Writing By Laura Brigham

It’s common to see people ask their phones for directions, have their Kindles read the paper to them, or watch them listen to the latest bestsellers on their iPods. Nobody thinks anything of it.

These same technologies, which are changing the ways we all share and receive information, are becoming particularly helpful to those with a wide range of disabilities. In Nevada, nearly 400,000 people are considered by the guidelines from the Centers for Disease Control to have some form of disability. For these people, the Nevada Assistive Technology Resource Center (NATRC) is there to help close the participation gap.

From tried and true electronic page turners to the latest and greatest high-tech tools like iPads, the NATRC offers anyone with a disability the opportunity to find greater independence and communication ability through its expertise and resources.

In this virtual-reality environment, beginning at the lobby of the Nevada Assistive Technology Resource Center, you can click on hotspots to explore the library of devices available for clients to check out, or to visit Scott Youngs in his office. (VR by Joan Grover, Bradley Rassler, Regina Revazova, and Abbie Walker.)

“The physical world may have been quite a challenge in the past,” said George McKinlay, data coordinator at the Nevada Center for Excellence in Disabilities, (NCED) of his clients with disabilities, “but now it’s not so much of a challenge, and we can start interacting better with some of our clients. They want to be part of the conversation.”

To help that conversation, NATRC (a part of the NCED at the University of Nevada, Reno (UNR) offers a lending library of assistive technology, such as Braille devices, digital magnifiers, hearing aids and voice recognition systems.

“Assistive Technology (AT) is a tool, but for me it’s about communication and participation,” George said. “Enhancing their lives means fuller inclusion and participation of everybody.”

And with more than 450 assistive technology tools in its lending library, plus the resources of its umbrella organization, the NCED and the NATRC can help those with disabilities access tools to reenter the workforce, transition from high school to college or a career, or simply engage in meaningful ways with those around them.

The goal for each client, according to Scott Youngs, project coordinator for the Americans with Disabilities Act (ADA) and AT projects at NCED, is to show them what exists and eliminate any barrier that prevents them from doing what they want to do.

“If they can’t access the computer, we try to find a way they can access the computer,” Scott said. “If they can’t read their mail, we figure that out. It’s matching their need with an appropriate technology solution. Improving their functional capacity to do something.”

AT collaboration

NATRC came together in the mid-2000s, through a granting process coincidence. The NCED and the State of Nevada Department of Employment, Training and Rehabilitation’s Vocational Rehabilitation division applied for the same grant independently of one another. The grantor agreed to fund both assistive technology projects if the two organizations agreed to work together.

George McKinlay

George McKinlay

Tami Brancamp, a speech pathologist who worked at NCED and wrote the initial grant application, said it took some time but the two groups found a way to work well together.

“We have different approaches,” Tami said, “but we learned how to work together and focus on how to best serve our population of people with disabilities, while meeting both of our agencies’ guidelines.” Brancamp is now an assistant professor in UNR’s Department of Speech Pathology and Audiology.

Mechelle Merrill, bureau chief at State of Nevada Bureau of Vocational Rehabilitation, agrees that through combined effort, NATRC provides invaluable service to those with disabilities.

“This is a resource that is unique in the northern Nevada community and has outreach all the way into the rural areas,” Mechelle said. “It is staffed with professionals that are unparalleled in our community, and it’s not just for the university, but the community. It is an amazing resource – unique and significant in its collaboration.”

Vocational Rehabilitation is a federally and state-funded program to help individuals who have disabilities that are getting in their way, Mechelle said.

“We help them keep a job or reenter the workforce.” And if that means assistive technology is needed, NATRC is there to help.

“Let’s say you have a disability that impedes your ability to type,” Mechelle said. “You might need certain technology to make you effective in your place of work. George and Scott might come to your work station to get a first-hand understanding of what your needs are.”

They also have an AT lab set up where clients can “try on” different technology to see what works best.

“It’s kind of like the mad scientist lab in that it just looks like a messy office,” Mechelle said. “But it’s the stuff that’s in it that’s the magic when paired with the individuals who know how to demonstrate it.”

If assistive technology devices are the magic, Scott and George are the magicians who make it work.

Scott Youngs / by Abbie Walker

“The NATRC, and specifically George and Scott, bring a level of expertise that is unparalleled in Northern Nevada,” Mechelle said. “The impact that they have on our clients is profound.”

With 468 assistive technology assets in its collection, NATRC lends about 150 to 200 devices a year and helps about 100 people a year through its employment project.

“There are a huge number of people who aren’t aware that technology even exists to help them with things,” Scott said. “Serving everyone – that’s the goal. When you provide someone an AT device that they never thought was out there to help them, that’s when you get the good feeling of doing something for somebody.”

Devices available for loan range from magnifiers for the vision impaired to DynaWrite keyboard communication devices for those who have trouble with speech.

NATRC has helped Denny Granata, a traumatic brain injury survivor, for several years.

“The things that assistive technology help me with now are using a wheelchair to get about anywhere, using a TTY relay phone, and using my DynaWrite or my iPad with Proloquo2Go for communicating,” Denny said via his iPad.

With coaching from a NATRC employee, Denny is working to move from the DynaWrite to the smaller, more-convenient iPad.

“It’s really important that a person has the ability to try out a tool or piece of equipment,” Tami said, “because it’s a financial commitment, and it’s not always paid for by an outside source. It can be family members who are paying.”

Catching up with tech

One of the newest assistive technology tools is probably the most well-known: the iPad. In addition to its more common usage for entertainment and information, the iPad can also serve as a multi-functional AT device, incorporating vision aides like magnification apps, speech solutions such as Proloquo2Go (a speech generator), and dexterity solutions like Dragon Dictation voice recognition app for those who have trouble using a keyboard.

The iPad is one example of how technology is changing the AT landscape quickly, but government policy has not caught up. Generally, Medicaid does not consider an iPad “assistive technology,” so it will not pay for a disabled person to get the device, Youngs said.

“People who aren’t Mac users think of the iPad as an expensive toy,” Scott said. “But really it can be used as a communication device paying $500 for the device and $200 for the software. DynaVox is just to communicate and can be $8,000. There’s a cost benefit to treating that iPad as a communication device, not just as entertainment.”

Mechelle agrees that the thinking within government systems needs to change.

“They don’t think forward to all of the other things [an iPad] might be in your life that might head off barriers that we haven’t even identified,” Mechelle said. “It’s very frustrating. The system would rather spend more on the tried and true and limited thing because they know it.”

But Mechelle, Scott, and George all said that eventually government will catch up with the new thinking.

“We don’t calculate the cost of care and supporting the person with disability and the people around them,” George said. “As a person becomes more independent, they become less costly to the people around them in terms of time and effort, which in turn leaves those people more able to participate in society, be it working more, recreating more or not having the health issues they might otherwise have. We don’t calculate those costs.”

Universal design

At NATRC, the staff is always thinking beyond the economic cost to the social profit.

“Technology is about future possibilities – technical control of possibility rather than solving here and now problems,” George said. “Because if you solve the here-and-now problems, then what’s next. I’m always looking much farther down the road and saying, ‘This is what we need to get to.’”

NATRC strives for a forward-thinking strategy that ensures maximum participation and communication for all, George said. For him, that means a world of “universal design.”

He said assistive technology is usually developed from people who are around people with a disability saying, “I think I have a solution for this.”  It’s become professionalized and commercialized, but ultimately many of advances come from peoples’ personal experiences.

“Universal design for me means that we have to think of the things we do in a fuller social context,” George said. “Be it the design of a curriculum or the design of a telephone. Design for all.”

For example, if video content is closed-captioned it becomes available to hearing-impaired people. But it also makes that content more accessible to everyone by way of it now being searchable. It’s more universally usable by all.

Tami said people with disabilities tend to be a “marginalized population, but they deserve to be with everyone else.” To make that happen, we need to “change our models from a disability model to everyone just lives in society and has equal opportunity to do what we need to do. … Everything that comes off the shelf should be accessible to all, and that isn’t where we are today yet.”

The Assistive Technology lending library at NATRC

Community outreach

Accessibility goes beyond developing the appropriate tool to remove a communication, mobility, or other obstacle. Sometimes accessibility comes down to geography.

“Between Ely and Elko, it’s three hours of windshield time and no resources,” Mechelle said, “but there are people in each community that are isolated and in need. It’s very challenging to provide services to all of Nevada equally.”

But NATRC is a statewide program open to anyone with a disability, and Scott and George are up to the challenge.

“We’d like to have an accessible bus so we could take all the equipment out with us, but we don’t.,” Scott said. “We’ve gone out to Ely, Elko, Eureka, Austin. It’s hard to get out there, and there aren’t as many clients. But if the demand says we need to go, we do. We’ll go to wherever they are, whether it’s rural, their home, their place of employment. We’ll make it happen.”

Even in Reno, getting the word out about disability services is a challenge.

“It’s hard to reach everybody,” Scott said. “We’re part of a collaboration, so other agencies like Care Chest and the Nevada Center for Independent Living send people to us. It’s a constant battle to get the word out.”

Referrals also come from school districts, word of mouth (parent to parent), Vocational Rehabilitation, speech pathologists, and rehabilitation hospitals.

Aging populations also can be difficult to reach out to: “Elderly people sometimes don’t identify themselves as disabled,” Scott said. “They just say, ‘Oh, I’ve got a bad knee,’ when they actually have a significant impairment that would be considered a disabling condition.”

The future

Through collaborations such as NATRC, Nevada is making strides in assistive technology, but that was not always the case.

“In the last 15 to 20 years, it’s just started to come on people’s radar that AT can help people with disabilities in a lot of different ways,” Scott said. “It’s a slow process. There’s never enough money. There’s never enough education. There’s never enough training.”

Scott said of particular concern now is transitioning youth from high school to jobs, careers, or college.

“We’re not getting to kids at a young enough age and introducing them to the technology soon enough” so they can develop digital literacy, he said. And even when the kids are provided AT tools while in the school system, those devices stay at the school when the child moves on.

“There’s a disconnect in the referral process,” Scott said. “They’re working on it.”

Leaving that child or anybody else without the tools that let them participate in the world around them is a tragedy, George said.

“There’s a cost of not doing something, and we do not calculate that at all,” he said. “The lost thoughts of an individual, the participation of that individual missing from society is incalculable.”