UNDERSTANDING AND SUPPORTING THE
ADOPTION OF ASSISTIVE TECHNOLOGIES
BY ADULTS WITH READING DISABILITIES
Dissertation
Defense
August 24, 2010
Katherine Deibel
Computer Science & Engineering
University of Washington
Background on reading disabilities
Identification of a need
Development of an assistive reading tool
Evaluatory study
Demonstration of effectiveness
2
Dissertation Defense
August 24, 2010
Defining AT Success
“When the participants used BookWise,
“their mean reading rate increased 25
“wpm, or 16%, ...”
q Elkind (1996)
Success
3
Dissertation Defense
Performance
Improvement
Likelihood
Of Being Used
August 24, 2010
8-75% of AT abandoned after
purchase (avg. rate is 35%)
Waste of time, funds, and
resources for all involved
Pessimism, defeat, and
learned helplessness
Refs: King (1999); Riemmer-Reiss & Wacker (2000); Tewey et al (1994)
4
Dissertation Defense
August 24, 2010
Research Questions
What technologies are used by adults
with reading disabilities?
What factors (technical, sociocultural,
environmental) influence technology
usage by adults with RDs?
How can we use these factors in the
design of better technologies that are
actually used?
5
Dissertation Defense
August 24, 2010
Contributions
Applying Value Sensitive Design to assistive
technologies and technology adoption
Literature analysis identifying critical value issues
among stakeholder groups
Case studies of online message board discussions
about RDs and technology
Interviews with young adults with RDs
Value-based technology reviews
Value-driven design guidelines
Proposal for socially -flexible reading tools that
support users with the aid of meta -tools
6
Dissertation Defense
August 24, 2010
Contributions (continued)
Synthesis of PATTC framework for
understanding technology usage
Identification and hypotheses about lack of ATs
for adults with RDs
Applying semiotic engineering to AT design
Expansion of VSD indirect stakeholders
Refinement of VSD methodologies
7
Dissertation Defense
August 24, 2010
Outline
Introduction
Background
Value Sensitive Design Methodology
VSD Research Highlights
Conclusions and Future Work
8
Dissertation Defense
August 24, 2010
Multiple Disciplines
Insights from many research areas:
Computer Science
Human-Computer Interaction
Assistive Technologies
Technology Adoption
Disability Studies
Education
Reading Sciences
Reading on Computers
9
Dissertation Defense
August 24, 2010
Critical Topics
What is a Reading Disability?
How does an RD impact the life of a person?
What ATs for RDs are currently available?
What is known about AT usage and RDs?
What drives [assistive] technology adoption?
10
Dissertation Defense
August 24, 2010
Reading Disability
A syndrome of multiple conditions affecting
the reading process despite sufficient
 Intelligence
 Education and practice
 Visual ability
Most common form is dyslexia
Affects 7-15% of the population
All languages
Approximately 50% of all U.S. postsecondary
students registered with disability services
Refs: NCES 1999-046; Peer & Reid (2001); Sands & Bucholz (1997); Wolf & Bowers(2000)
11
Dissertation Defense
August 24, 2010
Physical Traits
 L etter misid ent if icat io n
 L e ss sh o rt - te rm me mo r y
 Wo rd misid ent if icat io n
 S lowe r re ca ll
 Po o r rea d in g f lu en c y /spe e d
 V isu a l me mo r y issu e s
 Wo rd a mb ig u it y
 Po o r mo to r co o rdin at ion
 Po o r rea d in g co mp re h e nsio n
 O rga n izat io n sk ills
 V isu a l st ress
 S p e llin g d iff ic u lt ie s
 Eye st ra in a n d fat ig u e
 Writ in g d iff ic u lt ie s
 D ist ra c ted visu a l atte nt io n
 S t ro n g sp at ia l awa re n e ss
 Wo rd a n d lin e sk ip p in g
 A bst ra c t visu a lizat io n
 Po o r seq u en c in g sk ills
 Go o d at late ra l t h in k in g
 Atte nt io n d ef ic it s
 Ta le nt s in a rt a n d d e sig n
Refs: Evans (2001); Edwards (1994); Everatt (1999); Peer & Reid (2001); Sands & Bucholz (1997); Wilcutt &
Pennington (2000); Winner et al (2001); Wolf & Bowers(2000)
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Dissertation Defense
August 24, 2010
 Wo rd misid ent if icat io n
 Po o r rea d in g f lu en c y /spe e d
 S lowe r re ca ll
 V isu a l me mo r y issu e s
 Po o r rea d in g co mp re h e nsio n
 O rga n izat io n sk ills
 Eye st ra in a n d fat ig u e
Writing
 Po o r mo to r co o rdin at ion
 V isu a l st ress
Vision
 L e ss sh o rt - te rm me mo r y
 Wo rd a mb ig u it y
 S p e llin g d iff ic u lt ie s
 Writ in g d iff ic u lt ie s
 D ist ra c ted visu a l atte nt io n
 S t ro n g sp at ia l awa re n e ss
 Wo rd a n d lin e sk ip p in g
 A bst ra c t visu a lizat io n
 Po o r seq u en c in g sk ills
 Atte nt io n d ef ic it s
Strengths
Reading
 L etter misid ent if icat io n
Memory
Physical Traits
 Go o d at late ra l t h in k in g
 Ta le nt s in a rt a n d d e sig n
Refs: Evans (2001); Edwards (1994); Everatt (1999); Peer & Reid (2001); Sands & Bucholz (1997); Wilcutt &
Pennington (2000); Winner et al (2001); Wolf & Bowers(2000)
13
Dissertation Defense
August 24, 2010
Social Aspects
Depression
Anxiety with reading-related tasks
Self-doubt and low confidence
Feelings of isolation
Teasing and bullying
Expectations from others to fail
Accusations of laziness or fraud
Refs: Alexander-Passe (2006); Cory (2005); Edwards (1994); McDermott (1993); Peer & Reid (2001); Riddick
(1995); Williams & Ceci (1999); Zirkel (2000)
14
Dissertation Defense
August 24, 2010
Eight dyslexia “success” stories
Revelation of childhoods of:
Self-doubt
Depression
Feelings of isolation
Teasing from peers
Abuse from teachers
Expectations to fail
Janice Edwards (1994)
15
Dissertation Defense
Reluctance to continue
education despite admission to
universities
August 24, 2010
The Acquisition of a Child
by a Learning Disability
McDermott (1993)
8 year old Adam
Testing
Sessions
Classroom
Lessons
Four different reading scenarios
Different levels of awareness of
Adam’s RD by others
Worse performance with greater
awareness
16
Dissertation Defense
Cooking
Club
Everyday
Life
August 24, 2010
Other Studies
Clumsiness associated with dyslexia makes
students more likely to be bullied (Peer, 2001)
Dyslexia is the major source of daily anxiety in
lives of adolescents (Tsovili, 2004)
Increased risks of anxiety and depression with
reading-related tasks (Alexander-Passe, 2006)
Reactions of anger and denial by college
students with recent RD diagnoses (Armstrong
& Humphrey, 2009)
17
Dissertation Defense
August 24, 2010
Invisibility and Disclosure
RDs are not visually apparent to others
Allows individual to hide as “normal”
Avoid disability stigma
Limit knowledge to trusted others
Delay asking for help unless a crisis
necessitates the need for support
Students with RDs avoid registering with
disability services despite past use of
accommodations in K-12
Refs: Goffman (1962); Cory (2005); Matthews (2009)
18
Dissertation Defense
August 24, 2010
Critical Topics
What is a Reading Disability?
How does an RD impact the life of a person?
What ATs for RDs are currently available?
What is known about AT usage and RDs?
What drives [assistive] technology adoption?
19
Dissertation Defense
August 24, 2010
Assistive Technologies
Focus on reading support
Commercially available options
Audiobooks / Text-to-speech
Highlighting
Electronic Dictionaries
Color Overlays
Refs: Raskind & Higgins (1998); Lange et al (2006)
20
Dissertation Defense
August 24, 2010
ATs – Audiobooks / Text-to-Speech
Extensively studied and modified
Benefits
Bypasses letter and word processing deficits
Improves reading rate and word
identification
Requirements
Strong auditory skills (10-15% not helped)
Text digitization / OCR / Portable scanners
Quality computer voices / readers
Refs: Elkind et al (1995, 1996); Olson et al (1997); Olson & Wise (2006); Sands & Buschholz (1997)
21
Dissertation Defense
August 24, 2010
ATs – Highlighting
Cardboard text windows or automated
line and word highlighting
Benefits
Improved reading speed
Less distraction from surrounding words
Requirements
Digitization of texts (automated only)
Refs: Elkind et al (1995, 1996); Pepper & Lovegrove (1999); Hecker et al (2002)
22
Dissertation Defense
August 24, 2010
ATs – Electronic Dictionaries
Provide definitions on demand
Benefits
Portable
Improved understanding
Requirements
Text entry / Portable Scanner
Sense disambiguation
Refs: Raskind & Higgins (1998); Lange et al (2006)
23
Dissertation Defense
August 24, 2010
Assistive Technologies – Color Overlays
Colored transparencies placed over text
Benefits
Reduces visual stress and eye strain
Requirements
Ophthalmological tests to
determine need and optimal
color for each individual
Refs: Evans (2001); Jeanes et al (1997); Smith & Wilkins (2007); Wilkins et al (1996, 2005)
24
Dissertation Defense
August 24, 2010
Letter misid ent if icat ion
E lec t ron ic
D ic t io n a ry
Word misid ent if icat ion
Po o r re a d in g f lu e n c y / sp e e d
Wo rd a mb ig u it y
Po o r re a d in g co mp re h e nsio n
V isu a l st re ss
T TS
C o lo r
O ve rlays
Eye st ra in a n d fat ig u e
Wo rd a n d lin e sk ip p in g
Poor seq u en c in g skills
Less sh o rt - te rm me mo r y
Hig h lig ht ing
S lowe r re ca ll
V isu a l me mo r y issu e s
Atte nt io n d ef ic it s
Po o r mo to r co o rdin at ion
25
Dissertation Defense
August 24, 2010
Summary of Available ATs
Lack of diversity in commercial options
Despite diversity inherent to RDs
Near-absolute focus on text-to-speech
Address core letter and word identification deficits
Target primarily basic reading skills
Letter and word identification skills
Aligns with education’s focus on early learning
Not about reading from computer screens
Legacy of past display technologies
Lack of research initiatives from technologists
26
Dissertation Defense
August 24, 2010
Studies of AT Adoption and Usage
Phillips and Zhao (1993)
Elkind et al. (1996) **
Jeanes et al. (1997) **
Wehmeyer (1995, 1998)
Martin and McCormack (1999)
Riemer-Reiss and Wacker (2000) **
Koester (2003) **
Dawe (2006)
Shinohara and Tenenberg (2007)
Comden (2007) **
Deibel (2007, 2008) **
Personal communications with
AT specialists / researchers
K. Johnson (2008) **
McRitchie (2010) **
** Study involved participants with RDs
27
Dissertation Defense
August 24, 2010
STUDIES OF ASSISTIVE TECHNOLOGY ADOPTION
TYPES OF ASSISTIVE TECHNOLOGIES
MANY
Study involved RDs
Study involved no RDs
ONE
0%
100%
FOCUS ON READING DISABILITIES
28
Dissertation Defense
August 24, 2010
STUDIES OF ASSISTIVE TECHNOLOGY ADOPTION
TYPES OF ASSISTIVE TECHNOLOGIES
MANY
Adoption of specific
assistive technologies
Study involved RDs
Study involved no RDs
ONE
0%
100%
FOCUS ON READING DISABILITIES
29
Dissertation Defense
August 24, 2010
STUDIES OF ASSISTIVE TECHNOLOGY ADOPTION
TYPES OF ASSISTIVE TECHNOLOGIES
MANY
Study involved RDs
No studies of
general adoption by
users with RDs
Study involved no RDs
ONE
0%
100%
FOCUS ON READING DISABILITIES
30
Dissertation Defense
August 24, 2010
Critical Topics
What is a Reading Disability?
How does an RD impact the life of a person?
What ATs for RDs are currently available?
What is known about AT usage and RDs?
What drives [assistive] technology adoption?
31
Dissertation Defense
August 24, 2010
Technology Adoption
Multiple theories and frameworks
General:
Diffusion of Innovations ***
Technology Acceptance Model
Lazy User Model
AT Models: King ’s Human Factors
Baker ’s Basic Ergonomic Equation
Kintsch & DePaula Framework
Matching Person & Technology
PATTC Framework (Deibel)
32
Dissertation Defense
August 24, 2010
Diffusion of Innovations
Everett Rogers (1962, 2003)
General model of how new
ideas and technology spread
Applied to multiple fields
Number of adoptions
Has adapted to changes in
communication technologies
Cumulative adoptions
33
Dissertation Defense
August 24, 2010
Diffusion of Innovations
Knowledge and adoption of technologies
are guided by communication networks
and visibility of use
34
Dissertation Defense
August 24, 2010
Implications
People with RDs choose to hide their RD
Unlikely to use ATs publically
Unlikely to discuss AT usage
Unlikely to converse with AT specialists
Lack of communication hinders diffusion
Understanding AT adoption for people with
RDs is about understanding the decision
processes behind disclosure and hiding
35
Dissertation Defense
August 24, 2010
Outline
Introduction
Background
Value Sensitive Design Methodology
Theory
Agenda
VSD Research Highlights
Conclusions and Future Work
36
Dissertation Defense
August 24, 2010
Value Sensitive Design
Methodology for incorporating values
throughout the design process
Developed by Batya Friedman
Applications in urban planning, open -source,
groupware, conservation
Principle features:
Human values
Interactional approach
Direct and indirect stakeholders
Tripartite methodology
Refs: Borning et al (2005); Friedman & Kahn (2003); Friedman et al (2006); Miller et al (2007)
37
Dissertation Defense
August 24, 2010
Human Values
What a person or group of people judge
as important in life
Examples:
Privacy
Human welfare
Freedom from harm
Trust
Identity
Autonomy
Hiding and disclosure reflects
values of privacy and identity
38
Dissertation Defense
August 24, 2010
Interactional Theory
Society shapes technology usage
Technology usage shapes society
Technology adoption is driven by
public communication and usage
Features of an AT can label the
user as having a disability
39
Dissertation Defense
August 24, 2010
Stakeholders
People who are affected by a technology
Direct
Users of the technology
e.g. doctors using a patient database
Indirect
Non-users but still affected
e.g. patients in the database
Disclosure is shaped by the nature of the
relationship (friend, family, teacher, etc.)
40
Dissertation Defense
August 24, 2010
Tripartite Methodology
Conceptual Investigation
Empirical Investigation
– Identify relevant values
and stakeholders
– Confirm and refine
values and stakeholders
– Philosophy informed
– Social science methods
Technical Investigation
– Design and evaluate
technology
– Engineering methods
41
Dissertation Defense
August 24, 2010
Tripartite Methodology
Conceptual Investigation
Empirical Investigation
– Identify relevant values
and stakeholders
– Confirm and refine
values and stakeholders
– Philosophy informed
– Social science methods
VSD methodology embraces
multidisciplinary viewpoints
Technical Investigation
– Design and evaluate
technology
– Engineering methods
42
Dissertation Defense
August 24, 2010
Research Agenda
Use VSD to identify and analyze factors
influencing AT adoption for people with
RDs (and other life choices this group)
Focus:
People: Adults with reading disabilities
Technology: Generic reading widget
43
Dissertation Defense
August 24, 2010
Investigations
Conceptual / Empirical
Stakeholder brainstorming
Value-Theme Literature Analysis
Empirical
Case studies: Online discussions of RDs
Case studies: Interviews with adults with RDs
Technical
Value-based reviews of existing technologies
Value-guided design reviews
Calico: Socially-Flexible Reading Tools and Support
44
Dissertation Defense
August 24, 2010
Investigations
Conceptual / Empirical
Stakeholder brainstorming
Value-Theme Literature Analysis
Empirical
Case studies: Online discussions of RDs
Case studies: Interviews with adults with RDs
Technical
Value-based reviews of existing technologies
Value-guided design reviews
Calico: Socially -Flexible Reading Tools and Support
45
Dissertation Defense
August 24, 2010
Outline
Introduction
Background
Value Sensitive Design Methodology
VSD Research Highlights
Stakeholders
Values
Case Studies
Technologies
Conclusions and Future Work
46
Dissertation Defense
August 24, 2010
Identifying Stakeholders
Direct (use reading widget)
Adults with reading disabilities
Disability services
Human resources
Instructors
Collaborators (students, coworkers, etc.)
Indirect (affected by widget use)
Students in Same Class
Study / Group Partners
Coworkers
47
Dissertation Defense
August 24, 2010
What about…
Those who tease and ridicule?
Bullies?
Teachers who raise/lower self-esteem?
Family members who support?
The society that creates disability stigma?
There are stakeholders who affect
the usage of a technology
48
Dissertation Defense
August 24, 2010
Expanding Indirect Stakeholders
Affected by Usage
Students in Same Class
Study / Group Partners
Coworkers
Affect Usage
Disability advocates
Aware allies
Unaware allies
Stigmatizers
Affected by Usage and Affect Usage
Instructors
AT Developers
Disability services
RD Community
Human resources
49
Dissertation Defense
August 24, 2010
Outline
Introduction
Background
Value Sensitive Design Methodology
VSD Research Highlights
Stakeholders
Values
Case Studies
Technologies
Conclusions and Future Work
50
Dissertation Defense
August 24, 2010
Identifying Values
Apply value framework to the literature
I had been reading
57 papers, articles, and books
Education
Disability Studies
Technology Adoption
Assistive Technology
Reading Sciences
Sociology
Computer Science
HCI
Open coding approach
51
Dissertation Defense
August 24, 2010
Open Coding / Constant Comparative
Taylor & Bogdan (1998)
Method for labeling qualitative data
Labels are not defined a priori
Inductively develop labels from data
Multiple passes used to refine labels
Create
Merge
Support
52
Split
Remove
General Support
Faculty Support
Family Support
Friends Support
Dissertation Defense
General Support
Faculty Support
Family Support
General Support
Faculty Support
Family Support
Support Failure
August 24, 2010
Theme-Value Literature Analysis
Two coding efforts in parallel
Identify common research themes
Informed partially by keywords
21 themes identified
Identify relevant human values
Value suggestions from previous VSD studies
13 values identified
Papers labeled with Theme-Value tuples
Contribution: Annotated Bibliography
53
Dissertation Defense
August 24, 2010
Identified Themes (21)
Assistive Technologies
AT Adoption / Usage
Diffusion / Adoption
Human Factors
Defining Disability
Medical Model
Social Model
Diagnosis
Quality of Life
Education
Laws
54
Dissertation Defense
Accommodations / Treatments
Pride / Acceptance
Self-Advocacy
Embarrassment / Self -Loathing
Invisibility / Disclosure
Stigma
General Support Networks
Faculty Support
Family Support
Support Failure
August 24, 2010
Identified Values (13)
Access
Accountability
Choice
Community
Empowerment
Fairness
Human Welfare
55
Dissertation Defense
Identity
Literacy
Normalcy
Privacy
Respect
Trust
August 24, 2010
Elkind, J., Black, M. S., &
Murray, C. (1996). Computerbased compensation of adultreading disabilities. Annals of
Dyslexia, 46, 159–186.
56
Dissertation Defense
August 24, 2010
Adelman, P. B. & Vogel, S. A.
(1990). College graduates
with learning disabilities:
Employment attainment
and career patterns.
Learning Disability
Quarterly, 13(3), 154–166.
57
Dissertation Defense
August 24, 2010
Percentage of
Papers in Theme
0%
15%
30%
45%
>50%
58
Dissertation Defense
August 24, 2010
Percentage of
Papers in Theme
0%
Papers labeled Pride-Identity: %12
Papers in Pride Theme:
%24
Density:
50%
15%
30%
45%
>50%
59
Dissertation Defense
August 24, 2010
Percentage of
Papers in Theme
0%
15%
30%
Embarrassment/Self-Loathing
45%
>50%
60
Dissertation Defense
August 24, 2010
Human
Welfare
Percentage of
Papers in Theme
0%
15%
30%
45%
>50%
61
Dissertation Defense
August 24, 2010
Respect
Percentage of
Papers in Theme
0%
15%
30%
45%
>50%
62
Dissertation Defense
August 24, 2010
Critical Value: Access
Ability to use a system or service
Involved in
Motivates assistive technologies
Disability laws and policies
Education and schooling
Explicitly supported value
But…
From general disability literature
Access for overcoming barriers
Refs: Kim (2005); Scherer (2005); Scott et al (2003); Vance (2009); Williams & Shoulz (1982)
63
Dissertation Defense
August 24, 2010
Access and Reading Disabilities
Barrier
Access
No Barrier,
Just Difficult
64
Dissertation Defense
This is what reading is
like for people with RDs.
August 24, 2010
Critical Value: Fairness
All individuals should be treated
favorably and have opportunities
to succeed in life
Fundamental to idea of disability
law and accommodations
RD diagnosis and AT purchasing
Both are expensive
Periodic recertification required
Framed as a class issues
Refs: Brown (2009); Mooney (2007); Poplin (1995); Raskind et al (1995)
65
Dissertation Defense
August 24, 2010
Critical Value: Fairness
A major concern of some instructors
The Chronicle of Higher Education
Williams & Ceci (1999) Accommodating
learning disabilities can bestow unfair
advantages.
Zirkel (2000) Sorting out which students
have learning disabilities.
Kriscenski-Perry & McColm (2001). Who
Value
Tension:
really
has learning disabilities, and How
can we help
Instructors
maythem?
object to a reading widget
due to value concerns regarding fairness to
other students
66
Dissertation Defense
August 24, 2010
Critical Value: Literacy
Ability to consume and produce
information in a prescribed way
(i.e. reading and writing)
Necessary for participating in
today’s information society
Explicitly supported value
Refs: Kist (2004); New London Group (1996)
67
Dissertation Defense
August 24, 2010
Critical Value: Literacy
Expectation that a member of society
can read and write
Why Johnny Can’t Read (Flesch, 1955)
Source of embarrassment
Mocking of poor spelling or handwriting
(Cory, 2005); Tanner, 2009)
Avoidance of reading tasks (Edwards,
1994; Tanner, 2009)
Not limited to only people with RDs
Gomez et al (2004). Textual tactics of
identity.
68
Dissertation Defense
August 24, 2010
Critical Value: Normalcy
Societal Perspective:
The degree to which a person
conforms to the ideals of a society
Personal Perspective:
An individual’s conception of the
qualities of other members of
society are and how they compare
to the individual’s own
69
Dissertation Defense
August 24, 2010
Critical Value: Normalcy
Earlier classical concept of the
unreachable ideal
Entered English language c. 1860
Result of industrial, medicine, and
science revolutions
Based on notions of statistics / averages
Associated concepts
Conformity
Rejection
Average
Isolation
Sameness
Typical
Refs: Davis (1995); Foucault (1995); Goffman (1962); Mooney (2007)
70
Dissertation Defense
August 24, 2010
Critical Value: Normalcy
Reasons for inclusion as a value
Basis of medicine and ergonomics
Normal behaviors help keep society
and civilization stable
Used in scholarly definitions of
stigma, disability, and identity
These words are used by people
with RDs and other disabilities
VSD does not mandate that a value
must be positive
Refs: Brown (2009); Cory (2005); Davis (1995); Mooney (2007); Tanner (2009)
71
Dissertation Defense
August 24, 2010
Value Framework of Identity / Disclosure
Literacy
partially
defines
defines
Normalcy
Community
From most
members of
Shapes identity in a
person with an RD
Privacy
Identity
Triggers need to
keep RD private
72
Dissertation Defense
August 24, 2010
Normalcy is a Value Dam/Flow
Literacy
partially
defines
defines
Normalcy
Community
From most
members of
Shapes identity in a
person with an RD
Privacy
Identity
Triggers need to
keep RD private
73
Dissertation Defense
August 24, 2010
Outline
Introduction
Background
Value Sensitive Design Methodology
VSD Research Highlights
Stakeholders and Values Identification
Case Studies
Technologies
Conclusions and Future Work
74
Dissertation Defense
August 24, 2010
Case Studies
VSD Empirical Investigations
Explore, refine, and confirm importance of
identified values and stakeholders
Two efforts
Online Discussion Study
Semi-Structured Interview Study
75
Dissertation Defense
August 24, 2010
Online Discussions Study
Analyze threads from online discussion
boards regarding RDs and technology
Social observation study approximation
Approach
Select threads from boards about RDs
Three threads chosen for analysis
Qualitative analysis using identified themes,
values, and stakeholders as frameworks
Trust participants’ claims of having RDs
76
Dissertation Defense
August 24, 2010
Threads
“A Call for Help”
College student with dyslexia desperately
beseeching help about accommodations
“Composition, Computers, and Disability”
Discussion by college English composition
teachers about supporting disabled students
“Macs, Dyslexia, and a Documentary”
Initial thread about usefulness of Macs for
dyslexics evolves into discussion of recent
documentary “ The Dyslexia Myth”
77
Dissertation Defense
August 24, 2010
Semi-Structured Interview Study
10 interviews with adults with RDs / LDs
1 re-analysis of interview from earlier study
1 pilot participant
8 participants
Conversations about life story, how RDs
shaped their lives, and the role of reading
and technology in their daily lives
Same analysis approach as used in the
Online Discussion Study
78
Dissertation Defense
August 24, 2010
Participants
Recruited primarily from local universities
Students likely to read on a regular basis
Demographics
Gender:
5 males, 5 females
Age:
18-48 (Avg. 28.8)
Diagnosis: 7 childhood, 3 adulthood
International perspective:
1 childhood and college in Britain
1 graduate school in Britain
1 part of childhood in Israel
79
Dissertation Defense
August 24, 2010
Kellie (F, 29, childhood diagnosis, Pilot)
Successful web comic artist
Avid reader but slow
Has had to address her poor spelling:
So if anyone wants to tell me that I can't spell and
to enlighten me on the wonders of a new and fun
invention called a dictionary or spell check then I
would be overjoyed to tell them to GO TO F*ING
H*** AND DIE IN A VAT OF PIG S***
words of condolence, apology, ridicule or support
are unwanted and unneeded
Advocates for and inspires others with dyslexia
Admits she only does so as she cannot hide
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Nigel (M, 24, childhood diagnosis)
Graphic design / 3D modeling
Raised in Britain
Views self as lucky
Parents could afford good schooling for him
Brother was unable to have same schooling
Less visibly affected than schoolmates
Avoids telling employers
Would not use AT except at home
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Other Interview Findings
No use of assistive technologies and limited
knowledge of available AT
TTS generally disliked if tried previously
Alan, Calvin: Prefer human voices of audiobooks
Tara, Darren: No patience for TTS
Engage in reading regularly for pleasure or
work reasons
Tactical control over who they tell
Alan: Disability is a private topic he controls
Calvin: Negative work experience after telling boss
Emily, Nigel: Only if topic comes up
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Outline
Introduction
Background
Value Sensitive Design Methodology
VSD Research Highlights
Stakeholders and Values Identification
Case Studies
Technologies
Conclusions and Future Work
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Technical Investigations
Value-Informed Reviews of Existing ATs
Value-Informed Design Guidelines
Socially-Flexible Reading Tools & Support
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Technology Reviews
Existing assistive technologies
Accessibility standards and formats
Reading technologies
Books
iPad
iPhone
Kindle
Tablet computers
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Comparing Two TTS Systems
Kurzweil 3000
Access (Good)
Scan/import text
Access (Poor)
$1095-1495 per license
Choice (Good)
Multiple options/features
Privacy (Poor)
Out loud or headphones
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ReadPlease
Access (Poor)
Paste or type text
Access (Good)
Free or $50 upgrade
Choice (Average)
Few options/features
Privacy (Poor)
Out loud or headphones
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Design Guidelines










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ATs mu st su p p o rt re a d in g ( L ite ra c y )
S u p p ort a c q u isit io n o f d ig ita l tex t s ( A c c e ss)
Ty p o gra phy matte rs ( A c c e ss, A u to n omy, C h o ic e , L ite ra c y )
C o nt ro l d isc lo su re d u e to tec h n o logy u sa ge
( I d e nt it y, N o rma lc y, P riva c y )
P rovid e fe at u re s to ma n a ge d iffe re nt u sa ge co ntex t s
( C o mmu nit y, N o rma lc y, P riva c y )
P rovid e mu lt ip le fo rms o f a c co mmo dat io ns ( A c c e ss, C h o ic e )
P rovid e fe at u re s to fa c ilitate u sa ge n e go t iat io ns w it h o t h e r
sta ke h o ld e r g ro u ps ( A c c e ss, Fa irn e ss, Priva c y )
B rin g exp e rt k n owle dge to t h e e n d u se r
( A c c e ss, C h o ic e , E mp owe rme nt , Fa irn e ss)
C o n sid e r o p e n - so urce to mit igate cost s ( A c c ess, Fairn ess)
D e sig n fo r a ll re a d e rs ( Fa irn e ss, L ite ra c y, N o rma lc y )
Dissertation Defense
August 24, 2010
Designing an Adoptable Reading Widget
Sad Conclusion:
Assistive technologies for adults with RDs
are unlikely to be adopted
Reasons:
Society’s adherence to literacy and normalcy
Preference to hide disability from others
Limited public use of a “labeling ” technology
Stealth usage hinders technology diffusion
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Proposed Solutions
Change society’s views on disability or
disabled people’s reaction to normalcy
Long-term effort
Not feasible for a dissertation
Ongoing Efforts: Project Eye-To-Eye / DO-IT
Focus on reading widgets for everyone
General purpose reading support technology
A technology is normal if everyone uses it
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Calico – General Concept
Basic document viewer / browser software
Implement on tablet, laptop, Kindle, etc.
Designed for everyone to use
Extensible system through add-ons
Same idea as Firefox extensions
Customize Calico based on reading needs
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Example Add-Ons – General Reading
Reference / Footnote fetcher
Implement using REFORM (Toomin, 2009)
Table / Figure clipping
Keep thumbnails of selected text to the side
Similar concept to WinCuts (Tan et al, 2004)
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Example Add-Ons – Reading Disability
Text-To-Speech
Simulated Cardboard Window
TextLens (based on TableLens)
Smart Dictionary (word sense disambiguation)
Personalized Digital Typography (SeeWord)
On-Demand Text Simplification
Screen Overlays (based on Wilkins’s overlays)
Refs: Dickinson et al (2002); Petersen & Ostendorf (2007); Rao & Card (1994); ); Wilkins et al (1996, 2005)
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Benefits for Reading Disabilities
Able to offer variety of accommodations
Addresses diversity seen in RDs
Differing levels of disability visibility
Example: Text-To-Speech variations
 Regular Start-Stop TTS
 One word on-demand only TTS
 Phonological respeller
<foh-toh-graf>
The photograph showed the theft…
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Too Many Choices – The Problem
How does one select the best tool?
Number of available add-ons quickly
becomes overwhelming
How does one configure a tool?
Large parameter spaces are likely
(e.g. choosing an optimal background color)
User choices not necessarily optimal
SeeWord (Dickinson et al, 2002)
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Too Many Choices – The Solution
AT selection would normally be guided by
an AT specialist
Hiding prevents users with RDs from
consulting this expert knowledge
Therefore
Bring expert knowledge to the user
A meta-tool for recommending other tools
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Johnny Recommender System
Meta-tool to connect to other tools
Performs diagnostic assessment of user via:
Questionnaires (Perkins & Terhene, 2006)
Automated diagnosis tools ( Protopapas &
Skaloumbakas, 2007; Singleton et al, 2009)
Map assessments to classes of reading tools
Only recommends tools that follow a contract:
Must provide a demo of what the tool does
Must provide a configuration wizard
Contract motivated by semiotic engineering
approaches to usability (Deibel, 2007)
Refs: Deibel (2006, 2007); Sieckenius de Souza (2005)
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Another Meta-Tool: Context Manager
Chaney: Usage Context Manager
Activate different tools in different contexts
Facilitates different reading tasks
Allow for usage of “higher stigmatizing ”
tools when user feels comfortable/safe
Text-To-Speech tools
Default:
Phonetic Respeller
While alone:
Full Text-To-Speech
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Other Meta-Tools
Instructor Tools
Negotiate reasonable accommodations
Limit access during exams
Provide specific tools for a course
Business Tools
Specific tool packages for company
Negotiate reasonable accommodations
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Outline
Introduction
Background
Value Sensitive Design Methodology
VSD Research Highlights
Stakeholders and Values Identification
Case Studies
Technologies
Conclusions and Future Work
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Summary of Work
Understanding of the factors influencing
adoption of ATs by adults with RDs
People with RDs choose to hide RD from others
Influenced by values of normalcy and literacy
Technology usage reflects hiding
Current ATs fail to address value issues
Design guidelines for better technologies
Proposed Calico system navigates normalcy and
supports user management of social contexts
VSD is valuable for the study AT adoption
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Contributions
Applying Value Sensitive Design to assistive
technologies and technology adoption
Literature analysis identifying critical value issues
among stakeholder groups
Case studies of online message board discussions
about RDs and technology
Interviews with young adults with RDs
Value-based technology reviews
Value-driven design guidelines
Proposal for socially -flexible reading tools that
support users with the aid of meta -tools
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Contributions (continued)
Synthesis of PATTC framework for
understanding technology usage
Identification and hypotheses about lack of ATs
for adults with RDs
Applying semiotic engineering to AT design
Expansion of VSD indirect stakeholders
Refinement of VSD methodologies
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Future Work
Continued refinement of value framework
Additional online discussion thread analyses
Ongoing interviews with adults with RDs
Implementation of Calico
Medium-fidelity prototypes
Development of multiple reading tools
Proof-of-concept demonstration of Johnny
Encouragement of open -source efforts for building
ATs for reading
Applying VSD to other literacy or technology
adoption topics
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Thanks and Acknowledgments
My advisors and committee members
Center for Engineering Learning & Teaching
Literacy Source
DO-IT
For their conversations and advice:
Janet Davis, Ken Yasuhara , Sarah Read, Tim Wright,
Shaun Kane, Anna Cavender, Jim Borgford-Parnell, Cindy
Atman, Hilary Holz, Marian Petre, Batya Friedman,
Jonathan Mooney, Bryant Vehrs , Rebecca Cory, Dyane
Haynes, Michael Richarson , Josh Tenenberg , people in
the Spring 2008 VSD class, and many others
My family
My participants
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And special thanks and appreciation to
Linda Shapiro
Kraig M.
Jason Deibel
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Extra Slides
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Eyeglasses correct visual disability!
Without my monocle
I am genetically
disadvantaged.
Bollocks
David Malki, ECCC08
Wondermark
http://wondermark.com
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History of Eyeglasses
China, ≈1 CE:
Italy, 1260s:
Europe, 1500s:
Britain, 1725:
USA, 1780s:
Britain, 1825:
tion Defense
As eye protection
For farsightedness
For nearsightedness
Modern frame invented
Bifocals invented
For astigmatisms
August 24, 2010 108
“Glasses are very disfiguring to
“women and girls”
From a 1901 optician journal
Glasses not for public use
Used only for brief moments
Led to quick use optics
monocle
lady’s lorgnette
pince-nez
scissor glasses
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Except…
Scholars and academics
The clergy
The Spanish
THUS… THE ASSOCIATION OF
GLASSES WITH INTELLECTUAL
PURSUITS!!!
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Clergy Member
Poor Vision
Reading Latin Texts
+
Eyeglasses
Continuous Use
+
In Spain
Continuous Use
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Aristocrat
Poor Vision
Reading a Playbill
+
Eyeglasses
Brief Use
+
In Spain
Continuous Use
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Point of this Historical Sidetrack
Technology usage shapes people’s
perceptions of the users
Culture and society shapes how, when,
and if a technology is used
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PATTC Framework
Synthesis of general and AT adoption studies
Ability
P erson
A bility
T ask
Task
Technology
T echnology
C ontext
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Context
Person
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Lack of Available ATs – Three Hypotheses
Difficulty reading from digital devices
Most work conducted on desktop machines
Most work used in CRT displays
Influence of non-reading supportive
technologies not accounted for in earlier
studies
Potentials of portable computers (PDAs,
tablets, etc.) have yet to be explored
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Lack of Available ATs – Three Hypotheses
Difficulty reading from digital devices
Educational focus on learning to read
Emphasis on phonological processing deficit
Text-to-speech directly bypasses deficit
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Lack of Available ATs – Three Hypotheses
Difficulty reading from digital devices
Educational focus on learning to read
Technology experimentation is rare
What technology can do
What we can do with a technology
CHI, UIST, and ASSETS push possibilities
Lack of RD-related research
116 Dissertation Defense
August 24, 2010
ACM Digital Library Analysis
256 / 255,808 papers found on RDs
Open-coding of all articles
Only 27 actual papers about ATs for RDs
9 about ATs and disabilities in general
3 about programming and dyslexia
5 were about SeeWord
4 were by me
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Adoption Process
Awareness of
innovation
Decision
Adopt
Interest,
motivation,
and learning
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Reject
August 24, 2010
Adoption Process
Confirmation
and finalization
Full Adoption /
Integration
Adaptation /
Reinvention
Implementation,
integration, and
evaluation
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Abandonment /
Discontinuance
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AT ADOPTION
Survey studies of adoption and
abandonment
Longitudinal studies of AT usage
Models of AT adoption
AT design recommendations
Common findings throughout
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ADDITIONAL STUDIES:
Phillips and Zhao (1993);
Elkind et al. (1996);
Wehmeyer (1995, 1998);
Martin and McCormack
(1999); Riemer-Reiss and
Wacker (2000); Koester
(2003); Dawe (2006);
Shinohara and
Tenenberg (2007);
Scherer (2005)
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FACTORS IN AT ADOPTION
Involvement in selection process
Unawareness of what is available
Decision of doctors, experts, or insurance
company
Decision of caretakers
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FACTORS IN AT ADOPTION
Cost and Effort
Initial purchase
Physical and cognitive effort of usage
Maintenance / replacement costs
Utility : Cost balance
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FACTORS IN AT ADOPTION
Training
Serious time and effort
Presence of professional
support
Need for evidence of gains and
improvement
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FACTORS IN AT ADOPTION
Integration
Important tasks and activities
Multiple locales and contexts
Relative advantage
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FACTORS IN AT ADOPTION
Aesthetics and Cosmesis
Looks “institutional” or
“handicapped”
Colors
Personal style
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FACTORS IN AT ADOPTION
Stigma and Hiding
Social perceptions of disability
Past experiences of ridicule,
shame, or trauma
Denial or avoidance
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STIGMA CASE STUDY
Stephen Kuusisto
Blind due to premature birth
Actively disavowed his blindness
Mobility training in his early 30s
Guide dog in his mid 30s
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Existing Assistive Technologies Reviews
Kurzweil 3000
Access (Good)
Scan/import text
Access (Poor)
$1095-1495 per license
Choice (Good)
Multiple options/features
Privacy (Poor)
Out loud or headphones
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ReadPlease
Access (Poor)
Paste or type text
Access (Good)
Free or $50 upgrade
Choice (Average)
Few options/features
Privacy (Poor)
Out loud or headphones
August 24, 2010
Insights about the lack of TTS usage
Artificial nature of computer speech
Questionable effectiveness
Time and effort needed to scan texts
Monetary expense
When and where it can be used
Access to scanner
Public places
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A story of a girl with dyslexia…
A pair of headphones…
and a computer lab
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The Intel Reader
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The Intel Reader
Bulky
Camera with flash
Specialized piece of hardware
Where would it be used?
And why or why not?
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Wiccy-Ticcy Ray
Case study by Oliver Sacks
Tourette’s Syndrome
Only takes meds Monday-Thursday
Dedicated, staid worker during
work week
Vibrant, improvisational
drummer on weekends
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Stephen Kuusisto
Poet (attended Iowa Writers’ Workshop)
Blind due to premature birth
Both he and his parents actively
disavowed his blindness
Rode a bicycle until his 20s
Fulbright Scholar in Finland
Mobility training in his early 30s
Guide dog in his mid 30s
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Barry, Iowa Commission for the Blind
Adviser to Stephen Kuusisto
They grab your arm without asking, try to hustle you
across like a Secret Service agent shoving the
president. It ’s weird and fantastically annoying.
They ’ve made the assumption that blindness is a
mental condition. Those are the same people who
talk to your friends in restaurants, you know, waiters
who take everyone else’s order, then pause, look at
the blind guy, and say to the assembled sighted folks,
“And what will he be having?” That stuff can drive
you nuts! Or the assume that because you’re blind,
you can’t hear, and they shout at you.
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Barry, Iowa Commission for the Blind
Adviser to Stephen Kuusisto
But you know what? I wouldn’t trade any of that
away for the struggle that you’re living in. For you,
when you do tell some fucked-up professor you can’t
see—well, that becomes a struggle because they
don’t understand how someone without a cane or
dog can be blind. And of course, it ’s none of their
fucking business whether you use the can or not, I
know that. But in terms of your safety , and your
general ease of passage through the world, I can tell
you, it makes a real difference to use the damned
thing.
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Jonathan Mooney
Severe dyslexia and ADHD
Graduated with honors in
literature from Brown
Decided at age 12 to only be a
popular jock soccer player
He did not overcome his disability
He is not normal
He learns and thinks differently
but that is not his fault
137 Dissertation Defense
NORMAL
PEOPLE
SUCK!
August 24, 2010
Schematic of Adoption Support System
Reading
Tools
Docume
nt Viewer
Screening
Questionnai
re
Recommended Tools
Expert
System
A
Tool
Demo
Configurati
User
B
Tool
on Wizard
C
A. Overall application.
B. Detail of expert system.
C. Detail of a reading tool
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Screening Questionnaire
Disagree
Agree
Words on a page begin to move
around if I read for longer than 10
minutes.
.
.
.
Press
to listen to a short conversation. You will be
asked a few questions after it has completed.
– User completes questions about typical reading behaviors and
automated skill assessments
– System diagnoses the presence and strength of user’s reading
difficulties
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Tool Recommendation
Based on your responses, you experience some difficulty
recognizing words when you are reading.
Explain
Tools you might find helpful are:
Demo Configure
– Text Reader:
Given your strong auditory skills, hearing the text
read aloud…
– Phonetic Speller:
Demo Configure
This tool helps with recognizing a word by showing
how it is pronounced…
– System presents diagnoses and recommends tools
– User can ask for explanation of diagnoses and demonstrations
of the tools
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Diagnosis Explanation
Explanation: Word Recognition
Phonological Processing Score:
2 / 10
This score reflects your ability to process letters into
sounds, such as in the question…
– System refers to the user’s responses to provide transparency
of assessment
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Tool Demonstration
Demo: Phonetic Speller
Seeing how a word sounds can help you in identifying it.
With this tool, you can click on a word to show how it is
pronounced:
<foh-toh-graf>
The photograph showed the theft…
– Tool demonstrates what it does and explains why it could be
helpful
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Tool Configuration
Configure: Color Adjuster
To determine a background color that best reduces visual
stress, the system will perform an eye exam. You will
need a…
– Configuration wizard works with User to properly tune
reading tool
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