Assistive Technologies in the Library

Book: Assistive Technologies in the Library“Assistive technology” can be an intimidating (and expensive) phrase. However, it includes a wide variety of resources. Touch screens, alternative keyboards and pointing instruments, voice synthesizers, audio input, and large switches can be helpful to those with a variety of impairments. Likewise audiobooks and large-print resources are not only imperative for those with vision problems, but also can be helpful to those with learning disabilities. Those with vision and hearing disabilities can have difficulty in accessing resources once at the library due to communication challenges. Libraries do not typically staff sign language interpreters, though this is the primary form of communication for many in the Deaf community. Nor do most libraries provide Braille materials in the stacks for blind patrons. Even directional signs, including call numbers, can be difficult for those with dyslexia or dyscalculia to find materials on the shelves.

If you are looking for one comprehensive resource to give a complete overview of assistive technologies, Assistive Technologies in the Library by Barbara T. Mates is highly recommended. For libraries looking to start incorporating assistive technology in their institutions, the checklist of “Ten Items a Library Should Put on the Front Burner” is a optimal place to start:

1. Support an accessible website, and purchase accessible electronic data.

2. Purchase screen-enlarging software.

3. Purchase screen-reading software and oversize monitors.

4. Enable the library’s operating systems’s built-in accessibility attributes to be activated.

5. Purchase a collection of low-cost alternative input devices, such as trackballs, joysticks, and touch screens.

6. Purchase portable high-end magnifying devices (e.g., CCTVs)

7. Purchase assistive-listening devices and acquire a video relay system.

8. Purchase task lighting for workstations and work to reduce glare.

9. Purchase an adjustable worktable that can be raised or lowered depending on need.

and most important

10. Invest in training for library’s staff. (p. 165)

Published in 2011, this book is extremely up-to-date and covers a wide spectrum of disabilities, technologies, and resources. Available from the American Library Association ($55).


Mates BT, Reed WR. Assistive technologies in the library. Chicago: American Library Association; 2011.

Understanding Assistive Technology – Video

Understanding Assistive Technology – PACER Simon Technology Center

The Simon Technology Center (STC) at Minnesota’s PACER Center (Parent Advocacy Coalition for Educational Rights) presents a simple, illustrative definition of assistive technology. The STC provides assistive technology consultations and training in addition to a lending library. Their video presents a welcome reminder that assistive technology is not necessarily cost-prohibitive. The first example of assistive technology given is a simple foam grip that allows a child to hold a crayon. Eye glasses and corrective lenses are perhaps the most common form of assistive technology, and a reminder that many library patrons have special needs even if they are not considered to have a disability.

To find local resources in your state, the PACER Center recommends: The Association of Assistive Technology Act Programs (http://www.ataporg.org/).

The Society of Healthcare Professionals with Disabilities

Biomedical professionals with special needs should be considered when developing a strategy for an inclusive library. They are both patient and clinician. In addition to reference inquires that might arise when treating their patients, they may also have information and accessibility needs directly related to their own disabilities.

The Society of Healthcare Professionals with Disabilities (http://www.DisabilitySociety.org/) is an organization for health professionals with disabilities and associates. Providing professional resources and support, lifetime memberships are free. In addition to the global society, there are three subgroups:

  1. Physicians with Disabilities (www.PhysicianswithDisabilities.org)
  2. Pharmacists with Disabilities (http://www.PharmacistswithDisabilities.org)
  3. Nurses with Disabilities (http://NursingwithDisabilities.org)
The Society of Healthcare Professionals with Disabilities also maintains a blog that can be subscribed to via email or RSS.

Deaf Health Education Partnership: University of Pittsburgh HSLS & Western Pennsylvania School for the Deaf

Seeking to improve the health information literacy, the Health Sciences Library System (HSLS) at the University of Pittsburgh partnered with the Western Pennsylvania School for the Deaf (WPSD) in project also supported in part by the National Library of Medicine. Reference Librarians from the University of Pittsburgh worked with WPSD health educators and the learning center director to create  health eduction curriculum for the students which covered Internet health searches, health website evaluation, and an introduction to MedlinePlus.

Communication barriers to health information in the Deaf community can arise not only due to the hearing disability proper, but also in translating English to ASL (American Sign Language) and explaining complicated medical terminology. The partnership created a valuable exchange for all involved. WPSD staff educated the University Reference Librarian in techniques to improve communication with the Deaf, while the librarian instructed both staff and students to conduct authoritative Internet searches for health information.


Gregg AL, Wozar JA, Wessel CB, Epstein BA. Designing a curriculum on Internet health resources for deaf high school students. J Med Libr Assoc 2002 Oct;90(4):431-436. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC128959/

Universal Design for Learning

Introduction to UDL (Center for Applied Special Technology)

The Center for Applied Special Technology (CAST) leads the Universal Design for Learning movement based upon their research to improve instruction to children with special needs. UDL takes into account various learning styles of individuals in education and instruction. Universal Design for Learning considers neurological differences in the recognition, strategic, and affective networks in the brain, providing multiple means of representation (recognition network), action and expression (strategic network), and  engagement (expression network) in instructional strategies. The concepts of UDL can be applied to both health and information literacy in any biomedical library, and could be especially useful for those in academic health sciences libraries.


Center for Applied Special Technology. About UDL. [cited 2011 December 8]. Available at: http://www.cast.org/udl/index.html.

The Universal Design Movement

Initially, the term “Universal Design” was coined by architect, Ronald L. Mace, a graduate and affiliate of North Carolina State University. Universal Design (UD) is “the idea that all new environments and products to the greatest extent possible should be usable by everyone regardless of age, ability, or circumstance.” (1) His work eventually led to founding the Center for Universal Design based at NCSU.

The seven principles for Universal Design are:

  1. Equitable Use
  2. Flexibility in Use
  3. Simple and Intuitive Use
  4. Perceptible Information
  5. Tolerance for Error
  6. Low Physical Effort
  7. Size and Space for Approach and Use (1)
A 2009 article by  Ann S. Williams, PhD, RN, CDE  in Diabetes Education, encourages the adoption of UD principles not only in medical devices used to monitor diabetes, but also in Diabetes Self-Management Education (DSME), emphasizing a strategy to accommodate not just the 90% of average users, but as close to 100% as possible (2, p. 2)

As an illustration, consider a DSME class that contains persons with hearing loss, visual impairment, and ADD, as well as those without current disability. If essential material is simultaneously presented in both audible and visual formats – for example, using colorful illustrations in a slide presentation with detailed verbal description from the instructor – persons with hearing loss, visual impairments, and ADD will be better able to perceive, attend, and understand it. Adding a lively participatory game will enhance the attention of the person with ADD. Making all classroom materials available in printed handouts, and also in audio-recordings or digital format ensures that persons with visual impairment or ADD can review the information at their own pace and in their own way. (2, p. 5-6)

UD presents principles that are applicable to the biomedical field as a whole, and can be integral in overall health literacy and efforts in all biomedical libraries. As William proposes, if we begin new strategies with Universal Design principles in mind, we can potentially eliminate the need to add “adaptations or special design” at a later date. (2, p. 7)

(1) North Carolina State University, Center for Universal Design. 
The Principles of Universal Design. 2011; [cited 2011 December 7] Available at: http://www.ncsu.edu/project/design-projects/udi/center-for-universal-design/.

(2) Williams AS. Universal design in diabetes care: an idea whose time has come. Diabetes Educ 2009 Jan-Feb;35(1):45-57. doi:10.1177/0145721708329700

NoHands Mouse

NoHands MouseThe NoHands Mouse is a hands-free mouse that utilizes foot pedals, ideal for those with no or limited hand movement. Compatible with Windows, Mac, and Linux systems, one pedal controls movement of the cursor, while the other is used for clicking. Right and left click functions are accessed by a heel movement (right mouse button) and toe click (left mouse button). Interestingly, the commercial on the company’s website does not address disabilities per se, but is targeted at those looking to avoid carpel tunnel syndrome. Available for purchase directly from Hunter Digital, this alternative cursor device costs $359.99.

Creating an OPAC Low-Vision Workstation

In 1993 Patricia P. Nelson, M.L.S., M.A., AssistantDirector of the Denison Memorial Library, University of Colorado Health Sciences Center oversaw the creating a low-vision workstation for online catalog access. As the UCHSC is in a separate location from the rest of the campus, and other libraries, they saw a need to introduce special needs services locally within their institution.

The project was funded by a $12,000 grant from the Library Services and Construction Act (LSCA) of the Colorado State Library. The grant itself was an interesting partnership as this fund allocates monies to public libraries, and the UCHSC Library successfully pleaded their case as a public health information provider. Likewise, the Denison Memorial Library’s use of CARL OPAC software presented the opportunity to create a workstation that could be a blueprint for other Colorado Alliance Research Libraries. (p. 1)

Though both this article and workstation are now nearly twenty years old, and assistive technology has improved significantly, the process in securing funds, researching technology, and incorporating the workstation into their existing OPAC software is valuable to any biomedical library interested in expanding their services to those with low vision.


Nelson PP. A low-vision workstation for online catalog access: empowering persons with visual disabilities. Bull Med Libr Assoc 1995 Apr;83(2):247-248. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC226038/

The Disabled Nurse: Focus on Abilities

The Disabled Nurse: Focus on Abilities

Susan Fleming, MN, RN, CNS and PhD candidate at Washington State University College of Nursing shares her experience working as a nurse of over 35 years. Having been born with only one hand, Fleming has excelled in her profession with the help of a prosthetic hand. While offering encouragement to others in the field with a disability, her experience can be enlightening to there rest of the biomedical community as they serve those with disabilities.

Rural Public Health Nurses and Barriers to Serving the Special Needs Population

A study of health information needs of rural Oregon nurses published in 2008 indicates that there is a need to expand health literacy resources for the rural special needs population:

In addition to general nursing care resources, home visiting nurses wanted detailed resources for caring for patients with disabilities.  (p. 337)

For patients with disabilities that do not live in larger, urban areas access to special needs resources can be extremely limited. This lack of resources can also be extended to the local public health nurses that serve the population. Rural nurses and caretakers face the same barriers as their isolated community, including limited information resources, internet access, and training. (p. 336) Through their interviews, the authors noted that numerous rural public health nurses experienced frustration while attempting to use online database for their information needs. Reasons stated included frustration with restricted login access to databases and patient information that was too advanced for the reading level of their patients. (p. 339).

There is a need to improve access and training to the rural medical community across the board. However, those with special needs already have numerous barriers to health literacy resources and assistive technology. Therefore, when their public health nurses are also facing barriers to information resources, these barriers are magnified.


Turner AM, Stavri Z, Revere D, Altamore R. From the ground up: information needs of nurses in a rural public health department in Oregon. J Med Libr Assoc 2008 Oct;96(4):335-342. doi:  10.3163/1536-5050.96.4.008