Thoughts on Dedicated Devices

I just got back from the M-Enabling Summit in Washington DC, a global conference that focused on accessibility for aged populations and persons with disabilities. There were over 300 attendees from from over 30 countries, including representatives from some rather large companies (Apple, Microsoft, Research in Motion, IBM, and HTC to name a few). It was very interesting to see whatʼs coming next in the area of accessible technology, but it also opened my eyes to the fact that weʼve got a long way to go in the quest for making assistive technology truly accessible.

Re-Inventing the Wheel

As I sat through session after session where people were demonstrating their products (everything from screen readers to specialized devices to mobile applications), I was awe-struck at just how many dedicated devices there were. Personally, I believe this is backwards thinking. Here we are at a conference where weʼre supposed to be emphasizing the importance of accessibility for everyone, everywhere, and yet weʼre embracing and promoting an older way of thinking.

Simplify and Streamline

For example, do you have a smart phone? If you do, Iʼm sure you use it for more than just making calls. If you’re like most smart phone users, you use it to check your email, surf the web, update Facebook or Twitter, and even play a game or two. Yet when it comes to persons with disabilities, we believe that a dedicated device is better. Personally, I canʼt stand carrying around more than one device. Now imagine youʼre in a wheelchair and you need to have all of these devices mounted – it gets ridiculous!

Take Advantage of the iPad’s “Cool Factor”

One shocking statistic I took away from the M-Enabling Summit is that only 7% of people who receive a dedicated speech device actually use it! I have not been able to verify that statistic, but I have seen the effect of the principle behind it – dedicated devices generally have an undesirable social stigma attached to them that the user is trying to avoid. Don’t get me wrong, for some people, a dedicated device is great because they need the extra customization that they provide. On the other hand, I think itʼs a safe assumption to say that a significant number of those people are individuals who just don’t want to use (or at least be seen using) a dedicated device. On the other hand, the iPad has the opposite effect.  The iPad is “cool!” Who doesnʼt want an iPad? I’d be willing to bet that the majority of persons with disabilities do, especially when presented with a choice.

“Only 7% of people who receive a dedicated speech device actually use it.”

Doing More for Less with the iPad

Right now, Medicare and Medicaid (with the exception of a few states like Minnesota and New Hampshire) will not allow the iPad to be covered as an AAC device because it is not a “dedicated device.” The problem with that is, these devices (which are as simple as an Android tablet thatʼs “locked” into a particular app) can sell for up to $8,000 because thatʼs what insurance will cover. The iPad is much less expensive, and for the most part, a much more powerful tool. As an example, check out this video on our new Functional Communication System application, an app that sells for less than $50 in the iTunes App Store.

The iPad is an incredibly powerful tool that can be used as a speech device, but can serve a lot of other functions as well. This is not a negative, it is a positive, and it’s up to us to convince our lawmakers of the tremendous value of the iPad.

What do you think? Leave your thoughts in the comments below.

By | 2017-04-30T16:18:31-04:00 December 13th, 2011|Education|7 Comments

About the Author:

Mike is the President of the Conover Company, an assessment company that focuses on transition, social/emotional learning, and independent living skills.

7 Comments

  1. Rachel December 14, 2011 at 5:25 pm - Reply

    This is a very interesting article. I have seen the impact of those with disabilities using an iPad and it is tremendous. They are not only more interested, but the information learned through the use of the iPad seemed to be retained. I am excited to see the the iPad used more as a communication device as well for those who are non-verbal. Thank you for writing this.

    • Mike Schmitz December 19, 2011 at 5:13 pm - Reply

      Hi Rachel! Thanks for taking the time to read the blog and share your insights with us. We really value your feedback and are happy to see that you have had such a positive experience with the iPad!

  2. Ezra Reynolds December 30, 2011 at 1:38 pm - Reply

    The problem with a dedicated device that costs $8000 (because insurance will pay that for a dedicated device) is when the insurance(including Medicaid/Medicare) doesn’t cover it. We have worked with a lot of people who have been turned down for a device (low vision equipment, speech devices, etc.) because it is “not medically necessary”. Families of a person with a disability (especially a child) tend not to be rich – even with insurance, there are lots of therapies and services that are not fully covered by insurance and thus a lot of out-of-pocket expenses. Hearing “here is a device that will change your life (or your child’s life) and it costs the same as good used car” is a hard pitch to swallow. For people on a fixed income (social security, disability, etc.) the dedicated devices are priced way out of their reach.

    The main advantage of the dedicated device is durability. Many of them are sealed to resist drooling and have a case engineered to withstand significant abuse. The second advantage is ease of customization – you can customize the screens easily, but can’t leave the actual program. We had a child using a speech app on the iPad actually erase it from the app from the iTunes account, forcing a repurchase).

    These advantages are being steadily worn down. I have seen shock enclosures for the iPad that protect the screen and have a handle or a wheelchair mount. The communication apps are becoming steadily better, and there are parental controls on the iPad that can prevent deletion of apps (found after the above experience). Similar advancements are being made on the droid tablets.

    I am seeing a much larger number of people going to the iPad for accessibility. There will always be a need for dedicated devices – for the highly involved drooling child with spastic motion, an iPad will be destroyed quickly. There is not good switch access for an iPad – yes, there are bluetooth switches, but they tend to only work with apps from a particular vendor. However, I see dedicated devices becoming much more of a niche market.

    The desktop PC took off because it can do so many things – word processor, spreadsheet, calculator, paintbrush, design studio, internet, email, CD player, MP3 player, DVD player, arcade machine, etc. Tablets are taking off for the same reason. We are particularly fond of the built-in VoiceOver on the iThings that allow blind/low-vision/reading-impaired to use these devices easily.

    The logic for dedicated devices is backwards. It should be a device of last resort, not the de facto standard. The proper path should be to consider a multi-purpose, general-use, commodity good first, and only if that is not feasible consider a more niche application.

    • Mike Schmitz December 30, 2011 at 5:55 pm - Reply

      Hi Ezra,
      Thank you so much for sharing your insights on dedicated devices and the iPad. I think you made some very good points regarding the pro’s and con’s of both the iPad and dedicated devices, but like you said, the iPad is growing in popularity among people with disabilities. It is true, no device is without some flaws, but the iPad will only improve in functionality over time.

  3. Diana December 30, 2011 at 3:57 pm - Reply

    Without a doubt, the “ithings”- as a professor once called them are a game changer. As an Assistive Technology Professional, I feel many are losing sight of the “process” we need to continue to use before recommending these products. I have seen time and time again the “greatest new thing” over recommended, and under utilized. Additionally, most apps have no research based claims to prove there efficacy (although I recognize that many are based on software research from the past). I would undoubtedly recommend “ithings” for the RIGHT person/s but not before proper formal and informal assessments.
    As far as the “dedicated devices” I fought this battle for MANY years. There was at least for a long time in AAC that clinicians would not recommend “integrated devices.” Although I respected their reasons I think that they were missing the possibilities they could have been offering their clients. It is funny to look now at these same clinicians who are “singing” a different tune. Hmmmm? I agree there will always be a place for dedicated, but t underestimate the potential of individuals ultimately limites them. Great article.. keep them coming!

    • Mike Schmitz December 30, 2011 at 6:01 pm - Reply

      Hi Diana! It’s great to hear this kind of feedback from the perspective of an Assistive Technology Professional such as yourself. We agree with you that an app is only as valuable as the research backing it up. Thanks for joining in the conversation, we look forward to hearing from you again soon!

  4. Amy January 3, 2012 at 1:58 pm - Reply

    I also was at the M-enabling conference which I thought was not too much new information for me personally, but very interesting to see how the “generic” tech folks are beginning to appreciate the disability marketplace.
    Re: Dedicated “vs” generic discussion – assuming as Diana reminds us that the process of making the decisions is a solid one, and that there is also a solid planning for implementation, we should keep in mind that we all use multiple forms of communication. For example, I use a fully-featured desk top for work and the creation of large documents; my iPad as an all purpose tool when traveling (so I don’t need my Kindle, or blackberry, or netbook); my personal phone for texting; my blackberry as an “internet appliance” and work phone…so, think also how generic technologies may AUGMENT a dedicated device…vs. replace. One other thought that occurs to me is the ability to do multiple functions at the same time – a challenge for some of the tablets…Lastly, it is often the quality of the software or “app” that makes the difference. Some of the apps sold for “communication” are little more than automated flash cards, not helpful for fully functional communication not to mention language generation and acquisition. Do I think there’s a new generation of tools out there? absolutely! but like any tool, the object itself is not the focus but rather what it does, how it does it, what it takes to learn to use it and who uses it well!

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