Last week, I talked about the needs of people with visual, hearing, or mobility impairments when it comes to using a Mac. In a nutshell, the state of accessibility on the Macintosh is in decline and may become worse under Mac OS X before it gets better. Meanwhile, most people with disabilities are currently better served with Windows-based machines than Macs. (See "Accessibility on the Mac: Trouble in Paradise" in TidBITS-568.)
The Good News -- First off, all the usual advantages Macs enjoy over Windows - consistent, integrated user interface; easy networking; simplicity in installing and removing applications and system enhancements; and visual elegance - remain notable advantages for many disabled users. And there are some clear-cut superlatives, like built-in speech output (and speech recognition, however limited).
If you need to get a disabled coworker, employee, or friend or relative up and running on a Mac, it's usually possible. Your options are more limited than with Windows, but for nearly all relevant disabilities, there's at least something available to reduce or eliminate barriers.
Whether you're looking for Mac or Windows products, your first stop for information should be the long-standing magazine and Web site Closing the Gap, which offers a large searchable resource directory.
Mobility Impairment -- If you need help typing or using the mouse (for example, if you suffer from repetitive strain injury or have multiple sclerosis), you can use Apple's own accessibility software, which you might have to load onto your Mac via a custom install from a Mac OS CD-ROM. You can also download the files directly from Apple.
Sticky Keys and Mouse Keys are the most useful utilities in the package. With Sticky Keys, you can press modifier keys and letter or number keys in sequence instead of together: Command then Shift then Q, for example. Maddeningly, though, Sticky Keys turns itself off if you actually do manage to press a modifier and another key simultaneously (Command-Z, for example, since they're usually close together), thereby making you more disabled than you actually are. Mouse Keys lets you move the mouse by pressing keys on the numeric keypad. (There's a related utility, Mouse Keys for PowerBooks, for machines without numeric keypads.) However, those Apple utilities were always minimal and haven't been significantly improved in half a decade.
Third-party products might be a better option. Tash, Inc.'s $100 SwitchClick is a big, squat cylinder that substitutes for a mouse. You can use it with the $275 MouseMover software to control mouse functions like click, press and hold, or simply moving the mouse in a given direction.
From RJ Cooper comes the $100 SmartClick, software that substitutes for a mouse using a technique called "dwell selection:" you hover the mouse cursor on an object and make a selection with SmartClick's on-screen menus, which is then interpreted as the click, double-click, click-and-drag or similar action of a mouse. To make this function work, you need either a mouse or a trackball, a mouse substitute like Tash's SwitchClick or, even better, a HeadMouse from Origin Systems ($1,890 with USB cable).
With the HeadMouse, you wear a tiny self-adhesive silver dot on your forehead. The HeadMouse hardware, which sits atop your monitor or CPU, sends out twin infrared beams and triangulates the position of the dot on your forehead. Movements of the HeadMouse substitute for the movements of a regular mouse. Putting the HeadMouse and SmartClick together, even a quadriplegic can manipulate the mouse cursor purely through head movements and execute all the usual mouse actions.
For typing, someone with a moderate mobility impairment can use a customized hardware keyboard like the $780 Discover:Kenx (pronounced "Connects") by Don Johnston, Inc. It's a combination keyboard and mouse. If you need a very large keyboard, Don Johnston offers the $500 Discover:Board.
You can also use an onscreen keyboard - conceptually similar to Apple's Key Caps desk accessory - along with adaptive hardware, such as the $100 OnScreen by RJ Cooper.
Hearing Impairment -- The access requirements of deaf and hard-of-hearing people are quite modest given that, even in an age of Napster, computers are largely silent devices that communicate visually. In fact, computers as they stand now themselves provide a form of communications accessibility, since email and instant messaging don't require hearing at all.
There are a few places where audio is important. For instance, beep sounds on the Mac can be converted to menubar flashes by turning the alert sound volume to zero in the Sound control panel.
Forms of multimedia remain a perennial obstacle, and since multimedia now is making increasing inroads into the Internet, we'll wait until a later article to explore the problems and solutions there.
Visual Impairment -- Of the disabilities affected by computer use, visual impairment is the most significant. As we have seen with devices varying as widely as the Palm and a range of tablet computers, Internet refrigerators and whatnot, in real-world use a computer is mostly a display. If you can't see a display, how do you use a computer?
If you have a relatively modest visual impairment, all you may need is screen magnification. The free Apple utility CloseView provides bare-bones magnification, but you get what you pay for. Instead, opt for the $295 InLarge by Alva Access Group, the only screen magnifier of note for Macs. It features 16 magnification levels, three settings for controlling how the magnified portion of the screen moves, the capability to display only the area being magnified, and other options.
Many visually-impaired people find dark text on a brilliant white background unbearable. A very few applications - Web browsers, WordPerfect, Eudora - let you select the foreground and background colours, while the near-ubiquitous Microsoft Word limits you to black-on-white or white-on-blue. The Window Monkey utility lets you assign background colours and patterns to Finder windows.
If you're blind enough that you can't really see a monitor, you need something called a screen reader - a program that reads aloud on-screen text, menus, icons, and the like. Unfortunately, there's only one screen reader for Macintosh, Alva Access Group's $700 OutSpoken 9.
Screen-reader technology is advanced and competitive on Windows, and the three big-name programs there - Jaws, Window-Eyes, and IBM Home Page Reader - are all able to interpret Web sites (more or less accurately) and also interpret the tricks and features of standard application software.
In contrast, the somewhat outdated OutSpoken for Macintosh does not interpret HTML. According to Lou Grosso of Alva Access Group, OutSpoken 9 "will simply read from left to right the text that is on the screen. Web and HTML access will improve tremendously in OutSpoken X which should be released in late 2001." Moreover, Alva Access Group strongly cautions you not to use OutSpoken with Microsoft software. Of course, there are other software alternatives to Microsoft's products, but using them limits one's capability to work on documents in collaborative environments. In the real world, it is regrettably true that anyone who requires a screen reader is better off using Windows, and nearly all blind people do.
OutSpoken remains the only full-featured Mac screen reader comparable to what's available for Windows, but RJ Cooper offers the $95 KeyRead, a kind of mini-screen reader for blind kids $95. In addition, an old Apple utility that dates back to the AV Macs is still available online, in samizdat form. HearIt lets you select nearly any text in nearly any application and listen to it using Macintosh speech output.
On the Mac platform, people with disabilities have relatively few options when it comes to adaptive technology. There are more barriers to using a Mac than there need to be. Nonetheless, disabled Mac aficionados haven't been completely left out in the cold. Here's hoping Apple will acknowledge the strategic (and, increasingly, the legal) importance of actively supporting accessibility in all its forms, improving its own hardware and software and encouraging developers to close the technology gap between the Mac OS and Windows.
[Joe Clark is a former journalist in Toronto who's followed, written about, and worked in the disability field for two decades. Explore his many online accessibility resources at his Web site.]