05/16/2008

Rowena Portch, Accessibility Advocate

Multiple Sclerosis (MS) offers a variety of challenges, but that doesn't have to stop you from being productive on your computer. Learn how assistive technology can help.

Applies to
Microsoft Office 2007 Microsoft Office 2003 Help and How-to

A bit about Multiple Sclerosis and assistive technology

Multiple Sclerosis (MS) is an unpredictable disease that attacks the central nervous system. This autoimmune disease causes the body to attack the myelin sheath that insulates the nerves. When this myelin sheath is compromised, the nerve short circuits and causes myriad problems. Most people develop MS between the ages of 20 to 40. Some experts believe that MS is caused by an environmental trigger, or perhaps a virus, but the exact cause is unknown. Common symptoms of MS include blurred or double vision, color blindness, blindness in one eye, and poor muscle coordination. There are a host of other symptoms, such as restless leg syndrome and neuralgia; however, we are only focusing here on symptoms that affect a person's ability to work on the computer.

Assistive technology is any hardware, software, or a combination of tools that enables those with various impairments to stay productive. These tools empower folks with a variety of disabilities to be more independent and productive.

Because there are so many combinations of operating systems and versions of Office, I have included a list of helpful links at the end of this article to help you find the information that you need for your specific configuration and impairments.

There is a very helpful site for those who have MS. If you are looking for a great place to start, visit My MS My Way.

Loss of dexterity or motor skills

Imagine trying to click inside a tiny cell within an Excel spreadsheet when your hand and arm are shaking uncontrollably. This would be something like trying to scoop peas onto your fork during heavy turbulence in a small aircraft. Often with MS, using the keyboard can be difficult, and for some, it can be painful.

The new Ribbon UI in Microsoft Office 2007 Word can be very challenging for those who have little to no coordination in their fingers. Windows Vista and Windows XP offer a feature called Sticky Keys. When enabled, you are able to press one key at a time, instead of having to hold down two or more keys at the same time. This can be helpful if you have an easier time controlling one hand at a time, instead of both hands simultaneously. So, instead of having to press ALT+TAB to bring up a list of active windows, you can invoke Sticky Keys, and then press ALT, and then TAB.

If you find that you inadvertently press keys more than once, you can activate Bounce Keys to ignore keys that are pressed more than once, unless a specified time has passed between each key stroke.

Instead of using a mouse, you might find it easier using a touch screen. This device enables you to use your fingers to make a selection.

If you are unable to use a keyboard, use a head- or eye-pointing device to direct a low-level laser beam toward a special type of keyboard.

There are even on-screen keyboards that you can use with a joystick or pointing device.

If your speech is not impaired, you could use speech recognition software. Simply speak the commands that you want your computer to perform. For example, you can instruct the computer to start Word, address a new e-mail message to a specific person, or even shut down the system. Some speech recognition products enable you to control appliances in your home or office, as well as your computer.

Cognitive dysfunction

MS can often cause cognitive dysfunctions and learning impairments that make it challenging to work in Word, schedule appointments in Outlook, or work in Excel spreadsheets. There are tools you can use to help you stay focused.

In Word, you can add auto-correct entries for words that you frequently misspell. These auto-correct entries will also apply to e-mail message that you compose in Outlook.

To add an auto-correct entry in Word 2007, do the following:

1. Start Word 2007.
2. Press ALT+F, then I, then P, and then press ALT+A to open the Auto Correct dialog box.
3. Type the word as you commonly mistype it, and then press TAB.
4. Type the word as it should be spelled, and then press ENTER.

If you do better hearing words rather than reading them, have Narrator read the words back to you.

To start Narrator:

1. Press WIN KEY+U.
2. Press ALT+N.

To stop Narrator:

1. Press ALT+TAB, until the Microsoft Narrator window is selected.
2. Press ALT+X.
3. Confirm your decision to close Narrator by pressing Y for Yes.

Screen review utilities speak on-screen text and highlight the words as they are spoken. By converting the text to a computer voice, it often helps some people who have language impairments by offering a visual aid along with an audio stimulus.

Voice distortion

When you cannot speak effectively, it makes communicating very challenging. By using a speech synthesizer, or a screen-reading utility, you could type your thoughts and have the computer speak them for you. This tool is very handy in meetings, or when discussing business with clients.

Visual impairments

Visual impairments make it difficult to work on the computer because you cannot read the information that is presented. Whether you have low vision, or no vision, there are several tools available to help you stay productive.

Besides using the Windows Narrator program and text magnifying utilities, there are also a number of screen-readers available.

You can also adjust your computer for low vision, text and icon size, and screen magnification.

Helpful links

Now that I have told you about the many options available, here are some links that explain how to implement these features, and how to learn more about other assistive technology.

To learn how you can use technology to improve your qualtiy of life, visit My MS My Way.

To learn about assistive technology products, visit: Assistive Technology Products. If you click the Search for Assistive Technology Products link, you will be able to specify a product that interests you.

For more information about assistive technology that addresses specific impairments, visit: Guides by Impairment.

To learn how to configure your computer and make it more accessible, visit: Accessibility in Microsoft Products.

Contact me

If you have comments or suggestions for articles that you would find helpful, please send me an e-mail message at accessad@microsoft.com. I do monitor this mailbox each day and personally respond to your inquiries.

Read more articles by the Accessibility Advocate

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Introducing the Accessibility Advocate column

Making sense of HTML messages in Outlook

Become more efficient with accessibility tools

How to work with the visually impaired

Helpful feature in the spelling checker in Word 2007

Get organized with Outlook

Contribute an article

Each month, I publish an article from a contributing author. If you have something to share and want to see your name in the byline, send your article to accessad@microsoft.com

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About the author

Three years ago, I lost my sight to Retinitis Pigmentosa. Prior to that, I was a technical editor. Learning how to use a screen reader and a Braille display proved challenging enough — having to deal with non-accessible applications was unbearable. To remain productive, I had to learn how to use accessibility tools and write scripts to interact with applications that were not accessible. Tasks that used to take me only minutes to perform were taking hours. My productivity went down, along with my confidence and self esteem. As a result, I felt that people had to be educated about the importance of accessibility features in tools and applications. I volunteered to be a beta tester for SharePoint technologies, Microsoft Office, and third-party vendors of accessibility tools. These opportunities enabled me to offer feedback and help develop applications that everyone can use. Now, I want to share my experiences with other people through this column.

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