Français You must have JavaScript enabled to use this form. 1 2 IntroductionThe objective of this survey is to measure the impact of digital technologies on the lives of Canadians with disabilities. Information gathered will help to better understand how individuals with disabilities use or do not use the Internet and related computer technology. The questionnaire will take about 5 minutes to complete. The results from the survey will be used as a catalyst to further the economic and social inclusion for all people with disabilities in Canada. The survey results will also help improve the Neil Squire Society programs. The first questions are about the nature and extent of your disability. Do you have a disability? * Yes No What is the nature of your disability? (Check as many as apply.) Agility/Flexibility Communication Developmental Environmental Sensitivity Hearing Learning Memory Mental Health Mobility Pain Seeing Other Prefer not to answer I have another type of disability – please specify Overall, would you say that your disability limits your everyday life... None of the time Some of the time Most of the time All of the time Prefer not to answer The next few questions ask about your access to the Internet. Do you use the Internet? * Yes No How do you access the Internet? (Check as many as apply.) A Computer A tablet A Smart Phone Prefer not to answer Do you use any assistive devices to access the Internet, such as screen readers, voice input technology, text magnifying software, etc.? (Check as many as apply) Yes, I have assistive device(s) for my computer. Yes, I have assistive device(s) for my computer, but I need more. Yes, I have assistive device(s) for my tablet. Yes, I have assistive device(s) for my tablet, but I need more. Yes, I have assistive device(s) for my smartphone. Yes, I have assistive device(s) for my smartphone, but I need more. No, and I do not need any. No, but I need assistive device(s) for my computer. No, but I need assistive device(s) for my tablet. No, but I need assistive device(s) for my smartphone. I do not know what an assistive device is. I prefer not to answer. What do you use the Internet for? (Check as many as apply.) Work Do research Social media (Facebook, Instagram, Snapchat) Blogs (reading, creating) Video conferencing such as Zoom, Microsoft Teams, Google meetings, WebEx Listen to music using streaming services such as Spotify Play games Watch YouTube videos Watch TV, watch Netflix or other streamlining services Listen to the radio Listen to podcasts Read newspapers, magazines, books Buy tickets Book appointments Attend a health care appointment Financial (banking, paying bills) Online shopping (groceries, other items) Other Prefer not to answer Other Internet uses – please specify Do you have difficulty using the Internet? * Yes No How do you have difficulty using the Internet? (Check as many as apply.) It is difficult to search for information. It is difficult to navigate the web or to find the right webpages. It is difficult to use online services such as filling out forms or buying/ordering things. It is difficult to understand the content on webpages. It is difficult to use keywords to search for information. It is difficult because of the way that the webpages are designed. It is difficult because my assistive technology devices do not work with the Internet. It is difficult but I cannot describe the difficulty. I have other difficulties using the Internet. I prefer not to answer. I have other difficulties using the Internet – please specify Do you need someone to help you do things online? No, I do not need any help. Yes, some of the time. Yes, all of the time. Prefer not to answer. In the past year, has your use of the Internet… Increased Stayed the same Decreased Prefer not to answer What impact has having access to the internet had on your life? (Check as many as apply.) I feel more connected. I have been able to improve my income. I am able to continue my education/training. Other I prefer not to answer. Other impact – please specify Why do you not use the Internet? (Check as many as apply.) I’m not interested. It is too difficult to use. I do not know how to use it. I do not have a computer or a tablet or a smartphone. I have no Internet connection. I do not have the assistive devices that I need. It is too expensive. I have other reason(s) I don’t know. Prefer not to answer I have other reason(s) – please describe What impact has not having access to the internet had on your life? Now, a few questions about you. What is your postal code? What is your age? What is your gender? Man Woman Non-binary Prefer to self-describe Prefer not to answer Prefer to self-describe What is the highest certificate, diploma or degree that you have completed? Less than high school diploma or its equivalent High school diploma or a high school equivalency certificate Trades certificate or diploma College, CEGEP or other non-university certificate or diploma (other than trades certificates or diplomas) University certificate or diploma below the bachelor’s level Bachelor’s degree (e.g., B.A., B.A.(Hons), B.Sc., B. Ed., LL.B.) University certificate, diploma or degree above the bachelor’s level Prefer not to answer What is your employment status? I am self-employed I am employed part time (less than 37.5 hours per week) I am employed full time (37.5 hours per week) I am unemployed and looking for work I have a job but have been laid off I am retired I am not working and I am not looking for a job Prefer not to answer Other Other, please specify What are your living arrangements? I live alone. I live with my relatives. I live with people who are not related to me. I prefer not to answer. What was your personal income (after tax) in 2020? No personal income in 2020 Under $20,000 $20,000 to $49,999 $50,000 to $99,999 $100,000 or more Prefer not to answer Finally, the Neil Squire Society may wish to contact you at a later date to follow up on some of your answers. If you are willing to possibly receive a follow-up, please provide your first name and either an email address or a telephone number. First name Telephone number Email address Given that you do not have a disability, the remaining questions on the survey would not be applicable to you. Please share the link with others so that we can get information from as many Canadians with disabilities as possible. Leave this field blank Next Page >
