Thursday, November 12, 2015

How an iPhone changed a paralyzed veteran's life



While serving in Iraq as a medic in the U.S. Army, Ian Ralston was hit with a tiny ball bearing from an IED in 2010. He was left paralyzed from the neck down. 
Despite the hardship, Ralston quickly adopted a "make the best of it" attitude. "To me, there's absolutely no point in being upset about it," he told the told the WCF Courier nearly a year after he was injured. 
"I mean, yeah, it sucks. And if I had my choice, no, I wouldn't be in a wheelchair. But this is what I got right now. So I might as well make the best of it. If all you want to do is be upset about it, it's just going to make it that much harder for you to live with it, to cope with it. So I got past that quick."
That attitude has helped Ralston thrive. He's married, has newborn twins and uses a special wheelchair that helps him accomplish daily tasks—even operating his smartphone. 

Life changed by a smartphone


Like most new parents, Ralston posts photos of his children to Facebook, where he also posts status updates about his life.
Ralston does this using an iPhone 6 Plus — a phone he got eight months ago. The iPhone is Ralston's first smartphone.
"I got injured before the smartphone craze, so getting one now is really cool," Ralston tells me.
Many of us are familiar with accessibility options for visually impaired individuals; screen readers make it possible for users who are partially or fully blind to still read a computer screen. Dictation software has made it possible for those who can't move their arms or fingers to communicate.
But accessibility tech goes a lot further than that. Ralston, for example, is able to operate his iPhone 6 Plus using his mouth. His wheel chair uses what's called a sip-and-puff system. Blowing or sucking into a tube can move his chair around. It can also control the screen on his iPhone.
The iPhone connects to Ralston's chair using a small device called a Tecla Shield. This is basically a bluetooth adaptor that connects his phone — which is mounted on his wheelchair — to the wheelchair's sip-and-puff controls. 
The Tecla Shield is designed to work with iOS devices running iOS 7 or higher. Using a feature called Switch Control, Ralston can control and access different parts of the screen using his mouth.
For Ralston, the impact having a smartphone has had on his life has been both big and small.
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Having access to a phone gives him freedom and a sense of independence he didn't have before. "I'm on a vent because I can't breathe on my own," he explains. In the past, this meant that if he couldn't leave the house alone — in case something happened (a battery got too low, some tubing started to come out). Now, he has some independence and call his wife on her phone if he needs assistance.

"That was something I could never do before."
But it's not just the big stuff. Like most guys his age, Ralston is into fantasy football. He told me about how he recently was out and got a notification of an important movement that would affect his lineup. Using Yahoo's official Fantasy Football app, he was able to make changes to his team based on that news. "It sounds really trivial," Ralston concedes — but I disagree.
The reality is that most of us use our phones for a mix of reasons. The fact that Ralston can change his lineup no matter where he is — just like anyone else — is huge.
"I send texts [using the built-in dictation feature] and check Facebook like anyone else," he says. He also uses Siri to look some stuff up — a game score or the weather. 
The iPhone isn't Ralston's first experience with adaptive tech. He has used Dragon's Naturally Speaking software on his PC laptop for a few years to dictate emails or posts. He also uses his mouth to control his computer's mouse.
Still, the iPhone is a new experience because it is attached to the chair and as a result, can go everywhere with him.
A glitch between Ralston's phone and his chair meant he couldn't use the two together for a few weeks. "I was pissed off!" he tells me, surprised by how quickly he became reliant on the device.
Ralston almost seemed embarrassed by his addiction — but as I pointed out to him — that's the same way all of us — regardless of our physical abilities — feel about our phones. If my iPhone broke tomorrow, I know exactly how long I would be able to last without it: As long as it took to get to the nearest Apple Store to buy a new one.

Letting people know this is out there

Ralston's setup between his wheelchair and his iPhone was all covered by Veteran's Affairs.
As far as he knows, he was the 16th person in Washington state to get it. More people, he thinks, should know that this is available.
"And it's not just for vets or those of us with spinal injuries," he says. "People with ALS can benefit, too."
Getting it setup and certified through the VA was seamless, he says — at least in Seattle. "It takes about four hours to install," he says and then it took an hour or two for him to get the hang of.
Still, setup was intuitive and Ralston was able to play around while on the way back from getting it installed on his chair.

Getting developers on board

Although Ralston has success with most of the apps he wants to use, it's worth noting that not all apps are built with accessibility in mind.
When I asked him about any apps in particular that don't work well with his setup, he called out transportation maps like Apple Maps and Google Maps. "I like to look at maps and places," he explains, and it can be difficult with the current apps.
Apple makes it relatively easy for developers to add accessibility support — including access to Switch Control — in its apps. If an app supports Apple's screen reader, it probably also supports Switch Control.
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Developers don't always focus on accessibility until they hear from someone affected. And Ralston says he often doesn't want to complain because he's just so happy he has access to a phone at all.

Apple and other companies do actively work with vets and with the community to make accessibility better.
Ralston's advice for developers is to start playing with the accessibility settings on their own. There are YouTube videos that show how the features work and by trying to use an app without typical input, developers can get a real-world idea of what it might be like for someone like Ralston to use an app.