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deepwell gaming therapy

Are games the future of mental health treatment?

  • min read
    • In Kaspersky's Bring on the Future series, we meet people and businesses worldwide who are changing things for the better. One of the biggest challenges for mental health treatment is reaching more people who need it. Some don't realize they're mentally unwell. Others can't access therapy because of costs or waiting lists. Many don't like the idea of discussing their problems with a stranger. DeepWell DTx aims to change that by bringing mental health therapy to the masses – especially hard-to-reach patients – through gaming. Co-founders Ryan Douglas and Mike Wilson speak about why games are a great way to treat mental health issues – if you get the formula right. 1. Why did you decide to start DeepWell now? We found that mental health came up constantly in our respective careers – Mike in gaming and Ryan in creating medical devices and therapies. We saw many people were missing the resources or help to treat disorders like anxiety and depression. We often talked about what we could do to address this unmet need, then the deepening mental health crisis alongside the Covid-19 pandemic pushed us to start DeepWell. 2. What's DeepWell's philosophy? We put games and game developers first. There is no treatment without player engagement, so therapy must be embedded in a fun and engaging game. 3. How has your team of 40 experts across gaming, science and mental health helped your success? Our diverse team is made up of professionals at the top of their fields. Neurosurgeons, lawyers, creative strategists and others all work in service of the game developer. Without the game's fun, there is no therapy. 4. What can players expect might change after playing your games? Our games aim to help players improve their physical and emotional functioning. After playing consistently, you should notice greater resilience and capability to handle the stress and anxiety of daily life. 5. How has gaming supported your mental health? Which games do you recommend for therapy? At the moment we're focused on virtual reality (VR,) using games like Pistol Whip and motivational fitness apps like Supernatural for leisure and exercise. These games have especially helped during the pandemic for getting off the couch and quelling anxiety with movement. We've also found immersive fantasy games like Lorne Lanning's Oddworld and American McGee's Alice, role-playing games (RPGs) like Wizard101 and world-builders like Minecraft therapeutic for us and our families. Any game that takes you out of your head has potential benefits. 6. Who are your customers? Are businesses investing in these games, such as the healthcare industry, or any business hoping to improve employee wellbeing? We're reaching out directly to folks with mental health issues. We also partner with game developers, publishers and platforms to create new games or repurpose games that are already therapeutic. We hope our games will make mental health treatment accessible to a broader audience. 7. Serious games have evolved as a genre in recent decades, especially in academia and healthcare. Do you align with it? We are not serious games. We rely on the power of play and engagement that good games provide. While we see the value of other approaches, this is what makes us different. 8. How will your FDA games certification project benefit the industry and gamers? Being able to make claims and develop games with therapeutic intent, and to have players understand the therapeutic benefit of engaging, will change game development and the audience games can reach. 9. Can you tell us about games you plan to launch? The first game we're working on focuses on addressing stress, anxiety and symptoms of depression on a VR platform. More to come closer to launch. 10. How will you keep your products secure and safe for users? We closely follow the FDA and HIPAA guidelines and requirements for data management in prescription games. 11. What will success look like for DeepWell? Widespread recognition of the power of game developers to develop Immersive Medicine and being able to produce many therapeutic options for a range of cultures and mental health conditions.
How AI can make therapy better

Could AI make mental health therapy more effective?

  • min read
    • Artificial intelligence (AI) can analyze vast amounts of data more quickly than humans and draw accurate conclusions, making for myriad business applications. But now, some technologists and mental healthcare clinics are using artificial intelligence (AI) to inform mental health therapy. They think it could help pinpoint the most effective strategies to help sufferers get better. This may mean better staff retention and productivity and greater value for money from employee assistance programs for business. UK-based mental health clinic Ieso and US-based mental health technology firm Lyssn are among those experimenting with AI-augmented therapy. Why mental health is harder to treat I spoke with Valentin Tablan, Chief AI Officer at Ieso. He says while physical healthcare has MRIs, CAT scanners and hundreds of blood tests to diagnose conditions, "In mental healthcare, we've been slower to adopt technology. But that's changing. We can start using artificial intelligence and natural language processing techniques to understand therapy-specific language and gain insights from that." Ieso uses AI to analyze transcripts of patient-therapist conversations to identify which elements of therapy give the best outcomes, identify cases that may need a more experienced therapist and help evaluate the quality of care. They're also working on a cognitive behavioral therapy (CBT) companion app that supports patients in between therapy sessions. Lyssn also uses AI to evaluate the quality of psychotherapy and give therapists actionable feedback. Practitioners hope to increase recovery rates and quality of care to bring it on par with physical healthcare's higher recovery rates. Ieso has seen recovery rates increase 2 percent alongside its AI program – small but encouraging. AI no replacement for therapists "Psychotherapy's quality is usually measured by experts observing a conversation. Our AI is trained to replicate this human judgment, reducing the cost and time to evaluate the conversation," says Zac Imel, chief science officer and co-founder of Lyssn. More accessible, AI-powered forms of therapy include chatbots. These can help support patients between sessions, collect useful data and provide emotional support to people who cannot access therapy because of stigma, time or financial reasons. Chatbots simulate a conversation between humans, using AI to learn from examples of real conversations. The AI in this case is often trained on therapy session transcripts. It replicates how a therapist would respond to a patient with some accuracy. UK's National Health Service (NHS) says up to 8 million people in England want to access mental health treatment but do not qualify for it. High costs, long waiting lists and not wanting to unburden themselves to a stranger also keep people away from therapy. "One barrier to providing care to more people is that CBT, the most common evidence-based treatment for depression, is hard to teach. Having tools to speed up the training would help," Dr. Paola Pedrelli, Assistant Professor of Psychology at Harvard Medical School, told me. Additionally, supervisors usually evaluate and provide feedback to therapists in training, but there isn't always the time or resources. AI could bridge that gap. Pedrelli is part of a team that worked on a project using machine-learning algorithms to diagnose and monitor major depressive disorder. "Sometimes treatment takes months to work. Tools to speed the process would be beneficial," she added. AI's advantage over the human brain AI's biggest advantage over the human brain is being fast and reliable at analyzing data, said Imel of Lyssn. AI can quickly analyze, process and gain insight from large data sets, making it a powerful tool in mental healthcare where markers of recovery are vague. "With repetitive tasks, humans get tired and can drift over time. And if you show a human the same conversation twice, they might evaluate it differently. With AI – same data in, same answer out," Imel says. How AI-powered mental health can help employees AI-based therapy tools like Ieso's CBT companion app, Ellie, Woebot designed by Institute for Creative Technologies (ICT) at the University of Southern California, The Trevor Project's Crisis Contact Simulator and others cannot replace human therapists but help improve access and reduce cost. In a randomized, controlled trial of 70 participants, Woebot users displayed a significant decrease in depression symptoms compared with the control group. Both groups showed a decrease in anxiety. Those experiencing mental distress or stress at work could be directed to therapy bots as a bridge between needing therapy and getting access to it. Chatbots can also gather data about how a patient feels and suggest clinical intervention where required. Organizations considering employee access to therapy bots should consult an expert and make sure therapy is available alongside these solutions rather than as a substitute. Privacy and security in AI-powered therapy Alongside benefits, AI-powered therapy programs come with obvious cybersecurity and privacy risks. Sensitive and private conversations between patients and therapists could be exposed or manipulated. Iron-clad security is the first step to protecting patient privacy. Tablan and Imel shared the importance of data security to their companies and how they keep patient data safe, such as using multiple layers of security and robust security certifications. "Most people working at Ieso can't access this data. It's accessible to computers, but few humans," said Tablan. Even with the strongest security practices, risks to patient privacy still exist, as a lot depends on humans who can access the data. But those involved believe the potential benefits of AI-powered therapy outweigh the risks. AI-augmented, not AI-based therapy There's much to suggest unconscious bias is present in the therapy room as in other parts of life. Black and minority ethnic people are less likely to find counseling fit for purpose. Lesbian, gay and bisexual people also report greater dissatisfaction with counseling and psychotherapy than their heterosexual counterparts. When AI programs can imbibe biases in data used to train them, there must be concerns that AI-based outcomes could further marginalize some patients. Dr. Tonya Davis, faculty member at Northwestern University, Illinois, suggests "unconscious biases – things hidden just beneath the surface of our awareness" might impact training AI chatbots. "I think that if there is a deliberate effort to identify, understand and resolve biases beneath the surface of our awareness, we could be one step closer to addressing the cultural challenges in person-to-person interactions, thereby minimizing these challenges in the development of AI." Pedrelli said, "There have been cases where AI has provided inappropriate directions in the context of therapy. And AI is still unable to detect subtle emotional changes." However, AI tools only augment diagnosis and therapy. They shouldn't be relied on for unilateral decisions on patient care. "The tools we've built look over our quality of care – they never make any decisions automatically," said Tablan. "They just present information to a qualified clinician who has access to the transcripts and make up their own minds." Imel doesn't describe what Lyssn does as "AI-based therapy." Instead, he says, "This is about using technology to augment the human talent of therapists. So, it's human-based therapy, augmented by AI."
data cooling center

How Ireland is using waste heat from data centers to warm homes

  • min read
    • Home to the physical servers that keep the Cloud aloft, data centers have become vital pieces of global IT infrastructure. These centers now provide computing horsepower for billions of connected devices. But our digitized world needs a lot of energy to function. Data centers consume over 1 percent of the world's electricity. With thousands of servers to run and keep cool, large data centers can use as much electricity as a small city. Ireland's favorable geography and regulation have so far attracted over 70 data centers, powering global Cloud services for tech giants like Microsoft and TikTok. Managing the energy footprint of data centers is a challenge that will only grow. Ireland's energy regulator says data centers could use almost 30 percent of the country's electricity by 2027, endangering climate goals. Adding to the energy toll, over 75 percent of data center electricity becomes waste heat. Could the way data centers act like giant radiators help reduce some of their climate impact? Data centers make great heaters Ireland's weather is famously cold and wet at almost any time of year. Keeping homes and businesses warm, mostly using gas or oil boilers, makes up nearly a third of Ireland's carbon emissions. For John O'Shea, Energy Systems Analyst at Dublin energy agency Codema, the synergy between Ireland's heating needs and its data centers' waste heat is clear. "In winter, a data center can provide heating up to 85 degrees Fahrenheit (29 degrees Celsius) similar to a gas boiler, with better energy efficiency than a heat pump in a new house." O'Shea and his team are part of the Tallaght District Heating Scheme through the EU-funded Heat Net project. And it's on track to turn data center heat waste into a sustainable heat source for the Dublin suburb's homes and businesses. From 2022, water cooling servers in Tallaght's Amazon Web Services (AWS) data center will be upcycled through a new district heating network. A new way to approach an old solution As a way to heat buildings collectively in urban areas, district heating schemes are nothing new. In Scandinavia, the 1970s oil crisis made sustainable heating a priority for urban planners. In Copenhagen, almost 95 percent of heating comes from reused waste heat from factories and other heat emitters. Although data centers have been used to power existing district heating networks in Scandinavia, Tallaght might be first to build a new heating network around a data center. Using data center waste heat to provide low cost, sustainable heating is a rare win-win climate solution. O'Shea says, "From phase one, we'll save 1,500 tonnes of CO2 each year by using something that's otherwise vented into the atmosphere." He thinks the solution has global potential, pointing to a paper he co-authored showing unconventional heat sources like data centers could provide 10 percent of the EU's total heating and hot water. With efficient heating comes efficient cooling The district heating program also helps reduce another big environmental impact of data centers: Water use. Many data centers use evaporated water to cool servers. At peak times, one data center can use over a million liters of water a day. In return for transferring waste heat to the network, the center gets cooler water back, reducing or even removing the need for evaporation cooling. O'Shea says the system's benefits go even further. "Because our network is always monitoring heat output, we've got an extra set of eyes on the health of the data center cooling system." This extra monitoring could save money and hardware damage – a recent study of 41 data centers by leading digital infrastructure provider Vertiv found the average cost of a downtime event was over 506,000 US dollars. The most common cause was power or cooling failures. Beyond district heating Paul Deane, a researcher fellow at Ireland's MaREI Environment Research Institute, agrees the Tallaght heating solution has big potential but notes combining data centers with district heating "is not a magic bullet." Deane points out that in Ireland alone, data centers may contribute "around 1 million tonnes [of C02] each year by 2030." He thinks data center energy use demands a combined approach. "We need proactive solutions like district heating and other measures like greater renewable energy use and carbon offsetting." Some in the Irish parliament have described growing numbers of data centers when the government is reaffirming its commitment to a carbon-neutral future as "out of control," but Deane sees a silver lining. "You can look at data centers in two ways: As part of the problem or part of the solution. I like to look at them as a solution." He adds, "We need data centers, but we also need them to be cleaner." For Deane, proactive solutions like Tallaght's district heating system are a step in the right direction. With free heat from an industrial by-product and dramatically reduced CO2 emissions and water use, it's hard to argue with that.
Drones and emergency response

How drones with neural networks could transform disaster response

  • min read
    • Climate change and COVID-19 have made conversations on how we respond to emergencies mainstream. We've become more aware of the essential workers who risk their lives to save lives or even just keep things ticking over. We've seen multiple applications of new technology fast tracked in the quest to address never-before-seen challenges. In disaster relief, it's great to see ever-widening applications for drones (also known as unmanned aerial vehicles or UAVs,) with their ability to give a fast and relatively inexpensive overview. For example, during 2020's locust invasion, Kenyan Red Cross used drones to assess impact on agriculture and livestock and the effectiveness of control efforts. In Oregon, California and other fire-ravaged US states, firefighters used drones to map fires and even to drop incendiary fireballs that help stop forest fires. These start small fires, removing fuel an approaching fire needs to spread. Artificial brain takes to the sky At Kaspersky, we've been working on a particular contribution to making it easier for authorities to respond to disasters and emergencies with drones and artificial intelligence (AI.) We're piloting an emergency analytics system that uses a neural network. These are mathematical models or algorithms made up of interconnected nodes (neurons) working a little like a human brain. Drones gathering data and identifying objects Of this technology's many possible applications, the most important are in situations where human life is at risk. Drones collecting data for real-time analysis by neural networks can search for missing people, animals and houses washed away in floods. It can assess damage from aerial images after an incident or provide crowd management information, helping to avoid human crush incidents. We're working with drone manufacturers Albatros and have already installed the Kaspersky Neural Network in two of their drone models. In developing the system, we focused on its capacity to detect small objects in limited visibility. For example, emergency services need to find buildings that survived after an earthquake and distinguish residential from non-residential buildings. In a flood, they need to know the amount of debris in a flooded area. Machine learning technology like a neural network can process images and recognize objects instantly. In one of our tests, the Kaspersky Neural Network processed thousands of high-resolution images of rough terrain on a laptop with limited computing power in a few minutes. Our neural networks self-teaches – each time you use it, results improve. Trained on tens of thousands of images, it can recognize and classify people, houses, cars and more. You can process data onboard a drone or on a server or laptop after the flight. Nikita Kalmykov, CEO of drone makers Albatros says, "The system is initially focused on incident analytics and people search. It can also help in the agricultural, construction and oil industries. It has the flexibility customers need for intelligent aerial surveys." Concerns around drones in emergency relief Using drones that process and categorize information using a neural network comes with challenges. Drone technology researcher Faine Greenwood points out public distrust of drones has slowed their adoption in disaster relief. To help smooth over this turbulence, Humanitarian UAV Network educates people and develops standards for humanitarian drone use. When training a neural network, as with all AI, it's important to consider potential bias in data sets and work to reduce it. For example, can the system identify people of all skin colors, genders and body sizes? Can it identify buildings or plants seen in a wide range of countries? Gathering data ethically and storing it securely is another area of concern. In their best practice guidance, Humanitarian UAV Network advises, "Only collect aerial data that has a clear value for specific humanitarian purposes. Other data could be used in discriminatory or other negative ways, or exploited by third parties to harm local communities." The International Red Cross also issues a handbook for data protection in humanitarian action. One thing is clear: In a world of growing challenges in preserving human life, every new tool is worth having. While AI rapidly transforms every part of our lives, drones using neural networks have an important role in disaster relief. It's no surprise humanitarian organizations and emergency services increasingly use drones in their work. Processing information with neural networks can add another level of efficiency and effectiveness to their important work. I hope we'll see this technology widely adopted, and with it, many lives saved.
drones emergency response

Will drones be the next tech to transform healthcare?

  • min read
    • It was the longest five seconds of Dr. Shaf Keshavjee's life. On a late afternoon in 2021, he waited on the rooftop of Canada's Toronto General Hospital, watching a drone crest the horizon and hover above its landing pad. "It seemed to hover forever," says the director of the Toronto Lung Transplant Program. "In medicine, you do many stressful things with unknown outcomes. You're trained to handle it, because you have complete control of the situation," he tells me. "But this was different. I had to trust technology out of my control." The lungs, filled with oxygen and set at the correct temperature, traveled hundreds of feet in the air for nearly a mile over busy downtown Toronto. It took six minutes. This breakthrough flight was another rung on the ladder of a new application for drones in healthcare: Delivering organs quickly and efficiently for life-saving surgery. But at each rung, there are challenges – like responsible management of the crowded airspace of a new kind of highway. Flying medical supplies to kidneys and corneas Drones, unmanned aircraft systems (UAS) or unmanned aerial vehicles (UAV) were once regarded mainly as a hobby. But they're now poised to reach a market value of 40 billion US dollars by 2027. Some hope autonomous aircraft like MightyFly will soon deliver goods to shoppers. Hunter Kosar, owner of US shipping company Twisted Nail Broker Services, noted a niche hybrid-electric, vertical take-off and landing (VTOL) autonomous aircraft could focus on transporting time-sensitive supplies like organs. "Organs are light, expensive and needed fast. Healthcare would pay a lot to receive a heart for transplant in 90 minutes instead of 4 hours." In 2019, Zipline crafted a fleet of drones to carry medical supplies to Ghana's remote areas. In 2021, UPS Flight Forward achieved a US first by drone-delivering COVID-19 vaccines in North Carolina. To healthcare specialists, drones are an obvious next step for delivering organs beyond the usual helicopter or plane. In 2020 drone start-up MissionGO Unmanned Systems' medical cargo branch partnered with Nevada Donor Network to successfully deliver kidneys and corneas. The 10-mile (16 km) kidney delivery was the longest organ delivery flight in drone history. The organs were intentionally unusable as the flight's purpose was research. Lab technicians took a graft of the delivered kidney and found no negative effects from the flight. "The organs didn't degrade," says MissionGO CEO Scott Plank. Plank is encouraged by healthcare working with airspace "to solve a major problem, produce a lower carbon footprint and foster a more efficient supply chain." MissionGO is one of the few drone firms with US Federal Aviation Administration (FAA) certification to deliver human organs for transplant. It all began at University of Maryland in 2019 when a university team used a drone to deliver kidneys to a patient 2.8 miles (4.5km) away within 10 minutes. University of Maryland Medical Center's Dr. Joseph Scalea recognized he was onto something monumental and, within months, co-founded MissionGO. While organ delivery by drone is in its infancy, a concern nags enthusiasts like Dr. Keshavjee. "There must be a focus on safety and compliance. What will happen when drones take to the skies and start running into each other?" Managing a new kind of highway "Call us the Google Maps for drones, but the roads don't exist yet," says Michael Healander. His Detroit-based start-up Airspace Link may be about to become the US air traffic control system for drones. Already FAA-approved to oversee low altitude flights, Airspace Link helps drone pilots know where they can fly, any temporary flight restrictions ahead and nearest airport locations. They also communicate with 2,700 US airports, alerting them to any drones coming into their airspace. They use more than 50 datasets, from building footprints and heights to helipad locations to hyperlocal weather. Healander says drones are the future of delivering organs safely and efficiently. He also foresees other medical uses for drone delivery. "Delivering prescriptions to people with mobility challenges or in rural areas," he suggests. "Blood samples have to go to a lab, so instead of a patient waiting days, the drone could deliver the samples and the patient receive results in hours." Next time you happen to catch sight of a drone careening across the sky, it might be more than a tech lover having fun with a new toy. You may be witnessing a seismic shift in how we deliver critical medical treatment to those most in need.

How tech’s brightest stars are putting accessibility first

  • min read
    • Today, tech firms are starting to realize it's good for business if their technology is accessible to all users, whether disabled or non-disabled. But knowing that accessibility matters – and making it a core business priority in actions as well as words – are different things. I've been speaking with two companies celebrated for putting accessibility first in product design – fast-growing accounting software business Xero and accessible app and software designers Axess Lab. I also spoke with Siteimprove – a company making software that helps businesses catch and fix website accessibility problems. "Accessibility is important because customers are at the center of everything we do," says Laila Coulton, Head of Digital Accessibility at Xero. "Our culture values diversity and inclusion. We want to make a difference by championing these values within our sector and the broader community. As a large tech company, we believe it's our obligation." Hampus Sethfors, Co-founder and Accessibility and User Experience Specialist at Axess Lab, thinks similarly. "I see it as being on the right side of history. People with disabilities have been excluded and discriminated against. It's time humankind stepped up. Making the digital space inclusive is a huge part of that." Sethfors believes improved accessibility for disabled people benefits all users. "I've got a baby at home and constantly find myself one-handed, lacking time and lacking sleep. Building products that work for people with impairments is a way to build awesome products for everyone." How common are accessibility problems? Axess Lab examined digital products like banking apps, online shopping sites and food delivery apps to find out if disabled users can complete routine tasks. They've found problems so widespread that, more often than not, web users with disabilities simply can't use them. Sethfors thinks one of the main reasons behind this is that software engineering and web designer education rarely includes practical accessibility skills or knowledge. "Too few tech professionals have accessibility training. If you're trained, accessibility is little or no extra effort. Picking colors with enough contrast doesn't take longer than picking colors that contrast poorly – you just need to know how." Accessibility, usability or both? Some use terms like accessibility and usability interchangeably. But are they the same thing? Coulton of Xero says, "The two are intertwined. I challenge my teams to start with usability rather than ticking off accessibility compliance criteria. The focus should always be on the user experience. Accessibility is making sure as many people as possible enjoy those usable experiences." Sethfors points out, "If your product is only usable for some, it should be called Some User's Experience, or SUX, as Ubisoft accessibility specialist Billy Gregory tweeted. Usability is more than accessibility, but a product can't be usable unless it's accessible." Accessibility can mesh well with security and affordability too. Take, for example, Motorica, who work with prosthesis users to create high-tech, secure and affordable artificial limbs. Kaspersky helps Motorica make sure its prostheses are safe from cyber-intrusion. Focus on making things work for users Coulton says Xero reviews designs using the Perceivable, Operable, Understandable and Robust (POUR) framework from the Web Content Accessibility Guidelines (WCAG). The World Wide Web Consortium created it in consultation with disabled web users to give standards for making digital products accessible. "We review and test code, including automated and manual testing against the WCAG success criteria. We do functional testing using screen readers such as VoiceOver, NVDA and TalkBack. We also test and research with users with disabilities." Sethfors says sometimes businesses get too hung up on the guidelines. "They're long and complex, but accessibility is super interesting, fun and engaging. Instead, focus on making things work for users." Jennifer Chadwick, Senior Accessibility Consultant at Siteimprove, agrees. "Using a checklist to comply with WCAG is an excellent practice to introduce teams to implementing accessibility. Companies should also run regular usability testing with people with disabilities. Sites can comply with WCAG but not be optimal for users, so using the guidelines and conducting user testing is best." Where accessibility work fits When is the right time in development to think about accessibility? Coulton says, "Across the whole cycle. We start with inclusive research and setting the accessibility scope. Designers and Front End Developers must ensure accessibility is part of their definition of 'done.' We validate with user testing and the WCAG success criteria." Sethfors thinks you can never start too soon. "I'd start before the development cycle and build accessibility into current business habits. If you acceptance-test regularly, add accessibility criteria. If you user-test every other month, recruit one or two diverse users for each test. Take small steps, everywhere, all the time. It's more effective and fun, and less costly." Tobias Christian Jensen, Siteimprove Digital Accessibility Specialist, says it's crucial to be proactive. "Fixing accessibility retroactively is like adding plumbing after building a house. Accessibility should be a part of every step." Jensen recommends adopting a practice of Shifting Left, described by Siteimprove's Chadwick as, "Moving efforts around designing and testing for accessibility issues as far back in the workflow as you can. Everyone – from UX and graphic designers; to content writers; to developers – must consider the needs and preferences of people with disabilities as early as possible." Finding testers with disabilities So at some point (ideally, many points,) you'll need to find people with a range of disabilities to test your products. These include physical impairments, like motor impairment and using prosthesis, low vision, Deaf or hard of hearing, but also invisible impairments, like memory loss and inability to focus. Then there's neurodivergence such as autism, ADHD and learning difficulties, and much more. Sethfors suggests, "Find and partner with disability organizations in your area. Make sure you have a way to pay users to take part. If you need help recruiting, Fable specializes in recruiting diverse test users for larger organizations." Siteimprove has a rewarding partnership with Fable. "Our software monitors your efforts to meet WCAG conformance and best practice for code. We combine this with usability assessments for the most complex and high-traffic webpages by Fable's testers. Both provide valuable reports on barriers to remove." Starting your accessibility journey Coulton points to Sheri Byrne-Haber's words in her handbook for designers, Giving a Damn About Accessibility. "To avoid the peaks and valleys of the accessibility emotional roller coaster, people just getting started on their accessibility journey need to accept the following statement at face value: Your first effort at accessibility is unlikely to be outstanding. Don't use this as an excuse." Sethfors adds, "If you approach accessibility in the right way, you'll have a blast, make your team proud and create a better product for everyone."
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