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(and lack of adoption in the first place)
Why technology designed
to help, fails to do so
Expectations of the user are too high by
either or both the caregivers and the user.
 One may need to acknowledge that the
users may not be as “smart” as they had
dreamed. (H.’s mom made me take
“communication wall” away because it
was starting to show that H. didn’t know
Expectations are too low and the user is
either board by the device and/or doesn’t
use it because it is not useful to them.
Doesn’t do what you expected it to do.
Not adaptable enough to meet specific
Expectations of the device and what it can
do are to high by either or both the
caregivers and users.
A single device can not meet every sensory,
cognitive and physical need.
People (often specialists) get comfortable
with one thing and try and make it work for all
their clients. Companies promise the sky.
Social Aspects Isolation - because the user can now do
something independently, they don’t get
the human contact they received before.
People do not understand the device (e.g.
difficult voice to understand, complex
system like Mores code or icons that
represent different things to different
What does this mean to you?
Social Aspects
Fear of success
Things will change and change is
scary - independence is scary.
They won’t need me anymore
Fear of failure
Fear can make users unwilling to give it their all
Fear can make caregivers unwilling to give their
child are real chance because they can’t deal with
another failure.
Social Aspects
Families are used to the way things are.
Your replacing what already works (I know
what they mean, even if no one else can).
Learned helplessness
Not all members buy-in
Doesn’t become incorporated into
daily life because its easier to do
it for them in the short run.
Social Aspects
Fear that the device will provide their child
a crutch and they will stop working
towards self-sufficiency.
Social Aspects - Attitude
Don’t believe it will work.
Feel isolated from the decision making
Cultural differences
Different cultures have different “solutions”
Social Aspects - Cosmetic
It makes me/my child look different
Its not me - Its not really them
Social Aspects - Cultural
Device uses wrong sex or wrong ethnic
group icons. Icons are usually designed
for people with light skin. For a long time
there was only one voice for
communication devices and it was male.
Now there are more of choices.
Social Aspects - Cultural
Wrong language (e.g. H. learning to use
English communication device at school,
but goes home to Spanish speaking
Difficulties for the Caregiver
To many, technology is intimidating.
Not everyone knows (or wants to know)
how to use it.
Programming difficulties (e.g. Dynovox or
Liberator) The more a device can do, and
the more adaptable it is, the harder it is to
Not enough tech. Support (e.g. Words+)
Difficulties for the User
Technology is intimidating - this is
particularly true for the elderly. Kids jump
right in.
Difficulties for the User
Difficult to use
Sensory (can’t see it well because of glare)
Physically (its to hard to hit
the small buttons)
Cognitively (I can’t
remember all those
Difficulties for the User
Motivation to Complete a Task
Physical Effort + Cognitive Effort + Linguistic Effort
+ Learning Effort + Memory Effort + Time Load
A.T. success
King, 1999
Difficulties for the User
There are no instant results. This can lead
to disillusionment with the device.
Prevention of errors - users become
frustrated if all they do is make mistakes
at the beginning. Many need an errorless
teaching approach.
Difficulties for the User
Safety - if something goes wrong there
needs to be a safety mechanism (e.g
panic button on MAPs, a way back to the
last page on imail so you can make the
correct choice, or an “oops I didn’t mean
to say that” on a communication device).
Difficulties for the User
Device does not provide enough
feedback. (e.g. I can’t tell if I pressed the
button hard enough - I need a sound that
let’s me know).
Difficulties for the User
User’s abilities change
Their abilities improve
Their abilities decrease
Their abilities vary from day to day
Children get older
Device no longer age appropriate
Device no longer fits into the curriculum
Difficulties for User
User with a severe congenital physical
disability didn’t learn cause and effect
relationships. (e.g. Their movements were
never tied to things that happened around
them so they don’t understand that they
have any power).
Caregivers didn’t teach such children
about their effects.
Difficulties for the User
&/or the Caregiver
The device is not intuitive in either how it
is programmed or how it is used - They
use “unnatural patterns of mapping” (King,
Mechanical Difficulties
Cumbersome to take around (many
devices need to be big and durable for
kids with vision, physical or behavioral
problems, but this can cause them to be
heavy. If its not light, they’re not going to
lug it around).
Power supply drains to quickly (e.g M.
can’t bring her device anywhere because
the batter only lasts an hour).
Mechanical Difficulties
Breaks easily so you can’t rely on it. You
need to have back-up system in place.
(e.g. E.’s Dynovox getting erased from a
low battery. A. just spilled O.J. into her
Dynovox and now its out for a couple of
months being repaired).
Mechanical Difficulties
It does not interface with other
technologies because either it is to old, to
new or a P.C. (in this district). (e.g. B.H.’s
computer has no CD-Rom drive so I
couldn’t give them Boardmaker).
Who can help?
Assistive technology specialists
Company spokespeople
Assistive Technology
Don’t say “this is the one.”
Make sure users and their caregivers are
part of the decision making process.
Don’t raise expectations to high
Don’t try to solve every problem at once
Show, don’t just tell, families and teachers
how the technology can be integrated into
daily life.
Assistive Technology
Provide on-going training and support to
all caregivers involved.
Try to make the device mean less work
rather than more work for the caregiver
Assistive Technology
Start with the basics. You may know that a
child has all the potential in the world but
they need to understand cause and effect
relationships and their effect
on the environment before
they can reach that potential.
Start with simple to use devices, even if
they limit the user to make it less
intimidating to caregivers and users.
Assistive Technology
Start simple so results can be seen
Make technology show off strengths
before it shows off weaknesses.
Provide errorless instruction so the user
doesn’t make mistakes and avoids
Make sure you set-up a way out if the
user makes a mistake.
Assistive Technology
Start slowly so families can adapt and see
the benefits of change.
Be patient with caregivers.
Go slow because change can be scary let the user and his family set the pace.
Assistive Technology
Make sure the technology is adding to a
persons life from their perspective and is
not merely replacing.
Assistive Technology
Be sensitive to gender and ethnic
differences. You can now get icons which
represent people of different backgrounds.
Talk to families about what sort of icons
make sense to them.
Be sensitive to “coolness” and
age appropriateness of a device.
Assistive Technology
Make sure the device is going to meet the
need that the user wants to meet.
Make sure the device is going to be
adaptable to work with that user
Look visual, physical and cognitive loads
involved - simultaneously!
Does the device provide enough
Assistive Technology
Look at things like weight, durability and
power supply
Assistive Technology
Have several systems in place when
things don’t work or users abilities change
from day to day.
Realize their isn’t one lifetime solution.
Make sure that when your organizing
someone’s communication board,
Intellikeys overlay or what not, you don’t
use “unnatural patterns of mapping..”
Assistive Technology
Provide feedback to developers
Company Representatives
Don’t promise the answer to all their
Be honest about what the machine can
and can’t do.
Be there for technical support.
Don’t force a “fit” just to make a sale. (D.
became a sales rep. for multiple products
to avoid this).
Company Representatives
Don’t make it look so easy.
Repair devices quickly.
Don’t try to help all users with all their
problems in one device.
Need to be sensitive and think about the
social/emotional aspects that go into using
such a device.
Design it so users can have instant
gratification and success.
Design it so users and caregivers can’t
make mistakes when the start.
Make it intuitive.
Build in safety mechanisms if a user or
programmer makes a mistake.
Be sensitive to cosmetic aspects of
Design it with multi-cultural icons and
Design it with male and female icons and
Design it to be useful in multiple
Keep programming simple.
Allow for interface cross-over from other
Make it like regular computer interfaces.
Keep it highly customizable.
Sensory issues
Cognitive load
Physical load
Make it hard to break
Have a good power supply
Design it so people in the community can
understand it.
Don’t impress people by sounding
Become knowledgeable about assistive
technology and peoples’ abilities.
Be helpful
Be open to different ways of doing things.
What does the research say?
Percentage abandoned
Average time spent trying
Number of devices tried
Do certain devices provide a crutch which
reduces learning?