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Futures of Disabilities – Results of the Delphi Survey

Futures of Disabilities 

The Wireless RERC has been at the forefront of the migratory shift to wireless technology and how it can positively impact people with disabilities.  Reflection on the history of wireless accessibility and prospecting its future promise led us to convene the 2015 State of Technology Summit: ENVISIONING INCLUSIVE FUTURES.  As a result of a futures-oriented process, including a Delphi survey, this high level meeting prioritized disability access issues on a range of social, technology and policy factors.  This invitation-only event provided the unique opportunity to bring 45 subject matter experts together to advance pathways to a future which is more inclusive of all citizens.

The Delphi Survey

Background

The gap between the potential and the reality of technology as a resource for people with disabilities is growing. For example, CTIA-The Wireless Association reports wireless penetration in the US exceeding 104% and 90% of households using wireless products and services (2015). Wireless phone service expenses surpassed landline service expenses in 2007 with youth (under 25) spending the most on cellular service (United States Department of Labor, Bureau of Labor Statistics), indicating that youth are driving the move away from landline use. Such migratory trends and transitions in technology have the potential to create a large-scale, positive impact on educational attainment, employment and social inclusion.

At present the reality differs. While many companies and colleges only allow on-line applications, many such applications are not accessible to people with vision disabilities. Telework as an accommodation could improve the unemployment rate of people with disabilities as the availability of wirelessly connectivity and mobile devices has led to an increasing number of support applications. The availability of support technologies available to people with disabilities can also promote independence in the workplace.  Further, virtual technologies can be used to simulate job environments as a means of coaching people with disabilities on effective approaches to daily activities and work tasks. Yet with all of these technology advancements, non-institutionalized, people with disabilities, ages 21-64 still only make up 35% percent of the labor force, compared to 77% of their non-disabled counterparts (Erickson, et al. 2015). 

In terms of educational attainment, only 14% of non-institutionalized, people with disabilities age 21-64 have earned a Bachelor’s Degree or higher (Erickson, et al. 2015) in spite of the potential for tablet computers, eReaders and distance learning to positively impact inclusive educational environments.  The implementation and application of new technologies within the contexts of education, employment and social inclusion is currently not effectively meeting the needs, enhancing the independence or improving quality of life and community participation of people with disabilities.  The availability of the technology alone, is not a solution for the socioeconomic and cultural change required to significantly impact the population of people with disabilities. 

In some cases, new technological advances may result in some parts of the population being left behind. For instance, TTY (teletype) use among people with hearing loss is in rapid decline. Yet, there is only limited alternate access for a person who is Deaf or speech impaired to contact 9-1-1 from their mobile device.  Despite the body of disability access law, problems persist for people with disabilities gaining and maintaining access to information communications technologies and the benefits that ensue. Maintaining access is central to the discussion because technological developments far outpace the rules and regulations that govern their use.  A prime example is the to-and-fro of rules and regulations governing broadband.

Why are people with disabilities still not fully participating in the technological revolution, and what future possibilities exist to change the situation? What are the possible consequences of the migration to mobile, digital technologies for people with disabilities?  The focus of the Wireless RERC’s Delphi research was to seek answers to these and other questions such as why technology is not living up to its promise for people with disabilities. Is it policy, poor implementation, cost, disinterest, lack of awareness, prejudice?  What are the systemic barriers that keep people with disabilities excluded from full participation in the technological revolution? The outcomes of the research and the Summit proposed answers to these questions and suggested positive alternate futures.

Methodologies

Through the analysis of the results of a futures exercise utilizing a modified, policy-oriented Delphi method researchers explored answers to the questions posed by these challenges.  Delphi is a set of procedures for eliciting and refining the opinions of a group - usually but not always a panel of experts (Dalkey 1967, Brown 1968). It is a group communication process, aimed at “allowing a group of individuals, as a whole, to deal with a complex problem" (Linstone and Turoff , 1975:3). The aim of a policy Delphi is not to achieve consensus but to generate a wide range of views: in short to act as a forum for ideas and to explore a range of positions on different topics related to the issue (Bjil 1992). In this case the primary issue focus of the Delphi was on the migration from legacy technologies to advanced communications services and wireless technologies.  An ancillary focus was on the split between migrators and non-migrators, e.g. what is the nature of those who are falling behind, is the gap closeable and what is the potential of those who are already caught up? Migratory trends are interpreted broadly, to include macro trends (e.g. analog to digital, fixed to mobile, and content migration including social media, cloud, and smart/connected everything) and micro trends (e.g. print to electronic text, TTY to mobile, etc).

In preparation for the Summit, a literature review and environmental scan were conducted which identified search filters and possible impacts which could be affected by migratory trends (see figure below).

Figure 1:  Literature Review Framework and Progression

Title: Figure 1:  Literature Review Framework and Progression - Description: The image shows the progression of the literature review and environmental scan undertaken by the research team.  First the team searched various filters including technology, society, behavior and thought, economics, law and policy, and health to help identify migratory technological trends.  Impacts of migratory trends were also identified, including environment, employment, education, services, communications, security, computing, innovation, industry and business.  The Delphi study will then help to identify potential outcomes of migratory trends. Examples of outcomes inlcude barrier-free life, disability becoming an advantage, universal connectivity, and excluded populations.

In developing this schema, categories of opportunities and barriers were cross-referenced to arrive at sixteen areas of focus. The areas were: defining disability; cloud computing; near field communications; wearable devices; 3-D printing; ageing; shifts in familial patterns; environmental changes; employment; economic fundamentals; policy time lag with technology; implications of a more transparent policy process; privacy; secondary health conditions; health/environmental impacts; and  veterans.

Round one of the Delphi polling presented a description of these areas and resulted in 44 open and close-ended questions to prioritize the issues. In round two, a preliminary analysis of the first round of the Delphi process resulted in a refined set of 23 questions for the experts to indicate levels of probability that the issues would be addressed and/or realized.  Round three, was the Summit. The Summit participants, based on presentations and pursuant discussions, suggested possible futures that could counterbalance the otherwise grim picture that faced people with disabilities.

Delphi Results

Across two rounds of Delphi polling, more than 50 independent experts participated.  In round one, respondents from academia made up 40% of the total respondents, with industry (19%) and government (19%) respondents together serving as the counterweight.  Disability organizations (8.3%) rounded out the remaining independent experts.  However, in round two, the respondent profile was more balance across all groups.  Academia represented 33%, disability organizations (24%), business/industry (20%) and government at 22%.

Delphi Polling Results
  Round One Round Two
Academia 40% 33%
Disability Org  8.3%  4%
Business/Industry       19%    20%
Government 19% 22%


Top Issues Rated Very Important and Important – Round One

The closed questions broadly addressed the 16 focus areas identified above, asking respondents to rate the issues as very important, important, slightly important or not important.  The questions were designed to assess the experts’ priorities.  By combining the totals for those that selected important and very important, researchers arrived at the top seven issues identified by respondents:

  • The potential of apps, specifically in communications (98%)
  • Accessible solutions’ impact on technology adoption (94%)
  • Increased life expectancy of people w/disabilities (94%)
  • Time lag between innovation and policy/regulations (92%)
  • Affordability’s influence on technology adoption (90%)
  • Expanding role of the family caregiver (i.e. medical) (88%)
  • Greater stigma associated with mental health issues (88%)

With regards to people with disabilities, the expert respondents overwhelmingly deemed apps, and since apps operate on wireless devices, by extension smartphones, tablets and wearables, as the most important migratory trend.  The issue of increased life expectancy of people with disabilities also rated as very important.  This demographic trend could result in growing the population of people with disabilities, thus creating more demand for accessible technologies that support independent living.

Top Issues Rated Probable and Highly Probable – Round Two

Respondents were challenged to focus more narrowly on the migration from legacy, analog technologies to mobile, digital technologies. Some of the provisional conclusions (as suggested by the answers judged most probable, and with most confidence) reinforced the trends indicated in the first round. In general, respondents were confident of the increased importance of digital technology in the lives of people with disabilities. In particular migration of technology from analog to all things digital was judged likely to have a positive impact on the social inclusion of people with disabilities, the accessibility of wireless technologies positively impacting communications, and access to an inclusive education.

  • Digital technology will become more important (100%)
  • Wireless technology will increase social inclusion opportunities (95%)
  • Increased accessibility of wireless tech will increase communications (94%)
  • Tech migration could positively impact inclusive education (91%)
  • Tech convergence will increase independence (89%)
  • Migration could positively impact accessible public services (89%)
  • Smart environments for health, emergency response, etc. (88%)

Issues Rated Least Import and Least Probable

From a Futures perspective, it’s important to note the outliers, as they can be missed opportunities if ignored.  Their potential impacts may also go unnoticed and unchecked until they become a massive issue.  If the impact is positive, it’s a welcome surprise; but if the impact is negative, society has to scramble to fully understand and address the issue to mitigate any further damaging effects. By example, there was seeming skepticism about “smart environments” ever becoming a reality, and about the notion that the migration of technology from analog to all things digital could have a positive impact on accessible public services. If the accessibility of smart environments is not considered now, if they ever become a reality, retrofitting and reengineering might be required.  Further, if the smart environment features and interfaces are not relevant or usable by people with disabilities from the beginning, a new divide may be created where people with disabilities could be excluded from certain features and benefits of smart homes, buildings and cities. The top items in this category included:

Least Important

  • ADA Generation’s impact on migration to wireless technology (25%)
  • Perception of tech as fashionable impacting perception of disability (28%)
  • Youth w/disabilities more likely to share emergency information on social media (32%)
  • People w/disabilities representation in the media (33%)

Least Probable

  • Tech migration will have little impact on older adults (25%)
  • For redundancy and maintenance of capabilities traditional phone networks should be retained (31%)
  • Realization of the universal design principle (36%)

The final review of the Delphi took place at the State of Technology Summit. Within the context of technology migration, topic areas addressed by participants included accessible design, human augmentation, emergency response, personalization, wearables, robotics, aging, artificial intelligence, independent living and more.  The Summit brought together subject matter stakeholders to explore the implications of the current state and emerging trends in wireless technologies that are most likely to impact people with disabilities. The goal of the Summit was to identify ways and means to promote adoption of research findings, technology development, and policy recommendations for managing the technological migration from legacy technologies to advanced communications and computing services. The results and conclusions from the Summit are presented in these proceedings.

References

Bijl, R. “Delphi in a future scenario study on mental health and mental health care.” Futures, 24.3 (1992): 232-250. Print.

Brown, B. B. Delphi process: A methodology used for the elicitation of opinions of experts. Santa Monica, CA: The RAND Corporation. 1968. Print.

CTIA-The Wireless Association (2015).  CTIA's Wireless Industry Summary Report, Year-End 2014 Results, Web. 2 February 2016. http://www.ctia.org/your-wireless-life/how-wireless-works/annual-wireless-industry-survey.

Dalkey, N. C. Delphi. Santa Monica, CA: The RAND Corporation. 1967. Print.

Erickson, W., Lee, C., von Schrader, S. (2015). Disability Statistics from the 2013 American Community Survey (ACS). Ithaca, NY: Cornell University Employment and Disability Institute (EDI). Retrieved Feb 18, 2016 from

Linstone, H. A., & Turoff, M. (Eds.). The Delphi method: Techniques and applications. Boston, MA: Addison Wesley Publishing. 1975. Print.

United States Department of Labor, Bureau of Labor Statistics  (2009). Consumer Expenditure Survey: Spending on Cell Phone Services Has Exceeded Spending on Residential Phone Services (2001-2007), 14 Jan. 2009. Web. 24 April 2014.

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The Rehabilitation Engineering Research Center for Wireless Technologies is sponsored by the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR) of the U.S. Department of Health and Human Services under grant number 90RE5007-01-00. The opinions contained in this website are those of the Wireless RERC and do not necessarily reflect those of the U.S. Department of Health and Human Services or NIDILRR.