Adoption of Assistive Technologies for Reading
Disabilities:Cultural, Literacy, and Technological
Aspects
Katherine DeibelUniversity of Washington
Generals Exam PresentationNovember 16, 2007
K. Deibel, Assistive Technologies and Reading Disabilities 2
What I’ve been up to…
… for generals
… for my job
… for cooking
… for voting
… for fun
I’ve been reading…
K. Deibel, Assistive Technologies and Reading Disabilities 3
What is this talk about?
The usage and adoption of
assistive technologies by people
with reading disabilities
The usage and adoption of
assistive technologies by people
with reading disabilities
K. Deibel, Assistive Technologies and Reading Disabilities 4
Why does it matter?
– Reading is a critical skill in an information society
– 7—15% of the population have significant difficulties with reading
– Computer-based assistive tools can provide successful accommodations
– A tool is only helpful when it is used
Refs: Sands & Buchholz,1997
K. Deibel, Assistive Technologies and Reading Disabilities 5
Abandonment of Assistive Technology– 35% of all assistive technologies
purchased are abandoned
– Waste of resources, time, and funds for users and disability services
– Bad experiences lead to disillusionment about assistive technologies
Refs: Phillips & Zhao, 1993, Martin & McCormack, 1999; Rimer-Reiss & Wacker, 2000
K. Deibel, Assistive Technologies and Reading Disabilities 6
What I did– Reviewed the research literature on:
– Assistive technology for reading disabilities – Technology adoption and abandoment– Assistive technology adoption and
abandonment
– Brought in insights from other research areas: – Human-computer interaction– Reading on computers– Disability studies– Education
K. Deibel, Assistive Technologies and Reading Disabilities 7
Contributions
– Identified gaps in current work in this area
– Identified why those gaps exist and persist
– Research designs to address these gaps
– Synthesizing across disciplines
K. Deibel, Assistive Technologies and Reading Disabilities 8
Outline
– Motivation and Introduction
– Background– Reading Disabilities
– Assistive Technologies
– Overview of Research Literature
– Next Steps in Research
– Summary
K. Deibel, Assistive Technologies and Reading Disabilities 9
What is a reading disability?
A neurological condition defined as a profound difficulty with reading and learning how to read that cannot be explained because of:
– Low intelligence
– Limited sensory ability
– Lack of education
– Lack of socioeconomic opportunity
K. Deibel, Assistive Technologies and Reading Disabilities 10
What’s in a name?
– Dyslexia– Dysphonia (auditory)– Dyseidesia (visual)
– Word blindness– Phonological Processing Deficit– Strephosymbolia (twisted letters)– Visual Stress / Meares-Irlen Syndrome
Reading Disability
K. Deibel, Assistive Technologies and Reading Disabilities 11
Prevalence of reading disabilities– 7—15% of the population have some
difficulty with reading
– Reading disabilities occur in all languages
– Most common form of disability at 4-year universities in the U.S.– 46% of students registered as having a
disability
Refs: Sands & Buchholz, 1997; Lewis et al. 1999’ Smythe et al., 2004
K. Deibel, Assistive Technologies and Reading Disabilities 12
Difficulties
– Phonological processing deficit– Difficulty translating words into sound
– Word misidentification
– Dropping or substitution of letters in words
– Impacts reading comprehension
Refs: Perfetti et al., 1992; Dickinson et al., 2002
K. Deibel, Assistive Technologies and Reading Disabilities 13
Difficulties
– Phonological processing deficit
– Memory– Short-term memory
– Visual memory
Refs: Dickinson et al., 2002
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Difficulties
– Phonological processing deficit
– Memory
– Visual stress– Letters and words move and blur
together
– Eye strain and headaches
– Difficulty sustaining reading
– Affects 20—30% of the general population
Refs: Jeanes et al., 1997; Evans, 2001; Dickinson et al., 2002; Kriss & Evans, 2005
K. Deibel, Assistive Technologies and Reading Disabilities 15
Difficulties
– Phonological processing deficit
– Memory
– Visual stress
Refs: Dickinson et al., 2002
Severity of difficulties varies greatly across
individuals
K. Deibel, Assistive Technologies and Reading Disabilities 16
Sociocultural aspects of reading disabilities– Self-doubt, low confidence, and
feelings of isolation
– Teasing from peers
– Viewed as lazy or faking
– Expectations from others to fail
– Invisible aspect of disability encourages the hiding or limiting of knowledge of having the disability
Refs: McDermott, 1993; Edwards, 1994; Zirkel, 2000; Cory, 2005;
K. Deibel, Assistive Technologies and Reading Disabilities 17
Outline
– Motivation and Introduction
– Background– Reading Disabilities
– Assistive Technologies
– Overview of Research Literature
– Next Steps in Research
– Summary
K. Deibel, Assistive Technologies and Reading Disabilities 18
Assistive technologies for reading– Text-to-speech software
– Listening to text read aloud by a computer
– Bypasses phonological processing deficit
– Improves reading rate and word identification
– Users need strong auditory skills
– Requires digitization of texts
Refs: Elkind et al., 1996; Sands & Buchholz, 1997, Laga et al., 2006
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Assistive technologies for reading– Text-to-speech software
– Color overlays– Colored transparencies placed over text
to reduce visual stress
– Optimal color differs across individuals
– Optometric screening used to select optimal color
Refs: Jeanes et al., 1997; Evans, 2001; Dickinson et al., 2002; Kriss & Evans, 2005
K. Deibel, Assistive Technologies and Reading Disabilities 20
Outline
– Motivation and Introduction– Background– Overview of Research Literature
– Studies of assistive technology adoption– Models of technology adoption– Other research gaps– Summary of literature review
– Next Steps in Research– Summary
K. Deibel, Assistive Technologies and Reading Disabilities 21
Studies of assistive technology adoption– 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)
K. Deibel, Assistive Technologies and Reading Disabilities 22
Diversity of methodologies & approaches– Variety of methodologies:
– Large-scale quantitative surveys (4)
– Adoption studies of a single assistive technology (4)
– Small-scale qualitative case studies (3)
– Different approaches– Focus on one or many technologies
– Focus on one or many disabilities
K. Deibel, Assistive Technologies and Reading Disabilities 23
Studies of Assistive Technology Adoption
Types of Disabilities
ONE MANY
ONE
MANY
Typ
es o
f A
ssis
tive
Tec
hn
olo
gie
s
Study includes people with reading disabilities
Study does NOT include people with reading disabilities
K. Deibel, Assistive Technologies and Reading Disabilities 24
Inclusion of reading disabilities
– 6 of the 11 studies included individuals with reading disabilities:– Elkind et al. (1996)– Jeanes et al. (1997)– Riemer-Reiss and Wacker (2000)– Koester (2003)– Comden (2007)– Deibel (2007, 2008)
– Mixed-disability studies do not report results by type
K. Deibel, Assistive Technologies and Reading Disabilities 25
Studies of Assistive Technology Adoption
Study includes people with reading disabilities
Study does NOT include people with reading disabilities
Focus on Reading Disabilities
0% 100%
ONE
MANY
Typ
es o
f A
ssis
tive
Tec
hn
olo
gie
s
K. Deibel, Assistive Technologies and Reading Disabilities 26
Summary of findings
– Only specific technology studies for users with reading disabilities– No study of technology use among
people with reading disabilities– No “in the wild” studies of adoption
– Consistent findings of general predictors of technology adoption– Involvement of user in selection process– Observable performance benefit– Ease of maintenance and configuration
K. Deibel, Assistive Technologies and Reading Disabilities 27
Outline
– Motivation and Introduction– Background– Overview of Research Literature
– Studies of assistive technology adoption– Models of technology adoption– Other research gaps– Summary of literature review
– Next Steps in Research– Summary
K. Deibel, Assistive Technologies and Reading Disabilities 28
Models of [assistive] technology adoption– Baker’s Basic Ergonomic Equation
– Kintsch and DePaula’s Adoption Framework for Assistive Technologies
– Roger’s Diffusion of Innovations
Refs: Baker, 1986; King, 1999; Kintsch and DePaula, 2002; Rogers, 2003
Sociocultural factors of reading disabilities affect their usefulness
K. Deibel, Assistive Technologies and Reading Disabilities 29
Roger’s Diffusion of Innovations– Diffusion of Innovations is the seminal
text and theory on technology adoption
– Key aspect is communication of ideas
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Roger’s Diffusion of Innovations– People with reading disabilities tend
to tactically hide their disability from others– Stealth usage of technology slows
diffusion
– Social network of users is sparse
K. Deibel, Assistive Technologies and Reading Disabilities 31
Summary of findings
– Sociocultural aspects of reading disabilities hinders applicability of adoption models– Loss of communication and limited social
network due to invisibility of disability
– Stigma issues are a concern
– Lack of usage of models in the adoption studies– Models referenced only in Riemer-Reiss &
Wacker (2000) and Dawe (2006)
K. Deibel, Assistive Technologies and Reading Disabilities 32
Outline
– Motivation and Introduction– Background– Overview of Research Literature
– Studies of assistive technology adoption– Models of technology adoption– Other research gaps– Summary of literature review
– Next Steps in Research– Summary
K. Deibel, Assistive Technologies and Reading Disabilities 33
Further gaps in the research
– Reading on computers– 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
Refs: Farmer, 1992; Gujar et al., 1998; Waycott & Kukulska-Hulme, 2003
K. Deibel, Assistive Technologies and Reading Disabilities 34
Further gaps in the research
– Reading on computers
– Medical approach to reading disabilities– Near total focus on text-to-speech and
compensation / remediation of the phonological processing deficit
– Suggests use of the medical model of disability
– Limits assistive technology to “crutches” instead of “running shoes”
Refs: Hollan & Stornetta, 1992; Sands & Buchholz, 1997; Clough & Corbett, 2000
K. Deibel, Assistive Technologies and Reading Disabilities 35
Further gaps in the research
– Reading on computers
– Medical approach to reading disabilities
– Ignoring changes in reading over time– Emphasis on early intervention
– From “learning to read” to “reading to learn”
– Lack of support for more advanced reading skills and tasks
Refs: Wineburg, 1991; Cunningham & Stanovich, 1997; Peskin, 1998, Peer & Reid, 2001
K. Deibel, Assistive Technologies and Reading Disabilities 36
Further gaps in the research
– Reading on computers
– Medical approach to reading disabilities
– Ignoring changes in reading over time
– Focus on reading in schools– Reading takes place outside of schools
– Systems are often deployed within the schools
– Current assistive devices not designed for use in multiple localesRefs: Laga et al., 2006
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Summary of findings
– Various factors have limited previous assistive technology design and development– Technological
– Philosophical
– Educational
K. Deibel, Assistive Technologies and Reading Disabilities 38
Outline
– Motivation and Introduction– Background– Overview of Research Literature
– Studies of assistive technology adoption– Models of technology adoption– Other research gaps– Summary of literature review
– Next Steps in Research– Summary
K. Deibel, Assistive Technologies and Reading Disabilities 39
Summary of literature review
– Limited development of assistive technologies for supporting reading disabilities
– No knowledge of what technologies are used by people with reading disabilities
– Sociocultural aspects of reading disabilities cause problems with current models of technology adoption
K. Deibel, Assistive Technologies and Reading Disabilities 40
Outline
– Motivation and Introduction
– Background
– Overview of Research Literature
– Next Steps in Research
– Summary
K. Deibel, Assistive Technologies and Reading Disabilities 41
What to do next?
– Participatory design of assistive technologies has been successful – Aphasia Project (McGrenere et al, 2003)
– Orientation for Amnesiacs (Wu et al, 2005)
– Challenges to this approach– Diversity of user group is problematic
– Unclear on what technology needs to be built
K. Deibel, Assistive Technologies and Reading Disabilities 42
What we really need…
– Fill in the gaps:– What technologies are used? Not used?
– What contexts does reading take place in?
– What reading tasks should we support?
– Proactively address what is known?– How can we design assistive technology
to be more readily adopted?
K. Deibel, Assistive Technologies and Reading Disabilities 43
Proposed research
– Study of technology and literacy practices of people with reading disabilities
– Development of software tools that assist the adoption process
K. Deibel, Assistive Technologies and Reading Disabilities 44
Study of technology and literacy practices– Case study of people with reading
disabilities emphasizing:– their use of regular and assistive technologies
to support reading
– the types and contexts of their reading activities
– Methodologies:– Semi-structured interviews
– Technology biographies
– Modeled after the studies by Dawe (2006) and Shinohara & Tenenberg (2007)
K. Deibel, Assistive Technologies and Reading Disabilities 45
Assisting technology adoption through software
– Findings of adoption studies are fairly consistent
– General predictors of technology adoption:– Involvement of user in selection process
– Observable performance benefit
– Ease of maintenance and configuration
– Understanding of what the technology does
K. Deibel, Assistive Technologies and Reading Disabilities 46
Reframe findings as questions
– Successful adoption of assistive technology relies on the user knowing:– What does this device do?
– Why will this device help people with my disability?
– Will this device help me with my ability?
– How do I configure this device?
– How do I use this device?Can we develop a system that insures
these questions are answered?
K. Deibel, Assistive Technologies and Reading Disabilities 47
Semiotic engineering
– Interface is viewed as a communication between the designer and user
– Usability breakdowns are viewed as miscommunications
– Idea:– Use semiotic engineering principles and
practice to insure the adoption questions are answered
– Has yet to be applied to the design of assistive technologies (Deibel, 2007)Refs: de Souza, 2005; Deibel, 2007
K. Deibel, Assistive Technologies and Reading Disabilities 48
Schematic of Adoption Support System
Document Viewer
Reading Tools
User
Expert System
Screening Questionnaire
Recommended Tools
Tool Demo
Configuration Wizard
Tool
A
BC
A. Overall application. B. Detail of expert system. C. Detail of a reading tool
Refs: Deibel, 2007
K. Deibel, Assistive Technologies and Reading Disabilities 49
What I did– Reviewed the research literature on:
– Assistive technology for reading disabilities – Technology adoption and abandoment– Assistive technology adoption and
abandonment
– Brought in insights from other research areas: – Human-computer interaction– Reading on computers– Disability studies– Education
K. Deibel, Assistive Technologies and Reading Disabilities 50
Contributions– Identified gaps in current work in this area
– Lack of studies on [assistive] technology use
– Models of adoption are inappropriate
– Narrow focus on reading tasks and contexts
– Identified why those gaps exist and persist– Lack of attention to sociocultural factors
– Technology limitations
– Educational philosophies
– Research designs to address these gaps– Study of technology and literacy practices
– How to design technology to support the adoption process
– Synthesizing across mulitple disciplines
K. Deibel, Assistive Technologies and Reading Disabilities 51
Acknowledgements
– Bill Winn
– Jennifer C. Stone
– Dan Comden
– Hilary Holz
– Cynthia J. Atman
– Lindsay Michimoto
– Literacy Source
– Ken Yasuhara
– Richard C. Davis
– Imran Rashid
– Janet Davis
– Jim Borgford-Parnell
– Jason Deibel
– Johannes Gutenberg
Completion of this work would not have been possible without the influence of many people, including:
and my advisors and committee members.
K. Deibel, Assistive Technologies and Reading Disabilities 52
Extra slides
K. Deibel, Assistive Technologies and Reading Disabilities 53
The Statistics
Specific Learning Disability
55%Mobility / Orthopedic 12%Speech / Language 1%Blind / Visual 5%Hearing 6%Mental / Emotional 10%Health 6%Other 5%
ReadingDifficult
y
Disabilities at U.S. Colleges & Universities
(NCES Report 1999-046)
– 90% experience difficulty with reading (Kavale & Reese, 1992)
– Data includes ADD/ADHD
K. Deibel, Assistive Technologies and Reading Disabilities 54
Phonological Processing Deficit
MentalWord
Word
LetterForm
LetterSound
PhonemeMorpheme
K. Deibel, Assistive Technologies and Reading Disabilities 55
Other assistive technologies
– Cardboard windows
– Single word displays
– Semantic line breaking of text
– SeeWord
Refs: Frase & Schwartz, 1979; Pepper & Lovegrove, 1999; Dickinson et al., 2002
K. Deibel, Assistive Technologies and Reading Disabilities 56
Summary
– Review of technology adoption literature
– Identification of gaps and shortcomings of current research
– Proposal of two research paths to improve our understanding of how to support the usage of assistive technologies by people with reading disabilities