The value of a building design may be determined by the attention to detail. Do the accessories meet the personal needs of the users? Is the telephone equipped with amplification? Does the alarm clock have large lighted numerals? Can controls be easily operated? Does the interior reflect care and concern?

Small Appliances
Cordless units save time and energy. They can be operated from a distance by touch control, by phone, or with voice signals. Other controls for installed appliances should be set at counter level, accommodating children, people in wheelchairs, and adults of shorter stature. With smart appliances, like built-in vacuum systems, controls are eliminated. A vacuum system of this type is especially convenient because operation is easy and one-handed. To start, the hose is simply inserted into the inlet. Be sure to mount the inlet at a reachable height (15 in a.f.f.). A built-in vacuum system is also appropriate for people with allergies, since dust and other allergens are blown out of the house.

If the cost of a built-in vacuum is not in the budget, a portable vacuum can be strapped to the back of a wheelchair for easier use. The best offer controls located on a contoured handle, not on the machine. Specify a retractable cord and a dust bag which is easy to change. The hose should be crush resistant and long enough to reach around the wheelchair.

A cordless rechargeable vacuum cleaner saves time and effort on small cleanups. It is much more difficult to haul out a large vacuum and maneuver around the cord in a wheelchair. It also improves reach when a quick cleanup is in order. Consider an upright vacuum for people who may have difficulty pushing down on a hand-held hose. It should be light-weight.

Select small appliances that offer such safety features as a built-in ground fault circuit interrupter to prevent electrical shock. A hand-held hair dryer, for example, could be easily dropped into the bathtub or sink resulting in shock or fire.

Many people have a reduced reaction time to fire, and selection of an extinguisher becomes critical. Fire extinguishers are labeled for use with class "A", "B", or "C" fires. Class "A" fires are fueled by ordinary combustibles, class "B" by flammable liquids, and "C" by electrical appliances and wiring. For general use, select multi-purpose A-B-C models. Choose an extinguisher which has a slight texture on the canister to improve the grip, and is shaped not to roll off the lap of a seated user. Also, look for a unit which will stand up on a flat bottom.

Use a pedestal or mount the bottom at 27 in a.f.f. to prevent it from becoming a protruding hazard or out of reach for seated users. It should be easily removed from the wall, and removal of the unit should automatically remove the safety catch. Use several small extinguishers rather than one large model which is harder to handle. The diameter should be small enough to hold in one hand. Pictorial displays with sufficient contrast are preferable to written instructions.

Many small appliances and accessories originally designed for specific abilities are now being used universally. A universal alarm clocks features extra large numerals, raised indicators at each number, and audible cues. An optional bed vibrator can be added to awaken people with a wide range of hearing abilities. Talking calculators and desk clocks announce the time in a human-like voice. Talking wristwatches are available with an audible or vibrating alarm, and a talking thermometer states the temperature. Talking scales announce current weight as well as any weight gain or loss, and talking. For convenience look for models with toe-operated controls. These features help all users.

A cordless headset allows the televisions to be used without increasing the ambient noise level in the room. A tape player with a cordless headset and a remote control is used by blind people in place of notes when public speaking. Tape recorders are also used by people with coordination limits to take notes.

Office Equipment
Office equipment should be specified to improve accessibility for all employees. Printers, copiers, scanners, and fax machines, for example, should be usable at 30 in a.f.f. Touch controls should be located toward the front of the machines, and a clear floor space should also be provided to access the controls, load paper, and retrieve documents.

Office equipment with wireless remote control is a convenience for all people. Most stands for slide projectors are too high for adults of shorter stature or people in wheelchairs; a height adjustment may be needed. Many projectors can easily be stored in pop up stands for convenient access.

Calculators, automatic pencil sharpeners, and many other pieces of office equipment have been designed for one-handed use, an advantage to all users. Keyboards can now be added to that list. When selecting a model, specify right- or left-handed use.

Computers
Computers are used for a wide range of daily activities: telephoning, messaging, banking, and shopping, to name a few. Unlike telephones, computers can be used without verbal communication, a decided advantage for people with hearing or speech differences. Computers offer "bulletin boards", networks, and direct communication with anyone who has a touch-tone phone or a text telephone (also known as a TDD and TTY).1

A variety of accessories are available for computer use with a mouth stick or with one hand. A keyguard or wristguard stabilizes the finger, hand, or stick so that other keys are not pressed by accident. Software and operating systems now have built-in accessibility features that do not require users to press two keys simultaneously, as with the shift and control keys. Keyboard positions can be redefined. Other features slow down or eliminate the "auto-repeat" function, which may be difficult for some people to control.2 Voice recognition systems (which accept spoken commands) are also commonly available.3 With features like these in place, a person with quadriplegia can type up to 60 words-per-minute.

Keyboards are available with larger keys for people with differences in coordination. Some have single keys for frequently used words and phrases. For people who cannot depress keys, membrane keyboards are available. Switching systems can be operated by any movement and are used to replace keyboards. Switches are used in conjunction with a scanner or with Morse code, which is faster than scanning. Scanners provide wide choices of information on a screen or separate panel. The user selects the information of interest with a switch.

People with learning differences benefit from the immediate feedback offered by computers. Learners see, hear, and feel information (on a touch screen) to reinforce the message and allow for a variety of learning styles.

A speech synthesizer offers voice output for a person who cannot use the screen or who has a speech impairment. The computerized voice lets the user hear the information printed on the screen. It provides immediate audio feedback as data is entered, so mistakes are easily identified.4 When used with a telephone interface, a synthesizer can serve as a speaker phone allowing two-way conversation without the use of voice.

Braille systems and optical readers are helpful add-ons to improve visual acuity. A Braille display verbally "reads" the information from the screen and also presents it in Braille. Printed information can be scanned and displayed on a magnified screen, reprinted in Braille, or "read" by the speech synthesizer. This is especially helpful for dated information like newspapers or correspondence that needs attention before a tape or reading service can be used.5 Software is also available to enlarge text and images.

Computer peripherals are becoming more user friendly for people with varying abilities. A printer system, for example, can be operated with a mouth stick, by voice, or by hand without requiring manual dexterity. One excellent example of a user-friendly device is a disk loading system that can be fully operated with a mouth stick.

Drinking Fountains and Water Coolers
To minimize injuries to blind people who use canes, water coolers with floor clearances exceeding 27 in a.f.f. must not be placed in circulation paths.6 People in wheelchairs require a clearance of at least 27 in, so this is the exact clearance to meet the needs of both populations. Units recessed in alcoves can have higher clearances without becoming obstacles for people who sweep with a cane.

A recessed fountain or cooler with a forward approach must project between 17 and 19 in from the wall. The recess must be a minimum of 30 in wide and a maximum of 24 in deep. If only a side approach can be used on a fountain recessed more than 15 in, the recess must be 60 in wide. An alternate fountain should be offered for children with a spout no higher than 30 in a.f.f., a clear knee space of 24 in a.f.f., and a depth of at least 14 in.7

The ADA Accessibility Standards requires a combination of standard height drinking fountains and fountains lowered to the height of adults of shorter stature, children, and wheelchair users who require a spout no higher than 36 in a.f.f. The spout must be located close to the front of the unit (within 3 in with a round or oval bowl) with water flow parallel to the front edge. The flow must be at least 4 in high for use with a cup. A flat-bottom paper cup dispenser adjacent to the water fountain allows use by many people who can't reach the spout.

Controls must be located near the front edge of the fountain. They must be operable with one hand without tight pinching, tight grasping, or twisting of the wrist. An automatic sensor is most easily operated, freeing both hands to hold packages, luggage rollers, briefcases, etc.

Telephones
The simple telephone has now become a machine that understands specific voices, takes notes, communicates with others, and travels everywhere. When used as a component of a "smart" house, the phone can open doors, adjust heating and cooling, start the oven, and dim the lights. If water in a kettle is boiling on the stove, the level of the flame on the range can be lowered by a phone call from bed. One phone call can warm up the hot tub and start a romantic fire using a gas log in the fireplace.

In new commercial buildings, at least one forward reach telephone is required on each floor with usable elements no higher than 4 ft a.f.f. Keep the route to accessible phones free of obstacles and make sure that the public closed circuit phones are accessible. At least one pay phone must be accessible at each location where a pay phone is provided. Allow a 30 in x 48 in clear space in front of each for an approach in a wheelchair. The bottom of the public telephone and its surrounds must be no more than 27 in a.f.f. if it is in a circulation path.

Phones placed higher cannot be easily and consistently detected by blind people using canes. Recessed telephones offer protection for adults and children who sweep with canes, as well as access for people in wheelchairs, providing the recess is a minimum of 30 in wide and a maximum of 24 in deep with a clear floor space.8

If the existing wall phone is in an awkward location, replace it with a cordless phone. For people with reduced mobility, portable phones can prevent the race to the telephone or the frustration of a missed phone call. Choose a model with a two way intercom for communication between the base unit and the handset. Specify a phone that searches frequencies for the clearest channel. Clarity is just as important as volume for people with reduced hearing. It must also switch between tone and pulse. Other features to consider are automatic redial, volume control, and a ringer that cannot be heard through the earpiece.

A car phone is a convenience as well as a necessary security feature for people of all abilities. Many public phones are not accessible. With a car phone, help can be reached, appointments can be confirmed, and directions can be requested, resulting in a great savings of time and energy.

Touch controls on phones are easier to manipulate for people with differences in coordination. Card-dial telephones are also available. Touch controls on the headset are more convenient for use from bed. Make sure the cord to the handset will reach across the width of the bed and wall-mount lighter-weight phones for additional stability. Specify a cord length of at least 29 in between the handset and the base of all phones.9 This cord length is required on accessible public phones to facilitate use with a text telephone.

Phones with larger, easy-to-read push buttons are convenient for all users but essential for people with reduced vision. "Talking" caller identification devices are also available.

If touch controls are still too difficult, attach a touch plate. Pressure on any part of the plate dials an operator, who will, in turn, place the call. Puff-and-sip dialing systems are available on some telephones; the operator is contacted by blowing into a plastic tube. Voice-activated dialing service is also available.10 Some phones respond to the spoken name of the person to be called, recalling their number and dialing it.

Headsets, puff switches, lapel microphones, or pillow switches can be used by people with differences in arm motion or manual dexterity. An existing phone can be adapted with a telephone stand and a handset clamp. Some models have a lever-operated line interrupter that can be used by pushing with the hand, elbow, or foot. With the line interrupter, the handset can be left permanently in the clamp.

Light-touch speaker phones are useful for people with varying strength and coordination who may have difficulty with a handset. Speakers can also be attached to existing telephones. Models are available with touch tone, memory for automatic dialing, visual cuing, and an answering system.

Telephone receivers on required accessible phones must generate a magnetic field to be compatible with many hearing aids. In-line amplifiers are available, and portable amplifiers can be added to an existing telephone. Amplified phones are also available which control background noise, volume, and clarity control, boosting high frequency sounds. This feature is needed by 95% of people with reduced hearing.

Text telephones, tone ringers, gongs, and signals in other frequencies allow more choices in signaling an incoming call. Telephones can also be wired to room lights, flashing lights, or amplified signaling devices. Visual telephone signaling devices should be placed near the phone, not mounted high on a wall where they would could be mistaken for a fire alarm or obscured by smoke in the event of a fire.

Telephones, teleprinters, and other telephonic devices are available to transmit printed messages to a teletype emphasis printer or television monitor. A portable text telephone with a cellular phone adapter can be used to call any location with a compatible unit or through the relay system to an incompatible unit. Provide a shelf for the unit with a receptacle outlet within 4 ft. A built-in printer provides a record of the conversation, an advantage to all users. Some phones can be easily switched from text to voice. The switch also allows users to type ahead of incoming messages.

For a person with a soft voice or with speech differences, consider a programmable speech synthesizer or a handset for speech amplification. It plugs into any modular telephone and increases the volume of the voice by as much as 30%. Amplification may be critical for a person to be understood in an emergency.

Decorative Accessories
Decorative accessories may actually reduce stress when the user maintains control of the selection and chooses a "positive distraction."11 Universal art even appeals to people who are blind. In one creative example, visitors are encouraged to touch a tile mosaic, feeling their way through a maze to the fossil "reward" at the end.

Art can be a source of relaxation and pleasure or a source of irritation, depending on the reaction of the individual. The choice of art can be returned to the individual in a health care setting through a mobile cabinet or "art cart," which allows each person to personalize their room with the art of their choice. A similar program can be introduced in an office setting or in any other space principally occupied by one user.

Encourage people to display wall hangings or crafts to personalize the interior. Use accessories that reflect the interests of the individual. Collections can be displayed in curio cabinets or tables.

Hang some artwork and other wall-mounted accessories at a lower height for children, adults of shorter stature and people in wheelchairs. Include full length mirrors in the bedroom and by the front door to serve all populations. Elevate glass at least 10 in from the floor to avoid damage from wheelchair footrests.

Avoid tall arrangements of flowers or accessories on furniture that block a clear line of vision to interpreters or other people in the room. Tall arrangements may make it more difficult to maintain eye contact and to read lips and gestures.

Signs
Signs in public spaces are needed to control movement and to offer advice, information, and identification. They are important elements of both wayfinding and orientation strategies. Signs should be understandable, requiring no further clarification.12 Simple terms like "walkway" or "general hospital," for example, are more easily understood than "overhead link" or "medical pavilion."13 Signs should be consistent throughout the space, as succinct as possible, readable for all users (composed at a sixth-grade reading level), and stated in positive terms.14

To identify accessible facilities and parking, use the international symbol for accessibility. Parking signs should directly face the driver within a 60 degree cone of vision.15 In addition to the international symbol of accessibility, additional signage may be required. For example, parking for vans requires a sign stating "van accessible", and "areas of refuge" signs are also required. Text telephones must be marked with the international symbol for TTY, and volume control telephones and assistive listening systems must be identified by the international symbol of access for hearing loss. Inaccessible elements like entrances, exit stairways, toilet rooms, drinking fountains, and elevators must have signage offering directions to accessible features. Directional signage mounted over 80 in a.f.f. must have 3 in characters at a minimum.

Contrast, proportion, and redundant cuing are important signage features. Light yellow or white letters on a black background are the most readable for partially sighted users.16 The ADA Accessibility Standards recommends a contrast level of 70%. People who are color-blind will have difficulty with signs relying on contrast between red and green. People using different languages and learning skills may understand colored pictograms more easily than verbage.

Signs that offer tactile and audible cues as well as visual cues are important to people with differences in vision, reading, and learning abilities. Tactile signs must include letters or symbols raised a minimum of 1/32 in and must be accompanied with Grade 2 Braille angled for ease of use.17 Raised arabic numerals and standard block uppercase letters without serif are recommended.18 Raised characters must be 5/8 in to ¾ in high19 but no higher than 2 in.20

People with reduced vision appreciated well-placed tactile signs that identify accessible routes, common use spaces (e.g., cafeterias), or public health and safety features (e.g., fire exits, toilets, and hazardous areas). In the event of an emergency, exit signs should be backed up with a middle frequency audible signal to aid in location of an exit.21 Tactile maps lead users from larger to smaller details about a space. The metal ball on a tactile map indicates the location of the sign. Required tactile signs must be mounted at a height of 60 in a.f.f. (48 in for children) on the latch side of the door. A person must be able to approach within 3 in of signage without encountering protruding objects or standing within the swing of a door.

Audible signs may have touch controls or, with a controlled audience, may include infrared or low frequency radio signals. Receivers can be distributed in stadiums, auditoriums, hotels, convention centers, museums, schools, etc. The area is scanned with the receiver to pick up audible messages. Some facilities offer an interactive audio visual tour on a hand-held unit with large touch buttons and a visual printout. This unit is helpful to people with hearing, coordination, and visual differences.

All signs should be placed to avoid glare from windows and light sources, and glare free materials should be selected. Proportion can also improve visibility. Letters and numbers must have a width to height ratio between 1:1 and 3:5. The letter X, for example, could be 3 by 5 in. The ratio of the stroke width to the height must be between 1:5 and 1:10. If each line used to make the X is 1 in wide, then the line itself could be between 5 and 10 in length.22 Spacing between lines of text should be 25 to 30% of the point size.23

Plants
Plants add a feeling of life, vitality and growth to a space. They absorb carbon dioxide and other unwanted gases while adding oxygen to the air. Although people with mold allergies should probably avoid houseplants in moist soil, houseplants are helpful to people with other allergies. For example, Fichus plants will absorb formaldehyde, which outgasses from many building materials and carpeting. In a large planter keep houseplants in smaller pots so that they can be easily moved. Larger potted plants can be moved if they are in a mobile plant stand.

Lamps
Avoid installing any projecting wall lamp that could be an obstacle to people who may not see it or pick it up with a cane. Moveable floor lamps are more easily detected. Lighter weight floor lamps can be positioned from a wheelchair for task lighting, especially when they are adjustable in height. A touch control eliminates the switch, lighting the lamp when any metal surface is touched. Inexpensive touch converters for metal base lamps are available at many lighting stores. Squeeze switches on cords are also easily operated by many people. All lamps should have heavily weighted bases for stability.

Keep lamps at each task location, and choose designs that can be used in both the living room and bedroom for added flexibility. Use translucent shades for reading and opaque shades for accent color and ambient lighting. Plastic shades and fixtures are prone to volatile outgassing when exposed to high lamp temperatures. These gases may cause problems for people with allergies.24

Bedroom Accessories
Save energy, exertion, and time with well-organized storage. Plan "a place for everything" so that effort will not be wasted looking for lost items. Expand reachable storage in the closet with hanging racks for shoes and sweaters. High reach for adults of shorter stature and children typically ranges from 36 in to 44 in a.f.f. while adults in wheelchairs prefer a high reach of 48 in a.f.f. A universal solution is a pull down closet rod. Keep closet shelves transparent above eye level with plastic or wire shelves. Make maximum use of space at a reachable level with racks and shelves attached to the backs of doors. Add a carousel system that rotates hanging clothes. This type of system is appropriate for people in wheelchairs or anyone needing access to a tight storage space.

Accessories like keys, staplers, scissors, paper clips, tape, eyeglasses, pencils, and pens can be duplicated and stored in a variety of locations to save the energy required for extra trips and prolonged searches. Specify accessory holders at multiple locations. Have a pad and pencil at each telephone together with a directory.

Provide a lap stand for reading or working in bed. Bands on the stand hold the book firmly in place and allow the pages to be turned with one hand. Automatic page turners are also available. For ease of bed making with one hand, specify a quilt with a blanket cover that replaces the bedspread, blanket, and top sheet. With a covered comforter, the bed can be made with one easy motion, an advantage to all users. Also, a short comforter is easier to manipulate than a bedspread extending to the floor.

People who have trouble turning over in bed may require satin sheets which are used with satin pajamas. People in pain can move more easily on satin sheets; some maintain that this is the only way they can sleep. Others, however, slip out of bed or have difficulty getting into bed with satin sheets and pajamas

Many of the accessories discussed in this chapter are more adaptable than universal, but the distinction becomes less necessary with movable accessories which can be inexpensively replaced.


References
1. IBM National Support Center for Persons with Disabilities, Technology for Persons with Disabilities: An Introduction (Atlanta: IBM, 1991), 1-8.
2. IBM National Support Center, 1-8.
3. IBM National Support Center, 1-8.
4. IBM National Support Center, 1-8.
5. IBM National Support Center, 1-8.
6. Americans With Disabilities Act Accessibility Standards, 1991.
7. North Carolina State Building Code Council, North Carolina State Building Code, vol. 1 C (Raleigh: NCSBCC, 1989).
8. ADA Accessibility Standards, 1991.
9. ADA Accessibility Standards, 1991.
10. For additional information call the Voice Dialing Product Manager at Bell Atlantic at 212 395-8534
11. Roger S. Ulrich, "Effects of Interior Design on Wellness: Theory and Recent Scientific Research" (Paper delivered at the Third Symposium of Healthcare Interior Design, San Francisco, 15-18 November 1990).
12. Janet Reizenstein Carpman, Myron A. Grant and Deborah A. Simmons. Design That Cares. (Chicago: American Hospital Publishing, Inc., 1986), 26.
13. Carpman, Design That Cares, p. 27.
14. Carpman, Design That Cares, p. 28.
15. Carpman, Design That Cares, p. 28.
16. Salmen, John. Ed. "Low Vision Print Legibility". Universal Design Newsletter. (January 1994): 8.
17. ADA Accessibility Standards, 1991.
18. NCSBCC, 1989.
19. ADA Accessibility Standards, 1991.
20. ADA Accessibility Standards, 1991.
21. Carpman, Design That Cares, p. 52.
22. ADA Accessibility Standards, 1991.
23. Salmen, John. Ed. "Low Vision Print Legibility", 8.
24. Robert J. Kobet, "The Tight House Syndrome: Causes and Cures" (Paper delivered at the American Society of Interior Designers National Conference, Washington, D.C., August 1988).

Excerpted from Beautiful Universal Design by Cynthia Leibrock and James Evan Terry; used with permission.
Copyright © 1999 by Cynthia Leibrock and James Evan Terry