presentation about disability

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Disability Awareness

Supporting disability awarness.

Disability awareness is an avenue to social-emotional learning . Awareness is the foundation for empathy. To create a more inclusive world tomorrow students need opportunities to gain an awareness of disabilities today.

One of changing perspectives goals is to help students to gain knowledge and experience about disabilities and to teach them to bridge inclusion., some of our schools don’t offer real life examples of the many disabilities in the world. by talking and learning about disabilities we help our students develop awareness and empathy. and once that discussion begins they learn about how they are each different and how those differences are to be celebrated., disability is diversity, elementary disability awareness curriculum.

180+ CCSS-Aligned Lesson Plans (20-45 minute duration)

170+ Book Discussion & Literature Units

90+ Videos & Discussion

Experiential Activities

30+ Reflection Activities

Family Resources

Educator Resources

Middle School Disability Awareness Curriculum

80+ CCSS-Aligned Lesson Plans (25-45 minute duration)

50+ Books and Discussion Questions

60+ Videos and Discussion

10+ Reflection Activities

High School Disability Awareness Curriculum

40+ Lessons Within 12 Learning Modules (30 minute duration)

50+ Book Recommendations

10+ Call To Action Project Ideas and Resources

10+ Activities to Spark Discussion (15 minute duration)

Benefits Include:

Customizable lesson plans and hands-on activities, distance learning options and support, new content added annually, easy to use online platform for global access, outcomes focused on social-emotional learning, equity, and inclusion, optional personalized coaching available, interested in our curriculum.

Changing Perspectives' curriculum resources are accessible through  an online platform that allows users to access an array of customizable curricular resources, family resources, educator implementation guides, and more.

Learn more about the disability categories we use:

Autism spectrum.

Cognitive Differences

Hearing Loss/Deafness

Learning Disabilities

Physical Disabilities

Social/Emotional Impairments

Speech/Language Disabilities

Visual Impairments

More Details ...

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• Content is added to a Planner via an intuitive drag and drop interface.
• Days and content are easily added to and removed from the Planner.
• Planners are easily saved and retrieved.
• Unlimited planners are available.
• Planners can be emailed and/or printed and electronic versions contain links to the curriculum.
• Designed for educator customization. 
• There is a precurated library of resources, with a variety of media and methods, that allow you to prepare content the way you need and that fit your teaching style.
• Changing Perspectives experts, and experts in the field of disability awareness, create new content which is added to the Educator Portal each summer.
• Disability Awareness content is aligned with Common Core standards.

Educator Support

• Family newsletters, aligned with our disability categories, are available and can be distributed multiple ways (print, email, posted online).
• Template letters, in Word & Google docs, are available for you to customize and share with parents.
• Tips & tricks for in-person and virtual presentation of materials are available.
• A rich Resource Library of materials, for you and to share with others, is included and is regularly updated throughout the year.
• Individual coaching and professional development is available.

Changing Perspectives Alignment to Social-Emotional Learning Competencies

Changing Perspectives curricular resources are designed to support the work driven by social-emotional learning (SEL) competencies as developed by the Collaborative for Academic, Social, and Emotional Learning, or CASEL. We see disability awareness as a means of supporting schools’ efforts around SEL development. The following chart shows the alignment between Changing Perspectives curricula and the vital SEL standards that schools are focused on achieving for student success.

Self- Awareness

Students develop skills and language to describe themselves.

Students learn cultural identity through the lens of disability awareness.

Students explore their own strengths and challenges.

Students self-reflect about how they change as they grow.

Students form accurate self- perceptions.

Self- Management

Students consider their strengths and challenges to set personal goals.

Students have opportunities to develop self-advocacy skills.

Students gain greater self- confidence.

Social Awareness

Students can think through how others may be feeling in a given situation.

Students understand and embrace differences.

Students appreciate diversity.

Students are able to  take the perspective of another (empathy).

Students show respect for others.

Relationship Skills

Students develop relationships with people who are different from them.

Students develop appropriate communication skills.

Students build positive relationships with others.

Decision Making

Students understand the importance of ethical responsibility.

Students observe and consider problems carefully.

Students take steps to solve problems in effective, respectful ways.

Ready to Find Out More?

Want to find out more about Changing Perspectives’ Disability Awareness Curriculum? Contact us and schedule a complimentary conversation to see how we can help.

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Changing perspectives is a 501(c)(3) tax-exempt nonprofit organization registered in the us under ein 46-3115902.

Changing Perspectives

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Communicating With and About People with Disabilities

Download and print this page [PDF – 966 KB]

About 1 in 4, or 61 million, U.S. adults reports having some form of a disability. 1 Disability is part of the human experience, but sometimes people use words or phrases that are insensitive and do not promote understanding, dignity, and respect for people with disabilities. Most often than not, this is not intentional, but is disrespectful just the same.

• People-first language is the best place to start when talking to a person with a disability.
• If you are unsure, ask the person how he or she would like to be described.
• It is important to remember that preferences can vary.

People First Language

People-first language is used to communicate appropriately and respectfully with and about an individual with a disability. People-first language emphasizes the person first, not the disability. For example, when referring to a person with a disability, refer to the person first, by using phrases such as, “a person who …”, “a person with …” or, “person who has …”

These are some general tips you can follow:

• Okoro CA, Hollis ND, Cyrus AC, Griffin-Blake S. Prevalence of Disabilities and Health Care Access by Disability Status and Type Among Adults— United States, 2016. MMWR Morb Mortal Wkly Rep. 2018; 67:882–887. DOI: http://dx.doi.org/10.15585/mmwr.mm6732a3l.

For more resources on disability inclusion, visit www.cdc.gov/disabilities »

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• CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website.

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Let’s “Talk” about Disability

Published by Monica Ström Modified over 5 years ago

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Presentation on theme: "Let’s “Talk” about Disability"— Presentation transcript:

Technology as a Reasonable Accommodation Things to Consider ADA Trainer Network Module 7b Trainer’s Name Trainer’s Title Phone /Website Address 1.

Structural Accessibility of Public Entities ADA Trainer Network Module 5c Trainer’s Name Trainer’s Title Phone Number /Website Here 1.

The Business Case for Web Accessibility Trainer’s Name Trainer’s Title Phone Number /Web Address ADA Trainer Network Module 7g 1.

ADA Trainer Network Module 5e Trainer’s Name Trainer’s Title Phone /Website Address Supplemental Resources.

Accessible Technology and our Changing Workforce ADA Trainer Network Module 7a Trainer’s Name Trainer’s Title Phone Number /Website Here 1.

Web Accessibility Case Law Examples ADA Trainer Network Module 7i

Thinking it Through: Interactive Exercises about Public Entities and the ADA ADA Trainer Network Module 5d Trainer’s Name Trainer’s Title Phone Number.

Assessing Assistive Technology Needs Understanding the AT Evaluation Process 1 ADA Trainer Network Module 7c Trainer’s Name Trainer’s Title Phone /Website.

Program Accessibility in Public Facilities ADA Trainer Network Module 5b Trainer’s Name Trainer’s Title Phone Number /Website Here 1.

Designing your Website for Usability and Accessibility Trainers Name Organization Phone Number /Website ADA Trainer Network Module 7f 1.

The Web Experience for People with Disabilities ADA Trainer Network Module 7e 1 Trainer’s Name Trainer’s Title Phone /Website Address.

About Reasonable Accommodation ADA Trainer Network Module 3c 1 Trainer’s Name Trainer’s Title Phone /Web Page.

People with Disabilities: America’s Largest Minority ADA National Network Module 5a Trainer’s Name Trainer’s Title Phone Number /Website 1.

Disability in America: The Impact of Social Paradigms and Legislation 1 ADA Trainer Network Module 2c Trainer’s Name Trainer’s Title Phone Number /Web.

Navigating the Hiring Process as a Job-Seeker with a Disability 1 ADA Trainer Network Module 3f Trainer’s Name Trainer’s Title Phone Number /Website.

Trainer’s Name Trainer’s Title Further Resources for Disability & Employment: Continuing the Journey 1 Phone Number /Website Here ADA Trainer Network.

ADA Trainer Network Module 6b Trainer’s Name Trainer’s Title Phone /Website Legal Applications of Title III.

What Would You Do? A Quiz about Interacting with People with Disabilities Phone /Web Page ADA Trainer Network Module 2f 1 Trainer’s Name Trainer’s.

Title III Overview of Design Standards 1 ADA Trainer Network Module 6g Trainer’s Name Trainer’s Title Phone /Website.

In Their Shoes: Accessibility from Another Perspective 1 ADA Trainer Network Module 4a Trainer’s Name Trainer’s Title Phone Number /Web Address.

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© 2024 SlidePlayer.com Inc. All rights reserved.

A collection of TED Talks (and more) on the topic of Disability.

Video playlists about Disability

Designing for disability

Should we redesign humans?

Talks about disability.

A powerful new neurotech tool for augmenting your mind

How to help employees with disabilities thrive

The internet's accessibility problem -- and how to fix it

A disability-inclusive future of work

What I learned from dating while disabled

4 ways to design a disability-friendly future

A brain implant that turns your thoughts into text

The life-changing power of assistive technologies

The missing 96 percent of the universe

To overcome challenges, stop comparing yourself to others

¿Cuándo te importa mi silla de ruedas?

How technology has changed what it's like to be deaf

The perks of being a pirate

The cost of failing to design accessibly

How I helped make Lego accessible to the blind

A new way to define self-worth

Exclusive articles about disability, my personal lesson in “white privilege 101” and other of this week’s comments, i am also not an inspiration and other of this week’s smart comments, you get to decide if you’re an inspiration or not.

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Social Inclusion of People with Disabilities Campaign

It seems that you like this template, social inclusion of people with disabilities campaign presentation, free google slides theme, powerpoint template, and canva presentation template.

It's important that we create an environment that respects the right of disabled individuals to lead independent and meaningful lives. This easily editable Google Slides and PowerPoint template can help you provide key information on topics such as advocating for access rights, accommodating special needs, creating comfortable environments, forming relationships, and more. Download this design today and contribute to fostering a culture of acceptance and tolerance for all types of diversity!

Features of this template

• 100% editable and easy to modify
• 31 different slides to impress your audience
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• Includes 500+ icons and Flaticon’s extension for customizing your slides
• Designed to be used in Google Slides, Canva, and Microsoft PowerPoint
• 16:9 widescreen format suitable for all types of screens
• Includes information about fonts, colors, and credits of the resources used

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Attribution required If you are a free user, you must attribute Slidesgo by keeping the slide where the credits appear. How to attribute?

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The Faces and Facts of Disability

www.socialsecurity.gov/disabilityfacts/

Social Security Disability Insurance

• To qualify, the disabled person must have a recent work history
• Special rules apply to younger persons who need less work to qualify

Work Requirements

The amount of work you need depends on your age at the time disability starts

Before age 24 1-1/2 years of work in a three-year period before becoming disabled

Age 24-31 work during half the time between age 21 and the time the disability began

Age 31 or older work during five out of the 10 years before the disability began

Amount of Benefit

Benefits are calculated based on your entire work history

Who are Disability Insurance Beneficiaries?

Over 8.5 million

disabled workers receive disability insurance

A diverse group, including people with:

Disability Insurance Beneficiaries: Health

Disability Insurance beneficiaries that died within 5 years of receiving benefits

Disability Insurance Benefits are Modest

The average disability worker benefit:

$1,234 per month

$264 per week

$37 per day

cf. FPL for an individual: $1,065 per month

Even with disability insurance:

1 in 4 beneficiaries live in poverty and most are low-income (<200% FPL).

More than 11% of disabled workers are poor enough that they qualify for SSI.

More than 38% of disabled workers and 43% of all disabled beneficiaries receive less than $1000 per month.

Make your PowerPoint presentations accessible to people with disabilities

This topic gives you step-by-step instructions and best practices for making your PowerPoint presentations accessible and unlock your content to everyone, including people with disabilities.

PowerPoint has many features built-in that help people with different abilities to read and author presentations. In this topic, you learn, for example, how to work with the Accessibility Checker to tackle accessibility issues while you're creating your presentation. You'll also learn how to add alt texts to images so that people using screen readers are able to listen to what the image is all about. You can also read about how to use slide design, fonts, colors, and styles to maximize the inclusiveness of your slides before you share or present them to your audience.

In this topic

Best practices for making powerpoint presentations accessible.

Check accessibility while you work

Create accessible slides

Avoid using tables

Add alt text to visuals

Create accessible hyperlink text and add screentips, use accessible font format and color, use captions, subtitles, and alternative audio tracks in videos, save your presentation in a different format, test accessibility with a screen reader.

The following table includes key best practices for creating PowerPoint presentations that are accessible to people with disabilities.

Top of Page  

The Accessibility Checker is a tool that reviews your content and flags accessibility issues it comes across. It explains why each issue might be a potential problem for someone with a disability. The Accessibility Checker also suggests how you can resolve the issues that appear.

In PowerPoint, the Accessibility Checker runs automatically in the background when you're creating a presentation. If the Accessibility Checker detects accessibility issues, you will get a reminder in the status bar.

To manually launch the Accessibility Checker, select  Review  >  Check Accessibility . The  Accessibility  pane opens, and you can now review and fix accessibility issues. For more info, go to  Improve accessibility with the Accessibility Checker .

Top of Page

The following procedures describe how to make the slides in your PowerPoint presentations accessible. For more info, go to Video: Create slides with an accessible reading order and Video: Design slides for people with dyslexia .

Use an accessible presentation template

Use one of the accessible PowerPoint templates to make sure that your slide design, colors, contrast, and fonts are accessible for all audiences. They are also designed so that screen readers can more easily read the slide content.

To find an accessible template, select File > New .

In the Search for Online templates and themes text field, type accessible templates and press Enter.

In the search results, select a suitable template.

In the template preview, select Create .

Give every slide a title

One simple step towards inclusivity is having a unique, descriptive title on each slide, even if it isn't visible. A person with a visual disability that uses a screen reader relies on the slide titles to know which slide is which.

Use the Accessibility ribbon to make sure every slide has a title. For instructions, go to  Title a slide  and expand the "Use the Accessibility ribbon to title a slide" section.

Hide a slide title

You can position a title off the slide. That way, the slide has a title for accessibility, but you save space on the slide for other content. For instructions, go to  Title a slide  and expand the "Put a title on a slide, but make the title invisible" section.

If you want all or many of your slide titles to be hidden, you can modify the slide master. For instructions, go to  Title a slide  and expand the "Systematically hide slide titles" section.

Restore a slide design

If you've moved or edited a placeholder on a slide, you can reset the slide to its original design. All formatting (for example, fonts, colors, effects) go back to what has been assigned in the template. Restoring the design might also help you find title placeholders which need a unique title.

To restore all placeholders for the selected slide, on the Home tab, in the Slides group, select Reset .

Set the reading order of slide contents

Some people with visual disabilities use a screen reader to read the information on the slide. When you create slides, putting the objects in a logical reading order is crucial for screen reader users to understand the slide. 

Use the Accessibility Checker and the Reading Order pane to set the order in which the screen readers read the slide contents. When the screen reader reads the slide, it reads the objects in the order they are listed in the Reading Order pane. 

For the step-by-step instructions how to set the reading order, go to  Make slides easier to read by using the Reading Order pane .

Use built-in slide designs for inclusive reading order, colors, and more

PowerPoint has built-in, predesigned slide designs that contain placeholders for text, videos, pictures, and more. They also contain all the formatting, such as theme colors, fonts, and effects. To make sure that your slides are accessible, the built-in layouts are designed so that the reading order is the same for people who use assistive technologies such as screen readers and people who see. For more info, go to Video: Use accessible colors and styles in slides .

On the View tab, select  Normal .

On the Design tab, do one or both of the following:

Expand the Themes gallery and select the slide layout that you want. PowerPoint automatically applies this layout to the presentation.

Select Design Ideas  and select one of the predesigned designs.

In general, avoid tables if possible and present the data another way, like paragraphs with headings. Tables with fixed width might prove difficult to read for people who use Magnifier, because such tables force the content to a specific size. This makes the font very small, which forces Magnifier users to scroll horizontally, especially on mobile devices.

If you have to use tables, use the following guidelines to make sure your table is as accessible as possible:

Avoid fixed width tables.

Make sure the tables render properly on all devices, including phones and tablets.

If you have hyperlinks in your table, edit the link texts, so they make sense and don't break mid-sentence.

Make sure the slide content is easily read with Magnifier. View it on a mobile device to make sure people won’t need to horizontally scroll the slide on a phone, for example.

Use table headers.

Test accessibility with Immersive Reader.

Use table headers

Screen readers keep track of their location in a table by counting table cells. If a table is nested within another table or if a cell is merged or split, the screen reader loses count and can’t provide helpful information about the table after that point. Blank cells in a table could also mislead someone using a screen reader into thinking that there is nothing more in the table. Use a simple table structure for data only and specify column header information. Screen readers also use header information to identify rows and columns.

To ensure that tables don't contain split cells, merged cells, or nested tables, use the  Accessibility Checker .

Place the cursor anywhere in a table.

On the  Table Design  tab, in the  Table Styles Options group, select the  Header Row  checkbox.

Type your column headings.

Alt text helps people who use screen readers to understand what’s important in the visuals in your slides. Visual content includes pictures, SmartArt graphics, shapes, groups, charts, embedded objects, ink, and videos.

In alt text, briefly describe the image, its intent, and what is important about the image. Screen readers read the description to users who can’t see the content.

Tip:  To write a good alt text, make sure to convey the content and the purpose of the image in a concise and unambiguous manner. The alt text shouldn’t be longer than a short sentence or two—most of the time a few thoughtfully selected words will do. Do not repeat the surrounding textual content as alt text or use phrases referring to images, such as, "a graphic of" or "an image of." For more info on how to write alt text, go to  Everything you need to know to write effective alt text .

Avoid using text in images as the sole method of conveying important information. If you use images with text in them, repeat the text in the slide. In alt text of such images, mention the existence of the text and its intent. 

PowerPoint for PC in Microsoft 365 automatically generates alt texts for photos, stock images, and the PowerPoint icons by using intelligent services in the cloud. Always check the autogenerated alt texts to make sure they convey the right message. If necessary, edit the text. For charts, SmartArt, screenshots, or shapes, you need to add the alt texts manually.

For the step-by-step instructions on how to add or edit alt text, go to  Add alternative text to a shape, picture, chart, SmartArt graphic, or other object  and Video: Improve image accessibility in PowerPoint .

In the Alt Text pane, spelling errors are marked with a red squiggly line under the word. To correct the spelling, right-click the word and select from the suggested alternatives.

In the Alt Text pane, you can also select Generate a description for me to have Microsoft cloud-powered intelligent services create a description for you. You see the result in the alt text field. Remember to delete any comments PowerPoint added there, for example, "Description automatically generated."

To find missing alternative text, use the Accessibility Checker.

Note:  For audio and video content, in addition to alt text, include closed captioning for people who are deaf or have limited hearing.

People who use screen readers sometimes scan a list of links. Links should convey clear and accurate information about the destination. For example, avoid using link texts such as "Click here," "See this page," "Go here," or "Learn more." Instead include the full title of the destination page. You can also add ScreenTips that appear when your cursor hovers over text or images that include a hyperlink.

Tip:   If the title on the hyperlink's destination page gives an accurate summary of what’s on the page, use it for the hyperlink text. For example, this hyperlink text matches the title on the destination page:  Create more with Microsoft templates .

For the step-by-step instructions on how to create hyperlinks and ScreenTips, go to Add a hyperlink to a slide .

An accessible font doesn't exclude or slow down the reading speed of anyone reading a slide, including people with low vision or reading disability or people who are blind. The right font improves the legibility and readability of the text in the presentation.

For the step-by-step instructions on how to change fonts in PowerPoint go to Change the fonts in a presentation or  Change the default font in PowerPoint .

Use accessible font format

To reduce the reading load, select familiar sans serif fonts such as Arial or Calibri. Avoid using all capital letters and excessive italics or underlines.

A person with a vision disability might miss out on the meaning conveyed by particular colors. For example, add an underline to color-coded hyperlink text so that people who are colorblind know that the text is linked even if they can’t see the color. For headings, consider adding bold or using a larger font.

Use accessible font color

Here are some ideas to consider:

The text in your presentation should be readable in a high contrast mode. For example, use bright colors or high-contrast color schemes on opposite ends of the color spectrum. White and black schemes make it easier for people who are colorblind to distinguish text and shapes.

Use the predesigned Office Themes to make sure that your slide design is accessible. For instructions, go to  Use an accessible presentation template  or  Use built-in slide designs for inclusive reading order, colors, and more .

Use the Accessibility Checker to analyze the presentation and find insufficient color contrast. It finds insufficient color contrast in text with or without highlights or hyperlinks in shapes, tables, or SmartArt with solid opaque colors. It does not find insufficient color contrast in other cases such as text in a transparent text box or placeholder on top of the slide background, or color contrast issues in non-textual content.

PowerPoint supports the playback of video with multiple audio tracks. It also supports closed captions and subtitles that are embedded in video files.

Currently, only PowerPoint for Windows supports insertion and playback of closed captions or subtitles that are stored in files separate from the video. For all other editions of PowerPoint (such as PowerPoint for macOS or the mobile editions), closed captions or subtitles must be encoded into the video before they are inserted into PowerPoint.

Supported video formats for captions and subtitles vary depending on the operating system that you're using. Each operating system has settings to adjust how the closed captions or subtitles are displayed. For more information, go to Closed Caption file types supported by PowerPoint .

Closed captions, subtitles, and alternative audio tracks are not preserved when you use the Compress Media or Optimize Media Compatibility features. Also, when turning your presentation into a video , closed captions, subtitles, or alternative audio tracks in the embedded videos are not included in the video that is saved.

When you use the Save Media as command on a selected video, closed captions, subtitles, and multiple audio tracks embedded in the video are preserved in the video file that is saved.

To make your PowerPoint presentations with videos accessible, ensure the following:

Videos include an audio track with video descriptions, if needed, for users who are blind or have low vision.

Videos that include dialogue also include closed captions, in-band closed captions, open captions, or subtitles in a supported format for users that are deaf or hard-of-hearing.

For more information, refer to  Add closed captions or subtitles to media in PowerPoint . 

You can save your presentation in a format that can be easily read by a screen reader or be ported to a Braille reader. For instructions, go to  Video: Save a presentation in a different format or  Create accessible PDFs . Before converting a presentation into another format, make sure you run the Accessibility Checker and fix all reported issues.

When your presentation is ready and you've run the Accessibility Checker to make sure it is inclusive, you can try navigating the slides using a screen reader, for example, Narrator. Narrator comes with Windows, so there's no need to install anything. This is one additional way to spot issues in the navigation order, for example.

Start the screen reader. For example, to start Narrator, press Ctrl+Windows logo key+Enter.

Press F6 until the focus, the blue rectangle, is on the slide content area.

Press the Tab key to navigate the elements within the slide and fix the navigation order if needed. To move the focus away from the slide content, press Esc or F6.

Exit the screen reader. For example, to exit Narrator, press Ctrl+Windows logo key+Enter.

Rules for the Accessibility Checker

Everything you need to know to write effective alt text

Use a screen reader to attend a PowerPoint Live session in Microsoft Teams  

Make your Word documents accessible to people with disabilities

Make your Excel documents accessible to people with disabilities

Make your Outlook email accessible to people with disabilities

Closed Caption file types supported by PowerPoint

Use built-in slide designs for inclusive reading order, colors, and more

Use accessible hyperlink texts and screentips.

Use accessible text alignment and spacing

Create accessible lists

Test the accessibility of your slides with a screen reader.

The Accessibility Checker is a tool that reviews your content and flags accessibility issues it comes across. It explains why each issue might be a potential problem for someone with a disability. The Accessibility Checker also suggests how you can resolve the issues that appear.

PowerPoint has built-in slide designs that contain placeholders for text, videos, pictures, and more. They also contain all the formatting, such as theme colors, fonts, and effects. To make sure that your slides are accessible, the built-in layouts are designed so that the reading order is the same for people who see and people who use technology such as screen readers.

Tip:  For more info on what to consider when you're creating slides for people with dyslexia, go to  Design slides for people with dyslexia .

To find an accessible template, select File > New from Template .

In the Search  text field, type accessible templates , and then press Return.

Off-white backgrounds are better for people with perceptual disabilities, like dyslexia.

Select templates and themes with sans serif fonts that are 18 points or larger.

Look for solid backgrounds with contrasting text color.

Use the  Accessibility  ribbon to make sure every slide has a title. For the step-by-step instructions, go to  Title a slide  and expand the "Use the Accessibility ribbon to title a slide" section.

Tip:  If you've moved or edited a placeholder on a slide, you can reset the slide to its original design. All formatting (for example, fonts, colors, effects) go back to what has been assigned in the template. Restoring the original design might also help you find title placeholders which need a unique title. To restore all placeholders for the selected slide, on the Home tab, select Reset .

You can position a title off the slide. That way, the slide has a title for accessibility, but you save space on the slide for other content. For the step-by-step instructions, go to  Title a slide  and expand the "Put a title on a slide, but make the title invisible" section.

If you want all or many of your slide titles to be hidden, you can modify the slide master. For the step-by-step instructions, go to  Title a slide  and expand the "Systematically hide slide titles" section.

When someone who can see reads a slide, they usually read things, such as text or a picture, in the order the elements appear on the slide. In contrast, a screen reader reads the elements on a slide in the order they were added to the slide, which might be very different from the order in which things appear.

Use the Selection Pane to set the order in which screen readers read the slide contents. Screen readers read the objects in the reverse of the order they are listed in the Selection Pane .

To find slides with a problematic reading order, use the Accessibility Checker .

On the Home tab, select Arrange .

In the Arrange menu, select Selection Pane .

In the Selection Pane , to change the reading order, drag and drop items to the new location.

Avoid using tables 

In general, avoid tables if possible and present the data another way, like paragraphs with headings. Tables with fixed width might prove difficult to read for people who use magnifying features or apps, because such tables force the content to a specific size. This makes the font very small, which forces magnifier users to scroll horizontally, especially on mobile devices.

Make sure the slide content is easily read with magnifying features, such as Zoom . View it on a mobile device to make sure people won’t need to horizontally scroll the slide on a phone, for example.

Use table headers .

Test the accessibility of your slides with a screen reader .

If you do need to use tables, add headers to your table to help screen readers keep track of the columns and rows. If a table is nested within another table or if a cell is merged or split, the screen reader loses count and can’t provide helpful information about the table after that point. Blank cells in a table could also mislead someone using a screen reader into thinking that there is nothing more in the table. Screen readers also use header information to identify rows and columns. 

Type the column headers.

Avoid using text in images as the sole method of conveying important information. If you use images with text in them, repeat the text in the slide. In alt text of such images, mention the existence of the text and its intent.

For the step-by-step instructions on how to add or edit alt text, go to  Add alternative text to a shape, picture, chart, SmartArt graphic, or other object .

For audio and video content, in addition to alt text, include closed captioning for people who are deaf or have limited hearing.

In the  Alt Text  pane, spelling errors are marked with a red squiggly line under the word. To correct the spelling, select and right-click the word, and then select an option from the suggested alternatives.

In the  Alt Text  pane, you can also select  Generate a description for me  to have Microsoft cloud-powered intelligent services create a description for you. You'll see the result in the alt text field. Remember to delete any comments PowerPoint added there, for example, "Description automatically generated."

To find missing alternative text, use the  Accessibility Checker .

People who use screen readers sometimes scan a list of links. Links should convey clear and accurate information about the destination. For example, avoid using link texts such as "Click here," "See this page," "Go here," or "Learn more." Instead include the full title of the destination page. You can also add ScreenTips that appear when your cursor hovers over text or images that include a hyperlink. 

Tip:  If the title on the hyperlink's destination page gives an accurate summary of what’s on the page, use it for the hyperlink text. For example, this hyperlink text matches the title on the destination page: Create more with Microsoft templates .

For the step-by-step instructions on how to create hyperlinks, go to  Add a hyperlink to a slide . 

Use accessible font format and color

For the step-by-step instructions on how to change fonts in PowerPoint, go to  Change the fonts in a presentation . 

Use the predesigned themes to make sure that your slide design is accessible. For instructions, go to  Use an accessible presentation template  or  Use built-in slide designs for inclusive reading order, colors, and more .

Use the Accessibility Checker to analyze the presentation and find insufficient color contrast. It finds insufficient color contrast in text with or without highlights or hyperlinks in shapes, tables, or SmartArt with solid opaque colors. It does not find insufficient color contrast in other cases such as text in a transparent text box or placeholder on top of the slide background, or color contrast issues in non-textual content.

Use accessible text alignment and spacing 

People with dyslexia perceive text in a way that can make it difficult to distinguish letters and words. For example, they might perceive a line of text compressing into the line below, or adjacent letters seeming to merge. Also, having multiple blank lines or consecutive spaces can make keyboard navigation slow and screen reader usage more cumbersome.

Align your paragraph to the left to avoid uneven gaps between words, and increase or decrease the white space between lines to improve readability. Include sufficient white space between lines and paragraphs but avoid more than two spaces between words and two blank lines between paragraphs.

Select the piece of text you want to modify.

To make it easier for screen readers to read your slides, organize the information into small chunks such as bulleted or numbered lists.

Design lists so that you do not need to add a plain paragraph without a bullet or number to the middle of a list. If your list is broken up by a plain paragraph, some screen readers might announce the number of list items wrong. Also, the user might hear in the middle of the list that they are leaving the list.

Place the cursor where you want to create a list.

Type the text you want for each bullet or numbered item in the list.

Closed captions or subtitles must be encoded into the video before it is inserted into PowerPoint. PowerPoint does not support closed captions or subtitles that are stored in a separate file from the video file.

Supported video formats for captions and subtitles vary depending on the operating system that you're using. Each operating system has settings to adjust how the closed captions or subtitles are displayed. For more information, go to  Closed Caption file types supported by PowerPoint.

Closed captions, subtitles, and alternative audio tracks are not preserved when you use the Compress Media or Optimize Media Compatibility features. To learn more about optimizing media for compatibility, go to the section "Optimize media in your presentation for compatibility" in  Are you having video or audio playback issues?  Also, when turning your presentation into a video , closed captions, subtitles, or alternative audio tracks in the embedded videos are not included in the video that is saved.

When you use the Save Media as command on a selected video, closed captions, subtitles, and multiple audio tracks embedded in the video are preserved in the video file that is saved. For more info, go to  Save embedded media from a presentation (audio or video) .

Videos include an audio track with video descriptions, if needed, for users that are blind or have low vision.

Videos that include dialogue also include closed captions, in-band closed captions, open captions, or subtitles in a supported format for users that are deaf or hard-of-hearing.

When your presentation is ready and you've run the Accessibility Checker to make sure it is inclusive, you can try navigating the slides using a screen reader, for example, VoiceOver. VoiceOver comes with macOS, so there's no need to install anything. This is one additional way to spot issues in the navigation order, for example.

Start the screen reader. For example, to start VoiceOver, press Command+F5.

Press F6 until the focus, the black rectangle, is on the slide content area.

Exit the screen reader. For example, to exit VoiceOver, press Command+F5.

Best practices for making PowerPoint presentations accessible

Use accessible hyperlink texts

Use accessible text format and color

Test the accessibility of your slides

PowerPoint has built-in, predesigned slide designs that contain placeholders for text, videos, pictures, and more. They also contain all the formatting, such as theme colors, fonts, and effects. To make sure that your slides are accessible, the built-in layouts are designed so that the reading order is the same for people who use assistive technologies such as screen readers and people who see.

Select  Home > Design .

Select  Themes , and then select the theme you want.

One simple step towards inclusivity is having a unique, descriptive title on each slide, even if it isn't visible. A person with a visual disability that uses a screen reader relies on the slide titles to know which slide is which. With descriptive titles on each slide, everyone can quickly scan through a list of slide titles and go right to the slide they want.

On a slide, select the title placeholder, and then type the title.

Go through each slide in your presentation to make sure they all have titles.

Hide a slide title 

You can position a title off the slide. That way, the slide has a title for accessibility, but you save space on the slide for other content.

On a slide, tap and hold the title element.

Drag the title element outside the slide boundary and then lift your finger off the screen to drop the element off the slide.

Test the accessibility of your slides .

Screen readers keep track of their location in a table by counting table cells. If a table is nested within another table or if a cell is merged or split, the screen reader loses count and can’t provide helpful information about the table after that point. Blank cells in a table could also mislead someone using a screen reader into thinking that there is nothing more in the table. Use a simple table structure for data only and specify column header information. Screen readers also use header information to identify rows and columns. 

Select  Style Options and then select Header Row .

In your table, type the column headings.

Select the visual, for example, an image.

Select  Alt Text , and then type a description for the visual.

Mark visuals as decorative

If your visuals are purely decorative and add visual interest but aren't informative, you can mark them as such without needing to write any alt text. Examples of objects that should be marked as decorative are stylistic borders. People using screen readers will hear that these objects are decorative, so they know they aren’t missing any important information. 

Select the visual, for example, a picture or chart.

Select Alt Text .

Turn on the Mark as decorative switch, and then select Done .

Use accessible hyperlink texts 

People who use screen readers sometimes scan a list of links. Links should convey clear and accurate information about the destination. For example, avoid using link texts such as "Click here," "See this page," "Go here," or "Learn more." Instead include the full title of the destination page.

Tip:  If the title on the hyperlink's destination page gives an accurate summary of what’s on the page, use it for the hyperlink text. For example, this hyperlink text matches the title on the destination page:  Create more with Microsoft templates .

Select the piece of text you want to turn into a hyperlink. The context menu opens.

In the context menu, select Link . The Insert Hyperlink dialog box opens.

Type or paste the hyperlink URL to the ADDRESS text field.

If you want to change the hyperlink text, modify the text in the DISPLAY text field.

Use accessible text format and color

An accessible font doesn't exclude or slow down the reading speed of anyone reading a slide, including people with low vision or reading disability or people who are blind. The right font improves the legibility and readability of the text in the presentation. 

Use accessible text format 

Select the piece of text you want to format.

On the Home tab, select the current font type to open the font menu, and then select the font type you want or adjust the font size to your liking.

Use accessible text color

Use the predesigned Themes  to make sure that your slide design is accessible. For instructions, go to  Use built-in slide designs for inclusive reading order, colors, and more .

On the Home tab, select Font Color , and then pick the font color you want.

Select the text you want to modify.

Create accessible lists 

Design lists so that you do not need to add a plain paragraph without a bullet or number to the middle of a list. If your list is broken up by a plain paragraph, some screen readers might announce the number of list items wrong. Also, the user might hear in the middle of the list that they are leaving the list. 

On a slide, place the cursor where you want to create a list.

On the Home tab, select Bullets or Numbering , and then select the bullet or numbering style you want.

Type the first bulleted or numbered item in the list, and then select return on the on-screen keyboard. A new list item is added. Repeat this step for each list item you want to add.

When your slides are ready, you can try a few things to make sure they are accessible:

Switch to the full desktop or web version of PowerPoint, and then run the Accessibility Checker. The Accessibility Checker is a tool that reviews your content and flags accessibility issues it comes across. It explains why each issue might be a potential problem for someone with a disability. The Accessibility Checker also suggests how you can resolve the issues that appear. For instructions, go to  Improve accessibility with the Accessibility Checker .

In the PowerPoint for iOS app, you can try navigating the slides using the built-in screen reader, VoiceOver. VoiceOver comes with iOS, so there's no need to install anything. This is one additional way to spot issues in the navigation order, for example.

To turn on VoiceOver, do one of the following:

In your device settings, select  Accessibility  >  VoiceOver , and then turn on the  VoiceOver  switch.

Press the power button of your device three times.

To navigate the content in the slide, swipe left or right. Modify the reading order of the elements on the slides if necessary.

Tip:  To select an item in focus when VoiceOver is on, double-tap the screen.

To turn off VoiceOver, do one of the following:

In your device settings, select  Accessibility  >  VoiceOver , and then turn off the  VoiceOver  switch.

Make your OneNote notebooks accessible to people with disabilities

PowerPoint has built-in, predesigned slide designs that contain placeholders for text, videos, pictures, and more. They also contain all the formatting, such as theme colors, fonts, and effects. To make sure that your slides are accessible, the built-in layouts are designed so that the reading order is the same for people who use assistive technologies such as screen readers and people who see. 

Give every slide a title 

One simple step towards inclusivity is having a unique, descriptive title on each slide, even if it isn't visible. A person with a visual disability that uses a screen reader relies on the slide titles to know which slide is which. With descriptive titles on each slide, everyone can quickly scan through a list of slide titles and go right to the slide they want. 

Select  Style Options , and then select Header Row .

In the table, type the column headings.

On a slide, select a visual.

Select the visual.

Select  Alt Text .

Select the Mark as decorative checkbox.

Select the piece of text you want to turn into a hyperlink.

Select Home > Insert > Link .

Do one of the following:

To insert a hyperlink to a web page, select Insert Link . Type or paste the hyperlink URL to the  Address text field. If you want to change the hyperlink text, modify the text in the  Text to display text field.

To insert a link to a recent document, browse the Recent Items list until you find the one you want, and then select it.

On the  Home  tab, you can do, for example, the following:

To change the font type, select the current font type to open the Font menu, and then select the font type you want.

To adjust the font size, select the current font size, and then select the new font size.

Use the predesigned  Themes  to make sure that your slide design is accessible. For the step-by-step instructions, go to  Use built-in slide designs for inclusive reading order, colors, and more .

On the  Home  tab, expand the  Font Color menu, and then pick the color you want.

On the  Home  tab, select  Bullets  or  Numbering , and then select the bullet or numbering style you want.

Test the accessibility of your slides 

In the PowerPoint for Android app, you can try navigating the slides using the built-in screen reader, TalkBack. TalkBack comes with Android, so there's no need to install anything. This is one additional way to spot issues in the navigation order, for example.

To turn on TalkBack, do one of the following:

In your device settings, select  Accessibility  >  TalkBack , and then turn on the  Use service  switch.

Press and hold the volume keys of your device until the device vibrates.

Tip:  To select an item in focus when TalkBack is on, double-tap the screen.

To turn off TalkBack, do one of the following:

In your device settings, select  Accessibility  >  TalkBack , and then turn off the  Use service  switch.

Best practices for making PowerPoint for the web presentations accessible

Add alt text to visuals and tables.

The following table includes key best practices for creating PowerPoint for the web presentations that are accessible to people with disabilities.

Check accessibility while you work 

To manually launch the Accessibility Checker, select  Review  >  Check Accessibility . The  Accessibility  pane opens, and you can now review and fix accessibility issues. For more info, go to  Improve accessibility with the Accessibility Checker .

PowerPoint for the web has built-in slide designs that contain placeholders for text, videos, pictures, and more. They also contain all the formatting, such as theme colors, fonts, and effects. To make sure that your slides are accessible, the built-in layouts are designed so that the reading order is the same for people who see and people who use technology such as screen readers.

Tip:   For more info on what to consider when you're creating slides for people with dyslexia, go to  Design slides for people with dyslexia .

In your browser, go to Accessible PowerPoint template sampler .

On the Accessible PowerPoint template sampler  page, select Download . The template sampler is downloaded to your device.

Open the sampler in the full desktop version of PowerPoint, select a suitable slide design, and save it.

Open PowerPoint for the web in your browser, open the selected design, and create your presentation.

Use the  Accessibility  ribbon to make sure every slide has a title. For the step-by-step instructions, go to the section "Use the Accessibility ribbon to title a slide" in  Title a slide .

You can position a title off the slide. That way, the slide has a title for accessibility, but you save space on the slide for other content. For the step-by-step instructions, go to the section "Put a title on a slide, but make the title invisible" in  Title a slide .

Use an accessible reading order for the slide contents

Use the  Selection Pane  to set the order in which screen readers read the slide contents. Screen readers read the objects in the reverse of the order they are listed in the  Selection Pane .

To find slides with a problematic reading order, use the  Accessibility Checker .

On the Home tab, select Arrange > Selection Pane .

If you do need to use tables, add headers to your table to help screen readers keep track of the columns and rows. If a table is nested within another table or if a cell is merged or split, the screen reader loses count and can’t provide helpful information about the table after that point. Blank cells in a table could also mislead someone using a screen reader into thinking that there is nothing more in the table. Screen readers also use header information to identify rows and columns.

Select Table Design .

In the alt text description field, spelling errors are marked with a red squiggly line under the word.

In the visual's Alt Text  pane, you can also select  Generate a description for me  to have Microsoft cloud-powered intelligent services create a description for you. You'll see the result in the alt text field. Remember to delete any comments PowerPoint added there, for example, "Description automatically generated."

To add alt text to visuals and tables, do one of the following:

To add alt text to an image, do one of the following:

Right-click an image. Select Alt Text... .

Select an image. Select Picture  > Alt Text .

To add alt text to a SmartArt graphic, select a SmartArt graphic, and then select SmartArt  > Alt Text .

To add alt text to a shape or embedded video, select a shape or video, and then select Shape > Alt Text .

To add alt text to a table, place the cursor in any cell, and then select  Table Layout > Alt Text .

For images, type a description. For SmartArt graphics, shapes, videos, and tables, type a title and description.

For the step-by-step instructions on how to create hyperlinks, go to  Add a hyperlink to a slide .

To change the font format or color, select the piece of text you want to modify

Select the Home tab.

In the Font group, select your formatting options, for example, a different font type or color.

Type the text you want for each bulleted or numbered item in the list.

PowerPoint supports the playback of video with multiple audio tracks. It also supports closed captions and subtitles that are embedded in video files.

Closed captions or subtitles must be encoded into the video before it is inserted into PowerPoint. PowerPoint does not support closed captions or subtitles that are stored in a separate file from the video file.

Closed captions, subtitles, and alternative audio tracks are not preserved when you use the  Compress Media  or Optimize Media Compatibility features. To learn more about optimizing media for compatibility, go to the section "Optimize media in your presentation for compatibility" in  Are you having video or audio playback issues?  Also, when turning your presentation into a video, closed captions, subtitles, or alternative audio tracks in the embedded videos are not included in the video that is saved.

When you use the  Save Media as  command on a selected video, closed captions, subtitles, and multiple audio tracks embedded in the video are preserved in the video file that is saved. For more info, go to  Save embedded media from a presentation (audio or video) .

To make your PowerPoint presentations with videos accessible, ensure the following:

Improve accessibility with the Accessibility Checker

Make your Outlook email accessible to people with disabilities ​​​​​​​

Technical support for customers with disabilities

Microsoft wants to provide the best possible experience for all our customers. If you have a disability or questions related to accessibility, please contact the Microsoft Disability Answer Desk for technical assistance. The Disability Answer Desk support team is trained in using many popular assistive technologies and can offer assistance in English, Spanish, French, and American Sign Language. Please go to the Microsoft Disability Answer Desk site to find out the contact details for your region.

If you are a government, commercial, or enterprise user, please contact the enterprise Disability Answer Desk .

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UN Flagship Report On Disability And Development 2024

Pre-Launch Event on 10 June 2024

The UN Disability and Development Report 2024 will be pre-launched at a virtual event at 11am-12:30pm in New York on 10 June 2024. The Report will provide an updated comprehensive analysis to address the needs of the international community to achieve the Sustainable Development Goals for persons with disabilities. It presents the most recent global analysis based on an unprecedented amount of data, legislation and policies from all countries to understand the socio-economic circumstances of persons with disabilities worldwide and the challenges and barriers they face in their daily lives, including the exacerbated impacts due to the COVID-19 pandemic.

The Report was produced by DESA and is the outcome of a collective effort, involving United Nations entities and a wide range of other contributors, such as country experts and civil society, including organizations of persons with disabilities. The pre-launch event will be recorded and posted on our YouTube channel at: https://www.youtube.com/undesadspd .

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Convention on the Rights of Persons with Disabilities: 5 fast facts

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Imagine daily life without your sight, hearing or a limb or living with the challenges of neurodiversity or paralysis. That’s a reality for some. One in six of us – or 16 per cent – of the global population had a disability in 2023, according to the World Health Organization (WHO), and many depend on the  Convention on the Rights of Persons with Disabilities to help guard their fundamental freedoms and dignity.

The landmark legally binding treaty entered into force on 3 May 2008, marking a major milestone in the effort to promote, protect and ensure the full and equal enjoyment of all human rights for all.

Ahead of the 17th Conference of States Parties (COSP17) that starts on 11 June, here are five fast facts about the Convention and how it continues to impact the lives of 1.3 billion men, women and children living with disabilities around the world:

1. Why the world needs the Convention

People with disabilities face discrimination and the denial of their human rights around the world. Society’s barriers are the problem, not individual impairments.

That’s why the Convention exists.

The Convention is a human rights treaty that sets out how to make a world disability inclusive.

The goal is to create an enabling environment so that people living with disabilities can enjoy real equality in society.

2. Protected rights

The Convention emphasises that people living with disabilities must have their dignity respected and their voices heard and should be involved in making decisions that affect their lives. That includes all rights, from freedom of speech and education to healthcare and employment.

The treaty tells countries to remove obstacles that prevent people with disabilities from fully participating in all fields, from technology to politics.

It addresses those barriers, including discrimination and accessibility, and also calls for equality for women and girls. In addition, the treaty maps out ways countries around the world can remove barriers preventing people with disabilities from fully enjoying all their rights.

3. How the treaty is enforced

There are several ways the Convention is enforced, respected and implemented.

Individuals can bring petitions to the UN  Committee on the Rights of Persons with Disabilities to report breaches of their rights.

“The mere existence of the Convention gives persons with disabilities and their organisations the ability to say to their governments ‘you have accepted these obligations’ and insist that they be met.” said Don MacKay, chair of the committee that drafted the treaty.

The 18-member Geneva-based committee can also undertake inquires of grave or systematic violations of the Convention and monitors whether rights are being properly applied, online and off in times of peace and of war and other crises.

4. A seat at the table

A key to progress is bringing people whose rights are affected to the table.

This year, hundreds of delegates from non-governmental organizations (NGOs) are coming to New York to take part in the latest Conference of State Parties, COSP17, to be held in June 2024, one of the largest global meetings on disability rights.

Since the time the treaty was negotiated, the perspectives and input of people living with disabilities are being heard at meetings at the UN and in countries around the world.

The bigger table at UN Headquarters now accommodates accessibility requirements, including wheelchair access, hearing loops usage, documentation in Braille, large print or sign language usage.

5. In the spotlight

Global celebrities like the singer-songwriter and UN Messenger of Peace Stevie Wonder, who is visually impaired, have also added their voice.

“Someone being sighted doesn’t mean that they should be blind to those things in the world that we need to fix,” Mr. Wonder  said , noting that there are 300 million visually impaired people around the world.

“We really are abled persons with different abilities. We have to have inclusion.”

Watch UN Video’s Stories from the UN Archive on how the music icon challenged assumptions about Braille:  here .

“I think there are certain sort of stereotypes that we hear about autism, and I’ve learned very quickly through meeting people who either were parents of autistic children or meeting people with autism that those sort of stereotypes don’t really exist,” actor Dakota Fanning told UN News  in a conversation about her role as Wendy, who is autistic, in the film Please Stand By .

“So, I felt that I didn’t I want to further the stereotypes and that I wanted to really portray her as I would portray any other young woman,” she said.

“I have lived with discrimination for part of my life,” said Canadian activist, actor and talk show host Nick Herd, who was born with Down syndrome.

“When I was young, and growing up, I was bullied because of my disability, but now I can use that voice, from the child that I was, to be heard, louder and louder. I can shout it on the top of a building or off a mountain, bigger than the UN so that persons with disabilities are included at the table.”

“In war, those with disabilities are often represented as victims, denied equality in humanitarian support and excluded from peace processes,”  said renowned photographer Giles Duley, the first UN Global Advocate for persons with disabilities in conflict and peacebuilding situations.

“It is time for change, and if we work together, we have the strength and opportunity to create that change.”

Who’s on board?

The Convention on the Rights of Persons with Disabilities was opened for signature in 2006. Here’s who is on board:

• As of today, 191 nations and UN observers have ratified the treaty, and 106 have ratified its Optional Protocol
• Since the Convention entered into force in 2008, the UN and its agencies have worked towards amplifying its provisions
• The 2030 Agenda for Sustainable Development aims to leave no one behind in its 17 Sustainable Development Goals (SDGs)
• The Summit of the Future intends to realign international cooperation to be inclusive across the board
• Check out the  UN Disability Inclusion Strategy
• The Convention and its  Optional Protocol established annual meetings of treaty signatories – the “Conference of States Parties” ( COSP ) – to monitor implementation and discuss current themes and trends, with this year’s COSP17 focusing on jobs, tech and humanitarian emergencies at a meeting at UN Headquarters from 11 to 13 June 2024
• Learn about the Committee on the Rights of Persons with Disabilities  here
• Follow past and present annual Conferences of States Parties (COSP)  here
• persons with disabilities

DISABLED PEOPLE

Sep 04, 2014

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DISABLED PEOPLE. The population of disabled people includes wheelchair users, blind people and deaf people who are an important minority of the total,but the majority of disabled people have other (often less visible) impairments.

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DISABLED PEOPLE The population of disabled people includes wheelchair users, blind people and deaf people who are an important minority of the total,but the majority of disabled people have other (often less visible) impairments. Although older people are more likely to be disabled than younger people, trends show an increasing number of children reported as having complex needs, Autistic Spectrum disorders or mental health issues. Disabled people are doing less well than non-disabled people across a wide range of indicators and opportunities. The disadvantage faced by disabled people imposes significant economic and social costs on disabled people, on their families and friends, on the wider community and on the economy. Instead of being empowered to participate and be included, too many disabled people are left to depend on benefits and government support.. There are people suffering from handicap everywhere in the world. In the past there were many difficulties connected with the wrong use of the word handicap. Now we have different associations supporting these different groups. About integration at school the number of the disabled has become wider and wider from 10,000 to 34,000 integrated in different schools. Eugenia,Laura,Yulia,

THE DISABLED IN THE PAST Last century, during the second world war, a program of “ EUTHANASIA” was created against disabled children forced to live segregated in concentration camps. Such a plan was linked up to Nazi politics, where people of different culture are deprived of their personality, culture and ideology, above all disabled who were regarded as “ USELESS TO SOCIETY”. Consequently several extermination schools were born where firstly a lot of lethal injections were used to kill disabled children, like “ MORPHINE” and “ SCOPOLAMINA”, but there was a faster method to make this extermination quicker, that is, the use of gas. Many experiments were taken out in clinics. The Euthanasia in this field continued up to the end of the war, with the operation “14 F13”, and in the clinics where continued the elimination of the disabled children through “ THE WILD EUTHANASIA”, or rather the elimination of the sick without any authorization. On october 8, 1935 was emanated a second “LAW FOR THESAFEGUARD OF THE HEREDITARY HEALTH OF THE GERMAN PEOPLE”. With it the abortion was authorized in the case in which one of the parents was affected from hereditary illness. For this reason a law that authorized the forced sterilization of the people held bearers of hereditary illness was emanated. To support such a law some propagandas were shown through films, in schools and public places. The sanitary direction of the “THIRD REICH” crested in Germany 500 “CENTRES OFCONSULTATION FOR THE PROTECTION OF THE GENETIC PATRIMONY AND RACE”. The physicians that directed them picked up information to decide who had to be sterilized and to control the births of the physically, mentally, disabled babies. Alessia, Simona

InItaly • There are about 2 million 824 thousand disabled people in our country: • 900 thousand are men and 1 million 864 thousand are women. • It’s pointing out that 2 million 92 thousand disabled are over 64. The percentage of disabilities were shown during the school period, when mental disabilities are highlighted during school activities. • About 60 thousand of people under 65 are confined to wheelchairs. • Families are the main help to disabled people. • In 15% of Italian families there are disabled people. • 28 % of the disabled live alone against 8 % of non-disabled, and the majority of them are elderly. • 26 % of them are married • 68 % of disabled are unhappy with the difficulties in making friends. • 4.85 % are between six and more, and they live in a family. • The 17% are more than 60 years of age; the 37.7 % are 75 years old; 620.000 of these people are under 60; 188.000 of them are 14. • There are four different • typologies of disabilities: • Permanently forced to stay in wheelchairs or in bed; • Uneasy on getting dressed, on washing her/his body, on eating; • Disability on moving: for them it’s difficult to walk, to go up the stairs; • Sensorial disability: they can’t hear perfectly well.Alessia,Anna lisa, Francesca, Giorgia, Ilaria, Jessica

“ It’s difficult to realise if a person is mentally or physically disabled “ There are four kinds of DISABILITY: • disability in moving • individual confined life • disabilities in everyday living (difficulties to dress, to wash, to eat) • sensorial disabilities EDUCATION: Nowadays education is getting better and better: in fact, 38 % of the disabled between 15 and 44 years have got diplomas or degrees, but 14 % between 45 and 64 years haven't got them. JOB: Today the number of disabled without a job is high. In fact only 21 % are employed. FAMILY: 28 % of the disabled live alone and 26 % until 44 years live in the family. It is fundamental for them. SOCIALLIFE: It's difficult to participate in a social life because the disabled have a lot of problems which are due to their disabilities and to the environmental and cultural context. SPORT: Chiara, Francesca, Ilaria 26 % of the disabled play sport activities and 60 % of them is between 6 and 44 years.

Different kinds of disability

SOCIAL LIFE The social participation of the disabled people constitutes the greatest and the more difficult challange to face, because in it they add problems originated not only from the condition of the individual's disability, but above all and mainly from the environmental and cultural context. The information contained in the area in examination concern the social activities and the participation activities to associations, political parties and religious activities, the recourse to the services of public utility, the activities of leisure time, sporting activities, making friends and relationships with members of the family. INFORMATION Around 18 % of disabled people under 44 years read newspapers every day and 20% of the non- disabled people of the same age. 67 % of the disabled between 18 and 44 years listen to the radio and 92 % watch TV programs every day, 79 % and 97 % of non-disabled. 38 % of the disabled are informed about the Italian politics against 53 % among non-disabled. LEISURE ACTIVITIES 22 % of the disabled under 44 years go to the cinema, to the theatre or to TV shows, in opposition of 31% of non-disabled. 20 % of the disabled read books. SPORTING ACTIVITIES 26 % of the disabled people practise a sporting activity and 60 % of these are between six and forty-four years. The main reason for the sporting practice up to 64 years is for relaxation and then even therapeutic. The number of the disabled people enrolled to the Federation Disabled Sport has increased in the period 1989-1997, also the sporting societies, in average of around 5,3 points percent. The quality of the services offered by the sporting societies has improved: in fact, it is passed by an average of six operators for sporting society in 1989 to an average of fourteen operators in 1997. FRANCESCA, ILARIA, JESSICA

DISABILITY TODAY

Laws helping disabled people For many years political institutions have undertaken to enact laws about disabled people. The most recent European law, dated 15th December 2005, forbids every discrimination towards disabled people travelling by aeroplane. The great majority of the European Parliament was in favour of this law that passed with 506 votes in favour, 6 against and an abstention. This law is applied in the whole European Community. On the national field there is the general policy law of 5th February 1992, for assistence, social integration and disabled’s rights. This law was modified with the law ‘8th March 2000’ and with the legislative decree ‘26th March 2001’. On 9th July 2003, the Council of Ministers enacted a legislative decree that established a general summary of parity of treatment about occupation and working conditions. On 9th January 2004 the Italian Parliament approved a law that supports the access of disabled at computers. The oldest regional law of Lazio, a region in Central Italy,dates back to 19th September 1974 and deals with the development of precautionary and rehabilitation measures for disabled. This law was emended with the regional law of 9th June 1975. On 22nd January 1977 was passed the bill of refunding of the regional law of 19th September 1974. The accessibility at public transports for the disabled is guaranteed by the law approved on the 22nd of February 1985. The most recent regional law for disabled is dated 3rd November 2003 and concerns the institution of a council for disabled’s problems. Enrico, Martina

FACILITIES FOR DISABLED PEOPLE • DIURNAL CENTRES FOR REHABILITATION:sanitary structure for a maximum of 25 people. The centres offer: meals, daily activities, therapies, social activities, sanitary services, skilled staff for home sanitary requests. • RESIDENTIAL CENTRES:sanitary structure for a maximum of 20 people, school compulsory education is offered to the young disabled. • The centres offer: diurnal and nocturnal guardian attendance, meals, daily activities, socialization activities, therapies, sanitary performances, skilled staff for home sanitary requests. • COMMUNITIES:residential charitable structures for 12 adolescents or 6 children. • A community offers: day and night attendance, meals, education, jobs, social activities. • Cristina, Martina, Ramona

Architectural barriers for the disabled

Architectural Barriers • Many disabled people are still discriminated because of architectural barriers. • They can be represented for example by parking areas, doors, stairs or washbasins and toilets. • In Italy there are still a lot of architectural barriers, despite of the appointed laws in favour of the disabled. • The article 27 provides for: • New buildings which must be without architectural barriers; the disabled have to be allowed to stay everywhere. • To permit the disabled the best access in public and private buildings, the law says that: • accesses have to be at least 1 metre 50 centimetres wide; • steps: max 6 centimetres with anti-slide plans; • doors: at least 85 centimetres wide and handles 90 centimetres high; • lifts: all the buildings with more than one floor need a lift; • sporting centres and bathing establishments must respect the law for the disabled; • ramps must allow the passage of wheelchairs. • The law 13/89 shows that the disabled have to have economic contributions and they have to have the right to reach a building and to use spaces in safety and autonomy. • Alessandra, Luisa

The rights of the disabled at school: ...Each person has the right to be educated. The aim is the full development of human personality and sense of dignity, reinforcing the human rights and fundamental freedom. Primary education has to be compulsory and free for everybody. Thanks to the laws appointed in the 70s Italy has been depicted as a a vanguard world country in the specific area. The law named 104/92 guarantees the presence of disabled people at any kind of school: from primary to university. The article 13 requires the local government to adopt nursery schools according to the disabled children’s needs, providing skilled assistance. The law named 270/82 establishes in 30 children the highest number and in 13 children the lowest number in a class. The number is even reduced with the presence of disabled children (maximum 20, minimum 10). Articles n° 2 and 13 of the law named 517/77 provide the whole development of personality, in particular of disabled people, offering the assistance of a skilled teacher. Furthermore they are given free transport from their own house to school and vice versa. The entry to school is favoured by the elimination of architectural barriers which limit attendance. Valentina, Francesca, Denise, Serena

Fausto: a strong personality Fausto is 27 years old and has tought in Alessandro Manzoni High School under the assistance of a proper tutor in the Social Study Course. Even though Fausto is disabled, with accurate studies he is now able to teach and give his personal opinions as if he were an ordinary guy. In the Nursery School his mates learnt to understand and to know his difficulties. In Primary and Secondary School he was strongly helped but even mocked by some. We know this is a very important time for all, especially for those with difficulties, remaining touched for ever. In Higher Education he had the opportunity to develop with all his individual characteristics. Finally he got his degree with the maximum grade. Amelia, Ilenia, Piera, Veronica,

a way to feel free Paralympics • Olympic Games for disabled have been created for people who have phisical problems and they occur every 4 years. • The first person who thought of Paralympics was Ludwig Guttam in a British hospital . • The first Paralympics were in 1996 and 120 countries participated with a number of 35000 athletes. In the past the disabled used to be divided into categories according to their ability (blind, one-legged or one-armed people, people sitting in wheel-chairs). • All athletes involved in fencing normally practise their sport directly from their wheel-chairs. There are official sports which belong to Paralympics: basketball, cycling, horse-riding, swimming, football, volleyball, etc. • Winter Paralympics were inaugurated in 1976 and these Olympic Games involve Alpine and northern ski hockey and toboggan. The modern technology has highly increased the number of the accessible sports. • In Italy there is an association called FISD (Italian Federation Disabled Sport) that is an official company representing these activities. • The disabled can find some difficulties also in the development of easier activities and Olympic Games offer the best opportunity to overcome their difficulties participating actively in the different sports. Corina, Elisabetta, Ilaria,

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This paper is in the following e-collection/theme issue:

Published on 12.6.2024 in Vol 11 (2024)

Enabling People With Intellectual and Sensory Disabilities to Trigger a Tablet’s Delivery of Task Instructions by Walking to the Tablet: Proof-of-Concept Study

Authors of this article:

Original Paper

• Giulio E Lancioni 1 , PhD   ; 
• Nirbhay N Singh 2 , PhD   ; 
• Mark F O’Reilly 3 , PhD   ; 
• Jeff Sigafoos 4 , PhD   ; 
• Gloria Alberti 1 , MA   ; 
• Isabella Orlando 1 , MA   ; 
• Valeria Chiariello 1 , MA   ; 
• Lorenzo Desideri 5 , PhD  

1 Lega F D’Oro Research Center, Osimo, Italy

2 Department of Psychiatry and Health Behavior, Augusta University, Augusta, GA, United States

3 College of Education, University of Texas at Austin, Austin, TX, United States

4 School of Education, Victoria University of Wellington, Wellington, New Zealand

5 Department of Psychology, Sigmund Freud University, Milan, Italy

Corresponding Author:

Giulio E Lancioni, PhD

Lega F D’Oro Research Center

Via Linguetta 3

Osimo, 60027

Phone: 39 3408323465

Email: [email protected]

Background: People with intellectual and sensory or sensory-motor disabilities tend to have problems performing multistep tasks. To alleviate their problems, technological solutions have been developed that provide task-step instructions. Instructions are generally delivered at people’s request (eg, as they touch an area of a computer or tablet screen) or automatically, at preset intervals.

Objective: This study carried out a preliminary assessment of a new tablet-based technology system that presented task-step instructions when participants with intellectual and sensory disabilities walked close to the tablet (ie, did not require participants to perform fine motor responses on the tablet screen).

Methods: The system entailed a tablet and a wireless camera and was programmed to present instructions when participants approached the tablet, that is, when the camera positioned in front of the tablet detected them. Two instructions were available for each task step. One instruction concerned the object(s) that the participants were to collect, and the other instruction concerned the “where” and “how” the object(s) collected would need to be used. For 3 of the six participants, the two instructions were presented in succession, with the second instruction presented once the required object(s) had been collected. For the other 3 participants, the two instructions were presented simultaneously. Instructions consisted of pictorial representations combined with brief verbal phrases. The impact of the system was assessed for each of the 2 groups of participants using a nonconcurrent multiple baseline design across individuals.

Results: All participants were successful in using the system. Their mean frequency of correct task steps was close to or above 11.5 for tasks including 12 steps. Their level of correct performance tended to be much lower during the baseline phase when they were to receive the task-step instructions from a regular tablet through scrolling responses.

Conclusions: The findings, which need to be interpreted with caution given the preliminary nature of the study, suggest that the new tablet-based technology system might be useful for helping people with intellectual and sensory disabilities perform multistep tasks.

Introduction

People with intellectual disabilities tend to have problems carrying out multistep tasks, largely due to difficulties in remembering the different steps included in the tasks and the order in which they should be performed [ 1 - 5 ]. The problems may be even greater in situations where intellectual disabilities are combined with sensory or sensory-motor impairments [ 6 - 8 ]. In spite of the difficulties encountered, fostering the ability to carry out multistep tasks remains a main rehabilitation objective, vital for ensuring that people will be able to achieve functional occupation and have a constructive role within their daily contexts and possibly within vocational contexts [ 1 , 9 - 12 ]. Such achievement is considered critical for advancing their condition, offering them new socially adaptive opportunities, and improving their quality of life [ 8 , 11 , 13 - 19 ].

Given the relevance of enabling people to manage the performance of multistep tasks, a large variety of studies have been conducted with the aim of reaching this goal with the support of technological solutions [ 1 , 4 , 20 ]. These technological solutions, designed to provide instructions for performing task steps correctly and in the right sequence, present several differences [ 10 , 21 ]. The most obvious differences concern (1) the characteristics of the instructions provided (eg, static pictorial images vs video clips illustrating the steps with or without an accompanying verbal phrase describing the steps) and (2) the way those instructions are made available [ 1 , 4 ].

With regard to the latter aspect (ie, the way instructions are made available), two main approaches can be pointed out. The first approach relies on the use of computer or tablet devices that present instructions for the task steps based on participants’ requests. Typically, participants initiate the request by performing a specific action such as touching an area of the computer or tablet screen [ 5 , 9 , 22 - 24 ]. The second approach relies on computer, tablet, or smartphone devices presenting the instructions automatically, at preset time intervals, eliminating the need for participants to produce specific request responses [ 7 , 25 , 26 ]. The intervals between instructions are decided by staff personnel familiar with the participants and the time they require for carrying out the different task steps.

The second approach may be considered advantageous for participants who cannot successfully use the first approach due to challenges in providing appropriate responses on computer or tablet screens (eg, inaccuracy in executing touch and scroll responses required to operate these devices) [ 27 , 28 ]. On the other hand, the presentation of instructions at preset time intervals may not always be consistent (in synchrony) with the participants’ performance. Although staff may have estimates of the times required by the participants for carrying out the task steps, the participants’ response speed and efficacy may fluctuate within and across days, making the intervals programmed based on those estimates too long or too short [ 8 , 16 ]. This may lead to participants missing some instructions and related task steps or having to wait for the instructions.

A possible way to bypass the shortcomings of the aforementioned approaches may involve the development of a technology system that (1) presents instructions without requiring the participants’ performance of fine motor responses on the computer or tablet screen and simply (2) associates instruction presentation with participants’ walking toward the system [ 8 , 16 , 27 ]. Such a system would ensure that participants who struggle with performing accurate motor responses on a computer or tablet screen do not need to use those responses. At the same time, this system would guarantee that instructions are delivered at the appropriate time (directly linked to people’s actions) rather than at preset time intervals [ 8 , 16 , 29 ].

This study aimed to set up such a system and carry out a preliminary evaluation of it with 6 participants with intellectual and sensory disabilities. The system consisted of a tablet and a wireless camera and was programmed to present instructions when the participant approached the tablet, that is, as the participant was spotted by the camera positioned in front of the tablet. Two instructions were available for each task step. One instruction concerned the object(s) that the participants were to collect, and the other concerned the “where” and “how” the collected object(s) were to be used. For 3 participants, the two instructions were presented in succession, with the second instruction displayed after the required object(s) had been collected. For the other 3 participants, both instructions were presented simultaneously. Instructions consisted of pictorial representations combined with brief verbal phrases. For each of the two groups of participants, the study was conducted following single-case research methodology.

Participants

Table 1 lists the participants included in the study (categorized into two groups of 3 based on their use of the task-step instructions) and reports their chronological ages and their Vineland age equivalents for daily living skills (personal subdomain) and receptive communication. The participants, who have pseudonyms ( Table 1 ), were between 23 and 62 years of age. All of them were diagnosed with sensory disabilities. Specifically, Allie had severe hearing loss. Sylvie, Rowan, Demi, and Jolene had serious impairments of their neurovisual system, leading to severe limitations in their visual acuity. Emory presented with severe limitations in her visual acuity as well as severe hearing loss. The use of eyeglasses allowed all participants to discriminate pictorial images of familiar objects on a tablet screen and to navigate easily within familiar contexts. Vineland age equivalents (measured via the second edition of the Vineland Adaptive Behavior Scales [ 30 , 31 ]) ranged from 4 years to 5 years and 3 months for personal daily living skills and from 3 years and 4 months to 4 years and 3 months for receptive communication. All participants attended rehabilitation and care centers, where the psychological services classified their level of functioning within the moderate intellectual disability range. However, no IQ scores were available.

The participants were recruited for the study based on a number of general criteria. First, they were unable to carry out multistep tasks without staff guidance or specific step instructions. Second, they could use pictorial representations alone or in combination with simple verbal phrases as instructions for the performance of task steps. Third, they expressed their willingness to use the technology system adopted in this study (and shown to them in advance) for carrying out multistep tasks involving familiar material and areas within their daily contexts. Fourth, they had poor fine motor skills and were considered unable to reliably use a tablet for accessing a series of task-step instructions. Fifth, staff supported their involvement in the study and considered technology-aided task engagement a positive goal for the participants and their contexts.

a Age equivalents are based on the Italian standardization of the Vineland scales [ 30 ].

Ethical Considerations

The study was approved by the Ethics Committee of the Lega F. D’Oro, Osimo (Ancona), Italy (P072820235). All procedures performed were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

As mentioned above, the participants had expressed their willingness to use the technology system to carry out tasks involving familiar material. Moreover, staff had indicated that the participants would enjoy performing the tasks provided that difficulties and errors (and thus frustration) would be largely avoided, which was the expectation within this study. While these two points suggested the study would be a positive experience for the participants, it was not possible for them to read and sign a formal consent document. Consequently, their legal representatives were directly involved in the consent process, reading and signing the consent forms on the participants’ behalf.

Setting, Sessions, Tasks, Instructions, and Research Assistants

Familiar rooms within the participants’ daily environments constituted the setting for the study. Sessions were typically carried out 1 or 2 times per day, 4 to 6 days a week. During each session, the participants were asked to perform 1 task. Tasks consisted of combinations of 12 steps. Each step involved 2 simple actions, which were familiar and meaningful to the participants, for example, “take the toilet paper” and “bring the toilet paper to the men’s room.” The combinations of steps (and related actions) led to a recognizable and practically relevant outcome, such as setting up a bathroom and cleaning the entrance, arranging the living room and putting away papers and books, and preparing or cleaning the dining room [ 16 ]. Tasks could be flexible, that is, they could include different combinations of steps on different days based on practical and environmental conditions [ 16 ]. Moreover, a number of steps could be used across different tasks. In total, 9 tasks were available to each participant. Textbox 1 provides a combination of 12 steps that could be included in a task such as supplying the bathroom and arranging the kitchen.

The instructions the tablet provided for the 2 actions involved in each task step consisted of 2 pictures ( Figure 1 and Figure 2 ) accompanied by brief verbal phrases (explained further under the Technology System section below). For the first 3 participants listed in Table 1 (ie, Rowan, Allie, and Sylvie), the 2 pictures were presented separately (ie, one at a time in sequence), and each picture was accompanied by a verbal phrase matching it. For the other 3 participants (ie, Jolene, Emory, and Demi), the 2 pictures were presented simultaneously (ie, one next to the other, as shown in Figure 1 and Figure 2 ), accompanied by a verbal phrase matching them (explained under the Technology System section below).

The presentation of the two instructions available for each task step in sequence or simultaneously was based on the participants’ history, that is, their use of the pictures within their daily contexts, under the supervision of regular staff personnel. The research assistants were 4 women who held a master’s degree in psychology and had experience with the implementation of technology-aided programs with people with intellectual and multiple disabilities as well as with data collection strategies.

• Take the toilet paper and bring it to the men’s bathroom.
• Take the towel and bring it to the ladies’ bathroom.
• Take the toothpaste and bring it to the men’s bathroom.
• Take the toilet paper and bring it to the ladies’ bathroom.
• Take the deodorant and bring it to the ladies’ bathroom.
• Take liquid soap and bring it to the men’s bathroom.
• Take the aluminum and bring it to the microwave.
• Take paper towels and put them in the kitchen drawer.
• Take the chips and put them on the kitchen table.
• Take the flowers and put them in the kitchen sink.

Technology System

Basic components.

The technology included (1) a Samsung Galaxy tablet with an internet connection and MacroDroid and CloudEdge apps and (2) a DEATTI wireless (battery-powered) camera with a passive infrared sensor [ 32 ]. The tablet was also fitted with (1) pictures and verbal phrases used as instructions for the task steps; (2) positive-feedback pictures and praise words shown after the completion of each task step; and (3) videos with the participants’ preferred music, comic sketches, or food preparation presented after the completion of the last task step. The tablet was located in one of the rooms used for the tasks. The camera was positioned about 1.5 meters before the tablet. By walking to the tablet, the participants automatically activated the camera, making it send an input to the tablet via the CloudEdge app. This input was used by the MacroDroid app to make the tablet present task-step instructions.

Instructions Presentation

The first 3 participants (ie, Rowan, Allie, and Sylvie) received the two instructions available for each task step in succession (explained in the Setting, Sessions, Tasks, Instructions, and Research Assistants section). With a task step such as “bringing liquid soap from a store cabinet to the sink area of a specific bathroom,” for example, the instruction the participants received the first time they approached the tablet consisted of a picture showing the liquid soap inside a store cabinet (or simply the liquid soap) accompanied by the verbal phrase “take the soap.” The instruction they received the second time they approached the tablet for that step (while they were carrying the soap they had collected from the cabinet) involved a picture representing the soap on the sink of the red bathroom accompanied by the verbal phrase “bring the soap to the red bathroom.” Once a step was completed, approaching the tablet led to the tablet’s presentation of (1) positive feedback with a picture showing hand clapping, thumbs up, or another representation indicating approval and a praise word, and (2) the first instruction for the following task step. The process continued as described above for all other steps of the task and included the presentation of a 2.5-minute video of a preferred (music, comic, or food preparation) event following the completion of the last step. After the delivery of an instruction, the system had a brief period (15-25 seconds) of inertia to ensure that the participant could go back for a second look at the tablet screen without a change of instruction.

For the last 3 participants (ie, Jolene, Emory, and Demi), the tablet presented the two instructions available for each task step simultaneously. For example, for a step such as “bringing liquid soap from a store cabinet to the sink area of the red bathroom,” the tablet presented a picture showing soap (or soap in the cabinet) to the left and a picture showing soap on the sink of the red bathroom to the right and accompanied such presentation with a phrase like “take the soap and bring it to the red bathroom.” Returning to the tablet (ie, after completing a step) triggered the tablet’s presentation of positive feedback plus praise word followed by the presentation of the instructions for the next task step. The positive feedback and praise word after each completed step, the video of a preferred event at the end of the task, and the idleness of the tablet after the delivery of instructions matched those used for the first 3 participants.

Experimental Conditions and Data Analysis

The study started with a pretest verifying whether the participants could carry out the tasks independent of specific step instructions. After the pretest, each of the two groups of participants had a baseline phase followed by an intervention phase. These phases were implemented according to a nonconcurrent multiple baseline design across participants [ 33 , 34 ]. In practice, the participants of each group received different numbers of baseline sessions before the start of the intervention with the technology system. Pretest, baseline, and intervention sessions were implemented by the research assistants. To make sure that their application of the procedural conditions was accurate (that their level of procedural fidelity was high), two strategies were adopted. One involved their preliminary familiarization with those conditions while the other involved regular feedback on their performance [ 35 ]. Feedback was delivered by a research coordinator who had access to video recordings of the sessions.

The participants’ data concerning the correctly performed task steps were reported in graphic form. To simplify the graphic presentation, data points were made to represent blocks of sessions. The baseline and intervention frequencies of correct task steps were compared using the “Percentage of data points Exceeding the Median” method [ 36 , 37 ]. This method, which is one of the most practical tools to evaluate single-case research data, served to determine how many data points of the intervention phase were above the baseline median.

The pretest included 5 sessions. Each session started with the research assistant asking the participants to carry out a task. The request was made via a simple verbal statement and a general pictorial representation. The statement summarized what the participants were to do (eg, “you can supply the bathroom and set up the kitchen table”). The pictorial representation included a drawing of the areas (bathroom and kitchen table) involved in the task. The research assistant did not intervene if the participants carried out steps involved in the task. If the participants remained passive for 30-60 seconds or carried out a step not involved in the task, the research assistant provided guidance for a task step (eg, helped them to bring the toilet paper to a red bathroom). The session continued until the participants had carried out all task steps or had received the research assistant’s guidance for the performance of 2 steps. All the steps omitted as well as those carried out with the research assistant’s guidance were counted as noncorrect. At the end of a session, the participants were presented with a 2.5-minute video of preferred music, comic, or food preparation events.

The baseline included 7, 8, and 13 sessions for the participants of the first group and 6, 8, and 12 sessions for the participants of the second group. Those sessions served to determine whether the participants were able to use a tablet independently to obtain task-step instructions and then carry out those steps. Each session started with the research assistant placing a tablet on a desk and asking the participants to use it to get instructions for a specific task. Meanwhile, the research assistant demonstrated how to use the tablet (ie, operating horizontal scrolling) to receive the step instructions. If participants were unsuccessful or passive for 30-60 seconds, the research assistant provided guidance (ie, carried out the tablet scrolling for them and ensured that they performed the task step indicated by the tablet instructions). Two instances of guidance from research assistants were allowed per session. A session lasted until the participants had either carried out the last step of the task or failed to progress (eg, due to a new unsuccessful or passive period following the research assistant’s guidance instances or due to inaccurate scrolling leading them to skip the instructions or shut the presentation process). At the end of a session, the participants were presented with a 2.5-minute video of their preferred music, comic, or food preparation events.

Intervention

The intervention phase included 97, 83, and 88 sessions for the participants of the first group and 87, 64, and 69 sessions for the participants of the second group. During the intervention, the participants had the technology system that worked as described in the Technology System section. The objective was to determine whether the system was suitable to help the participants carry out the tasks correctly. Each session started with the research assistant accompanying the participants to the area where the tablet was available (ie, just before the camera). When the camera detected the participants, the tablet was triggered to produce the first instruction delivery. All the rest was as described in the Technology System section. The first 2 sessions served as introductory sessions in which the research assistant could provide guidance any time the participants showed signs of hesitation or difficulty. During the following (regular intervention) sessions, no research assistant’s guidance was available except if a participant asked for it.

Data Recording

Data recording concerned (1) the number of task steps performed correctly (ie, in line with the step descriptions and independent of the research assistant’s guidance) within the sessions and (2) the length of the sessions. Data were recorded by the research assistants responsible for the implementation of the sessions. Interrater agreement was assessed by having a reliability observer record the participants’ performance of the task steps and the sessions’ length in 21% to 23% of the participants’ sessions. The percentage of agreement (calculated by dividing the number of sessions in which the 2 raters reported the same number of correct steps and session lengths differing by less than 1.5 minutes by the total number of sessions in which agreement was checked, and multiplying by 100%) ranged between 91 and 100% across participants.

Figures 3 and 4 report the baseline and intervention data for the first group of participants (ie, Rowan, Allie, and Sylvie) and the second group of participants (ie, Jolene, Emory, and Demi), respectively. The black triangles represent mean frequencies of correct task steps over blocks of 2 sessions. Occasional blocks with 3 sessions (at the end of the phases) are marked with an arrow. The figures do not report the 2 introductory sessions carried out at the start of the intervention phase.

During the pretest, the participants’ frequency of correct task steps per session was (virtually) zero. Indeed, they could carry out a single step (not necessarily involved in the task presented) or remain inactive. All sessions were interrupted after they had received guidance for 2 task steps. The mean session length was below 10 minutes for all participants.

During the baseline, the participants’ mean frequency of correct steps per session varied between about 1.5 (Allie) and 6 (Emory) out of the 12 steps available for each of the tasks. Such frequency reflected their inaccurate (unreliable) use of the tablet (ie, skipping step instructions or blocking the scrolling process and closing the instructions’ presentation) with the consequent omission of many task steps. The mean session length was about 6.5 (Jolene) to 14.5 (Emory) minutes. The mean length across participants was about 11.5 minutes.

During the intervention, the participants carried out the tasks successfully, and the mean frequency of task steps performed correctly per session varied between near 11.5 (Jolene and Demi) and above 11.5 (all other participants). The mean session length varied between about 15 (Demi) and 29.5 (Allie) minutes. The mean length across participants was about 19.5 minutes. The session length reported for pretest, baseline, and intervention always included the 2.5-minute preferred video shown at the end of the sessions. The large differences in the session length observed during the intervention (when the frequency of correct steps was similar across participants) mainly reflected differences in the participants’ performance speed. The Percentage of data points Exceeding the Median method showed indices of 1 for all participants (ie, all their intervention data points were higher than their median baseline frequency value) confirming the strong impact of the intervention with the technology system on their task performance.

Principal Findings

The results suggest that the technology system used during the intervention was adequate to help the participants receive step instructions in a timely fashion and without the need to produce specific responses on the tablet. The participants’ high frequency of correct task steps and the stability of such frequency across the intervention phase suggest that the instruction process was suitable for them and that they had sufficient motivation to maintain their task performance over time [ 38 - 40 ]. In light of the above, a few considerations may be in order.

First, the new technology system seems to have the characteristics required to bypass the limitations of the two main instruction technology approaches typically used with people with intellectual and developmental disabilities, that is, the approach requiring the participants to seek the instructions through simple responses on the tablet or computer’s screen and the approach providing automatic presentation of the instructions, at preset time intervals [ 1 , 4 ]. Indeed, by avoiding the need for fine motor request responses, the new system can successfully help participants who, due to poor fine motor skills, would fail to benefit from the first approach. Moreover, by ensuring a timely presentation of the step instructions based on the participants’ walking to the tablet, the new system would avoid any reliance on prearranged instruction deliveries and related risks of instruction neglect in case of performance difficulties or slowness.

Second, the system can be flexible concerning the way the instructions are presented. As viewed in this study, for example, the system can be set to present the two instructions concerning each task step at successive times for people who can handle only one simple instruction at a time (people with poor working memory [ 41 , 42 ]). The system can also be set to present the two instructions of each step simultaneously for participants who are able to handle more complex instruction inputs. Technically, the system could also be set up to present the step instructions in small chunks with people who have a relatively high level of functioning or have become very familiar with the tasks on hand and no longer need an analytic step-by-step instruction process [ 43 - 46 ].

Third, the system can be easily used for supporting tasks that may change across days in terms of the steps included. The most direct and fast way to arrange the sequence of steps included in the task on any particular day is to provide the system with a sequence of numbers representing the codes for those steps [ 16 ]. To facilitate the use of the system by staff and caregivers who have limited familiarity with technology, the system could be fitted with a series of tasks and variations thereof that can be selected by writing their names or any other code used in storing them in the tablet memory.

Fourth, the use of a webcam to trigger the tablet to present instructions can be considered a rather simple technology solution [ 47 - 50 ]. The webcam is a small battery-powered device connected to the tablet via Bluetooth, a device that is much simpler and easier to operate than conventional motion sensors, such as the Philips Hue motion sensors [ 51 ]. Moreover, the webcam’s cost (about US $60) is largely affordable [ 52 ]. When using the system within a daily context, one would be advised to locate the webcam and the tablet in a room corner. This would minimize the risk that people sharing the room with the participants can accidentally interfere with the system’s functioning.

Limitations and Future Research

The study presents 4 basic limitations, namely, the small number of participants, lack of generalization and maintenance data, lack of participants’ satisfaction data, and lack of social validation of the technology and its impact. The first limitation reflects the preliminary nature of the study, prevents one from making general statements about the findings reported, and underlines the need for new studies with additional participants [ 53 - 55 ]. The second limitation calls for new studies directed at (1) extending the number of sessions implemented and the intervention period to verify whether the intervention effects last and consolidate over time and (2) carrying out the sessions in different settings (provided these were familiar to the participants) to determine how extensively and profitably the system could be used within daily contexts [ 39 , 55 - 57 ].

The third limitation necessitates assessing how the participants perceive the intervention program. The assessment could consist of having the participants choose between the sessions with the system and other types of daily occupation. Large levels of preference for the sessions over other types of occupation would suggest participants’ satisfaction with the sessions [ 58 - 61 ]. The fourth limitation underlines the need for new studies to include staff and caregivers in the evaluation of the technology and its impact, as these personnel are finally responsible for applying the program and its technology in daily contexts. A practical way to include these personnel in the evaluation could involve (1) the personnel’s access to videos reporting the performance of different participants during intervention sessions and (2) the personnel’s rating of the videos on points such as the participants’ comfort during the sessions, the relevance of their task performance, and the overall acceptability and applicability of the intervention program [ 62 , 63 ].

Conclusions

In conclusion, the results of this study suggest that the technology system used for the intervention program implemented with 6 participants was effective in helping them carry out fairly complex tasks independently and accurately. Although quite encouraging, these results are to be taken with caution, given the limitations of the study mentioned above. New studies should address those limitations and provide the evidence necessary to determine the applicability and impact of the present technology-aided program. New research may also assess the possibility of upgrading and optimizing the technology to facilitate and extend its use across settings and people.

Data Availability

The data sets generated during and analyzed during this study are available from the corresponding author on reasonable request.

Authors' Contributions

GEL was responsible for setting up the study, acquiring and analyzing the data, as well as writing the manuscript. NNS, MFO, and JS collaborated in setting up the study, analyzing the data, and editing the manuscript. GA, IO, VC, and LD collaborated in setting up the study and the technology system, acquiring and analyzing the data, as well as editing the manuscript.

Conflicts of Interest

None declared.

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Edited by M Mulvenna; submitted 09.04.24; peer-reviewed by YS Hwang; comments to author 12.05.24; revised version received 15.05.24; accepted 15.05.24; published 12.06.24.

©Giulio E Lancioni, Nirbhay N Singh, Mark F O’Reilly, Jeff Sigafoos, Gloria Alberti, Isabella Orlando, Valeria Chiariello, Lorenzo Desideri. Originally published in JMIR Rehabilitation and Assistive Technology (https://rehab.jmir.org), 12.06.2024.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Rehabilitation and Assistive Technology, is properly cited. The complete bibliographic information, a link to the original publication on https://rehab.jmir.org/, as well as this copyright and license information must be included.