Adoption of Assistive Technologies
for Reading Disabilities:
Cultural, Literacy, and Technological
Aspects
Katherine Deibel
University of Washington
Generals Exam Presentation
November 16, 2007
What I’ve been up to…
I’ve been reading…
… for generals
… for my job
… for cooking
… for voting
… for fun
K. Deibel, Assistive Technologies and Reading Disabilities
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What is this talk about?
The usage and adoption of
assistive technologies by people
with reading disabilities
K. Deibel, Assistive Technologies and Reading Disabilities
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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
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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
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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
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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
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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
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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
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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
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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
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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
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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
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Difficulties
– Phonological processing deficit
– Memory
– Visual stress
Severity of difficulties varies
greatly across individuals
Refs: Dickinson et al., 2002
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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;
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Outline
– Motivation and Introduction
– Background
– Reading Disabilities
– Assistive Technologies
– Overview of Research Literature
– Next Steps in Research
– Summary
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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
K. Deibel, Assistive Technologies and Reading Disabilities
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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
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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
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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)
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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
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Types of Assistive Technologies
Studies of Assistive Technology Adoption
MANY
Study includes
people with reading
disabilities
Study does NOT
include people with
reading disabilities
ONE
ONE
MANY
Types of Disabilities
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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
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Types of Assistive Technologies
Studies of Assistive Technology Adoption
MANY
Study includes
people with reading
disabilities
Study does NOT
include people with
reading disabilities
ONE
0%
100%
Focus on Reading Disabilities
K. Deibel, Assistive Technologies and Reading Disabilities
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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
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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
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Models of [assistive] technology adoption
– Baker’s Basic Ergonomic Equation
– Kintsch and DePaula’s Adoption Framework for
Assistive Technologies
– Roger’s Diffusion of Innovations
Sociocultural factors of reading
disabilities affect their usefulness
Refs: Baker, 1986; King, 1999; Kintsch and DePaula, 2002; Rogers, 2003
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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
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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)
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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
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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
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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
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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
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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 locales
Refs: 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
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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
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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
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Outline
– Motivation and Introduction
– Background
– Overview of Research Literature
– Next Steps in Research
– Summary
K. Deibel, Assistive Technologies and Reading Disabilities
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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
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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?
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Proposed research
– Study of technology and literacy
practices of people with reading
disabilities
– Development of software tools that
assist the adoption process
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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)
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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
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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?
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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
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Schematic of Adoption Support System
Reading
Tools
Document
Viewer
Screening
Questionnaire
Recommended Tools
Expert
System
A
Tool Demo
User
B
Configuration
Wizard
C
Tool
A. Overall application.
B. Detail of expert system.
C. Detail of a reading tool
Refs: Deibel, 2007
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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
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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
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Acknowledgements
Completion of this work would not have been possible
without the influence of many people, including:
– Bill Winn
– Ken Yasuhara
– Jennifer C. Stone
– Richard C. Davis
– Dan Comden
– Imran Rashid
– Hilary Holz
– Janet Davis
– Cynthia J. Atman
– Jim Borgford-Parnell
– Lindsay Michimoto
– Jason Deibel
– Literacy Source
– Johannes Gutenberg
and my advisors and committee members.
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Extra slides
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The Statistics
Reading
Difficulty
Specific Learning Disability 55%
Mobility
/ Orthopedic
– 90% experience
difficulty 12%
with
Speech
/ Language
1%
reading
(Kavale & Reese, 1992)
Blind
/ Visual
– Data
includes ADD/ADHD 5%
Hearing
6%
Mental / Emotional
10%
Health
6%
Other
5%
Disabilities at U.S. Colleges & Universities
(NCES Report 1999-046)
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Phonological Processing Deficit
Mental
Word
Morpheme
Phoneme
Letter
Form
Letter
Sound
Word
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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
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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
K. Deibel, Assistive Technologies and Reading Disabilities
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