device. And then the bottom one is an iPad based system with an AAC app.

So kind of moving on to the next phase, we're going to be talking about finding AAC. So how do we get devices? And how do we identify which ones are a good fit? So some more terms to know. Keep in mind that as we're talking throughout this presentation, there is going to be a large focus on the insurance funding process, so using medical insurance to pay for an AAC device. That's not the only way to pay for an AAC device, but a lot of the other types of forms, and a lot of the language we use to talk about funding kind of comes from the more insurancey world of things.

So here's just some more terms to know while we're talking today. So DME, that stands for durable medical equipment. Durable medical equipment can be really any type of medical device that somebody might use. And in this case, a piece of DME for communication, that would be one of our AAC systems. A bundled iPad, that is going to be an-- we're going to use that term to refer to iPads that are funded through a specific AAC vendor.

Different vendors are going to sell iPad products. Basically, their bundled iPads are an iPad in a case with a communication app on it, but they're going to have a specific name. So the examples we have here on the slide say the TalkPad Wego edition, that's from the company Talk To Me Technologies and Smartbox. The Quick Talker Freestyle is from the company Ablenet. And then Choice Communicator is from the company ACCI.

Even though they have different names, at the end of the day, they're still an iPad in a case with an app, but insurance doesn't outright like to pay for a kind of consumer grade iPad. You can't just go to Target, or Walmart, or Amazon, and buy an iPad and pay for it yourself out of pocket, and then have insurance reimburse you. That's not really an option. You have to go through one of these special vendors to purchase the iPad preloaded with the AAC software.

Next, we have dedicated communication device. So this is another one of those umbrella terms. A dedicated communication device is a device that is funded through insurance, and it's dedicated only for communication. That means that it's locked down to the communication software.

If you look at the bottom of the screen, there's images of all kinds of different AAC devices from different companies. And you'll notice that they're all kind of computerized fancy tablets. At the end of the day, they're computers, they have access to the internet. You can do other types of things besides just communicating on most of these products.

It's just that when insurance pays for them, they are locked down, meaning, you can't get to the internet. You can't get to those external features. A lot of times, that's offered behind a paywall. So you can pay out of pocket, then maybe like a small fee, sometimes, it ranges from $20 to $50. Some companies, it's free. You just have to ask. But you can then get your AAC device unlocked and then be able to use it as basically a functioning computer.

You can go on the internet, you can watch Netflix on a lot of these systems. You can send emails, get text messages depending on what type of device you have. So especially for someone with a complex body and complex access needs, they can do a lot more than just communicate using their device. It can be integrated for home environmental controls, all kinds of different things. But in a lot of those cases, insurance doesn't want to pay for those other things, those environmental controls, or the leisure access that you can have on one of these devices.

And then we already said speech-generating device, dedicated communication devices can come as speech-generating devices. And those bundled iPads are dedicated communication devices. And they are also speech generating devices. So a lot of these terms kind of blend together.

So the next part, what is an AAC evaluation? In my practice, we tend to look at AAC evaluations as either formal or informal. So when I talk about them being formal, that's usually for evaluations that are needed for insurance funding purposes.

So that being said, there's a lot of steps and information that needs to be collected if you're going down the insurance funding route. Sometimes, if you're going to pay for a device out of pocket, or through a grant program, or other avenues, you don't necessarily need to go through all those bells and whistles to find the right choice. But when we're talking about the evaluations, we're going to be looking at that from more of that insurance focused perspective.

So an AAC evaluation can be a lot of different things. But really, overall, we're going to use this as an opportunity to identify the person's best communication modalities, and also, those areas of communication where they might need some additional support. We're going to also explore what types of systems, and devices, and strategies are out there and available for that individual.

And then we're going to find the solutions that are going to work for that person. So we do that really by one, identifying all the things that a person can do, what they want to do, and what they need, and then taking the devices that are available on the market, and matching them to the individual. So there's a phrase, or a term that they use that's called feature matching. We want to match the person to the features that exist within a device.

And then we're going to determine which one is appropriate for the individual. Sometimes, in a lot of cases, that's through device trials. We might try out one, and it's great. Yay, perfect. But then other times, we might get some feedback and say, hey, we need to go and revisit, and try some other options out there to find a better fit, or a better solution. Whenever you are going through medical insurance, that's when you're going to need that big, fancy formal evaluation. And that evaluation is going to need to be conducted by a licensed and certified speech language pathologist, especially in the state of Pennsylvania, if you're looking for insurance funding purposes.

So here's just a visual to go over that evaluation process. We're going to gather that information. Then we're going to take that information about the person, about what they want to do, what tools exist. And then we're going to look into device and system trials.

So sometimes, the devices, a lot of companies are going to offer similar systems. Some are going to offer more specialized systems. And so we might have to determine how many trials, or where we're doing our trials based on the products that the company sells, or the different companies sell. So, for example, if we're looking for one particular app, we might have a lot of options and can pick from different companies that have different cases, and different size devices.

But if we're looking for a very specific type of language software, or a very specific app, not every company might offer that one. Some companies might only offer their proprietary language and AAC software, so that might narrow down some of our choices. That's kind of the same thing too, with some of our access methods.

So if somebody needs eye gaze, that's not necessarily available on every single system. Or every single eye gaze camera is not compatible with every single AAC device. So we have to narrow down and find the best combination, the best pros and cons, to get a person closest to their ultimate solution. And then we're going to look at funding sources after we decide what product is the best fit. And then hopefully, we go through the funding process, and then we obtain that AAC device for the person to own.

So some information, when we are doing any type of evaluation, but especially one with the goal for insurance funding purposes, the SLP on the case, or that the person is working with, they're going to collect information like case history and background, and that's going to include things like medical diagnosis. All that information is needed to submit in these reports. We're going to look at the person from a holistic perspective as well, so we're going to get information about their sensory needs, cognition, fine, and gross motor abilities, hearing, and vision. We're going to need to know if that person is using a wheelchair or a power chair, that they might need some additional accessories, whether they're going to be able to use their finger to interact with the screen of a device, or if they need other accessories to be able to access and navigate their system.

And then we're going to again, look at their communication overall. So how do they communicate? And then also, where are they communicating? Who are they communicating with? We want to look at all of those things.

And then we take a peek at your speech and language skills overall. So a person might be able to use some of their speech. But when we're writing up this big, fancy report as an SLP, we don't really want to focus on all the things that the person can do. In a lot of cases, we really want to highlight the things that are hard, or that a person can't do. And that's because we have to really battle the insurance company, and we need to unfortunately, come from a more deficit and impairment based approach when we're getting funding for these types of devices.

We don't want the insurance to come back and say, oh, well, they can use their speech sometimes, so they don't need this device. Sometimes isn't good enough when it comes to communication. We need to be able to have an effective and efficient way to communicate all the time, not just sometimes.

And then we're also going to need to look at that access method, that again, either if it's eye gaze, is it switch? Do they need something to help them with their fine motor to physically touch the device with a finger, or a toe, or a different body part? We might need additional accessories to be successful with navigating and using our system.

So if we're a powerchair or a wheelchair user, we might need a mounting system to attach our communication device. We might need a key guard. So that's a screen overlay that can act like a bumper on the surface of a device to help somebody with making more accurate selections.

We might need those switches. We might need an eye gaze camera accessory. So all of those things we're going to need to identify as having a need for that person to be successful with their device. And we're going to need to be able to justify why they need that and why is it medically necessary.

So device trials, after we've kind of done that evaluation, and narrowed down, and talked about some options, in a lot of cases, it's probably really good to do a device trial. Sometimes, your insurance is also going to require a device trial. And what that trial looks like the length of that, how many devices it needs to be, is dependent on the type of insurance and plan that the person has. But a overall like, very similar idea is that most insurance companies do require about three options were considered, or actually trialed. Some get a little more specific with those requirements, but it's always good to at least in the report, include information about three things that were considered, including the device that was selected.

So some options for device trials you can borrow. If you are a person in Pennsylvania, you can borrow equipment from the TechOWL Lending Library. We have lots of iPads that can come with multiple AAC apps on them. And that's a free service.

We do also have some more dedicated systems as well, like, some gaze devices. We have switch accessories. But I will say that sometimes, we can't necessarily keep up with the companies in terms of staying with the latest and greatest tech that's available on the market. So if somebody really wants to try out the features of the latest model, it might be a good option to go and look to the vendor directly to trial their specific products.

Another thing too, about the device vendors is, there's usually folks that worked for those companies that can come out and provide more hands-on support to individuals, families, teams with getting some of those more specific setups of devices set correctly for the person. Like I said, I consider myself an AAC specialist, but there are so many products out there on the market. It's hard for me to know the ins and outs of every single device from every single company out there.

So I tend to rely a lot on the device vendors to assist with especially like, access modes, and some of those more nitty-gritty type programming things that were computer functions of these communication devices, so that we're giving the individual and their family the best chance at trying it out in a more successful way than maybe me doing some trial and error and guess and check. That might not be the best solution. So definitely, reach out to vendors. I highly recommend that.

Other options for device loans would be through PaTTAN, and that is for school districts. So that is another option that exists for folks in Pennsylvania. So some things to think about when you're doing the device trials, and then after device trials, during it, especially initially, we want to make sure that we're providing access to this AAC in all settings. A lot of insurances are going to require examples of how this device was used, how it was successful for the person. And they're going to want to hear where the person used the device, and especially if they used it out in the community, and what that looked like.

We want to make sure too that support persons are modeling language throughout the day, especially for emerging communicators, where this might be the first AAC system that they've actually tried. It's not just fair to hand the person the device and go, here you go. Try it out, see if you like it. In some cases, this is brand new information, and the person needs to see it be used. Caregivers and support persons should use it together with the individual to give them the best chance of learning how to use that system, and the best chance of being successful.

We also want the trials to be realistic, so we don't want to make this an unpleasant experience for a person, or for it to feel like work. So if it's being used with rather than at a person, that can be a lot easier to introduce, and give it a fair chance. We also want team members to take relevant data. For a lot of the teams that I work with, I usually ask for like, anecdotal information, or qualitative information.

I want to know how was the device used? Did he like it? Why did she like the device? Like, what worked? What didn't work?

And I want to hear examples of what was said on the device. If you can tell me that we used it to order at a restaurant, or he brought it to his doctor's appointment and asked a question, that's great information. We want to be able to include that in the person's report when we submit to insurance.

And then all throughout the device trial, we want to make sure, again, we're using it, we're sharing data, we're celebrating victories, we're setting the person up for easy wins. But we also want to make sure too, that we're customizing that device, so that it has vocabulary that's useful and familiar to the individual. A lot of devices kind of come out of the box with lots of things pre-programmed, but some of that might not be what the person wants or needs to say.

Now, when I say this, you don't want to spend so much time customizing during a trial, especially if you only have a couple weeks with the device, that you're actually doing more editing and programming than actually using the device. But you do want to make sure that there are choices and options there that are relevant and meaningful to the person. And then after trials, I really do encourage teams to meet and discuss how it went.

And then that discussion can help provide the direction for next steps, whether that's saying, yes, this worked, we're going to move right into our device funding, or hey, this didn't work so well. Let's go back and look at some other options. Maybe we need to revisit the trials. Maybe we need to tweak some things, or try it again.

So all that information is super useful. And even if you do have to do another trial, or do try a completely different device, or go in a different direction, that's not time wasted. That's information that's going to be useful down the road for when you do find the solution that you want to get funded.

So more on our funding, so I already mentioned medical necessity a little bit. But just to focus a little bit more, here on the slide are just some definitions. Every company, insurance company is going to have their specific definition of what medical necessity means. But overall, it's kind of a way to say that this device is needed for the person's medical functioning, their day to day.

Medical necessity is different than educational needs. So when I write a report, meaning, that we're going to look for insurance funding, I can say that this person needs this communication device to participate in school. But the medical insurance, they don't really care that the device is needed for academic purposes.

They care more about that this device is needed for the person to get their wants, their needs, and like, to talk about their health, to request care, those types of self-concepts. So that's kind of a little bit of the difference when we're writing reports, and we're trying to justify why a person needs a device, we really focus more on that kind of medical talking about our health care, talking with doctors, with emergency personnel. Those types of things tend to be like, good key phrases that insurance seems to like.

So here is just a visual to break down what these insurance funded devices look like. So we have the starting point is that AAC device. And then we kind of have funding broken down. So the items that are dedicated AAC devices, and then branch off from there, those are our insurance ones.

We can have our dedicated systems. And technically, somebody could pay for them outright, out of pocket if they want, but a lot of these devices are really expensive. Then you also have your iPad based systems, which tend to be a little easier, or more consumer market friendly to be able to have purchased.

You don't need a prescription to be able to go and buy an iPad from Target, and then download an AAC app. Anybody can do that, but some of these apps are pretty costly. Some are free, and that's great. Others can be over $400, including tax.

So when a person does want to make an out of pocket payment for an app, it's always good to maybe have tried it, unless you're 100% sure this is the app for me, or the person I'm working with. So that's kind of when we might encourage you to borrow from the TechOWL Lending Library, or another resource. So that you're making sure that you've tried out the app, you know what it is before you invest your own money into that system.

And that's good too, with of course, insurance funding as well. Usually, in the insurance world, you can get a device funded once every five or so years, unless there's some sort of big problem or big issue. But a lot of times, if it's just like, oh, we made a mistake, I actually don't like this app, I like this other one better, that's not often going to be the easiest fix. So when we look at our AAC devices, we have our more specialized speech-generating devices, and then we have our bundled iPads. Those are the two big ones that we'll talk about in terms of getting funded.

So here on this slide, are just a few more examples of different types of dedicated speech-generating devices. This is not the end-all-be-all list of devices. There's a lot more out there, and we're constantly seeing new ones come out on the market, but these are just some examples to make you familiar with some names.

So we have the PRC Accent, the Grid Pad, that's from SmartBox. Then we have the Tobii I-Series. So these are eye gaze devices from the company Tobii Dynavox. And then last, we have the NeuroNode Trilogy, which is from the company Control Bionics.

And here are some more examples of those bundled iPads. I talked about a couple of them earlier, but now, here's some pictures to go along with that view. So we have the QuickTalker Freestyle. That's from the company Ablenet. We have the PRC Via, the Tobii SC Tablet. That's another one from Tobii Dynavox, and then the TalkPad Wego edition. That's from Talk To Me Technologies and Smartbox, now that those two companies have merged.

One thing to reiterate here is that with the bundled iPads, some companies are going to offer a whole list of apps that you can choose from. Other companies are going to be limited in that they're only going to sell you an iPad, or have iPads available with their proprietary apps and software. So that can be a deal breaker depending on which company you might want to go with.

So you might really like the case, and the options that you have with company A, but the app that you need is only available from company B. So you might then have to make a choice with which is more important. And sometimes, too, that if you have specific accessories, a lot of companies might be able to work with you to get you a different case and things like that. So stuff's not necessarily always a deal breaker. There's always workarounds and other creative solutions, but those are things that you might have to determine. Sometimes, we do have to make choices and weigh our options.

So cost estimates, when we're looking at an iPad and creating a speech-generating device just from consumer products, so meaning, I went to the Apple store, I picked up an iPad, and then I downloaded an app, we're looking anywhere between probably 500 to $800, depending on the accessories, or if we're getting different gigabytes, and memory, and things like that, they might be more expensive. But in most of those cases, you can get an iPad with an app and all the bells and whistles for about under $1,000 out of pocket.

When we're looking at our dedicated devices, those are usually going to be over $1,000 plus. Our eye gaze devices are going to cost as much as a car, in a lot of cases, out of pocket. So that's really where insurance is going to come into play, because most people don't have an extra 16,000-$20,000 to pay for a eye gaze communication system.

And then anytime we're adding accessories, so things like mounting equipment, key guards, anything like that, those additional accessories are also going to have additional costs that go into them. And any time there's an additional cost, or an additional request, we have to then be able to justify that request, especially when we're looking at funding sources where we're asking other people to purchase the equipment. So think insurance, grants, waiver funding, those types of things. We're always going to need to be able to justify and argue for what we need.

So an overview of some of those different funding options, there's a variety depending on what the person is involved in, maybe their age, things like that. So one doesn't have to be the end-all-be-all for your funding, but these are just some options to get you started. So we have waivers. We have your insurance, whether that's your private or supplemental, Medicaid and Medicare. Sometimes, OVR, or an employer can pay for devices. Also, if a student is still school age, and they have an IEP, that device can possibly be funded through their IEP.

There's also things like, grants available, or the Pennsylvania Assistive Technology Foundation, PATF. They also offer low and no interest loans for assistive technology. Keep in mind, that's not just limited to AAC, but other forms of AT as well. And then you also have the out of pocket, private pay, or crowdsourcing options as well.

So looking at some of our public and private funding sources, so here on this slide, it's just breaking it down into some public options that might be available for a person. Some other ones that weren't on the slide previously, was early intervention, the CHIP program, and then other special programs that people might be eligible for, and then our private funding sources. You can also look at things like private foundations or charities.

A lot of them might have special grant programs, or they might offer kind of like, a one off thing that they might be able to fund a device for a person. There's also options to get reused equipment. So at TechOWL we do run a reuse program, where if people donate their AAC device, or other types of AT that they no longer need or use, that it can then find a new home for somebody that does need it.

And sometimes, you can get equipment made depending on what it is. I would say, it might be really difficult to make a fancy, eye gaze communication device out of nothing. But you might be able to get a light tech AAC system made for you, or an accessory made for you, maybe like a keyguard through 3D printing. And we do have a slide later that does look at the 3D printed key cards that TechOWL does make.

So to go over more information about our general funding process, this slide is just a visual about starting that funding process. So we want to really know what that person needs, and what they want. So looking at, again, the person holistically, all their features that they're looking for in a device, what's going to work best for them. That helps us narrow down what our options are.

We want to also know what potential funding sources are out there and available to that person. Sometimes, for example, some insurance companies don't have a co-pay, and they'll cover a device all the way. We've also seen some companies charge a $1,000 co-pay for an iPad based system, which at that point, you might as well just go and buy the device out of pocket yourself. But even that can be really hard for some individuals and families. So they might need to find another funding option to go along with their insurance to cover that copay fee. So being able to think ahead, and looking at all the different possible avenues is usually a good plan to start.

And then you need to apply to those funding sources. So each funding source is going to have maybe some different rules and steps. Some grant programs might only run on a certain time frame of the year, like, for example, a quarterly basis. And then other funding sources might be a pair of last resort, meaning that you've tried other options, and you need to have proof that you've tried, say, insurance, and were denied before that they will jump in and cover something.

And a lot of times, too, you're going to have a wait, especially with insurance. I've had devices get funded after all the paperwork is in within a week, and they're shipped out the next week. And then I've had other ones where it's taken almost over a year for a device to be funded, and be in the hands of the individual. So it really just depends on the funding source, and honestly, whose desk I think it gets on. So there's a lot that goes into funding, and it can be a timely process in a lot of cases.

And especially with the insurance world, we might get a denial, and then we have to fight the insurance company to get that person a device. Just because we get a denial letter doesn't mean it's over. Usually, in a lot of cases, we can just write a letter further justifying why they need it, and there's a good chance then it'll get approved.

But then sometimes, you have to do what we call a peer-to-peer. So in that case, the SLP will need to meet-- most likely, it's a phone call-- with a doctor from the insurance company, and then kind of further justify to them in a conversation about why the person needs this device funded. And then hopefully, after all that, then the device will be approved, and the person will get the equipment that they needed.

So the next couple of slides are just going to show some different considerations for some of the funding source options. And this isn't-- you have to do this. This is just to help teams navigate some of these funding solutions. So one thing to mention when we're looking at schools is, what kind of school does the person go to, if they're a student in their school age.

So if they're in a private school, there might be a chance that there is some sort of discretionary funds to pay for some sort of equipment like this. There might be charitable contributions that can go towards students. Also, if the student has an IEP, whether they're in the private or the public school, if the device is in the IEP, then the school district does need to provide that device for them.

When an AAC device is purchased with school funds, however, that device does not necessarily belong to the student. If it's purchased with medical insurance funds, like the school SLP uses, or writes a report, and uses the student's medical insurance to pay for it, or their access funds, then the device belongs to the student. But if the school district just pays for it outright, then that's where that question of ownership comes into play.

And if the student, for whatever reason, moves in the middle of the year, or maybe they graduate, they might not be able to take that device with them, because it doesn't belong to them. And that's something to consider. Just because you graduated doesn't mean you no longer have to communicate. So we want to think about those things before making decisions of how we're obtaining devices.

Other things too that you might see is when a school district pays for a device, there might be the question of whether the student is allowed to bring it home on the weekends, or over holiday, or summer breaks. Just because you go home, again, doesn't mean you stop communicating. You still need to be able to communicate, and do your homework, talk about school, those types of things. But sometimes, then that becomes up to debate with the IEP team and the school district. So those are things-- I don't have a magic answer-- but those are things that individuals, and their teams, and families should consider when maybe working with schools for funding.

Same thing for early intervention, if a child is receiving early intervention services, we might identify that they need an AAC device, but the AAC device process might be taking a little bit of time. And when a child ages out of early intervention, especially in the Philadelphia and Pennsylvania area, there tends to be a little bit of a limbo for that child between when their early intervention services end, and when they enter in and get their next stages of services, whatever those look like for the child. So we might have started the AAC funding process, but now, they no longer have that SOP, they no longer have that provider.

And then it becomes a question of, well, how are we going to get a device? What if they need to do an appeal? What do we do next? That's another situation. I don't have a magic answer, but those are things that families and teams can consider when making decisions about whether they want to move forward now. Maybe they want to wait, try other things, or how they pursue funding.

Same thing with waivers. We want to look at what kind of waiver the individual has. Some waivers will have a cap for assistive technology in AAC, especially if equipment is over a certain cost, it might then require additional paperwork, additional justifications for a waiver funding monies to be used. So those are, again, things to consider.

Another thing as well is that some waivers might have a lifetime cap. And with a lifetime cap, that can be a little tricky, because a person might need that technology now, but especially if they're a younger individual, we don't know where they're going to be in, the later part of their life, what type of AT technology they're going to need down the road, and what that looks like. So we don't necessarily want to use a huge chunk of their money right away right now when they're younger, and then have nothing left over for later. Of course, there's always loopholes and exceptions to things, but these are conversations that individuals, families, teams need to be having with their supports coordinators before making official decisions.

So now, the next couple of slides are going to focus more in depth on that SLP, so that speech language pathologist funding process. I've kind of already mentioned some of this funding information, or this report information a little bit. But when we're-- especially if you're the SLP working with an individual and their family, you want to make sure that you really kind of know the process, and are familiar with those steps involved. We want to make sure that we've identified what the person needs and how we're going to move forward with that. Do we have backup plans if the first funding source we tried falls through?

Another thing, too, is that not every single device does need to go through medical insurance. Sometimes, maybe, we want to be creative and look at other options, whether that's because we know their insurance is going to take a long time, or maybe it's because we need to actually use the device for things like leisure or job supports. So we need it to be unlocked, and we need to navigate through a different avenue.

So when we're starting that insurance process, we want to make sure that we've completed device trials, especially if they're needed. Again, you can borrow from the TechOWL Lending Library directly through vendors, again, PATTAN for school students. We also want to make sure that we're gathering all the documents that are needed. So that being said, when we are anticipating using insurance funding, I tend to recommend to the families I work with that you don't call your insurance company directly and ask which devices and network, because nine times out of 10, the device that they're going to tell you, or the company that sells AAC that they're going to tell you is in network is not the right fit for the individual.

Sometimes, it is. But in my experience, it's usually not. And we don't want the insurance company to dictate what the person needs, or what they should have. We need to identify that based on an unbiased evaluation and trials, and then go to the insurance company, and tell them this is what we need, approved and funded.

Of course, that doesn't work in every single case. Sometimes, it's a long, drawn out battle. And sometimes, we have to pivot. But we want to make sure that we're at least fighting from the get go for what the person needs, rather than what the insurance company says they can have.

So we need to gather different materials, because we're going to create a packet that we're going to submit to that device vendor, the person selling the AAC device. They're going to take all those documents, and submit them, and deal with the insurance company. So they tend to act as a go between the SLP, the family, the individual and the medical insurance, which is kind of nice, because they'll tell you, they'll hold your hand, they'll tell you what to do throughout the process in most cases.

So typically, you're going to need copies of your insurance cards front and back. And that includes any and all insurance that you have. What can delay the process is if you know, oh, we also get it. We have our access insurance, but then we also get supplemental from a parent's work, but that was forgot to be mentioned. And now, when the company runs the insurance information, it gets flagged that there was another policy. And so what happens is, then that delays getting them that device, or getting that approval, and that submission. So it's good to get all that information up front.

What's also needed is a doctor's prescription, or a certificate of medical necessity. Most AAC vendors are going to have a special form that they use with the correct wording that's needed on that form, and they'll reach out to the doctor directly in most cases. The prescription is not like a traditional medication prescription. Other things, too, is that a lot of insurances might require a visit to the doctor within the last six months, so that's something that the family might need to get updated. They might also require face-to-face visit notes as well. So any paperwork from the doctor might need to be gathered as well.

There's a lot of forms, including the assignment of medical benefits form, that the family or the individual will need to sign. And then there's the SLP's super long and detailed insurance funding report. So all of that gets submitted to the device vendor, who then deals with the insurance company.

So here on this slide is just a list of information that's needed in most SLP report formats. A lot of vendors will have online forms or templates to fill out with the information that you need to get the devices approved. But here's just a list that goes over the basic information that you need. So it's a lot of background information, an overview of the person's communication. There's a really detailed, comprehensive assessment looking at the person from a holistic perspective.

And then we also want to talk about how things like vision, and hearing, and cognition does that, or does it not impact their ability to use an AAC device? We have to look at their daily communication needs, who, and where, and what they're talking about, and need to be able to communicate with and where. And then we also need to talk about how their needs cannot be met by other non AAC device options.

So for example, how does sign language might not fit their needs? How does using a writing utensil and paper not meet their needs? How does going to speech therapy, maybe that's not going to meet their needs? Or using a light tech paper based system, how that doesn't meet their needs. So we need to be able to justify and rule all those options out as alternatives that don't work for this person.

And then even more information, we're going to talk about all the devices we've trialed, and we're going to say why they weren't a good fit, why we're not considering them anymore. And then we're going to justify the one that we are recommending. We're going to say why this one was the best, that it has all the features that the person needs, and why we're recommending it.

We're then going to include things like treatment goals. We're going to say that the SLP is-- they're not biased. They don't work or have any financial stake with any of the AAC companies. And they're going to sign off on that report and send it, and hopefully, it gets the device funded.

So that is funding in a very general sense. A lot of more specific information can be shared. Each insurance company, each device vendor is a little different with their process. So if at any time anybody ever has questions, you can always reach out to us at TechOWL, and we're happy to help guide you through that process, or answer any of those questions you might have.

The next couple slides are just going to look at some general resources. So here are some additional programs that TechOWL offers. We have some programs that can help folks get other forms of assistive technology, for example, like, our free special phone program, where ICanConnect, which is to help folks who are deafblind get equipment.

Our Fabrication program, CreATe Together, can help 3D print a keyguard for your AAC device. And we have a slide with some examples of that coming up. Another program we have is a mini grant program. This one that we offer, as well as many others that are outside of our organization, a lot of times, grant programs are going to be what we consider a payer of last resort. So you will need to have tried other options as well.

And a lot of times too, with grants, it's good to mention and look into that sometimes, they will be like a one time use you. You apply, you've gotten accepted, you get the funds, you're not able to apply again. So those are things to just keep in mind when you're looking at some more creative or alternative funding options. And then we talked about reuse, TechOWL, if you're looking for equipment in your part of the state, sometimes, there might be AAC devices that come through our reuse partners.

Here's some examples of those 3D printed key guards. So if you need one of these for your AAC device, we can provide them for you for free through our 3D printing program at TechOWL. We just need the dimensions of your AAC device, and we can get that customized and sent to you if you are a Pennsylvania resident.

Here is some more specific information for PATF for low interest and zero interest loans for assistive technology. Some additional information about TechOWL's AAC services. We do have specific project contracts, for example, with Philadelphia Intellectual Disability Services and Early Intervention, as well as with Pennsylvania's Office of Developmental Programs. That specific program that we run is called JustSO Speech Services. There are specific requirements for eligibility with these programs.

So if you have any questions, or know somebody who might benefit from getting some more AAC supports, you can always reach out to us and we can see if that person may be eligible for one of these. And if they are, if they're not, we are still going to be going to answer questions. We can provide a free device demonstration. We can do informal video chats as well to talk about which AAC options are out there, or answer questions you might have.

We also have our ACES program. Show a slide for that in a minute. And then we also have more information at our website, AACCommunity.net. There are additional resources about funding and the insurance process on there as well.

ACES, so that is our Augmentative Communication, Empowerment, and Supports program. That's a program at Temple where young adult AAC users of at least 18 years and older can come to Temple for about a week, and get different types of training, and participate in communication class, learning new skills with their AAC, as well as participating in different leisure, listening to speakers, attending different sessions. And so we'll be offering it this July upcoming in 2025. If you are interested, or know someone who might be interested in attending, we encourage anyone to apply at our TechOWL website. Here on the slide is a link for the ACES program.

And then we also encourage you to follow us on social media. We have a pretty active Facebook, Instagram, and TikTok, so we're always sharing new information about new learning opportunities, trainings, as well as just sharing information about assistive technology. So please do follow us to stay up to date with all that exciting info.

Our general TechOWL contact information, our information for the Institute on Disabilities as well. And then I just ask if for attendees to please complete this survey to let us know how we're doing, and what information that you would like to see us cover in the future. This helps us also tell our funders that we're doing a hopefully, a great job, or an OK job, if that is what we're doing as well, so that we can continue to provide training opportunities like this, and making sure that we're sharing the information that the community wants and needs to hear and learn.

CAITLIN MCKENNY: Welcome. Thank you all for joining us today for February's tech accelerator webinar. Our presentation topic this month is home automation for being self-sufficient. And this session is being recorded, and the video will include picture in picture ASL translation, as well as a full transcript. So you'll be able to access that recording on our website at disabilities.temple.edu, and I'll put that link in the chat for everybody to access later, as well.

And that website is also where you can register for future webinars. So TechOWL has a wonderful series of 18 topics, running from July of 2024 to December of 2025. Each is being held on the third Thursday of the month and is offered at two times, 12:00 noon and at 4:00 PM, so you can pick whichever fits your schedule. They are the same content.

We have a guest speaker scheduled for next month. Tiffany Wilson will be coming to talk to us about safety and privacy issues that intersect with implementing smart home technology. So that will be a wonderful session. We're looking forward to that, and especially useful for those of you in attendance today who will already have a nice base of knowledge about the types of devices and the functions that are available through smart home equipment, so make sure to join us again next month for that session on March 20.

And all of these webinars are part of the Tech Accelerator program. So this is an initiative funded by the Office of Developmental Programs and the Office of Long Term Living here in the Commonwealth of Pennsylvania, and this project is made possible through funding from the American Rescue Plan Act.

The Pennsylvania Tech Accelerator Project includes five major focus areas, training and resources to build capacity for stakeholders, readiness evaluation to develop tools for successful adoption of remote supports and assistive tech, a statewide assessment to plan and benchmark the technology for systems change, a provider survey to assess technology awareness and resources among providers, and finally, two technology summits, which will be live events hosted in Philadelphia and Pittsburgh this coming March to enhance awareness of tech solutions. So you can learn more about all of these fantastic projects on our website at disabilities.temple.edu by using the link that I put in the chat.

And with that, I would like to turn it over to today's speaker, Laura Sarnoff, who's going to share with us some wonderful information about smart home technology.

LAURA SLOTKOFF: Hello, everyone. Let me pull up the presentation.

All right. And as Caitlin said, this presentation is to give an overview of smart home automation for being self-sufficient.

My name is Laura Slotkoff. I'm the Emergency Preparedness Coordinator at TechOWL. I'm also an occupational therapist and RESNA-certified assistive technology professional. And my experience with smart home equipment is having been on an AT evaluation team. I participated in evaluations of adults and for the Office of Vocational Rehab, including how they can use smart home technology to help them perform tasks in their job or in college with their schoolwork.

And I also participated in the Pennsylvania AT Foundation's Smart Homes Made Simple advisory committee. I have a few links related to that later on. That was a project by the Pennsylvania AT Foundation, where they created a website and guide with a lot of very helpful information for how smart home equipment and devices can be helpful for people with disabilities, and making that information accessible for people with disabilities.

So this is just an outline of what I'm going to be talking about, just general overview of smart home equipment. Talk a little bit about can benefit from that equipment. I'll give examples of different types of devices, talk about how to get started installation and setup of devices. And then I'll talk a little bit about funding and answer any questions you all may have.

So what is smart home technology? These are devices that allow you to more easily monitor and control your home. They are mainstream off the shelf devices, which tends to mean that they are more affordable and accessible than certain past environmental control units that were made specifically for people with disabilities that used to exist.

And these devices can allow you to manage your lighting, heating and cooling, appliances, security, and entertainment at home. And part of what's so great about them is they have a lot of different features about how you act that can help you activate them in different ways than just turning a light switch with your hand.

Most are controlled through a central hub or through their own individual devices and have apps of their own that they come with. You need a smartphone, usually, to operate them. And they also need to be connected through a network. Usually that is Wi-Fi internet access. Sometimes that is a different type of network, like Bluetooth, or a mesh network like Zigbee.

Some of the different ways these devices can be activated is by touch, voice command, or through the use of assistive technology devices, like switches, joysticks, gaze, and augmentative and alternative communication systems.

So who could benefit from smart home technology? The answer is honestly anyone. It can make your life much simpler and more streamlined, which is really nice, but it can be especially helpful for those with disabilities or older adults to be able to increase their independence and participation in activities at home.

While not every device has every feature to accommodate any type of need, I'm going to go through and give a few examples of the accessibility features that can help to empower you in home with smart home devices. So for somebody who has difficulty with mobility or using their hands, a lot of these devices can be activated with switches, eye gaze, or voice control, making operating a variety of appliances and devices hands free, which can be a real game changer for somebody who has limited use of their hands or mobility.

There's also, if somebody uses a motorized wheelchair, whatever input they use to control the wheelchair, like a joystick, for example, they could use Bluetooth to connect to their smartphone and to smart devices throughout their home through that smartphone, and use the joystick to operate it.

If someone has learning disabilities, difficulty with their memory or cognition, they can benefit from the variety of options for auditory, visual, and/or tactile cues and reminders. Things-- so like auditory, if they have a smart speaker, it can say reminders to them, like you need to leave for work in 15 minutes, you have a meeting starting in five minutes, if they need that verbal cue. Visually, if they have-- it can send a text or alert to either a smartwatch or their phone. And tactile cues usually mean, say, if they have a wearable device, a smart device like a watch, it'll vibrate to give them a cue to check on something.

You can also set up automatic schedules, which only need to be set up once, and then you don't have to think about it again, so, for example, a smart vacuum to go on at 4:00 PM every day. And smart sensors, such as movement sensors that can automatically turn on lights when you walk into a room, so you don't have to have the cognitive load of thinking about and making as many choices throughout the day. You can have things just set up for you.

If somebody has a speech-related disability, I will say that while they have made some strides with smart speakers to be more inclusive of recognizing different types of voices and enunciations and speech speeds, it's still not great. If you have impaired speech, it may make it hard to operate devices by voice. There is, fortunately, a variety of other inputs that can be used, such as the different ways of controlling touch and with switches. And also, fortunately, my experience has been that they tend to recognize a lot of voices used in alternative and augmentative communication devices, as well.

And if somebody has a hearing loss related disability, the tactile cues, the vibration from wearables and smart devices can be very helpful, as well as the visual alerts, like flashing lights. So that can be used with anything from you get a flashing light alert or a vibration when someone rings the doorbell, or maybe you have a smart smoke alarm that instead of setting off an alarm that you can't hear, it flashes a light and sends a message to you to your device.

I'm just going to go through a few examples of different types of smart home equipment that are out there, and how those can be helpful. For lighting control, a dark house can be intimidating, but also dangerous for people of any age. With smart lighting in the form of in-wall switches or dimmers and LED bulbs, you have so many more options. It allows you to put lighting on a schedule. You can have lights triggered by movement or other devices, or simply turn the lights on and off with a voice command or a smartphone.

This can also improve safety, such as by being able to turn off the light easily at the end of the day from in bed, rather than needing to-- if it's set up like the way my bedroom is, the overhead light switch is right by the door, and if I didn't use smart home technology, I would have to at the end of the day turn off the light by the door and then stumble in the dark to my bed. This changes that. No need for that.

Smart bulbs can also give you the flexibility to change the brightness and color of the light, which is very nice. It can also be helpful for outdoor lighting, which you can set to automatically come on when it gets dark.

Smart thermostat and other such devices like fans, smart fireplaces, smart blinds, these can all be helpful for controlling the temperature within the home and give somebody more independence for controlling that. You can even have this to be integrated as part of a routine, such as by giving a voice command at nighttime can trigger the window blinds to close, a fan to start, and the thermostat to be set to 70 degrees or whatever you want it to be at. And these features might be especially important for somebody who isn't able to turn on or off or set these things with their hands, and maybe have a condition where symptoms are triggered by heat.

And it would also really be helpful for home access. With smart locks for doors, you never have to worry about a forgotten key again. There's smart locks that can be unlocked through a fingerprint, a code, or a phone app. Also, smart doorbells often have a camera, so you can see on your phone or smart display who's at the door, when packages are delivered, even if you're not there at the time.

Also, if you're somebody who has caregivers frequently coming in and out of the home, it can make it easier to track who arrives and when, and easier to be able to let them in and out safely without having to leave the door unlocked all day or a key outside.

Another important area is safety and security. There are indoor and outdoor smart cameras and security systems, smart smoke and carbon monoxide detectors. One thing that's nice about the security system is they usually contain multiple things, like maybe the camera and the detectors all in one. So you know that they're compatible and you don't need to juggle different devices and different apps.

One thing that's nice about the smart smoke and carbon monoxide detectors in particular is that you can, as I was saying before, you can set how change how the alarm works. So it doesn't have to be sound. It can be in addition to a siren, have a flashing light. You can have a message sent to your phone or another type of device. And it can also send messages to caregivers and neighbors, loved ones, to alert them, as well.

Wearables such as smartwatches can help with tracking health information and alert caregivers or emergency providers in the event of a fall. This is actually something that has been really helpful for my mother, who has some conditions that have made her as she's gotten older, her balance is not as good, and that has been a big concern that she might fall when no one else was around. So her having a smartwatch has actually helped her to get help when she was home alone and had a fall.

There's also a variety of supports for caregivers to monitor and provide support for an individual remotely, and to be easily alerted in the event of an emergency. This can allow for the person at home to have increased independence while also giving peace of mind for caregivers.

One example is a smart medication dispenser, which provides alerts, can send a text, a verbal reminder, vibration cue, whatever it's set up for, to a smartwatch or to a phone, with a reminder to take a medication, and can also let when you're close to running out and need a refill. And if you do miss a dose, it can then alert your caregiver or like a parent, for example, instead of maybe that parent otherwise would be constantly reminding and nagging, which isn't great for either side. So this is a way that can help.

These different types of smart home equipment can also help for access to TV shows, movies, podcasts, music, radio, a lot of smart speakers. You can use them to get the news, hear a joke. It might not be a good joke, but it can tell you jokes. Also to stream different apps and things on the TV, which is really nice, having the option to do that through eye gaze or through a switch or through voice. The other nice thing is, if you're playing music or a podcast, the devices can actually provide suggestions for what to listen to next.

Use of smart home speakers and apps can be really helpful for different types, all different types of home management tasks, such as finding out information, paying bills and managing finances, coordinating transportation, managing your calendar, and creating reminders and lists. For example, you could create your grocery list just using your voice and have it show up on the smart display, and possibly even use an app to order groceries through the smart display.

You can also use smart speaker and/or various smart apps to make grocery lists. And-- I said that. I'm sorry.

You can also have it send a reminder before an appointment, or when it's time to leave to get somewhere. And smart vacuums and mops can ensure messes and spills are cleaned up right away and clean the floors on a schedule. So if you want it done every-- if you want the vacuum to go every day at 4:00 PM, you can set it once and it'll go every day at 4:00 PM. Automatic food and water dispensers can also that only need to be occasionally refilled can also be helpful for taking care of pets.

There are also smart plugs that can turn most simple, not smart electronic devices, if they have a simple on and off like a coffee machine, if you plug it into the smart plug, it becomes a smart home tool.

There are also smart larger appliances, like smart fridges, smart ovens, and stove tops. These tend to be more expensive and sometimes just something to keep in mind, the technology that makes them smart may not last as long as its not smart counterpart, meaning they may need to replace the entire appliance sooner if the chip inside of it dies. So that's just something to keep in mind.

Smart speakers and displays can also connect you to a variety of other smart devices. If you do have a display and you have difficulty with your vision, it can be helpful for Alexa has something called show and tell. There's an app called Be My Eyes app, and they can actually use the camera inside the smart device. If you put an object in front of it, it can verbally identify the object.

So this can be used to help streamline your schedule. I just wanted to talk for a minute about automation and routines. So automation is when you set the time and schedule for a smart device. And it just goes, like I was saying with the smart vacuum, if you want it to run every day at 4:00 PM, you set it once and it goes. You set your alarm clock for a certain time five days a week, it's done. It stays, it goes.

While routines, for this, one command can trigger multiple smart home devices to take actions. So if an alarm goes off to wake you up in the morning or you a smart speaker reports the weather and the appointments you have that day, smart coffee maker turns on, all of that can happen with one trigger. Or at the end of the day, if you say, Alexa, good night, maybe that cues other smart home devices to turn off the lights, turn the overhead fan on, and turn a white noise machine on. So it's really nice having that option to really set up routines and make it all smooth and connected.

So just figured I'd walk you through a little possible smart morning routine. Just an example of how it can enhance that routine. Say I wake up in the morning. I use the wake word, Alexa, and say, good morning, Alexa, good morning. This triggers my smart speaker to tell me the weather, whatever appointments and meetings I have scheduled for that day. And also, my coffee machine turns on and all that happens with just the one trigger.

I may also have previously set up smart home features on an automatic schedule, so I have my reminder going off to take my medication. I do that, and then if I'm losing track of time, I can have the smart speaker send a voice alert out and a message to my phone saying, 30 minute warning to go to work in 30 minutes, and then again at 15 minutes, it can tell me. So do I need to go in 15.

The watch, so having a smart watch can be especially helpful for this. Say I'm in a different room than where my speaker is, so I may have forgotten my phone somewhere and don't have the speaker in the room. I will still get the alert because of my watch. And then when I do leave for work, I can double check on my phone that all my kitchen appliances and lights are turned off and my door automatically locks. If I need to go back in because I forgot something, maybe I can just use my fingerprint or a code on my phone to quickly go back in and grab whatever it is.

So I know that's a lot of information, and there's a lot of devices out there. So it can be a little overwhelming where to get started. It's OK to start small. A lot of people start with just either like a smart speaker or a smart display, since there's so much you can do with just that, and then can grow from there. It does get more complicated as you add more devices, because you do have to be really thoughtful about device compatibility and make sure they work together.

So as you consider what devices might be best for you, you really want to think about what you want to accomplish, where in your home you want to accomplish it, and what features you need. The Smart Home Made Simple website has a really nice assessment guide that walks you through with a bunch of questions and checklists to help you determine that information, and also to figure out the compatibility, all the different pieces. And I'll show you an example of that at the end.

So this I did take right from the smart home website. I thought it was a really nice and helpful list of the basics of what you need to install, connect, and set up your devices. You do need a mobile device. While a tablet can work, a smartphone tends to be preferred. It's more secure, and there may be features that you can't get on a tablet that you can on a smartphone. And you want to make sure you have the latest version of Android or iOS, the Apple operating system.

You definitely want to make sure you have a dependable Wi-Fi internet service at the location where you want the device to be installed, and there is a Wi-Fi extender, if needed, for internet access in certain places.

You also need access to your router, its ID and password, and a system for creating and managing multiple secure passwords. Fortunately, there are apps that can help with that.

And you may need somebody to help you, either you or someone else who has the comfort and ability to install and support the devices. This might include rebooting the router, plugging devices in, and understanding how devices connect to Wi-Fi.

You also want an understanding of the limits of your home construction, electrical system, and internet connection. So you want to make sure your internet speed isn't too slow for it to work on. If you need something hardwired, you may need to hire an electrician, such as for a smart switch. In home construction, that might be something such as putting in a smart lock on a door.

So you can look into getting professional support if it is necessary. If you do need more, if your team, you and your team need some extra help, like I said, maybe for an electrician or a handyman to help with the construction tasks, you can find a lot of handymen through the app Handy and Angie's List, things like that. A lot of them are able to help with simple setup of devices and attaching, say, a smart camera to the outside wall, something like that.

Also, if you buy a device from somewhere like Best Buy or Lowe's, they may have installation service they can provide. I know Best Buy definitely does. You can also get help from professionals like occupational therapists, physical therapists, speech language pathologists, and assistive technology specialists.

If you're still having a really hard time, It's a more complex smart home setup you're going for, there are also professional smart home installation companies. You can usually find them by searching on Google. One good one in the Philly area I know is called Sun Curb.

So I also wanted to talk a little bit about funding, some considerations for that. The prices of smart home equipment can really range depending on what it is, from $20 for a smart plug to thousands for a smart fridge. If you do want to try some smart home equipment for free before purchasing, not a smart fridge, but we have smart speakers and displays and some sensors, things like that. The TechOWL assistive technology lending library has a few smart home kits that anyone in Pennsylvania can borrow for free for five weeks.

Another thing you might want to consider when purchasing is seeing if it's a one time fee or an ongoing subscription fee. Some may charge a subscription to get all the features of the device or storage, if it's like a camera and you want to store the video that it's been taking over time. There also can be a fee for some health monitoring communication systems.

Also, you want to consider if you need funding for any accessories, such as a mount for a smart display or the installation costs, like having smart windows installed or a smart fan hardwired.

Even though smart home technology is considered mainstream off the shelf, it is also assistive technology. And because of that, there are some programs that can help with funding for it, such as Pennsylvania's HCBS waiver program, as well as the Office of Vocational Rehab, if you're working with them and you show smart home equipment that it could help you at work or in college, they may be able to help fund that. The Pennsylvania AT Foundation also has an alternate financing program where they can provide no interest and low interest loans. There's also private grants out there.

So here's our contact information. Please feel free to reach out and talk to us and get in touch at any time. Now I'm going to see if you guys-- well, I'm going to show you-- I said questions, but let me-- first. I'm going to actually show you guys some of the resources I was talking about.

So this is in our TechOWL lending library. You can get a smart home kit that includes one Echo Plus and one Echo Dot, so there's two smart speakers, a smart light bulb, one contact center, and two smart plugs to try out. We also have two Echo Show displays available to lend out for free.

We also have on our website a bit more information. As I was saying, you really have to think about compatibility with devices. If you go, say, to the Amazon Smart Home page, you can find all of their Amazon-specific smart home equipment, which of course, is all going to be compatible with each other. Same thing if you go with Google Home, which is a very common one. If you go to their site, you're able to find all of their devices. And if you buy it from the same company and organization, it does tend to be easier to set it all up and have it work together.

This is Best Buy's smart home page. I just wanted to show that they are able to help with setup of smart home equipment bought through them, which is really nice. They also have some really nice resources on their page.

And here's Home Depot's. They also have some nice resources, buying guides that can provide a lot of good tips, as well.

OK, I got one more page to show you. So this is the self-assessment tool I mentioned from Smart Homes Made Simple. It starts with just a simple checklist asking about what are the daily and routine activities you want to be able to do more independently at home, and then it goes on asking about some more specifics about your disability and technology, information about your home, the areas of your home you may want to have devices in, and information about your technology brand preference, if you prefer Android versus Apple and what technology you currently have. So you can-- it makes it really nice and streamlined to be able to see it all in one place and see how it'll all work together.

And this is something, along with the Smart Home Made Simple guide, that is available for free on the Smart Homes Made Simple website. And this was put together by the Pennsylvania AT Foundation.

So here's the table of contents. It also has that self-assessment tool right in there. And it gives information about stories from people with disabilities who have smart home technology and how they use it in their homes, as well as advice for getting started, how to set it up, where to find support, where to find funding, a lot of good tips and information in a way that's nice and accessible, which is great.

If you also go on the website for the smarthomesmadesimple.org, you can also find videos of webinars talking more about different aspects of smart home equipment and videos showing people with disabilities in their home environment, using that smart home equipment, and how they use it.

Yeah, so it has a lot of good information. Nice layout. It's easy to look at in here.

CAITLIN MCKENNY: Laura, if I can interrupt you, we do have a few questions in the chat that you might want to discuss.

So the first question, you did partially answer that, but if there's anything else you'd like to add, who could help this get this tech running smoothly? So was this something that TechOWL would guide someone with, or what would your installation options be?

LAURA SLOTKOFF: Yeah, so I see you put Sun Curb in there. They are a good resource if you need a lot more help. It depends on what type of help you need with it, I would think. So especially if you're going to borrow from us, I would think that we might be able to help somewhat. We do have a hotline number for TechOWL, and I can pull that up, if you need.

CAITLIN MCKENNY: Certainly. And especially if you're in a decision making part of your process, if you're interested in speaking with someone about access methods for your controls, if you want to know about will my AC device be compatible with voice control, or do I need an adaptation to be able to use a switch or a touch screen differently? We'd love to help you problem solve that if you live in Pennsylvania. So TechOWL is limited to Pennsylvania, but every state and US territory has a state AT Act program. And I could put a link in the chat for you to find your local program if you're not in Pennsylvania.

LAURA SLOTKOFF: Yeah, I was just going to say the same thing. And like you said, there's a lot of-- if you just get a handyman, sometimes that's all-- That might be all you need to help install it. A locksmith at this point, and most of them would probably know how to install a smart lock.

If you're renting, I would definitely say talk to your landlord if you need something installed that's going to change the environment. And if you do have any therapists who come into the home or who you see to help support you on a regular basis, they might be able to help, as well.

And we can definitely, like she was saying, help with the decision making process. And oops, sorry. Here is our number and email and chat feature if you want any support at any point.

You say there's any other questions? Caitlin?

CAITLIN MCKENNY: It looks like that was most of our questions. You already mentioned that if you are in a rental, you'll want to get permission from your landlord before making any structural changes, like installing an alternative door lock. But that is a reasonable accommodation, so they'll just let you know if they want you to uninstall it and replace the original lock when you move out.

And we also had a question about some specific devices, some interest in a smart pill box. That would be a wonderful thing to be able to try out from the TechOWL lending library or through your local AT Act program if you're not in Pennsylvania. They do come in lots of different shapes and sizes, with different functions and features, depending on if you need them to be locked or if it's OK for them to be accessible. So it's a great opportunity to use the library there.

LAURA SLOTKOFF: Thanks. Are there any devices that will allow you to amplify your voice? So we actually were just talking about it's something that I know that they've been working on behind the scenes for improving recognition of voices better. But I don't know that it's totally there yet.

CAITLIN MCKENNY: Anyone who has a low volume voice might already want to consider personal wearable voice amplifiers for conversational purposes anyway, and those same tools will also be helpful for helping Alexa hear you better, as well.

LAURA SLOTKOFF: And I do think there are some smart home features, like on an iPhone, to help with that, as well.

I know if you have a stutter or speak slowly, that can be an issue at times, that it has a set time that it listens for, and if you don't say what it's listening for fast enough, sometimes it won't catch it, which can be an issue.

CAITLIN MCKENNY: Another option could potentially be if you are using your phone, to have a Bluetooth microphone connected to your phone, so you're wearing a little lapel microphone or something maybe on a headset, and that will bring your voice directly to your phone to give the commands if you happen to be using your phone for that.

Great. Well, I will-- can we put up the survey link? Yes, you got it. You know it's going.

LAURA SLOTKOFF: Yeah, sorry. For some reason, it wasn't letting me see the chat at the same time as I was sharing my screen. So I took it down so I could read any questions and comments.

So here's the link to our survey, title of presentation, Home Automation, presenter, Laura S. That's me. And hope this was helpful. Please feel free to reach out to us if you have any further questions that we can help with.

CAITLIN MCKENNY: And there will be a follow up email that contains the materials from today's presentation, as well as a link to register for any future webinars that you might be interested in attending, such as that March 20 smart home privacy topic. We'd love to see you there, as well, so look for a follow up email sometime over the next couple of days that will have the slides from today and have a link to additional opportunities.

CAITLIN MCKENNEY: Hey, welcome. Thank you all for joining us today for the March tech accelerator webinar. Our presentation topic this month is smart home safety and supporting digital choice. This session is being recorded, and the video will include picture-in-picture ASL interpretation as well as a full transcript. You'll be able to access that on our website at Disabilities.Temple.edu. I will put that link in the chat for everyone as well. And that website is also where you can register for future webinars.

TechOWL has a wonderful series of 18 topics that began in July of 2024 and will be running through this December of 2025. They are held on the third Thursday of the month, offered at two times 12:00 and 4:00. This series is part of the Tech Accelerator program, which is an initiative funded by the Office of Developmental Programs and the Office of Long-Term Living here in Pennsylvania. This project is made possible through funding from the American Rescue Plan Act.

The Pennsylvania Tech Accelerator project includes five major focus areas-- training and resources to build capacity for stakeholders, readiness evaluation to develop tools for successful adoption of remote supports and assistive tech, statewide assessment to plan and benchmark a technology first systems change, a provider survey to assess technology and awareness among providers, and then two technology summits, which we just held as live events in Philadelphia and Pittsburgh within the past two weeks. You can learn more about all of those projects on our website.

Without further ado, I would like to introduce our guest speaker for today. So Tiffany Wilson is the owner of Wilson Inclusive Solutions, and Tiffany has over 15 years of experience in disability services and has published work on the unintended harm of smart home devices as assistive technology. So thank you, Tiffany.

TIFFANY WILSON: Thank you. I just realized I left my slides from this morning, or this afternoon's presentation if you're in Pennsylvania. So now I have the slides up and ready to go. And I want to thank Caitlin. I want to thank the Institute on Disabilities at Temple University and also the AT Act program, TechOWL, that is also housed within the Institute on Disabilities, for having me here today to discuss the importance of digital autonomy. And the presentation is supporting digital choice-- smart home safety.

Through implementing large scale assistive technology initiatives, including Alaska's Federal AT program, I've witnessed how smart home technology is changing lives. However, I've also seen complex challenges that go along with internet-based and off-the-shelf technology used as assistive technology. These situations have often caused unintended harm, and we're going to talk about that today. These experiences and observations are outlined in various scenarios, and if we don't cover a specific scenario that you're concerned about, please wait for the question and answer session and hopefully, we can get your questions answered.

I believe that the successful implementation of smart home and internet-based assistive technology requires clear professional boundaries, ones that protect boundaries and privacy while empowering genuine independence. Today, we will explore how to apply person-centered principles to digital environments, establish professional boundaries in digital environments, and connect end users with resources and supports for their digital independence. Throughout this presentation, I will refer to people receiving your support as in users.

This is to emphasize their role as active technology users with agency and choice. I'll also be using the term direct service provider or direct service support professional in a general manner, and it just means any provider who provides disability support services who is maybe not an assistive technology assessor or not within the assistive technology equipment distribution programs. So this is for more our general audience to talk about smart home safety for your participants, your clients, whatever term that you use in your program. You can access the slide by going to change ChangeAccess.com/Slides or use a QR code.

Let's get into considerations in our communication framework. I gotta say the disclaimer. If I mention the name of a product or company, all of their trademarks, names, everything is property of the owners. And mentioning it is not a specific product endorsement. Attendees, implement any strategies at your own risk and discretion, and also be aware that privacy regulations and policies vary by state, agency, and setting.

Today, our communication access framework is that all communication styles are important and welcome. We respect diverse perspectives and contributions. What may work in one environment may not work in another environment. Questions will be answered at the end of the presentation. Please direct all your questions to the Q&A section in Zoom. We'll try to grab questions from chat, but no promises as things move quickly. We will also have alternative ways for asking questions if text-based communication is not accessible to you, or if you prefer to use American Sign Language.

So let's talk about person-centered digital autonomy. Person-centered digital autonomy is a person-centered approach to digital choice. Just like we apply these principles in physical environments, care planning, and promote personal choice in person, we should also extend these same principles into the digital environment as we modernize with new technology and provide access with digital technologies.

To create this extension into the digital space, we first need to understand what self-determination means in a digital world. Simply put, digital self-determination means people should be able to use and control their own technology according to their own choices. This concept of digital self-determination was first coined by Doctor Jorn Lengsfeld It's about ensuring individuals have the power to make informed decisions about the technology in their lives rather than have others control it for them.

For this reason, I created the digital choice framework. I built it on established and researched person-centered principles, and it focuses on one fundamental principle-- end users must drive their own technology decisions. True digital support means respecting end users as technology decision makers and never using technology for control or personal convenience at the expense of autonomy. This is important as we move into talking about boundaries and implementing smart home tools safely.

First, let's just talk about digital spaces and the types of boundaries we should have. They can be less visible than physical ones. They're equally important. Just as there are clear lines we don't cross in someone's home, we need similar frameworks for digital environments. Professional boundaries and digital spaces protect both end users and service providers. These essential boundaries include account ownership.

End users should control their own accounts and login information. There should be professional separation. We should never use our personal device, accounts, or phone numbers. Our phone numbers should not be used for multi-factor authentication for our clients. We should also have privacy boundaries. We should protect sensitive information and respect digital spaces. There should be financial separation with clear boundaries in regard to purchases and subscriptions and all the costs that come along with assistive technology acquisition.

We should understand there are limits to our roles as technical supports or providing technical advice. We should connect end users to qualified or appointed tech specialists rather than trying to figure it out as a care provider. Know this-- even well-intentioned tech support can create significant risks from dependency to-- let me say that again. From dependency and all the way to privacy violations to financial entanglement and regulatory problems. I've seen it. This is far from limiting support from end users. Clear professional boundaries actually enhance support by preserving genuine autonomy and protecting everyone involved.

When we talk about privacy, we should also talk about HIPAA, the US Health care law, the Health Insurance Portability and Accountability Act. And a lot of us are bound by HIPAA, not all of us, but we should really understand and think about privacy boundaries when we're implementing smart home technology or assisting others with theirs. And it becomes very critical when we cause unintended harm with end users' private information. This technology often captures, stores, and transmits information that could contain protected health information.

It creates challenges and considerations that we should make now that we weren't having to make in the past. Now, the technology is modernizing, and we should consider how these devices send and receive data. Did you know that HIPAA identifies 18 data elements as Protected Health Information, or PHI? This includes data-- a data point is a name, a location, et cetera. It covers more than just the diagnosis. Just because you don't mention a diagnosis doesn't mean you may not inadvertently-- you may inadvertently cross a privacy or HIPAA violation.

For privacy boundaries in a digital setting, I believe that PHI belongs to the end user, and they decide how it is used and transmitted in their smart home devices. Support staff should not have independent access to digital accounts for end users. And end users, or their legal guardians, not support staff, should control account setup and management.

One example was a well-meaning direct service provider who bought iPads for the participants in their program. They thought they were being helpful setting up all the Apple ID accounts for the iPads on the behalf of their participants. And what they did to set it up without consent and without talking to their participants or about account management or anything like that, they took the protected health information from their agency intake form and created the Apple ID account without consent.

So they took private information from a disability service intake registration form, protected by HIPAA, and created Apple ID account on their behalf. For them, it was a HIPAA violation and not good practice. As support environments become increasingly digital, we must think differently about privacy protection. Maintaining proper boundaries respects and protects everyone involved. When in doubt, we should always err on the side of protecting end user privacy and refer to our agency policies. It's better to be cautious than cause unintended harm.

Now that we've examined some specific boundaries and privacy considerations, let's summarize your role supporting digital choice. Our role as direct service provider is to champion digital autonomy not control technology decisions and empower others to learn to control their own technology or have self-determination. You are, or hopefully by the end of this course, digital choice advocates. And what that means is that you promote technological self-determination and privacy practices in assistive technology implementation.

Remember, our goal is not to prevent or limit technology access or adoption. It is to support it while maintaining appropriate professional boundaries. Let's talk about specific scenarios to illustrate these principles in action and give you more specific ideas. In the handouts, you'll find a tool called the digital choice decision pathway. For the sake of time, I'll summarize it for you.

The framework assists you in evaluating a technology support requests from end users potentially cross professional boundaries. It guides you through steps with considerations about account creation, device sharing, financial handling, and information access. It's not comprehensive. It's a simple tool to help you find the right way to say "yes" while respecting boundaries and supporting digital autonomy.

Let's talk about how smart home devices are changing lives and providing access. Every day tech is becoming more popular and affordable, making it easier for people to use off-the-shelf devices, like smart home speakers, as assistive technology instead of expensive specialized tools or specialized assistive technology. There are also cell phones, smart assistants, tablets, and we're seeing more and more all of these devices being distributed in assistive technology program. Also, more and more people are able to afford it individually.

This is what's great about smart home technology. This slide shows a person controlling various smart home devices in their living room. Consider a person with a physical mobility challenges and how they can control their home and environment with off-the-shelf devices instead of costly proprietary environmental controls. The example has a robot vacuum. The individual is controlling their lights, the temperature, speakers.

And this slide shows more examples. Smart cameras can enable those with mobility challenges or limitations to see visitors. Tablets can do many things. They can control environments, provide vital communication apps. Smart assistants can support memory, time keeping, and even provide visual descriptions. Not only do these technologies offer convenient and affordable options, they can also create genuine autonomy and connection.

In the next section, we will explore common situations you might encounter and couple ideas on supporting end users who have smart home technology. These scenarios come from real life experience from various support environments. For each, we'll discuss the situation and potential responses. Again, if your situation is not discussed, feel free to put it in the Q&A or ask us at the end, and we'll see if we can get it covered.

Let's talk about account management. One of the most common boundary challenges involves managing accounts. For various reasons, end s often request or need assistance setting up accounts. And these days, there's an account for everything-- the device, the app, online services. And in my observation in Alaska, the most common reason people needed assistance was lack of digital literacy.

I've observed consistent challenges when support staff create accounts for end users. Ownership becomes unclear. Privacy violations happen. The end user becomes dependent on staff for access, and digital independence is compromised. This can be particularly concerning with accounts that require payment information, like an Amazon account that is required to use an Alexa device. Setting up these accounts for someone else creates financial and privacy boundary issues.

In one case, a well-meaning support professional created digital accounts for everyone they served, not the same one who used the protected health information. And they provided several different smart devices. When that staff member left the organization, several individuals lost access to their assistive technology because no one else knew their login information.

Let's talk about a scenario with account management. Maria received an Amazon Echo as a gift and asked, "can you just set it up for me? I don't understand technical things." What would you do? Think about your answer privately or drop it in the chat. I am locating-- there is my Zoom bar, so I can open my chat.

So A is go ahead and set it up using your Amazon account. B, create an account in her name. C, explain you can't set it up, but connect her with Amazon or other resources for digital literacy, or even possibly an AT program. D, tell her she shouldn't use technology she doesn't understand. What would you do? Feel free to throw it in the chat.

So I feel the best answer is C to connect Maria. And I'm seeing some C's coming in. Thank you for your responses in the chat. Connecting Maria with resources maintains boundaries while still providing support. A and B cross boundaries by controlling account creation, and D dismisses her autonomy and interest in technology.

Now let's talk about privacy boundaries. Smart home technologies, especially cameras and monitoring devices, they capture, store, and potentially share deeply personal information out to that device company server outside the home. Most smart devices store data in cloud services that are not HIPAA compliant.

End users can use these devices, of course, however they want. But as direct service providers, we need to be careful about using these smart home devices, encouraging their use, or setting up accounts because we may potentially violate HIPAA. Other things that these devices capture are voice recordings, activity patterns, could be eye movements for VR headsets, health data is collected. Does anybody use the Apple Watch and your health data on it? I use it for assistive technology.

In the end, it's about end users maintaining control over what devices capture their information and how their data is used. They can choose to use it however they want. But it's not up to me to decide for them or use their protected health information. So remember, this data could sit on third party servers with limited to no privacy protection.

Let's talk about a scenario. "Robert's family wants to install a camera in his bedroom to quote, 'keep an eye on him' at night. They ask for your help to set it up. Robert hasn't expressed an opinion." What would you do? Feel free to drop it in the chat.

A, install the camera since family members requested it. They should know what's best, right? B, connect them with AT specialists or experts who can discuss different monitoring options or alternatives. C, install the camera, but position it to avoid capturing personal activities. And D, tell them it's not your problem. They need to figure it out themselves.

What would you do? Yes, we've got some B's. And yes, that is right, in my opinion. Connecting the family with experts who can advise on appropriate monitoring options, talk about various tools, and maybe not-- it may not even be a monitoring option that this person needs. There's other tools that could assist. This connects them with the experts and respects privacy while fulfilling your role as a resource connector.

And I love the comment in the chat about the family needing opportunity to learn about supports other than cameras. I wholeheartedly agree. They may not have been exposed to other options. A and C violate privacy boundaries by implementing surveillance without consent. And option D is dismissive.

And yes, this has happened, and even to the point of where an assisted living home considered using smart cameras to monitor their residents. Some had guardians, some did not. And of course, we educated them and discussed with them how, in this particular case, it was not appropriate, and how the assisted living home would be violating HIPAA with a smart camera because those recordings live on the cloud. There are more closed systems, and there are systems that may offer more strict privacy protections, but it's really important to connect them with the right resources.

Financial boundaries-- many smart devices require payment information or they require subscriptions or ongoing purchases. Key points-- never share your payment information. Yes, it's happened. Oh, I helped somebody download an app or it's just $0.99. Let me get that for you. You should maintain clear financial separation and be cautious about encouraging purchases that has a long-term financial impact or long-term financial implications.

Are you encouraging someone to use their funds in a certain way? Even well-intentioned financial entanglements can lead to complicated situations that blur professional boundaries and potentially violate organizational policies. Let's consider the next scenario. James asks, "can you just help me set up my account and figure out how to pay for apps on my iPad? What would you do?

A, set up the account using his credit card information. B, connect him with appropriate resources or supports to learn how to get assistance for creating the account or learning how to set up an account from Apple, like the Apple Store. D, create the account, but tell him to add the payment later. So you don't touch his financial information. D, set it up using your card until he can add his own. Access is access, right? I'm seeing some B's.

Yes, yes, I believe that the best answer is B to connect James with resources maintains financial boundaries while providing support. It keeps payment information separate while ensuring James gets the assistance he needs. A and C cross boundaries by directly handling account and financial information, while D creates an appropriate financial entanglement by using your own payment method.

Let's talk about tech support boundaries. As digital environments become more complex, there's often pressure to solve technical problems for individuals who are still learning about technology and increasing their digital literacy. However, we must recognize when these technical problems may beyond our role or expertise to provide support.

The key principle-- know when to refer to specialists. Ensure information stays with the end user. Understand the limits of your technical role. Just because you understand something does not mean it is your role to assist technically.

In most situations, it can be best to connect folks with appropriate resources that increase their independence and their learning for digital portfolio-- managing their digital portfolios. This is often more empowering than implementing solutions yourself. Account ownership and digital portfolio management are fundamental aspects of digital autonomy and literacy.

Let's consider this scenario. Susan has forgotten her email password again. She asked, can you just create a new account for me and just keep the password? It'll help me out in case I forget it again. What would you do? A, create the account and store the passwords securely somewhere. B, create the account but have her store the password securely. C, recommend specific password solutions. D, connect her to her natural supports in her life or other resources.

Oh, the answers here. We've got D. Yes, the band's best-- I believe the best answer is D to connect Susan with digital literacy resources or AT specialists or other natural supports or guardians can maintain boundaries and respect her autonomy while still ensuring she gets proper assistance. A and B cross boundaries by creating and managing her account. C crosses a boundary by making a specific technical recommendations that may not match her needs or abilities.

Also consider this-- many service providers and assistive technology assessors recommended the password management tool LastPass. Guess what? LastPass had a privacy breach in 2022. Could we potentially be held liable or accountable for recommending a tool that became insecure and experienced a privacy breach?

That is something that we should consider, and allow the other person to make their own informed choice about the appropriate tools that they need. And AT centers and other supports trained in that will be helpful-- be able to help the individual make that determination.

Which brings us to our next slide. You have a lot of excellent resources in Pennsylvania. It was really great to work with Caitlin on this, to put it together. In the handouts, you will find the full document.

And for here, I'm just going to be brief, but the document has contact information and websites. Because I know it's difficult to watch someone struggle, and we do want to create digital autonomy, and we want to improve digital independence-- excuse me, access for digital autonomy. And we can do that by connecting to resources.

So in southeast Pennsylvania, you do have your digital navigator programs. Their website isn't currently working, but you can connect with 211. There's Computer Reach in western Pennsylvania. Online programs, local libraries and community centers. And it's really important that individuals understand their technology, they understand their accounts, and we raise the digital literacy. Well, I would say everyone, but I also believe that it's very important that if we're providing devices or supporting devices, that's digital literacy and autonomy, very important.

You also have your assistive technology resource center through TechOWL or your centers across the state. And then TechOWL holds the assistive technology program funding through the federal government that allows them to provide free demonstrations, loans, and awareness about assistive technology for free statewide. So when in doubt, you could call your AT program, and they may be able to direct you to the right resource. But they're also a great local support.

The technical support section does not have specific phone numbers or websites. It can vary by device. For instance, there's manufacturer specific support for devices. If somebody needs assistance for setting up an Amazon Alexa account, have them call-- maybe one option is having them call Amazon, and have their customer service rep assist them with help setting it up.

For instance, I attend these assistive technology conferences, like CSUN, in California. And all of these companies, like Amazon and Google, are there telling us about their accessible customer service options. Let's try them out. Let's help Amazon be better and more accessible. So let's work together to increase literacy on all sides. There's also repair-- authorized repair locations, specialized accessibility helplines. Excuse me. Excuse me.

Companies like Apple, Microsoft, Google, they have accessibility helplines. Some of them even have partnered with apps like Be My Eyes to also provide visual access or direct calling through Be My Eyes for support. The power of these resources isn't in handling technical issues yourself but in connecting end users with the right expertise to maintain their digital autonomy. This approach empowers independence while respecting professional boundaries.

In closing, please remember the goal isn't to avoid technology or not promote smart home technology or say that it's bad. The goal is to empower digital autonomy. By understanding these digital boundaries and having resources ready for referral, you become true digital choice advocates, and you champion digital autonomy.

Remember, unintended harm is still harm. Let's work together to promote and empower digital autonomy while reducing the potential harm to those we support. Brings me to the question slide. I'm going to describe the slide and the process, and then turn it over to Caitlin to manage the questions.

So the communication framework-- your communication and your questions are important to us. We offer two ways to ask questions, through the Zoom Q&A or you can ask it live, if you prefer an alternative to text-based communication, or if you would like to use American Sign Language. We'll rotate between these methods.

If you would like to ask a question live, please follow these steps. Use the Raise Hand tool and wait for approval. If you're unable to use the tool, please connect with Caitlin. Once you are approved, please turn on your camera to ensure lip reading access for others, if you're using your mouth to speak. Keep your question brief and allow time for processing. And after asking your question, please turn off your camera and microphone unless instructed otherwise.

Sometimes I might want to ask you more questions. I'll ask you to stay on the line. The Zoom, I guess it's not the line. You can find my contact information by using the QR code or going to the website. pxl.to/Tiffany. And if you would like a certificate of attendance for this session, please email Questions@ChangeAccess.com, and we'll be happy to send you one next week. Over to Caitlin.

CAITLIN MCKENNEY: Wonderful. Thank you, Tiffany. So I don't see any text-based questions coming in through the Q&A or the chat yet. Let's see, does anyone have a question that they would like to raise their hand to ask in person?

And we have a little bit of time here, so if y'all want to chat, I'm here. Tiffany, I have a question for you.

TIFFANY WILSON: OK.

CAITLIN MCKENNEY: We discussed a little bit earlier today the different policies that smart home speaker companies, like Amazon and Google, have regarding storage of data. In terms of figuring out when they're listening or not listening. And I know that some of those change relatively frequently. Amazon seems to be just changing theirs. Some point in the next couple of weeks, sometime this month, they're going to be changing it so that you can no longer opt out of sending your requests to the cloud.

Is there a good way to keep on top of that stuff? How often do you recheck the privacy settings? Is it every time you install a device for someone? Or how do you keep on track of those?

TIFFANY WILSON: That's a great question. And you're asking from the perspective of an assistive technology provider?

CAITLIN MCKENNEY: Right.

TIFFANY WILSON: OK. Great question. And so you're right. It looks like you stay up on the news. I just read that article too. So with devices, we're not-- they're not necessarily bound by regulations in the way they implement their privacy practices.

And so with that, that means a lot of these devices are not secure. And in the past, smart home-- the smart speakers and these companies we talked about Amazon, Amazon would say that they did not save the recordings and that it would only be activated on the wake word. And we're learning in the news recently that these companies are changing their policies.

And because they're private companies that are selling us a product, they can decide their own privacy practices. And they are not medical devices. And so, to answer your question, Caitlin, what I normally do is I try to follow any newsletters I can find from the company or notifications. There are some companies that every time they have an update, they'll email it out what the patch is, what the update is.

You could check their current privacy policy practices. And so what I would do is I would also flip that in more learn where these companies host their privacy practices, and do they offer it in plain language? If they don't, can you take it and put it into plain language and understanding it? And honestly, they could change it tomorrow.

They could tell us, they could not tell us. And so instead of getting into the details of what parts are protected and what's not, it's best to just say that smart home devices are not secure, and they don't have robust privacy practices, and that we encourage individuals to learn what that means. As an assistive technology provider, I have used more plain language tools to explain privacy practices. But you also have to be careful interpreting these practices because then you might be interpreting wrong.

So I know that there's not a black and white answer, but I think it's more looking at smart home technology is not secure. Cybersecurity professionals will tell you that. And I think it's just a good rule of thumb that people know that. And then you just explain that "not secure" means that their information is not in a contained environment in their home. And that it goes out to the company and may live there, we don't know how long. And that is a risk that they take.

CAITLIN MCKENNEY: That's a fantastic answer. Thank you. Tiffany, I think seeing all of these different updates tempts me to get into the weeds with making sure that I know all the nitty gritty about it. And it's really much simpler to just make sure we all know that it's not perfect.

TIFFANY WILSON: Yes And I did try to get in the weeds. And with each company changing, and it varies why, there is a website I recently learned about-- I haven't used, but I'll send it to you, Caitlin. And this company claims to take terms and conditions and put it in plain language.

It's a tool for people to use. I haven't used it and people would have to use it at their own risk. Although I do caution being careful because terms and conditions are potentially legal agreements. So if you're setting up an account on somebody's behalf, you may be potentially agreeing to something legally for them. Or if you decide to explain terms and conditions to someone, are you potentially explaining a legal document to them? And is that appropriate? So those are other privacy considerations for terms and conditions.

CAITLIN MCKENNEY: Does anyone else have a question or a scenario they wanted to share and get an opinion on? Well, you do have Tiffany's contact information here on the slide and on the link in the chat. You all have my contact information as well from the Zoom registration, and you're more than welcome to reach out to TechOWL if you're in Pennsylvania or to your local assistive technology ACT program if any questions arise for you later and you're looking to continue this conversation.

Thank you all so much for joining us today. And, Tiffany, I really appreciate your time here. Thank you so much for having this conversation with us and providing these resources.

TIFFANY WILSON: Thank you. And thank you Temple University and everyone for attending.

CAITLIN MCKENNEY: All right. Have a good evening.

KIRK BEHNKE: Thank you for joining us this afternoon. Thank you for joining us today for our June Tech Accelerator webinar. My name is Kirk Behnke and I will be your moderator for today's session. 

Our presentation topic this month is Tools For Hearing. This is the first session of our current series, which is called Tools For Employment, Independence, and Socialization. So we'll be having tools for hearing, we'll have tools for vision, we'll have tools for reading, and then we'll also talk about switch and switch access. 

This session is being recorded and the video will include a picture in picture for American Sign Language translation, as well as a full transcript. You can access that video on our website at disabilities.temple.edu. And I will put that link in the chat. That website is also where you can register for future webinars. 

TechOWL has a wonderful series of 18 topics, which we have run from July of last year and will continue through December of this year. Each session will be held twice on the third Thursday of the month and offered at two times, one at 12:00 noon and then one at 4:00 PM Eastern. Both the sessions will have the same content, so you can attend whichever one is most convenient for you. 

This series is part of the Tech Accelerator program, and this is an initiative funded by the Office of Developmental Programs and also the Office of Long Term Living here in the Commonwealth of Pennsylvania. And this is made possible through funding from the American Rescue Plan Act. You can learn more about the Tech Accelerator program and the fantastic projects on our website, using the link in the chat that either I will provide or someone from TechOWL will provide. Thank you. You did that. The information will also be sent to you in a follow up email, along with the PowerPoint and any other materials from today's sessions. 

For those of you who are joining us for the first time, TechOWL stands for Technology for Our Whole Lives and is a federally designated Assistive Technology Act program serving the Commonwealth of Pennsylvania. So just so you know that every US state and territory has one of these programs, and they share some commonalities, such as having a device lending library, durable medical equipment utilization programs, and they also offer training as well as educational opportunities just like this one. So if you live, or if someone who you love lives outside of Pennsylvania, then you'll want to look up their local AT Act program in order to fully take advantage of those services within their state. 

OK, now to introduce you to our speaker. I'm sorry, I didn't even switch my slides here. OK. Now to introduce our speaker for today, Laura. Laura is our speaker, and she's been Pennsylvania's telecommunication device distribution program manager since October of 2018. Prior to joining the Institute on Disabilities TechOWL team at Temple University, Laura worked with adults and aging in long term care settings since 1999. 

She attained a Bachelor of music and master of arts in music therapy from Immaculata University. Laura also has an active role as the business manager and singer of the longest running feminist choir in the country, called ANNA Crusis Feminist Choir. If you don't know that, you might want to look it up. She is also actively learning American Sign Language, and of course, she enjoys baking traditional Italian cookies, cakes, and pastries for friends and families. So without further ado, Laura, take it away. 

LAURA GRASSIA: Hi, everyone. Thanks for joining us today. I'm just getting my slide deck up here. And as Kirk said, we will be sharing this with you after the presentation. And I just need to make this smaller. Perfect. And I'm thankful for the captioner today. I have a microphone issue during this session and I tried everything to rectify it, but I cannot. 

So again, thanks for joining us. We're going to talk about tools for hearing. Let me see. So this is me and my contact information. So email and phone numbers. So please feel free to reach out if you have any questions, concerns, thoughts or if you can tell me something I missed I'd love to learn. 

This presentation is going to be-- it has image descriptions. So I'm going to describe the slides. I also have alt texted all the pictures and images. We have a captioner. And there are other accommodations such as the CART provider and ASL interpreters. So accessibility is on point, hopefully, and is helpful to you. 

So our goals today are going to be to discover tech that can assist your approach to hearing loss. So whether it's you or a loved one or a classroom setting or a senior citizen place anywhere, hopefully this will help teach you something new or tell you about some equipment that we might have or that is available in the world. So we're going to explore a range of tools made to enhance communication, accessibility, and the quality of life. 

We're also going to learn about the practical applications of hearing tools. And we're going to make what you already have work for you. So if you have a smartphone or if you have something that's amplified or captioned, a tablet or something, this is the place for you in case you need a quick fix or somebody you encounter in your daily life could use something to help them hear. 

Some terms. These terms are going to be mentioned. Some of them are old fashioned or antiquated. Hearing impaired. That is a term that seniors or the people of the silent or golden generation use a lot. It is not the term that the youngins use. They use hearing loss. Some folks use hard of hearing. Some folks use hearing disability. Nothing is wrong. It's just preference. Deafness. Deaf with a capital D and deaf with a lowercase d. So these are all some terms that you might hear or read in this presentation. 

I want to go through some lofty things first and then we'll get to the specialized equipment. So some hearing facts. And this is from the Hearing Loss Association of America, which is hearingloss.org. And please feel free to visit the website below. They have a great knowledge. They have a great repository of data and also some suggestions. And it's just a great website and a great organization. 

More than 50 million Americans have some degree of hearing loss. Hearing loss is the third most chronic physical condition in the US, twice as prevalent as diabetes or cancer. Hearing health tells us, and that is the Hearing Industry's Association, that hearing losses associated with other common health issues, such as diabetes and heart disease, and hearing loss is on the rise and is expected to affect 2.5 billion people worldwide by 2050. 

So when granny told you to lower the volume on your headphones, she wasn't wrong. So make sure you practice that hearing safety and turn down the headphones. Turn down the music. Your hearing is very important and it doesn't last forever. 

So some impacts of untreated hearing loss are avoiding and withdrawing from social activities, reduced alertness, and increase risk to personal safety. The number one way I could tell if I had the attention of my seniors and my activities is if they were nodding off, then we would check the hearing aid or I would move closer to them and they would be wide awake again. So that's an important tell. 

Impaired memory and the ability to learn new tasks. You might be irritable. You might be angry or frustrated. The people around you might be that way as well, because they can't communicate properly with you because you can't hear. Fatigue, tension, stress, depression. This is a loss. So hearing loss means all these things could happen. 

Social rejection, loneliness, and relationship strain. When my dad's hearing aids are not working correctly, my mom is the first person to know and the first person to tell him or yell at him, I should say. It can reduce job performance and it diminishes psychological and overall health in general. So betterhearing.org, that is that Hearing Industries Association, they have some great resources. I put the website at the bottom for you to review. 

I'd like to talk about now the Telecommunications Relay Service. And it's commonly referred to as TRS. And that is a well established system in telecommunications. So telecommunications is communicating distantly. So not face to face. It is through the telephone, through the internet. And that could be a video, voice, or text message. It allows people who are deaf, hard of hearing, deafblind, or have speech disabilities to communicate with standard telephone users through a communication assistant or artificial intelligence. 

And AI, Artificial Intelligence, is kind of newer. It's within the last couple years that people have been-- manufacturers and the creators of equipment and apps and things have been using that. Most commonly, AI is like Google Live Transcribe. But we're going to get into that. 

So this is right off the FCC's website. So the Federal Commission on Communication. So this is offered federally. So not all of the services are in each state, but most of them, like the traditional PTY based TRS's, and that uses a teletypewriter, a TTY. And that's for text communication relayed by the communication assistant. So TTYs are kind of becoming extinct in the world, and that is because the analog copper lines are disintegrating and there is no push to service those lines. 

Now the push is to go to a digital line such as fiber optics. There's also satellite. There's a whole bunch of other types of digital services for telephone lines. This is a problem because there are still folks that use TTYs. And we do have an option for those folks if they want to learned something new, and that would be a wireless device, a cell phone or a tablet. So we'll get into that. 

The next one is voice carryover, so VCO. It allows someone who has a hearing disability to speak directly and receive text responses from the communication assistant. Hearing carryover is kind of the opposite. It allows someone with a speech disability to hear the conversation and type their responses, which the communication assistant reads out loud. 

Deafblind service allows people with combined vision and hearing loss to place and receive telephone calls. So DBS users type their messages and read the other person's responses typed by a communication assistant on a Braille display. So this service is for people that have both combined hearing and vision loss. And they use a Braille display. So they have to know Braille. 

Speech to speech. That's when the communication assistant who is specially trained to understand speech disorder, that person re-voices what the caller with the speech disability is saying so that their message is understood by the other person on the line. 

Video V-- sorry, Video Relay Services, VRS, uses video conferencing for ASL communication with the communication assistant who acts as an interpreter. So there are video phones and there are specialized equipment for this type of service. Now there's an app for that. So there's quite a few apps and we'll get through them at the end of the presentation. 

So way back I think in the 20-- not sure exactly when, but at least by 2015, internet protocol caption telephone services and internet protocol relay services, IP relay, these were introduced. So this is a specialized piece of equipment and it uses internet connectivity. So whether it's ethernet or hardwired or Wi-Fi to provide captions of the other party's conversation, allowing the user to simultaneously read and listen. That's so that they don't miss any words that they hear. So it's pretty important for understanding. But IP, Internet Protocol, is all through the internet and not through the traditional telephone lines. 

So if you'd like to learn more, Pennsylvania's relay service is provided by Hamilton Relay. And they have a website and you could search PA relay or dial 711 if you have to call someone with a hearing disability. What's wonderful about the communication assistance is if you've never used relay services, they will tell you how to do that before the call is placed. 

So I think that's a really amazing thing, because there is a special, I don't want to say code, but it's a code, to use that service so that you know when to stop talking or even to end the call. So that communication assistant is very helpful. This service is 24 hours a day, 7 days a week, 365 days a year. So they never take a vacation. There's always someone there to answer the call. 

All right. So if you have any questions, please put them in the chat. And then there will be time at the end so you can ask your questions by voice if you prefer. So we're going to discover tech right now. And device demonstrations are available at your local assistive technology resource center. So if you wanted to compare and contrast devices, you would be able to make an appointment and try those devices. 

And if you wanted to further try them, you could borrow equipment from the statewide lending library. So we have a statewide lending library. Every state does. And that library can provide you with specialized equipment. It's shipped to your house. You can use it for five weeks and then you would send it back. And this is kind of like the try before you buy process. I think it's a great idea so that you're not buying all this expensive equipment and then it doesn't work for you and then what do you do with it. 

So next, you could ask your primary care physician or see an audiologist. Audiologists can be nestled in the ear, nose, and throat doctor's offices. They have experience with equipment and they might have referrals. So it's a great resource there. 

And finally, you can join a support group and crowdsource. So support groups for hearing loss. They are the Hearing Loss Association of America, HLAA. They provide regional support groups and events. So you could look on the HLAA website and find a support group near you. You might just catch me or one of my colleagues chatting with them as well. We do a lot of presentations with those groups. 

So I wanted to include this slide, hearing tests or audiometry, just in case. Or maybe hold this in the back pocket in case this potentially would help you. Now, in this picture, I picked this one because I figured a few folks on the call might be on here who went to school in the '50s and the '60s. This is a woman who is working her audiometer. And she is sitting across from a child with headphones on, and she's adjusting the dials and hoping that the child can hear the different frequencies. 

So I'm sure that you've had this done at school. So these types of tests evaluate your ability to hear, and they can also detect what type of hearing loss you have. So there's mild, moderate, and severe. There is also profoundly severe. But we're just going to go to the severe level at this time. Audiologists can recommend treatments like hearing aids and cochlear implants. 

Most people in the US have had hearing screenings during their lifetime. So you might not remember this one, but right after you were born, you had one to confirm whether you could hear or not. Children as part of their well checks or at school. And I remember distinctly at school, even though I went in the '80s, we had hearing tests in grade school or elementary school. And adults. So if you have an issue with hearing, you can hear people talk, you have to turn up the volume on the TV or radio, it might be time to go get a hearing test. It's always good to have a baseline as well. 

So the audiologist has a certain amount of tests. They have types of tests that you can learn about. And so pure tone testing is pretty common. And this finds the quietest volume that you can hear. And that's the one where it's the high and the low frequencies. And you raise your hand if you can hear them. There is also bone conduction testing. And this shows any issues with the tiny hairs in your cochlea. So it sends vibrations to the auditory nerve and then they hopefully will go to the brain. 

Speech testing shows how you understand speech. So this one was a great one for me, and it showed that I did not understand speech. So you're given a whole bunch of words and you have to say them back. And sometimes you hear them. Sometimes it sounds like Charlie Brown's teacher. So auditory brain stem response checks the connection between your inner ear and your brain. Otoacoustic emissions checks inner ear function. And tympanometry checks how well your eardrum moves. So I did include a source there for the Cleveland Clinic. It's a pretty good source for learning about things, medical diagnostic stuff. 

Alrighty. So now we're going to learn and explore some equipment here. Now, this is actual tactile equipment. You can touch it. You can wear it. I encourage you to reach out to your AT program in your state and get a demo and try this stuff out. It's pretty neat. 

So we have amplified phones and accessories. You'll see here that we have the Clarity BT 914 on the left. It's a cordless phone with large handset buttons and also an answering machine. So some landline equipment. It is drastically reduce requests for this type of equipment, but we still have those folks with landlines that need a little boost. 

So that BT means Bluetooth, and that means you can Bluetooth up to two, either a cell phone or a headset or something, so that you don't have to hold the handset or you can have that amplified phone call on your cell phone. So it's pretty neat equipment there. There is no talking keypad, but the buttons are pretty big, the numbers and stuff. So that might be good for someone with low vision. 

To the left, there we have that box with the strobe light. That is a clear sounds ringer flasher signaler for a landline. We see these paired with TTYs or with amplified phones. There is a speaker there on the right side with a very loud ringer. And then there's that strobe light. There's toggles on the bottom. You can adjust the tone, how many times, or the flashing pattern, I should say. And also how loud the alerter alerts. 

Down on the bottom there, underneath that signaler there is a amplified answering machine. It's a lovely piece of equipment. It amplifies louder than the subway runs. So there's also big buttons. And you also have three slow talk modes. So if you can't understand the message, you could play it again at a slower speaking rate. And if you can't understand that, then you can also go down two more speaking rates. So that's pretty neat. 

There's also an inline phone amplifier and that's that clarity telephone amplifier. It's that kind of white device with that little cord sticking up at the top. And that would bypass the handset of a corded phone. And there's that toggle there that you can adjust. This one really is only-- it really only works well with an analog phone line, those old fashioned copper lines that come from the wall, because there is a lot of static on a digital line. 

We have our tried and true up top there, the Clarity Alto Plus. It has a lovely volume wheel that you can adjust the ringer and also the voice on the other line with that little rolly volume button. And has awesome backlit buttons and a really large caller ID display. And on the right side, that is the cell phone amplifier. 

And you'll notice that it kind of resembles a handset. So that thing up top there, where you put your ear, is an acoustic cup. And it has a rubberized gasket on it. So it forms a great seal to your ear. And you would Bluetooth your existing cell phone to that. You could also pop this on the car visor and have amplified phone calls in the car. 

And we're going to go right over to our caption telephones. I'm going to go to the middle one that says, "hi, grandma, how are you?" That is the a Cadillac version of our CapTel 2400I, I meaning Internet. So this is one of the phones that requires a phone line and internet in order to generate the captions. What's really cool about it is it could be a speakerphone. It's also a touchtone phone. 

There's a way to turn off the captions if someone that doesn't have hearing loss wants to use the phone. Then there's also a one button dialing to the customer service agent at the CapTel. So it would be the PA relay or Hamilton. And they would be able to troubleshoot phone issues or service issues or something like that. This phone is very easy to set up. And it's also amplified to a certain degree. 

Now, on the left side here, we have the Clarity XLC8. And this is a voice carryover. So basically someone would pick up that handset and speak and then read the captions from the caller. This requires a phone line and Wi-Fi in the home. And it also uses the artificial intelligence. So there's no relay person. It's a completely private call. 

And it's a really great phone for someone with hearing loss. It can amplify up to 50 decibels. It rings at 90 decibels, which is when the subway passes. That's how loud that is. It comes with a little wireless hub that would hook on to the Wi-Fi at your house. So it's a pretty inexpensive way to have captions in the home. 

We also have a Clarity Alto. And that top right corner there. This one is another option for folks that don't have internet at their house. So this would work on the phone line. And on that left side, that black box there, that's called a voice to text converter. So that voice to text converter does exactly what the name is. It converts a voice to text. And that text is displayed on the screen via AI. So there's no relay person in the middle. This is a very expensive way. This is about a $1,200, $1,500 phone combo pack here. Not a combo, but a package, I should say. So this is for folks that don't want internet but want the captioning. 

Next, we have some alerting devices and signallers. So these are for folks to use in the home. So if they would need extra alerting if they couldn't hear certain things. So the first thing we have here is on the left at the top is our Bowman. Sorry, Symfon and Bellman. Or Bellman and Symfon Vibio Bed Shaker. This little square device, it's probably the size of a coaster. 

I love this device. It has a snooze tail. So if you want to snooze the alarm, you pull the tail and that will snooze it. And you can set how many minutes your snooze is on the app that you have to download. What's really neat is that once you set it through the app, you can turn off your phone, and that bed shaker will still work. So that's cool. Deaf and hard of hearing people, they put this under their pillow or under the mattress, between the mattresses, and it will vibrate and wake them up. 

Next is a bright light signaler. So this will flash. It can be hooked up to a transmitter, to the doorbell, or to a phone. So another Bellman and Symfon bright light signaler. The next device over. So that blue portion where that phone is resting is the flasher. And it rings and flashes when a notification comes through. Now that phones are a little bit more techier, it actually works through radio waves. 

So not through a digital app or something. It's a little bit primitive now. But you used to be able to plug in through your earphone jack and plug into it, and that's how it would signal. Now it just knows. It just rings and flashes. This is a really great model for-- you can charge your phone. It's not wireless charging, but you can plug it in through the cords go through that underneath part where the phone rests. There's also some settings on the side. You can adjust for the flashing patterns and the ringing signalers as well. 

So over to the right is the home aware system from Sonic Alert. This is a receiver. It can be hooked up to your smoke alarm, your doorbell, a baby monitor. So there's lots of accessories that could be hooked up. And this lets the user know what is happening around them. So if the smoke detector's going off, it will say smoke. If the baby is crying, it will say baby. So there's some other settings you can go through that. 

On the bottom left is the Sonic Alert alarm clock. So this alarm clock, it rings at-- it alerts, sorry, at 98 decibels. And it has additional accessories like a corded bed shaker. And that's all the way to the right. Also, I love this one because it has a lamp feature. So the alerting could be a lamp flashing on and off. And then if you wanted to use the lamp to read, you would just hit that yellow button that says Lamp and the lamp would go on. So it's pretty neat. We see a lot of these go out in the lending library when kids go to college, because they're not home anymore and their mom won't be waking them up anymore. So they have to get up on their own. 

And the next and final thing on the page in the middle of that bottom row is called the square glow. And you'll see in the picture there are two squares and they glow. And they also have some ringing patterns as well. All the colors you could think of. And this is a doorbell model. So the doorbell is the little black piece in there, the black button. And then there is a receiver there. I'm sorry, a transmitter. 

And you can hook this up so that when someone rings the doorbell, it will flash. There's home kits that you can hook up to your phone to alert that your phone is ringing and other accessories. So this is an amazing piece of equipment created by a deaf guy named Julio. And he's really taken deaf folks' suggestions and really made this into a really neat piece of equipment. So we also have this in our community space on campus. It lets us know when the door opens so we can serve the customer. 

So we have our assistive listening devices. And so these are some options. I'm going to briefly go through them. On the top left, we have a bone conduction headset. So the gentleman is wearing this. You can see that it's not stuck in his ear canal. It is on the outside of the ear. And that way he can hear his surroundings. So this creates a vibration in that bone there. And that's what the sounds passes through. We see these a lot used with active people, whether you're on a bicycle or running. I use these when I run and they are fabulous because I can hear everything around me. 

So these are some-- the next few items we have on the top is called the Conversor Pro Plus. And below that, we have the Bellman Audio Domino Pro FM system. So these are some devices. You place one of them where the sounds is happening and then you can hook headphones up. So you plug it into the remote. And that will put the sounds in your ear. 

So that way you can hear the speaker or the television. Some folks even wear something that's around their neck, and you have the headphones in your ears and they would hear you. I'm sorry. You would hear them. Pardon me. So these devices are usually rechargeable batteries. 

And they're pretty neat pieces of equipment. We're going to get into smartphones in a little bit, and you're going to see some other ways to have assistive listening on your smartphone. But these are actual physical devices. Some folks just like an added piece, especially if they're senior or if they're old school. They don't want to have a phone. They want to have something else. 

So this other thing on the bottom here on the left is called the BeHear Axis. And what's really cool about this one is that that little thing in the middle that looks like Pac-Man is the charging cradle. So this is great for folks with arthritis or have trouble plugging in things, like plugging into little ports. 

So this is a really great way to charge it. You would place that around your neck like a scarf and put those earbuds in, and you would be able to adjust the sound. And also mono directional and omnidirectional. So mono is one way. Omni is always. So you can adjust that as well. 

There's the next one over is great for seniors. That's called the BeHear SMARTO. And that little remote in the middle has some great big buttons. And there's some colored buttons there as well, red and green. You pop the headphones on and it's sort of like a-- it'll pick up the sounds around you. That way you can hear conversations better and things like that. 

We also have to the right is one of my favorites. It's the amplified TV listener. And that's the stethoscope style. And basically, there is a transmitter you place by the television, and that transmits the sound into these little headset, into the ears. So listening ears. There's a whole bunch of different brands. But this is the G mark brand. And they even used to make hearing aids stethoscope style as well. So I had a vet one time in the veterans hospital back in 2002, and he had this type of model hearing aid. So very bulky, but he couldn't hear without it. 

And last but not least, we have the Williams Sound Pocket Talker. And you would plug in a headset into this thing. And that little black thing on top is the microphone. And you would point it in the direction of the sound you wanted to hear, and it would amplify into your earphones. So all of this is available to borrow in the lending library at TechOWL. 

And I couldn't get away without saying something about over-the-counter hearing aids. So if you wanted to learn more about that, the HLAA website, hearingloss.org, has lots of great information. I left the website there at the bottom. And over-the-counter hearing aids, they're not installed by a hearing aid fitter. 

You find some and you put them in and you Bluetooth them to a device and that's how they work. Some of them come with a little box that you can use as a transmitter. So they come in all shapes and styles. They're also less expensive than your hearing aids that would be prescribed. They range between 250 and 1,200, $1,250. So some of them are very small and some of them are not so small. 

Now, my favorite topic is smart devices or smartphones, tablets. So they can do most of all what we talked about before here. So to the left here I have an emergency notification screen from the Android operating device. I also have in the middle there, that's the iPhone sound recognition app or accessibility feature. It's a siren, a sound that has been recognized as a siren. 

And that's how folks-- some folks don't use those bulky devices. They use their smartphone to be their ears. And then I have a screenshot of the CapTel. So this is Hamilton by CapTel app. This is a captioning app for phone calls. And this is available on both operating systems. 

So these are all the things that smart devices can do. They still can do most of it. And I put most because they can't do everything. They can't make you a cup of coffee. Or can they? I think they might. There are Wi-Fi and apps for that for Keurig and things like that. But alerting device. The smartphone has vibration or it uses flashing notifications with the camera flash. Live caption or live-- so Google Live Transcribe. 

They can caption conversations. They can caption calls. You have your personal listening device, hearing aids, cochlear implants, or just your Bluetooth headset or earbuds. I use mine all the time to listen to the television, because I can't understand. The distance from the television sound speaker to my ear is just too far away, and it just gets wonky. So instead of that, we have the earbud right in the ear, and the phone hears and transmits that sounds to the ear. 

You have voice assistants, Siri or Google. Real time text is the cell phone's way of making a TTY. So you can have AI generated captions, or you can actually have a communication assistant come in and caption that call. This is a newer option. It's not as well known. It is like text messaging, but without having to hit send. So you can't write crazy things. You have to just be direct and not delete when you want to type something, but then delete it. The other person will see it. 

There is also text to speech, speech to text, video relay services with an app, hearing devices, hearing aid compatibility and applications, and also those headphone listening safeguards. So it can be very helpful to save your hearing. 

And I spoke about this just a few seconds ago. Your smartphone accessories. So Apple has what's called Made For iPhone and then Made For iPad, iPod, MFI. So that's what that stands for. They can act as a listening device, TV ears. There's models that have noise cancellation and transparency modes so that you can run or ride your bicycle and hear your surroundings. They are more expensive, but they have a more unified user experience. 

When you go to the Android system, it's everything else. So there's no certification. They don't have MFA. It doesn't exist for Android. So any Bluetooth hearing, any Bluetooth earphones will work. There's more choices. There's a better price range, but it's a less unified experience. So sometimes those cheaper or less expensive devices, they're not as good. Sometimes the Bluetooth doesn't connect. So that's something to think about. 

Here are all the hearing aid and smartphone apps. Not all of them, but there's a lot of them. I listed them just in case you wanted to do research later. There's a lot of companies out there. So I have the black device is a cochlear implant with processor. And then on the right there, that silver thing is a hearing aid. 

And apps for phone calls and video calls. So on the left, we have Caption Call, InnoCaption, Nagish, which is a newer one, and then our Hamilton Mobile CapTel app. So this is just a couple of them. This isn't all of them. And we have the video call apps, VRS. So Convo. nTouch is the Sorenson app. Sorenson is a big name in relay video calls and things. And then there's also purple. So P is for purple. 

And finally, I want to encourage you to talk the talk. So when speaking with someone who is hard of hearing in person, it's really great to face the person at a close enough distance for them to understand you. So speak slowly and clearly. Speak loudly, but there's no need to yell. 

And when speaking with someone who's hard of hearing on the phone, you want to speak directly into the receiver. So no shoulder balancing or speakerphone or anything. You speak directly into that receiver. Speak slowly and clearly. Offer to spell your name using a word that begins with each letter. And I suggest that you learn the military alphabet. I've done that. I actually have a laminated military alphabet in front of my computer so that I can limit the pauses of having to think of what word goes with each letter. So the military alphabet that is most used in the world. 

And a pro tip when leaving your phone number on a voicemail, say each number slowly and deliberately, so you only need to say it once. I can't tell you how many calls I can't return because they either rush through the number or I just can't understand the message because they're speaking too fast. So just think everybody's hard of hearing and just slow down a little. 

Now, I'd like to open it up for some questions. If you'd like to unmute. Or Kirk, can you check the chat for me, see if there's any questions? 

KIRK BEHNKE: Sure. Michelle asks, are there any over-the-counter hearing aids available for children? 

LAURA GRASSIA: Oh, I'm not exactly sure of that. I would totally go with the primary, their pediatrician for that. I think children need that extra help. And who would pay for that? I would think that their insurance could cover hearing equipment. I just think adults are Medicare, Medicaid. They don't cover the insurance. They don't cover the hearing aids. But I haven't heard of any. Yeah, I would check with HLAA or even ask your audiologist, Michelle. 

KIRK BEHNKE: Michelle said the law said not for under age 18, but maybe it changed. Is that for Medicare? 

LAURA GRASSIA: So I know the law was from the Biden administration, or I think that's when it came into effect. But yeah, I'm not aware of any changes. 

KIRK BEHNKE: Yeah, I'm not either. Good question though. But I would also say that check with, as Laura said, check with your primary care physician. And then they might make a referral to an audiologist and/or a speech language pathologist if you feel like there's a deficit there. And then they could then either make the referral and/or other suggestions for possibly an audiogram, find out where the child is missing, any type of hearing deficits, et cetera, and then move on from there. 

LAURA GRASSIA: Yeah, I think children-- I don't think I would mess around with that, just because the impacts of hearing loss in children and their speech. And that's important to get services right away to help that so there's no delay in school. 

KIRK BEHNKE: Yeah. It is becoming a little bit more blurred. The whole over-the-counter devices that are available and the accommodations, it's one of the double edged swords about having more universally designed accommodations available to you. But then again, are those available to you at all times and all places and who will be responsible for purchasing those or acquiring those? And then also who's there for the maintenance and the follow up and all that? So that's a really great question, Michelle. Thank you. 

LAURA GRASSIA: It is, yeah. A lot of gray area. Any other questions? 

KIRK BEHNKE: I don't see any other chats, Laura. We're just right on time. So I want to thank you once again for your presentation today. It was very comprehensive and I love the flow and it was great. If you could also, our participants, if you would take a short survey, we would really appreciate that. There's a QR code there. And we look forward to seeing you at another webinar next month, in July. Third Thursday of the month. And we will be doing AT for reading, I believe. 

KIRK BEHNKE: Hello, everyone, and welcome to today's webinar from the Pennsylvania Tech Accelerator program, sponsored by TechOWL and Temple University Institute on Disabilities. We're going to give 30 more seconds to let people come in, but please know that we will get started right away. Thank you. 

OK, great. Thanks, everybody, for coming today and joining us for our July Tech Accelerator webinar. My name is Kirk Behnke, and I will be your moderator for today's session. Our presentation topic this month is tools for vision. This is the second session of our current series entitled Tools For Employment, Independence, and Socialization. 

This particular session is being recorded, and the video will include a picture in picture ASL and translation, as well as a full transcript. Jule Ann will also be highlighting a few of her technologies that she uses in her video. So if you wanted to see what she's pointing to, you would just highlight or spotlight her when she is presenting. That way you can see her and then see the PowerPoint slides as well. 

So you could also access this recorded video on our website at disabilities.temple.edu. And someone will put a link in the chat with all the resources for today's webinar. So at that website, you also can register for future webinars. The TechOWL has a wonderful series of 18 topics, which we have run from last July of 2024, and it will continue until December of this particular calendar year. 

So each session is held twice, the third Thursday of the month, and it's offered two times, one at 12:00 noon and one at 4 o'clock, which is this time slot. So both sessions have the same content. So you can attend whichever one you most convenient for you and for your schedule. 

So this series is part of the Tech Accelerator program. This is an affiliate-- sorry, this is an initiative funded by the Office of Developmental Programs and the Office of Long Term Living here in the Commonwealth of Pennsylvania. And this is also made possible through funding from the American Rescue Plan Act. You can learn more about the Technology Accelerator Program and the other projects that we have on our website by using that link in the chat. And the information could also be sent to you in a follow up email, along with a PowerPoint and other materials from today's sessions. 

For those of you who are joining us for the first time, TechOWL, which stands for Technology for Our Whole Lives, is the federally funded, designated assistive technology program serving the Commonwealth of Pennsylvania. So every US state and territory has one of these programs, and they share some commonalities, such as having a device lending library, durable medical equipment utilization programs, offers training, education, and other opportunities. So if you're not from Pennsylvania, just contact your state Tech Act program, and you can follow up with them to find out what other services they provide for you. 

So today, we are very fortunate to have Jule Ann Lieberman. She is a certified low vision therapist and certified assistive technology instruction specialist at TechOWL, the Institute on Disabilities at Temple University. So Jule Ann, I know that you will want to probably introduce yourself, so I'm going to pass it right over on to you. And again, thank you all for joining us today. 

JULE ANN LIEBERMAN: OK. I'm going to try to get over to my slideshow here. Come on. Oh, not that one. There we go. 

KIRK BEHNKE: Looks good. We're seeing it. Thank you. 

JULE ANN LIEBERMAN: OK, good. OK, so a little bit about me. Again, I have lived a life with low vision. Started losing my vision early on, in elementary school. And by the time I was in high school, I was legally blind, 20 over 200. For those that may not be familiar with that term, that think about the old eye chart, and that would be the big E. So at the very top. That would be all that I could see by the time I was 16. 

And then over time, since it is a progressive loss due to a genetic retinal disorder called cone rod dystrophy, I also have the genetic markers for Stargardt's, so I have both. Lucky me. Which means over time, I've lost more and more acuity. So now I'm defined as profound vision loss. So I can see the light on the computer here that the screen is lit up. But as far as reading any content or seeing anything beyond that, that's beyond me at this point. 

So with that said, I also then used technology going into undergraduate way back when. And the technology was pretty antique, if you look at it now. But it did provide me an opportunity to be able to read all my textbooks again, without having to hold it two inches from my nose with magnifying spectacles on. 

So it did provide me-- they used to call them closed circuit TVs. Some still call them that. They're technically video magnifiers, but they can allow to zoom in. And we'll talk a little bit more about that coming up on print and displayed on a screen. So I went from a mediocre student to Dean's list in one semester once I got the technology that I needed. 

So technology is very near and dear to my heart. And so I used technology in graduate school. I was a person that was entering as a mature person, shall we say. And by then, the computer technology caught up. So I was using screen readers and screen magnification software in order for me to access the information on my coursework, which was all online. So therefore, I had to read a lot of material and participate in discussion board threads. 

I'm married for almost 43 years now, have three adult children, and recently became a grandmother, which I'm very proud of, of a little baby girl. And so I'm, again, living life to the fullest, as we say. I've been living, again, on my own without any assistance other than from my family's support. That helps me out with some of the activities of daily living. 

But as I pointed out yesterday to one of my callers, I said, yes, indeed, I'm very fortunate. I do have the support. So when I need a ride, I can ask for a ride to get to one place to another. But I have to be careful how often I ask for help. And I don't want to take advantage of people or make them feel like I'm a burden. 

So with technology, things like using Uber, using not so much paratransit, but the regional rail system, the SEPTA transportation system, which what we have here, public transit. I've been very fortunate that as much as I can, I do remain as independent as possible. 

Then it goes into presentation view. Hang on. It didn't move this time. That's better. OK. That's me. There we go. Let's move on. 

Our goals for today. Since it's such a broad-- there's a lot. I'm sorry. I jumped past that one. There's a lot of conversations we can have about all different kinds of the technology. And since this is such a broad audience, I wanted to make sure that we try to cover everything that we needed to do in a very brief, short manner. So we're going to be talking about some of the simple adaptations that you can make, which technically sort of tools. 

Then we'll also move on to some devices, technology for reading. We'll get into technology for getting around, orientation and mobility a little bit. And so then we'll talk about some of the tasks that we can accomplish by using apps and technology, including wearable technology that's the latest greatest things that's out there. 

So simple adaptations. Sometimes the simplest things are the most effective. So for me to use my microwave, for example, I have tactile marks on the buttons so that I can find the Start button, the Cancel button, and I usually put the tack, a little locator dot, on number 5 on the keypad. That is the same parallel I use on a telephone. 

So every phone that you have will have a tactile mark. When I'm talking about the desktop phones, home phones, I'll have a tactile mark on number 5. Even some cell phones that have keypads that have the numeric keypad will have some kind of indication at number 5. 

And what that does for me is it tells me that above it is 2, on the left of it is 4, on the right is 6. So below an 8 is, again, below the number 5. So I can find my orientation very quickly. I keep getting things on my watch. I'm sorry. So hang on. Let me stop that. It's the timer. Stop. 

OK, so with that said there are some of the simple things that you can do. Yes, I do use an Apple Watch and I set a timer, which now keeps going off, and I don't know why it's not talking to me [INAUDIBLE]. In any case, we'll move on. 

OK, technology for magnification. Now, again, optical magnifiers are usually the first thing people go to. The problem with optical magnifiers is it can only magnify to the degree of the curve of the lens, which means is that you might need more than one magnifier. For example, your medication bottles may have font in 0.4 font size. And your newspaper, for example, might be in 10 point font. So with that said, you would probably need multiple magnifiers to get to the size that you need to be able to read it effectively. 

So what technology does in our magnification devices, it allows you to zoom in. And you can also use your smartphone to zoom in by using the camera on the smartphone. There's also specialty apps that can do that. There's a whole plethora of apps out there for persons with vision loss. And I'd be happy to share that if you contact me directly rather than going through each one of them. 

But to give you an example of the devices for magnification, I put them in two different categories. The first one is a portable device, and I'm going to hold it up. This is the Ruby Video Magnifier. This is a portable device. I opened up the handle. 

And when you open up the handle, it becomes a variable magnification device, which means you can put it closer. It zooms it in. You pull it away. It makes it smaller, which means you can find more on the page. The larger you make the magnification, the less you're going to be able to see on this little screen. 

But it's perfect for things like reading price tags, reading short passages, looking something up in your cookbook, for example. I used to say phone books, but they don't make them anymore. But they give you an idea. 

You also can change the color contrast. Some people with low vision do better if they have a black background with white letters. You can also make it full color. You can also make it high contrast white with black letters. And there's also some other color options on there. So you can switch that out. 

You can also change the magnification. I'm going to turn this upside down here. You can also turn the magnification level up by pressing one of the buttons that will increase it. And it then cycles all the way through four different sizes. 

You can also then freeze the image as well, and that image then will remain on the screen until you, quote, "unfreeze" it. That's really helpful if you're looking at something at a distance like prices on a shelf at the grocery store. You can snap the freeze image and then bring it closer to you. It also will still magnify if you increase the magnification at that point too. So again, handy for things like menus, reading short passages in a book. Reading for long periods is going to be very tedious, as you'll have to move across the screen in order to get all the information depending on the size of the magnification at one time. 

If you do fold the handle down, as right now, you can lay it flat, which makes it a little more comfortable. Because if you do have the handle extended, it will keep trying to refocus, which might get blurry. So I usually tell people, if you're going to be reading for more than a spot check, then you may want to put it in this position so that you're able to move it across the page more effectively. 

The next one I have here is-- and there are multiple devices in our lending library that you could try out if you live in Pennsylvania. This particular one is our Ruby 10, which includes OCR. I have it upside down. Here we go. And what it can do then is it can snap a picture of the image that you want to take as far as text, and then perform what they call optical character recognition. 

So it takes that picture and then turns it back into text that can be read aloud on the screen. It also can be magnified and you can move across the screen using the cursor arrows should you need to move it that way. So it does provide an awful lot of flexibility. This is something that was something I dreamed of maybe 10 years ago, that they would have something portable that can do the OCR. 

Now, you also can do that on your phone. Some of the apps that are very good at that are Microsoft produced one called Seeing, S-E-E-I-N-G, capital A-I. That's a free app on both Android and iOS. We also have one called Envision. And Envision does similar things that the Seeing AI app, also available on both Google and Android. So yeah, Android and iOS. 

It also has-- one of the nice things about Envision is that you can also export what you've read into another app. So in other words, if you wanted to save that priceless letter that you won that sweepstakes, which I know we still get sometimes, then you can actually save it as a file on your smartphone to read it later. So there's a little bit more flexibility with Envision. 

I just had students evaluate that in my course that I was teaching, and they actually found some of the features of Seeing AI a little bit more user friendly, but they liked some of the extra features that the Envision app had as well. So again, there's a lot of ways to get around reading with large print and magnification as well as having it take a picture and read it back. That's called audio supported reading. 

OK, so I do have a picture of the Ruby here. By the way, if you do need accessible content, the PowerPoint does have alt text included in it, so it does describe it. The second image on here is the Topaz desktop video magnification system. They've come a long way since 1975, trust me, where it took up a whole desk. It was two separate devices. 

Now this particular one is in something called an inline system. So the camera is underneath the monitor. The tray below is where you would place the object that you want magnified, including text. The tray, they call it an xy table, and that can move forward, up and down, right to left so that no matter what size magnification enlargement you're using, you'll be able to follow the line of text that you're reading, for example, or examine an image. I like putting pictures of my grandbaby under there and making her real big and cute so I can possibly see some of the image of her on the screen. 

And audio and Braille technology for reading. Sometimes it's just better to listen to something, especially if you're listening for something for a long period of time. And also the Braille technology. Braille is very important for literacy. I like to emphasize that. Unfortunately, I don't read Braille. I have neuropathy in my fingers at this point, so it's a little hard for me to decipher all the Braille cells. 

But if you have a young person, I highly encourage them, even if they have low vision, to learn how to read Braille, because it does make a big difference in the long run, especially if you have a progressive vision loss like myself. And it's not dead. Braille is not dead. Now, with Braille technology, you can take advantage of using Braille, which is, again, includes things like punctuation, whereas an audio recording will not do the punctuation for you. 

So with that said, there are some of the great options out there now for technology, some of which can be paired with a phone or connected to a computer so that you have the advantage of having the refreshable Braille display. You can follow the Braille along the line of text. 

The Talking Book players. Again, I've been a member of the Talking Book program since probably 1974. So the equipment over the years has changed dramatically. Right now, they have a digital player, a Talking Book player, and they also have options where you can download from their mobile website on your phone, as well as on a portable player. And I'm going to show you first the one from the Talking Book program that you receive. And this is, again, provided by the library service. 

What's great about this device is that the buttons are very tactile. They also, if you just put the power button on and don't insert a book, it will read the-- I have it upside down. Thank you. It will read what that key does. What's great also is that it has a sleep timer. Some of us fall asleep while we're listening to books, especially when we're tired. So often you can set a sleep timer there so it can turn off automatically, so you never lose your place. You can also insert bookmarks on it. 

It has volume control. The speaker on this is very good. It also has tone control. Some people hear things better if, indeed, it's a different pitch. Children's voices that are high pitched, for example, may be harder to understand, especially as we age. So you can lower the tone of it. You can also change the rate of speed that it's read aloud. People that have been listening to books as long as I have, have a tendency to make it faster because our comprehension by listening has gone up over the years. So that's the one from the Talking Book player. 

The books come in a cartridge. And that can be sent to you, again, free of charge by the US Postal Service. And as soon as I get there. And it comes in a container like this, which would have your name on it. When you first receive it, you flip the card over, then it goes back to your library. This is an example of a cartridge that comes in it. And a lot of the libraries go typically would be one book on the cartridge. 

But you can also request multiple books be put on the cartridge, and you can navigate using that player. You can't put it in wrong. There's only one way that will fit in, and you slide it in the slot on it. And also it has that little finger hole here that persons with physical motor control disabilities or arthritis, like me, can actually find it and pull it out easily. 

The Talking Book program recently, in Pennsylvania, it's called LAMP, Library of Accessible Media Pennsylvania. And so it's open to anybody that has a print disability, a physical disability that makes it difficult for you to hold or read a book, a regular book. So there are a lot of opportunities now for people expanded access to reading these books. 

I have a portable player that happens to be mine that I like. I have a joke that I like to say, so I hope people aren't offended. I was at a conference years ago and I demonstrated three different Talking Book players, portable ones like this one here. This happens to be the Victor Reader Stream, I think version two, I think they call this now, and it's the latest edition of it. And at this conference, I was explaining that I like different aspects of each one of the book players out there. Some are better at recording. Some can do navigation in recordings. So there was a lot of different features of it. 

And when I was asked at the end when I opened up the questions, I'm pretty sure it was the vendor or the manufacturer, asked me which one did I like the best. And I said, I like all of them, for different reasons. However, I said, I'm married to a man named John, but I sleep with Victor. So in other words, this is on my bedside. So when I can't sleep at night, something will wake me up. I can go back to sleep listening to a book. 

So again, these also have sleep timers on it. So it's a really very useful way. I download books either through my computer for the website, which is BARD, Braille and Audio Reading Download service, the Talking Book program. Or I can also use this as a Wi-Fi capability. I can download the books on there. Now, you have to be a member. But again, the membership has now been expanded. 

Another nice thing about these players, this particular player, is that I can add Bookshare books to it. And in Pennsylvania, if you're a member of LAMP, you can get your Bookshare books without a membership fee. You also can listen to NFB Newsline without any type of fee downloaded right on this particular device. So those are some of my favorites. And yes, I read an awful lot of books. On my last vacation, I read three books in two weeks. One was 17 hours long. So I do like to use these players. 

Now, that has examples of the Braille technology. It's a Braille display. They all have Braille keyboard entry options in there, which is the Perkins style keyboard, which is the six keys plus you can add an eighth or eight keys for computer Braille. It also has navigation cursor movements so you can move across the line. 

Typically they're single line. There are some new devices coming out, one of which is from American Printing House for the Blind, which is known as the Monarch, which is a full page of Braille. It doesn't have the pins that pop up like you do on these Braille, but it's more of a membrane that you can feel the Braille cells. It also allows you for tactile graphics as well. But currently right now, these devices are what's available in our lending library, as well as options for people to, again, obtain them through whatever assistive technology program is there. 

The other device that I have is from the library, if I can find it. Yes. Here we are. This is one that in our lending library is called the Orbit Reader. It can read the books from the Talking Book program. I always turn it upside down, because I don't have the display, which would be down here. The refreshable Braille would be on here. 

You can download books directly by using their Wi-Fi. You can also connect it to the computer and then download books like I did with the audiobooks from the BARD website. And also there are ones that the libraries do provide. In Pennsylvania, they're providing the Zoomax version. There's also the HumanWare version that other states are providing. So it kind of depends. Check with your national Talking Book program in your state to find out what particular device would be available. 

But it's really nice, because it's pocket size in some ways. Well, I guess you need a big pocket. But you can put it in your purse or your backpack. And that way when you get stuck at the doctor's office, like happened to me two weeks ago for two hours, I could be entertained by listening to a book in my case. Or someone had a one of those Braille devices, they can actually be sitting there reading. Just like someone else picks up a magazine, you can be able to do that with these particular devices, portable devices. 

So I mention the Kindle here because some of them do-- well, all of them have display options in the books. And that means that it can make the print larger. It can also make the spacing between the lines bigger. It also could do contrast settings. So the persons that like that black background with white letters can benefit from a switch in the contrast. That also has on, not all of them, however, but some of the Kindle devices have what they call voice view, which means its text is speech. 

So it would read the menus and it will read any of the content that's been allowed through digital rights management to be accessed using a screen reader. So not every book on the Kindle store has that capability to be read aloud to you with voice view, but more and more are available. So that it's something to take-- if you have a Kindle, especially if you need the text to speech, to give it a try. 

They don't have a speaker jack on these devices anymore. However, if you use the Kindle app on a tablet device, then you can, obviously, if it has a speaker jack, excuse me, a headphone jack, you can attach it that way. But what you can do, though, and one of the recent advancements in these Kindle devices, is that once you pair Bluetooth headphones to it and now when you power it on, it will find, as long as the headset's turned on, headphones are turned on, it will find it. 

Previously, it was one of those things you had to keep it powered on in order for it to find, which really drove me crazy. I didn't like keeping it plugged in all the time. So make sure that it would connect using the text to speech screen reader. But they've come a long way in this capability. So again, if that's an option for you, especially your low vision clients or students, give that in mind. It's a possibility. 

As an AT professional, kind of our brains go to what is the simplest first. So I look at things first as in and what's already available on the devices. And over the years, each one of the operating systems, Windows and Mac, as well as the mobile devices, include an option to enable accessibility features for vision. So if you haven't tried them out, I suggest you do. 

And over the years, things have improved dramatically on you have options for choosing which voice, which synthesizer. You can change the rate of speech so that you can either speed it up, like some of my friends do, or slow it down like I do sometimes, so that I can understand it when the text to speech is reading it. You can also change the, again, the voice and the pitch as well. So there's a lot of customizations that you can do on these particular devices that are built in. So Windows has it. Mac has it, as well as iOS and the Android tablets, as well as the Chromebooks. 

So Windows accessibility for vision. The first thing I'm going to tell you is that it does have options for a magnifier. It also has options for text to speech, and that's called a narrator. Currently with magnifier, I believe that you can enable a screen read aloud feature, but I'm not sure how well it works totally with Narrator. I haven't checked the updates lately since Windows just updated. So who knows? It might be available to do that now to run them both at the same time. 

But it is a great option out there for individuals, especially if you think about it in the workplace. If indeed your employer doesn't provide a reasonable accommodation for a third party software, this is a quick fix is Narrator. So you go to Settings and go to Accessibility, Vision, and you choose Magnifier. And you choose from this screen enlargement. 

You can also choose how the enlargement goes, whether it's just a magnifying glass that follows the cursor, or a split screen where some of it's magnified and some of it's not, or a full screen magnification. Again, it can go up quite high. The higher you make it, just like with a video magnifier, the higher the magnification, the more mousing around you're going to have to do. But for people that are new to vision loss, it's really a great step into using accessibility. 

And on Macs, you want to go to System Preferences and then choose Accessibility and choose Vision. That allows you to then choose what their magnifier is called Zoom. And it, again, can enlarge text. It can do different type of displays. It also can have contrast-- both of them can have contrast changes as well. I usually start with individuals to see first if, indeed, if you just change the font sizes, make it bold, change the color contrast and display settings, whether that helps first. And if that's not enough increase in visibility, then we start looking at the magnifiers that are built in like Zoom. 

Likewise, with the text to speech, I introduce Voice Over to individuals. And I'll be totally honest, I am not a great Mac user with Voice Over. It's just a matter of when you learned one way to do something in Windows, it's hard to make that quick switch over to a Mac. But that's one of my goals for the next year, is to get more proficient in using Voice Over on a Mac. But it is available there. 

Again, same type of settings in Voice Over as you can do with Narrator. You can change the rate of speech. You can change the pitch. You can change the synthesizer. So you can have one voice reading one component of the computer screen and another reading the text aloud. So there's a lot of different options that you can set up in all these screen readers. 

One thing I did want to mention about screen readers is how does that work? Again, I'm a geek. And it really does interpret the video signal. So whatever's going to be displayed on the screen will then be verbalized. It also reads the things in the background. So when I open up, say, Microsoft Word, it will tell me that Microsoft Word is opening. It'll also tell me the title of the document. It reads a lot of information that may or may not be visible on the screen. 

So when I tell people I use mine on beginner mode, because I teach a lot new people, you can change the settings on the screen reader so it doesn't have to say all that much. But bear in mind, that's how it's presenting to this screen reader, the speech synthesizer. It's actually taking the information that's on the background that's being sent to the display. 

So let's go back to Chromebook here. Chromebook also has features for accessibility. You can enable it by going to the system's tray, choosing Accessibility, and then choose Vision. Their screen magnification is called Magnifier. And their text to speech is called Chromevox, V-O-X. C-H-R-O-M-E-V-O-X. 

Things to note about this on the Chromebook. Yes, Chromebooks are typically less expensive. They are browser based, so everything you're doing is on the internet. So you have to have an internet connection to do much of anything on a Chromebook. 

The other thing is that Chromebooks have a very small display compared to what you can buy on laptops or tablets, for example. So with that said, keep that in mind if you're using Magnifier. So as I mentioned, the higher the magnification, the less you're going to see of the content on the screen, the more mousing around you're going to have to do and move the cursor along. So think carefully if you're going to be purchasing a Chromebook or using a Chromebook. 

Likewise with Chromevox, one of the things about these computers that you can-- or excuse me, Chromebooks that you can get very cheaply is they don't have an awful lot of processor speed, how quickly the computer operates, as well as enough RAM, Random Access Memory. And when you're running an accessibility feature, plus doing whatever activity you're doing on the internet, it's going to grab up memory. 

So I usually recommend a minimum of 16 gigabytes of RAM on a Chromebook. So that might mean that you might need a little higher end device, higher processor speed for able to effectively work well with Chromevox or the Magnifier. 

iPhones and iPads likewise has the screen reader Voice Over. It also has Zoom Magnifier on it. You go to the Settings icon and then you choose Accessibility, and then you choose Vision. And you have an option for Magnifier-- excuse me, Zoom, as well as Voice Over, which is the text to speech. 

And I highly recommend that people try out the tutorials that come along with it. For example, there are gesture commands that will enable magnification very quickly and to the custom setting that you chose. So that's a gesture command. So it's not just tapping once on what you would see under your finger. It's involving different gesture commands. So these tutorials come in handy, especially so with voiceover users. 

And I know sometimes people that aren't used to listening to a screen synthesis or using a mobile device with text to speech on it, it's a hard transition for them for some cases. It's not that hard, but I've heard people get frustrated because when you use Voice Over, for example, anything that's under your finger, it's going to talk to you. And in order for you to activate it, you're going to have to double tap. So each time you put your finger on an icon, you're going to have to double tap to get that activated. And if you just swipe from left to right, it's going to move from one icon to another, so instead of moving from page to page. So paying attention to those tutorials, I think is very important, whether you're using an iPhone or an iPad. 

Likewise, Android phones and tablets, they have their own accessibility features. Surprise, surprise. You go to Settings, you go to Accessibility, you go to Vision. And their screen magnification is called Magnifier. And also their text to speech is called Talk Back. Likewise, they have gesture commands. The difference that I found between Talk Back and Voice Over, they have some very similar commands, but they also have some unique commands in Talk Back that it's worth going through the tutorial to get comfortable using it on an Android phone. 

Visibility, as far as vision, just display settings, comparing the two of them, there are a little bit more options in the iOS for clarity in different font sizes than you do standard in the Android operating system. It doesn't mean that it won't work for that individual, but it just may be that if, indeed, those display options, you are more limited in the Android, so they may have to go to magnifier faster than they would have to do so on a Zoom on an iPad or an iPhone. 

Devices for safe travel. They come in categories. GPS for navigation. You also go to obstacle detection. You also have for indoor wayfinding navigation. I can get to a building using a GPS app. I can get to the front door and then inside. Depending on how well I know the building, I might need help getting from point A to point B, because I can't read the signs on the wall. There are some apps, of course, that I could probably take a picture and have it read it back to me, but again, that's tedious. So the new frontier, as I say, is indoor wayfinding. We'll get into that a little bit in a minute. 

Obstacle detection. Some of the most common devices that are used are the WEWalk cane and the Mini Guide, for example. There are a few other ones that you can purchase through specialty catalogs. And they all kind of have a different form factors, different shapes and sizes. The WEWalk cane is something that you can attach to a white cane. It includes both GPS and obstacle detection. You'll need to activate the GPS through the app on your smartphone, however. 

But one thing about obstacle detection you really shouldn't be using WEWalk cane unless you've had good mobility training using a white cane. Because relying on the obstacle detection may not be your best option. Because if you're in a very dense environment, like say, traveling on the streets of Philadelphia and there's a lot of people, you're going to get a lot of signals bouncing back at you. 

So it's a matter of determining, OK, what is that? I call it the cognitive load. What does that vibration mean? And if you're using a white cane, you're going to be able to determine what obstacle's ahead of when you encounter it rather than listening, or again, waiting for the vibrations on the obstacle detection. 

But again, for those that it would benefit, for somebody who walks rather slow, is what I say, is a WEWalk cane, that they can actually get a warning ahead of them outside. Also, it has indoor door. Obstacle detection. So some times that you're in an unfamiliar location, that might be helpful to have that so that you can determine that a cubicle wall is there rather than waiting to encounter it with your white cane. So there are some advantages and disadvantages of using obstacle detection, as you can tell. 

GPS. Some of them do include some indoor wayfinding. I was happy to discover one day by accident when I had Blind Square, which is one of the apps that I have on my phone, announced to me as I walked by our kitchen area, which is called, and somebody had dropped what they call a cookie or a tag. And they called it IOD pantry. I was like, whoa. The first time I heard indoor wayfinding. 

Now, that is also, again, dependent on how good the signal it is, because it's still using GPS satellites in order for it to work that way. There are some new apps out there that will allow you to have some indoor wayfinding. Let's see. Am I on the next slide? Let's go to the next slide. There we go. Indoor wayfinding. 

Good Maps is one of the apps that I actually tried out when I was at a conference. The Marriott in Anaheim, when I was at the CSUN conference, did have it mapped with Good Maps. What they do is that the venue or the location can request for Good Maps to come out for a cost, square footage by square footage. They literally use a scanning device that then records the layout of that environment. They label it and then they save that map to a cloud. 

So the end user, for example, like myself, could download the app, use it for free, and if that venue or location has a Good Maps cloud map in there, I can activate it by choosing that location. It'll come up on the list of the app. So it can be very effective. And I found that very helpful from getting from one workshop room to another. I only got lost once, so I think that's pretty good considering it was a four day conference. And again, it's all a matter how interpreting that information and what information has been coded in their. 

Navi-Lens is a different approach. They actually provide you with ability to create tags, which would be then coded to identify that location. And they're usually discretely placed on a sign, like, say, a room sign. They do recommend not using it on a glossy surface. So if you have a really fancy sign that it's in Cyrillic font, for example, and is on a glossy background, it's not as effective. 

However, what it does do, though, is that within about 8 to 10 feet, it will announce the next tag that's on there. So that's really helpful for getting around in an environment. Again, depending how close you put these tags, the more information you're going to get, which also can be bombarding like the obstacle detection. But we're going to experiment with that here at TechOWL's space coming up in a few months. So we're going to try that out. 

The next one I mentioned here is also the WayAround tags. And I got to experience that by when I got trained for my new guide dog. They decided to put ADA signs next to various residents' rooms that you were using while you were there. And as long as you knew where the sign was, it was great. You can also then-- but you needed to be close to it with your phone. So within about eight inches, I had to hold it so that it could recognize the tag. 

But you can customize the tag and you can change it very easily through the website application. And when I put the phone up to the tag, my dorm room, it said "welcome Jule Ann," which kind of freaked me out a little bit, and also then described how the room was laid out inside. 

So again, I call that the least expensive alternative of all of them, WayAround tags. Also, the app is free. The tags are not, but it's also commonly used by people that are blind or low vision to identify objects that they've pre-recorded a tag. So in other words, they can help you sort your clothing in your closet, for example. 

Voice assistance and artificial assistance. Now we're getting into some of the hotter topics of voice assistants. The speaker devices, like the Amazon Echo and the Google Assistant devices, they're great for getting information, quick answers to questions, as long as you learn their wake up calls and how to ask a question. And again, they are using artificial intelligence to retrieve the answer. You have to be connected to a Wi-Fi in order for it to work. Most of these devices will require you to have an app on a smart device, whether it be a tablet or an iPhone, at least for the setup process, so that you can use that. 

On your smartphone, though, however, you already have some built in. On an iPhone, the voice assistant is called Siri. And on an Android phone, it's the Google Assistant. And again, with the wake up call, you can get a great deal of information there. I always caution, though, however, not to rely totally as the access point. As good as these assistants are, there are some limitations of what they can do. 

In other words, I use as an example that Siri can place a call for you. Siri can answer a call for you. Siri can hang up a call for you. But if you get a call in at the same time while you're talking to someone, you have to hang up that first call in order to answer the second call. So little things like that, which again, if you don't know enough about how to use accessibility devices on the phone in general, you're probably at a disadvantage. So I always encourage people to take advantage of both using the voice assistants as well as the accessibility devices on the phone. 

Wearable options. Now, this is, again, the latest, greatest hot things out there. They come in various price points and various types. I have here with me the OrCam MyEye 2. I also have the Envision AI glasses. I also have a AIRx bone conduction headphones that connect to an iPhone. All three of these devices, for setup, it helps to have an app. 

The OrCam, you don't necessarily need an app. So you don't need to have your smartphone with you. It can perform certain functions without using connected to a smartphone. For example, it can take a picture and read a text back to you. It can also describe a scene, I think whatever is limited to what they've already have in their database. It can recognize people if you've recorded that image of that person. 

And again, the other ones do involve using Wi-Fi access or, in this case, with an iPhone or a mobile device, you can make that as your hotspot to connect it. So they're really a great alternative for use. Again, the AIRx vision is tethered to the phone. So the disadvantage for me is I don't like too many cables. But it's a great alternative for people that don't like using the touch screen type of devices. 

So first I'm going to start with-- where is my OrCam? Here it is. OK. The OrCam MyEye is a device that gets mounted onto your glasses. So I'm going to take this off first. And it has a little mount that you can order extra ones. So if you have a different pair of glasses like maybe your computer glasses, or maybe your sunglasses and your regular spectacles. You can put that on there. When we loan these out, we loan them with this pair of spectacles so that it's already mounted. 

The mount is now a magnetic device. So you might have seen me. I'll do it again. It quickly attaches to it. The camera is here in that little circle, as I feel with my finger in the front. It is a touch screen. So you can activate different menus and different activities by using that touchscreen, which I'll turn on the side here so you can see it better. You can also use voice commands. 

And again, the OrCam is somewhat limited in some of the features compared to the other devices. However, there are individuals that would prefer to have this type of device because, again, it's quick and easy to learn. Again, the voice commands. And they only want it to do for certain tasks anyway. So, it might be a good option. For me, the disadvantage also too is that it's also $4,999. So a little bit pricey for individuals out of pocket. 

The next one I'm going to show you is the Envision AI glasses. This is my own personal one. It is set on the old Google glasses. There are other options, and I'll hold it up, there are other options out there for frames that you can choose. It is a camera, like I say, a little geeky here, that's mounted here on the temple of the device. So it's already pre-mounted. 

You can also then remove this temple and put it on a different frame that you can also purchase from them. Of course, they want you to buy accessory, right? So that's kind of nice. It does have a touchpad feature like the OrCam does. It also has a voice activation so that you can actually give it a voice command to take a picture, read it back to you the text on the screen. 

Also, it really did a nice job of describing a scene. I was really kind of impressed with it at a conference when I took a picture of the front of the room. It told me that there was a slide presentation on the screen, as well as told me how many people were sitting in front as presenters, which I thought was kind of cool. So it does have that ability to describe scene. 

The difference between this and the OrCam, for example, it also allows you to take advantage of something called Be My Eyes, which is an app you can download on your phone. But this can also call using Be My Eyes, using your smartphone, and the camera here. So it makes it hands free. Will allow the Be My Eyes volunteer to see what's going on through that camera lens. 

It also has something called Envision Ally, which means it's a group of people that have agreed to be your assistant. So when they'll get a notice on their smartphone, they open up the app, and then they can literally see what you're looking at through that camera on there. 

That's just things that you can use both these devices for, like currency identification, color identification, scan and read text, read text by taking a picture and it will do the optical character recognition, which I mentioned earlier. So that's some of, again, the advantages. 

Now, again, we're stepping down a little bit in the price. These are the home edition, and that was $2,400. You can buy a professional edition for $3,500. I believe that's still a price. They also have just a read version, which will only take a picture and read it back to you. So it doesn't have that calling features and all that into it. And that's less expensive. That's $1,500. So compared to the OrCam, yeah, we're talking price points a little bit better. But again, it really comes down to what the individual prefers to use. 

The last one I'm going to show you is the RX AI Vision. AIRx Vision. 

KIRK BEHNKE: Jule, I just want to interrupt here. You have two more minutes. 

JULE ANN LIEBERMAN: Two more minutes. OK, I'll speed it up. They're bone conduction headphones. And so if you have an Android phone, you just connect it into the power connection there. And the camera's up here on that. 

What's nice about this is that it's not a touchpad. It has the navigation keys for pause, fast forward, and rewind. You can also then choose different menus that are involved in the device. They just came out with this year an adapter so that I can use it with an app on my iPhone as well. So I would plug that cable into this, and then this becomes the navigation pad for the iPhone edition. So that's some of the cool things. 

One that I don't have yet is the Echo Vision, which is coming out next month supposedly. And that provides the options for, again, similar type of things where it can take a picture, read it back to you. That one is I think they're retailing that one for $600. The next one down is the Meta glasses, mainstream devices that we're now having the capability to do that. They're very popular, can do a lot of the same functions here, and also now just recently added Be My Eyes ability. 

And I believe maybe still pending, but it might have been approved recently, to include the contacting an IRA agent. An IRA agent, compared to Be My Eyes, is that the IRA agent is a trained person who knows how to work with blind people, not just a volunteer. But it is a subscription, so you will have a monthly fee on that. 

There you go. Conclusions. So with this, there are a lot of options out there for everyday tasks and in the workplace that you can use these devices. If you have questions that didn't get answered on the chat, don't hesitate to contact me. 

I'm sure that Caitlin or Kirk can put up in the chat feature my web-- or excuse me, my email address is jule.ann.lieberman L-I-E-B-E-R-M-A-N @temple.edu. You can also send a message to TechOWL, T-E-C-H-O-W-L @temple.edu. Also visit our website, www.techowlpa.org. 

We have a chat feature. They can direct a message to me that way. Also just visit the website. It's just got oodles of great information there on all our different services that are out there. And worst case scenario, you can always call 800-204-7428, because I answer the calls Monday through Friday in the morning, Eastern Standard Time. Eastern Daylight savings time right now. And I'd be happy to. 

And otherwise, if you want to have a question for me, I'm sure the AT staff in the afternoon would be happy to get that information connections made with me. So hopefully we've answered some of your questions, and I thank you so much for taking the time to join us today. 

KIRK BEHNKE: Yes, thanks, everybody. Jule Ann, thank you so much for your continuous expertise in this particular area as well as the lived experiences as well. So thank you for sharing your stories, your technologies, and thank you, everyone, for joining us today. 

JULE ANN LIEBERMAN: Have a great day, everybody. 

CAITLIN MCKENNEY: Hello, hello. All right, I'll get started with introductions as people trickle in. Welcome. Thank you all for joining us today for the October Tech Accelerator webinar. Our presentation topic this month is going to be Accessibility and Video Gaming. 

This session is being recorded and will include picture-in-picture ASL translation, as well as a full transcript on our website. That'll be posted at disabilities.temple.edu. And I will put that link in the Chat for everyone as well. So all of 18 webinars running from July of 2024 to December of 2025 are going to be available there for viewing. 

We do have two more live topics coming up after this month's. So November is going to be Adaptive Art. And then December will have a presentation highlighting Assistive Tech in Rec Therapy. We're going to have guest speakers for both of those topics, so we're looking forward to them. 

This series is a part of the Tech Accelerator program, so this is an initiative funded by the Office of Developmental Programs and the Office of Long-Term Living here in the Commonwealth of Pennsylvania. And that's made possible through funding from the American Rescue Plan Act. The Pennsylvania Tech Accelerator project includes five major focus areas-- Training and Resources to build capacity for stakeholders, a Readiness Evaluation to develop tools for the successful adoption of remote supports and assistive tech, a Statewide Assessment to plan and benchmark Technology First Systems Change, a Provider Survey to assess technology awareness and resources among providers, and finally, two Technology Summits, which were live events hosted in Philadelphia and Pittsburgh this past spring. So you can learn more about all of those fantastic projects on our website at disabilities.temple.edu, using the link in the Chat. 

All right, so let's get started to our topic for the day. My name is Caitlin. I am an Assistive Technology professional here at TechOWL. 

And I am also joined by my colleague Jenn, one of our SLPs here on the TechOWL team today. We both have experience working with students who have complex access needs such as switches and eye gaze. And we're both very enthusiastic about the notion of accessibility in general and also the idea that play is the work of children and these are transferable skills. 

So before we get started here, I wanted to see if anybody felt like sharing in the Chat what your experience with gaming is, whether for yourself or a child or a student or a consumer that you support. What are the benefits you see? Why do you gain? 

This could include functional benefits, like practicing physical and cognitive skills that are going to translate to other tasks. It could include social benefits, building community, and fostering supportive relationships. There are also potential mental and emotional benefits to gaming, so some people play video games in order to relax. Feel free to add your comments to the Chat as we go along, too. I don't want to rush anybody. 

So as we get started here today, we're going to first work on identifying what our interests are. So what kind of games do you or a person you support want to play? You might be looking at games from different genres, like racing games, battle games, puzzles, sports, first-person shooters, sandbox games, et cetera. 

You also might be looking at specific franchises or platforms in your decision making. So if you know that you really, really want to be able to play Mario Kart, then you know it's going to have to be on a Nintendo platform. So that's going to influence which console and perhaps even which controllers you decide to use. 

The other thing we'll look at for our decision making about where to get started in games is what your support needs are. How might your disability and also your level of experience with gaming impact your setup? And your adaptive setup could also be impacted by the level of tech experience of caregivers or support personnel around you, making sure we choose something that's going to be utilized and effectively utilized by everybody who's in charge of helping to set it up. If motor control is a concern for your disability, you'll want to start by identifying some access points at your body. And if motivation or frustration tolerance might be a challenge for you, we'll take that into consideration when looking at what kind of games we're going to play. 

So some examples of what does it look like to have games from different genres-- so racing games, for example-- what kind of skills in terms of reaction time, precision, or what kind of hardware, such as number of buttons, switches, triggers, joysticks, do these games typically require? Racing games typically do require a joystick of some sort to steer, access to at least two buttons for things like acceleration and drifting, plus a way to trigger traps or to use object boosts. So a lot of those features can be automated with accessibility settings depending on the game. Auto steering, for instance, is an option in Disney Speedstorm as well as in Mario Kart. 

And these types of games are also accommodating of different frustration tolerances. I like that Mario and Disney lift you back onto the track automatically if you fall, for example. And they tell you if you're going backwards. So overall, racing games are a nice intro point for lots of different people. They've got limited time-sensitive components. It's possible to play without a great deal of precision and still have a very fun and rewarding experience. 

So asking these same questions of ourselves, what skills or hardware does this type of game require? If we look at side-scroller games, so these are games that are kind of just a two-dimensional, one-directional playing field here, you're going to be able to do that with just arrow keys. You don't necessarily need a joystick. So you could have a switch array with switches representing up, down, left, right. Maybe you control those with your feet. Maybe you control those with your head or different body parts. 

If it's a battle game, you will want to consider reaction time. But there are lots of side scrollers that are more adventure and exploration based, so those might not require fast reactions or much precision. And they also might have save points to avoid losing progress, so knowing how to take advantage of those. 

On the screen here, I have an example of the Brawlhalla video game on the left and then a screenshot from a game called Ori and the Blind Forest on the right. And Ori and the Blind Forest is an adventure and exploration game. It does allow you to save your progress at any point, so you can restart from a saved point if a challenge becomes too difficult. 

Then finally, our third genre example is going to be first-person shooters. These are probably the most demanding type of gameplay to adapt. They do need complex controls like access to two joysticks, typically, because you want to be able to direct navigation as well as aim. These types of games are also more cognitively demanding because the game requires fast reaction time and sometimes high levels of precision. 

So the examples here are Apex Legends on the left. We have someone who looks like they're reaching up to go down some sort of zipline or wire to the ground. And then on the right, we have a screenshot from Call of Duty and the first-person point of view of someone aiming a gun. 

So a lot of you might not be gamers. I didn't see a whole lot of answers in the Chat to our reasons for gaming questions. So what do we do if we don't know what kind of games you might be interested in or what game has features that are going to be most conducive to your success? So there are tons of resources out there to help you identify options. And I'll be sharing a list of these types of databases at the end of the presentation but also giving you a little sneak peek of them throughout. 

So here is a sneak peek of the Accessible Games Database. And along the left side, there's a filtered search function. For this example, I've checked off the Narrator box under Visual Features. So it's giving me a list of 17 games that provide narration for visually impaired players. 

And they include Assassin's Creed, Far Cry, Forza titles. Madden NFL is further down this list. And from here, I can narrow my search by selecting a specific platform that I want games to be compatible with. If I own an Xbox or a PlayStation or I want to play on a PC, I could narrow my search down that way. I could also select a specific content rating maybe if I were selecting a game for a child, for instance. 

Here is another such resource. This one is called the Family Gaming Database. And on the launch page, we get a list of tags, everything from what controls this game needs to whether or not it has specific in-game features like a tutorial or practice arena. So if I click on one of these tags, for example, the one-button tag to see games under that tag, these are things that can be played with a single button. So Mario Kart can be played with a single button. 

I've done that one before. You can take advantage of their auto accelerator and their steering assist features for that. The next game listed is called The Alto Collection. It looks like a side scroller where your character is a snowboarder, and that sounds fun, and then the third on their list, called OCO. 

It looks like some sort of colorful pong-type of platformer game. And I think that one is inherently a one-button game for all players, so no modifications required. But this is a list of 40 games. So again, you might need to filter by compatibility with the console that you intend to play on or by age range, et cetera. So you could go up to the top and click on Show Filters in order to access all of those other additional settings. 

OK, so we've identified some potential games we might be interested in or might be suitable for our needs. And we're excited to get started, to jump in, to start playing. What do we need? How do we play? So I'm going to tell you a little bit about the adaptive controllers that are available on the market. And then Jenn's going to tell us a little bit about accessories for them and how to combine and position these things. 

The first and perhaps most flexible controller option is the Xbox Adaptive Controller. So this was released in 2018. And it's available for purchase at major retailers. You can get it from Best Buy, from the Microsoft stores. You can buy it at Target. 

This controller is a flat rectangle with two large black buttons. There's also to the left a small directional arrow pad. But the most important feature is going to be the 3.5 millimeter switch ports that line all along the back of the controller. So here, you can plug in external buttons to mimic every single function on a traditional Xbox gaming controller. You have your X, Y, B, A buttons. 

And now as external buttons, they can travel, so you can position them near any part of your body for easier access. This setup is highly customizable. It's all about the accessories. So the Xbox Adaptive Controller supports pretty much any type of switch. It also supports both USB and 3.5 millimeter joysticks. 

That makes it more flexible than any of the other adaptive controller options we're going to see. That's one reason why you might choose to use this controller, even if you don't own an Xbox. So even if you're using a Nintendo or a PlayStation console, it's possible to do that. So you just need an adapter in order to connect the Xbox controller to one of those other manufacturers' platforms. And we'll talk about how to do that after. 

I also wanted to mention that Xbox did release an Adaptive Joystick this year. So it brings all the functions of one half of a controller into your palm. So you've got the four buttons, the two triggers, and one joystick. 

In addition to holding it in your hand, another way you can use this adaptive joystick is you can mount it for use with your chin, for instance. So it does, like all the other Xbox accessories, it has a threaded hole in the base so that you can screw it on to mounting equipment. So the controller, the joystick, and even the individual switches from Microsoft and from Xbox can all be mounted that way, which is pretty thoughtful design. 

All right, so the next accessible controller to come out after the Xbox is we now also have a PlayStation Access Controller. This is a circular device with circumferential buttons, so almost like petals on a flower. And it's a really strong choice for one-handed gamers because you can access all of those petals with the fingers and palm of one hand. 

It's also the only adaptive controller that comes with an integrated joystick. The downside to the PlayStation Access Controller is that it only has four switch inputs, so I would not recommend this one for someone who is primarily a switch user. Great for one-handed gamers, though. 

And then finally, so our third major brand is Nintendo. This is the Nintendo HORI Flex controller. This one is not sold at major retailers, so it's only available for online purchase through one partner in the US, which would be AbleGamers. But similar to the Xbox Adaptive Controller, it offers those 3.5 millimeter switch inputs to mimic every function of the regular handheld gaming controller. 

However, it also provides the option of accessing those controls in the form of mid-sized buttons built right into the face of the controller. So if someone were to just need buttons enlarged and not need them repositioned, this could be a decent controller option for them. Another strength is that this is the only console-based controller that can be paired with eye gaze. So you can plug a USB-based eye tracker into the HORI Flex and get eye-gaze gaming with minimal setup. One thing to be aware of is that this controller is only comparable with a couple brands of joysticks, such as the Optima. So in that regard, it doesn't give us nearly as many options for accessories as the Xbox Adaptive Controller did. 

The same company does also make a couple other potentially useful pieces of hardware. One of them would be the Fighting Stick, which is an arcade style controller, so it doesn't have switch inputs. But it does come with a joystick built in. And you might also consider things like their racing wheel or their flight controls as potentially adaptive hardware. So the racing wheel and the flight controls aren't specifically designed for disability. But the ergonomics of it, the different grip options, might happen to work better for some people than having to grip a joystick. 

Similarly, there are third-party controllers by a company called 8BitDo that could have adaptive applications. So the first is the 8BitDo Lite SE, which is the Xbox Wireless Controller. And the second is the 8BitDo Arcade Stick, which can be used on an Nintendo Switch or on a computer. And both of those controllers include two programmable macro buttons. 

So this is in the form of an external switch on the Xbox version and in the form of the two top black buttons on the arcade-stick version. So those are two buttons that can be programmed without any software just by holding down a programming key on the controller to do whatever it is you need that button to do when you press it. So it could be a series of button presses. It could be to hold down something. It could be just to relocate a button that's difficult for you to reach otherwise. 

And finally, the last of our truly adaptive controllers is going to be the QuadStick. So remember, when we touched on the cognitive load and the level of physical access-- it's required for a first-person shooter game. So this is the adaptation you need for that. The QuadStick is going to be the best option for anyone who wants to play those intensive, joystick-dependent games but doesn't have good wrist movement. 

So it uses a combination of a mouse-controlled joystick that you can move with your lips and a series of sip and puff straws built into the mouthpiece. This was designed for users who have limited upper extremity movement, maybe don't have any control of their arms at all. And the mouthpiece includes three holes that you can access individually or in groups and combinations. 

So it's like playing different notes on a harmonica. If you suck in air, it's going to trigger one function. If you blow out air, it's going to trigger a different function. So between three holes, two options of in or out-- that's like the equivalent of having 20 something different buttons at your disposal. 

And someone can fact check me on that. It's been a while since I did factorials. If anyone in the Chat is a high school math teacher, let us know. Three button options, two in-out combinations-- the math there comes out to 20 something. But as you can imagine, there is a bit of a learning curve to using this device. 

So the nature of being so customizable means it can take some programming to get it to work the way you want it to work. But it also means that you don't have to use it to its full potential. You could just use it as a mouse joystick and program one or two functions in with the sip and puffs. And that would get you pretty far in gaming. 

An additional accessory that's sometimes used in conjunction with the QuadStick would be voice controls. There's a software called VoiceAttack, which offers free programming of up to 20 commands. And this screenshot here shows programming of a test command. So when I say the word test, the computer will press and hold down the S key for 0.3 seconds and then release it. 

That's just an example. But you can imagine the possibilities here of making one-word commands for a whole series of different button combinations. You can hold things down. It can press multiple things in a row, press things simultaneously, and all just used with your voice. 

Honorable mentions-- some other third-party controllers from manufacturers with an interest in accessibility-- Blue Tip Gaming designs arcade-style controllers for Xbox. ByoWave manufacturers the Proteus Controller, which is a modular device. So you can take it apart and put it back together in new shapes. You've got these four cubes here. You've got two that have joysticks and two that have the set of four-button pads. And you can imagine if you were to take those apart and rearrange them into maybe a single vertical or horizontal line. It's like building LEGOs where you can combine them in whatever way fits your needs. 

And then finally, on the far right, we have an example of a custom one-handed controller from a company called Evil Controllers. I'm told that they are named that because they are one of the first big operations to modify controllers. And that was sketchy business in the gaming world because it's automatically assumed that mods are for cheating. But in this example, what we're seeing here is a one-handed controller. 

So they've wired an external thumbstick to replace the left joystick. And they've also moved the left triggers onto the right-side grip. So this controller can be used by someone without a left hand. All right, I'm going to turn it over to Jenn to tell us a little bit about other accessories to use with our controllers. 

JENN LISBERGER: Thank you. Hi, everyone. So we're going to talk a little bit about the different accessories you might want to explore that will allow you to better customize the adaptive controllers and ensure that they are accessible. 

So first, we're going to talk about switches. As discussed, the various controllers have switch ports which allow you to connect a switch that you've mapped out for a specific gaming function. As Caitlin mentioned, you can use any 3.5 millimeter switch. So if you have switches already, you can use them. 

What you see in the picture on the screen is the Logitech Adaptive Gaming Kit. This is to give an example of a affordable gaming kit that has a lot of options available. It comes with 12 switches, different sizes, a Velcro pad for those switches, and labels, so you can clearly see which switch does which function. And again, it's for a pretty reasonable price. 

If you're in the field, you know that switches are very expensive. [CHUCKLES] So this is a really nice all-inclusive package. But again, any switches that you have available that have that 3.5 millimeters should be compatible. 

We're going to talk a little bit about joysticks. So you can also connect an external joystick to your adaptive controllers. These are really helpful for racing games or games that require directional control. There are different options available on the market. You'll see it says UltraStik and Zik-Zak, they come with different grip styles, so you can find something that is comfortable for your hand and for you to rest on and utilize. 

So once you have your controller, your switches, and joystick if needed, you want to make sure that you look at how all of these are positioned around you and in front of you. This can vary depending on the game that you're playing in terms of the positioning of the switches. Different games utilize different functions and different buttons more frequently than others, so you want to take that into consideration. 

When setting up your controllers, a good rule of thumb is to prioritize controls that are the most essential for the game and most frequently used. You want to make sure that you can quickly access the controls that require fast reaction time. So if you're doing a game that has attacking or dodging and you want to respond quickly, you want to make sure that that is in a position that you're able to access as quickly as possible. 

You want to take into consideration where you'll be playing, so you can find the best surface to attach your controller and switches and joystick if needed. As previously mentioned, the Logitech Adaptive Gaming Kit comes with a pad to attach switches with Velcro. But you can also explore lap trays or if you or an individual you're working with has a wheelchair that has a tray already attached, you can place the controller and accessories directly on that tray. Keep in mind you might need additional accessories to help secure the controller switches and joystick. 

So Dycem is a great option for the controller itself as well as the joystick if you don't want to attach Velcro to it. You can use Velcro on your switches. Or if you need heavy-duty Velcro, that exists as well. So you just want to take a look at what that best surface is to make gaming fun, accessible, and comfortable. 

And there are mounting options. I know Caitlin had talked a lot about this earlier. But you are able to mount the controller itself, which is great. If you don't want to or don't have a table or tray available, you can explore mounting options for the controller as well as the accessories. You want to make sure you're considering any other items you already have mounted. 

When you're setting up the mounts for gaming specifically, you can explore different options that would meet your specific needs. And when we were talking about switches, again, we're looking at anywhere that your switch access point is, we can find a mounting position for it. So the one picture shows a head array. But again, you can mount things to be accessible at your knee, at your elbow, at your chin-- H to T-- anywhere that we want to have those things mounted. 

CAITLIN MCKENNEY: Thank you, Jenn. OK, so we've talked a little bit now about features in the hardware of the game and accessories that we can buy to physically interact with it. Now we're going to talk about the other side, meaning features within the console or features within the Accessibility menu of the game. 

So we'll start with Xbox. Xbox is probably the most reliable console in terms of accessibility over time. So their features, their devices, tend to have continued support across editions and be backwards compatible as well. The first feature we'll talk about is Controller Assist. So this was formerly-- not formally-- that's a typo-- called copilot. 

And copilot or Controller Assist is when you have two different controllers representing the same player or the same character in the game. So, for instance, if I'm playing with some switch-user students who are maybe new to using their switches more at a cause and effect level, they might be interested in making the objects move, making the bombs be thrown at someone in Mario Kart or making the goose pick up the keys in the Untitled Goose Game. Or they might be interested in making the goose honk in the Untitled Goose Game. 

So they could be doing whatever button presses interest and motivate them. And meanwhile, the second person can be holding a standard controller to do the navigation to move the character. And both those controllers, the standard one and the adaptive controller, are going to be working collaboratively, so it becomes a multiplayer game. 

The second feature we'll look at within the console is button remapping. So this is when you go into the Settings menu and you change the function of a button on the controller. We'll see what this looks like on the adaptive controller in just a moment. But this picture on this screen is showing what it looks like on a standard controller. 

So you can have a profile set in which maybe the A button is turned into the X button because for some reason, that's easier for you to press in that location. And then there are settings for navigating the console itself, so screen reader, high contrast, magnification, et cetera, to help you with the setup of your game. Another feature in service I want to highlight is the Disability Answer Desk to get support from Microsoft. 

So sometimes when companies put out a product that has accessibility features or adaptive applications to it, you call their customer support line. And nobody on the other end understands those particular features or functions of the product. So that can be really frustrating. And Microsoft has solved this problem by having a dedicated customer service team specifically knowledgeable about accessibility features and about their adaptive products. So Microsoft has that Disability Answer Desk. 

So here's what the button mapping looks like for the adaptive controller, which can be configured either right on the Xbox or you can also configure it using the Xbox accessories app on a computer. You'll see that there are lines pointing to each of the ports and keys on the adaptive controller. And there's a grayed-out icon showing you what that key or port is currently programmed to do. 

And you can go ahead and click on that picture and change what it's programmed to do. So most frequently, we would want to be remapping the two large buttons. And then you might remap one of the smaller ports in order to reassign those A and B functions that you moved from large buttons. 

The same thing can be done on PlayStation and Nintendo as well. So customizing button assignments on PlayStation-- and you can do it with a standard controller. Or you can do it with an adaptive controller. It also has that copilot feature. On PlayStation, they call it Assist Controller. 

So you can have an adaptive controller and a standard controller or even two adaptive controllers programmed to control the same player. We used this recently in the community space for playing with the Astro's playgrounds on PlayStation because there's one feature that the adaptive controllers don't have, which is that touch pad that's built into PlayStation's standard controllers. So you needed access to that touch pad in order to get through that particular game. So we had the access controller and the typical regular controller both controlling the same little Astro character so that we could make it through together. 

One option that PlayStation offers on their button remapping that the other consoles don't is a toggle feature. This is super helpful for things like acceleration in a racing game. So instead of having to hold down the trigger that controls acceleration or to keep going, you can press it once. 

It'll be toggled on. And then you press it again to toggle it off when you're done with it. So that's very helpful to have that as a controller setting and not have to rely on the game offering that as an in-game setting. And then again, there are accessibility settings such as screen reader, high-contrast settings, magnification, captions, et cetera for navigating within the console itself. 

OK, looking at the accessibility settings in Nintendo, so they do have button mapping. However, you have to use a computer in order to remap the adaptive controller. So PlayStation and Xbox, you can remap all the controllers right on the console. Nintendo, you can only remap the traditional standard JoyCons or Nintendo controllers on the console. You have to connect it to a computer in order to remap the adaptive controller. 

It does have screen reader, high contrast, magnification, et cetera, under Accessibility Settings in the console. And overall, Nintendo doesn't have a lot of accessibility support. But the nature of the games on this platform, it has a lot of arcade-style games. For instance, it means that it still tends to be a strong contender for a lot of adaptive gamers. There are plenty of adaptive gamers that prefer and choose Nintendo as a platform, particularly beginning gamers or people who are into those arcade-style games or looking for something that only Nintendo offers. 

Well, another thing I wanted to point out about the Nintendo is with the latest addition of the Nintendo Switch, you now can plug the adaptive controller right into the handheld console without having to attach it to a television. So I think we're going to see a lot more uptake of adaptive controller use on this platform now that that's an option that you can use the handheld. 

All right, so I mentioned before that many of these controllers can be used on competitors' consoles. So you could plug in an Xbox adaptive controller to a PlayStation, for example. You just need to have the right adapter. So I'm going to take a moment here to highlight another one of those resource databases that I will be linking to at the end of the presentation. 

So this is Gaming Readapted, a website run by Drew Redepenning. He is an assistive technology professional and a biomedical engineer who has a lot of experience working in rehab contexts. And he gives walkthroughs of various controllers, including guides to using adapters. So here is an illustration of that feature. 

If we go to the Adapters tab at the top of the Gaming Readapted website, we see the Controller Connect tool. And then here, it's going to list in drop-down menus the names of each console that we might want to connect, either the QuadStick, the Xbox Adaptive Controller, or the PlayStation Access Controller too. So we have the name of the controller at that top of the column and then links to each console type. 

For example, if we wanted to connect an Xbox Adaptive Controller to a PlayStation 5 console, how would I do that? So I'll click the PlayStation 5 link under Xbox Adaptive Controller. And it shows me one option is to use a Brook adapter. So that gives me a video of how to do that as well as giving me a link of where I could purchase that kind of adapter. 

And if we scroll down more, we see that we also have a second option called the PS5 MATE. So we can get some information about what accessories that adapter is compatible with. And if we think we might use some of those other tools down the road, such as the QuadStick, maybe we go with an adapter that can handle that second accessory as well. So it gives us all the information we might need in order to make a decision about what types of adapters to buy. 

All right, let's see. We've learned about button mapping. We saw some console accessibility settings. But our gameplay experience is also going to depend upon the accessibility features for the individual game. So in-game settings cover everything from color contrast to captions. 

And some of those settings, by the way, are being used by non-disabled gamers as well, so curb-cut effect, right? Increasing ease of access is good for everyone. You have competitive Fortnite players out there using those on-screen visual cues for audio effects to tell them what direction the sound's coming from or changing their color palette to high contrast because research supposedly says that our brains react fastest to the color yellow. So we're looking for that competitive advantage of processing alert faster than their opponent. 

But some other examples of options to look for in games-- racing games, you might have auto-acceleration or steering-assist features. You can find those in Mario Kart for sure and in Disney Speedstorm. In first-person shooter games, look for options like auto reloading, single-stick movement, or swap sticks while aimed so that you can use the joystick for aiming and then switch it back automatically to navigation. Those are features available in games like The Last of Us and Gears 5. 

Then in role-playing and battle games and lots of other-- even some of the puzzle and adventure games-- you'll have adjustable difficulty level, so you can choose to play the game on easy. That's available in games like Baldur's Gate, Elder Scrolls, and Forza. And then finally, in puzzle and adventure games, some of the options to look for might be things like audio panning or colorblind mode. I wanted to highlight here that there is an entire genre, if you will, of games that are specifically audio games, so they have a main output of sound rather than graphics. 

Two examples of this are The Vale-- Shadow of the Crown and the game called Ear Monsters. So the premise of The Vale is that the main character is blind, so there are, therefore, no visuals in the game. Instead, you're using directional sound. For example, if the next task on my adventure requires a blacksmith, then I need to go into the town square and listen for the sound of the hammer. And I can tell when wearing headphones which direction that sound is coming from and walk that way. 

Similarly, the premise of Ear Monsters is that monsters from a parallel dimension are invisible when they worm-hole into our universe. So we can't see the monsters. But we can hear them. And I haven't played this one yet. 

But I know that similar games like Audio Pong sometimes use the frequency of the sound as well as the volume in order to indicate proximity. So in both of these games, all players must rely on their sound, not their vision, to complete the goals. So it's a cool example of inclusivity without any accommodations, that sighted and blind players are just automatically on an even playing field here. 

All right, demonstrations and acquisition-- where can we get our hands on trying out or learning more about some of these games, some of these devices? You might be surprised to learn that there are opportunities for in-person gaming potentially near you. So the first photo on the left here is from the Inglis Innovation Center here in Philadelphia. They do one-to-one demos as well as community events-- even in some cases, home visits to help players set up their assistive technology needs. 

The picture on the right is from Abilities in Motion. They are the Center for Independent Living out in Berks County. They have an esports and gaming center that's primarily PC-based. They hold community events. 

And they also hold tournaments there. I was able to go to one of their tournaments over the summer. It was a lot of fun. And they also have pay-per-hour individual gaming sessions. 

Of course, TechOWL does have our own community space here in Philadelphia as well. Our community space has all three consoles. We have the Xbox, PlayStation, and the Nintendo, along with the adaptive controllers for each and other accessories like switches and various styles of joystick for people to try. If you live in Pennsylvania, you can also try many of those materials from the comfort of your own home by borrowing them through TechOWL's lending library, which is a free online service available to anyone who lives in Pennsylvania. Items are mailed right to your home to try for free, with a return shipping label prepaid in the box. 

So if you don't know where in-person services might be near you, first of all, you can ask your local AT Act Program for ideas. But also, you can consider some online play options. So we have two organizations here. The first is SpecialEffect. They host multiplayer online games for eye gaze and switch users. 

And then the second is the Adaptive Esports Tournaments series. Adaptive Esports Tournaments is a collaboration between the charity AbleGamers and Adaptive Action Sports, which is sponsored by Logitech. So these are competitive, paid esports tournaments that just happen to be disabled players. 

OK, here is that promised Additional Resources slide-- other places you can go for support. You can submit a peer-support request at the AbleGamers website. You can ask your question or browse other people's ideas and experiences on Discord and Reddit in the DisabledGamers communities. And you can look up how-to videos and other educational resources on things like how to choose a controller or a game on the Gaming Readapted website. 

In addition to those resources, we have a list of game review sites-- Accessible Games Database, Can I Play That, Game Accessibility Nexus, GameAccess Knowledgebase, and the Family Gaming Database. These are places you can go to filter by keyword, by accessibility feature, by content type, to learn about what games might interest you and meet your access needs. 

Now, whenever I present on any type of assistive technology, I know I'm going to get questions on how to buy things because assistive tech is expensive. The Xbox Adaptive Controller costs $100, plus another 100 for the switch kit-- maybe another $30 if you need a joystick. If you need a tray or a mount, that's more. So the typical official providers like medical or educational or vocational entities are not super likely to fund your gaming equipment. An exception would be if you can make it cross over from gaming to other computer-related tasks. 

And say, for example, the QuadStick, which runs upwards of $500 now, can give you access to a computer, so things like sending emails, attending online classes or meetings, completing data-entry tasks. I don't know-- being a computer programmer. The sky's the limit. So the point being, if you can make the case that your computer equipment is good for something other than gaming, then do it. You might be able to get it funded that way. 

Otherwise, there are charitable foundations and grassroots networks-- places such as AbleGamers, which helps provide adaptive equipment to people who need it. You can also get free 3D-printed controller modifications from The Controller Project. That would do things like building up a joystick to be larger or installing a lever to be able to reach a trigger with the opposite hand. A number of grants for assistive technology are happy to fund rec and leisure items. And you can get information about grants that you might qualify for, as well as any loan programs that exist in your state, by contacting your Assistive Technology Act Program. 

So most states have an alternative financing program. Sometimes it's run directly within the AT Act Program's other offerings. And sometimes, such as here in Pennsylvania, it's run by a third party. Like, we have had the Pennsylvania Assistive Technology Foundation-- PATF-- to offer 0 interest or low interest loans and payment assistance. 

All right, before I pause for questions here, I do have an opportunity for you all to give us feedback about this presentation, about topics you hope to see in future presentations, and help give us the data we need in order to keep offering programming like this. I will put that link in the Chat as well. So if you are able to take a moment to fill out our survey, we would appreciate it. And then I'm also going to take questions from the audience. 

ALANNA RAFFEL: All right, it looks like we are good to go. So welcome, everyone, and thank you all for joining us today for the November Tech Accelerator Webinar. Our presentation topic this month is Assistive Technology for Art. 

This session is being recorded. And the video will include picture-in-picture, sign language interpretation, as well as a full transcript. You'll be able to access that video on our website. And I will put that link in the chat. The website is also where you can register for the next and final webinar in this series, which is on December 11, 2025. 

This series is part of the Tech Accelerator Program. It's an initiative funded by the Office of Developmental Programs and the Office of Long-Term Living here in the Commonwealth of Pennsylvania. It's made possible through funding from the American Rescue Plan Act. 

The Pennsylvania Tech Accelerator project includes five major focus areas-- training and resources to build capacity for stakeholders; readiness evaluation to develop tools for successful adoption of remote supports and assistive tech; statewide assessment to plan and benchmark a Technology First Systems Change; a provider survey to assess technology awareness and resources among providers; and finally, two technology summits, which were live events hosted in Philadelphia and Pittsburgh this past spring. 

You can learn more about all of these fantastic projects on our website at disabilities.temple.edu using the links I'll put in the chat shortly. 

ALEX LEE: [LAUGHS] Yes, this is Putting the AT in ArT. First of all, hi, I'm Alex. I have my master's in Art Therapy and Counseling from Drexel. And I'm a board-certified art therapist. I'm also working towards my licensure for professional counseling. This is my colleague, Colleen. 

COLLEEN MCALLISTER: Hello. I am a recreation therapist. I went to East Stroudsburg University a very, very long time ago. And I'm a certified ATR Recreation Specialist. So I've been at Magee for 18 years in our inpatient acute rehab hospital for five years, six years, something like that. And then I've been down at our outpatient facility in our day rehab program for the past 13 years. 

ALEX LEE: Yeah, I've been at Magee for about 2 and 1/2 years now. I also did my internship here when I was in school. And I spend both time here at our outpatient as well as our inpatient hospital, which brings us to what art therapy and rec therapy look like at Moss-Magee. 

Again, we have our inpatient hospital. It's much more acute. We tend to be working more acutely towards physical cognitive goals. And then we have outpatient facility where people can continue to get that treatment and reintegrate into the community. So a lot more focus on that community building and that transition as people return home with maybe a change in functioning or a new disability. 

We do individual sessions, co-treatment sessions with physical, occupational, and speech therapies. And then we do a lot of group sessions down here as well. We exist primarily to support PT, OT, and speech. And that's definitely a part of our skill set and adapting, for me, art to meet those goals. 

And then also, it's a great way to touch on mental health and building coping skills and adapting and coping with, again, a change in function. We also, again, have a really great community down here and are working on building community resources outside of Magee as well, to help people reintegrate into their communities and remain involved in some of the creative arts and recreational and leisure activities. 

COLLEEN MCALLISTER: The other thing is our main hospital has a AT room where patients get set up with learning about what AT is and how they can use it in their personal life as well as their home, for smart homes. 

A lot of their hospital rooms are set up with AT being voice controlled, so to control their lights, their shades, their TV, all of that kind of stuff. So they get really introduced to it there. Then they have an actual room where they have a smart wall. And they can learn all different types of AT stuff there. 

And then when they transition down to here, we have a smaller AT room where we can continue growing and exploring and then adding in all the different aspects that they want, whether it's going back to school, going back to home, or exploring the creative arts world. 

ALEX LEE: So we'll start off with talking about some of our low-tech adaptive tools that we use. Then, we'll move into some high-tech stuff and then art materials and specific adaptations of art processes. 

To start off, we have foam grip tubing, which is a great addition to any paintbrush, pencil, marker, crochet hooks. They have different sizes. They fit different-sized things. There are different options. And they can be cut to size. 

Yeah, but they're just a really great option to build up the handle of any tool that you might be working with. Also, all the slides, I have links to these materials. So if anybody wants to explore that, they will be in the slides. Alanna is going to send those out to everybody. 

The next one is Dycem. It's a rubbery, non-slip mat just to help keep things from sliding. You can buy it in thinner rolls and cut it to size. Or they have thicker, coaster-like squares and circles that can be used as well. 

As Colleen brought up in our earlier session, they're also really reusable. They clean very easily with just soap and water. So any fuzz that builds up, they can be cleaned up to stick for forever, basically. [LAUGHS] Even paint you can peel off of it. 

Next is Coban tape. Tape, in general, can just come really in handy. And it's a really simple low-budget thing. But Coban, in particular, similar to the foam tubing, can build up the thickness of whatever writing or painting utensil you're using, or whatever tool. 

We've even used it to tape things to people's hands to help stabilize it. If they need a certain angle that they can't get with another device, we'll just tape it right on. 

Next, we have a U-cuff. So a universal cuff fits most pens, pencils, brushes. And you can tape things to it. But it has an adjustable Velcro strap that goes right over your hand into your palm. They have silicone ones that attach around your hand onto both ends of whatever utensil you're using, and then these fabric ones that your utensil would slide into a little sleeve or a little pocket on the inside of it. 

We also have wrist supports. Some have U-cuffs attached, but you can also put a U-cuff over this. And it's really similar, but just gives that additional support throughout the wrist and forearm to help stabilize and get as much control as possible. 

And the next one is mouthsticks. So they're a great option for folks that don't have any arm movement. But I also find that some people that have some movement still prefer mouthsticks because they can use it with more control. So again, it's like a stylus that has a screw on the end to put in your writing utensil. And then the opposite end has a flat mouth guard that would fit right between your teeth. 

Another lower cost option that we've played a lot with is a plastic Popsicle stick or tongue depressor, and attaching a Pen Pal Holder to the end of it. It's like an adhesive, little rubbery holder that you can put pens and pencils into. Or even, we'll stabilize it with some tape sometimes. I like to give people options for trying both of these. 

Because different people have different preferences. Some people like the tongue depressor because they can use their tongue more to help control what they're doing, not just their head. And some people will prefer the mouth guard shape. They find that it's easier on their jaw, things like that. 

What else? We have easels. Pretty straightforward in the art world, I feel like. They're a great to way to prop up materials for better reach and visibility. And posturally, it's a little bit easier, so you're not leaning over what you're working on. 

But they usually have a lip at the bottom that holds your paper or your canvas, whatever you're working on. This one here also holds some art materials within it. But there's a lot of good options for those. A lap desk. 

COLLEEN MCALLISTER: So then, lap desks are good so that if you either don't have a table that's adjustable or your chair just doesn't fit under things nicely, you can put it on your lap. It's a beanbag on the one side. And then the top part is hard plastic. It has a ledge so that whatever you're working with doesn't slide off. 

Or you can tape it or use Dycem underneath it. It's very, very lightweight. And it has, I think, a handle so people can carry it and take it and be versatile with it out in the community as well-- especially if they're going somewhere and they need to eat or something like that. So you can use it for many, many things, not just art. Next slide. 

ALEX LEE: Yeah. I would say this one's good, too, if it really just needs to be that much closer-- 

COLLEEN MCALLISTER: Closer, yeah. 

ALEX LEE: --than the table is. From here, we're going to move into some of our high-tech adaptive stuff. Colleen's going to lead the way here. 

COLLEEN MCALLISTER: So with high tech, most people think it's more technology-based, and it's true. Glassouse is a great option if you don't have a lot of arm movement or fine motor skills, that you put the glasses on and your head acts as the mouse. So you can look side to side, up and down. You do need a little bit good cervical range of motion. 

If you just have slight, you can't calibrate it on there because you need to turn all the way to the side. So there is that little downfall if you don't have great cervical range of motion. But typically, we can figure something out, depending on what you're using it with. But there's different attachments to what people's needs are. So the first one is the blue foam and is a bite switch. 

The next one is a foot pedal. Then the pink, round circular one is a press switch. But they have other ones on the website. These are the three that we typically use. There is a chin switch. There's a sip and puff. And there's one other one. I can't think of it right now. A finger switch, a clicker, if you have just a little bit of a digit movement. 

They I'll just click up into it. It's Bluetooth. It pairs with pretty much all devices. I've used it on a cell phone. I used it on an iPad. I've used it on a laptop, a desktop. And it's no problem. It's just Bluetooth. It has about a six-hour battery, I believe. It is a little tight when you first get it on the heads, as people have to, their heads have to stretch it out a little bit. 

But yeah, you can click, drag, scroll. You can get a keyboard put up and then you can type stuff out. I also like to use this with people's voices, if they can, so that you're using your head and your voice so you're not individually typing out every single word. But you can do painting, drawing all with it. It's a great resource. 

The Apple pen, it only works with MacBooks and, I believe, iPads. It does not work with an iPhone. But you can easily fit it into a U-cuff. You can weave it between your fingers. You can wrap stuff with it. 

It's just a fine-point tip, which is really nice if you're into drawing and you really want to get that defined line versus a stylus tip, which is thicker. And it's flexible, so sometimes you have to really press hard. So if you don't have a great pressure to press, it just basically can glide on it. You don't really have to do much with it. So it's a nice aspect. 

The Magic Trackpad, that is an Apple product as well. It does not work with a cell phone. It's basically a square mousepad. As you can see, the patient using it with a stylus. You have to have a light touch to click it. But you also don't have to have really grandiose movements on the trackpad. 

You can be very subtle with a slight movement, and then just pick up. And then your mouse will just follow it. So you don't have to go really crazy movement with it. I also like it because once we start thinking of high-tech stuff, from my point of view, we really think about posturing and body mechanics. 

So if somebody is really like stretching an arm out to get to the iPad screen or their head is really looking down and you're doing something that you enjoy doing for hours, you're going to eventually get pain in those areas. So trying to think about body mechanics and proper positioning so that you can enjoy what you're doing for longer periods of time. 

So the trackpad, you don't have to look at it. All you have to do is look at your device that you're using it with ahead of you and just follow the mouse and whatever you're doing. So it's Bluetooth connected as well. It's pretty small, but you can take it and do whatever you want with it. So that's a nice option. 

The Augmental MouthPad, it's a newer device that's out. It was originally designed for ALS patients. We met with the rep. He came down here to show us how to use it. And we got a personal trial. So basically what you do is that copper piece is your mouse pad. 

And you use your tongue to swipe up, down, side so your cursor will move all over to where you want. And then you tap your tongue to double click where you want to go. It's a learning curve. You can change the speed, how much pressure, how much force you have to click. 

You can use head gestures with it. You have to download the app onto a PC or a laptop, as long as it has Windows 11 or it's a MacBook. And then once that's downloaded and you change all your settings the way you want it to, you can use it on a cell phone. You can use it on an iPad. 

The retainer gets custom built to you. Say, you want to order it, they find a local dentist in your area and they do a 3D scan of your mouth. And then it takes a few weeks, maybe about a month for them to design it. They ship it to you. And then, basically, mine fit perfect. 

But if it's slightly off, you can dip it into a little bit of warm water. And it softens. And then just remold it. So if you ever have dental changes or something like that, as long as it's not super drastic, it should stay fit to your mouth. But the middle picture is a 3D printing box where it charges. 

And it lasts about, I think, it's six to eight hours as well, if you need to use it. But I'm still learning it. But you do have a slight little lisp when you're talking with it, but it's pretty minor. But your tongue's not necessarily fatigued with it. It's just a learning curve because you don't realize all the ways your tongue can do things. 

And you're just like, oh, crap. And you have to be, depending on the settings that you have, either really precise with it. So I'm still actively learning. But they help you with it and navigate. And they have customer service that you can touch base. They're out of California, I believe. But it's great, a great option if you don't have arm movement or anything like that. 

Tobii Dynavox Eye Gaze, so we use these a lot at Magee, if our patients have language deficits and they can't communicate as well. The speech therapist will usually initiate this for the patient if they feel like their cognition is appropriate to use it. Because it is training, a lot of training to know all the ins and outs. 

But also it's very tiring on the eyes. So they have to get used to and adjusted. So a rep from Tobii will come out and work with the patient. But then once they get the hang of it and they can do it, they can use just their eye movements to click on anything that you would on a computer. 

You can have apps downloaded. So you can pretty much do social media, drawing, anything that you want with it. It is a process. Some insurances will cover it. I don't know what this would be out of pocket, but I know it's not cheap. But if you need a communication device, usually, insurance, typically, we can justify it for you. 

Another great thing that is now out there everywhere. IKEA has them. You can get them on Amazon. This is a high-low desk. There are ones that are manual where you can have somebody crank it to the adjusted height that you want. 

But the powered ones are great because all you have to do is press an up or down button, and the table will go up and down-- so if you're in a manual chair and then you want to get in your power chair, or vice versa. Or for those that maybe want to do some standing, you can make it a standing desk. It's great. Some of them, you can preset the heights that you want. 

So all you have to do is press it once, and then it goes to that height and you're good. But it's nice that you can get close to things. You're not far away. Your legs are not scraping the top of a table. But yeah, these are great. And they come in different widths and different lengths. So depending on what you're using it for, there's all different kinds. 

ALEX LEE: So we're going to jump back to some art materials and specific adaptations of those, just starting out some general materials, drawing supplies, painting supplies, clay. And then I have listed whether it's more fine motor or whether it's more gross motor, visual, tactile. It's all about finding a right fit for you, in addition to the adaptive materials. 

And another consideration that I always think for folks, especially at home, is how clean it is, or how messy, if it's something that you can do independently or if you're going to need help cleaning it up, or it's going to take hours to clean up. We want obviously it to be a good fit for your creative process, but also realistically and logistically that it matches what you're looking for. 

So drawing, painting, both really easily adaptable. Some are messier, but there are very low-mess options. The same thing goes for clay. There's a little bit of a steeper learning curve sometimes. But there are options like Model Magic, which is very, very soft and not messy at all. 

There's ceramic clay, which can be a little bit harder. What was I going to say? Oh, but it's much messier. But they're really great for low vision and folks that really are trying to engage in something much more tactile. What else? We have mosaic materials, other textiles, yarn, felt, macramé. 

We have paper. And we do a lot of 3D crafts here as well. These are all things that I think a little bit can be out of the norm, but can be really accessible for some folks. Mosaics can be much more abstract. They can get messy, but they're generally very structured. And you can do them in all different ways using stuff at home. 

Textile stuff is very fine-motor and very tactile, but it's very low mess. Not always the most easily adaptable, but we've done things like felt collages, which is a lot more adaptable than maybe crocheting or knitting. We do paper stuff, collage, origami-- same thing, pretty fine-motor heavy. 

And precision can be an issue, but otherwise generally pretty clean and structured. And like I said, we do a lot of painting of wooden bird houses or ceramic flowerpots, things like that that can be a little bit easier and a little bit less messy, very structured and adaptable to what you're working on. 

These are some of the very specific adaptive devices about art. So one is an adaptive ceramic wheel. They have tabletop wheels as well. They have a wide access to them. They're very wide, so you can fit powered wheelchairs into them. They raise and lower and adapt to whatever height is best for you. 

This is the ceramic wheel or the adaptive wheel. They have a foot pedal that can be doubled as a hand pedal. So it can be raised up to the side and a knob can be attached to it so that you're controlling the speed of the wheel with your hand instead of your foot. And they actually have arm supports on the side as well that also can be doubled for just tabletop space that's a little bit closer to your body. 

A tabletop wheel is another option. Not as many bells and whistles as the adaptive wheel, but a little bit more portable, probably, if you have your own setup at home. I don't have a link for these because they are quite expensive. 

I am working on building a list of community resources and seeing if there's anywhere in the community that has access to these things. And that is something that I can certainly share down the line. But just so that if this is something you're interested in, you have a starting point of what to ask for and what to look for when looking for adaptive art centers. 

Another one is adaptive photography. They have a lot of different arms, tripods, stabilizers, and attachments that can be attached to wheelchairs. They have body equipment that you can wear as well as bite and tongue switches. So this link at the bottom is a link that kind of gives you a breakdown and some examples of those equipment pieces. 

Photography can be great with photo editing. Ir can be a really fun, creative process in Photoshop as well as Procreate. Another option that came up was drones. And doing photography with drones can be kind of cool. And I know there's a lot of adaptive devices that relate to that as well. 

And there's adaptive crochet. This is super DIY. This photo is an adaptive crochet hook that somebody I found on Instagram, her name is Helen Zhao. I don't want to butcher her name, but it's on the screen. She has an Instagram and a YouTube channel. 

She crochet's one handed. So she created this device. I have recreated it myself using things that I already had at the studio. So for me, it was very no-cost, but you could do these things at a really low cost as well. There is a very steep learning curve to adapting crochet. But it's a really cool process. And she has a lot of great videos and tutorials online. 

COLLEEN MCALLISTER: The other thing, we had a patient who had a hemi-arm that was not necessarily super functional. So we put a U-cuff on her, put the crocheting thing so that it just rested where her arm naturally just lays. And we were able to use her good arm and just have that be stationary, too. 

So some people, if they don't want to necessarily adapt-- if they want to use their other arm, but it's maybe just not functional enough-- that's something you can use your other arm, maybe, as a stationary and have it gripped in there. And then you're just using your good hand to crochet and do those skills. 

ALEX LEE: Yeah. I think, generally, with all of this stuff, it is not a one-size-fits-all. And there are a million different ways to make it work. It's just putting in the time and the energy to figure it out. Lastly, this is Procreate-- and more generally, digital art. But Procreate is a digital art app that's really great for accessible art making. 

It's no-mess. It's great for people with limited range of motion, though there is a bit of a learning curve. But there are a lot of free tutorials online. And they do have a lot of great accessibility settings. We have a quad amputee that does a lot of digital art making-- 

COLLEEN MCALLISTER: Without her prosthesis. 

ALEX LEE: Without her prosthesis, yeah. So it's great for that one-handed use or limited, fine-motor even. So it's really versatile, a lot of different brushes, layering, special effects that can mimic other forms of art. And it was designed specifically for Apple products. 

So it does work best on an iPad with an Apple Pencil, but it can be used elsewhere. And again, the accessibility settings are great, particularly with the iPads. Because Apple already has really good accessibility programming. So they pair together really well. And it's a really fun one to explore. 

Lastly, I just wanted to share that the biggest thing is-- what am I trying to say? It's late in the day. The biggest thing is adapting your mindset to the materials that you have and the things that you want to create. All day long, I just take what we have and make it work. 

I've taken paint brushes and taken the metal tip and bent it sideways so that somebody that uses their prosthesis could paint without having to bring their shoulder all the way up to their ear, to bring their prosthesis down. So really, just taking things and thinking outside of the box can be really fun. And I think it's just really important when adapting your creative process. 

Final considerations, chairs that raise and lower or offer additional lumbar or arm support-- this is a good one, especially, again, for pain and sitting in a position for a long period of time. It's just important to have good supports. Again, tape is something that we use for everything and anything, just to make our own DIY art materials and art setups. 

Another one is 3D printing. I shared this example earlier of, I had our 3D printing team print an ashtray as a shallow water bowl that has little divots in the side that your paintbrush can rest on, so that folks with limited like dexterity were able to clean their brushes really easily and make sure that they didn't roll away from them on the lip of whatever cup they would have used otherwise. 

So 3D printing can be a cool way to adapt some stuff and to repurpose stuff. Other considerations-- cost of materials and community resources. Things can be expensive. So again, I recommend adapting what you have first. 

I also think that trying things out in the community, if possible, is a great way to see if you like something and envision how you might engage with that process or that material before going all-in on it and investing time and money on something that might not be a good fit. 

Yeah, I think that is all we had. I am happy to answer general or very specific questions. Again, we take things case by case. So, yeah, I'll open it back up. 

ALANNA RAFFEL: Thank you, Alex and Colleen I know, it feels much later than it is. It feels like-- 

ALEX LEE: The sun is down and my brain is off. 

ALANNA RAFFEL: I'm like, is it not 8 o'clock? 

ALEX LEE: [LAUGHS] 

ALANNA RAFFEL: Thank you again so much for sharing all that great information. I'll open it up, if anyone has any questions they want to ask. I asked them in the earlier session, people have asked me about accessible beading, do you have any ideas for that? If you have any issues that have been plaguing you in your practice or anything like that, feel free to ask any questions, either in the chat or you can unmute yourself. 

As you're pondering your questions, I will pop a couple more links in the chat for you. So I'm sharing a link to the PA Tech Accelerator website, in general. That's where a recording of this with an ASL interpreter, picture-in-picture, will go once it's edited. And there are recordings of all the past, there are 16 other webinars that we've done so far. 

And we have one more after this one in December, on December 11, about assistive tech for rec and leisure, with some rec therapists from Inglis. I also put a link to the state AT Act Program. So here at TechOWL, we represent the state assistive technology program for Pennsylvania. But if you don't live in Pennsylvania, you might be interested in connecting with your state's assistive technology program. 

I'd actually love to hear maybe who's in the room, what states. Are you all from Pennsylvania? Are you from other states? Feel free to pop in the chat where you're from. And I also put a link-- Tennessee, cool. I put a link to a feedback survey. If you have a moment to fill that out, the link is there. Another Pennsylvania, great. 

So in Pennsylvania, we represent the Assistive Technology Act Program. We do have some accessible adaptive art things in our Lending Library. We have a water painting tool. That's pretty cool. I don't know if you've seen that, Alex and Colleen. 

We have Guided Hands, which you could use it for art making, lots of cool things that anyone in Pennsylvania can borrow from our library. I will put that link in the chat as well, in case you are not familiar with it. That is the place where you can borrow all kinds of tools. 

If there is an adaptive art tool-- and this goes for you too, Alex and Colleen-- that we don't have in our Lending Library that you think we should have in our Lending Library that you'd be interested in being able to trial with patients, or if anyone else has any suggestions, there's a button on that website to request specific devices to be added to our library. 

And we really do seek out what-- we want to have the things that people want. Otherwise, we don't want to just put random things in our Lending Library that nobody wants. So we really want to know what people want. So please use that button to suggest items that maybe we can add to the Lending Library. 

And obviously, I want to make sure there's lots of cool adaptive art stuff in there, but that goes for any kind of adaptive tools, assistive technology. Does anyone have any questions before we wrap up? 

LINDA GONZALEZ: I have a quick question. 

ALANNA RAFFEL: Yeah, Linda, go ahead. 

LINDA GONZALEZ: So I'm working with someone who, she'll make some advocacy presentations. And we're working on making a PowerPoint of one of her presentations. And she can use the computer and keyboard and mouse and everything. 

It is a little challenging sometimes using the mouse. In PowerPoint, it has to be very precise. If she's going to resize a text box, she has to hover the mouse just so over the edge of the box. And it's very easy to lose the cursor she needs to resize. Or if she clicks when she has the right cursor, if it moves slightly, then she loses what she's doing. 

So I was wondering if something like the Magic Trackpad is a little easier, as far as the moving and clicking. I feel like getting the mouse in a very precise spot and then clicking it without having it move out of place has been a challenge. So I wonder if you have experience with the Magic Trackpad and if it's kind of like that. 

COLLEEN MCALLISTER: I've never used it for a text box, trying to drag it to make it bigger. But it's your speed that's controlling it. So where a mouse, it's kind of on a ball and it can go all over. It's your hand. So if you're clicking and then dragging, it's however your movement of your arm is is how fast it's going to go. So you don't necessarily lose it. 

Because even if, let's say you're dragging it, and you get to here and you unclick it, then you go back; your hand can be anywhere on the [INAUDIBLE]. It still stays in that spot. So you can rest it and then go back and then click and then drag. You could be fast. You could be slow. It's to what your ability is. 

So a lot of our tetraplegics use it in U-cuffs. And they're zipping around. These young people, they beat me. I'm like, oh, I can't even find the mouse. And you can change the color of the mouse. 

So sometimes your dot on it is different, so you can change it and brighten it and make it bigger or smaller so that it's easy to find, too. And then where you're hovering to click on stuff, it's like a dot, but then there's a circle around it. And it makes it a little bit bigger to where you can click. 

So you don't have to be so precise on clicking certain things. We stumbled upon this because one of our patients was very limited with his range of motion with his arm. And he can now use his iPad with no problem. 

So it might be a little bit easier than a trackball or a regular mouse to navigate. Because I feel like you can get wild and crazy with the balls. A trackball, you can't really slow down that-- if you're going like this, it's like, shoop, off, up on the page or whatever. But I feel like the trackpad is a little bit easier. 

LINDA GONZALEZ: OK. 

COLLEEN MCALLISTER: If you have a laptop that has that little mouse pad on it, you might be able to trial that with a stylus or their finger and see how they do with it. 

LINDA GONZALEZ: Does it work similar to the trackpad on a laptop? 

COLLEEN MCALLISTER: It does. It's just a little bit, I feel like, bigger than laptops. And I feel like because it's so small, you sometimes have to-- I'm able-bodied with my hand, so I'm able to just whatever and do. 

I feel like it's bigger, so you don't have to readjust for a while. So if you want to try something like that and see if that's easy for them. Because I think with that trackpad on a laptop, though, I think you have the buttons below it, if I'm correct. 

LINDA GONZALEZ: Yeah. 

COLLEEN MCALLISTER: So you still have to click them, whereas this you just have to press down on the trackpad. 

LINDA GONZALEZ: Oh, I see, OK. Yeah, that sounds interesting. 

COLLEEN MCALLISTER: Yeah. So I feel like our patients that are tetras that maybe only have tenodesis available, they're zipping through it with no issues. 

LINDA GONZALEZ: Awesome. Thank you. 

COLLEEN MCALLISTER: You're welcome. I hope that answers it. 

LINDA GONZALEZ: Mhm, yeah. 

ALANNA RAFFEL: I don't know if we have that in the Lending Library. And I'm wondering-- 

COLLEEN MCALLISTER: Honestly, I didn't even know Apple made it. 

ALANNA RAFFEL: OK. 

COLLEEN MCALLISTER: I just was trying to figure out, there's gotta be something out there. And their last update was 2018. But they sell it. It's still on their website. They're selling them. 

ALANNA RAFFEL: All right, I'll have to check that out. Maybe it's something we need to add to the Lending Library. I'll also take an opportunity, I feel like I'm always learning so much from other people and other people that are part of this conversation. 

So I just wanted to give an opportunity, if anyone else has a favorite adaptive art tool or cool thing that they have discovered that other people might be interested in, feel free to pop that in the chat, if you want to share with other people something that you think is cool, or a social media account of a cool-- like the one you mentioned, Alex, or any-- 

COLLEEN MCALLISTER: What we have tried-- sorry to cut you off. 

ALANNA RAFFEL: No, go for it. 

COLLEEN MCALLISTER: Because we're at an outpatient, sometimes I'll just make things for splinting material. I've done a two, it's like two circles connected together with a little one. And if they don't do well with the U-cuff, it's like two fingers hooked. And then it's kind of like-- can I have your pen? 

ALEX LEE: Yeah. 

COLLEEN MCALLISTER: --kind of angled like this. And then they can do it a little bit better that way. I just make things up. I've done it for mascara, if you're making mascara. And then tetras can do that, or lipstick. We'll find a way and make it work for them. And not everything works the same for everybody. 

Even if you're the same diagnosis, the same level, you always present a little bit different. So we're tweaking things left and right and just trying to be creative. And then somebody's like, well, turn it this way. And then it's like, game over. It's, oh, yeah, why didn't I think of that? 

ALANNA RAFFEL: Yeah. It's so nice to have an opportunity to problem solve like that. I feel like I interact with a lot of people who aren't necessarily in rehab, aren't necessarily seeing clinicians regularly and don't have as much opportunity to problem solve and be creative with someone. 

So it's so nice to see that folks have the opportunity to do that with you and can bring that home with them into their life. And I feel like it's so powerful to have someone just problem solving with you to figure things out like that. 

COLLEEN MCALLISTER: Yeah, there's a lot of things that you can look online that they're a million dollars. And you're just like, I really don't want to spend that much money on something, so if you can have somebody who's even handy in your house that can build it. 

Or like what we said, instead of buying Coban, if you're just building up a pencil or a pen or whatever, you can literally just get a couple rubber bands and build it up that way. Then you have that rubbery, tactile. 

ALANNA RAFFEL: Yeah. 

COLLEEN MCALLISTER: And it works just as well. 

ALANNA RAFFEL: For sure. Yeah, or instead of Dycem, I sometimes recommend shelf liner. 

COLLEEN MCALLISTER: Yeah. 

ALANNA RAFFEL: Yeah. Dycem still is a special material that shelf liner doesn't replicate. But sometimes we can find things that work. Awesome. Well, if there are no other questions, we will say farewell for now. And we'll see you on December 11. I popped the link in the chat. Oh, Meredith, did you have something? 

MEREDITH MCDEVITT: I wanted to ask, so I teach elementary art education-- I'll turn my camera on, sorry. Hi, everybody. I'm in my classroom right now. And I teach a group of six children who are severely autistic. All the children are non-speaking. And they use assistive technology to communicate. 

And I thank you so much for sharing all the tools. I'm definitely going to look into those tools. I was just wondering if you had any projects? This is my second year teaching them. I'm a Conshohocken Elementary in Conshohocken. 

Yeah, I just wanted to see if you had any recommendations for how to structure their studio time. I'm keeping it very open-ended right now, where I have stations set up. And they explore a different station and they hop to a new one. But yeah, if you had any advice or anything you wanted to share with me? 

ALEX LEE: Yeah, absolutely. Yeah, we do a lot of different projects. Again, I feel like you probably would be able to agree that you encounter this, but after working with a patient once, I'm like, OK, I know the amount of structure that you need. You know what I mean? 

You tend to, the more you work with people and the more you work with a given population, you can anticipate what's going to be better and what's going to fall apart or be too much. So I feel like something I've learned is adding structure to two things that maybe aren't structured by adding steps to it or not bringing out a material right away-- like showing examples first, letting people get into that. 

And then when everybody's done with that, OK, now we're going to bring out the supplies. Now, gather your supplies, whatever-- and really implementing a lot of steps to try not to overwhelm almost. I find a lot of difficulty with that, especially at the main hospital. 

If somebody wants to do mosaics, we have boxes, many, many boxes of mosaic supplies. I'm like, what color do you want? What shape? What size, whatever? I go to bring them all out. And then I'm like, there are five boxes on the table. This is too overwhelming. 

So starting with one and then noticing that somebody's going for the red ones. OK, I'm going to show you this other box, really building in that structure. As far as projects go, we'll do simple things like tape paintings, where we'll put tape in a geometric spot on canvases. 

And then you can paint them in all different colors. You can blend the colors. You can do whatever. And then it dries, you take it off. It's simple, very abstract stuff. Collage, and even felt collage can be really fun because it's tactile. And you can really build. It's simple, too. 

It's not overwhelming with images. It's more focused on shape and color-- so even just breaking down some of the elements of more complex things into something that's simpler. Yeah, I don't know. I could talk about different projects all day. So if you want, I'm happy to-- 

COLLEEN MCALLISTER: Maybe depending on your students, how they learn, some people are very abstract and they can do well with abstract. And others need break-down, step-by-step. You give me a blank canvas, I'm like, I have no idea. And our patients, some are really good and they can just go to town and do their own thing. And the other ones are just sitting there staring at each other. 

So I feel like if you have a mix of them, then you can have one section being very structured. And the other one, if they want to explore and create on their own, having that, and they can go to their own section, that could also help, too. Versus, if they're like, I don't like to follow these steps. I want to do my own thing and be creative. That can help as well. 

ALEX LEE: Or materials that they can get more creative with. Watercolor is a good example where you can get kind of crazy and messy with watercolor. But it's otherwise pretty straightforward. And you can follow that step by step. Another one is tissue paper, things like that where people tend to approach it the same of, oh, I'm going to lay this flat and I'm going to layer it. 

And then you have somebody that bunches it up and glues it that way and makes it three dimensional. And you're like, OK. You totally took it and ran with it. So stuff like that where you get a little bit of the best of both worlds and people can push their creativity, if that's what they're into. 

MEREDITH MCDEVITT: Thank you so much. I appreciate your time. 

ALEX LEE: Yeah, absolutely. Thanks for the question. 

ALANNA RAFFEL: Thanks. Now I want to go play with tissue paper. I put a link to an adaptive art list on our website, as well as a link that, Meredith, if you or anyone on the call is interested in connecting with a TechOWL staff member, Pennsylvania-specific-- Tennessee, you might have to connect with your own state-- to set up an appointment with a AT Specialist. 

Everyone, if you're in the area, can come visit our community space on Temple's campus, where we have some adaptive art stuff and other fun 3D printed tools and things like that. So I will make sure to also send all this information out, including the slides, to everyone who was here today. So thank you, thank you again to Alex and Colleen. And we will see you on December 11, everyone. Bye. 

COLLEEN MCALLISTER: Bye. 

ALEX LEE: Thanks, everyone. 

COLLEEN MCALLISTER: Thank you. 

ALANNA RAFFEL: Thank you.