The email newsletter on
technology issues for people
with visual impairment and blindness.
E-Access Bulletin web site (including archive): <http://www.e-accessibility.com>

Sponsored by the Royal National Institute for the Blind <http://www.rnib.org.uk>
and the National Library for the Blind

Please forward this bulletin to friends or colleagues so they can subscribe by
emailing <mailto:eab-subs@headstar.com> full details at the end of the bulletin. The more subscribers we have,
the better our free service can become!

NOTE: As a navigation aid to those using screen readers, all headings begin with an asterisk and end with a full stop. Please let us know if there is anything else we could do to make navigation of the bulletin easier.

[Issue starts.]

* ISSUE 26, FEBRUARY 2002.


Section two - �The Inbox'
Readers forum.

Section three: E-learning
- Open door policy: the Open University is has ambitions to become the UK's leader in accessible e-learning technology, Dan Jellinek reports.

Section four: Conference preview � CSUN. This year's �Technologies and persons with disabilities� conference looks at training and educational issues, writes Phil Cain.

Section five: Health � access to electronic records. The introduction of electronic health records should inspire doctors to make their communications more accessible, says Kevin Carey.

[Contents ends.]



The RNIB is to offer free web site audits to a series of selected highprofile UK organisations over the next two years, in a new phase of its �See it right� campaign funded by financial services group Standard Life.

Standard Life is providing 50,000 pounds a year for two years, plus a member of staff on secondment, to allow RNIB to offer the free audits to around 50 organisations a year at an estimated cost of between 600 and 1,450 pounds per audit. After two years the process will be reviewed.

Anyone is free to apply, but the organisations to be audited will be selected to represent a cross-section of sectors including retail, charity, travel, education, utility and telecommunications, and government. It is hoped the initiative will raise awareness of web accessibility issues across society.

The �See it right� scheme has already audited several major organisations including Tesco.com, Marks & Spencer, PSI Group, BT, the British Library, and the government�s web portal UK Online. Standard Life is committed to making all of its own web sites accessible by the end of the year.

The audits will use the world wide web consortium�s �WAI� accessibility standards (http://www.w3c.org/wai), and the RNIB estimates that the cost of making the average site accessible following audit will be between one and two per cent of original design costs.

Colin Low, the chairman of RNIB, said the inaccessibility of most web sites currently means that for example �blind people were not able to fill in census returns in privacy online, or book a seat at the theatre without having to hang on the telephone for an eternity�.

He said the internet could bring a vast amount of information within reach of blind people for the first time, and with 8.7 million people with disabilities in the UK exercising spending power of more than 40 billion pounds, it makes strong business sense for companies to embrace inclusive design.


This year's UK local government elections, due to take place in May, will see trials of internet voting, telephone voting and electronic kiosk voting overseen by the Department for Transport, Local Government and the Regions.

One of the most compelling arguments for electronic voting is that it could offer people with disabilities, including the blind and visually impaired, the chance to vote in complete privacy for the first time.

Five local authorities - Nantwich, Liverpool, Sheffield, Swindon and St Albans - will offer constituents the chance to vote using ordinary computers or phones. Two of these - Sheffield and St Albans - together with Chester, will also offer the option to vote using a computer kiosk. It is not known if the kiosks will contain speech software or if they will have tactile cues on the keypads.

Not all of these trials have had details of their private sector partners confirmed, but Liverpool and Sheffield city councils are in talks with telecoms giant BT and online voting company election.com; while Swindon is believed to be discussing its options with the elections body Electoral Reform Services. Both BT and the ERS said their systems would be accessible.

The DTLR has told E-Access Bulletin that all of the systems shortlisted will be compliant with the Disability Discrimination Act.

Meanwhile the Irish government this week announced it too is to try out electronic voting systems in May. Kiosk systems will be used to cast and count votes in Dublin North, Dublin West and Meath in the country's upcoming general election. However, the government has ruled out the use of a voice-activated voting system in the trial because of its cost. See: http://www.environ.ie/pressindex.html


EU member states need to be told web accessibility need not be excessively expensive, the European Union's powerful Economic and Social Committee said this week.

The comments came in response to a recent European Commission communication encouraging European institutions and member states to make their web presence accessible (see EAB, October and November 2001).

The committee also said there is a need for developers and disabled users to participate in joint training. It pledged to make its own web site accessible by the end of the year.

The pronouncements follow research into accessibility issues by Miguel Angel Cabra de Luna, director of Spanish charity for the blind ONCE, on behalf of the ESC. A report will be posted shortly onto the committee's web site (http://www.esc.eu.int).


The Irish government has decided to postpone the reading of its Disability Bill in the Dial, the Irish parliament, in the face of "unanimous objections" from disability rights organisations during the consultation period.

The bill, which was due to be introduced last week, was lambasted by pressure groups which said it fails to confer sufficient rights to people with disabilities, their parents, siblings and carers.

The draft bill did say public sector bodies must ensure their buildings and information are made available to everyone, "so far as practicable". But critics pointed out that Section 47 of the bill would deny the right to redress through civil courts.

According to Gerry Ellis, an accessibility consultant and former chairperson of People with Disabilities in Ireland: "There is nothing [in the bill] about any rights to access to information technology. No powers for any ombudsman or other authority to ensure access. No mention of public procurement policy including accessibility as part of its criteria. Nothing about accessibility being a condition for the granting of a thirdgeneration mobile phone licence. In other words, there may be theory, but nothing to make us feel that there will be actual progress."

To read more about the bill, see the following accessible links site compiled by campaigner Barry McMullin:


Accessibility is a central judging criteria for this year�s UK Government Internet Awards, due to be announced on 18 March by the government's Central Office of Information.

E-Access Bulletin understands that the HM Treasury web site (http://www.hm-treasury.gov.uk) is favourite to win a special award for accessibility. The site is approved by the �Bobby� accessibility checker (http://www.cast.org/bobby) and offers a full text-only version.

The overall winner of best government site will also be a site with clear layout and easy navigation. For more information on the awards see: http://www.internetforum.gov.uk


* VIP HOSTING: A web hosting service specifically aimed at blind and

visually impaired people, 'VIP Lorimernet', was launched last month: http://www.lorimernet.co.uk

* NOVEL BOOK: 'Building accessible web sites', a book by US media

access guru Joe Clark, is due out this spring: http://www.joeclark.org/book

* SHARE LAUNCH: Bookshare, the online e-book sharing platform,

launched last week, offering access to bestsellers including A Beautiful Mind, John Adams, and The Fellowship of the Ring. At present copyright restrictions mean the service is available only to disabled US citizens:

[Section one ends.]


* XP RESULT: In our last issue Paul Evans, Technology Project Officer

with the RNIB's Technology in Learning and Employment programme, asked for information on Windows XP and accessibility. Erin Renschler of Microsoft's corporate PR agency obliged with a link to a relevant feature on Microsoft's web site:
Erin also sent in another relevant press release and a fact sheet for Paul. If other readers are interested in receiving a copy of these please email Tamara Fletcher on tamara@headstar.com with a message saying 'XP Access'.

* OUTLOOK FAIR: Meanwhile Sandy Bannister is looking for a

manual or tutorial on Microsoft Outlook 2000. If anyone knows of one which is accessible please email inbox@headstar.com

[Section two ends.]



The Open University (http://www.open.ac.uk), the distance-learning institution that is Britain�s largest higher education body, is set to become the UK�s largest developer of accessible learning technology as well.

The OU currently serves around 140,000 undergraduate students, of whom more than 7,500 have some kind of disability. Around 900 are blind or visually impaired.

As a distance learning pioneer, technology plays a central role in the university�s courses, with its own electronic conferencing system allowing students on more than 150 courses to exchange more than 150,000 messages a day.

Last year, the university announced in this bulletin that it was to create a Centre for Assistive Technology and Enabling Research (CATER) for disabled students, backed by one million UK pounds from the Higher Education Funding Council for England, in the largest project of its kind in the UK (see E-Access Bulletin, January 2001).

The centre is now up and running and headed by Ralph Keats, who used the RNIB�s recent �Techshare� conference to explain the university�s plans for improving access.

�Far too often in the past we have created courses and then looked at accessibility afterwards as a bolt-on,� he said. �We had to fight for every scrap of funding. But now it is at the heart of everything we do � I can�t believe the changes that have taken place over the past three years.�

The Open University has recently been granted the power to act as its own awarding authority for disabled student allowances, without having to go through central government, Keats said. Since each student with disabilities may require as much as 4,500 pounds worth of specialist technology for work leading to a degree, �we acquired a lot of buying power overnight. Last year we spent three million pounds on access technology.�

Increased influence came along with the spending power, he said, �Suppliers want your business and so will work with you and we can help to raise standards."

CATER is gearing up to work with everyone involved in putting out OU courses, from graphic designers to those creating CD-ROM packs, to help ensure their work is accessible. It is also going to assess new learning technologies as they appear, for their potential.

One of the main access technologies the university is currently developing is �DREAM� (Digitally Recorded Educational Audio Materials), a project which intends to replace analogue audio recording of course materials with digital recording, to enhance their quality, interactivity and accessibility.

Some 1,200 OU students currently access courses by audio cassette, including the 900 visually impaired people plus a further 300 with dyslexia or manual impairments. Sound quality can be poor, however, and degrades over time, and searching for material across a course of several cassettes is all but impossible. Furthermore when courses are revised every few years, an entirely new set of analogue tapes needs to be created.

With digitised texts, there are a range of user interfaces from which students can choose, as well as approved accessible web interfaces to course information and work for blind students.

Another institution leading the way in accessible online learning is the Royal National College for the Blind (http://www.rncb.ac.uk), an independent national and international specialist further education college.

�The college aims to help learners control and manage their own learning, and this brings a heavy emphasis on control of computer systems,� said Tim Ashmore, RNCB learning support manager.

�However, there is no consistent national approach at the moment in training teachers in online learning. There are pockets of activity, for example at the education technology agency Becta, but where is the consistent strategy that we can tap into?�

The college has its own intranet for teachers and students, �RNC Intralearn�, and students are gradually taught how to access learning materials for themselves, Ashmore said. �Many learners do not have the basic skills, so we are making it part of the core curriculum. There are other problems, including funding, but this is the only way to go, not least because we want our learners to continue to use these technology skills beyond their college courses.�

Shirley Evans, RNCB learning technology co-ordinator, said the college had reviewed around 30 different �virtual learning environment� products for their accessibility. �Accessibility as a huge issue, but the core test seemed to be: did the environment work with a screen reader?� she said.

The answer to many of the problems faced by the college and other educational institutions as likely to be at least partly the establishment of specialist teams of teachers nationally who could help teachers locally with accessibility issues, Evans said.

Whatever the solutions, time is running out for both specialist and mainstream education providers to get these issues right. Under the new Special Educational Needs Disabilities Act (SENDA), from September 2002 it will be unlawful for all education providers to discriminate against disabled students by treating them less favourably than others, and institutions will be required to make adjustments including making electronic courseware accessible; and allowing disabled people equal access to technical support for their equipment (see http://www.techdis.ac.uk/articles/SENDRE.htm).

The Open University�s Ralph Keats acknowledges that there will always be problems making some types of course accessible, for example music courses where special notations may be used, current affairs courses where material needed to be up to the minute, and any new course where materials were still being developed.

But he said the SENDA plus possible support from the Human Rights Act meant visually impaired students would have more legislative help than ever before in seeking accessibility. �We�ve never had it so good.�

[Section three ends.]



This year's annual 'Technologies and persons with disabilities' conference at the Center on Disabilities, California State University (CSUN � http://www.csun.edu/cod) is focusing on the educational challenges of assistive technology. Topics to be covered include training, online teaching, and the access conundrums posed by non-Roman writing systems such as Braille, mathematics and musical notation.

The following is a round-up of some of the main sessions relating to blindness and visual impairment, with links to the relevant session summaries.

Hans Russman of the Institute for Blind and Partially Sighted in Denmark has created a training course to help blind computer users pick up tips from sighted colleagues. To do this the institute uses tactile diagrams to illustrate the format of typical Windows screens: http://www.csun.edu/cod/conf2002/proceedings/163.htm

Brian Hardy and Brian Charlson, meanwhile, will outline the results of a US-Australian trial of 'community models' in training people to use information technology outside the workplace: http://www.csun.edu/cod/conf2002/proceedings/156.htm

A paper outlining how UK-based trainer's skills will in the future be assessed, certified and updated will be presented by Steve Tyler, from the RNIB, and Sarah Morley of the British Computer Association for the Blind:
http://www.csun.edu/cod/conf2002/proceedings/153.htm Meanwhile Elizabeth Cohen and Walter Kimble of the University of Southern Maine will explain how they are using the internet to train and certify university educators in assistive technology: http://www.csun.edu/cod/conf2002/proceedings/232.htm

Debra Bauder from the University Of Louisville and Debbie Sharon of the Bluegrass Technology Center will explain how assistive technology training is delivered direct to the end user for free in Kentucky using the internet:

More general e-learning topics are also given prominent billing with a talk on the development of peer-reviewed lecture note distribution platform Merlot:
http://www.csun.edu/cod/conf2002/proceedings/9.htm There will also be a demonstration of software that creates accessible narrated PowerPoint presentations, by Dick Banks of Equal Access to Software and Information:

Bill McAmis of the Bakersfield City School District will explain how his education authority installed a bilingual and accessible intranet in its elementary schools in California. To give an idea of the scale of the challenge, McAmis notes that the schools teach more than 28,000 elementary school students:

Donna McNear of Rum River Special Education Cooperative and Larry Lewis and Jim Halliday of HumanWare will also examine bilingualism in the classroom, in considering the high tech needs of students learning in Braille:

For those struggling to learn Braille, Mimi Berman from Independent Living Aids in Jericho will demonstrate the BrailleMaster. The machine teaches Braille dot patterns, level two contractions and the most commonly used English words:

Glen Gordon of Freedom Scientific will preview the company's next generation of Braille note-taking devices. These will incorporate a web browser and the ability to play streaming audio: http://www.csun.edu/cod/conf2002/proceedings/111.htm

VisuAide's Yvan Lagace will preview the development of a portable orientation device that could be used in conjunction with Braille note takers by the end of June this year. Victor Escort, as the global positioning system (GPS) will be known, will be adapted to work with a wider range of personal digital assistants in 2003: http://www.csun.edu/cod/conf2002/proceedings/268.htm

Yoshinobu Maeda of Japan's Niigata University will present research suggesting that the descriptions given to users of GPS orientation systems should give information about both landmarks and intersections: http://www.csun.edu/cod/conf2002/proceedings/296.htm

The advent of Section 508, which requires US government agencies to provide accessible information, is high on the CSUN agenda this year. Among presentations on this topic is one from representatives of the US Internal Revenue Service, which will say: "Section 508 provides a tremendous opportunity for us to improve service to all of our customers":

Karl Hebenstreit Jr of the General Services Administration, the US procurement department, will outline a development process known as 'bootstrapping' in which the users of software help make it more accessible:

Jim Fruchterman, the man behind the development of the JAWS screenreader and now head of technology nonprofit Benetech, will provide an update on the progress of the recently launched US digital book sharing platform Bookshare:
http://www.csun.edu/cod/conf2002/proceedings/135.htm Meanwhile, Larry Skutchan and Keith Creasy from the American Printing House for the Blind will show how to create electronic books in the new DAISY 3.0 e-book format using a program called BookMaster. Skutchan told E-Access Bulletin that the software is expected to be released in April and will cost around 350 dollars: http://www.csun.edu/cod/conf2002/proceedings/158.htm

Also debuting at CSUN are prototype web browser WebIE and Organiser, an aptly named personal organiser. Paul Blenkhorn and Gareth Evans, the creators of these two pieces of Microsoft-enhancement software, conducted their research at the University of Manchester Institute of Science and Technology in the UK, with the financial assistance of the Guide Dogs for the Blind Association: http://www.csun.edu/cod/conf2002/proceedings/55.htm

Deborah Gilden from the Kettlewell Eye Research Institute is also hoping to help visually impaired people make the most of Microsoft software. "Few realise that Microsoft Office applications include many features that, although not intended for low-vision viewers, can serve as even more powerful and flexible tools for making screen images accessible," Gilden says:

John Gardner of Oregon State University will announce progress in solving the knotty problem of providing access to mathematical notation (see section three, January 2002). A beta version of a mathematical text editing suite called WinTriangle has been in testing since September last year:
http://www.csun.edu/cod/conf2002/proceedings/300.htm Nancilu McClellan will also address the problem of accessible mathematics in a talk outlining how to use the speech recognition capabilities of Dragon's NaturallySpeaking Professional and Dragon Dictate:

William McCann and David Pinto of Dancing Dots will demonstrate how JAWS screenreader scripts can be used by blind people to record, edit and notate music using mainstream computers packages: http://www.csun.edu/cod/conf2002/proceedings/264.htm

On an international note, Hiroyuki Nakamura from the Japanese Institute for Communication Environment will plead for harmonisation in the accessibility standards-setting processes being developed by different countries. He outlines how Japanese access rules have become confusing and contradictory because they have been set by two different bodies, the Ministry of Posts and Telecommunications and the Ministry of International Trade and Industry:

[Section four ends.]



by Kevin Carey humanity@atlas.co.uk

The key question in Umberto Eco�s novel �The name of the rose� is whether the monks are keeping their books from people or for them. The same question might be put to lawyers stubbornly sticking to their Latin and doctors who are still wedded to Greek. This may be fine enough in law where most people expect lawyers to represent them but it is no longer acceptable in health care, where people want much more control over what happens to them.

We ought to remember it is less than two years since a paediatrician was attacked because vigilantes thought he was a paedophile. Well, you may know the difference between a -trician and a -phile but how many of us know our -ectomy from our -otomy? Taking more control of our bodies requires a better understanding of what clinicians are doing, or failing to do.

Dropping the Greek will no doubt help, but we will need to go a good deal further than this in ensuring the digitisation of medical records also increases their accessibility and usefulness. A record that is either too vague or too indicative is bound to cause enquiry and distress. So it is not only a matter of words but of understanding the way that human beings handle information.

If you have a cancer, to be told that simply there are a variety of measures that might be taken or, conversely, to be given a single stark statistic relating to the probable cause or outcome of the disease and nothing else, is bound to cause concern.

The problem is further complicated by the fact that the information contained in a patient�s digital record will be compared with a mass of health and medical information found by patients on the web, some from NHS sites but much of it from the sites of non-governmental organisations, support groups, or campaigning organisations that my rely on talking up a problem to raise funds for dealing with it, not to mention an explosion of �alternative� therapy sites from the relatively mainstream to the Druidic.

If we look at digital medical records there are really three areas of interest for the patient: what is this condition; how does it affect me; and what should I do? The first of these questions hardly concerns traditional medical records because professionals already know the background detail, and the third is not strictly a matter for a record either, since it concerns the future. But in the mind of the patient, all three have great weight.

Even if you are inclined to adopt a wholly mechanistic view of physical wellbeing, that the brain has nothing to do with a stomach condition, for example, there is still a serious problem in translating anatomy and chemistry into humanity. With respect to personalising the condition, there is not only the question of the syndrome as it relates to an individual but there is also, crucially, the question of statistical probability. And despite being a society that depends to a massive degree on the manipulation of information we are, by and large, statistically illiterate.

Most of us cannot distinguish the causal from the contingent nor the highly probable from the statistically possible. We live in an age where the media have a vested interest in discrediting the sane statistical truth, the most startling recent health-related examples being the brief hysteria over necrotising fasciitis (the �flesh-eating bug�) and continuing wild stories about cloning.

Finally there are further, more prosaic requirements for people be able to get hold of the information they need. Will the print size and font be adjustable, for example, or will people be able to choose between image maps and text explanations? However these questions, though vitally important, are trivial next to the ones posed above about the fundamental accessibility and usefulness of the information in the record. Before we get too obsessed, yet again, with the technology, we need to look at the psychology.

NOTE: This article first appeared in our sister publication Future Health Bulletin (http://www.headstar.com/futurehealth). To subscribe to the plain text version of this bulletin email: fh-text-subscribe@headstar.com
or for the HTML version email:

[Section five ends.]


To subscribe to this free monthly bulletin, e-mail eab-subs@headstar.com with 'subscribe eab' in the subject header. You can list other email addresses to subscribe in the body of the message. Please encourage all your colleagues to sign up!

To unsubscribe at any time, put 'unsubscribe eab' in the subject header.

Please send comments on coverage or leads to Dan Jellinek at: dan@headstar.com

Copyright 2002 Headstar Ltd. http://www.headstar.com ISSN 1476-6337
The Bulletin may be reproduced in full as long as all parts including this copyright notice are included. Sections of the report may be quoted as long as they are clearly sourced as 'taken from e-access bulletin, a free monthly email newsletter', and our web site address http://www.eaccessibility. com is also cited.

Editor - Dan Jellinek dan@headstar.com Deputy Editor - Phil Cain phil@headstar.com Reporter - Tamara Fletcher tamara@headstar.com Editorial Advisor - Kevin Carey humanity@atlas.co.uk

[Issue ends.]