Accessibility, Disabilities, and Virtual Reality Solutions

Microsoft Cantroller example of usage for visually impaired in virtual reality.
What is it like to see for the first time? UploadVR reported the story of Jamie Soar who experienced seeing for the first time in 2016. Not because of surgery or some amazing medicines, but because he had donned a VR headset.

As the headset fired up its loading room demo Soar found himself in a state of shock. His whole life he had been forced to lean in close to computer screens, books, televisions, people, anything just to get a clear look. But inside this revolutionary new device, he discovered a world that was leaning in to him.

The unique technical design of a VR headset was having something of a counteractive effect to Soar’s Pigmentosa. These contraptions may be designed to provide the illusion of depth through special lenses, but in physical reality the screens they are employing are mere centimeters away from a user’s face. This, coupled with the dual-screen projection method of the Vive — in which every single image a user sees is actually two images relayed to separate screens in front of each eyeball — ended up being the perfect storm of factors to judo-flip Soar’s typical visual impairments and render his vision closer to normal than he had experienced in decades.

Accessibility issues are a top priority in education as educators are often on the front lines to ensure equal access to all, and few things are more profound than helping a student experience and see, literally and figuratively. In the United States, 40 million Americans are classified as disabled, 12.6% of the population. Disabled World reports that 15% of the world’s population has some form of disability, and estimates that 33% of 20 year-old workers will become disabled before reaching retirement age, which ties in with the CDC Morbidity and Mortality Report in 2018 stating 1 in 4 US adults have a disability that “impacts major life activities.” An estimated 200 million people globally are visually impaired, though World Health Organization estimates 1.3 billion people live with some form of vision impairment, the majority of them over 50 years of age. These numbers are considered under-reported estimates.

Virtual reality provides opportunities for many for socialization, adventure, and experiences they may not enjoy in the real world. Those with autism, social anxieties, and mental health challenges find comfort and safety in virtual social apps and experiences. Many visually impaired VR users discover they can literally see more than they can without VR, opening up visual worlds and experiences they’ve not been able to access in the real world. Alex Lee shared his story in ALPHR about seeing more in VR after losing his sight, quoting Gary Rubin, professor of visual funtion and rehabilitation at UCL:

“The closer something is, the more magnified it is. Placing two screens inches from your eyes is essentially making things larger by filling your field of vision. Additionally, the device will have automatic gain control, which will adjust and boost the contrast of the scene. Contrast is very important in making things visible.”

This was one of many inspirations for Educators in VR to bring you more meetups and workshops on accessibility in the future. We’ve been researching the various topics of disabilities associated with virtual reality and spatial technologies, from the perspective of learners, researchers, and educators, and want to share a few of our findings and discoveries with you. It is a vast topic, so please let us know what topics and areas of study you wish for us to bring to our meetups and workshops in the comments or on our Educators in VR Discord group.

When Technology Embraces Accessibility

In “Why AR/VR Developers Should Prioritize Accessibility in UI/UX Design” on Medium by Ben Formaker-Olivas, he shared insights and lessons learned as a new user struggled with the setup. Through the problem-solving process, he learned that the game was not set to deal with her dwarfism. He had to lower the overall perspective settings so he could play the game on his knees and it could accommodate her height.

Up until this point in history, technology has required minimal physical interaction to access, in the form of typing, clicking, or tapping/swiping. That being said, many with alternative accessibility needs still find using a keyboard, mouse, or touchscreen cumbersome or simply impossible. Immersive technologies multiply the physical component of that interaction substantially, often requiring full-body interactions. When it comes to using VR, standing for long periods, wearing a heavy headset, and holding clunky controllers all stand as immediate barriers to entry for many users. As someone with arthritis, I’ve often had to pause a VR game after standing caused the pain in my ankles to become distracting. With the current AR headsets, current functionality like hand tracking could be unstable or unusable for many, such as those with prosthetic limbs or limb paralysis. Taking a look at the software running on these platforms, the chances that content will lack accessibility options only rises. Audio clarity, text size and contrast, button layout options, movement requirements, and countless other factors each contribute to whether an application is going to be a comfortable, and accessible, experience for the user.

In combination with the usability design of the hardware, these factors collectively fall under user interface (UI) and, more broadly, user experience (UX) design. These areas of study employ psychology, anthropology, anatomy, color theory, and a host of other resources to shape a user’s experience with a product.

The points he makes are valid for every part of the development of these technologies such as always considering the end users, ensuring there are diverse voices included in the project, check your assumptions, and make accessibility a priority.

Andrew Burton wrote an article on TheNextWeb about putting accessibility at the forefront of tech, explaining how thinking beyond basic problem-solving can inspire technology to benefit, and consumers as well:

Outside of potentially enabling millions of people with impairments, flipping the way we think about technology access and data consumption can have wondrous consequences, sparking research with beneficial side effects.

Headphones, for example, changed little in the past 50 years until a company began thinking of our hearing like eyesight and designed on the basis that perhaps we all hear slightly differently. Nuraphone’s product development starts with Otoacoustic emission’ (akin to a child’s hearing test to assess deafness.) It’s the company’s secret sauce used to create unique hearing profiles for every user and thus improve the sound quality, like prescription glasses for your ears.

Similarly, haptic feedback has long been harnessed as a useful signal for the visually impaired to engage with technology, but it’s also providing a new dimension to music listening by delivering bass directly to the user’s body via wearable devices. Cementing the virtuous circle of innovation, comparable technology has since been used to help hearing impaired users enjoy live gigs.

There are people who have lived on both sides of the equation. Those born with impairments who regain full functionality and others who lost a sense or a physical ability. They offer unique perspectives, and some drive radical change.

Rebecca Graetz, ED.D tackled the myths about accessibility and online learning on eCampus News, starting with the fact that students often do not report the need for disability accommodations in an online course because they don’t want to deal with the paperwork and attention they may get in the accommodation process, sometimes triggering social anxieties. An excellent point she makes is on captioning:

Captioning is not just for those who need accommodations because of hearing differences. It is for the international students who experience language barriers, students who learn differently, and for those who might need to watch a video in a sound-sensitive area (e.g., a library, someone taking care of a sick kid who is sleeping). Doing what we ask our students to do in the world of accessibility brings awareness.

Looking back to 2010, ABC News featured a report on Dr. Dave Waner of the Center for Really Neat Research in New York demonstrating a virtual reality interface that uses the face to control movement in VR. It was the early days, so it is fascinating to see how far we’ve come, and how much further we have to go.

Microsoft Takes the Disability Lead

Microsoft made accessibility a priority in their apps and hardware, developing the SeeingVR app, developed in partnership with Cornell University, to make virtual reality accessible to the visuallay impaired. Their program developed 14 tools to tackle visual impairment challenges, delivered as engine plugins for Unity. Most do not require specific developer effort. The tools include magnification lens, bifocal lens, brightness lens, contrast lens, edge enhancement, peripheral remapping, text augmentation, text to speech, depth measurement, and more. If you are a developer or designer using Unity, check these out and ensure they are a part of your program.

Microsoft also created a haptic controller called the “canetroller” that works as a white cane but integrates into the virtual reality environment.

Microsoft has also patented a braille-displaying controller accessory for the blind that will work with virtual reality and other controller based games and apps. It appears to attach to the back of a standard Xbox One controller offering “a plurality of paddles arranged as a braille cell on the housing, and a control circuit to translate a touch force applied to at least a portion of the plurality of paddles into individual braille characters.”

Here are some articles and more information about Microsoft and its partners as they expand the possibilities for accessibility and disabilities through virtual reality and Windows Mixed Reality:

Virtual Reality and Vision Impairment Solutions

A collaboration project between the Business Information Systems program at Saskatchewan Polytenic and CNIB (Canada National Institute for the Blind) created VR games for the visually impaired for climbing rocks. The students choose a task that would be fun and not too visually fast-paced. The fact that this was student created as a class project makes the potential for similar programs globally to not only offer curriculum opportunities but helps educate the youth on accessibility issues.

The Smithsonian American Art Museum offers virtual tours with vision impairment features to permit students to explore. The Google Arts and Culture app for iOS and Android also features visually impairment accessibility features.

CNET’s 2016 article on how VR and AR can help restore sight turned out to be mostly prophetic, highlighting tools such as IrisVision, a headset that includes vision-aid features, a personal voice command assistant, and integration with IrisReader, the OCR text-to-speech reader to display large, high contrast fonts for easier reading. With the power and affordability of new mobile VR devices, and the integration of AR in almost all mobile devices by default, many stand-alone devices are now apps.

Augmented reality devices are being studied to determine if it will help patients with age-related macular degeneration and other low vision conditions by mapping out the ever changing scotomas in each eye and “through neuroadaptation, the brain does not see a blind spot where the scotoma was, but a complete image, while maintaining peripheral vision,” filling in the vision gaps.

According to a report in Helio, news for the primary care optometry industry, work is ongoing for development of treatments and training using virtual reality. Virtual reality is being used for surgical training and prep, training those with some visual impairments to enhance user’s current perception of reality through vision therapy and sports vision training, and even retrain the muscles in and around one or both eyes for amblyopia and other related issues.

Accessibility Challenges with Virtual Reality Solutions

Research in 2017 on immersive virtual reality for pediatric pain and using virtual reality for pain and anxiety management brought the benefits of VR to children’s hospitals and care centers. In 2018, researchers from the Florida Atlantic University found that fear of needles (needle phobia) was reduced through the use of virtual reality headsets, resulting in a 94% reduction in action fear and pain over anticipated. The impact of the distraction and reduction of anxiety needs further research for application in the educational environment, opening up new areas of research and study.

BreakThru, developed by the University of Georgia and Georgia Institute of Technology, aids students with disabilities pursue STEM careers and further their education.

Embrace the life VR is an association designing applications developed by and for wheelchair users to aid navigation in different environments “while providing a positive therapeutic effect that decreases anxiety, increases social integration, and improves quality of life.”

In April, a virtual reality program intended to mitigate workplace unconscious bias, covering disabilities as well as class and race bias, was launched by BCT Partners and Red Fern Consulting to deal with workplace discrimination. Called Through My Eyes, the program is designed to promote empathy and teach employees how to recognize unconscious bias through real-time scenarios. We’d love to see similar applications available for students as well.

More and more hospices and patient care centers and hospitals are using virtual reality in different ways to relieve pain and offer palliative care for patients. In Ohio, a grant from the Robert and Esther Black Family Foundation brought VRT video technology to hospice patients with realistic 360-degree, photographic and animated 3D images and videos with environmental sounds to immerse patients in these virtual worlds. They found it helps patients relive memories and “return to places of emotional significance, or experience something or somewhere that they desire.”

Honor Everywhere has created VR experiences for aging, disabled, or terminally ill World War II veterans to aid them in virtually visiting war memorials. Imagine this being available to students, too.

In the US it is estimated that 1 in 59 children are on the autism spectrum. Research continues to show that virtual reality helps autistic children and youth in many ways including overcoming fears and phobias, treating autism (PDF), using virtual reality for training social skills (PDF), and even help police learn how to react to autistic people. Spectrum News has an extensive article on how virtual reality is transforming autism studies and research with more information, as does VR Fitness Insider.

While this may see like more science fiction than reality, scientists have developed a brain implant that read’s people’s minds and converts their thoughts into speech. A team at the University of California, San Francisco has published their findings in the journal Nature and could revolutionize access for those with motor neuron disease, brain injury, throat cancer, strokes, neurodegenerative disease, locked-in syndrome, or other speech impairments. Once improved, incorporating this technology into VR and AR should be a simple process, allowing social interaction beyond voice.

Video Stories, Research, and Commentary

Here are more videos on virtual reality for disabilities. Some of these date back a few years and others are more recent, offering an educator and researchers perspectives as well as first hand experiences.

Virtual Reality Accessibility Groups and Associations

Educators in VR isn’t the only group dedicated to accessibility, diversity, and inclusion. Here are some other groups and associations working on this in virtual reality, and we’d love to add to this list, so let us know if you are working with or familiar with other similar groups.

For More Information

Other articles and research included the following. Please note that some of the papers require subscriptions and membership access:

We hope this list of the possibilities in virtual and augmented reality solutions may inspire you in developing your own curriculum as well as offer resources for speakers and further research. As with all such resource articles, if you find additional information that may be helpful, please let us know. And if you are an Educators in VR member and would like to contribute to the resources and wisdom shared here, please contact us.

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Accessibility, Disabilities, and Virtual Reality Solutions