Inclusivity Requires A Paradigm Shift

1 Billion plus people is not a niche market.

According to the World Health Organisation:

One in seven of the world’s population has some kind of disability.

Niche Market

A billion is obviously an extremely large number of individuals, that have needs to be met.

In the Western world the populations are ageing, improvements in healthcare are helping people live longer – this means that the number of people who require assistance coping with age related conditions is only going to grow.

There are likely to be ever increasing numbers of people with poor vision, hearing loss, limited mobility and cognitive difficulties and we need to ensure that they are not excluded.

This is what is sometimes referred to as a Megatrend. Megatrends are great forces in societal development that will affect all areas – state, market and civil society – for many years to come.

Another Megatrend is the rapid growth and increased mobility of populations.

This will put a strain on all kinds of resources but from an inclusion point of view there is great deal of cross over with the needs of the disability community.

Economic migrants and refugees from war and famine will often face language barriers to inclusion in their new countries.

Couple this with the need to educate and raise literacy levels in the general population as a whole and you have a problem that is just too big for governments to ignore.


Why then is there a belief that it is something that is small scale?

Perhaps the answer to this is because we are not focusing on the commonality of needs and trying to address each individual problem separately:

For example we frequently deal separately with the needs of people with dyslexia to the needs of people with poor literacy or those who face a language barrier when accessing technology and information, and separately again when addressing the needs of people with limited or no vision.

Whilst the way that these groups will interact with technology will be different the underlying technologies that are useful to them are often quite similar.

We have allowed special interest groups who are no doubt well-intentioned, to distort and fragment our understanding of the problem and where we often have a case where only those that shout loudest get their needs served.

Some disability advocacy groups are better organised and better funded than others:

Organisations such as the Action On Hearing Loss (formerly the RNID), NFB (National Federation of the Blind) in the US and RNIB have been very effective at lobbying and raising awareness – other organisations that represent the needs of people with Cognitive Difficulties such as Dyslexia, Dyscalculia, ADD, Aspergers etc. have historically been far less effective.

We have in effect created our own artificial niches.

This has created confusion and led to companies and governments addressing some issues to the detriment of others:

An example of this is VoiceOver on the iPhone, I think that what Apple has done for people with vision impairments is fantastic; they have embedded accessibility for blind people deep into the operating system.

  • But this is not something we can really call inclusive.
  • One group of people is no less deserving than another of these tools.

As a person with dyslexia I don’t use Voice Over on the iPhone because it turns off most of the stuff I want; including the normal touch screen interface with standard gestures.

It would not have taken much for Apple to give users greater control over the accessibility features rather than dictating preferences.

By giving the user greater configurability they would have immediately made their phones accessible to a much wider group of people who are currently excluded.

Why are more big companies not queuing up to get a slice of this huge market?

One reason may be the fact that this issues appear complex and they are not sure where to start. 
It is easier for them to focus on doing the stuff that they know and understand.

Another has to be fragmentation and the niche behaviour of the accessibility industry.

A fragmented market is not an attractive one to the big players, when we present and represent the needs of each disability separately we are making it less likely that business will address the issue.

I have been doing a lot of thinking recently about Accessibility and Assistive Technology and this has prompted me to have lengthy conversations with a number of good people like Gregg Vanderheiden at the Trace Center, Jonathan Hassell former Head of Accessibility for the BBC and Sandi Wassmer of Copious who recently shared her Ten Principles of Inclusive Web Design.

These conversations highlighted one key point for me:

We cannot afford to try and solve these problems one at a time.

Technology is moving faster than ever.

The pace of development and intensity of competition has led to fragmentation.

The way we consume information is changing, the growth of smartphones is explosive we should not confine our efforts to the desktop computer:

  • We are moving rapidly towards an “internet of things” where many kinds of devices are connected and consume and generate information.
  • There are over a Billion computers in the world but 5 Billion people own a mobile phone.
  • Yet for the most part mobiles are horribly inaccessible in themselves and accessing information on the web via a mobile is clunky at best.
  • Addressing inclusion one website at a time or one application at a time is a thankless task and ultimately a losing game.

The proliferation of data is enormous and will continue to accelerate:

  • There has been an explosion of User Generated Content.
  • More and more stuff is published by amateurs who are not web designers and have no knowledge of code or how to create accessible content.
  • Citizen journalism, social media and blogging are all adding to the weight of data out there and the trend is for this to accelerate as more and more people post stuff online from their mobiles.
  • Up until now great deal of focus has been placed on making websites conform with W3C’s WCAG (Web Content Accessibility Guidelines).
  • This approach is having some qualified success for the online presence of Governments (National & Local), big companies and service providers.
  • But it is leaving the rest of the web untouched and inaccessible.

It seems to me that the key to ensuring greater inclusion is to make the Apps, compilers, social media tools, content management systems, and blogging tools produce more accessible content for the people who are using them without them having to think about it.

Let’s be realistic;

The average blogger or social media user has nothing against people with disabilities.

But their needs don’t spring to mind when they are posting something about the party they just went to or the football match they are watching.

To be honest I think that it is unreasonable to expect them to.

This is why initiatives like Fix the Web are commendable but in my opinion doomed to limited success at best.

Addressing web accessibility one website at a time is akin to recalling every car in the world and retrofitting an electric motor.

It is not going to happen.

Access to Assistive Technologies is key to inclusion.

But only 15% of those who need them have these tools!

So what are the main issues?


The mainstream AT products are too expensive putting them out of the reach of those that need them most:

  • People on low incomes, excluded from work because of their disability, or unable to find funding.
  • People in poorer countries where grant support is not available or scarce at best.

In the western world the provision of AT has been subsidised by governments – this is great for the citizens who get what they need to access information and have a fair chance of leading a meaningful life being able to participate in education and work.

However, it has also had the effect of protecting AT vendors from market forces that have driven down the price of technology in the mainstream.

The argument has always been that Assistive Technology is a niche market with small customer bases and high production costs, that the challenges faced in producing AT are somehow harder than the challenges faced by other companies developing new technology and that this justifies the prices charged for products like JAWS, Read & Write, Dragon or Kurzweil.

Certainly my previous experience of being involved in developing AT software was a mixed bag.

Some of the development work was tricky, but I doubt it was harder than for others.

One of the barriers to setting an affordable price to the consumer was the cost of licensing components such as the OCR and Text To Speech.

Because the product we were developing was AT the vendors charged us between seven and thirty times the price that they charged for the same components when they were included in games or other mainstream consumer software using the niche market, low volume argument.

This is a self-fulfilling prophecy; if you price a product designed to address the needs of people who are often in the poorer segment of society in the hundreds of pounds you are pretty much sure only to sell a handful.

Lack of innovation and interoperability.

The market is changing and AT vendors need to up their game.

Despite the high cost of much Assistive Technology, there has not been much in the way of innovation in the well-known AT products for a long time.

Yes each new version brings another feature that can be used to justify the update but there has been nothing groundbreaking for years now and many of these feature are just serving to make the software more cumbersome.

I really believe that given the high cost of AT that the vendors ought to do more to make their products flexible enough to work with emerging mainstream technologies.  They should not just cry foul and blame everyone else.  Both the developers of new technology platforms and AT vendors need to be working to make their products work with each other out of the box as far as possible.

For example I do not agree with the approach taken by Freedom Scientific which I have encountered when reporting incompatibilities with JAWS and other software:

The stock response seems to be “get one of our partners to script it for you”.

This approach means that the work to make JAWS work with other programs is expensive, disjointed and does not get included in the application itself to benefit other users.

This has parallels with the problems we experience with web accessibility.

AT is all to often platform dependant.

Mobile technology is driving innovation – companies like Google and Apple have made it relatively easy for people to develop applications for their mobile operating systems, even Microsoft is doing it.

Furthermore these companies have given small developers a route to market that they did not have before, via their Appstores.

This has led to the launch of a raft of reasonably priced Assistive Technologies on mobile platforms.

Currently these products are not of the complexity or breadth of some of the AT available on a PC or Mac but the pace of development is fast.

Very few AT vendors are doing stuff on mobile and this is to my mind a big mistake.

Freeware and Open Source AT?

There is a growing amount of Assistive Technology available these days that is available for free or at low-cost and much of it is open source and developed collaboratively.

A great example of this is the free screen reader NVDA.

Whilst this is a good thing there is risk attached to this approach – by relying on volunteers or being funded by charitable contributions the products risk being outstripped by the pace of technology development and becoming out of date, losing compatibility and interoperability.

I am not arguing that AT producers should make no money; everyone in business has a right to expect to be allowed earn money for their work.

I am arguing that by abandoning the niche mentality, dropping prices significantly and addressing the needs of the larger market they will help more people and make more money.


Sometimes an Assistive Technology will by the very nature of what it does need to look and feel different from mainstream technology but often it does not have to.

A colleague of mine who is blind told me about visiting a trade fair for the visually impaired where he was looking to find a new watch.

He left disappointed and empty-handed because in his words he was “looking for something a little less blind”.

I am fed up of seeing software that looks like it was written for Windows 95 and that costs the earth.

We can and should do better – anyone who tells you otherwise is either lazy or lying.

The same applies to Assistive hardware and gadgets.

Even if it was free I would not want to use lots of the AT on offer today unless I had to because it flags up the fact that I am different.

Who wants to cart about the IntelReader which looks like it has been made by Fischer Price when you could use the K-reader, Beyo Reader, or CapturaTalk on a modern mobile phone?

Be honest which would you rather use?


Intel Reader - It's huge

Or something like this?

Capturatalk on a Standard SmartPhone


Plextalk Daisy Player

Or something like this?

Apple's Ipad 2

Certainly when I speak to people I know who use Assistive Technology they want to use consumer products like everyone else.  I know that Sandi Wassmer was delighted by the fact that her iPad 2 which she uses with Apple’s inbuilt accessibility tools was the subject of gadget envy.

If we are to achieve inclusion the solution needs to be in the mainstream

We need to engage with the people developing tomorrows technology right now.

Believe that we can use mainstream technologies to meet a far greater number of our inclusion needs.

We need to demonstrate that building inclusivity into their devices, platforms and software is a necessary part of their product development cycle.

That by doing so they are opening themselves up to a bigger and more profitable market than they already have.

Manufacturers need to provide a mechanism or framework to give greater configurability to their end users and make it easy for AT developers to make their products work with mainstream products.

To date only a handful of hardware device manufacturers have developed products that have accessibility features built-in  – software is further ahead in this respect.

Middleware may hold some of the answers.

I am looking at a number of solutions that hold out the hope of making mainstream consumer devices work in a way that makes them far more inclusive.

Perhaps the most exciting thing that I have come across recently is the GPII (Global Public Inclusive Architecture), the brain child of Gregg Vanderheiden.

It is a hugely ambitious undertaking that is fraught with the risk of failure but given the currently broken state of inclusion I think it is well worth pursuing.

I will be getting involved and encourage anyone else that wants to make a more inclusive future to do so too.

Here’s a summary from the GPII Website

GPII is a software and service enhancement to our broadband infrastructure designed to:

  • allow users to invoke and use the access features they need anywhere, anytime, on any device
  • provide users with simple flexible ways (“wizards”) to determine which access solutions work best for them
  • lower the cost to develop new types of assistive technology and new built-in “extended usability” features by
  • providing rich development tools
  • allowing developers, researchers, and consumers to work together to create better solutions with less duplication of effort
  • providing common core modules and services that can be used to build both commercial AT and built-in access features
  • reduce the delay in affordable access to new mainstream technologies as they are released
  • increase the number and variety of developers and invigorating the field by
    • lowering the entry costs for new assistive technology developers
    • providing a low-cost mechanism for moving new ideas from research to the market
  • increase the number and types of different access solutions, providing a better match for more types of users
  • provide better solutions for low incidence disabilities and combinations of disabilities not served well today (e.g., cognitive impairments, deaf-blindness)
  • improve the interoperability between mainstream and assistive technologies
  • increase the market penetration for all assistive technologies by increasing awareness and extending opportunities to try and select products and services
  • provide a mechanism to create ‘ubiquitous’ accessibility to match the evolving ubiquitous technologies
  • lower the cost to governments, businesses, employers, and others who need to provide access to all they serve
  • make it easier (less expensive and more realistic) for libraries and other public access points to serve all patrons
  • provide these rich, robust tools to citizens of developing countries, affordably

If you have a spare 8 minutes why not watch the video.

32 thoughts on “Inclusivity Requires A Paradigm Shift

  1. Wow you have packed so many ideas into one blog that I am feeling rather unsure about this comment but perhaps those of us working in the field of Assistive Technology and web accessibility need to mix with colleagues across the communities of practice – health, social, education and home care more often to see the innovations that are happening in the different environments. Stop being gatekeepers of specialisms and open up without fear of losing our grip on what is a widening market.

    So where do we start in this brave new world of Mainstreaming AT?

    If I want something to help my mother read books – do I turn to an assistive technologist? who is that person and where are they? Not in her village, doctor’s practice, library (if it is still open) so where does she go – Ask a friend – Ask a daughter – well she may be lucky! Google for what? She can’t see much of the web page and certainly does not know Ctrl+ to zoom.

    Maybe we need to look at our own practices and see how we can cross those boundaries to the 1 Billion, as I am worried that we are missing an awful lot of these people and not getting what we already have in our toolkit to the right folk. Innovation is there – such as this Braille iPad ( idea announced today, but here is another problem – how do we keep up, check what really works and alert users to what has been added to the kit available? Somehow we need to get it all onto the high street but with the right support.

    • Thanks EA. Great comments.

      I did consider breaking it up into parts but the problems and issues are interlinked. Indeed if anything breaking it up into chunks would be mirroring the fragmentation that we are experiencing and that I wish to move beyond.

      Absolutely we need to be engaging beyond our own specialisms.

      The gatekeepers are holding the gate half open, we need to be much more open to working with business and other disciplines if we are to INCLUDE the untouched 85% of people who would benefit from assitive technologies and services that are accessible to and via them.

      Your talk about taking the products on to the high street is exactly where it needs to be and I believe that we can reach a point where it is possible to do this. Not that many years ago you would go to a PC world or equivalent buy a PC, get given a box and an extended warrantee (if the sales assistant was pushy enough) and that was that. You’d go home and figure it out for yourself. Today these same companies will come to your home and set it up for you and walk you through the basics, much as Assistive Technology companies like Microlink and Iansyst have been doing for years. Is it too much of a leap of faith to believe that it is possible to make that extra step?

      • Well the problem is this mainstreaming – so for example – what my mother needed was a Kindle and not a specialist piece of AT , but she also needed guidance as to how to make the best use of the device with large fonts and text to speech – the latter was poor and we could have done with decent TTS as we have in some well known AT devices and of course it did not work with all books… so you can see the dilemma – mainstream technology working as AT – I knew about the issues, but she could not understand why it would not do what she wanted! IPad option would not work in the sun and Victor Readers etc did not give her access to the books she could get with one click on her Amazon account! The extra step is quite a large leap of faith!

      • I take your point about the screens on the ipad not doing what you want, but there will be tablets this autumn sporting Super AMOLED displays which will work outside.

    • As a special education student, currently in an Assistive technology course, we are currently discussing is technology necessary in the classroom? Is AT fair? Why do some people think that using AT is considered cheating.

      How do we bridge that gap and let people understand how AT actually levels the playing field for a student with disabilities?

      i really enjoyed the section about how if we want AT to be accepted, we need to make it mainstream. I completely agree!

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    • Thanks for the comment and I am glad to hear that we share objectives.

      I deliberately steared away from using the word accessible because I think that rightly or wrongly people view accessibility as very niche, and also technocratic.

      My intent with this blog post was to blow that assumption away and to INCLUDE the widest possible demographic, that is why I used different lingo.

  3. Much food for thought here. Thanks for the GPII video and link, as their approach most closely mirrors my thoughts on the matter and I hadn’t encountered them before. Their approach to Accessibility/Inclusivity mirrors my own thoughts on these issues.

    • Thanks for the comment Henry.

      I think that the GPII is a fantastic idea. The difficulty will be in the execution, getting everyone to sign up and implimenting it.

      That said I am not going to walk away from a challenge because from what I have seen so far it is the best shot we have of mainstreaming accesibility and AT to bring about inclusion.

  4. Great write up, I can only echo it throughout, it is up to the main stream developers and AT specialist to get together and look at all of the options when developing a new product or App etc…
    This narrow thinking propergated by large charitable organisations really bugs me, we need all AT people to get together and work as one, print impairment (I know some do not like the term) but its the same issue for all, Dyslexia, Low Vision, Blind or Language problems.
    When I first joined the AT industry, a great quote from John Gill is one I will never forget. ‘Design with disability in mind and you design a better product for all’

    • Thanks Norman,

      I think when companies begin to appreciate that they can be inclusive and more profitable they will embed it into their way of working.

      It was really nice to see Olympus understood the need a few years back and have consistently produced a range of high quality, desireable yet accessible digital recorders. More companies need to follow this model.


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  7. It’s all a little overwhelming, isn’t it? My business, Accommodating Homes, aims to use the occupational therapist as the health-professional link between an individual’s needs/desires and his/her interface with the environment. To do that effectively, we have to know what’s going on in the technology/assistive technology worlds, home-product manufacturing, interior design and on and on. Right now, consumers with physical limitations (including those imposed simply by aging) have no way to pull all of this together to really maximize their ability to live comfortably and safely in their own homes. You’re right, there’s an enormous amount of fragmentation. AH is trying to meet this need in our own little corner of the world.

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  9. Great article! I agree putting it into one post is important because it shows how extensive the issue is.

    I think another part of the fragmentation is that its hard even to talk about accessibility or inclusivity without leaving someone out. I’ve seen the most well-meaning people presenting at conferences using the most open-ended language and they still got pulled up for not using the correct terminology.

  10. Great article – so many topics for thought. As someone working for an AT vendor trying to bring innovation to the market, I thought I’d throw some more fuel on the fire! Historically, the AT industry has developed to meet the needs of its biggest customers – education, health and other government-funded organisations, not the user. It’s these customers and their funding schemes that define what is and isn’t AT, not the users or the technology experts. These organisations look to AT vendors to provide the assistive technology knowledge and support as part and parcel of the price of the technology, not pay for it directly. And why do those organisations need that level of support? Well my (personal) view is that, in the UK, the assistive technology field isn’t embedded in the world of technology, it’s an add-on to disability organisations, professionals and teachers roles. And its these professionals who are the gateway to those people who benefit from accessibility and AT (whether no-cost, low-cost or commercial). Users who may benefit from assistive technology -whether disabled or struggling with literacy and language barriers – don’t know the power of the technology that they have in their hands and until those users take control of the purchasing and selection process, the assistive technology market will struggle to move to a mainstream business model. The success of iOS devices with their combination of built-in AT plus low-cost apps just might prove to be the tool that does it – just see what impact it is having in the AAC world.
    Final thoughts – I’m still astonished that after a decade in this field, I am still talking to teachers who don’t know what text-to-speech is, let alone that they’ve already got it in some form on practically every computer in their classroom. We need primary-school teacher’s knowledge of accessibility to be considered as important as how to teach PowerPoint.

    • Hi Abi,

      Thanks for the great comments.

      I absolutely agree we ought to be focussing on the consumer of the products and services.

      You are also right that information around AT ought to be part of the core curriculum for teacher training.

  11. Hello Neil,

    Thanks so much for putting together the argument (both in terms of the audience/business case), and all in one place too, for mainstreaming accessibility and assistive technologies. It’s long been a bug bear of mine that we’re often told about the compelling business case for inclusive design and yet there are so few real world examples of this happening in the mainstream.

    I’m co-founder of Enabled by Design (, a community of people who are passionate about design for all. We believe that good design can support people to live as independently as possible, by helping to make day-to-day tasks that little bit easier. Would it be possible to publish your blog post above on our website, as I’m sure our community would find this of interest.

    Look forward to hearing from you soon. Thanks!


    • Hi Denise,

      Thank you for your comments. I’d be delighted for you publish my post on your site.

      I hope to follow up this post shortly with some more ideas on how we can engage with business and I’d welcome input.


  12. Neil, thanks for taking a leadership role on this issue and opening up the conversation to a wide range of colleagues. The trick is to open up the discussion in a way that that allows for cross-industry, cross-discipline, cross-sector collaboration, inclusiveness and the full-on embrace of new, smarter approaches while also being aware that all journeys begin with a single step, and that the ultimate goal here is addressing the needs of 1 billion people through specific changes in the design/UI of thousands of types of gadgets, and in the supply chain that builds them. Not a small undertaking.

    My brother died of multiple sclerosis three days ago, so I’m preoccupied with family affairs right now. But I know that in his last years, as he was losing sensation in his arms and fingers, he increased my awareness of and appreciation for the need for greater attention being paid to smart, inclusive technologies that empower everyone. Hope your effort brings about the changes we need, and hope to raise a glass with you in Cambridge or London again one day.

    • Hi JD,

      Thanks for taking the time to come back to me here and on G+ especially since you have much more pressing familiy matters.

      I truly believe that mainstreaming is the only way we’ll achieve inclusion.

      I know it’s a huge undertaking but it’d be wrong not to try.

      I definitely look forward to raising a glass with you, you never know I might just make it over the pond one of these days…


  13. As someone exposed to the idea of ADA compliancy for residences, I jumped on the Universal Design bangwagon years ago. I named my company, Adaptability because I thought Accessibility was too narrow and could become stigmatized. There’s talk of renaming the Aging in Place concept and I thought of Adaptable Living. UD covers all no matter their limitations and that’s way we need to spread the word about this type of design so that architects, designers, developers and builders start thinking about this!

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  15. Great Article! It is indeed very helpful. Can you please indicate to me the source of fact that only 15% 15% of those who need AT have these tools? This is a very useful data for me.

  16. Hi Neil
    I think you are right to try to bring all the discussion into one place, as fragmenting it leads to its devaluing. Its a frustrating thing (alongside digital inclusion in general) as everyone knows it makes sense, but its one where commercial market forces pull in different directions, to get the easy hits, when with just a little more effort, whole other sections of the population could be included. I do think that GPII looks like a really powerful concept. Im going to disagree with you on something though 🙂 The title. Yes of course I get it, but saying it needs a “paradigm shift” makes people think its a big thing, when actually its not. GPII isn’t really a big thing for technology developers to adopt, but its impact could be enormous. Yes it does need to be viewed in a different way, but I don’t think people understand the subtlety of the word ‘paradigm’, and think it means whole new way of doing things. That might scare them into thinking its all just too hard!

  17. Hi Neil – I came across your article during research of Megatrends from secondary literature sources, to update white paper originally written in 2009. Thanks for creating and sharing such a well written and thought provoking article on megatrends. I work within a market that serves the needs of the ageing megatrend and help people to access technologies that will help them feel better and look better as they live longer lives. We are both connected via commonality in how technology can improve quality of life, and to make that technology accessible to many, but we are approaching it from a totally different angle. Thanks again, Nina

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