Wednesday, March 28, 2012

The pros and cons of truncated domes, should one disability trump another?

A yellow plastic square of raised truncated domes.

By Shannon Coe, Reuse and Finance Coordinator 

As you are crossing the street, many of you may notice the yellow dots on the curb ramps. You may even notice them covering the entire crosswalk from the front of the shopping mall to the parking lot. The yellow dots, also known as truncated domes, are an Americans with Disabilities Act (ADA) requirement. After the ADA was enacted in 1990, cities had to put in curb ramps between the street and sidewalk. But the curb ramps were a problem for people with visual impairments because they lost the visual cue to distinguish the boundary between the sidewalk and street. In order to resolve this issue, the Americans with Disabilities Act Accessibility Guidelines (ADAAG), required detectable warnings on curb cuts since July 2001. It has been required on edges of transit platforms since 1991. And only the truncated domes can be used as detectable warnings. Other tactile warnings and designs that have similar pavement textures as curb ramps are not permitted.

The intent of the truncated domes is to warn people with visual impairments of potential hazard when entering the street. People with visual impairments can feel the dots underneath their feet or cane to detect the crosswalk.

Although I understand the purpose of truncated domes, I find them to be unsafe for people with mobility impairments. Many of my friends who use manual wheelchairs, including myself, secretly complain how truncated domes create barriers for us. Why do we complain secretly? Because if we complained openly, people may think we are insensitive and do not care for the rights of people with visual impairments. But this is not true; we want to maintain unity in the disability community. Nevertheless, every time I approach the yellow dots on the curb ramp in my manual wheelchair, I tremble with fear that I might trip on one of the yellow dots and fall on my face. I know of friends in manual wheelchairs who have tripped on the dots and ended up in hospitals with broken bones. Whenever I cross the street, I need the momentum to push myself up and down the curb ramp but the dots are too bumpy. My front wheels are small so they cannot ride over the bumps easily. Furthermore, the bumps trigger muscle spasms for some people with spinal cord injury.

Shannon carefully navigating a curb cut with truncated domes
Therefore, should one disability trump another disability? Even though we should accommodate the needs of all people with disabilities, we should also “share the road.” Instead of putting truncated domes all around curb ramps or storefronts, I suggest leaving sections without truncated domes so people in wheelchairs can easily access those areas. This small change can make a huge difference in the safety of people with mobility impairments.

Share your thoughts about truncated domes. Do you think we need them? Are there other options for universal access?

Tuesday, March 20, 2012

Accessible Course Management courtesy of Moodle

by Rosemarie Punzalan, CFILC's Training Specialist

The CSUN's 27th Annual International Technology and Persons with Disabilities Conference was held in San Diego from February 27 - March 3, 2012. I had the opportunity to attend Thursday sessions as well as network with professionals, especially the vendors. The session that interested me the most was: Creating Accessible Online Learning Content: Learn how to create Accessible Online Learning Content using the Moodle LMS to Deliver your Courses Online.

Moodle LMS (Learning Management System) is a course management system designed for educators who want to create quality online courses. It is a free and open source software that is used by universities, schools, companies and independent teachers. Moodle is not 100% accessible. Some built-in Moodle features are barriers like the multimedia filters and the "File Picker" widget.

Luckily, there is a solution. Carroll Center for the Blind has created an online course that instructs curriculum developers on how to create accessible course materials using Moodle. Their solutions include:

  • Configure Moodle to create the most accessible framework for delivering courses. 
  • Provide effective and easy-to-use tools and filters to make it easy for content creators to embed rich media into their curriculum. 
  • Instruct course creators in the use of Markdown, a lightweight markup language, designed to reduce the learning curve required to publish semantic, standards compliant HTML instead of a WYSIWYG. 
  • Create a system of best practices and clearly define and illustrate them to content creators. 
  • Introduce accessibility and usability concepts by interweaving them with concepts already familiar to content creators. 
In the past I created a quick AT Network Moodle as a test for the Training Program and did not complete it because there were some accessibility challenges. With the above solutions I am thinking of spending some time creating an AT Network Training Program that consists of Self-Paced Trainings and Archived Trainings.

Have you heard of Moodle LMS? If so, have you used it and what for? Let us know in the comment box below.


Presentation in Markdown (text) format (good for screen reader access) -

Presentation in HTML (best for screen reader access) -

Monday, March 12, 2012

Medicare Competitive Bidding: Little Saving for Taxpayers, Big Headaches for Consumers

by Allan Friedman, CFILC's Technologies Manager

Not much has changed in the year since Medicare's Competitive Bidding program for Durable Medical Equipment, Prosthetics, Orthotics and supplies (DMEPOS) was launched in nine municipal areas, including Riverside-San Bernardino-Ontario in California, except for the fact that in the Riverside-San Bernardino-Ontario metropolitan area, now just 37 service providers for power wheelchairs are serving the same geographic area that previously had 375 companies for consumers to choose from.  Some consumers now have quite a few miles to travel for services.

The program, which is supposed to reduce the cost of DMEPOS that Medicare pays for, has been effective.  It the nine communities where the program pilot launched in 2011, DMEPOS costs have dropped 5.6%.  But unintended consequences which the home healthcare industry and consumer advocates warned about have also come to pass. 

Small businesses, which provided a variety of AT devices and home healthcare products, have been driven out of business by larger companies, often providing service in communities where they have no physical presence. Many "mom and pop" companies that did not win contracts for big ticket items have been forced out of business as their customers have been forced to get their equipment from the one or two vendors who won contracts for their area.

Consumers have had extended hospital stays while waiting to get their AT, have had to wait for deliveries by mail, make arrangements with multiple vendors for various products, and have lost services once provided by vendors they had an established relationship with, all due to the bidding process.

In short, the competitive bidding process has reduced cost for Medicare at the expense of consumer choice, access and quality.
The American Association for Homecare and others have proposed an alternative, urging Congress to enact the Market Pricing Program (MPP), a reform of the pricing system that is an alternative to the competitive bidding process now in place and scheduled for expansion next year.

The Market Pricing Program would establish fair market pricing for several categories of equipment through a proper auction process.  Using smaller geographic areas, the prices would be more in line with actual costs in each region and allow many more vendors to participate in the program.

One of the most important actions consumers can take to support this alternative is to add their testimony to stories already collected which demonstrate the difficulties caused by the competitive bidding process. is collecting stories to share with legislators and others.  If you or someone you know has had problems getting DME or home healthcare supplies as a result of the changes instituted in January 2011, then go to and share your story.  This is the best way to demonstrate to legislators that the bidding program is harming, rather than helping consumers and the saving realized by competitive bidding are more than offset by the delays and difficulties the program has caused.

Wednesday, March 7, 2012

Cool New AT Found at the CSUN Conference

by Rachel Anderson, CFILC's Information & Assistance Advocate

During CSUN's annual International Technology & Persons with Disabilities Conference in San Diego last week, we were exposed to so many cool new AT devices and software. Below are just a few inexpensive assistive technology options we learned about at the conference.

Interact - AS
Interact – AS by Auditory Sciences demonstrated their system for removing communication barriers in a variety of formats – for both professionals and everyday consumers.  Interact - AS supports written, typed or spoken input and transcriptions are instantly transcribed and displayed, including an optional synchronized audio recording.  This system, which can be pre-configured or loaded onto your own PC, allows individuals that are deaf to directly communicate with people who do not know sign language.  It allows a person that has difficulty writing or typing to dictate memos or other text and it allows those that don’t have the ability to speak a voice through writing or typing – and with a wide variety of regional accents.  It also even has a Visualize tab that includes a sketch pad showing pictures or videos.  The Consumer Edition is $149 and the Professional Edition is $795.

Capti App
This nifty little app called Capti by CharmTech Labs can currently be used with an iPhone or iPod touch and the company has goals of expanding it for the iPad as well as for android and PC users in the near future. Inexpensively priced at $2.99, this app is useful for anyone, and is especially helpful for people who are blind or have low vision. The way it works is as you browse the web with its built-in browser - similar to the standard Safari web browser - you can bookmark web pages to add them to a playlist and listen to them at your convenience. The best news is that Capti skips the ads and clutter, downloads articles that span multiple pages and reads only the main content. It uses a built-in TTS with American English naturally sounding voices and will read from your playlist even if you are offline. Capti can also be used with VoiceOver screen readers.

Flipper Remote
Are you or is someone you know sick of complex remotes with a million tiny buttons? This useful little flipper is great for people who regularly watch 30 channels or less. It is also great for people who have memory loss or simply can’t stand complicated remote controls. The channels can be pre-programmed and, once set, there is a locking option to avoid an accidental re-programming. It has only six large colorful buttons to push and makes volume and channel-changing much easier.  It works with all major TVs, cable boxes and satellite. Order it online for $24.95 plus shipping and handling.