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7. Broadband use relevant to disabled and elderly people: A Scandinavian Perspective

JAN-INGVAR LINDSTROM - Sweden

I have been given the task to talk about what is going on in Scandinavia in this area. The Scandinavian countries are Denmark, Norway and Sweden, but Finland and Iceland are included as well.

The Nordic Countries

Table 7.1. The population of Nordic countries

Table 7.1 shows the number of inhabitants in those countries in total. We talk about 23 million people. Sweden is the biggest country with 9 million. The other big ones have 5 million and 4 million. Greenland and the Faroe Islands, belong in some ways to Denmark, but they have small numbers of people.

I would like first to look at the responsibilities for providing communication facilities in our countries these days. I have conducted a little investigation as to the situation is in these countries. There seems to be a move from traditional, state operators to private entrepreneurs, such as the operator "3" in Sweden, which you have here as well, or the telecom agencies, which are like Ofcom here, and other governmental bodies. We have PTS in Sweden, which stands for Post and Telecom Agencies. KIA has established a special kind of competence centre in Denmark. These are the three that more or less have taken over these days, with a few exceptions, but there are very few, if any, of the old traditional operators left.

In Denmark, there does not seem to be very much going on right now as they are in a policy creating phase. Finland has just stopped a project on mobile interpretation and sign language education over broadband. Norway has for some time established some kind of remote video communication which I think is ISDN based, not so much for disabled people but for hospital care. In Sweden, there are seven broadband projects. Six of those have already been completed or are just going to be reported on, and the seventh has just started.

All these countries have already established some kind of video communication for sign language communication for deaf people. In Sweden, we have the widest spread; I think something like 300 subscribers to video communication for sign language, so just a replacement for ordinary telephones.

I received a lot of information from the Swedish PTS Telecoms Agency. The information from the slides comes from them. PTS received an assignment from the Swedish Government in December 2001 to establish seven trial projects with a budget of two million euros for that. I will tell you a bit about those seven projects.

(All pictures by courtesy of the Swedish Post and Telecom Agency)

Service centre for deaf-blind people

The first one may perhaps be surprising because it has less to do with deafness than blindness. The project is a kind of "remote eye" for people who are blind or deaf-blind. A webcam is installed in the home of the blind person and connected to a monitor at a service center. The camera can be operated (moved) from the service center. The customer can call the service center and ask for help, e.g. asking them to check the colour of a tie or describe the picture on a post-card. The information can be provided either by voice or as text on a Braille display.

Broadband for deaf-blind people - service centre

Fig 7.1. Description of service centre for deaf blind people

In this case, as in all the others, I should emphasise that the solution is based on standard components. There is no research involved in these seven projects at all. It is based on ordinary equipment. The research, if any, is confined to the evaluation phase to see what sense it makes.

Communication for people with intellectual impairments

In the next project, Fig 7.2, a broadband application for people with intellectual impairments is shown. It is well known that people who have intellectual impairments and development problems have difficulties using ordinary telephones because they have difficulty with abstract concepts. They benefit from seeing the person they are talking to, or to see articles and objects spoken about. This is not the same situation for broadband communication which was set up in the home and connected up with other groups of disabled or impaired individuals. The people in the service centres also speak with these people in a much better way than they can do with an ordinary telephone.

Broadband for people with intellectual impairments

Fig 7.2. Broadband for people with intellectual impairments

Distribution of talking books

The next project Fig 7.3 shows broadband for people with reading disabilities - distribution of talking books. In Sweden we have a state library, the Central Talking book and Braille Library in Stockholm which provides recorded material and Braille books. They are trialing streaming talking books in libraries, so a person with reading disabilities, maybe because of blindness or dyslexia, or problems with their hands and arms, is entitled to borrow talking books this way.

Perhaps he or she cannot go to the library. If they want to have that book, they can be connected directly to that library. Because of the broadband connection and the very quick supply of information, he or she has to wait just a few minutes to get the whole recorded book on a CD. There are other ideas about this as well, to provide people with this facility at home. The advantage is you can get the information on computer at home based on the DAISY standard.

Broadband for people with reading disabilities - distribution of talking books

Fig 7.3 Distribution of talking books

Distance education for people with mild aphasia

Another group of people who have problems with communication are those with mild aphasia. We have run several projects earlier providing communication for these people, but this was tried again, now on broadband. In Fig 7.4, you can see a typical communication site. It provides vocal communication, possibilities to talk or listen, and pictures and supporting material on the display. Connection could be to some kind of caring centre or teachers, or whatever.

Distance education for people with mild aphasia

Fig 7.4 Broadband use by people with mild aphasia

Distance education in and of Sign Language

The next project Fig 7.5 is about distance education in Sign Language via broadband. I guess the situation is similar England and many other countries, but in Sweden the resources are scarce when it comes to sign language interpreters and people who know sign language. For teaching people sign language or teaching subjects by using sign language, it is difficult.

A small number of people who would like to learn sign language, or learn a special subject via sign language have been provided with video terminals. They have a broadband connection to a centre where a teacher is teaching sign language or a specific subject.

Distance education in sign language via broadband

Fig 7.5 Distance education using sign language

Winning communication - occupational guidance

The next project is called winning communication, distance occupational guidance, Fig 7.6. In Sweden, when looking for a job, one can consult a local office of the labour market and speak with a placement officer to find out what is available in terms of jobs, and related facilities. When it comes to people with disabilities, in general, placement officers are not so well acquainted with the special conditions of people with disabilities. Therefore, they often need assistance by a placement expert who may have to travel quite a distance to see the client. This is time consuming and one has to decide long in advance to make an appointment and have that expert, or perhaps even two experts, coming to assist.

Winning Communication - distance occupational guidance

Fig 7.6 Occupational guidance using broadband

Now, this assistance has been provided via remote video communication.
This has been trialed now, with great success. A video terminal at the local labour market office can be connected a specialized employment centre, where those experts are available.

Mobile video communication

The six above mentioned projects are almost completed. The seventh one - perhaps the most interesting - concerns the application of mobile Sign Language communication over the 3G network. The six above mentioned ones used ADSL, i.e. about 500kbps. In the case of 3G the bit rate is much lower - less than one tenth of the broadband rate.

The company "3" in Sweden has provided a number of deaf young people in Sweden with mobile 3G telephones, free of charge. The project has an agreement with a Sign Language interpretation centre, Fig 7.8.

Mobile video communication for deaf people

Fig 7.8 Video communication for deaf people

Students can use their mobile phone to call each other and have a conversation via Sign Language. I have seen some of them holding the phone with one hand and making sign language with the other. - I do not understand how they do it! More important perhaps is the possibility to connect the telephone to the service centre, where a Sign Language interpreter is ready to assist.

What I would have liked to show you on the video that regrettably does not work here, is a situation where a young deaf girl comes to a dentist's reception and wants to make an appointment. The deaf girl dials the telephone number to the interpretation centre and so gets in visual contact with the Sign Language interpreter. She walks up to the reception desk, the receptionist comes, and girl says to the service centre, "I would like an appointment with my dentist" in Sign Language. The interpreter speaks back on the telephone and the receptionist can hear: "I would like to have an appointment with my dentist." She finds out about the possible time, and comes back and gives the answer. The answer is signed back. That is an example of mobile video communication. Although the picture quality is poor, it is good to have ones Sign Language interpreter in the pocket.

Questions

Something they asked was "how can you communicate with a mobile phone and an ordinary video on the computer". As I understand it, this is a faked picture. The man here at the centre has also to use a mobile phone with poor resolution. For the time being, there is a separate project going on to get something between the mobile telephone and the terminal at the service centre, to make the situation for the interpreter a bit better. At the moment, as you know, the resolution is poor.

These are seven practical examples of what is going on in Sweden right now. For the near future, PTS will continue the trial with the interpretation centre for mobile Sign Language communication, and improve it. The operation and development of the broadband service for digital talking books will be extended. We'll continue with trials with streaming talking books, which means downloading the books directly in the home as they are recorded. We investigate the possibilities of a national digital distribution service.

When I talk about the talking books, I mean pre-recorded or recorded books, but there is a possibility also to send the digital stream down to a person's home and convert it there with the aid of synthetic speech. If one can stand the artificial voice, one can get access to any kind of literature very quickly.

Then there is the national initiative to promote winning communication, and investigate the possibilities for winning communication in other similar operations. It must not be confined perhaps to seeking a job. There may be other situations where one needs experts to help, which can be facilitated by such a connection.

We also need to organise the financing. The subsidy of computers and broadband facilities for people with disabilities is very important. Good results from trials are important, but to implement it is another matter. The idea is to create a central competence and resource centre for video conference solutions and services, and to devote funds to libraries for increased costs in handling digital talking books.

One remaining problem is that of copyright in conjunction with the new technology. Some information must not be spread without control. Also, we should devote funds to stimulate distance education.

Finally, there should be increased focus on IT based assistive devices, with a more uniform and flexible prescribing process. We have, unfortunately, different systems for providing different kinds of assistive technology. Providing a video phone is different from providing a wheelchair, for example, or a hearing aid, and we would like to see a more homogenous system for dealing with this.

We will also continue broadband trials for people with disabilities with an emphasis on mobility. Also, we look forward to mobile telephones with hopefully better picture quality.

Discussion

TONY SHIPLEY: Your example of the mobile telephone used for signing suggests yet another slant on the meaning of accessibility. Clearly, what is now going to be very, very important is to have a small stand, so that the telephone can be placed and supported on the desk while its camera is aimed at the user. We have another accessibility feature that has to be introduced.

JAN-INGVAR LINDSTROM: In the video I would have shown, the girl comes to the reception, takes the phone out, unfolds the lid, puts it on the desk and starts signing with both hands. It does not seem to be a problem. I have seen people using these telephones holding them with one hand and signing with the other! That is incredible.

I have learned over the years that sometimes, and rightly so, we put the ambition level very high, but when it comes to reality people seem to be able to cope with much lower quality, once they are motivated. Remember the childhood of telephony, spread worldwide despite poor quality! The same for record players and a lot of other technology.

MIKE MARTIN: How many service providers are there in the Nordic countries or Scandinavia, because it seems to me you have "3", who are supporting this, and we have a similar situation here. We have BT, who are doing a lot of work. We have (or I have) singularly failed to make contact with any of the others. Nobody has shown any interest, so how are we going to spread these things? We have perhaps one in each country.

JAN-INGVAR LINDSTROM: I cannot answer your question, because we have a lot of them in Sweden. Very few have shown any interest at all in disabled people's needs. "3" is a new operator.

A better answer would be: please, do what you can to enhance international co-operation. You have COST 219, where John Gill here is a member. Patrick Roe, the Chairman of COST 219, is sitting over there. Ask them to tell people from other countries, "In our country we are doing so and so." I guess it could be some kind of lever to go to another country and say, "3 has provided mobile phones free of charge in Sweden. Why don`t you do it here?" Possibly there are other things we could benefit from in Sweden as well. That is one of the advantages of international co-operation, in my opinion.

"3" does this, of course, for advertising, because it gives publicity. They are all over the television and newspapers, saying, "We are a fantastic company."

SEAN HOPKINS: I would like to ask a two-part question. Going back to your point about the free services provided to persons with hearing impairments, which I have myself, I understand that the Federal Communications Commission in the United States also obliges the various commercial and other operators to provide free services of this kind which are supported by a pool of funds from the operators. I wonder if you would advocate that such a system was adopted here, so that disabled and other persons would be able to get proper access to video link services.

Secondly, I believe it is also part of your telemedicine services that your clinical staff, particularly in the Arctic regions, can actually link with their video phones to the practitioners and hospitals, and deliver things such as vital signs monitoring by plugging in to their laptops. Could you comment on that?

JAN-INGVAR LINDSTROM: I will do my very best. I do not know about the last matter, I must say. To my knowledge at least, no mobile telephones have been used in these connections, but there are a number of fixed video communication links between hospitals and local caring centres with quick and easy access to experts. I have seen such good examples in Norway as well, where they have had the possibility to follow up the treatment of children with cerebral palsy, for example, to see how they develop, without having to fly people back and forth in the country.

When it comes to how to provide these devices concerning the financial matters, I can only say that, in Sweden, the Government has been very open-minded and positive about these activities. They are providing, so far at least, all kinds of equipment free of charge, but the hearing impaired or deaf person has to pay the fee for being connected, to my knowledge. I do not know whether it is going to be changed, but the Government is providing the hardware and installation, and everything like that, but then you have to pay for establishing the contact.

RUTH MYERS: I was interested to hear what you had to say. In this country, we like to use mobile phones for lipreading as well. It is very helpful to people who use lipreading who do not always hear or understand everything that is said, but the ideal scenario would be also to have some text, so that you can clarify. How much can we hope to see?

JAN-INGVAR LINDSTROM: It is an interesting topic per se! If we talk about text transmission in mobile telephones, there is no problem. You already have SMS. I do not know whether you look for a kind of conversion mechanism that lets one person's speech be automatically converted into text. That is a very difficult matter, if that is what you mean.

RUTH MYERS: Even with signing, I think it would be helpful to be able to clarify whether you are talking about 7 or 17, 4 or 14 or 40. Even when you are signing, it can be confusing, if the picture is not crystal clear.

JAN-INGVAR LINDSTROM: I agree with you completely. As far as I understand, lipreading is beyond the discussion here. It is not possible to read a person's lips.

We have another interesting project in Sweden on lip-reading, the Synface project, but I am afraid that would be too far away from broadband. However, development is going on to add a screen to an ordinary telephone with an artificial face, so when people call and the hard-of-hearing receiver switches on the screen, he or she has the artificial face with the lips on the screen. Despite a very narrow bandwidth, one can see the lips moving in pace with the incoming speech, thus enhancing the understanding. You do not look very happy about it, but I can tell you that we have tried it successfully.

RUTH MYERS: I hate artificial faces. They are horrible!

JAN-INGVAR LINDSTROM: We can show it to you. As a matter of fact, we have people from RNID and the University College of London who are on board this project. I think they would be happy to demonstrate it to you.

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Last updated: 02.10.2008    © Copyright reserved