Disability Studies Quarterly Fall 2008, Volume 28, No.4 <www.dsq-sds.org> Copyright 2008 by the Society for Disability Studies

Introduction

The present paper reports on the implications of the changeover from analogue to digital broadcasting for the accessibility of television for people with disabilities. Television viewing is the single largest leisure time activity in the US. According to Sanchez-Taberna and Carvajal (2002), US adults view an average of 28 Hours of TV per week. It is estimated that 98% of all households have a television and the average numbers of sets per household is 2.2. While there is limited research data available on TV viewing by people with disabilities in general, there is evidence that people with vision impairments are active TV viewers (American Foundation for the Blind, 2003). There is also evidence that older people watch more hours of television than younger people (Grajczyk & Zöllner, 1998).

The US government has recently passed legislation for a complete turn to digital broadcasting by February 2009 (Clark, 2006). This legislation means that consumers who currently use analogue TV's and rely only on broadcast access (i.e. those who do not have cable or satellite) will need to purchase either a digital television or a set-top box (STB) to be able to view television after this date. The changeover to digital broadcasting will significantly change the way that people who currently use broadcast TV access and interact with television. Requiring the use of a set top box or a digital TV, for those who can afford it, the changeover will significantly increase the complexity of the technology required to access television. Increasing the complexity of the TV user interface will mean that there is some risk that people with disabilities and older people may also be unable to access it effectively. This potential difficulty is particularly significant since access to information and services via the more familiar television interface could potentially be of real value to the older disabled who may be less likely to use personal computers. This paper aims to review the major accessibility issues for digital television and assess the potential exclusion of older people and people with disabilities in the US from access to TV as a result of the changeover to digital TV.

Why we should be concerned about access to TV viewing for people with disabilities and older people? TV is one of the major sources of information and entertainment for the majority of the US population (Frey, Benesch, & Stutzer, 2005), and ensuring and maintaining access for people with disabilities and older people is essential to allowing them to participate in and enjoy day to day life. It may be argued that the free market and technological change will ensure access for people with disabilities. However as Greg Vanderheiden noted in his (1990) paper "Thirty something million—should they be exceptions?" history has repeatedly shown that accessibility issues tend not be solved by market forces or technological change.

A further argument for addressing the accessibility of digital TV concerns the potential for the capabilities of digital TV to be used to provide access to Government information and services and for functions such as emergency and disaster alerts. Access for older people and people with disabilities is of critical importance for both of these functions. Finally, there is also clearly a significant argument in terms of market penetration for both service providers and receiver manufacturers to optimize the accessibility of their product for the entire potential user population, including the growing segment comprising older and disabled people.

This paper reviews the following areas:

1. The legislative and rule making activity in the US relevant to accessibility of digital TV;
2. The effect of the changeover to digital on different types of TV delivery, broadcast, cable and satellite and the implications for people with disabilities;
3. Statistical data on disability in the US population in relation to the ways in which digital broadcasting is anticipated to change the physical, sensory and cognitive capabilities required to access TV;
4. Current research on accessibility of digital TV and emerging solutions;
5. A comparison between the US and the further advanced UK situation with regards to switchover to digital broadcasting is presented.

U.S. Legislation and rule making activity related to disability access to Digital TV

The digital TV legislation in the US includes a subsidy for households to purchase two STBs (Digital TV Designline, 2006). Substantial numbers of people with disabilities and many older people are on low incomes and are likely to access digital broadcast TV using STB's. Consequently, the accessibility and usability of STB's is likely to be a critical factor in determining the accessibility of digital broadcast TV for older people and people with disabilities.

The significance of access to TV for people with hearing impairment was recognized in 1990 with the television decoder circuitry act which required that after July 1, 1993 all television receivers manufactured in the US or imported into the US with a screen size of 13 inches or larger must be capable of receiving and displaying closed captions. This should be seen in the context of the Americans with Disabilities act passed in 1990 to protect persons with disabilities from discrimination based on their disability. The ADA also specifically mandated captioning for all government funded public service announcements (US Department of Commerce, 2003).

Rules adopted by the Federal Communications Commission (FCC) in 1990 and 1991 provided specifications for the reception and display of closed captioning on broadcast and cable TV (Federal Communications Commission, 2000). These rules require the provision of closed captioning in digital broadcast television and the provision of video description. Captions are synchronized text equivalents of the audio information and include speech and other audio, including sound effects and music. Captions are referred to as closed when they are not normally visible but require decoder equipment to view. The requirement to provide closed captioning has been continued with digital TV (Federal Communications Commission 2000). It is important to note that the standards specify the captioning to be provided but do not specify the television receiver user interface.

Video description involves the insertion into a TV program of narrated descriptions of settings and actions that are not otherwise reflected in the dialogue, such as the movement of a person in the scene. On existing analogue televisions video description is usually accessed by pressing a button on the remote labeled SAP (secondary audio program). The rule requiring provision of video description was struck down by the US DC District Circuit Court of Appeals (Motion Picture Association of America Inc v. Federal Communications Commission and United States of America, 2002) however, some video description is still being provided.

It is clear that legislation and regulations for accessibility of digital TV have focused on providing accommodations for people with hearing and vision impairment and have in general not addressed access issues for people with other types of disabilities such as cognitive impairment. Thus far relatively little attention has been given to the access needs of other disability groups and older people.

How will people with disabilities be affected by the change from analogue to digital broadcast TV?

In order to understand this issue we need to first consider the ways that television is delivered in the US and the impact of the changeover to digital TV on the different modes of delivery. There are three main methods by which TV is currently delivered:

1. Analogue Broadcast: The signal is delivered to the household via ground based broadcast. The signal is received with a TV antennae and a set top box is not required.
2. Cable: Signal is delivered to the household via cable.
3. Satellite: The signal is delivered to the household via a satellite broadcast and received with a satellite dish.

According to Nielsen (2007), in 2006, 64% of US households had cable access and 25% had satellite access. A report by the Leichtman Research Group (2007) found that about 15% of US households appear to rely solely on broadcast TV. With regard to cable and satellite access, the responsibility for enabling continued access after the changeover to digital broadcast will rest with the service provider. For those households that rely on broadcast to access TV the responsibility for enabling continued access after the changeover to digital broadcast will rest with the household. Those households that rely solely on broadcast access are likely to be mainly low income households. This indicates that the changeover to digital television will have a greater impact for low income households.

Among people aged 25 to 64 years 12.3% of those with no disability had an annual income of less than $20,000. By comparison 18.3% of those with a non-severe disability and 37.8% of those with severe disability had annual incomes under $20,000. For people aged 65 years and older, the comparable figures are 26.7% no disability, 32.3% with a non-severe disability and 45.9% of those with a severe disability are on an annual income of less than $20,000 (US Census Bureau, 2006). This is consistent with the reliable and well documented association between disability and having a low annual income (see for example Kaplan, Pamuk, Lynch, Cohen and Balfour, 1996). Thus, people with disabilities and especially the elderly disabled would be expected to be over-represented in households relying solely on broadcast for access to TV.

To further understand the potential effect of the planned changeover to digital broadcast on access it is important first to understand the baseline levels of exclusion experienced with the existing analogue system. It is clear that some people with disabilities experience limitations in their capacity to access existing analogue television. People who are blind or vision impaired will be unable to see images on the screen. A survey conducted by the American Foundation for the Blind found that 99% of blind and vision impaired people surveyed owned a television, 83% owned a VCR and 68% have cable TV (American Foundation for the Blind, 2003). With items of everyday technology such as TV that have been in existence for a substantial period people with disabilities and older people often develop individual solutions that enable them to access the product e.g. they may own older models with simple analogue controls such as dials.

In general, people with hearing impairment are able to access analogue TV using captions. It is important to note however that Deaf people whose primary language is sign are currently limited in their access to programming that does not provide sign translation. Also people with hearing impairment who also have some vision impairment may have difficulty or be unable to read captions. People with dexterity impairments may have difficulty using remote controls due to factors such as the size and sensitivity of buttons and the shape and surface texture of remote controls.

With regards to access for people with cognitive impairment, the mental model required to access existing analogue systems is simple and intuitive and represents a form of deeply embedded cultural knowledge. While there appears to be no data available on this it is likely that the majority of people with cognitive impairments who are unable to operate an analogue television (people with dementia, or significant brain injury) will be living in nursing homes or supported accommodation where tasks such as operating the television would be done by an assistant.

To understand the extent to which digital TV may result in increased exclusion compared to the existing analogue system it is necessary to consider:

1. The additional capabilities needed to access digital TV compared to the existing analogue system. In order to identify these additional capabilities it is useful to review some of the key usage scenarios that viewers will need to deal with in order to access digital TV;
2. The rates of different types of disability in the population; and
3. The ways that different disabilities may limit people's ability to view and interact with digital television.

The adoption and use of digital TV will require users to complete a number of scenarios that involve different tasks and require different or make increased demand on functional abilities compared to the use of analogue TV. The key scenarios that digital TV users need to be able to complete include:

1. Purchasing and installing equipment, either a digital TV or a STB;
2. Accessing TV programs using digital TV;
3. Accessing configuration and accessibility options such as captioning and video description; and
4. Accessing interactive services.

The first scenario, purchase and installation, will differ depending on whether the viewer is purchasing a digital television or a set-top box. Digital TVs are relatively complex pieces of consumer technology and can be quite complex to configure correctly. In practice, given the cost differential, it is likely that many older people and people with disabilities will use a set-top box to access digital TV.

In the case of digital set-top boxes, the prospective purchaser needs to understand before purchase how and whether the device can be connected to their existing television/ VCR. To set-up the product the viewer needs to be able to correctly configure the STB to work with their existing equipment. Both the purchase and installation process involve a level of cognitive difficulty that is substantially greater than for analogue TV.

In order to access programs using the set-top box the viewer will normally need to use a second remote control (i.e. the remote for the STB.). Remote controls for set top boxes typically have more controls and added functionality compared to those for TV's. In addition, remote controls for STB's need to be used in conjunction with on screen displays, a new mode of interaction that introduces new visual and cognitive demands. Further, there may be a time lag between actions taken using a STB remote control and a system response which is a new interaction that users may not understand.

Accessing interactive services will typically require the viewer to navigate onscreen menus using the remote control. These may be inaccessible for people who cannot read text on the screen. They may also be inaccessible for people with motor impairment who have difficulty using the remote control. Menus with a number of levels and/or a large number of items are likely to present difficulty for people with cognitive and/or language impairment.

There is a wide range of disability statistics available, however, for the exclusion analysis the data needs to provide a breakdown by specific functional limitation experienced. For this review I have used the data published by the US Census Bureau from the 2002 Survey of Income and Program Participation, SIPP (US Census Bureau, 2006). An additional advantage of this survey is that it provides a breakdown by age.

Table 1: Prevalence of selected types of disability among individuals 15 years and older in the US11.

Disability Type	15 years and older		25 to 64 years		65 years and older
	Not severe	Severe	Not severe	Severe	Not severe	Severe
Seeing words/letters (%) and N2	5.3% N=11,750	1.4% N=3,077	3.9% N=5,819	0.9% N=1,343	16.1% N=5,419	4.4% N=1,501
Hearing conversation (%) and N	3.1% N=7,830	0.4% N=972	2.0% N=3,010	0.3% N=418	10.8% N=3,660	1.5% N=506
Grasping objects (%) and N	2.7% N=6,052	0.3% N=690	2.2% N=3290	0.2% N=310	7.8% N=2,647	1.0% N=331
Mental disability3 (%) and N	3.6% N=7,918		3.0% N=4,537		4.8% N=1,633

Table 1 shows the percentages of people with different types of disability by age in the US population. The numbers of people with low vision are expected to increase with the aging population. People who are unable to read words or letters will be unable to read instruction materials if these are not provided in accessible formats and they will be unable to use onscreen menus. Both of these facts indicate that people with vision impairment are likely to experience significantly greater exclusion as a result of the introduction of digital TV. Also people over 65 with severe difficulty in seeing words or letters are likely to be unable to use the onscreen menus.

Hearing impairment increases in frequency with age with 10.8% of those aged over 65 years reporting difficulty hearing conversations. Rates of hearing impairment are expected to increase with the aging population. People with hearing impairment can access digital TV using closed captioning. Overall, we would not expect an increased risk of exclusion for people with hearing impairment. However, people with hearing impairment who have other disabilities such as vision loss, dexterity difficulties, or cognitive impairment may be excluded from accessing digital TV due to access issues related to these areas of impairment.

Table 1 shows that 2.2% of the population aged 25-64 reported difficulty in grasping objects. People with impaired dexterity may be unable to press buttons and/or to hold or point a remote control. This disability is strongly associated with aging due to conditions such as arthritis and approximately 7.8% of people over 65 report difficulties in grasping objects. Access to digital TV places significantly greater demands on dexterity compared to the analogue system. First, set up requires the ability to access the rear of the TV and connect the cables. Second, using digital TV requires increased use of a remote control to select options from on screen displays. These two factors suggest that people with dexterity impairment will experience increased rates of exclusion as a result of the changeover to digital TV.

Mental disabilities include learning disability, Alzheimer's and related conditions, and other mental and/or emotional conditions. In total, 3% of the US population aged 25-64 reported one or more of these conditions. Cognitive impairment is associated with aging due to the increased frequency of Alzheimer's and related conditions. Some 6% of people over 65 report one or more of these conditions. Cognitive impairment may limit an individual's ability to understand or remember complex commands. As discussed, the purchase and installation of a digital STB introduces significant new cognitive demands. Accessing digital TV will also often require the user to select options using the remote from displays on the screen. This selection process requires the user to form a new and more complex mental model compared to existing analogue systems. These factors indicate that people with cognitive impairment are likely to experience substantially greater levels of exclusion with digital compared to the analogue system.

It is also important to consider people with disabilities' familiarity with technology in assessing their risk of design exclusion. The population of people with disabilities can be divided into several groups by chronological age and age of onset of disability. First, there is the population of younger disabled people (i.e. those aged under sixty five) who comprise both people with early onset disability and people with acquired disability as a result of accidents and illness. Second, there is population of people with disabilities aged over sixty five, these can be divided into people aging with disability (people with an early onset or acquired disability moving into the older age group) and people aging into disability (those with age related impairment or disability).

It is likely that people with early onset or acquired disability will have contact with either the disability community and/or rehabilitation and support services that will provide information regarding assistive technology and accessibility for everyday technology such as television. By contrast, older disabled people are less likely to identify as disabled and to make use of rehabilitation services (Bruce, Mckennel, & Walker, 1998). This suggests that older people with late onset vision, dexterity and cognitive impairments are likely to be at a greater risk of experiencing exclusion from TV viewing as a result of the changeover to digital broadcasting. On the one hand, they will encounter the barrier due to the lack of fit between the technology and their capabilities and on the other they are less likely to access disability information and resources that younger disabled people are aware of.

Research on the accessibility of digital TV

Both the way in which digital television is delivered to the viewer and the equipment used by the viewer to access digital television influence the interaction experienced by the viewer and consequently then influences accessibility for viewers with disabilities. When digital TV is delivered by broadcast, data and/or additional multimedia can be incorporated into the video stream and made available either upon the viewer's selection in real time or stored on the hard disk thus enabling "local interactivity" (Gill & Perera, 2003). The most common application of this has been the development of electronic program guides or EPGs. These enable viewers to review and select programs from program descriptions and schedules on screen.

When digital television is delivered via either cable or satellite this enables "true interactivity" where the user transmits requests through a return channel and the provider supplies individually requested data and services separately from the main video program. Interactive services can also be provided with IP based television where television is delivered via broadband IP connection to the household. However, for many people on low incomes (including older people and people with disabilities), it is likely that their only means of access to TV will remain broadcast TV. Regardless of whether they have access to fully interactive services or to local interaction (EPGs), for older and disabled viewers the accessibility and ease of use of the interactive elements of the interface will be critical.

Because existing analogue television sets are unable to display digital broadcast signal the planned switchover to digital broadcast would otherwise have required all TV owners to purchase a new digital television. The solution that has been developed to accommodate this issue, particularly for people on low incomes, has been the development of digital set- top boxes (STBs) that translate the digital signal and display it on existing analogue televisions. The information available on the accessibility of digital TV equipment for consumers is limited. A recent submission by the Coalition of organizations for accessible technology to the Federal Communications Commission (DTV Consumer Education Initiative, 2007) documents some of the problems that have been identified by disability groups in this area. These include, problems with captioning and also that the complex menu structures make it difficult or impossible for people with disabilities to access controls and settings for accessibility features such as video description used by people with vision loss. A key issue for both closed captioning and video description in relation to the changeover to digital TV is to ensure that the added complexity of the user interface with digital television does not result in the controls required to activate these options becoming difficult for people with disabilities to locate and use. It has been recommended that the control for captioning should be a standard button on the remote in the same way that the volume is controlled directly from the remote (CENELEC, 2003). In addition, the changeover to digital introduces the possibility of making captions more customizable. For example, with digital technology the font size could be made adjustable for people with low vision as well as hearing impairment (CENELEC, 2003).

Set top boxes are likely to be the primary means of access to digital TV for people on low incomes, a group that includes many people with disabilities and the elderly. In considering the accessibility of set top boxes there are several separate issues that need to be considered. When a set top box is purchased initially it needs to be connected to the equipment already in the purchaser's home—their television, external antenna, and often also a DVD player and or video cassette recorder. The correct connection can be quite complex and variable. The person doing the connection needs to be able to read the instruction materials and to connect the appropriate cables to the connectors on each item of equipment. It is likely that many people with limited vision or manual dexterity and those unfamiliar with technology would find this difficult.

The remote control represents a key aspect of the user interface for digital television. Use of the remote control becomes more complex and more critical compared to analogue TV because it is used in conjunction with interactive content on the screen. Carmichael, Rice, Sloan and Gregor (2006) identified the design of remote controls as a significant factor limiting the accessibility of digital TV for some disabled and elderly people. They identified excessive numbers of buttons, with limited meaningful grouping and often inadequate labels as particular problems. They also note that a basic problem with remote controls with digital TV is that there are effectively two user interfaces the remote and the TV screen. A study by Hamano (2005) investigated the usability of analogue TV remote controls for a group of non disabled elderly. This study found that non disabled older people experienced significant usability issues with existing remote controls for analogue TVs. A study by Mann, Ottenbacher, Tomita and Packard (1994) investigated the design of hand-held remotes for older people with impairments. Mann et al found that their older users performed significantly better (i.e. made fewer errors) when provided with remotes with large buttons, large font labels, and high colour contrast between the button labels and the remote. Older users also showed a strong preference for the remotes with large buttons compared to an existing commercial remote control with more functions and smaller buttons.

A further area where digital television introduces new accessibility issues concerns the delivery of interactive content such as electronic program guides. Berglund and Johansson (2004) investigated design of an electronic program guide and remote control that enabled multimodal access using spoken or written natural language and a visual display. They argue that the key problem with interaction with digital TV is the increased complexity of the interaction. After analysing a range of alternative strategies they argue that providing a multimodal interface with spoken/ written natural language input and voice output represents an optimal design. They report on the development of a demonstration prototype that showed good results with users in a controlled trial. While this study did not directly address access for viewers with disabilities the authors argue that their approach has potential to enable access for a wider range of viewers than current designs (e.g. non disabled elderly). The National Centre for Accessible Media (NCAM) has investigated making onscreen menus accessible by adding audio output (NCAM, 2003). They have demonstrated the feasibility of doing this via prototypes and mock-ups and have produced guidelines for developers. However, their work points to a number of key limitations of existing technology. First, many digital set top boxes, particularly those provided by cable companies to customers, do not have the computing capacity to support speech output. Second, the interactive content (EPGs) would need to contain the embedded information required to support speech output.

Overall the added complexity of the digital TV user interface may represent a significant barrier for older people (Rogers and Fisk 2003) as well as presenting particular issues for younger adults with disabilities e.g. accessing accessibility controls via menu structures. A study by Newell (2003) noted that the design of digital TV appears to assume that the typical viewers of TV are highly dextrous, have good vision and memory and are interested and able to spend a long period of time playing with the system to obtain the results that they desire. Newell argued that there are great advantages from both a commercial and a social perspective in designing digital TV to be accessible for all. The widespread use of TV captions on TV's in noisy environments supports the idea that features designed to support access for people with disabilities often have benefits for nondisabled users. Thus, given that digital TV is a product that is intended for use by the great majority of the population it is clear that universal design—making the product accessible for as many of the target population as is feasible—is the most appropriate solution rather than offering add-on assistive technology solutions for people with disabilities.

Comparison with the UK experience

Progress on the changeover to digital TV in the UK is substantially further advanced than in the US and provides a good indication of emerging issues with regard to accessibility for older people and people with disabilities. The UK Disability Discrimination Act requires that "reasonable steps" are taken to avoid discrimination against disabled people (Disability Discrimination Act, 2005). The Office of Communications (OFCOM), the body responsible for regulation in this area, has as part of its duty under the Communications Act 2003 to ensure that "domestic electronic communications" apparatus is developed which is capable of being used with ease, and without modification, by the widest possible range of individuals including those with disabilities (Communications Act, 2003). Carmichael, Rice, Sloan and Gregor (2006) concluded in their review of progress on accessibility of digital TV in the UK that there is serious cause for concern because

the rapidity with which the UK government wants the switchover complete despite the fact that many of the Governments own commissioned reports indicate that significant usability and accessibility problems remain which must be addressed and resolved before the switchover is complete.

It should be noted that this pressure to complete the switchover quickly is occurring despite a strong statement of commitment to access for all by OFCOM (Newell, 2003).

In a report commissioned by the UK Government, Klein, Karger, and Sinclair (2003) presented an investigation of the accessibility of digital STBs available on the UK market at that time. This report is significant because it addressed accessibility of STBs for people with a range of disabilities. Klein et al. (2003) concluded that the STBs available in the UK when the report was produced were likely to present significant accessibility problems for people with vision impairment, people with dexterity impairment and people with cognitive impairment. They identified barriers to purchasing and initial set up of equipment likely to result in the exclusion of people with vision impairment, people with dexterity impairment and those with cognitive impairments. They estimated, based on available data on functional capabilities for the UK population, that 48.1% of people over 75 would be excluded from purchase and installation of an STB. This report appears to be the only systematic analysis of the potential level of exclusion of people with disabilities from access to set top boxes. While technological change in set top box design will clearly influence the relevance of these findings it represents a significant indicator of potential issues in this area.

In summary, there is evidence from the UK experience of continuing difficulties with access for people with disabilities in the context of a significant effort and a legal mandate for accessibility. While it is important to be cautious about direct extrapolation this suggests that similar issues could arise in the US.

Conclusion

The aim of this paper was to investigate the potential impact of the planned changeover from analogue to digital TV on the accessibility of TV for people with disabilities in the US. The current regulatory requirements for accessibility of digital TV in the US relate to closed captioning and video description and do not address the accessibility of the television user interface—the design of interactive content and the remote control device. This review has shown that the planned changeover to digital TV has the potential to result in increased levels of exclusion of people with vision, dexterity and cognitive impairments.

The group at most risk of exclusion will be those on low incomes who currently rely on broadcast access to TV. A substantial percentage of these people will be people over 65 who are likely to experience added difficulty as in many cases they will have become disabled later in life and will not be in contact with the disability organizations and resources accessed by the younger disabled population. While the review found a range of studies and prototyping efforts in relation to accessibility of digital television, the only generally available technologies outside of research settings are currently closed captioning and described video.

People over 65 on low incomes and with disability are likely to be a relatively isolated population. This group are unlikely to be in touch with disability groups who could otherwise assist them with technology access issues such as the digital television changeover. This group may need individual outreach to assist them in obtaining and setting up appropriate solutions for individual needs. Local seniors' organizations could provide this support if they are given support to do so.

The introduction of digital TV has the potential to offer significant benefits for older people and people with disabilities. The flexibility of digital TV means that it should be possible to deliver improved accommodations for people with disabilities such as making the font size of captions variable to assist people with vision and hearing impairment. Digital TV can also be used to deliver information and services to the home that could offer real benefits for older people who wish to remain in their own homes as they age. However, for these benefits to be realized the technology must be accessible to all.

One of the major underlying problems in improving the accessibility of digital TV hardware is that STBs and TVs along with other household electronic devices currently only provide a single dedicated user interface. A future prospect in this area is the standardization effort being carried out for "Alternative user interface access" within the V2 technical committee of the International Committee for Information Technology Standards (NCITS V2, n.d). The full extent of this work is beyond the scope of the current paper, however, its objective is to define a standard that in future would enable people with disability to control other devices, including televisions, using their preferred access device e.g. a Braille based computer, single switch device etc.

One of the major implications of the analysis presented here is that the intersection of age and disability in the population implies a need for a broader approach to the development of design accommodations to support access by people with disabilities to technology based products and services that also address the needs of older people. Historically, progress in the accessibility of technology has been driven by the efforts of disability groups that have primarily represented younger disabled people with early onset disabilities. However, increasingly in the future the population of people with disabilities will comprise people who have aged with disabilities and seniors with later onset acquired disability. The other important element that emerges from this review is significance of income. The group who are most at risk of being excluded from access are those with disabilities who are also on low incomes. This is not to suggest that the situation will be easy for people with disabilities with more income but that they are likely to have access to more options and solutions.

Both older people with acquired disability and people with early onset disability will have grown up with technology in their lives and are likely to expect to continue using technology as they age to enable them to participate fully in day to day life. Racino and Heumann (1992) argued that in the context of the increasing intersection of age and disability, organizations in these areas should work together to advance the common interests of both groups. By working together on accessibility, aging and disability organizations could advance both the market proposition for accessibility, and the interests of disabled people and older people in being able to exercise a wider range of choices in their daily lives.