Monday, June 07, 2010

iPad for low vision elderly

My 80 yo mother's macular degeneration is limiting her ability to read printed books. I took her to an Apple store this past weekend to see how she'd do with an iPad.

It took us a while to figure out how to configure it. The default accessibility settings assume no vision, so each letter is spoken before it can be selected and entered. Accessibility mode also changes gesture behavior to a less natural mode with a steeper learning curve.

We got the best results with the following setup:
  • From the accessibility menu, configure the screen "home button" to enable VoiceOver on 3 consecutive pushes. (Her arthritis and neuropathy made this a bit tricky, but counting "1, 2, 3" as she pressed did the trick. Once she had the rhythm she could do it reliably.) This lets us turn it on and off as needed, and stay with the standard gestures much of the time.
  • Enable three finger tap to zoom -- and three fingers to move the zoom image. This just magnifies pixels so it's of limited use but it can come in handy. It's normally not compatible with VoiceOver, but if you keep VoiceOver off normally, and enable it just when needed, this can work. From Safari you can get much nicer results from finger zooming web pages
  • Disable the keyboard Voice assist.
  • Slow the VoiceOver rate way down
In iBooks we set the book size to the largest available font. My mother was able to read the sample texts. She could also triple-tap enable VoiceOver, then double tap on the page to have VoiceOver (monotonously but clearly) read the page text.

She had less success with the Safari and Mail.app, but we didn't spend enough time practicing them. Because of the limited zooming of Mail.app and the finger zoom in Safari I wonder if she’ll do better using Gmail.

The iBook experiment was encouraging. She's a sucker for Apple look and feel so she was quite fond of the iPad.

I'm not sure it makes sense to buy her one. For one thing I'm not sure how I can get content on her iPad from my home. If Apple does a bit more work, next year's iPad would be a much better option (though in her age and health, a year is a very long time). If I do go ahead I'll configure it at my home then transfer the paired iTunes Library to her Mac Mini.

See also:
Update 6/11/2010: I did buy her one. Some quick notes from today:
  • Darn. I forgot my AMEX card with its 1 year warrantee extension.
  • There are no ear buds in the box.
  • The charger cable is hard to insert initially. I expect it will be easier with practice. I’ll modify the standard connector (tape, etc) so it’s easier for her to grip and insert.
I’ll write a post later (see update) on how I configure, which apps I use, book buying, how I manage iTunes prep here and then transfer to her, etc. (For one thing, I’ll setup a user account on a laptop for her iPad’s iTunes sync during initial configuration.)


Update 6/14/10: The Kindle is a dismal failure.

Update 6/17/10: Accessibility gestures are documented in the secret User Guide.

Update 8/18/10Grandma's iPad - A user guide and review

4 comments:

K said...

"Lite Notes" may be a useful app for low vision people. Writing emails, shopping lists or notes is easy to handle.
Its possible to zoom text with a pinch. The App remembers the text size for each note. Searching notes only in upright position.
Very good handling with few commands in every edge of the ipad. White text on Black Background could be a good idea to be realized in the future. At the moment this feature can only be activated by the general settings of the ipad.

John Gordon said...

Nice tip. I downloaded it and I agree. It may also be just the thing she needs to send simple email messages. It would be nice if they made some of their target icons more obvious.

I've rarely seen text scaling like this. Thanks!

K said...

Have a look at "Dragon Dictation".
I have made a short break between every spoken word in a sentence.

In german the recognition is gorgeous.

It´s also available in US an UK Version. In Germany it costs nothing.

Unbelievable!

Cheers
Klaus

BethEl said...

This is an extremely helpful thread for me... just today I talked with my uncle's occupational therapist, and she recommended an iPad for him. He is legally blind due to irreversible macular degeneration.

Thanks to your detailed descriptions of the various ways in which your mom interacted with (and had some trouble with) this interface has answered many of my questions.

Thank you for doing the work of writing all your and your mom's experiences out. It is helpful to me, because we both are not only dealing with the low vision, but also some of the ravages of aging as well, making things like multi-finger swipes or intricate lists of gestures to remember a little more complicated!

--B